Objective:To investigate the effect of chronic ethanol consumption on sensory information transmission in the cerebellar molecular layer and reveal the mechanism of chronic alcoholism on sensory information transmission and integration in the cerebellar cortex.Methods:Fifty healthy male ICR mice aged 6-8 weeks were randomly divided into saline group(control group)and ethanol consumption group(alcohol group) according to the random number table, with 25 mice in each group.The mice in alcohol group were injected intraperitoneally with 20% ethanol daily, while the mice in control group were injected with the same dose of normal saline. All mice were injected intraperitoneally once a day for 28 days.Through electrophysiological technology, patch-clamp amplifier and data acquisition software were used to record the changes in cerebellar molecular layer field potential of mice in the alcohol group and control group induced by sensory stimulation.Clampfit 10.3 software was used to record and analyze the electrophysiological data. SPSS 22.0 software was used for statistical analysis. Paired t-test and one-way ANOVA were used to analyze the differences before and after treatment. Results:After giving the stimulation of wind blowing, the amplitude of P1 in alcohol group was significantly higher than that in control group ((121.31±3.5)%, (97.2±2.7)%; t=26.08, P<0.05), and the area under the P1 curve (AUC) of the alcohol group was significantly lower than that of the control group ((127.1±4.2)%, (102.2±3.5)%; t=22.95, P<0.05). There was no significant difference in N1 amplitude between the two groups (P>0.05). When L-NNA, an inhibitor of nitric oxide synthase, was perfused into the brain surface of mice, the amplitude of P1 in alcohol group was significantly lower than that before administration ((76.2±4.8)%, (103.5±3.6)%; t=22.60, P<0.05), but there was no difference of the amplitude of P1 before administration and after elution ((101.5±4.6)%) ( t=1.70, P>0.05). After the L-NNA was perfused, the AUC of P1 was significantly lower than that before administration((72.4±5.6)%, (102.7±2.66)% ( t=24. 58, P<0.05), and there was no significant difference between before administration and after elution( (100.6±3.5)%, t=1.81, P>0.05). When L-NNA was perfused into the brain surface of mice, the amplitude of P1 in control group was (104.3±1.6)% and it had no differences compared with before administration(102.2±5.6)%, t=1.84, P>0.05) and after elution(102.5±4.5)%, t=1.92, P>0.05). And the AUC of P1 in control group after perfused L-NNA had no differences compared with before administration(103.5±2.6)%, (102.5±4.6)%) and after elution((101.9±3.7)%, t=0.99, 1.81, both P>0.05). When the mouse brain surface was perfused with NO donor SNAP, the amplitude of P1 in the control group was significantly higher than that before administration( (128.2±3.4)%, (103.5±2.6)%; t=28.89, P<0. 05) and there was no difference between before administration and after elution( (105.4±4.2)% , t=1.93, P>0.05). The AUC of P1((125.4±4.4)%) was higher than before administration((104.3±4.6)% , t=16.60, P<0.05) and there was no difference between before administration and after elution(103.5±4.2)%, t=0.65, P>0.05). Conclusion:Chronic ethanol consumption significantly enhances the inhibitory response, and the enhancement of inhibitory components stems from the activation of the NO signaling pathway.

BACKGROUND: The area of myocardial infarction is the determinative factor of acute myocardial infarction prognosis. Amelioration of blood transportation and replacement therapy can reduce infarction area. Bone marrow mesenchymal stem cells can differentiate into cardiovascular tissue and are easy to obtain. After cultured and expanded in vitro, they can become the ideal cells for cardiovascular replacement therapy.OBJECTIVE: To evaluate the therapeutic effect of intracoronary transplantation of bone marrow mesenchymal stem cells in the treatment of myocardial infarction. DESIGN: Self-control observation taking the patients as subjects.SETTING: Department of Cardiology, Department of Nuclear Medicine,Echocardiogram Room, Nanjing First Hospital Affiliated to Nanjing Medical University.PARTICIPANTS: Totally 20 patients with acute myocardial infarction who received the therapy of bone marrow mesenchymal stem cells transplantation in the Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University during March 2003 to March 2004 were recurited. Informed consents were obtained from the patients, and the complete postoperative follow up was over 3 months. The patients include 15 male and 5 female, and they were aged (64±10) years.METHODS: All the patients underwent percutaneous coronary intervention (PCI) to treat infarction-related blood vessel. Autologous bone marrow was taken from the patients, then stem cells were extracted to be performed in vitro induction, differentiation and proliferation, and transplanted infarction-related blood vessel through coronary artery at the mean number of (21.7±30.14)× 107 within 2 weeks. Before and 3 months after transplantation of stem cells, patients underwent gated dual-isotopic myocardial perfusion/metabolic imaging (18-fluoro-2-deoxy-glucose, 18F-FDG) examination. Survived and necrotic myocardia were predicted and infarction area was obtained. At the same time, wall motion and heart function index were evaluated with ultrasound cardiography (UCG)examination, and they were re-checked 3 months after operation to evaluate the amelioration of wall motion and heart function index. A 5-point scale was used in the evaluation of gated dual-isotopic myocardial perfusion/metabolic imaging (18F-FDG) examination: point 0: normal, 1: sparse, 2:obviously sparse, 3: defected. Evaluative standard of UCG: point 1: normal,2: reduced, 3: obviously reduced, 4: no ventricular wall motion or paradoxical motion; Wall motion with 2 points or more than 2 points suggests it is improved.MAIN OUTCOME MEASURES: ① Results of gated dual-isotopic myocardial perfusion/ metabolic imaging (18F-FDG-SPECT); ②Infarctionrelated myocardial segment score and heart function index before and after stem cell transplantation of patients in ECG follow-up observation.RESULTS: All the 20 patients participated in the result analysis.Results of gated dual-isotopic myocardial perrusion/metabolic imaging (18F-FDG-SPECT): The myocardial perfusion defect area of 20 patients was significantly reduced after therapy than before therapy [(33±15)%,-(44±18)% ,P ＜ 0.05]; Metabolie defect area was significantly reduced after therapy than before therapy [(33±17)%, (43±21)% ,P ＜ 0.05];Before therapy, there were 199 segments, in which blood flow reperfusion was matched to glycometabolism defect, and they were determined as necrotic myocardium. After therapy, blood flow perfusion metabolism was improved in 79 segments, but blood flow perfusion and glycometabolism were not improved significantly in 120 segments (P ＜ 0.05). Results of UCG: ejection fraction of patients was significantly larger after therapy than before therapy [(53±8)%, (42±7)% ,P ＜ 0.05].CONCLUSION: Intracoronary transplantation of human bone marrow mesenchymal stem cells for treating myocardial infarction is simple to operate. After therapy, the infarction area is obviously reduced, myocardial blood flow perfusion and metabolism of necrotic area improve, myocardial segments without survival determined before operation reduce sigrificantly and the heart function of patients improve.

Ethanol is one of the most widely used and abused psychoactive substances in the world. Long-term and excessive intake of alcohol can damage the central nervous system and lead to impairment of its function. As an important component of the central nervous system, cerebellum is one of the main target organs damaged by ethanol. Acute and chronic ethanol intake can damage human motor coordination, motor learning and some cognitive functions. Its damage mechanism is generally believed to be caused by the abnormal function of cerebellar cortical neural circuit caused by ethanol intake. Combined with recent studies on the mouse model of long-term ethanol intake, this article reviews the cerebellar neural network mechanism of long-term ethanol intake from various aspects, with a view to providing research and development in behavioral movement, motor coordination, cognitive function, depression, and offers new ideas with the rise of precision medicine for treatment. People are increasingly interested in exploring the mechanism of long-term ethanol intake on the cerebellar neural network. How to improve or block the corresponding mechanism based on the mechanism of action found in existing research is an important proposition in future research.

