Objective To investigate the postmortem redistrib ution of morphine in rat model of chronic morphine poisoning. Methods Samples including cardiac blood, liver, heart, kidney, lung and brain tissues were collected in the rats with chronic morphine poisoning at 0～96 h after death, respectively. The morphine amount was measured with solid phase ext raction-gas chromatography. Results The study showed an increase in morphine concentrat ion of postmortem cardiac blood. Significant increase in morphine level was also observed 24～96 h after death in liver, heart and brain tissues, while the kid ney morphine levels decreased at 96 h after death. In the liver there was the g reatest increase (25-fold) in morphine levels 96 h after death. All the sample s showed marked alterations in morphine concentration within 96 h after death c ompared with cardiac blood at time of death. The postmortem morphine levels in b rain were closely related to those in the heart blood. Conclusion The postmortem redistribution of morphine exists in rats with chronic morphine poisoning. The brain tissues may better represent morphine levels in heart blood at the time of death.

Objective To investigate the expression of PTEN and vascular endothelial growth factor (VEGF) in esophageal carcinoma and the relationship between their expression.Methods The expression of PTEN and VEGF were detected using immunohistochemical S-P method.Results Among 80 cases of esophageal carcino- ma,31 showed positive staining of PTEN (38.75%),while all 20 case of normal mucosa showed positiva staimng of PTEN.The expression level of PTEN in highly differentiated squamous carcinoma was higher than that low differ- entiated squamous carcinoma.Also,the expression of PTEN was significantly correlated with lymph node metastasis (r=0.61,P<0.01)and differentiation(r=0.57.P<0.05).In 80 cases of esophageal carcinoma,57(70.13%) were of positive staining of VEGF,while in 20 of normal esophageal mucosa,only 3 showed positive staining of VEGF.The expression of VEGF was markedly correlated with infiltrative deepness(r=0.49,P<0.05)and lymph node metastasis(r=0.55,P<0.05)and differentiation(r=0.48,P<0.05).Conclusion Combined detection of PTEN and VEGF maybe helpful to evaluate prognosis and infiltrative capability of esophageal carcinoma,with sig- nificant importance to the prediction of the prognosis of esophageal carcinoam.

Objective:To evaluate the short-term efficacy and safety of Apollo stent in the treatment of symptomatic basilar artery stenosis.Methods:Patients with symptomatic basilar artery stenosis admitted to the Fourth Affiliated Hospital of China Medical University from January 2017 to May 2020 were selected and treated with Apollo stent implantation. The changes of clinical symptoms and the success rate of operation were evaluated. Postoperative complications included symptomatic intracranial hemorrhage, hyperperfusion, and new ischemic stroke, and follow-up results were evaluated 3 to 6 months later.Results:A total of 96 patients were included in this study, and all of them were confirmed by angiography to have severe basilar artery stenosis corresponding to the symptoms. Among them, 88 patients received stent implantation, with a success rate of 100%. Among the 88 patients, 86 received Apollo stent implantation, and 2 patients received self-Peng stent implantation. Among 86 patients with Apollo stent implantation, the lesions were located in the proximal segment in 73 cases (84.88%), in the middle segment in 10 cases (11.63%), and in the distal segment in 3 cases (3.49%). The degree of stenosis was (93.72±3.86)%, the length of stenosis was (8.50±2.65)mm, the residual stenosis rate was (1.76±4.87)%, and Mori type A lesions in 80 cases, type B lesions in 3 cases, and type C lesions in 3 cases. Among 86 patients with Apollo stent implantation, the incidence of perioperative neurological complications was 6.98%(6/86), including 1 case in the proximal part of the basilar artery (vascular rupture), 3 cases in the middle part of the basilar artery (perforating artery occlusion in 1 case, acute thrombosis artery occlusion in 2 cases), and 2 cases in the distal part (both acute vascular occlusion). Alteplase was injected into the microcatheter during the operation, and contact thrombolysis was performed. Immediately digital subtraction angiography (DSA) showed that the blood vessels were opened, and 1 case with neurological deficit was left. No hyperperfusion occurred in all patients. All patients were followed up for three months after operation. Among them, 58 patients had a good prognosis in the proximal segment of the basilar artery, 18 patients had a good prognosis in the middle segment, 4 patients had a good prognosis in the distal segment, and 6 patients had a bad prognosis (1 patient died). Postoperative stent restenosis occurred in 5 cases (5.81%), recurrent stroke in 3 cases (3.49%), and disabling stroke in 1 case (1.16%).Conclusions:Apollo stent is safe and effective in the treatment of symptomatic basilar artery stenosis, with good short-term prognosis, and long-term prognosis needs to be further studied.

