Objective To study the effect of early application of naloxone on serum high sensitivity C-reactive protein(hs-CRP) and S100B protein in neonates with hypoxic-ischemic encephalopathy.Methods According to the digital table,86 neonates with hypoxic-ischemic encephalopathy were randomly divided into the control group (n =43 cases) and the observation group (n =43 cases).The control group was treated by conventional therapy,while the observation group was treated by conventional therapy plus naloxone.They were treated for 7-10 days.The clinical effect was evaluated.Serum hs-CRP and S100B protein were detected before and after treatment.Results The total effective rate of the control group was 86.0％,which was significantly lower than 97.7％ of the observation group (x2 =5.78,P ＜ 0.05).The sense of recovery,reflecting the recovery and muscle tension recovery time of the observation group were less than those in the control group (t =5.017 2,3.991 6,2.904 8,all P ＜ 0.05).After treatment,the sertum hs-CRP and S100B protein in the two groups were significantly decreased (t =6.776 2,10.903 8,7.772 8,11.092 6,all P ＜ 0.01),compared with the control group,the decrease of the observation group was more significant (t =3.368 2,3.092 8,all P ＜ 0.05).Conclusion Early application of naloxone in neonates with hypoxic-ischemic encephalopathy can decrease serum hs-CRP and S100B protein.

Objectives To investigate the effects of Apelin 13 on myocardial metabolism in diabetic rats.Methods A total of 40 male Wister rats were randomly divided into normal control group (NC,n=8) and experimental group (n =32).Diabetic rats model were induced by high-sugar and high-fat diet combined with low-dose intraperitoneal injection of streptozotocin (STZ).The wellestablished 28 diabetic model rats were randomly divided into diabetic model group (DM,n=14) and apelin-13 treated group (n=14).In the Apelin-13 group,diabetic rats were administered Apelin-13 [0.1 μmol/(kg · d)]by intraperitoneal injection for 10 weeks,while the control group and diabetic model group were given an equal volume of 0.9％ NaCl.At the end of the 10th week,all rats were sacrificed after fasting glucose measurement.Levels of serum free fatty acids (FFA) and myocardial FFA were measured by ELISA.Expression of myocardial glucose transporter member 4 (GLUT4) were detected by immunohistochemistry.The mRNA expressions of myocardial PPARα,CD36 and CPT-1 were detected by real-time fluorescence quantitative PCR.Results Fasting blood glucose,serum FFA and myocardial FFA were significantly higher in DM group than in NC group (all P＜ 0.05).The level of plasma glucose and myocardial FFA were significant lower(P＞0.05) in Apelin-13 treated group than in DM group;but serum FFA was not significantly lower(P＜0.05).The mRNA expressions of PPARα,CD36,CPT-1 in cardiac myocyte were higher in DM group and Apelin-13 treated group than in control(P＜0.05),and lower in Apelin-13 treated group than in DM group(P＜ 0.05).The expression of myocardial GLUT4 was significantly lower in DM group(1.138±0.316)and in Apelin-13-treated group (4.631 ± 1.832) than in NC group(9.132 ± 2.156),(F=65.507,P＜ 0.05),and higher in Apelin-13-treated group than in DM group(P＜0.05).Conclusions Apelin-13 increases myocardial expression of GLUT4,improves utilization of FFA,and it can effectively reduce the expression of PPARα,CD36 and CPT-1.Therefore,it may play a vital role in the improvement of myocardial metabolism in diabetic rats.

Objective To investigate the effect of norepinephrine infusion at 0.03-0.3 μg·kg-1 ·min-1 on renal function in patients undergoing kidney transplantation. Methods Thirty-two ASA Ⅲ or Ⅳ patients aged 22-64 yr weighing 44-88 kg undergoing kidney transplantation were studied. Dialysis was performed within 36 h before operation. Blood pressure was fairly stable. Combined spinal-epidural anesthesia (CSEA) was performed. Spinal anesthesia was performed at L2,3 interspace and hyperbaric 0.5% bupivacaine 10-15 mg was injected into the subarachnoid space. The upper level of sensory block measured by pin-prick reached T6. Epidural catheter was placed at T11,12 interspace and 1% ropivacaine was given intermittently. The patients were randomly allocated into preoperative baseline level (increase or decrease amplitude ＜ 10% of baseline level) by dopamine or norepinephrine infusion during operation. Venous blood samples and urine samples were obtained at the end of operation and 12 h after operation for determination of serum concentrations of cystatin C and β2-microglobulin and urine α1- and β2-microglobulin concentrations. Urine was collected and the volume was recorded. Meanwhile the consumption of furosemide administration during the 12 h after operation was recorded. Results The two groups were comparable with respect to age, M/F sex ratio, body weight, the volume of urine and fluid infused, and the consumption of furosemide. There was no significant difference in serum cystatin C and β2-microgiobulin and urine α1- and β2-microglobulin concentratious, urine volume and consumption of furosemide administration between the transplantation without adverse effect on kidney allograft function.

