Objective To observe the protective effect of ghrelin on hippocampal injury induced by global cerebral ischemia/reperfusion (I/R) and explore its effect mechanisms.Methods The male Sprague-Dawley (SD) rats were randomly divided into four groups,namely sham group,I/R group,normal saline (NS)+I/R group and Ghrelin+I/R group,with 42 rats in each group.The model of I/R was reproduced by clipping bilateral carotid artery of rats 15 minutes and then releasing them for 60 minutes.There were no challenges for rats in sham group,just exposed their carotid artery.Ghrelin+I/R group and NS+I/R group were challenged by injecting 1 μ.L ghrelin or NS into lateral ventricle before I/R.Some of brain tissue in the rats was harvested after experiment to determine the levels of malonaldehyele (MDA),myeloperoxidase (MPO) and glutathione (GSH) in hippocampus by using chemical colorimetry and observe infarct sizes and histopathology.Single extracellular neuron discharge in other rats was recorded to observe the activity of glutamic sensitive neurons (Glu-N) and γ-aminobutyric acid (GABA) sensitive neurons (GABA-N) in hippocampus CA1 region of rats suffered I/R.Results Compared with sham group,the levels of MDA and MPO in hippocampus of rats in the I/R group were raised markedly,the level of GSH was decreased significantly,the infarct sizes was increased significantly and pycnosis neurons were increased markedly.All sorts of indexes between NS+I/R group and I/R group showed no significantly statistical significance.Compared with NS+I/R group,the levels of MDA and MPO in hippocampus of rats in the Ghrelin+I/R group were decreased significantly [MDA (nmol/g):16.4 ± 4.2 vs.24.5 ± 6.7,MPO (nmol/g):6.4 ± 1.8 vs.10.2 ± 2.9,both P ＜ 0.05],the activity of GSH was risen remarkably (μmol/g:2.65 ± 0.72 vs.1.66 ± 0.50,P ＜ 0.05),the infarct sizes of hippocampus were reduced markedly [(43.9 ± 9.5)％ vs.(77.0 ± 12.7)％,P ＜ 0.01],the number of pycnosis neuron was reduced markedly (cells:36.2±4.5 vs.47.1 ±6.1,P ＜ 0.01).The results of electrophysiology showed that the discharge frequency of Glu-N and GABA-N in hippocampus CA1 region of rats in I/R group increased markedly as compared with sham group,and no significant difference in the discharge frequency of Glu-N and GABA-N between NS+I/R group and I/R group.Compared with NS+I/R group,injected ghrelin could make the discharge frequency of Glu-N in hippocampus CA1 region of rats decreased markedly (Hz:3.81 ±0.67 vs.4.98±0.33 at ischemia,3.01 ±0.37 vs.3.77 ± 0.41 at reperfusion,both P ＜ 0.05),and the discharge frequency of GABA-N increased markedly (Hz:5.62 ± 0.54 vs.3.62±0.39 at ischemia,4.81±0.48 vs.3.71±0.21 at reperfusion,both P ＜ 0.05).Conclusion Ghrelin might protect hippocampal neuron after I/R iniury,and neuron excitability decrease might be related.

