It is now clear that both endogenous and exogenous sources of nitric oxide(NO) exert important modulatory effects on cardiac mitochondrial function.There is also growing evidence that NO can be produced within the mitochondria themselves.NO can influence respiratory activity,both through direct effects on the respiratory chain or indirectly via modulation of mitochondrial calcium accumulation.At pathological concentrations,NO causes irreversible alterations in respiratory function and also interacts with reactive oxygen species(ROS) to form reactive nitrogen species(RNS),which may further impair mitochondrial respiration and even lead to open the mitochondrial permeability transition pore and induce cell death.Diabetes,aging,myocardial ischemia,and heart failure are all associated with altered ROS generation,which can alter the delicate regulatory balance of effects of NO in the mitochondria.

Objective To improve the diagnosis and treatment based on the retrospective clinical analysis of 86 patients with leishmaniasis, an endemic disease caused by various species of Leishmania. Methods The data of 86 consecutive patients with visceral leishmaniasis and lymph node leishmaniasis were retrospectively reviewed, including epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and prognosis. Results There were specific endemic zones of leishmaniasis in Sichuan province. The main clinical symptoms and signs in the initial evaluation were: fever (100%), splenomegaly (100%), enlarged lymph nodes with hepatosplenomegaly (58.1%). All patients were treated with sodium pentavalent antimony gluconate (SPAG). About 95.3% (82/86) of the patients were cured, 3.5% (3/86) improved, and 1.2% (1/86) relapsed. Splenotomy was carried out for 2.3% (2/86) of the patients. The misdiagnosis rate was 30.2%.Conclusions Visceral leishmaniasis has no specific manifestations and is easily misdiagnosed. If leishmaniasis is suspected, bone marrow biopsy and smear examination, lymph node biopsy, rk-39 strip test for visceral leishmaniasis pathogen should be done to improve the outcome. SPAG is the first choice for leishmaniasis chemotherapy.

Background Choroidal neovascularization (CNV) of macular zone is one of blinding eye diseases.Conventional treatment methods include photodynamic therapy and intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs.However,there are some adverse effects following these treatments.Researches showed that fiajianzhujing decoction,a Chinese herbal medicine,can inhibit CNV.Objective This study was to investigate the impact of drug serum offiajianzhujing decocation (drug serum) on the proliferation of rat choroidal vascular endothelial cells (RCVECs).Methods Jiajianzhujing decoction (0.525 g/ml) was used by intragastric administration with the dosage 20 ml/kg for 3 days,and the abdominal aortic blood was collected 2 hours after last dosage to prepare the drug serum.Cultured RCVECs were divided into 4 groups.CoCl2 with the concentration of 100 μmol/L (100 μl) was added in the medium to establish the anoxic models in the CoCl2 group,and 20％ drug serum was added in the anoxic culture medium in the drug serum+CoCl2 group.Regular culture medium was used in the blank control group,and 20％ pure serum was added in the anoxic culture medium in the pure serum+CoCl2 group.The cells were incubated for consecutive 24 hours,and the growth of the cells was detected by monotetrazolium (MTT) assay as absorbance (A).The expressions of gene and protein of hypoxia-inducible factor-1 α (HIF-1 α) and VEGF in the cells were detected by reverse transcription PCR and Western blot,respectively.This study was approved by the Ethics Committee of Eye Hospital of China Academy of Chinese Medical Sciences.Results Cultured cells grew well with fusiform shape.Hypoxic cell models were created by adding CoCl2.The mean A values were 0.659± 0.051,0.757±0.553,0.683±0.037 and O.731 ±O.038 in the blank control group,CoCl2 group,drug serum+CoCl2 group and pure serum+CoCl2 group,respectively,and the A value in the CoCl2 group was significantly elevated in comparison with the blank control group and drug serum+CoCl2 group (both at P＜0.O1).The significant differences were found in the relative expressions of HIF-1 α and VEGF among the blank control group,CoCl2 group,drug serum+ CoC12 group and pure serum+CoCl2 group (HIF-1 α:F =3.100,P＜0.05;VEGF mRNA:F =3.420,P＜0.05;HIF-1 α protein:F=470.600,P =0.000;VEGF protein:F =146.700,P =0.000),and the relative expressions of HIF-1α mRNA,VEGF mRNA,HIF-1α protein and VEGF protein in the CoCl2 group were significantly higher than those in the blank control group and drug serum+CoCl2 group (all at P＜0.05).Conclusions Drug serum ofjiajianzhujing decoction can inhibit the growth and proliferation of hypoxic RCVECs by down-regulating the secretion of HIF-1α and VEGF.

Objective To investigate the difference between nodular gastritis and atrophy gastritis.Methods During 2004.4～2005.3, the clinical, endoscopic and pathological findings of nodular gastritis and atrophy gastritis were analysed.Results Nodular gastritis is usually classified as nodular type A(nodular gastritis) and type B(atrophic gastritis with nodular changes). The endoscopic appearance of nodular gastritis was characterized as uniform miliary pattern and predominantly affected young women. The incidence of dyspeptic symptom was higher in patients with nodular gastritis than in atrophy gastritis. Nodular gastritis in adults is caused by Helicobacter pylori infection. Antral biopsy specimens showed lymphoid follicle formation and/or marked lymphoid aggregates. The prevalence of lymphoid follicle formation in the antrum was higher in patients with nodular gastritis than atrophy gastritis. Moderate to severe atrophy gastritis also usually has the same nodular endoscopic appearance,but that is not uniform and intensive.Conclusion Nodular gastritis is a very special gastritis with Helicobacter pylori infection and is different from atrophy gastritis.It is worth to be noticed.

