Objective To study the differences between diet induced obesity (DIO) and diet induced obesity resistance (DIO-R) during insulin resistance (IR) in rats. Method Male SD rats were fed by high-fat diet 1 (45 % fat kJ) after adaptation. At 3rd week, rats were divided into 3 groups according to their body weight: rats belonging to the middle 1/3 of their body weights were the control group, and was fed by control diet (10 % fat kJ). The heaviest 1/3 and the lightest 1/3 belong to DIO and DIO-R group, respectively, and were fed by high-fat diet 2 (60 % fat kJ). Five rats were selected randomly from each group and sacarified at 3rd, 6th, 8th, 10th and 11th week. The energy intake, body fat contents, fasting blood glucose (FBG), serum lipid, serum insulin, insulin sensitive index(ISI)and leptin of rats were monitored dynamically. Results DIO rats were significantly different from DIO-R and control rats in energy intake, body fat content, FBG, lipid, serum insulin and leptin. Conclusion Fed by the same high-fat diet, DIO rats are more sensitive than DIO-R rats to become IR.

Objective To detect the frequency of peripheral blood CD4+ CD25high Tr and CD4+CD25lowT cells and expression of programmed death-1 ( PD-1 ) on their surface in the patients with systemic lupus erythematosus(SLE) and their clinical signifcance is analyzed.Methods The expression of PD-1 on the CD4+ CD25highTr and CD4+CD25lowT cells was examined in patients with 33 active SLE,18 inactive SLE and 38 healthy controls(HC) by flow cytometry.Clinical manifestations and laboratory findings of SLE were collected.Patients were divided into two groups according to their disease activity.SLE disease activity index(SLEDAI) score≥10 was defined as high disease activity and ＜10 as inactivity.The percentage of CD4+ CD25highTr and CD4+CD25lowT cells and proportions of expression of PD-1 on their surface were compared between not only inactive or active SLE patients and healthy controls (HC),but also between patients with lupus nephritis and without lupus nephritis.Correlation with clincal manifestations and laboratory findings was analyzed.Results (1)The proportions of CD4+CD25highTr and CD4+CD25low T cells were significantly decreased in active and inactive SLE patients as compared with HC.(2)The percentage of CD4+ CD25lowPD-1 +Tr and in active and inactive SLE patients were higher than HC.The proportions of CD4+CD25lowPD-1+ T cells were significantly increased in HC and inactive SLE patients as compared with inactive SLE patients.(3) The proportions of CD4+CD25highPD-1+Tr in SLE patients with nephritis were higher than those in patients without nephritis.But the percentage of CD4+ CD25 lowPD-1 + T cells was significantly decreased in SLE patients with nephritis as compared those without nephritis.(4)A positive correlation was observed for proportions of CD4+CD25highPD-1 + T cells with SLEDAI score.Proportions of CD4+ CD25high Tr,CD4+ CD25low PD-1 + T cells was inversely correlated with SLEDAI score.Conclusion The aberrations of proportions of CD4+CD25highpD-1+,CD4+CD25lowPD-1+,CD4+CD25high and CD4+CD25low T cells were observed in patients with SLE.The abnormality of PD-1 and PD-L1 pathway may play an important role in the function and number of Tr.