Objective:To investigate the efficacy and safety of the rotational arch method of revealing the spinal canal and implanting back in resection of benign intravertebral tumours.Methods:A total of 17 patients with benign intravertebral tumors of the thoracolumbar spine who underwent a rotational arch method of revealing the spinal canal and implantation back in combination with tumor resection in Luoyang Orthopaedic-Traumatological Hospital of Henan Province from April 2017 to October 2022 were retrospectively analyzed. There were 9 males and 8 females, aged 58.59±13.57 years (range, 29-75 years). There were 7 cases of thoracic intravertebral tumors, 2 cases of thoracolumbar intravertebral tumors, and 8 cases of lumbar intravertebral tumors. The operated segments were 6 cases of single-segment, 8 cases of double-segment, and 3 cases of triple-segment. The disease duration was 20.35±16.58 months (range, 3-60 months). Histopathology showed 9 cases of schwannoma, 5 cases of meningioma, 2 cases of teratoma, and 1 case of dermoid cyst. The operation time, intraoperative blood loss, postoperative spinal canal volume, stability of internal fixation, and lamina healing were recorded. The Cobb angle, American Spinal Injury Association (ASIA) classification and Oswestry disability index (ODI) were compared before and after operation.Results:All patients were successfully operated and followed up for an average of 10.5±2.4 months (range, 6-20 months). The operation time was 156.76±26.81 min (range, 120-210 min) and intraoperative bleeding was 338.24±97.68 ml (range, 200-600 ml). There was no neurovascular injury during the operation. Incomplete spinous process fracture occurred in 1 case due to excessive exertion, which healed well without special treatment. Postoperative drainage volume was 147.06±31.58 ml (range, 100-210 ml). The patient's local Cobb angle was 14.15°±6.58° preoperatively and 14.73°±6.34° postoperatively, with no statistically significant difference ( t=1.810, P=0.089). The patient's ODI was 63.65%±6.57% preoperatively and decreased to 23.88%±4.21% at the final follow-up, with statistically significant difference ( t=53.359, P<0.001). In 17 patients, there were 2 cases of ASIA grade B, 9 cases of grade C, and 6 cases of grade D before operation, and 1 case of ASIA grade B, 4 cases of grade C, 8 cases of grade D, and 4 cases of grade E at the final follow-up, which was a significant improvement compared with the preoperative period, and the difference was statistically significant ( Z=2.587, P=0.010). All patients' incisions healed at stage I, and none of them had complications such as cerebrospinal fluid leakage and epidural haematoma. Three-dimensional CT of the spine at 6 months after operation showed that none of the patients had displacement of the vertebral plate, loosening of the internal fixation, infection or fracture. Conclusion:The rotational arch method of revealing the spinal canal and implantation back in combination with tumor resection for the treatment of benign intravertebral canal tumors has good postoperative neurological function recovery and a low complication rate, which is a safe and effective surgical procedure for the treatment of benign intravertebral canal tumours.

