C1q /TNF-related proteins (CTRPs)belong to the same category of C1q /TNF-related protein family,mainly secreted by adipose tissue and widely expressed in human and rodent.Their function turned out to be metabolic modulation,cardiovascular system protection and suppression of inflammation.But for metabolic modulation,enhancing the synthesis of glycogen,promoting fatty acid uptake and oxidation,in-creasing insulin sensitivity is the major role of CTRPs playing in governing the metabolism.Each CTRP has its own unique tissue expression profile and nonredundant function in regulating sugar and /or fat metabo-lism.In this review we focus on the recent progress about the metabolic function of CTRPs.

Objective To observe the effect of light emitting diode (LED) red light irradiation on serum lipid in experimental hyperlipidemia rats. Methods 36 healthy male Sprague-Dawley rats were randomly divided into normal control group (n=12) and hyperlipidemic model group (n=24). The normal group was fed with normal diet while the hyperlipidemic model group with fat-rich forage for 6 weeks. The hyperlipidemic model group rats were randomly divided into the hyperlipidemic control group (n=12) and LED treatment group (n=12), and the latter accepted LED red light irradiation for 28 d. The levels of serum lipid including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), and the activities of lipoproteinesterase (LPL) and hepatic lipase (HL) were detected with biochemical assay. The expression of 3-hydroxy-3-methylglutaryl coenzyme A reducase (HMG-CR) of hepatic tissue were measured with immunohistochemical staining. Results Compared with the hyperlipidemic control group, the levels of serum TC, TG and LDL-C decreased while the serum HDL-C increased significantly in the LED treatment group (P<0.01) after treated with LED. The levels of LPL and HL in serum increased (P<0.01) while the activity of HMG-CR decreased (P<0.05). Conclusion LED red light irradiation might play a regulating effect on serum lipid by enhancing the activities of LPL and HL and inhibiting the expression of HMG-CR to interfere the metabolism of TC, TG, LDL-C and HDL-C.

Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting (PONV) in patients undergoing thyroidectomy.Methods One hundred patients (39 males and 61 females,ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal-antiemetic therapy group (group M).Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M,which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P<0.05).The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P<0.05).Conclusion The multimodal-antiemetic therapy: prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.

Objective To evaluate the role of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in mild head hypothermia-induced reduction of global cerebral ischemiareperfusion (I/R) injury in rats.Methods Sixty male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 5 groups (n=12 each) using a random number table:sham operation group (group S),group I/R,mild hypothermia + I/R group (group H),mild hypothermia + I/R + solvent control group (group DM),and mild hypothermia + I/R + PI3K inhibitor LY294002 group (group LY).Global cerebral I/R was induced by modified four-vessel occlusion method described by Pulsinelli.In H group,when the hippocampal temperature was decreased to 33℃ using nasopharyngeal cooling,the bilateral common carotid arteries were occluded for 15 min followed by reperfusion,and hippocampal hypothermia was maintained at 32.5-33.5 ℃ for 1 h.In DM and LY groups,DMSO and LY294002 5 μl were injected into the left ventricle,respectively,and 20 min later the other procedures were similar to those previously described in group H.At 8 h of reperfusion,6 rats were sacrificed,and hippocampal specimens were obtained to detect the expression of pFoxO3a,Bcl-2 and Bax (by immuno-histochemistry).The expression of phosphor-Akt (p-Akt) was determined by Western blot.Results Compared with group S,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated in I/R,H and DM groups,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/Bax was increased in H and DM groups,and the ratio of Bcl-2/Bax was decreased in I/R and LY groups.Compared with group I/R,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/ Bax was increased in H and DM groups.Compared with H and DM groups,the expression of p-Akt,pFoxO3a and Bcl-2 was down-regulated,the expression of Bax was up-regulated,and the ratio of Bcl-2/ Bax was decreased in group LY.Conclusion PI3K/Akt signaling pathway is involved in reduction of global cerebral I/R injury by mild head hypothermia in rats.

