G protein-coupled estrogen receptor(GPER), as a newly discovered estrogen membrane protein-coupled receptor, has attracted much attention in endocrine metabolism research in recent years.Abnormal glucose and lipid metabolism and imbalance of inflammatory response mediated by GPER is one of the pathogenesis mechanisms of various endocrine and metabolic diseases.GPER is expected to become a new drug target for the treatment of coronary atherosclerosis, obesity and diabetes.This article briefly reviews the progress of GPER-mediated estrogen signaling pathway in terms of glucose metabolism, lipid metabolism and inflammation.

Objective:To explore the lactate metabolism in brain tissue of the mice with early acute hypoxia-ischemia injury,and to provide data support for 9.4T 1 H-NMR spectroscopy in detecting the lactate level clinically.Methods:Eighty Kunming mice were randomly divided into sixteen groups (0 s,20 s,40 s,60 s,2 min,4 min, 6 min,8 min, 10 min, 12 min, 14 min, 16 min, 18 min,and 20 min)according to the duration of hypoxia-ischemia (n=5).The changes of lactate levels were detected by 9.4T 1 H-NMR spectroscopy. Results:After the initiation of hypoxia-ischemia injury,the lactate level began to increase rapidly to the highest value of (6.89 ± 0.34)μmol·g-1 at 20 s,then started to decline quickly from 40 s to 2 min,and eventually decreased to a stable level of (4.85±0.36)μmol·g-1 until 6 min.Compared with control group,the levels of lactate in brain tissue of the mice in hypoxic-ischemic groups were increased (P <0.01).Conclusion:40 s of acute hypoxia-ischemia may be the lactate cerebral neuron threshold during the anaerobic glycolysis. 9.4T1 H-MRS can provide the exact time window for detecting the lactate metabolism.

Objective To evaluate the clinical significance of tension-free vaginal tape(TVT) procedure in the treatment with elder female stress incontinence(SUI). Methods Six patients with proven SUI were undergone the TVT with SPRAC. Results Six patients were operated under low spinal anesthesia. Mean operation time was 31.6 minutes and the mean blood loss was 36.2 ml. Five patients were able to micturate spontaneously within 24 hours after operation. One patient with fatty and vaginal colpoptosis was in-dwelling catheter for one week. Patients were followed-up for 10-28 months. Five patients were completely cured and one patient was failed after operation three months. Two patients were de novo urgency. One patient complained of persistent suprapubic discomfort. Conclusions The tension-free vaginal tape operation is a safe and effective surgical procedure for the treatment of urinary stress incontinence with fatty vaginal colpoptosis in elderly females.

Objective To investigate prospectively effects of different drainage methods on preventing anastomotie leakage after Dixon operation in rectal carcinomas.Methods During the period of January 2002 to January 2007,450 patients with rectal carcinomas received Dixon operation.They were divided into three groups ( group A,B,and C) in order of admission.Presacral drainage was done in Group A,presaeral drainage + drainage through anus with one tubes in Group B,and presacral drainage + drainage through anus with two tubes in Group C.The postoperative complications of three groups were observed.Results There was 7.33% (11/150) ,8.00% (12/150) and 6.67% (10/150) wound infection in group A,B and C respectively.8.67% (13/150),6.67% (10/150) and 1.33% (2/150) anastomotic leakage occurred in group A,B and C respectively.Three groups had a similar wound infection ineidence(P ＞0.05).The occurrence of anastomotic leakage in group C was statistically lower than that in group A and B ( P ＜ 0.05 ).Conclusion Presacral drainage + drainage through anus with two tubes can effectively prevent anastomotic leakage after Dixon operation in rectal carcinomas.

Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.

Background Although remarkable progress has been made in microsurgery, surgery of intracranial aneurysm still encounters various complications. Cerebral ischemia and postoperative disorders of nervous system could be induced by various specific operation procedures. To improve the outcomes in intracranial aneurysm surgery and to minimize the occurrence of postoperative ischemic complications, it is necessary to perform real-time monitoring on ischemic damages for the corresponding functional areas. To elevate the sensitivity of Eps changes for the detection of cerebral ischemia induced by operation, we monitored Motion Evoked Potential ( MEPs), Somatosensory Evoked Potential (SSEPs)and Brainstem Auditory Evoked Potential (BAEPs) in microsurgical operations of intracranial aneurysms. And then the correlation between Eps changes and clinical outcome was investigated.Methods MEPs, SSEPs, and BAEPs were recorded intra-operatively for 25 cases in intracranial aneurysms. Monitored results and clinical outcome were analyzed in a prospective observational design.Results The MEPs in 5 of 21 cases, the SSEPs in 5 of 25 cases and the BAEPs in 1 of 3 cases showed inadequate temporary clipping, inadvertent occlusion, inadequate retraction, vasospasm, or compromise to perforating vessels. 3 patients developed advanced weakness, which showed abnormal SSEPs in only one patient while showed abnormal MEPs in all 3 cases.Conclusions The MEPs is more sensitive than SSEPs in monitoring the motor ischemic impairments. The monitoring results were correlated to the clinical outcome closely. Monitoring Eps in keyhole microsurgery of intracranial aneurysms could improve the sensitivity in detecting insufficient distal collateral flow. And then successful completion of potentially hazardous maneuvers would be attained.

