Objective To explore the values of electromyography to examine birth injuries.Methods 34 cases of birth injuries were studied,the electromyography and motor nerve conduction of brachial plexcy were recorded.Then,the location and severity of birth injuries were determined.Results Among 34 cases,according to the location of injuries,there were 10 cases of upper trunk injuries,7 cases of upper and middle trunk injuries,5 cases of middle and lower trunk injuries,5 cases of lower trunk injuries,and 7 cases of whole brachialplexus injuries.On the other hand,according to the severity of injuries,there were one case of complete injuries and 33 cases of incomplete injuries which included 2 cases of severe injuries and 31 cases of slight injuries.Conclusion Electromyography is the reliable method to identify the location and severity of brachial plexus injuries,and this examination is necessary to diagnose birth injuries with great clinical values.

Objective To evaluate the diagnostic value of velocity parameters of Tardus-Parvus for the detection of renal artery stenosis ( RAS) ( diameter reduction ≥50%) and to determine the useful cutoffs for these parameters .Methods A study group was composed of 221 renal arteries that were detected Tardus-Parvus by color Doppler flow imaging and were referred to abdomino-aorto-re-nal arteriography afterwards .Five Doppler parameters including the peak systolic velocity ( PSV ) , end-diastolic minimum velocity (EDV), resistance index (RI), acceleration time (AT), and accelerated velocity (AC) from each location including renal aorta ( MRA) , segmental artery ( SRA) , interlobar artery ( IRA) , and arcuate artery ( ARA) were archived and compared among the differ-ent groups .Renal artery angiography showed arterial canon reduced 50% or higher RAS .Arteries were considered stenosed on renal arteriography if there was a diameter reduction of greater than 50%.Statistical analysis to determine the best parameter for predicting a RAS was performed with the receiver operating characteristic ( ROC) curves.The sensitivity, specificity, and negative and positive predicting values at various cutoffs were calculated .Results Renal artery stenosis degree was less than 50% in 16 cases, 50%~99%in 197 cases, completely occluded in 2 cases, and no stenosis in 6 case by renal arteriography .For RAS with inner diameter re-duction of 50%or more, the ROC curve analysis showed renal artery flow velocity had a good sensitivity and specificity , 50%~99%of the RAS had optimal threshold value in PSV 20 cm/s, EDV 10 cm/s, RI 0.50, AT 0.09 s, and AC 1.5 m/s2.Conclusions Tardus-Parvus had high specificity and sensitivity for diagnosis of stenosis rate in more than 50% of the RAS, low sensitivity for the narrow degree in 0~49%, and no clinical value for the renal artery occlusion .

Objective To study the effect of 1?,25-dihydroxyvitamin D3[1,25-(OH)2D3] on cytoskeleton,gap junction intercellular communication (GJIC) and intracellular Ca2+ ([Ca2+]i) in osteoblasts (OB) in vitro. Method OB were isolated from calvaria bone. After 20 min and after 24 h treated by 1,25-(OH)2 VD3 (0,10-9,10-8,10-7 mol/L),[Ca2+]i was evaluated. F-actin and GJIC were observed after 24 and 48 h incubation later. Results Compared with the control group,[Ca2+]i in all 1,25-(OH)2 D3 groups was increased significantly at 20 min. [Ca2+]i in 10-9 mol/L 1,25-(OH)2D3 group was the lowest at 24 h after treatment. OB in 10-8 and 10-7 mol/L 1,25-(OH)2D3 groups were flat,and stress fibers were formed. The expression of F-actin in control group and 10-9 mol/L 1,25-(OH)2D3 group was reduced at 48 h after treatment. Compared with the control group,GJIC was weakened very significantly after treated with 10-9 mol/L 1,25-(OH)2D3 at 48 h,but enhanced very significantly in the group with 10-8 and 10-7 mol/L. Conclusion Higher dosage of 1,25-(OH)2D3 can maintain the morphology of OB and stimulate the communication among OB,but lower dosage can inhibit it.

