Objective To evaluate the role of the mitochondrial ATP-sensitive potassium (mitoKATP) channel in reduction of myocardial ischemia-reperfusion (I/R) injury by calcitonin gene-related peptide (CGRP) in rats in an in vitro experiment.Methods Healthy adult male Sprague-Dawley rats,weighing 250-300 g,were used in this study.After the animals were anesthetized,their hearts were immediately removed and retrogradely perfused with oxygenated K-H solution at 37 ℃ in a Langendorff apparatus.Twenty-four isolated rat hearts were assigned into 4 groups (n =6 each) using a random number table:control group (C group),I/R group,CGRP group and 5-hydroxydecanoate (5-HD) group.The hearts were first perfused with K-H solution for 30 min in the three groups.The hearts were continuously perfused with K-H solution for 150 min in group C.The hearts were subjected to ischemia for 30 min followed by 120 min of reperfusion to establish the model of myocardial I/R injury.In group CGRP,after the hearts were perfused with K-H solution for 10 min,10-8 mol/L CGRP was infused for 20 min at a rate of 0.5 ml/min via the aorta,and then the model of myocardial I/R injury was established.In 5-HD group,specific mito-KATP channel blocker 5-HD 100 μmol/L was infused for 10 min at a rate of 0.5 ml/nin via the aorta,and the other treatments were similar to those previously described in CGRP group.At the end of equilibration and 30,60,90 and 120 min of reperfusion,heart rate (HR),left ventricular systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP) and the maximum rate of increase or decrease in left ventricular pressure (±dp/dtmax) were recorded.The myocardial infarct size was measured by 2,3,5-triphenyltetrazolium chloride staining at 120 min of reperfusion.Results Compared with C group,HR,LVSP and ±dp/dtmax were significantly decreased and LVEDP was increased during reperfusion,and the percentage of myocardial infarct size was increased at 120 min of reperfusion in the other three groups (P＜0.05).Compared with I/R group,HR,LVSP and ±dp/dtmax were significantly increased and LVEDP was decreased during reperfusion,and the percentage of nyocardial infarct size was decreased at 120 min of reperfusion in CGRP group (P＜0.05).Compared with CGRP group,HR,LVSP and ±dp/dtmax were significantly decreased and LVEDP was increased during reperfusion,and the percentage of myocardial infarct size was increased at 120 min of reperfusion in 5-HD group (P＜0.05).Conclusion Opening of mito-KATP channels is involved in CGRP-iuduced reduction of myocardial I/R injury in rats in an in vitro experiment.

Objective To investigate the outcomes of arthroscopic reduction and internal fixation with cannulate lag screw for avulsion fracture of tibial intercondylar anterior eminence.Methods From May 2004 to December 2007,30 cases of tibial intercondylar anterior eminence avulsion fracture were treated by arthroscopic reduction and fixation with cannulated lag screw.Among the patients,there were 10 females and 20 males,ranging from 15 to 79 years old with an average age of 32.0.There were 12 fresh fractures and 18 old fractures.According to Meyers-McKeever-Zaricnyl's classification systems,there were 8 cases of type Ⅱ,15 cases of type Ⅲ,and 7 cases of type Ⅳ.Patients were encouraged to do postoperative rehabilitation,such as active joint extension and flexion,exercise of isometric contraction of quadriceps femoris.The treatment outcomes were evaluated by Lysholm and Irrgang knee score system.Results All patients were followed up for 3 months to 60 months(averaging 31.2 months).X rays revealed bony healing 2 months after operation.The joints were stable.Negative Lachaman and drawer and jerk tests were found in all cases,and there was no dysfunction in the knee joints.Lysholm scores were increased from(60.8?1.5)to(95.5?3.5)while Irrgang scores increased from(55.5?3.3)to(90.5?2.5).Conclusion Arthroscopic treatment of avulsion fracture of tibial intercondylar anterior eminence is an easy approach with minimal invasion,and has reliable reduction and fixation with satisfied results.