AIM: To observe the effect of hydrogen sulfide (H_2S) on the rat cardiac function in vitro, to explorer the physiological regulation of endogenous H_2S on myocardial action. METHODS: H_2S concentration and production in the rat myocardial tissues were detected. The expression of CSE (a kind of key enzyme of endogenous H_2S production) mRNA in myocardial tissues was screened by RT-PCR. Langendorff apparatus was used to perfuse the rat heart in vitro. After 20 minutes of stabilization, NaHS (10~-6 -10~-3 mol/L) were added cumulatively in order to the perfusive fluid, and another group applied physiological concentration NaHS (4?10~-4 mol/L), continuously perfusion for 20 min, heart rate (HR), difference of left ventricular pressure (△LVP), left ventricular peak rate of contraction (+LV dp/dt_~max ), peak rate of relaxation (-LV dp/dt_~max ) and coronary perfusive flow (CPF) were measured at the times. Finally, glibenclamide was applied to block the K_~ATP channel of heart, to observe the effect of NaHS at physiological concentration on cardiac function. RESULTS: NaHS concentration-dependently inhibited left ventricular ?dp/dt_~max and △LVP (P

Objective To evaluate the clinical value of 18F-FDG PET/CT for detecting tumor on physical examination people with unexplained elevated serum carcinoembryonic antigen (CEA). Methods A total of 100 physical examination people with unexplained elevated serum levels of CEA in our hospital from June 2010 to December 2014 were involved in the study. All the people were detected with 18F-FDG PET/CT. The pathology, clinical follow ups and conventional medical imaging results were combined to evaluate the value of 18F-FDG PET/CT in diagnosing tumor. The doubling time (DT) of CEA was calculated in the patients who were received more than twice of serum CEA detection. The relationships between serum CEA levels, CEA DT and 18F-FDG PET/CT imaging were analyzed. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of serum CEA. Results Twenty-seven patients were confirmed with malignant tumor, and the rest of 73 cases were excluded. The 18F-FDG PET/CT reported one false positive and one false negative respectively. The sensitivity, specificity, accuracy, positive and negative predictive values of 18F-FDG PET/CT in diagnosing malignant tumors were 96.3%, 98.6%, 98.0%, 96.3% and 98.6% respectively. The median serum CEA levels were significantly higher in the positive 18F-FDG PET/CT patients than those in the negative patients (Z=5.796, P<0.05). The prevalence of 18F-FDG PET/CT positive patients was higher with an increase in absolute CEA levels (χ2=37.823, P<0.05). The median DT of serum CEA levels was shorter in the positive 18F-FDG PET/CT patients than that in the negative patients (Z=4.301,P<0.05). The positive rates of 18F-FDG PET/CT in patients with 0 d180 d and DT<0 d (χ2=17.472 and 17.325, both P<0.05). There was no significant difference in the positive rate of 18F-FDG PET/CT between patients with DT>180 d and patients with DT<0 d (χ2=0.255,P>0.05). The area under the curve (AUC) of serum CEA was 0.894, the optimal diagnostic cutoff value was 14.24μg/L. Conclusion 18F-FDG PET/CT is a useful image modality for detecting malignant tumors in patients with unexplained elevated serum CEA, especially for patients with CEA≥14.24μg/L and increase progressively.