Objective To investigate the effects of dexmedetomidine on plasma IL-8,IL-10 level and lung AQP1 expression in patients undergoing one lung ventilation(OLV).Methods Forty patients,ASA Ⅰ or Ⅱ,scheduled for lung cancer radical surgery were randomly divided into two groups:control group (group C)and dexmedetomidine group (group D).In group D,dexmedetomi-dine 1 μg/kg (initial dose)was given over more than 10 min before anaesthesia induction,followed by continuous infusion at 0.5 μg·kg-1 ·h-1 until 30 min before the end of operation.In group C,the e-qual volume of normal saline was infused.Blood samples were collected at immediately before OLV (T1 ),30 (T2 ),60 (T3 ),120 (T4 )min of OLV,30 min after lung inflate (T5 )and 2 h after opera-tion (T6 )for determination of plasma IL-8 and IL-10 levels.Lung tissues were obtained at T1 for de-termination of AQP1 expression.Results Compared with the value at T1 ,plasma IL-8 levels in group C at T3-T6 and in group D at T3-T5 were increased,plasma IL-10 levels were increased in both groups at T2-T5 (P <0.05).Compared with group C,plasma IL-8 levels at T3-T6 were decreased and plasma IL-10 levels at T2-T5 were increased in group D (P <0.05).Compared with the value at immediately before OLV,the expression of AQP1 was decreased at the time of lobectomy of lungs in group C (P<0.05).Compared with group C,the expression of AQP1 at the time of lobectomy of lungs in group D was increased (P <0.05).Conclusion Dexmedetomidine 1 μg/kg followed by continuous infusion at 0.5 μg·kg-1 ·h-1 can reduce inflammatory response,up-regulate the expression of AQP1 in pa-tients undergoing OLV.

Objective The aim of this study is to examine the expressions of Toll like receptor (TLR) 7 and TLR9 in the peripheral blood B lymphocytes of SLE patients and to analyze the correlation between TLR7/9 and clinical parameters. Methods lntracellular expression of TLR7/9 in the peripheral blood CD19+Blymphocytes was analyzed in 50 SLE patients and 30 healthy controls by flow cytometry. The difference of intracellular TLR7/9 expression levels in two groups was compared. Furthermore,the correlation between TLR7/9 expression and clinical parameters such as ESR, CRP, complement 3 (C3), complement 4 (CA), the level of serum IgG, anti-double stranded DNA antibody, anti-nuclear antibodies, SLEDAI score and urine protein excretion level, were analyzed. Results Compared with healthy subjects, the proportion of B cells expressing TLR7 and TLR9 was higher among SLE patients. Positive correlation was observed between TLR7 expression levels and clinical measurement of the SLEDAI and ESR. Negative correlation was observed between TLR7 expression levels and serum C3 levels. Positive correlation was observed between TLR9 expression levels and SLEDAI scores. Negative correlation was observed between TLR9 expression levels and serum C3 levels. Conclusion TLR7 and TLR9 expression is increased in the peripheral blood B cells of SLE patients, and correlates well with clinical parameters.

Objective To evaluate the role of endoplasmic reticulum stress in ketamine-induced apoptosis in rat neurons.Methods Rat adrenal pheochromocytoma cell line (PC12 cells) was seeded in the culture dishes 100 mm in diameter (10 ml/dish) or in 6-well plates (2 ml/well) at a density of 5 × 105 cells/ml.PC12 cells were divided into 4 groups (n =6 each) using a random number table:control group (group C);ketamine group (group K);endoplasmic reticulum stress inhibitor salubrinal group (group S);ketamine + salubrinal group (group K+S).In group C,the cells were cultured in the plain culture medium.In group K,1.5 mmol/L ketamine was added.In group S,30 mmol/L salubrinal was added.In group K + S,1.5 mmol/L ketamine and 30 mmol/L salubrinal were added.At 24 h of incubation,the cell morphology was observed under light microscope,the expression of Bip and caspase-12 in PC12 cells was detected by Western blot,and the cell apoptosis was measured by flow cytometry.The apoptosis rate was calculated.Results Compared with group C,the expression of Bip and caspase-12 was significantly upregulated,and the apoptosis rate was increased in K and K + S groups (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group S (P＞ 0.05).Compared with group K,the expression of Bip and caspase-12 was significantly down-regulated,and the apoptosis rate was decreased in group K+S (P＜0.05).The degree of damage to PC12 cells was more serious in group K than in group C..The degree of damage to PC12 cells in group K+S was significantly mnilder than that in group K and more serious than that in group C.Conclusion The mechanism by which ketamine induces neuronal apoptosis is related to the enhancement of endoplasmic reticulum stress in rats.