To relationship between ambulatory 24h blood pressure parameters and left ventricular hyper‐trophy in patients with essential hypertension .Methods :A total of 106 EH patients (EH group) and 50 healthy vol‐unteers (healthy control group) were selected from our hospital ,and all subjects received 24h ambulatory blood pres‐sure monitoring .According to clinical condition ,EH patients were divided into stage I group (n＝43) ,stage II and III group (n＝63) ;according to left ventricular mass index (LVMI) ,they were divided into no left ventricular hy‐pertrophy (NLVH) group (n＝ 56 ) and LVH group (n＝ 50 ) ,blood pressure load and blood pressure variability (BPV) indexes were compared among above groups .Results : Compared with stage I group ,there were significant rise in percentages of 24hSBP load ≥ 25% (20. 93% vs.77.78%) , 24h mean SBP (24hmSBP )≥ 130mmHg (30.23% vs.73.02%) and 24hSBP standard deviation (24hSSD)≥11.9 (16. 27% vs.82. 54%) in stage II and III group , P＝0. 001 all.Compared with healthy control group ,there were significant rise in daytime mean DBP (dm‐DBP) ,nighttime mean DBP (nmDBP) ,24hSBP load ,24hDBP load and nighttime SBP (nSBP) load in NLVH group and LVH group , P＜0.05 or ＜0.01 ;compared with NLVH group ,there were significant rise in 24hmSBP ,night‐time mean SBP (nmSBP) ,daytime SBP (dSBP) load ,24hSSD and daytime SBP standard deviation (dSSD) in LVH group , P＜ 0.05 or ＜ 0.01 ; compared with stage I group , there were significant rise in 24hmSBP , nmSBP , 24hSBPload ,nSBP load ,24hSSD ,dSSD and nighttime SBP standard deviation (nSSD) in stage II and III group , P＜0.05 or ＜0.01. Conclusion : The 24h blood pressure parameters is closely associated with left ventricular hyper‐trophy in patients with essential hypertension .Reducing 24h ambulatory blood pressure load and variability can re‐duce risk of left ventricular hypertrophy .

Since the approval of gemtuzumab ozogamicin, an antibody–drug conjugate (ADC) targeting CD33 in 2000, 13 ADC drugs have been approved by the FDA. Although these drugs have clearly improved the survival of patients with various types of advanced cancers, their significant toxicity has compromised their therapeutic benefits. The adverse reactions of ADC drugs are complex and include on-target and off-target toxicities, where the payload drug is a determining factor. Antibody and linker may also affect the degree of toxicity. Combination therapy becomes an important strategy in anticancer treatment because of its increased efficiency, but treatment-related adverse reactions also increase accordingly. This review comprehensively analyzes the toxicity mechanisms of current ADC drugs and proposes various optimization strategies, including but not limited to optimizing linker molecules, upgrading antibody design, and changing drug administration strategies, to improve the overall safety profile of ADC drugs.

Objective Toinvestigatethevalueof3.0T MRreducedfield-of-view (rFOV)IVIM-DWIondistinguishingprostate cancerandprostatehypertrophy.Methods 30patientswithpathologicallyprovenprostatecancerand38patientswithprostatehypertrophy accordingtotheresultsofbiopsywereanalyzedretrospectively,whounderwent3.0T MRrFOV multipleb-valueDWIscanpreoperatively.The DWIscanwasperformedusing11b-valuesof0,30,50,100,150,200,400,800,1000,1500and2000s/mm2.ADC,slowdiffusion coefficient(D),fastdiffusioncoefficient(D?)andperfusionfraction(f)weremeasuredoncancerousfociandprostatehyperplasiafoci.Allofthe datawereanalyzed.Results TheADC,D,D?andfvaluesoftheprostatecancerwere(0.61±0.12)×10-3 mm2/s,(0.41±0.08)×10-3 mm2/s, (88.0±40.3)×10-3mm2/s,289.3%±29.4%,respectively,and(09.0±01.7)×10-3mm2/s,(05.4±01.3)×10-3mm2/s,(46.1±15.3)×10-3 mm2/s, 474.3%±10.85%,respectively,forprostatehypertrophy.Thedifferencesamongthefourparameterswerestatisticallysignificant(P<0.05).The areasofADC,D,D?andfvaluesunderROCcurvestodistinguishbetweenprostatecancerandprostatehypertrophywere09.32,08.27,01.58,0.976, respectively.Conclusion 3.0T MRrFOVIVIM-DWIcanreflectthetruewaterdiffusion motionandperfusionintheprostate,and maycontributetothedifferentialdiagnosisofprostatecancerandbenignprostatehyperplasia.

