Objective To study the effects of Ginkgo biloba extract(EGb) on the volume of cerebral infarction and expression of caspase-3 in ischemic-reperfusion rats.Methods Setting up the brain ischemic and reperfusion model in rats by Nagasawa way.Both groups rats treated with small dose of EGb and large dose of EGb were injected intraperitoneally with EGb 50 mg/kg and 100 mg/kg at 30 min before the trial and 1 h after cerebral ischemic respectively.The infarction volume and caspase-3 expression were detected by TTC staining and immunohisto-chemistry.Then the results were compared with ischemic-reperfusion group.Results In groups treated with small dose of EGb and large dose of EGb,infarction volumes [(83.4?2.9)mm3,(37.0?2.5)mm3] were smaller obviously than that in the ischemic-reperfusion group [(138.8?6.1)mm3](all P

Type 2 diabetes mellitus (T2DM) is one of the most serious public health problems,while the detailed mechanisms underlying its pathology remain obscure.MicroRNAs (miRNAs),which are single-stranded noncoding RNAs,are considered to be involved in various pathological processes,especially in T2DM.MiRNA has become a noval player in insulin resistance,islet dysfunction,and even in the diabetes related complications.

Objective To evaluate the effect of propofol postconditioning on the activities of proapoptotic proteins Bid,Bim and Puma in rat cortical neurons subjected to oxygen-glucose deprivation/restoration (OGD/R) and the relationship with p38 mitogen-activated protein kinase (p38MAPK) signaling pathway.Methods The cortical neurons obtained from Sprague-Dawley rats (＜24 h after birth) were cultured in vitro and seeded in 6-well culture palate (2 ml/well).The cortical neurons were randomly divided into 4 groups (n =42 each) using a random number table:control group (group C),OGD/R group,propofol postconditioning group (group P),and propofol postconditioning + p38MAPK inhibitor SB202190 group (group PS).The neurons were subjected to O2-glucose deprivation for 90 min followed by restoration of O2-glucose supply for 24 h.In P and PS groups,propofol with the final concentration of 50 μmol/L was added to the culture medium immediately after restoration of O2-glucose supply,and the neurons were cultured for 2 h.SB202190 with the final concentration of 50 μmol/L was added to the culture medium at 1 h before O2-glucose deprivation,and the neurons were cultured for 2 h.The neuronal apoptosis was detected using Annexin V-FITC/PI double staining combined with flow cytometry,the number of viable neurons was evaluated by methyl thiazolyl tetrazolium assay,and the amount of lactic dehydrogenase (LDH) released was measured using colorimetric method.Mitochondrial membrane potential (MMP) was assessed by JC-1 fluorescence assay.The expression of Bid,Bim and Puma proteins was determined by Western blot.Results Compared with group C,the apoptosis rate and amount of LDH released were significantly increased,the neuronal survival rate and MMP were significantly decreased,and the expression of Bid,Bim and Puma was significantly up-regulated in group OGD/R (P＜0.05).Compared with group OGD/R,the apoptosis rate and amount of LDH released were significantly decreased,the neuronal survival rate and MMP were significantly increased,and the expression of Bid,Bim and Puma was significantly down-regulated in P and PS groups (P＜0.05).Compared with group P,the apoptosis rate and amount of LDH released were significantly increased,the neuronal survival rate and MMP were significantly decreased,and the expression of Bid,Bim and Puma was significantly up-regulated in group PS (P＜0.05).Conclusion Propofol postconditioning reduces OGD/R-induced injury to rat cortical neurons through activating p38MAPK signaling pathway and inhibiting activities of pro-apoptotic proteins Bid,Bim and Puma.

Objective To evaluate the role of mitochondrial ATP-seusitive potassium (mito-KATP) channels in sevoflurane postconditioning-induced inhibition of oxygen-glucose dcprivation and restoration (OGD/R)-induced pyroptosis in primary rat cardiomyocytes.Methods Cardiomyocytes of newborn Sprague-Dawley rats (＜48 h after birth) were cultured in vitro and seeded in 6-well dishes (2 cm in diameter)or in 96-well plates.The cells were divided into 6 groups (n =15 each) using a random number table:control group (group C),OGD/R group (group O),sevoflurane postconditioning group (group Sev),sevoflurane postconditioning plus 5-hydroxydecanoate (5-HD) group (group SH),5-HD group (group H) and OGD/R plus 5-HD group (group HO).The cardiomyocytes were subjected to oxygen-glucose deprivation for 4 h followed by restoration of oxygen-glucose supply for 24 h.After oxygen-glucose restoration,the cardiomyocytes in the culture media were exposed to 2％ sevoflurane for 1 h to perform sevoflurane postconditioning.At 1 h before oxygen-glucose deprivation,a specific mito-KATP channel blocker 5-HD 100 μmol/L was added to the culture media.Cardiomyocytes were cultured in normal culture atmosphere in group C.Cardiomyocytes were collected at 24 h of oxygen-glucose restoration.Cell pyroptosis was detected by double flow cytometry AlexaFour488 (caspase-1 FLICA staining) and TMR red (DNA staining) staining.The pyroptosis rate was calculated.The cell survival rate was measured by methyl thiazolyl tetrazolium assay.The content of reactive oxygen species (ROS) in mitochondria was determined by 2',7'-dichlorofluorescin diacetate assay.The mitochondrial membrane potential (MMP) was measured by using JC-I fluorescent probe.The expression of interleukin-1beta (IL-1β) was determined by Western blot.Results Compared with group C,the pyroptosis rate and ROS content were significantly increased,the cell survival rate and MMP were decreased,and the expression of IL-1β was up-regulated in group O (P＜0.05).Compared with group O,the pyroptosis rate and ROS content were significantly decreased,the cell survival rate and MMP were increased,and the expression of IL-1β was down-regulated in group Sev (P＜0.05).Compared with group Sev,the pyroptosis rate and ROS content were significantly increased,the cell survival rate and M MP were decreased,and the expression of IL-1β was up-regulated in group SH (P＜0.05).Compared with group SH,the pyroptosis rate and ROS content were significantly increased,the cell survival rate and MMP were decreased,and the expression of IL-1β was up-regulated in group H O (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning inhibits OGD/R-induced pyroptosis in primary rat cardiomyocytes is probably associated with increasing mito-KATP channel opening.