Objective:To investigate the clinical efficacy of distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries.Methods:A retrospective cohort analysis was made on clinical data of 72 patients with ankle fracture accompanied with distal tibiofibular syndesmosis injuries admitted to 909th Hospital of Joint Service Support Force of PLA from September 2017 to September 2020, including 38 males and 34 females, aged 19-65 years [(42.5±12.2)years]. The fracture was type B in 30 patients, type C 1 in 29 and type C2 in 13 according to Danis-Weber classification. A total of 36 patients were treated by distal tibiofibular screw fixation combined with ligament repair (fixation+repair group) and 24 patients by distal tibiofibular screw fixation (fixation group). Operation time, intraoperative blood loss and hospital stay were recorded. Visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and ankle range of motion (ROM) were determined at 1, 3 months postoperatively and at the final follow-up. Complications were documented. Results:All patients were followed up for 12-22 months [(15.9±2.2)months]. There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups (all P>0.05). VAS in fixation+repair group was (3.1±1.0)points and (2.1±0.6)points at 1, 3 months postoperatively, significantly lower than (3.9±0.8)points and (2.6±0.8)points in fixation group (all P<0.05), but the score showed no significant difference between the two groups at the final follow-up ( P>0.05). AOFAS score in fixation+repair group was (64.7±4.0)points, (73.2±3.4)points and (87.2±3.4)points at 1, 3 months postoperatively and at the final follow-up, significantly higher than (60.1±4.9)points, (70.2±1.9)points and (84.1±2.6)points in fixation group (all P<0.05). There was no significant difference in the ROM between the two groups at 1 month postoperatively ( P>0.05), but the ROM at 3 months postoperatively and at the final follow-up in fixation+repair group [(44.4±2.9)° and (52.3±2.5)°, respectively] was significantly higher than that in fixation group [(41.4±2.7)° and (50.1±2.7)°, respectively] (all P<0.05). There was 1 patient with internal fixation loosening in fixation+repair group, with the incidence of complications of 3% (1/36). While the incidence of complications was significantly lhigher in fixation group [17%(6/36)], including 2 patients with re-separation of distal tibiofibular syndesmosis, 2 with internal fixation loosening and 2 with internal fixation breakage ( P<0.05). Conclusion:Compared with distal tibiofibular screw fixation, distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries is effective to early relieve ankle pain, improve ankle function and ROM, and reduce occurrence of complications.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Objective:To explore the effect of atlantoaxial fusion on the growth and development of children′s cervical spine.Methods:The clinical data of 12 children with atlantoaxial dislocation who underwent posterior atlantoaxial fusion at Department of Orthopaedics,the 909th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from June 2002 to September 2013 were retrospective analyzed. There were 7 males and 5 females,with age of (8.1±3.1)years (range:3 to 13 years).Nine cases were traumatic and 3 cases were congenital malformations,1 of the children had Down syndrome. All children underwent posterior atlantoaxial fusion. Furthermore,the information of the height and anteroposterior width of the cervical vertebral bodies and vertical growth rate of the fusion mass were collected from all patients immediately postoperatively and during the follow-up.The range of motion in cervical spine were collected preoperatively and during follow-up period. Data were compared using independent sample t test, paired sample t test and repeated-measurement. Results:All 12 children had regular follow-up within (122.4±25.3)months(range:65 to 163 months). The height and anteroposterior width of the cervical vertebral bodies were similar to these results with those in published reports of growth in normal children of the same age(all P<0.01). At the last follow-up,atlantoaxial fusion of 11 cases had substantial growth (vertical growth rate of the fusion mass:11 cases ≥10%, 1 case <10%);the range of motion in cervical spine was close to the normal level (flexion(55.2±5.0)°,extension (65.3±4.9)°,left bending (41.7±4.5)°,right bending (42.4±4.4)°,left rotation (66.4±5.6)°,right rotation (68.5±5.8)°). Conclusions:Atlantoaxial fusion surgery is satisfactory in the treatment of pediatric atlantoaxial dislocation.During the follow-up,the growth and development of the cervical spine is close to that of normal children of the same age.In long-term observation,it has been found that the operation has no negative effect on the growth and development of the children′s cervical spine.

Objective:To explore the effect of atlantoaxial fusion on the growth and development of children′s cervical spine.Methods:The clinical data of 12 children with atlantoaxial dislocation who underwent posterior atlantoaxial fusion at Department of Orthopaedics,the 909th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from June 2002 to September 2013 were retrospective analyzed. There were 7 males and 5 females,with age of (8.1±3.1)years (range:3 to 13 years).Nine cases were traumatic and 3 cases were congenital malformations,1 of the children had Down syndrome. All children underwent posterior atlantoaxial fusion. Furthermore,the information of the height and anteroposterior width of the cervical vertebral bodies and vertical growth rate of the fusion mass were collected from all patients immediately postoperatively and during the follow-up.The range of motion in cervical spine were collected preoperatively and during follow-up period. Data were compared using independent sample t test, paired sample t test and repeated-measurement. Results:All 12 children had regular follow-up within (122.4±25.3)months(range:65 to 163 months). The height and anteroposterior width of the cervical vertebral bodies were similar to these results with those in published reports of growth in normal children of the same age(all P<0.01). At the last follow-up,atlantoaxial fusion of 11 cases had substantial growth (vertical growth rate of the fusion mass:11 cases ≥10%, 1 case <10%);the range of motion in cervical spine was close to the normal level (flexion(55.2±5.0)°,extension (65.3±4.9)°,left bending (41.7±4.5)°,right bending (42.4±4.4)°,left rotation (66.4±5.6)°,right rotation (68.5±5.8)°). Conclusions:Atlantoaxial fusion surgery is satisfactory in the treatment of pediatric atlantoaxial dislocation.During the follow-up,the growth and development of the cervical spine is close to that of normal children of the same age.In long-term observation,it has been found that the operation has no negative effect on the growth and development of the children′s cervical spine.