Objective To compare the urodynamic parameters in female patients with incontinence with or without pelvic organ prolapse. Methods The urodynamic data from 140 patients diagnosed urinary incontinence and another 42 patients coexisted with pelvic organ prolapse were reviewed and analyzed. The urodynamics parameters were compared in perfusion, urination, bladder compliance, maximum urinary flow rate (Qmax), detrusor muscle pressure of maximum urinary flow rate (Pdet,Qmax), minimum urinary flow rate(Pdet, Qmax), urethral resistance factor (RUA), obstruction of bladder index (OBI) and normalized detrusor contractility. The influence of pelvic organ prolapses with incontinence on bladder filling and voiding function was evaluated also.Results There were no significant differences between 140 patients of urinary incontinence and 42 patients coexisted with pelvic organ prolapse in perfusion (P=0.142), bladder compliance (P=0.273), Qmax(P=0.192),Pdet (P=-0. 629), Qmin (P=0.365) and normalized detrusor contractility (P=0.380). There were significant differences in age(P=2.2×10-5), urination(P=0.034), Pdet.Qmax(P=0.045), RUA(P=0.018), OBI (P=0.017). Conclusions There is not clinically significant change in urine storage function of bladder in patients with pelvic organ prolapse, but the parameters of voiding function of bladder may existe difference. The increased bladder outlet resistance and postvoid residual urine are noticed in patients with pelvic organ prolapse.

Objective Intercellular adhesion molecule-1 (ICAM-1) plays an important role in mediating pulmonary infiltration of neutrophils .The aim of the study was to observe the expression of ICAM-1 and its potential regulators MK 2/HuR in pulmonary micro-vascular endothelial cells ( PMVEC ) in mice with acute respiratory distress syndrome ( ARDS) induced by lipopolysaccharide ( LPS) . Methods Ten 6-8 weeks old healthy C57BL/6 mice were randomly divided into an LPS and a control group of equal number , the former injected intraperitoneally with LPS diluted in 100 μL PBS while the latter with PBS only , both at 5 mg per kg of the body weight .At 24 hours after injection , all the mice were sacrificed .Real-time PCR was used to determine the mRNA expressions of HuR and ICAM-1 in the PMVECs, Western bolt employed to detect the protein expressions of MK2, HuR and ICAM-1, and flow cytometry adopted to measure the ICAM-1 expression on the surface of the PMVECs and pulmonary infiltration of neutrophils . Results The W/D ratio in the lung tissue of the mice was significantly lower in the LPS than in the control group (3.61 ±0.28 vs 6.16 ±0.40, P<0.05), while the rate of neutrophil infiltration markedly higher in the former than in the latter ([13.92 ±3.23]%vs [3.24 ±1.24]%, P<0.05).The mRNA and protein expressions of ICAM-1 in the PMVECs were significantly elevated in the LPS group as compared with that in the control (P<0.05), and so was the mRNA expression of HuR (P<0.05).No remarkable changes were observed in the expressions of total MK 2 and HuR proteins, but phosphorylated MK2 (p-MK2) and cytoplasmic HuR were increased in the LPS-stimulated mice. Conclusion Specific blockage or reduction of the HuR expression in PMVECs may lower the expression of ICAM-1, reduce neutrophil infiltration , and lessen pathophysiological changes in mice with ARDS .

Objective To Establish an evaluation system of the quality of life for Chinese liver and kidney transplant recipients,and develop a specialized scale to measure the quality of life (QOL)for such recipients preliminarily.Methods By combining subjective and objective methods,this study determined the evaluation system and created items of QOL scale based on literature analysis,Delphi method (expert consultation),interviews,and experience of researchers.Then,a nationwide clinical survey was conducted on 5 Level Ⅲ Class A hospitals.454 valid questionnaires were collected,including 153 from liver recipients,and 301 from kidney recipients.Subjective statistical methods such as critical Ratio method,correlation coefficient method,dispersion tendency method,and exploratory factor analysis were used for selection of questionnaire items.Results The study established an evaluation system of QOL for liver and kidney transplant recipients,including 4 primary indexes and 12 secondary indexes,and developed QOL scales that were appropriate for liver and kidney transplant recipients respectively.Conclusions The structure of QOL scale for liver and kidney transplant recipients was basically consistent with theoretical assumption.The QOL scale for patients showed good reliability and validity,therefore,it can fully reflect the quality of their life.

Objective To explore the factors associated with the quality of life (QOL) in patients after liver and kidney transplantation.Methods A multicenter cross-sectional survey was carried out in 5 Level Ⅲ Class A hospitals.153 liver transplant recipients and 301 kidney transplant recipients of outpatient clinic follow-up from March to December in 2015 were selected and investigated with a self-designed general state questionnaire,and Quality of Life Scale for Liver and Kidney Transplant Recipients which developed by our research group.Results There were significant differences in QOL total score in liver and kidney transplant recipients among groups of marital status and occupation.Divorced,unemployed and low-educated patients showed lower QOL total score than married,employed and high-educated ones (P ＜ 0.05).As compared with non-living-related transplantation group,patients undergoing living-related transplantation presented a better status in QOL total scores (P＜0.05).The QOL total score was obviously lower in patients suffering from complications and rejection than in those without occurrence of complications and rejection (P＜ 0.01).Postoperative time was correlated positively and significantly with QOL scores,and variances existed among different stages postoperation (P ＜ 0.01).Multivariable regression analysis demonstrated that education,marital status,postoperative time,type of donor and chemotherapy were the factors influencing liver transplant recipients' QOL,while marital status,postoperative time,type of donor,medical care assurance,complications and rejection after operation had effect on kidney transplant recipients.Conclusion Attaching importance to QOF among liver and kidney transplant recipients,and implementing scientific and effective nursing intervention based on the characteristics of them are necessary.