Objectives To investigate the changes of erythropoietin(EPO)expression in rats after focal cerebral ischemia/reperfusion injury.Methods Male Sprague-Dawley rats were randomly divided into normal,sham,cerebral ischemic/reperfusion(CIR)groups.Middle cerebral artery occlusion(MACO)model was established by Longa's method,and reperfusion was followed 2 hours after occlusion in CIR group.The rats' brain neurological deficit scores were evaluated at 24 h,48 h,72 h and 96 h after reperfusion.The protein expression of EPO was determined by immunohistochemistry staining and Western blotting in each time points.Results The rats' brain neurological deficit scores at 48 h,72 h and 96 h were significantly increased(3.40±0.32,3.60±0.17,3.70±0.21,all P<0.05)compared with those at 24 h(3.00±0.22)after reperfusion in CIR group.The results of immunohistochemistry staining and Western blotting showed that the positive expression of EPO proteins in rats started at 24 h(0.36±0.05,140.20±0.30)after cerebral ischemic/reperfusion injury,increased significantly at 48 h(1.09±0.10,145.40±0.16),reached the peak at 72 h(1.29±0.09,156.23±0.12),began to decline at 96 h(0.98±0.04,141.56±0.36).Conclusions Cerebral ischemia and reperfusion injury can induce increased expression of EPO protein,which suggests that EPO may have protective effect on nerve cells under the condition of ischemia and reperfusion.

Objective To investigate the expression of Caspase-9 and heat-shock protein-90 (HSP 90) in rats after focal cerebral ischemia-reperfusion injury.Methods The male SD rats (200-250 g) were divided into three groups by the random number table: normal group, sham group and cerebral ischemia-reperfusion (CIR) group.Each group was sorted into four subgroups including group 6 h, group 24 h, group 48 h and group 72 h according to the reperfusion time.Suture-occluded method was adopted to prepare focal cerebral ischemia-reperfusion(CIR) injury in rat model.Enzymelinked immunosorbent assay (ELISA) method was used to detect the variations of Caspase-9 and HSP-90 expression in rats.Results The changes in Caspase-9 and HSP 90 expression in the brain cells were observed by ELISA method.The expression of Caspase-9 and HSP-90 was weakly expressed in sham group, and was at peak in CIR group within 24 h-48 h, then began to decline at 72 h after the reperfusion time.The differences in the expression of caspase-9 and HSP-70 between sham group and normal group were not statistically significant.Conclusions Apoptotic cells gradually increase along with reperfusion time and reach the peak at 48 h after cerebral ischemia-reperfusion.In ischemia half dark stripe, the expression of Caspase-9 and HSP 90 is increased in neuronal cells after cerebral ischemia-reperfusion, and the positive cells number is at peak at 48 h after cerebral ischemiareperfusion.Apoptosis of neuronal cells after cerebral ischemia and reperfusion is a dynamic evolutionary process.The expression of Caspase-9 and HSP 90 in nerve cells plays an important role in regulating cell apoptosis.