OBJECTIVE:To investigate the effect of the extracts of Polygonum lapathifolium on the activity of ?-glucosidase.METHODS:Soxhlet extraction was applied to extract overground part of P.lapathifolium,and the inhibition effect of extracts on ?-glucosidase was determined with 96-microplate-based method,and the inhibitory kinetic characteristics of methanol extract was investigated using Lineweaver-Burk method.RESULTS:The extracts from P.lapathifolium showed good inhibitory activity.The methanol extract had the highest inhibitory activity (IC50=2.13 ?g?mL-1)followed by ethyl acetate extract (IC50=3.826 ?g?mL-1),petroleum ether extract (IC50=230.86 ?g ? mL-1).And they were all higher than that of acarbose (IC50=1 103.01 ?g?mL-1) as positive control.Inhibitory kinetics test indicated that methanol extract was noncompetitive inhibitor.CONCLUSION:The extracts of P.lapathifolium have good inhibition effect on the activity of ?-glucosidase with a good prospect of development and utilization.

Objective:To identify the risk factors for moderate-to-severe pain in postanesthesia care unit (PACU) in the patients undergoing thoracic surgery.Methods:The medical records of patients of both sexes, aged 18-80 yr, of American Society of Anesthesiologists(ASA) physical status Ⅰ-Ⅲ, transferred to PACU with tracheal intubation from January 2019 to January 2020, were retrospectively collected.Combined intravenous-inhalational anesthesia was used during surgery.The patient′s age, gender, ASA physical status, smoking history, drinking history, history of non-thoracic surgery, history of hypertension, history of diabetes mellitus, and history of immune system disease were collected.The operation method, type of operation, operation time, intraoperative nerve block and use of opioids and dexmedetomidine were also collected.The consumption of rescue analgesics during PACU, occurrence of nausea and vomiting, and length of stay in PACU were also collected.Patients were divided into moderate-to-severe pain group (VAS score>3 points) and non-moderate-to-severe pain group (VAS score≤3 points) according to the VAS scores at rest and during activity at 10 min after extubation in PACU.Logistic regression analysis was used to identity the risk factors for moderate-to-severe pain in PACU.Results:A total of 1 698 patients were included in this study, the incidence of moderate-to-severe pain at rest was 46.70%, and the incidence of moderate-to-severe pain during activity was 54.12%.The results of logistic regression analysis showed that female, radical resection of esophageal cancer, mediastinal surgery, internal fixation for rib/sternal surgery were risk factors for moderate-to-severe pain in PACU, and increasing age, endoscopic surgery, intraoperative use of nerve block and dexmedetomidine were protective factors for moderate-to-severe pain in PACU in the patients undergoing thoracic surgery ( P<0.05). Conclusion:Female, radical resection of esophageal cancer, mediastinal surgery, and rib/sternal surgery are risk factors for moderate-to-severe pain in PACU in the patients undergoing thoracic surgery; increasing age, endoscopic surgery, intraoperative use of nerve block and dexmedetomidine are protective factors for moderate-to-severe pain in PACU in the patients undergoing thoracic surgery.

Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.

Objective To evaluate the effect of dexmedetomidine on autophagy in the hippocampal neurons of rats with traumatic brain injury (TBI).Methods Adult male Sprague-Dawley rats,aged 12-16 weeks,weighing 340-370 g,were randomly divided into 3 groups (n=80 each) using a random number table:sham operation group (group S),traumatic brain injury group (group TBI) and dexmedetomidine group (group Dex).The rats were subjected to a diffuse cortical impact injury caused by a modified weight-drop device to induce TBI.Dexmedetomidine 15 μg/kg was injected intravenously immediately after TBI in Dex group.At 24 and 48 h after TBI,neurological deficit score (NDS) was assessed,Morris water maze test was performed,and brains were removed for detection of brain water content in the brain tissue.At 6,12,24 and 48 h after TBI,the expression of hippocampal LC3]Ⅱ was determined using Western blot analysis.Results Compared with group S,brain water content and NDS were significantly increased at 24 and 48 h after TBI,the escape latency was prolonged,and the expression of hippocampal LC3 Ⅱ was upregulated at 6,12,24 and 48 h after TBI in TBI group.Compared with TBI group,brain water content and NDS were significantly decreased at 24 and 48 h after TBI,the escape latency was shortened,and the expression of hippocampal LC3 Ⅱ was down-regulated at 6,12,24 and 48 h after TBI in Dex group.Conclusion The mechanism by which dexmedetomidine reduces TBI is related to inhibition of autophagy in the hippocampal neurons of rats.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

Objective To discuss the clinical ultiliazation and significance of microembolus detection by transcranial Doppler (TCD) sonography in intracranial stenosis-occlusive disease.Data sources All related articles in this review were mainly searched from PubMed published in English from 1996 to 2012 using the terms of microembolic signal,transcranial Doppler,intracranial stenosis,stroke.Study selection Original articles and reviews were selected if they were related to the clinical utilization of microembolus detection in intracranial stenosis-occlusive disease.Results Intracranial stenosis is a significant cause of cerebral emboli,and microembolus detection by TCD sonography were widely used in exploring the mechanisms of ischemic stroke with intracranial stenosis (including the middle cerebral artery stenosis and the vertebral-basilar stenosis),evaluating the prognosis of acute stroke,evaluating the therapeutic effects,and predicting the recurrent events of stroke.Conclusion Microembolus detection by TCD sonography plays an important role in the cerebral ischemic stroke patients with intracranial stenosis.