Objective To investigate the characteristics and related risk factors associated with tuberculosis(TB) in patients with systemic lupus erythematosus (SLE) who received glucocorticoid and immunosuppressive therapy. Methods Among the 452 SLE patients underwent the treatment of glucocorticoid and immunosuppressive agent, the clinical data was reviewed and summarized retrospectively.Results 42 of 452(9.29% ) patients were diagnosed as TB infection. 11 patients (23.81% )had exudative pulmonary tuberculosis and 31 patients(73.81% ) had extra-plumonary TB. Statistics of the 31 patientsshowed that 8 patients( 19.05% ) had hematogenous disseminated pulmonary tuberculosis;6 (14.29%) had tuberculo-meningitis ;2 (4.76%) had thoracic cavity TB; 2 ( 4.76% ) had abdominal cavity TB; 1 ( 2.38% )had crewels ; 1 ( 2.38% ) had bone tuberculosis and 1 (2.38%) had nephronophthisis. The focus of infection was not found in 10 patients. Of all 42 patients with TB infection, 38 cases suffered form lupus nephritis, 40 with hypoalbuminosis, 10 with TB history, 14 had leucocytopenia or hyperglycaemia, respectively. The effect of antiTB therapy started up at least 7 days, or in 4 weeks as longest. 2 patients died of hematogenous disseminated pulmonary tuberculosis. Conclusion Under the treatment of glucocorticoid and immunosuppressive agent ,TB incidence in patients with SLE is obviously higher than that of common people.Extra-pulmonary rib and serious infection are more frequently. It is shown that those who had lupus nephritis or TB history are more susceptible to TB.

Objective To investigate the resting?state functional alteration in posterior cingulate cortex ( PCC) in Type 2 diabetes ( T2DM) patients with cognitive impairment and to determine the relation?ship of rs?fMRI changes with cognitive decline. Methods Resting?state functional magnetic resonance ima?ging was performed T2DM patients with impaired cognition ( n=19) and healthy control subjects ( n=20) . The amplitude of low frequency fluctuations ( ALFF) and regional homogeneity ( ReHo) values were calcu?lated in left PCC to represent the spontaneous brain activity. Using left PCC as a seed region,the functional connectivity of the whole brain was mapped. In addition,correlation analysis was conducted among ALFF,Re?Ho,and neuropsychological test scores. Results The ALFF values of left PCC (0.72±0.37) was decreased compared with the control group(1.09±0.46),but the ReHo value(1.12±0.10)was not significantly changed compared with control group (1.14±0.11). The functional connectivity was decreased with the left medial temporal lobe,left superior and middle temporal gyrus,right superior frontal gyrus,and right supplementary motor area ( SMA) ,while it was increased with the left middle frontal gyrus,inferior frontal gyrus and right cerebella. MoCA scores were positively correlated with the ALFF values of left PCC. Conclusion In resting state,the spontaneous activity and functional connectivity of PCC is altered in T2DM patients with cognitive impairement;and the function of PCC contributes to the cognitive decline associated with T2DM.The decrease of ALFF value of PCC may help to detect the cognitive decline of T2DM.