Objective:To investigate mechanisms underlying the signal crosstalk of VEGF-IL-6-STAT3 between cutaneous melanoma cells and vascular endothelial cells.Methods:EC-304 vascular endothelial cells were divided into 3 groups: control group cultured in conventional endothelial cell-conditioned medium, vascular endothelial growth factor (VEGF) group cultured in endothelial cell-conditioned medium containing 50 μg/L VEGF 165, A375 co-culture group co-cultured with a melanoma cell line A375. After 24-, 48- and 72-hour treatment, the culture medium was collected, and enzyme-linked immunosorbent assay was performed to detect the level of interleukin-6 (IL-6) . Cultured A375 cells were divided into 4 groups: control group receiving conventional culture in Dulbecco′s modified Eagle′s medium (DMEM) , A375+ EC-304 group co-cultured with EC-304 cells, A375+ EC-304+ IL-6 group co-cultured with EC-304 cells in DMEM containing 50 μg/L IL-6 (an agonist of the signal transducer and activator of transcription-3 [STAT3] pathway) , A375+ EC-304+ JSI-124 group co-cultured with EC-304 cells in DMEM containing 1 μmol/L JSI-124 (a STAT3 pathway inhibitor) . After 24-, 48- and 72-hour treatment, cells were collected, and Western blot analysis, cell counting kit-8 (CCK8) assay and Transwell invasion assay were performed to determine the protein expression of STAT3 and phosphorylated (p) -STAT3, cellular proliferative activity and invasive activity, respectively. Two-way analysis of variance and t test were used for statistical analysis. Results:The level of IL-6 significantly increased in the culture medium of EC-304 cells in the VEGF group and A375 co-culture group compared with the control group ( FVEGF = 29.63, P < 0.001; FA375 = 11.09, P = 0.020) . Compared with the control group, the A375+ EC-304 group showed significantly enhanced protein expression of p-STAT3 in A375 cells ( P < 0.001) , increased cell activity ( P < 0.001) , and increased number of invasive cells (152.66 ± 16.04 vs. 86.13 ± 7.24, t= 4.43, P < 0.001) ; compared with the A375+ EC-304 group, the A375+ EC-304+ IL-6 group showed significantly increased protein expression of p-STAT3 ( P < 0.001) , enhanced cell activity ( P < 0.001) , and increased number of invasive cells (187.34 ± 14.38, t= 2.17, P < 0.001) ; compared with the A375+ EC-304 group, the A375+ EC-304+ JSI-124 group showed significantly decreased protein expression of p-STAT3 ( P < 0.001) , decreased cell activity ( P < 0.001) , and decreased number of invasive cells (124.92 ± 8.72, t=-1.86, P < 0.001) . Conclusion:There is a signal crosstalk of VEGF-IL-6-STAT3 between cutaneous melanoma cells and vascular endothelial cells, which may play an important role in the proliferation and invasion of A375 cells.

Objective To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in a new operative position, flank suspended supine position. Methods The new position hold affected flank suspended by raising the ipsilateral shoulder and haunch with two 3-liter saline bags, and set up waist bridge simultaneously. From March 2010 to October 2010, a series of 173 patients underwent PCNL with the new supine position under epidural anesthesia. The average age was (50± 11) years, and the average bulk of the stone was (2. 9±1.0) cm. All patients were placed in the new supine position. Under ultrasound guidance, the desired calix or pelvis was punctured near the posterior axillary line, then dilating the tract and establishing the 16 F or 20 F tract for PCNL. Results The pelvicaliceal system could be successfully approached in all patients. The procedure was well tolerated in all patients. Mean operation time was (86 ± 34) min. 80. 3% of the patients were rendered free of stones by the initial PCNL. Thirty-four cases had residual stones, and a second PCNL was performed in 16 cases to clear the residual stones. Only 1 patient required blood transfusion.None of the patients suffered visceral injury. Conclusion The new supine position is safe and effective for PCNL.