Objective To investigate the safety of laparoscopic common bile duct exploration and lithotomy with primary closure and without placing drainage tube postoperatively.Methods Forty patients who received laparoscopic common bile duct exploration and lithotomy at the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 2011 to June 2013 were prospectively analyzed.All the patients were randomly divided into 2 groups according to the random number table.Twenty patients in the experimental group did not received drainage tube placement,and the other 20 patients in the control group had subhepatic drainage after operation.The operation time,duration of hospital stay and incidence of postoperative complications were compared between the 2 groups.Patients received computed tomography and B sonography at postoperative month 1 and 3,and then patients were reexamined every 6 months till postoperative year 3.The follow-up was ended on July 31,2013.The measurement data and the count data were analyzed using the independent sample t test and the Fisher exact probability,respectively.Results Patients in the 2 groups were cured after the operation.The operation time and duration of hospital stay were (117 ± 11) minutes and (5.6 ± 0.6) days in the experimental group,and (108 ± 12)minutes and (7.9 ± 0.7)days in the control group,with significant difference between the 2 groups (t =2.453,-ll.388,P ＜ 0.05).No complications including bile leakage,residual stones,obstructive jaundice,abdominal bleeding and subphrenic infection were detected after the operation.Thirty-one patients were followed up for 1 month to 2 years,no bile duct stone recurrence or biliary stricture were detected during the follow-up.Conclusion Laparoscopic common bile duct exploration and lithotomy with primary closure and without placing drainage tube postoperatively is safe and feasible.

OBJECTIVE To investigate the clinical features and risks factors of nosocomial bacterial infection in patients with systemic lupus erythematosus(SLE).METHODS Five hundred and ninety-seven patients with SLE were classed into two groups,the group of nosocomial bacterial infection and the control group according to the results of bacteriological examinations.A comparison was performed between the two groups.RESULTS According to the infection sites,36% occurred in the respiratory tract and lungs,29.0% in the urinary tract,19.9% in the blood system and 15.1% in other tissues and organs.From them,75.8% onsets of nosocomial bacterial infection were chronic or insidious.The pathogens of nosocomial bacterial infection were mostly opportunistic,45.6% were G-bacilli,40.9% G+cocci and 13.9% were other bacteria.The eight major risk factors included lung disease,the more than 3 damaged organs or systems,plasma albumin under 30 g/L,long application of large dose glucocorticoid(GC),treatment of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressant usage,use of broad-spectrum antibiotics before hospitalization and the time in hospital over 3 weeks.CONCLUSIONS The respiratory tract and lungs are the commonest site of nosocomial bacterial infection in patients with SLE.Most of the pathogens may be opportunistic of G-bacilli and G+cocci.The clinical features are untypical.It may decrease the incidence of the nosocomial bacterial infection to diminish by decreasing dose and the course of GC treatment after the patient's condition improved,select prudently application of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressants,cautiously use of broad-spectrum antibiotics and shorten the duration of hospitalization.

Objective: To analyse the effects of physical activity on neurocognitive function in children with autism spectrum disorder (ASD),so as to provide a theoretical basis and specific guidance for the clinical cognitive function rehabilitation practice of ASD children. Methods: Relevant literature on the effects of physical activity on neurocognitive function in children with ASD were searched in the China National Knowledge Infrastructure (CNKI), Wanfang, Web of Science, and EBSCO databases from their inception to March 2024 using specific subject terms. Information on authors, countries, publication dates, study populations, diagnostic criterion, interventions, measurement tools and study results were extracted postscreening. The methodological quality of the articles was assessed using the PEDro Scale, followed by a systematic review. Results: A total of seventeen articles and were included in the study and English literature, most of them were of good quality. The study included 10 randomized controlled trials, 4 quasiexperimental designs, and 3 preand posttest designs. The rehabilitative effects of physical activity on children with ASD were primarily observed in enhanced attention and executive function, as well as improvements in brain structure and function. Children with ASD showed varying cognitive effects in physical and skillbased programs, with skillbased activities like basketball and table tennis notably improving cognitive function. Conclusion Physical activity is an effective intervention that enhances cognitive abilities such as attention and executive function, as well as brain structure and function in children with ASD.