Objective:To explore values and differences of multi-modality image registration and normalization methods in 18F-AV45 PET quantitative analysis of Alzheimer′s disease (AD). Methods:Twenty AD patients (10 males, 10 females; age (77.0±5.8) years) and 20 normal controls (NC; 8 males, 12 females; age (75.2±4.8) years) from the AD neuroimaging initiative (ADNI) open database of the National Institute on Aging were analyzed. β-amyloid (Aβ) deposition (positive/negative) was assessed by visual analysis. The SUV ratio (SUVr) in each brain region and individual average SUVr were calculated using template normalization method (M1), normalization after registration with 18F-FDG PET or MRI image (M2 or M3) respectively with the cerebellum as the reference area. The intra-class correlation coefficient (ICC) was used to complete the reliability between methods, and independent-sample t test and one-way repeated measures analysis of variance were used to compare the differences of quantitative indexes between different groups and different methods. ROC curve analysis was used to compare the diagnostic efficacy in distinguishing AD and NC, Aβ positive and negative cases. Results:There were 15 and 6 patients with positive Aβ deposition in AD group and in NC group respectively by visual analysis. The SUVrs of three methods were with good consistency (ICC=0.82, P<0.001), and the differences among individual average SUVrs (1.29±0.17, 1.36±0.23, 1.45±0.24) were significant ( F=68.78, P<0.001). There were significant differences between AD group (1.39±0.17, 1.48±0.24, 1.58±0.25) and NC group (1.20±0.10, 1.24±0.15, 1.33±0.16; t values: 3.55-4.33, all P<0.05), Aβ positive group (1.39±0.16, 1.50±0.21, 1.59±0.23) and negative group (1.19±0.11, 1.21±0.14, 1.31±0.15; t values: 4.58, 5.11, 4.41, all P<0.001), and the individual average SUVr of M3 was higher (both P<0.001). The AUCs of distinguishing Aβ positive and negative deposition of M1-M3 were 0.86, 0.88, 0.84 and the thresholds of SUVrs were 1.29, 1.37, 1.52, respectively. Conclusion:The three multi-modality registration and normalization methods are reliable methods for quantitation of 18F-AV45 PET imaging with certain differences, and should be selected carefully based on data conditions in practice.

Objective To evaluate the changes of left ventricular hemodynamics and systolic function in patients with apical aneurysm after percutaneous ventricular restoration ( PVR) by echocardiography . Methods Fifty patients with apical aneurysm were divided into PVR group ( 25 cases) and conservative treatment group ( control group ,25 cases ) . Two-dimensional transthoracic echocardiography ( 2D-TTE ) combined with real-time three-dimensional transesophageal echocardiography( RT-3DTEE) were applied for all the subjects in PVR group on preoperative ,one week after operaction ,three months after operaction and in control group on initial stage of prevent ventricular remodeling therapy ,one week after therapy ,three months after therapy to obtain left ventricular end-diastolic diameter( LVEDD) ,left ventricular end-systolic diameter( LVSDD) ,left ventricular end-diastolic volume( EDV ) ,end-systolic volume( ESV ) ,left ventricular ejection fraction( LVEF) ,left ventricular fractional shortening ( LVFS ) ,body surface area ( BSA ) ,stroke volume( SV) ,stroke volume index ( SVI) ,cardiac output ( CO ) ,cardiac output index ( CI) . Results There were significant differences in all parameters( P < 0 .05) especially in LVEF and SVI( P < 0 .01) between PVR group and control group in the following three months after operaction ,while there was no significant difference of the following one week after operaction( P > 0 .05) .Compared with preoperative ,there was no difference in all parameters in the following one week after operaction ( P > 0 .05) ,there was significant increase in SV and significant reduce in LVEDD and EDV ( P < 0 .01) between preoperative and in the following three months after operaction ,while there was no significant difference between preoperative and in the following one week after operaction ( P > 0 .05 ) .For the control group there was no significant difference between initial stage of prevevt ventricular remodeling therapy and in the following one week or three months after operaction .Conclusions PVR has a definite effect on left ventricular hemodynamics and systolic function in patients with apical aneurysm in the short term ,while 2D-TTE and RT-3DTEE provides a reliable basis for clinical to evaluate the effect of the PVR .

