Objective To investigate the correlation of endothelial inflammation in patients with acute myocardial infarction (AMI)with no-reflow and severity of coronary lesion.Methods A total of 120 patients with AMI were all treated with percutaneous coronary intervention (PCI).The patients who had intraoperative no-reflow were in case group (n=40).The patients who were also treated by PCI but did not have no-reflow in the same period in our hospital served as the control group (n=80).According to the results of coronary angiography, no-reflow group patients were divided into three subgroups:single lesion group (n=14),two-lesion group (n=10), and three-lesion group (n=1 6 ).We monitored these patients’immediate postoperative endothelial microparticles (EMPs)and soluble intercellular adhesion molecule-1 (sICAM-1 )levels in both groups with flow cytometry and ELISA methods.Results In the case group,immediate postoperative EMPs and sICAM-1 levels in the blood circulation were significantly higher than those in the control group.EMPs area and sICAM-1 area under the curve in the case group were 0.755 and 0.701,which showed that EMPs and sICAM-1 levels had a good correlation with the occurrence of non-reflow in AMI patients after PCI.Gensini score and EMPs level rose with the increase of the lesion counts,and the level of EMPs was positively correlated with Gensini score.Conclusion In patients with AMI,the EMPs and sICAM-1 levels can well predict the occurrence of no-reflow and are of some value in predicting the severity of coronary lesion.

Objective:To preliminarily explore the long-term improvement of low-frequency deep brain stimulation (DBS) on the nucleus basalis of Meynert (NBM) in cognitive disorders, neuropsychiatric symptoms and sleep disorders of patients with early-onset severe Alzheimer's disease (AD).Methods:A retrospective study was performed; 18 patients with early-onset severe AD admitted to Department of Neurosurgery, First Medical Center of PLA General Hospital from January 2016 to December 2022 were included. These patients were divided into NBM-DBS group and control group according to different treatments; 6 patients received low-frequency NBM-DBS on basis of conservative treatments; 12 patients accepted conservative treatments. Changes in Brief Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), Hamilton Depression Rating Scale (HAMD), Becker-Lavanson Mania Scale (BRMS), Pittsburgh Sleep Quality Index (PSQI), and Zarit Caregiver Burden Interview (ZBI) were observed before treatment and 1 year after follow up.Results:MMSE and MoCA scores 1 year after follow up obviously reduced compared with those before treatment in both NBM-DBS and control patients; MMSE and MoCA scores in NBM-DBS patients showed no significant differences between 1 year after follow up and before treatment ( P>0.05), while significant differences were noted in the control group between 1 year after follow-up and before treatment ( P<0.05); and no significant differences in MMSE and MoCA scores were noted between the 2 groups 1 year after follow up ( P>0.05). NPI, HAMD, BRMS and ZBI scores in the NBM-DBS group 1 year after follow up were significantly different compared with those before treatment ( P<0.05); no significant differences were noted in NPI, HAMD and ZBI scores in the control group between 1 year after follow up and before treatment ( P>0.05), while significant difference was noted in BRMS scores ( P<0.05); significant differences in NPI, HAMD, BRMS and ZBI scores were noted between the 2 groups 1 year after follow up ( P<0.05). Conclusion:Low-frequency NBM-DBS is not only effective in improving cognitive disorders, but also effective in improving neuropsychiatric symptoms and sleep disorders, as well as reducing caregiver burden in patients with early-onset severe AD.

Objective: To explore the clinicopathological features and the renal biopsy process of a case of IgG4-related chronic interstitial nephritis with perirenal capsule involved and review associated literature to improve the clinician's understanding for this disease and to perform a better renal biopsy. Methods: The onset, diagnosis and treatment course of the disease were described and associated literature were reviewed to summary the clinicopathologic features and key points in renal biopsy. Results: The data of the patient showed that the urine specific gravity was 1.011, with urine protein ± and urine sugar 3+. The concentration of hemoglobin was 53 g/L, serum creatinine was 1665 μmol/L, and IgG4 was 9.39 g/L. Computed tomography showed that both kidneys enlarged slightly with decreased density and low density shadow around the kidneys. On contrast-enhanced scan, irregular low-density enhancement areas were found in both kidneys, and the edge of the boundary was not clear. For the first renal biopsy, no renal parenchyma was found except mainly hyaline collagen fibrils. At the second time, 3 pieces of tissues were obtained, which showed chronic interstitial glomerulonephritis. The IgG4 positive plasma cells were about 60/HPF and the IgG4⁺/IgG⁺cells ratio was more than 40%. The diagnosis of IgG4-related chronic interstitial glomerulonephritis was confirmed. After corticosteroid treatment, the serum creatinine decreased to 502 μmol/L after the patient got rid of dialysis. Conclusions There are various manifestations of renal damage caused by IgG4-related disease. It is necessary to pay attention to the involvement of the perirenal capsule, and to balance the risk of bleeding and poor sampling in renal biopsy.

The molecular mechanism of cleft lip and palate has been a hot topic for research in recent years.With the development of genetic technology,more than 100 genes have been associated with cleft lip and palate,though the pathological mechanism of such genes has not been delineated.The information carried by each of these genes may affect the phenotype through signal pathway,and abnormal function of these signal pathways has been found in the formation of cleft lip and palate.A series of signal factors have known to involve in the regulation of gene expression,and may interact with each other to form complex signal regulatory networks which are involved in the guidance of cell activity and tissue formation.This article has summarized several signal pathways related to lip and palate,and the molecular mechanism underlying the development of lip and palate.