Objective To investigate the clinicopathological features,treatment and prognosis of leiomyomatosis peritonealis disseminata (LPD).Methods A total of 10 patients suffered from LPD after laparoscopic uterine myomectomy were collected in the First Affiliated Hospital of Zhengzhou University from September 2012 to September 2016,and all clinical database were retrospectively analyzed.Results (1)Clinical features:the age of 10 cases was 25-50 years old,and 8 cases of them were in child-bearing age,while 2 cases were in perimenopausal period.Of 10 cases,2 cases manifested as discontinuous lower abdominal pain,and the other cases were seen the doctor for the examinations found tumors of pelvis or abdomen.All 10 cases had a history of laparoscopic uterine myomectomy under went power morcellation with an average of (4.0±2.2) years (range 1.3 to 8.1 years),2 cases of them had a history of oral hormone treatment after the first myoma morcellation.(2) Treatment methods and postoperative pathologic diagnosis:during intraoperative exploration,LPD nodules were most distributed in Douglas pouch (10 cases),and next in mesentery (7 cases),abdominal peritoneum (6 cases) and omentum majus (4 cases),etc.Seven of the 8 cases of child-bearing age were performed laparoscopic LPD nodules removal,1 case gone combined with laparotomy and resecting LPD nodules;2 cases in perimenopausal period done laparotomy oophorotomy and resected all LPD nodules and omentum.(3) Postoperative relapse and reproductive outcomes:the follow-up time of all cases was 2.8 years,and no recurrence was found during the follow-up period;2 cases had natural conception and term vaginal birth during the follow-up period.Conclusions LPD is mainly related to iatrogenic planting and spreading,which is a benign disease and characterized by multiple smooth muscle nodules throughout abdominopelvic cavity,and the nodules of LPD is commonly located in Douglas pouch,mesenteric and omentaum majus,etc.The preferred method of LPD should be individual operative treatment according to different situations,and in which patients may be have better prognosis.

Objective To study the application value of MSCT in preoperative evaluation of rectal cancer before surgery.Methods Clinical materials of 146 patients with colonoscopy and clinical proved rectal cancer were recruited.MSCT were performed with plain and triphasic dynamic contrast enhancement before surgery.The value of MSCT was evaluated by comparing the results of pre-operative evaluation with the surgical results.Results 130 cases accepted surgical treatment:3 cases of transanal local excision,28 cases of Miles operation,3 cases of Hartmann operation,96 cases of Dixon.Preoperative evaluation of MSCT:33 cases of Miles,4 cases of Hartmann,88 cases of Dixon,5 cases of local excision of the anus.The accuracy on MSCT preoperative evaluation was 84.62%. MSCT preoperative evaluation consistency was consistent with postoperative outcome(k=0.653,χ2=225.352,P=0.000).Conclu-sion It is high accuracy for MSCT in preoperative evaluation of rectal cancer,and it can provide important significance for preopera-tive selection of surgical procedures.

Objective To explore the best multiplicities of infection (MOI),the expression of the target gene and in vitro MR imaging of adenovirus vector-mediated transferrin receptor (TFRC) reporter gene transfection of human colorectal cancer Lovo cells.Methods Lovo cells were transfected with recombinant adenovirus (Ad-TFRC) at 5,10,50,100 MOI to determine the best MOI,and quantitative real-time PCR was performed to detect the eDNA of TFRC.The transfected cells were incubated in the culture medium including Tf-USPIO of various concentrations,and were observed by Prussian blue staining,then the cell viability was evaluated via Trypan blue staining.The labeled cells were scanned with 7.0T MR T2W,T2 map,T2* map sequences,and the signal intensities were analyzed.Results Ad-TFRC were successfully transfected into Lovo cells.The best MOI was 50,and the efficiency of infection was more than 90％.The relative expression amount of TFRC in transfected cells was higher than that in control Lovo cells by real-time quantitive PCR (P＜ 0.01).Prussian blue staining showed numerous blue iron particles in transfected cells when the best labeling concentration was 1.5 μg/ml.Trypan blue staining results of transfected Lovo cells and control Lovo cells was (93.80± 1.60)％ and (95.10±2.30) ％,respectively (P＞0.05).MR imaging in vitro showed that compared with control Lovo cells,the signal intensity decreased on T2WI,T2 map and T2* map sequences in transfected Lovo cells (P＜0.05).Conclusion TFRC reporter gene can be efficiently mediated by adenovirus for expression in Lovo cells.After magnetization labeling,7.0T MR imaging of Lovo cells can be successfully achieved in vitro.