OBJE CTIVE To investigate the clinical characteristics of a dverse drug reactions of asparaginase-associated pancreatitis（AAP），so as to provide reference for clinical safe medication. METHODS Analysis and identification were performed on a severe adverse reaction case of acute pancreatitis complicated with diabetic ketoacidosis and liver injury in a patient with acute lymphoblastic leukemia in our hospital after using pegaspargase. Retrieved from Wanfang database ，CNKI，PubMed and Embase database，case reports of AAP were collected and summarized in terms of patient demographics ，drug use ，incubation period and adverse reaction outcome. Combined with this case ，the disease characteristics and potential risk factors of AAP were analyzed and discussed. RESULTS After analysis and identification ，it was determined that AAP occurred in this patient. A total of 47 case reports were retrieved from the database ，and a total of 52 patients（including this patient ）were included in the analysis ，including 29 males and 23 females，mainly minors （65.4％）. L-asparaginase was the main asparaginase preparation that causes AAP （80.8％）. Gastrointestinal symptoms were the main prodromal symptoms （92.3％），which could be accompanied by other asparaginase related adverse reactions. AAP could occur after 1-33 times of administration ，and the median latency was 14 days after administration；compared with children ，median latency of AAP in adult patients was shortened significantly （11 d vs. 16 d，P＝ 0.049）；the median latency of AAP had longer tendency in patients treated with pegaspargase than that of L-asparaginase （17 d vs. 12.5 d，P＝0.490）. Of the cases included in the analysis ，8 patients died due to AAP ，1 of which was related to re-exposure to asparaginase preparations. CONCLUSIONS Acute pancreatitis is a serious and potentially fatal adverse drug reaction of ； asparaginase preparations. Clinical medical staff should pay attention to the characteristics of AAP ，consider the possibility ： of AAP when the patients have gastrointestinal symptoms and do a good job in patient education and pharmaceutical care to minimize the damage caused by AAP to patients.

Objective To investigate the clinical features,laboratory indicators and prognosis of patients with bacterial ascites,and to provide evidence for early clinical diagnosis and treatmen.Methods Clinical data of patients diagnosed with cirrhosis ascites from First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2019 to January 2022 were retrospectively analyzed.According to diagnostic criteria,they were divided into bacterial ascites group(n=24),spontaneous bacterial peritonitis group(n=20)and control group(n=26).The clinical features,laboratory indicators and prognosis of three groups were compared.Results Cirrhosis ascites caused by hepatitis B accounted for the highest proportion.The white blood cell count,neutrophil percentage,ascites white blood cell and polymorphonuclear leukocyte count of patients in bacterial ascites group were significantly higher than those in control group(P<0.05).Gram-positive bacteria was the main pathogens causing bacterial ascites,among which staphylococcus accounts for the highest proportion.Ten cases of bacterial ascites with symptoms of infection were treated with ascites culture and anti-infection therapy.The 14 patients without symptoms of infection were given different treatment according to the development of the disease,one patient died,and the other patients improved.Conclusion The number of patients with bacterial ascites was large,and the main pathogenic bacteria was Gram-positive coccus.The combination of clinical symptoms and laboratory indicators is beneficial to the early diagnosis of bacterial ascites and the decision of treatment.

In contrast to the well-established genomic 5-methylcytosine (5mC), the existence of N⁶-methyladenine (6 mA) in eukaryotic genomes was discovered only recently. Initial studies found that it was actively regulated in cancer cells, suggesting its involvement in the process of carcinogenesis. However, the contribution of 6 mA in tongue squamous cell carcinoma (TSCC) still remains uncharacterized. In this study, a pan-cancer type analysis was first performed, which revealed enhanced 6 mA metabolism in diverse cancer types. The study was then focused on the regulation of 6 mA metabolism, as well as its effects on TSCC cells. To these aspects, genome 6 mA level was found greatly increased in TSCC tissues and cultured cells. By knocking down 6 mA methylases N6AMT1 and METTL4, the level of genomic 6 mA was decreased in TSCC cells. This led to suppressed colony formation and cell migration. By contrast, knockdown of 6 mA demethylase ALKBH1 resulted in an increased 6 mA level, enhanced colony formation, and cell migration. Further study suggested that regulation of the NF-κB pathway might contribute to the enhanced migration of TSCC cells. Therefore, in the case of TSCC, we have shown that genomic 6 mA modification is involved in the proliferation and migration of cancer cells.
AlkB Homolog 1, Histone H2a Dioxygenase/metabolism* ; Carcinoma, Squamous Cell/pathology* ; Cell Line, Tumor ; Cell Movement/genetics* ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Site-Specific DNA-Methyltransferase (Adenine-Specific)/metabolism* ; Tongue Neoplasms/metabolism*