Background::While type 2 diabetes mellitus (T2DM) is considered a putative causal risk factor for coronary artery disease (CAD), the intrinsic link underlying T2DM and CAD is not fully understood. We aimed to highlight the importance of integrated care targeting both diseases by investigating the phenotypic and genetic relationships between T2DM and CAD.Methods::We evaluated phenotypic associations using data from the United Kingdom Biobank ( N = 472,050). We investigated genetic relationships by leveraging genomic data conducted in European ancestry for T2DM, with and without adjustment for body mass index (BMI) (T2DM: Ncase/ Ncontrol = 74,124/824,006; T2DM adjusted for BMI [T2DM adjBMI]: Ncase/ Ncontrol = 50,409/523,897) and for CAD ( Ncase/ Ncontrol = 181,522/984,168). We performed additional analyses using genomic data conducted in multiancestry individuals for T2DM ( Ncase/ Ncontrol = 180,834/1,159,055). Results::Observational analysis suggested a bidirectional relationship between T2DM and CAD (T2DM→CAD: hazard ratio [HR] = 2.12, 95% confidence interval [CI]: 2.01–2.24; CAD→T2DM: HR = 1.72, 95% CI: 1.63–1.81). A positive overall genetic correlation between T2DM and CAD was observed ( rg = 0.39, P = 1.43 × 10 -75), which was largely independent of BMI (T2DM adjBMI–CAD: rg = 0.31, P = 1.20 × 10 –36). This was corroborated by six local signals, among which 9p21.3 showed the strongest genetic correlation. Cross-trait meta-analysis replicated 101 previously reported loci and discovered six novel pleiotropic loci. Mendelian randomization analysis supported a bidirectional causal relationship (T2DM→CAD: odds ratio [OR] = 1.13, 95% CI: 1.11-1.16; CAD→T2DM: OR = 1.12, 95% CI: 1.07-1.18), which was confirmed in multiancestry individuals (T2DM→CAD: OR = 1.13, 95% CI: 1.10-1.16; CAD→T2DM: OR = 1.08, 95% CI: 1.04-1.13). This bidirectional relationship was significantly mediated by systolic blood pressure and intake of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, with mediation proportions of 54.1% (95% CI: 24.9-83.4%) and 90.4% (95% CI: 29.3-151.5%), respectively. Conclusion::Our observational and genetic analyses demonstrated an intrinsic bidirectional relationship between T2DM and CAD and clarified the biological mechanisms underlying this relationship.

ObjectiveTo explore the mechanism of Buzhong Yiqitang on pyroptosis in autoimmune thyroiditis （AIT） mice based on the NOD-like receptor hot protein domain related protein 3 （NLRP3）/cysteinyl aspartate specific proteinase-1（Caspase-1）/Gasdermin D （GSDMD） pathway. MethodSixty NOD.H-2^h4 mice were divided into normal group， model group， low， medium， and high dose groups （4.10， 8.19， 16.38 g·kg^-1）of Buzhong Yiqitang， and selenium yeast tablet group （0.26 mg·kg^-1）， with 10 mice in each group. Except for the normal group， all other groups were given 0.05% NaI by gavage for eight weeks to establish a model and then received the drug treatment for eight weeks. The serum levels of thyroid peroxidase antibody （TPO-Ab） and thyroglobulin antibody （TgAb） were detected using enzyme-linked immunosorbent assay （ELISA） method. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in mouse thyroid tissue. The immunohistochemical method was used to detect the protein expression of NLRP3， Caspase-1， interleukin-1β （IL-1β）， and interleukin-18 （IL-18）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of NLRP3， Caspase-1， IL-1β， and IL-18. Western blot was used to detect the levels of pyroptosis-related proteins in thyroid tissue. ResultCompared with the normal group， the serum levels of TPO-Ab and TgAb in the model group were significantly increased （P<0.01）. Thyroid follicles either increased in a cubic shape or were damaged and atrophied， with a large number of lymphocytes infiltrating around the follicles. Compared with the model group， the levels of TPO-Ab and TgAb in other groups were significantly reduced （P<0.01）， and the morphology and structure of follicles were improved. The degree of lymphocyte infiltration was reduced. Among them， the medium dose group of Buzhong Yiqitang had the most significant reduction and improvement effect. Compared with the normal group， the positive products and mRNA expression of NLRP3， Caspase-1， IL-1β， and IL-18 proteins in the thyroid tissue of the model group significantly increased （P<0.01）， and the protein expression levels of NLRP3， cleaved Caspase-1， IL-1β， IL-18， and GSDMD-N were significantly increased （P<0.05， P<0.01）. Compared with the model group， the positive products and mRNA expression of NLRP3， Caspase-1， IL-1β， and IL-18 proteins in other groups were significantly reduced （P<0.05， P<0.01）， with the most significant reduction effect in the medium dose group of Buzhong Yiqitang. The protein expression levels of NLRP3， cleaved Caspase-1， IL-1β， IL-18， and GSDMD-N were significantly reduced （P<0.05， P<0.01）. ConclusionBuzhong Yiqitang can improve AIT， and its mechanism may be achieved by regulating the NLRP3/Caspase-1/GSDMD signaling pathway to inhibit pyroptosis.