Gap junctions mediate direct communication between cells; however, toxicological cascade triggered by nonessential metals can abrogate cellular signaling mediated by gap junctions. Although cadmium (Cd) is known to induce apoptosis in organs and tissues, the mechanisms that underlie gap junction activity in Cd-induced apoptosis in BRL 3A rat liver cells has yet to be established. In this study, we showed that Cd treatment decreased the cell index (a measure of cellular electrical impedance) in BRL 3A cells. Mechanistically, we found that Cd exposure decreased expression of connexin 43 (Cx43), increased expression of p-Cx43 and elevated intracellular free Ca2+ concentration, corresponding to a decrease in gap junctional intercellular communication. Gap junction blockage pretreatment with 18β-glycyrrhizic acid (GA) promoted Cd-induced apoptosis, involving changes in expression of Bax, Bcl-2, caspase-3 and the mitochondrial transmembrane electrical potential (Δψm). Additionally, GA was found to enhance ERK and p38 activation during Cd-induced activation of mitogen-activated protein kinases, but had no significant effect on JNK activation. Our results indicated the apoptosis-related proteins and the ERK and p38 signaling pathways may participate in gap junction blockage promoting Cd-induced apoptosis in BRL 3A cells.
Animals ; Apoptosis/*drug effects ; Cadmium/*toxicity ; Calcium/metabolism ; Cell Communication/drug effects ; Connexin 43/genetics ; Enzyme Activation/drug effects ; Gap Junctions/*drug effects ; Gene Expression Regulation/drug effects ; Hepatocytes/cytology/*drug effects ; Rats ; Signal Transduction/drug effects

Objective:To investigate the transfection of recombinant adenovirus vectors containing the hypoxia inducible factor-1α gene (AdHIF-1α)in rat brain microvascular endothelial cells(BMECs) and to provide a theoretical basis for the treatment of hypoxic BMECs by AdHIF-1α.Methods:Rat BMECs were isolated, identified, and cultured in a maintenance medium containing 100 μmol/L cobalt dichloride (CoCl 2), establishing a hypoxia model of BMECs; then AdHIF-1α was transfected into hypoxic BMECs.The transfection of fluorescent protein was observed under a fluorescence microscope. Results:Transfection of AdHIF-1α into BMECs was monitored under a fluorescence microscope at 12 h, 24 h, 48 h and 72 h, respectively.Minor fluorescence began to appear at 12 h (0.13±0.01), and the fluorescence expression increased at 24 h (0.46±0.03, q=25.88, P<0.01), was most obvious at 48 h (0.97±0.05, q=40.00, P<0.01), and decreased at 72 h (0.38±0.02, q=46.28, P<0.01). Conclusions:Recombinant adenovirus vectors containing AdHIF-1α can be transfected into hypoxic BMECs in vitro.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.

BACKGROUND:As a dominant breed pig in southwest China,the southern Yunnan small-ear pig has been widely used as an experimental animal in the basic research of other disciplines,but there are still no reports on its application in anterior cruciate ligament reconstruction. OBJECTIVE:To establish a large animal model of the southern Yunnan small-ear pig with anterior cruciate ligament with autologous Achilles tendon was established. METHODS:Twenty adult female Yunnan small-ear pigs were equally randomized into two groups.In the autologous Achilles tendon group,the right knee anterior cruciate ligament was reconstructed with autologous Achilles tendon as a graft,while in the sham-operated group,a similar operation was performed on the right knee without any treatment of the anterior cruciate ligament.General conditions of each pig were observed and recorded before and 12 months after surgery.Ligaments and grafts were taken for gross observation and MAS scoring.Hematoxylin-eosin staining was performed to observe morphological characteristics of ligaments.The staining and arrangement of type I and type Ⅲ collagen were evaluated by immunohistochemistry.Transmission electron microscopy was used to observe the type,size,diameter,ratio,and distribution of collagen fibers in ligaments. RESULTS AND CONCLUSION:All animals had normal diet and activity,good wound healing,no obvious inflammatory reaction,no local purulent infection,and no significant changes in mental and urinary conditions compared with those before surgery.The reconstructed cruciate ligament of the knee was intact,with no stiffness and normal range of motion.Both the anterior drawer and Lachman tests were negative.Gross observation of the graft:12 months after surgery,the grafts was in good position,with good integrity,obvious tension,ligament color close to the original anterior cruciate ligament,and complete surface synovial coverage.Most of the intraarticular ligaments in the autologous Achilles tendon group were defined as MAS I type and a few were defined as MAS Ⅱ type.In the sham-operated group,the intraarticular ligament was defined as MAS I type.Hematoxylin-eosin staining indicated that,12 months after surgery,collagen fibers in the autologous Achilles tendon group began to appear bundled,isotropic,and uniformly arranged,with more obvious isotropic corrugations,and the nuclei were mainly linear or spindle-shaped,which were similar to those in normal anterior cruciate ligament tissue of the sham-operated group.Immunohistochemistry results indicated that,12 months after surgery,there was a higher expression of type I collagen and significantly less expression of type Ⅲ collagen in the reconstructed anterior cruciate ligament in the autologous Achilles tendon group.The degree of type I and type Ⅲ staining was similar in the two groups.Under the transmission electron microscope,the diameter,arrangement and density of collagen fibers in the reconstructed anterior cruciate ligament of the autologous Achilles tendon group were similar to those of the original anterior cruciate ligament at 12 months after surgery,indicating that the ligament remodeling process had been basically completed in the autologous Achilles tendon group at 12 months after surgery.Through a comprehensive evaluation of animal general conditions,ligament general view,MAS score,hematoxylin-eosin staining,immunohistochemistry,and transmission electron microscopy observation,we successfully established a large animal model of anterior cruciate ligament reconstruction using autogenous Achilles tendon in southern Yunnan small-ear pigs,with good morphological,histological and ultrastructural results.

