Objective: To explore the mediating effects of activities of daily living (ADL) and social interaction on the relationship between intergenerational support and depressive symptoms in the elderly. Methods: Basic information, ADL, social interaction and intergenerational support from children of the elderly aged 60 years and above were collected through the 2020 database of China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated using the Short Version of Center for Epidemiological Studies Depression Scales, and the mediating effects of ADL and social interaction on intergenerational support and depressive symptoms in the elderly was analyzed using Process program. Results: A total of 3 174 individuals were enrolled, including 1 638 males (51.61%) and 1 536 females (48.39%), and 2 264 individuals were aged 60 to <70 years (71.33%). The median score of depressive symptoms was 8 (interquartile range, 13), with 1 346 individuals (42.41%) identified as having depressive symptoms. The median scores of intergenerational support from children, ADL, and social interaction were 2 (interquartile range, 3), 0 (interquartile range, 1) and 3 (interquartile range, 6), respectively. Intergenerational support negatively affected depressive symptoms through the independent mediating effects of ADL (effect value=-0.224, 95%CI: -0.288 to -0.161) and social interaction (effect value=-0.516, 95%CI: -0.807 to -0.228), and negatively affected depressive symptoms via the chain mediating role of ADL and social interaction (effect value=-0.184, 95%CI: -0.237 to -0.134). The total mediating effect value was -0.924, accounting for 46.67% of the total effect. Conclusion Intergenerational support has a negative indirect impact on depressive symptoms in the elderly, mediated through ADL and social interaction.

Objective To evaluate the clinical efficacy of expulsive therapy using alpha 1-selective adrenoblocker and prostaglandin synthetase inhibitor for distal ureteral stones.Methods 94 patients with distal ureteral stone were randomly divided into study group and control group.In study group,47 cases received tamsulosin 0.2mg daily and dielofenac rectal suppositories 50mg 2 times daily,while watchful waiting without tamsulosin and diclofenac suppository in 47 cases of control group.Observation lasted 2 weeks and also stone expelled as end point.Results No severe adverse reactions related to the drugs were noted and no patients withdrew from the study.The stone-free rate was 91.5%(43/47) of the study group and 25.5% (12/47) of the control group (P＜0.01).A mean stone expelling date of the control group was(8.9±4.3)d and that of the study group was(6.4±3.7)d(P＜0.01).Rates of renoureteral colic recurred in the study group and the control group were 4.3%(2/47) and 48.9%(23/47),respectively (P＜0.01).Conclusion Treatment of distal ureteral stones wlth tamsulosin and dielofenac suppository can increase the stone-free rate,shorten mean stone expelling date,decrease rate of renottreteral colic recurred.

Objective To evaluate the effect of remifentanil preconditioning on myocardial ischemia-reperfusion (I/R) injury in aged rats.Methods Twenty-four healthy male Sprague-Dawley rats,aged 15-18 months,weighing 465-580 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group I/R and remifentanil preconditioning group (group RP).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Myocardial I/R was induced by 30 min occlusion of anterior descending branch of left coronary artery followed by 120 min reperfusion in group I/R.In group RP,remifentanil 10 μg · kg-1 · min-1 was infused intravenously for 20 min followed by 10 min washout before myocardial I/R.In group S,the anterior descending branch was only exposed but not ligated.At 30 min before ligation and 120 min of reperfusion,the activities of serum lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were determined.The hearts were removed at 120 min of reperfusion for determination of myocardial infarct size,the percentage of myocardial infarct size was calculated,and myocardial specimens were obtained for observing myocardial ultrastructure.Results Compared with group S,the activities of serum LDH and CK-MB were significantly increased at 120 min of reperfusion in I/R and RP groups.Compared with group I/R,the activities of serum LDH and CKMB were significantly decreased,the percentage of myocardial infarct size was decreased,and the pathological changes were attenuated in group RP.Conclusion Remifentanil preconditioning can attenuate myocardial I/R injury in aged rats.

Objective To study the morphological variations of maxillary sinus and to provide anatomical basis for maxillary posterior teeth implantation and extraction usingcone-beam computed tomography (CBCT) scan-ning. Methods CBCT images from 403 patients were reviewed. The minimal distance from sinus floor to alveolar ridge wasmeasured and the number of patients with clinical features such as having sinus septum , mucosal thicken-ing and posterior teeth roots extend into maxillary sinus were counted. Results The mean value of the minimal dis-tance from maxillary sinus floor to alveolar ridge was about 8.3 mm, there was no significant statistical difference between sex, but there was a significant statisticalsignificant difference between the left sides and the right sides. Occurrences of sinus septum, mucosal thickening and roots into sinus were 98.6%, 31% (in which 56.3% of mu-cosal thickening were related to apical periodontitis) and 47%. there was no significantstatisticaldifference between the two sides in males females. Conclusions The morphological variations of maxillary sinus are significant. Chron-ic inflammation in maxillary sinuis is closely related to the position of maxillary posterior teeth roots and periapical lesions.

