Objective To evaluate the effect of oxycodone pretreatment on autophagy during renal ischemia-reperfusion (I/R) in rats.Methods Thirty-six SPF healthy adult male Wistar rats,aged 6-9 weeks,weighing 180-220 g,were divided into 3 groups (n=12 each) using a random number table:sham operation group (Sham group),I/R group and oxycodone pretreatment group (Oxy group).The left renal pedicles were clamped with atraumatic microclips for 45 min followed by reperfusion to establish the model of renal I/R injury in I/R and Oxy groups.Oxycodone 0.5 mg/kg was injected via the caudal vein at 15 min before ischemia in group Oxy,and the equal volume of normal saline was given instead in I/R and Sham groups.At 24 h of reperfusion,blood samples were collected from hearts for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations.The animals were then sacrificed and left renal tissues were obtained for examination of pathological changes (with a light microscope) and for determination of Bcl-2 and Beclin-1 expression (by immunohistochemistry).Results Compared with Sham group,the concentrations of serum Cr and BUN were significantly increased,and the expression of Bcl-2 and Beclin-1 in renal tissues was up-regulated at 24 h of reperfusion in I/R and Oxy groups (P<0.05).Compared with I/R group,the concentrations of serum Cr and BUN were significantly decreased,the expression of Bcl-2 in renal tissues was up-regulated,and the expression of Beclin-1 in renal tissues was down-regulated at 24 h of reperfusion (P<0.05),and the pathological changes were significantly attenuated in Oxy group.Conclusion Oxycodone pretreatment inhibits autophagy through up-regulating the expression of Bcl-2 and down-regulating the expression of Beclin-1,thus attenuating renal I/R injury in rats.

Objective To evaluate the effect of sufentanil postconditioning on renal ischemia-reperfusion (I/R) injury in rats and the relationship with autophagy.Methods Thirty pathogen-free healthy adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were divided into 3 groups (n=10 each)using a random nunber table:sham operation group (group S),group I/R and sufentanil postconditioning group (group SP).The left renal pedicle was clamped for 45 mnin with an atraumatic vascular clamp followed by reperfusion,and the right kidney was removed immediately after onset of reperfusion in anesthetized rats to establish the model of renal I/R injury in I/R and SP groups.In group S,the left renal pedicle was only isolated,and the right kidney was removed.Sufentanil 1 μg/kg was injected via the tail vein at 5 min before reperfusion in group SP,while the equal volume of normal saline was given instead in S and I/R groups.At 24 h of reperfusion,blood samples were collected by cardiac puncture for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations.The animnals were then sacrificed,and the left renal specimens were obtained for examination of pathological changes (with light microscopes) and for determination of the expression of microtubule-associated protein 1 light chain 3 (LC3) and Beclin-1 in renal tissues (by immuno-histochemistry).Results Conpared with group S,the serum Cr and BUN concentrations were significantly increased,and the expression of LC3 and Beclin-1 in renal tissues was up-regulated (P＜0.05),and the pathological changes of kidneys were aggravated in I/R and SP groups.Compared with group I/R,the serum Cr and BUN concentrations were significantly decreased,the expression of LC3 and Beclin-1 in renal tissues was down-regulated (P＜0.05),and the pathological changes of kidneys were significantly attenuated in group SP.Conclusion Sufentanil postconditioning can attenuate renal I/R injury,and the mechanism may be related to inhibition of autophagy in rats.

Objective To analyse the effect of antivirus treatment on the survival time of chronic severe hepatitis B retrospectively.Methods one hundred and twenty-one patients with chronic severe hepatitis B and positive HBV DNA were divided into 3 groups:42 patients in entecavir(ETV)group,34 patients in lamivudine(LVD)group and 45 patients in control group.The primary data were recorded and followed.The survival curve was described using Kaolain-Maier method.The comparison of survival rate among groups was done using Logrank test.Results The baseline characteristics were well balanced among 3 groups.When the follow-up ended,the mean survival time of ETV group,LVD group and control group was(49.4±5.8)weeks,(51.6±6.7)weeks,(32.8±5.7)weeks;the total survival rate was 0.567,0.557,0.318 respectively,there was a statistical difference between ETV group and control grouP(χ2=5.742,P<0.05),or between LVD group and control group (χ2=5.472,P<0.05).There was not statistical difference between ETV group and LVD group in the week of 2,4,8,12,24,48.Conclusion ETV and LVD can improve the survival rate of chronic severe heoatitis B,and ETV iS not different from LVD.

Objective To systematically compare the combined spinal-epidural block versus epidural block for labor analgesia.Methods PubMed,Embase,Cochrane Library and Web of Science were searched for randomized controlled trials involving the comparison of combined spinal-epidural block versus epidural block for labor analgesia from the date of database establishment up to September 2016.Evaluation indexes included visual analog scale scores (at 5,10 and 15 min after analgesia),onset time of analgesia,duration of analgesia,duration of the second stage of labor,cesarean section and assisted vaginal delivery,development of Apgar scores of the neonates＜7 (at 1 and 5 min after birth) and occurrence of adverse reactions.The quality of the trials was evaluated according to Cochrane Handbook 5.1.0 criteria,and meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results Twenty studies involving 6 297 patients were included in this meta-analysis.Compared with group epidural block,visual analog scale scores were significantly decreased at 5,10 and 15 min after analgesia,the onset time of analgesia was shortened,and the incidence of pruritus and hypotension was increased in group combined spinalepidural block (P＜0.05).Conclusion Compared with epidural block,although the combined spinalepidural block has faster onset,the adverse effects are more when used for labor analgesia.