OBJECTIVE To observe the efficacy of vericiguat in the treatment of acute decompensated heart failure （HF） and its effect on left ventricular ejection fraction （LVEF） in patients with different left ventricular end-diastolic internal diameters （LVDd）. METHODS A total of 52 patients with acute decompensated HF who were hospitalized in Anqing Municipal Hospital from September 2022 to May 2023 and were stabilized by intravenous injection of diuretics or vasodilators and then given vericiguat orally were selected. Clinical baseline data were collected， and blood creatinine （Scr）， estimated glomerular filtration rate （eGFR）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， echocardiographic indexes（LVEF， LVDd）， and Kansas City cardiomyopathy questionnaire （KCCQ） scores and so on were recorded and analyzed at 1 and 6 months after treatment. The patients were divided into two subgroups according to whether they had dilated cardiomyopathy or not， the baseline data were compared between the two subgroups， and the changes in the above follow-up indexes for the entire population and two subgroups of patients were analyzed by using mixed effect model. RESULTS Patients in the dilated cardiomyopathy group were significantly younger than those in the nondilated cardiomyopathy group， while the former had a lower proportion of patients with combined coronary artery disease， longer LVDd， lower LVEF levels， and more HF patients with reduced ejection fraction （P＜0.05）. Compared with baseline values， KCCQ scores were significantly higher in patients in the whole population， non-dilated cardiomyopathy group and dilated cardiomyopathy group at 1 month after treatment （P＜0.001）. The difference between the whole population in terms of elevated KCCQ scores and decreased lg（NT-proBNP） levels was statistically significant at 6 months after treatment （P＜0.05）； the levels of lg（NT-proBNP）of two subgroups were significantly decreased and KCCQ scores were significantly increased （P＜0.05）， but the difference was not statistically significant （P＞0.05）； LVEF levels of the patients E-mail：guangf4-508@163.com in both subgroups were significantly elevated （P＜0.05） and the difference between the subgroups amounted to 7.52% （P＝0.030）. Mixed effect model result showed that whether patients had coronary artery disease and different baseline levels of LVDd were likely to affect follow-up LVEF levels， with coronary artery disease contributing to follow-up LVEF elevation （P＝0.043）， but the coronary artery disease subgroup × time interaction was not significant （P＞0.05）；compared with patients with baseline LVDd ≥62 mm， patients with baseline LVDd≤61 mm had a faster LVEF improvement （P＜0.05）. CONCLUSIONS Vericiguat is able to improve cardiac function and quality of life in patients with acute decompensated HF without negatively affecting their renal function. The drug is able to significantly improve LVEF levels in patients with baseline LVDd ≤61 mm.