AIM To observe the effects of Huangdi Anxiao Capsules (Puerariae lobatae Radix,Eriobotryae Folium,Notoginseng Radix et Rhizoma,etc.) on blood glucose and insulin resistance in GK rats with type 2 diabetes mellitus (T2DM) and its possible mechanism of action.METHODS GK rats with T2DM included in the experiment were randomly divided into model group,rosiglitazone (1.44 mg/kg) group,Shenqi Jiangtang Granules (1.08 g/kg) group,Huangdi Anxiao Capsules high,medium and low (12,6,3 g/kg) group and normal control group of Wistar rats.After six weeks of consecutive administration,fasting blood glucose (FBG),serum insulin (FINS),fasting plasma glucose (FPG),and insulin resistance index (HOMA-IR) were measured in all groups.Serum biochemical indexes of (TG,TC,HDL-C,LDL-C),glycosylated hemoglobin (HbA1c),glucagon-like peptide (GLP-1) and insulin-like growth factor (IGF-1) were measured.The pancreatic tissue was obtained by routine paraffin embedding and HE staining to observe the pathological changes.RESULTS Compared with the normal group,FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1c of the model group were significantly higher (P ＜0.01),and GLP-1 and IGF-1 expressions were markedly decreased (P ＜ 0.01).Compared with the model group,the levels of FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1 c in Huangdi Anxiao Capsules high-,medium-and low-dose group were significantly decreased (P ＜ 0.05,P ＜0.01);GLP-1 and IGF-1 expressions were markedly increased (P ＜0.05,P ＜0.01),compared with the model group,the structure changes of pancreatic tissue in Huangdi Anxiao Capsules high-,medium-and low-dose groups largely reduced.CONCLUSION Huangdi Anxiao Capsules can reduce GK rats fasting blood glucose,insulin resistance,and its mechanism may be related to promoting the emergence and proliferation of pancreatic islet cells,improving the function of islet beta cells,and increasing insulin secretion.

Objective To analysis the clinical pathway management efficiency under different DRG groups, for a basis for further optimizing clinical pathway management. Methods The retrospective analysis method was used to compare the average length of stay, sub-average costs, and drug proportions of patients with different DRGs in the same clinical pathway. Shapiro-Wilk was used to detect the normality of the samples, t test was used to analyze measurement data conformed to the normal distribution, non-parametric test was used to analyze the abnormal distribution data, and enumeration data was detected by using chi-square test. Results For patients with a clinical pathway of bronchial pneumonia, patients with severe complications and concomitant symptoms had no significant difference in mean hospitalization and sub-costs, regardless of whether they completed or entered the clinical pathway ( P >0.05). For the other two DRG patients, the difference between the average length of stay, sub-average costs, and the proportion of medications for patients who completed the clinical pathway and withdrew from or did not complete the clinical pathway was significant(P<0.05). In the severe surgical group, the length of stay and average cost for patients who completed the clinical pathway were lower than those who exited or did not enter the clinical pathway(P<0.05). Conclusions Patients with different severity of DRGs should be cautious when they are enrolled in the clinical pathway.

Objective To analyze the differences in hospitalization days and costs of patients with acute cholecystitis in different departments or diagnosis related groups ( DRGs ), and provide scientific references for clinical medical management. Methods All the medical record homepages of the patients with acute cholecystitis were selected from a tertiary hospital from January 2017 to December 2017. The hospital analysis system of DRGs was used to calculate the classification results of DRGs. The Kruskal-Wallis H test was used to analyze the differences in hospital stays and costs between different DRGs or departments. Results The average length of stay was the shortest and the hospitalization cost in the department of hepatobiliary surgery was lower than other departments among patients with surgery and non-surgical(all P<0.05); The average length of stay at the department of hepatobiliary surgery was lower than the same other DRGs groups, namely the department of digestive medicine and gastrointestinal surgery(all P<0.05). There was no significant difference in the cost of " acute biliary tract disease with complications" between the various departments(P>0.05). The average cost in the department of hepatobiliary surgery was the lowest, and the average cost of gastrointestinal surgery was the highest in two DRGs of " acute biliary disease without complications and concomitant symptoms" and " laparoscopic cholecystectomy without common bile duct exploration" ( all P < 0.05 ). Conclusions Department of hepatobiliary surgery was better than other departments in the treatment of acute cholecystitis. Medical institutions should follow the principle of special treatment to reduce interdisciplinary patients and improve the professional competitiveness of the department.