Objective To evaluate the effect of oxycodone pretreatment on cell apoptosis during renal ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy male Wistar rats,weighing 180-220 g,aged 6-9 weeks,were divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),renal I/R group (group I/R) and oxycodone pretreatment group (group O).The left renal pedicles were clamped with atraumatic microclips for 45 min followed by reperfusion,and the right kidney was removed immediately after onset of reperfusion to establish the model of renal I/R injury in I/R and O groups.At 10 min before ischemia,oxycodone 0.5 mg/kg was injected via the tail vein in group O,while the equal volume of normal saline was given via the tail vein instead of oxycodone in I/R and S groups.Blood samples were collected by cardiac puncture at 24 h of reperfusion for measurement of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The animals were then sacrificed,and the left renal specimens were obtained for examination of the pathological changes (with a light microscope) and for determination of the expression of Bcl-2,Bax and caspase-3 in renal tissues (by immunohistochemistry).Bcl-2/Bax ratio was calculated.Results Compared with group S,the serum Cr and BUN concentrations were significantly increased,the expression of Bcl-2,Bax and caspase-3 in renal tissues was up-regulated,and the Bcl-2/Bax ratio was decreased in I/R and O groups (P＜0.05).Compared with group I/R,the serum Cr and BUN concentrations were significantly decreased,the expression of Bcl-2 in renal tissues was up-regulated,the expression of Bax and caspase-3 in renal tissues was down-regulated,the Bcl-2/Bax ratio was increased (P＜0.05),and the pathological changes were significantly attenuated in group O.Conclusion The mechanism by which oxycodone pretreatment reduces renal I/R injury may be related to inhibition of cell apoptosis in rats.

Renal ischemia-reperfusion injury (RIRI) is the main cause of acute kidney injury (AKI), which commonly occurs in surgery, severe trauma, shock and drug-induced kidney injury. At present, effective treatment for RIRI is still lacking. Oxidative stress is the major pathological injury mechanism of RIRI. Nuclear factor E2-related factor 2 (Nrf2) is the key transcription factor of anti-oxidative stress response, which may activate various cytoprotective genes related to redox and detoxification. Recent studies have shown that Nrf2 may play a protective role in the protection and treatment of RIRI by regulating oxidative stress, inflammation, cell apoptosis and autophagy, etc. Consequently, the structure and biological function of Nrf2, related signaling pathways, its role in the incidence and development of RIRI and potential mechanism were reviewed in this article, aiming to provide novel ideas for the prevention and treatment of RIRI.

Objective To evaluate ultrasound assisted virtual MRI guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) adjacent to gastrointestinal tract with artificial ascites.Methods A total of 33 HCC lesions in 32 patients adjacent to gastrointestinal tract in our hospital were collected.After the establishment of artificial ascites,they were treated with radiofrequency ablation guided by ultrasound-guiding fusion and virtual MRI navigation.The curative effect and complication rate were compared with the control group (non-hollow GI tract abutting HCC lesions).Results All 33 lesions were completely ablated without residual.After 1 month and 3 months follow-up,the reexamination of contrast-enhanced ultrasound and MRI showed no activity and no new lesions.All cases had no serious complications such as gastrointestinal injury.There were no statistically significant differences in tumor complete inactivation rate,complication rate and recurrence rate between the two groups.Conclusion Ultrasound-guiding fusion and virtual MRI guided radiofrequency ablation with artificial ascites is safe and effective in the treatment of liver cancer adjacent to gastrointestinal tract.

Objective To analyze the core genes of lung ischemia-reperfusion injury and construct a competitive endogenous RNA (ceRNA) network. Methods Original data of GSE145989 were downloaded from the Gene Expression Omnibus (GEO) database as the training set, and the GSE172222 and GSE9634 datasets were used as the validation sets, and the differentially-expressed genes (DEG) were identified. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. Protein-protein interaction (PPI) network was constructed, and the core genes were screened, and the diagnostic values of these core genes and the immune infiltration levels of immune cells were evaluated. The ceRNA network was constructed and validated. The targeted drugs based on ceRNA network were assessed. Results A total of 179 DEG were identified, including 61 down-regulated and 118 up-regulated genes. GO analysis showed that DEGs were associated with multiple biological processes, such as cell migration, differentiation and regulation, etc. They were correlated with cell components, such as vesicle membrane, serosa and membrane raft, etc. They were also associated with multiple molecular functions, such as chemokine receptor, G protein-coupled receptor, immune receptor activity and antigen binding, etc. KEGG pathway enrichment analysis revealed that DEG were involved in tumor necrosis factor (TNF), Wnt, interleukin (IL)-17 and nuclear factor (NF)-κB signaling pathways, etc. PPI network suggested that CD8A, IL2RG, STAT1, CD3G and SYK were the core genes of lung ischemia-reperfusion injury. The ceRNA network prompted that miR-146a-3p, miR-28-5p and miR-593-3p were related to the expression level of CD3G. The miR-149-3p, miR-342-5p, miR-873-5p and miR-491-5p were correlated with the expression level of IL-2RG. The miR-194-3p, miR-512-3p, miR-377-3p and miR-590-3p were associated with the expression level of SYK. The miR-590-3p and miR-875-3p were related to the expression level of CD8A. The miR-143-5p, miR-1231, miR-590-3p and miR-875-3p were associated with the expression level of STAT1. There were 13 targeted drugs for CD3G, 4 targeted drugs for IL-2RG, 28 targeted drugs for SYK and 3 targeted drugs for lncRNA MUC2. No targeted drugs were identified for CD8A, STAT1 and other ceRNA network genes. Conclusions CD8A, IL2RG, STAT1, CD3G and SYK are the core genes of lung ischemia-reperfusion injury. The research and analysis of these core genes probably contribute to the diagnosis of lung ischemia-reperfusion injury and providing novel research ideas and therapeutic targets.