Objective:To investigate the application value of preoperative clinical and magnetic resonance imaging (MRI) targetoid enhancement combined with alpha-fetoprotein in evaluating the expression of cytokeratin 19 (CK19) in patients undergoing radical resection for single hepatocellular carcinoma (HCC) without macrovascular invasion.Methods:The retrospective cohort study was conducted. The clinicopathological data of 220 patients who underwent radical resection for single HCC without macrovascular invasion in the General Hospital of Ningxia Medical University from January 2016 to December 2020 were collected. There were 171 males and 49 females, aged (56±11)years. Of the 220 patients, 52 cases showed positive CK19 expression, while 168 cases showed negative CK19 expression. Observation indicators: (1) MRI and immunohistochemical staining results of patients with different status of CK19 expression; (2) comparison of clinical features of patients with different status of CK19 expression; (3) comparison of MRI features in patients with different status of CK19 expression; (4) analysis of influencing factors for CK19 expression in patients and predictive value. The normality of continuous variables was tested using the Shapiro-Wilk test. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers and (or) percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was analyzed by the non-parameter rank sum test. The relevant clinical and imaging features with P<0.05 were included in the binary Logistic regression model. The receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) was used to evaluate the predictive efficiency of the model. Results:(1) MRI and immunohistochemical staining results of patients with different status of CK19 expre-ssion. Results of MRI examination in patients with positive CK19 expression showed the tumors with low-signal intensity on plain T1-weighted imaging, annular high enhancement in the arterial phase, clear boundaries in the portal venous phase, central enhance-ment in the delayed phase and targetoid high signals on diffusion-weighted imaging (DWI). Immuno-histochemical staining revealed a positive CK19 expression. Results of MRI examination in patients with negative CK19 expression showed the tumors with low-signal intensity on plain T1-weighted imaging, non-annular high enhancement in the arterial phase, unclear boundaries in the portal venous phase, low signals compared with peripheral liver tissue in the delayed phase and uniform high signals on DWI. Immunohistochemical staining revealed a negative CK19 expression. (2) Clinical features of patients with different status of CK19 expression. The neutrophil count and cases with alpha-fetoprotein (AFP) ≥400 μg/L were 3.07(2.21,4.41)×10 9/L and 26 in patients with positive CK19 expression, versus 2.72(2.05, 3.51)×10 9/L and 48 in patients with negative CK19 expression, showing significant differences between them ( Z=?2.06, χ2=8.17, P<0.05). (3) Compari-son of MRI features in patients with different status of CK19 expression. Cases with tumor diameter ≥ 5 cm and cases with tumor showing targetoid enhancement were 34 and 22 in patients with positive CK19 expression, versus 82 and 24 in patients with negative CK19 expression, showing significant differences between them ( χ2=4.38, 18.86, P<0.05). (4) Analysis of influencing factors for CK19 expression in patients and predictive value. Results of multivariate analysis showed that AFP ≥ 400 μg/L and targetoid enhance-ment were independent risk factors for positive CK19 expression in HCC patients [ odds ratio=2.09, 3.23, 95% confidence interval ( CI) as 1.06?4.13, 1.49?6.99, P<0.05]. Results of ROC curve analysis showed that the AUC of targetoid enhancement for predicting positive CK19 expression was 0.64 (95% CI as 0.57?0.71), with the sensitivity and specificity as 42.31% and 85.71%. The AUC of AFP ≥400 μg/L for predicting positive CK19 expression was 0.61 (95% CI as 0.53?0.68), with the sensitivity and specificity as 51.00% and 71.43%. The AUC of targetoid enhancement combined with AFP ≥400 μg/L for predicting positive CK19 expression was 0.69 (95% CI as 0.61?0.77), with the sensitivity and specificity as 67.31% and 63.10%, respectively. Conclusions:Targetoid enhancement and AFP ≥400 μg/L are independent risk factors for positive CK19 expression in patients with single HCC without macrovascular invasion. Their combination has clinical value for preoperative evaluation of CK19 expression.

Objective: Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. Methods: The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12–18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma’anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. Results: The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027–1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028–1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199–3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052–3.633), suicide attempts (OR=1.765, 95% CI=1.037–3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523–2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196–0.952). Conclusion EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.