Objective To investigate the strategy of cardiopulmonary resuscitation (CPR) after lung protective mechanical ventilation in critical children and follow-up study of the survivals 90 d after discharge.Methods Four hundred and eighty-nine cases of respiratory cardiac arrest which occurred for various reasons from January 2011 to June 2016 were analyzed in Pediatric Intensive Care Unit (PICU) in Guiyang Children's Hospital,in which mechanical ventilation was performed after CPR in 251 cases,death,or giving up treatment within 24 h in 83 cases,children surviving ＞ 24 h in 168 cases,118 cases were assigned into small tidal volume ventilation group,and 50 cases into conventional tidal volume ventilation group,and according to the tidal volume to adjust positive end expiratory pressure ventilation (PEEP),and the oxygen partial pressure [pa (O2)] and the oxygen index (OI),the change of the indexes of blood gas analysis,lactic acid clearance,and oxygenation were also observed.To observe the complications of mechanical ventilation,the situation of withdrawing machine as well as the outcome of the children.Follow-up was conducted for 90 d,including continuous respiratory symptoms,lung imaging examination after discharge and lung function,nervous system examination.Results (1) After mechanical ventilation treatment of 48 hours,compared with the levels of fractional inspired oxygen (FiO2) (0.42 ± 0.15 vs.0.43 ± 0.22),pa (O2) (8.25 ± 0.22 vs.8.27 ± 0.68),OI (5.33 ± 2.01 vs.6.59 ± 1.99) and lactic acid clearance(61.05 ± 1.87 vs.60.93 ± 2.71) between the routine tidal volume ventilation group and the lower tidal volume ventilation group,showing that the difference had no statistical significance (t =1.645,1.165,2.302,2.037,all P ＞ 0.05).(2) In small tidal volume group,the incidence of ventilator associated lung injury was significantly lower than that in the conventional tidal volume group,and the difference was statistically significant (x2 =5.873,P ＜ 0.05).(3) Comparing 2 groups of different tidal volume ventilation,the mortality of critical ill children had no statistically significant difference (x2 =1.063,P ＞ 0.05).(4) One hundred and twenty-seven cases of children survived and were discharged,and compared with their discharge,the follow-up of 62 cases after discharge for 30 d,90 d showed that all the children's lung function improved,tidal volume,inspiratory and expiratory time ratio(I/E),volume ratio of peak(VP/VE),time ratio of peak(TP/TE) and breathing rate(RR) were also improved,and there was significant difference (F =43.225,6.108,68.821,78.237,20.361,all P ＜ 0.05).(5) Neurological examination and children's brain function classification rating scale showed that some children had nerve dysfunction.Conclusions Small tidal volume ventilation in reducing the occurrence of ventilator associated lung injury is superior to the conventional tidal volume ventilation.To improve case fatality rate of the children with cardiac arrest resuscitation and oxygenation is not better than the conventional tidal volume group.Dynamic monitoring is helpful to adjust breathing mechanics indexes and parameters and ventilator.Through the follow-up most of the discharged children recovered well,but a few had recurrent respiratory infection and neurological sequelae.