Objective To explore the feasibility and evaluate its efficacy of transnasal marsupialization of maxillary cyst under nasal endoscope. Methods 15 cases of maxillary cyst were treated by endoscopic marsupialization in nasal. According to the situation of maxillary cysts, the fenestration of bottom nasal was opened in 6 cases, the fenestration of inferior nasal meatus was opened in 7 cases and inferior nasaI meatus was opened through the prelacrimal duct recess in 2 cases under the nasal endoscope. With partial removal of the cyst wall, the cyst and maxillary sinus was fused into a cavity if necessary. This ensured nasal drainage through the cyst cavity and nasal cavity or maxillary sinus. Results The operations of the 15 patients were success without complications. All patients were followed up for 6 to 24 months after operation. Operation cavity to complete epithelization in 2 to 3 months, the cyst cavity drained well with no recurrence. Conclusion Endoscopic marsupialization in nasal is a feasible alternative for management maxillary cyst. It makes the procedure simple, less traumatic, quick recovery, definite curative effect and low recurrence rate.

The aim of this project is to establish a fibroblast growth factor-21 (FGF-21) signaling pathway targeted cell model, for screening a class of FGF-21 receptor agonists as anti-diabetic candidates. FGF-21 requires beta klotho transmembrane proteins as co-receptor for the activation of tyrosine kinase FGF receptor (FGFR) signaling, thereby activating a series of intracellular signaling pathways and regulating gene transcription for glucose metabolism. Firstly a recombinant plasmid expressing co-receptor beta klotho and EGFP reporter genes was constructed. After introducing the recombinant plasmid into package cells, the cell culture supernatant was used to infect 3T3-L1 cells, which were then screened for stably expressing beta klotho gene. Administration of FGF-21 increased the expression of GLUT1 and stimulated GLUT1-mediated glucose uptake. This novel cell model can be conveniently used in high-throughput drug screening of FGF-21 or FGF-21 analogues.

Objective To study the impact of preprocedure intravenous urography(IVU)on the outcome of shock wave Iithotripsy(SWL)for the middle and lower ureteral stones.Methods 112 patients with solitary radiopaque the middle and lower ureterat stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were divided randomly to two treatment groups.IVU group(n=56)had IVU before the start of SwL,whereas patients in the control group(n=56)underwent SWL without IVU.Postoperative success,stone-free rates and complications were evaluated in both groups.Results Eleven patients in the IVU group were excluded from the study.The SUCCESS rate[91.1%(41/45)in IVP group VS 94.6%(53/56)in control group],stone-free rate[88.9%(40/45)vs 89.3%(50/56)],and complication rate[22.2%(10/45)vs 21.4%(12/56)]were similar in two groups(P＞0.05).ConclusionIt is not necessary to obtain an IVU for patients who have solitary radiopaque the middle and lower calculi on plain radiographs with no severe hydronephrosis on ultrasonographic examination before scheduling them for SWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.

Objective To evaluate the effect of hypoxia-preconditioned bone marrow mesenchymal stem cells (BMSCs) on the expression of HO-1 during spinal ischemia-reperfusion (I/R) in rats.Methods Thirty healthy adult Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 5 groups with 6 animals in each group using a random number table:sham operation group (group S),I/R group,PBS group,BMSC transplantation group (BMSC group) and hypoxic preconditioning group (group HP).In group HP,BMSCs were exposed to 3％O2-5％CO2-92％N2 for 24 h for hypoxia preconditioning.In PBS,BMSC and HP groups,PBS,BMSCs and BMSCs for hypoxic preconditioning were injected intrathecally,respectively,and 60 min later spinal I/R was induced by clamping the aorta in the rats anesthetized with chloral hydrate.At 6,12,24 and 48 h and 7 days of reperfusion,the neurological function was evaluated and scored.At day 7 of reperfusion,the rats were sacrificed,and spinal cord tissues were obtained for determination of HO-1 expression (by Western blot) and HO-1 mRNA expression (using real-time PCR).Results Compared with group S,the neurological function score was significantly decreased at each time point of reperfusion,and the expression of HO-1 mRNA and protein in spinal cord tissues was up-regulated in the other groups.Compared with group I/R,the neurological function score was significantly increased at each time point of reperfusion,and the expression of HO-1 mRNA and protein in spinal cord tissues was upregulated in BMSC and HP groups,and no significant change was found in group PBS in the parameters mentioned above.Compared with group BMSC,the neurological function score was significantly increased at each time point of reperfusion,and the expression of HO-1 mRNA and protein in spinal cord tissues was up-regulated in group HP.Conclusion The mechanism by which hypoxic preconditioning enhances protection of spinal cord by BMSC transplantation may be related to up-regulation of HO-1 expression in rats.