Objective:To evaluate the efficacy of gonadotropin-releasing hormone agonist (GnRH-a) pretreatment before total hysterectomy for adenomyosis patients with uterine volume ≥12 gestational weeks and moderate or severe anemia.Methods:From January 2018 to March 2023, 689 patients who underwent total hysterectomy for adenomyosis in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. According to the preoperative medication, they were divided into study group (127 cases) and control group (562 cases). Patients in the study group underwent GnRH-a pretreatment for 3 cycles before surgery, and the control group received operation directly. SPSS 26.0 software was used to perform 1∶1 matching for the two groups of patients through the propensity score matching method. Matching variables included age, body mass index, gravidity, parity, history of pelvic and abdominal surgery, menstrual cycle, menstrual period, dysmenorrhea score, initial diagnosis of cancer antigen 125 (CA 125), uterine volume and hemoglobin value. The dysmenorrhea score, uterine volume, hemoglobin value and CA 125 level before and after GnRH-a pretreatment in the study group were compared. And the duration of operation, intraoperative blood loss, postoperative white blood cell count, perioperative blood transfusion cases, postoperative disease rate, duration of hospitalization, total hospitalization cost between the two groups were compared. Results:With propensity score matching, 119 patients in the study group and 119 patients in the control group were finally enrolled in this study. In the study group, before and after the treatment with GnRH-a, the dysmenorrhea score (7.4±1.7 vs 5.6±1.8), uterine volume [(362±160) vs (233±126) cm 3], hemoglobin value [(74.1±10.7) vs (102.5±13.5) g/L], and CA 125 level [(104±76) vs (64±51) kU/L] were statistically different (all P<0.05). There were statistical differences of operation time [(86±18) vs (116±31) minutes], intraoperative blood loss [(24±9) vs (43±22) ml], white blood cell count after 1 day of operation [(9.80±0.10)×10 9/L vs (9.90±0.10)×10 9/L], number of perioperative blood transfusion case [5.9% (7/119) vs 61.3% (73/119)], postoperative disease rate [5.0% (6/119) vs 16.0% (19/119)], hospitalization duration [(7.1±1.6) vs (7.9±1.6) days], and total hospitalization cost [(35 323±5 275) vs (37 159±5 640) yuan] between the study group and the control group (all P<0.05). Conclusion:The pretreatment of using GnRH-a before total hysterectomy for adenomyosis patients with uterine volume ≥12 gestational weeks and moderate or severe anemia is not only conducive to improving dysmenorrhea, signs of anemia, reducing uterine volume, but also conducive to the implementation of surgery, reducing intraoperative and postoperative complications, and reducing hospital costs.

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.

Pluripotent stem cells (PSCs) can be expanded in vitro in different culture conditions, resulting in a spectrum of cell states with distinct properties. Understanding how PSCs transition from one state to another, ultimately leading to lineage-specific differentiation, is important for devel-opmental biology and regenerative medicine. Although there is significant information regarding gene expression changes controlling these transitions, less is known about post-translational modifi-cations of proteins. Protein crotonylation is a newly discovered post-translational modification where lysine residues are modified with a crotonyl group. Here, we employed affinity purification of crotonylated peptides and liquid chromatography–tandem mass spectrometry (LC–MS/MS) to systematically profile protein crotonylation in mouse PSCs in different states includ-ing ground, metastable, and primed states, as well as metastable PSCs undergoing early pluripotency exit. We successfully identified 3628 high-confidence crotonylated sites in 1426 proteins. These crotonylated proteins are enriched for factors involved in functions/processes related to pluripotency such as RNA biogenesis, central carbon metabolism, and proteasome function. Moreover, we found that increasing the cellular levels of crotonyl-coenzyme A (crotonyl-CoA) through crotonic acid treatment promotes proteasome activity in metastable PSCs and delays their differentiation, consis-tent with previous observations showing that enhanced proteasome activity helps to sustain pluripo-tency. Our atlas of protein crotonylation will be valuable for further studies of pluripotency regulation and may also provide insights into the role of metabolism in other cell fate transitions.

Immune Checkpoint Inhibitors ; Transcriptome ; Immunotherapy ; Biomarkers, Tumor