Objective To explore the clinical application value of MRI fat quantification parameter[verte-bral bone marrow fat fraction(FF)]combined with 25-hydroxyvitamin D[25(OH)D]in predicting fracture risk in patients with osteoporosis.Methods A total of 90 patients with osteoporosis who were admitted to the hospital from January 2023 to April 2024 were selected as the subjects.Among them,50 patients with osteoporotic vertebral com-pression fractures were included in the fracture group,and 40 patients without fractures were included in the control group.All patients underwent the iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL-IQ)method of MRI to measure the FF of each vertebra among L1-5 and the average FF of L1-5.Serum 25(OH)D level was detected by electrochemiluminescence method.FF and serum 25(OH)D levels of the two groups were compared.The correlation of FF,25(OH)D and bone mineral density(BMD)was analyzed.Multi-variate logistic regression analysis was conducted to screen the risk factors for fracture in patients with osteoporosis.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of FF,25(OH)D,and their combination for fracture in patients with osteoporosis.Results Patients in the fracture group were older than those in the control group.BMD and serum 25(OH)D level were lower than those of the control group(P<0.05).The FF of L2 and average FF of L1-5 in the fracture group were higher than those in the control group(P<0.05).Correlation analysis results showed that the FF of L2 and the average FF of L1-5 were negatively correlated with BMD(P<0.05),while serum 25(OH)D level was positively correlated with BMD(P<0.05).Multivariate logistic regression analysis showed that age and FF of L2 were independent risk factors for fracture in patients with osteoporo-sis,while BMD and 25(OH)D were protective factors(P<0.05).ROC curves indicated that the AUC values of FF of L2 and 25(OH)D for predicting fracture were 0.714(95%CI:0.606～0.822)and 0.774(95%CI:0.672～0.876).The AUC of joint prediction was 0.923(95%CI:0.867～0.978),which was significantly larger than that of separate prediction(P<0.05).Conclusions FF of L2 and serum 25(OH)D are related to fracture in patients with osteopo-rosis.Age and BMD are factors influencing the occurrence of fracture in patients with osteoporosis.FF of L2 and 25(OH)D have certain predictive value for fracture risk in patients with osteoporosis,and combined detection of the two can improve predictive efficiency.

Objective:To systematically evaluate the prevalence of malnutrition in elderly patients with diabetes.Methods:A total of eight databases, namely PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and VIP Database, were systematically searched for cross-sectional studies on malnutrition in elderly diabetic patients published from the inception of the databases to September 13, 2023. Two researchers independently conducted literature screening, data extraction, and quality assessment. Data analysis was performed using Stata 16.0 software.Results:A total of 22 studies were included, involving 6 349 elderly diabetic patients. Results of the meta-analysis showed that the overall prevalence of malnutrition in elderly patients with diabetes was 32.3% (95% CI: 0.21 to 0.43), and the prevalence of at-risk of malnutrition was 49.0% (95% CI: 0.31 to 0.67). Subgroup analysis showed that the prevalence of malnutrition in elderly diabetic patients with chronic complications (56.8%) was significantly higher than those without chronic complications (21.9%). Inpatients also showed a higher prevalence compared with outpatients and community (44.4%, 29.0%, and 18.5%, respectively). The prevalence of malnutrition as per mini-nutritional assessment scale was higher than that as per mini-nutritional assessment short-form scale (35.8% vs. 23.3%, P<0.05). There was no significant difference in the prevalence of malnutrition in elderly diabetic patients of different genders ( P>0.05). Conclusions:The prevalence of malnutrition and at-risk of malnutrition in elderly diabetic patients is high. In clinical practice, we should not only strengthen the early diagnosis of malnutrition in patients, but also emphasize the screening of malnutrition risk, implement timely corresponding interventions, and promote patient education on nutrition and health, to improve the prognosis and quality of life in elderly diabetes patients.

Under the current situation of the rapid development of brain-like artificial intelligence and the increasingly complex electromagnetic environment, the most bionic and anti-interference spiking neural network has shown great potential in computing speed, real-time information processing, and spatiotemporal data processing. Spiking neural network is the core part of brain-like artificial intelligence, which realizes brain-like computing by simulating the structure of biological neural network and the way of information transmission. This article first summarizes the advantages and disadvantages of the five models, and analyzes the characteristics of several network topologies. Then, it summarizes the spiking neural network algorithms. The unsupervised learning based on spike timing dependent plasticity (STDP) rules and four types of supervised learning algorithms are analyzed. Finally, the research on brain-like neuromorphic chips at home and abroad are reviewed. This paper aims to provide learning ideas and research directions for new colleagues in the field of spiking neural network.
Algorithms ; Artificial Intelligence ; Brain ; Neural Networks, Computer