Objective To investigate the effects of allele-31 C>T on the binding activity to IL-1βpromoter of the nuclear transcription factor C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection.Methods The electrophoretic mobility shift assay ( EMSA) was performed to explore whether the nuclear transcription factor C/EBPβand PU.1 could bind to -31 region in IL-1βpromoter.The C/EBPβ-and PU.1-expressing vectors were constructed and co-transfected into HeLa cells with IL-1βpromoter luciferase vector.The expression of C/EBPβand PU.1 was confirmed using Western blotting assay, and the promoter activity was determined using Dual-Glo Luciferase system under various transfection conditions. Lentivirus-mediated RNA interference was used to explore the effects of C/EBPβand PU.1 on IL-1βexpression.GraphPad Prism 5.0 was used for data analysis.Results EMSA results showed that both C/EBPβand PU.1 could bind to -31 region in IL-1βpromoter.Both C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection could increase IL-1βpromoter activity, especially for the -31 T allele (t=22.33 and 7.98,P<0.01), and there was a synergy on the promoter activity between C/EBPβand PU.1.The promoter activity decreased significantly when C/EBPβand/or PU.1 were silenced by lentivirus-mediated RNA interference (q=5.79, 6.23 and 11.66,P<0.01).Conclusion The allele-31 C>T can induce IL-1βpromoter activity and gene transcription through regulation of binding activity to C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection.

Objective To investigate the diagnosis and treatment of congenital mesenteric hiatal hernia in aduls.Methods The retrospective cross-sectional study was conducted.The clinical data of 11 adult patients with congenital mesenteric hiatal hernia who were admitted to the First Affiliated Hospital of Henan University from January 1999 to January 2016 were collected.All patients underwent abdominal X-ray and ultrasound examinations.Patients diagnosed as with intestinal obstruction or suspected intra-abdominal hernias underwent abdominal CT examination,and then were finally confirmed during surgery.Patients diagnosed as with mesenteric hiatal hernia received necrotic tissues resection and tissue repair (small intestine resection and anastomosis) if there was necrosis of hernia contents,and closing mesenteric hiatus.Patients without small intestine necrosis received closure of mesenteric hiatus after retraction of the hernia contents.Observation indicators:(1) clinical manifestations,(2) imaging findings,(3) treatment,(4) pathological examination,(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative complications up to March 2017.Results (1) Clinical manifestations:all 11 patients were acute onset,with incentives of satiation,postprandial exercise and diarrhea.The time from onset to admission was 2.0-30.0 hours,with an average time of 9.8 hours.The main symptoms included abdominal pain,nausea and vomiting,exhaust reduction and other intestinal obstruction performances.Eleven patients received physical examination,and 10 showed abdominal bulge,including 9 with intestinal type.Eleven patients had abdominal tenderness,and 9 combined with rebound tenderness.Abdominal percussion of 11 patients showed hyperresonant without shifting dullness,and active,muted and fading bowel sounds were detected in 1,3 and 7 patients,respectively.(2) Imaging examination:of 11 patients receiving abdominal X-ray examination,2 had intestinal loop and 4 had the intestinal obstruction performances such as typical gas-liquid plane.Abdominal ultrasound examination of 11 patients showed no specific findings due to abdominal intestinal gas,and 10 with peritoneal effusion.Of 11 patients,1 didn't receive abdominal CT scan due to preoperatively misdiagnose with acute appendicitis and 10 underwent abdominal CT scan.Nine patients were diagnosed with intestinal torsion by abdominal CT scan and then underwent enhanced CT scan,and 8 with small mesenteric vascular torsion and swirling sign were diagnosed with small intestine torsion and partial necrosis of small intestine.(3) Treatment:1 patient preoperatively misdiagnosed with acute appendicitis was converted to exploratory laparotomy,and 10 patients underwent exploratory laparotomy due to complete intestinal obstruction or progressive increase in symptoms.Intraoperative exploration showed that intestinal mesenteric hiatus and colon mesenteric hiatus were respectively in 8 and 3 patients,and hiatuses were round or oval,with a diameter of 2.0-8.0 cm and an average of 4.4 cm.Hernia contents were small intestine.The partial small intestine in 10 patients were resected and then mesenteric hiatus was closed due to necrosis of the small intestine,with removal length of 110-250 cm and an average of 176 cm,and length of remaining small intestine was 80-230 cm,with an average of 159 cm.The hernia into small intestine in 1 patient without complete necrosis was retracted to abdominal cavity after symptomatic treatment,and closing mesenteric hiatus.Eleven patients were cured and out of hospital after operation,without nosocomial complications.(4) Pathological examination:small intestine ischemic necrosis was detected in 10 patients after partial small intestine resection.(5) Follow-up situations:all patients were followed up for 12-24 months,without malnutrition,short bowel syndrome and other complications.Conclusions Without history of abdominal trauma or surgery,with incentives of the satiation,postprandial exercise and diarrhea,abnormal retroperitoneal small intestine shadow and small intestinal torsion diagnosed by CT scan and absent intestine sign by enhanced CT scan can be helpful to diagnose congenital mesenteric hiatal hernia in adults and small intestinal necrosis.Surgery is the only effective method in the treatment of congenital mesenteric hiatal hernia in adults.