Objective:Anatomical study of the cross-donor flap pedicled with the peroneal artery and the discussion of the effect of clinical application, so as to describe a new method for the repair of large-area soft tissue defects in the foot and ankle.Methods:From June 2016 to August 2019, 12 specimens of adult lower limbs were studied. The popliteal arteries were perfused with perchloroethylene-ethyl acetate-lead oxide and red perchloroethylene-ethyl acetate. The origin, number, outer diameter, course and distribution of perforating branches of the peroneal artery were anatomically observed. The source, distribution and anastomosis of the skin nutrient vessels in the posterolateral area of the calf were also studied. Relationship of the blood supply between the peroneal arteries and veins and the nutritional vessels of the sural nerve were observed. In 9 patients, the peroneal artery and vein were designed as the pedicle of cross-donor flap in the repair of large soft tissue defects of foot and ankle. The patients were entered follow-up through outpatient visits and telephone interviews.Results:Among the 12 adult specimens of lower limbs, there were 65 perforating branches from the peroneal artery, 4-7 branches on each side, with an average of (5.41±1.00) branches. The diameter of the penetrating deep fascia was(1.07±0.36) mm. The perforator branches were mostly distributed in 3 sections of 4.0-11.0 cm, 16.0-21.0 cm and 24.0-27.0 cm away from the lateral malleolus, accounting for 48%, 24% and 17% of the total number of perforators, respectively. The outer diameters of the perforator vessels were (0.92±0.26)(0.56-1.68) mm, (1.32±0.38)(0.60-2.14) mm, and (0.98±0.28)(0.62-1.36) mm. The length of the pedicle of the perforator vessels were (3.91±0.96)(2.15-5.78) cm, (5.34±0.50)(4.01-5.85) cm, and (3.31±1.15)(2.16-5.66) cm. The perforating branches in the 3 sections appeared constantly. The diameter of the vessels was≥0.5 mm with an average length of at(4.19±1.16)(2.15-5.85) cm. The vascular network of the flap in the posterolateral area of the calf was mainly composed of subdermal vascular network and deep fascial vascular network. The deep fascia vascular network in the posterolateral area of the calf had 3 obvious longitudinal chains, including the medial sural neurotrophic vascular chain, the small saphenous vein-sural nerve communicating branch vascular chain and the lateral sural neurotrophic vascular chain, which took the nutrient blood supply from the perforating branches of the peroneal artery also formed a longitudinal and transverse anastomosis between the perforating branches of the peroneal artery. In the clinical trials performed on 9 patients, all soft tissue defects of foot and ankle were repaired. The composite tissue flap survived without infection or necrosis. The follow-up was lasted for 12 months to 3 years. The postoperative function and the donor site appearance were good and the patients walked normally. According to the American Orthopaedic Foot and Ankle Association(AOFAS) foot scoring standard, the function of affected feet were evaluated. Five patients were excellent and 4 were good.Conclusion:The cross-donor flaps pedicled with peroneal arteries and veins has sufficient blood supply and a large area. It provides a method for the repair of large-area soft tissue defects in the foot and ankle.

OBJECTIVEThis study aims to investigate the characteristics and general rules of adverse drug reactions (ADR) in a 3A-grade stomatology hospital for safe and rational drug use in clinical stomatology.

METHODSWe retrospectively analyzed 52 ADR cases (1∶1.36, males∶females) reported in the West China Hospital of Stomatology of Sichuan University from 2014 to 2016 in terms of gender and age distributions, drug categories, and clinical manifestations.

RESULTSEight kinds of drugs and antibiotics were predominately used [24 cases, 46.15% (24/52)], followed by nutrition drugs and antitumor drugs. Cephalosporin was the leading antibiotic drug associated with ADR [20 cases, 83.33% (20/24)]. Intravenous infusion was the most common route of drug administration [49 cases, 94.23% (49/52)]. The most common manifestations of the ADR were damages of the skin and its appendages and lesions of the digestive and nervous systems.

CONCLUSIONSStrengthening the ADR monitoring system and further management should be implemented to alleviate ADR in stomatology hospitals.