Objective To evaluate the association between hypersensitive C reactive protein (hs-CRP) and the incidence of acute kidney injury in subarachnoid hemorrhage(SAH) patients.Methods It retrospectively recruited 213 cases of computerized tomography validated SAH patients from the neurology ICU from Beijing Tiantan Hospital between January 2012 and January 2015.The average age was (56.29±11.95) years old,and the patients were divided into AKI and non-AKI groups according to Kidney Disease: Improving Global Outcomes (KDIGO) diagnosis standards, Clinical features of AKI and Non-AKI patients including serum levels of hs-CRP were compared and multi-logistic regression was applied to find the risk factors concerning with the incidence of AKI.Receiver operating characteristics (ROC) curve was also plotted to evaluate the diagnostic value of hs-CRP towards the incidence of AKI.Results A total of 25 (11.74%) patients developed AKI.Average age of the SAH patients in both AKI and non-AKI groups were (63.60±12.21) years old vs.(55.31±11.60) years old(t=-3.33, P<0.05).The ratios of diabetics were were 28.00% vs.11.17% (χ2=5.47,P<0.05) and the ratio of proteinuria were 80.00% vs.34.57%, respectively (χ2=3.83, P<0.05).The median of serum creatinie were 63.72(51.45, 79.72)μmol/L vs.53.21(45.27, 65.62)μmol/L (P<0.05), and serum hs-CRP were (14.12±5.03)mg/L vs.(10.23±6.76)mg/L (P<0.05), and the ratios of antibiotics application were 84.00% vs.43.08% (P<0.05 for all).Multi-logistic regression analysis showed that serum hs-CRP was an independent risk factors for AKI after age, serum creatinine at admission were adjusted.[OR (95% CI) was 3.33(1.13, 9.85),P<0.05 for all].The area under curve of ROC was 0.69 (P<0.05), and the cut-off point of serum hs-CRP under the maximum Youden index was 13.85 mg/L.Conclusion Serum hs-CRP is an independent risk factor of theincidence of AKI in SAH patients, the significantly increase of serum hs-CRP might be an important predictor of the incidence of AKI in SAH patients.

OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.

Purpose To investigate the diagnostic utility of the immunohistochemical markers SALL4, D2-40 and Glypican-3 in prima-ry testicular germ cell tumors (TGCTs). Methods The expression of SALL4, D2-40 and Glypican-3 protein was detected by EnVi-sion immunohistochemical method in 56 cases of primary testicular germ cell tumors, including 5 intratubular germ cell neoplasms ( IT-GCNs) , 10 seminomas, 14 embryonal carcinomas ( ECs) , 14 yolk sac tumors ( YSTs) , 1 choriocarcinoma, 5 immature teratomas and 12 mature teratomas. 10 normal testicular tissues and 5 lymphomas were selected as control. Results All of ITGCNs, seminomas, YSTs and ECs were diffusely strongly positive for SALL4. Focal SALL4 staining was seen in choriocarcinoma, 3 of 5 immature terato-mas and 3 of 12 mature teratomas. All of ITGCNs, seminomas showed diffusely strong D2-40 staining. ECs (4/14) were focally posi-tive for D2-40, while choriocarcinoma, YSTs and teratomas were negative for D2-40. Glypican-3 was diffusely positive in YSTs (13/14), and focally weakly positive in ECs (2/14), respectively. ITGCNs, seminomas, choriocarcinoma and teratoma were negative for Glypican-3. In contrast, 10 normal testicular tissues and 5 lymphomas showed no SALL4, D2-40 and Glypican-3 staining. Conclu-sions SALL4 is a useful diagnostic marker with high sensitivity and specificity for TGCTs. Combination of SALL4, D2-40 and Glypi-can-3 is helpful to the diagnosis and differential diagnosis for TGCTs.

Objective To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in inhibition of oxygen-glucose deprivation and restoration (OGD/R)-induced apoptosis in rat cortical neurons by sevoflurane and the relationship with mitochondrial permeability transition pore (mPTP).Methods The rat cortical neurons were cultured in vitro and seeded in 6-well or 12-well culture plates.The neurons were randomly divided into 4 groups (n =18 each) using a random number table:control group (group C);OGD/R group (group O);sevoflurane group (group OS);sevoflurane + ERK1/2 inhibitor PD98059 group (group OSP).The neurons were subjected to O2-glucose deprivation for 90 min followed by restoration of O2-glucose supply for 24 h in group O.The neurons were incubated with 2％ sevoflurane for 2 h after OGD/R in group OS.OGD/R was performed at 1 h after ERK1/2 inhibitor PD98059 30 μmol/L was added,and the neurons were incubated with 2％ sevoflurane for 2 h after OGD/R in group OSP.At 24 h of restoration of O2-glucose supply,the expression of phosphorylated ERK1/2 (p-ERK1/2) in neurons was measured by Western blot,the neuronal apoptosis was detected using Annexin V-FITC/PI double staining combined with flow cytometry,and the opening of mPTP was determined through measuring the optical density at 540 nm.The apoptosis rate was calculated.Results Compared with group C,the expression of p-ERK1/2 in neurons was significantly up-regulated,and the apoptosis rate and mPTP opening were significantly increased in group O (P＜0.05).Compared with group O,the expression of p-ERK1/2 in neurons was significantly up-regulated,and the apoptosis rate and mPTP opening were significantly decreased in group OS (P＜0.05).Compared with group OS,the expression of p-ERK1/2 in neurons was significantly down-regulated,and the apoptosis rate and mPTP opening were significantly increased in group OSP (P＜0.05).Conclusion The mechanism by which sevoflurane inhibits OGD/R-induced apoptosis in rat cortical neurons is related to inhibition of mPTP opening after activation of ERK signaling pathway.