Objective To investigate the relationship between telomerase reverse transcriptase (TERT) gene expression and astrocyte activation.Methods Twenty neonatal 3-day-old male SD rats were used for culture of the astrocytes.The astrocytes were divided into Group A (activated,non-transfected astrocytes),Group B (activated,transfected astrocytes),Group C (unactivated astrocytes) and Group D (activated,empty plasmid transfected astrocytes) according to the random number table,with 5 rats per group.The cell proliferation rate in each group was detected by cell counting kit-8 (CCK-8) ;TERT expression by immunocytochemical method; expressions of TERT and glial fibrillary acidic protein (GFAP) genes by RT-PCR assay.Results Astrocytic proliferation ability in Group B lowered significantly as compared with that in Groups A,D and C (F =43.418,P ＜ 0.01).Expressions of TERT and GFAP mRNAs in Groups A and D were significantly higher than those in Group B and C,and no significant difference was found between Groups A and D.Besides,there was a linear correlation between mRNAs expressions of both genes in Groups A and D (r =0.701,0.704,P ＜ 0.01),while no significant linear correlation was observed in Groups B and C (r =0.260,P ＞ 0.05).Expressions of TERT and GFAP proteins in Groups A and D were markedly higher than those in Groups B and C and no significant difference was found between Groups A and D.Conclusion TERT genes are involved in the activation of astrocytes and exert effect on promoting the activation of astrocytes.

BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation, however there is rare report addressing the construction of the lentivirus targeted its genes to inhibit its expression in the spinal cord astrocytes.
OBJECTIVE:To construct recombinant lentivirus vector expressing smal interfering RNA against TERT gene and to evaluate its potential for inhibiting the TERT expression.
METHODS:After shRNA-TERT sequence was designed and synthesized, the sequence was amplified by PCR and then connected to plasmid pLentilox3.7U6-hTERT to construct recombinant plasmid. The recombinant plasmid was then transfected to DH5αcel s to screen positive colony, and the sequence was identified. The recombinant plasmid pLentilox3.7U6-TERT was transfected in 293T cel s, generating recombinant lentivirus Le-TERT. The titer of recombinant lentivirus was determined and Le-TERT was transfected into the rat spinal cord astrocytes. The expression of TERT in astrocytes was detected by RT-PCR, western blot and immunofluorescence assay.
RESULTS AND CONCLUSION:The gene sequencing analysis confirmed that, recombinant plasmid pLentilox3.7U6-TERT was successful y constructed. The real-time quantitative PCR, western blot analysis and immunofluorescence assay indicated that, after Le-TERT was transfected in the astrocytes for 4 days, the inhibition rate of TERT mRNA was (63.98±2.6)%, and Le-TERT was lowly expressed in the transfected astrocytes. Recombinant expression vector pLentilox3.7U6-TERT can produce the lentivirus at high titer and effectively inhibit TERT expression in the transfected astrocytes.

Objective To evaluate the influence of positive end-expiratory pressure (PEEP) on intracranial pressure and cerebral perfusion pressure in dogs with or without intracranial hypertension caused by frontal intracerebral hematoma. Methods Eighteen dogs were randomly divided into three groups. In Group B and Group C, the intracranial hypertension was respectively higher than 25 mmHg but less than 40 mmHg and higher than 40 mmHg induced by autoblood clotting injection into the right frontal lobe, while Group A as control was of normal intracranial pressure. PEEP was applied in increment of 3 cmH2O from 0 to 18 cmH2O, each level lasting 20 min. The intracranial pressure (ICP) was monitored by an optical fiber transducer implanted into left frontal lobe. Mean arterial pressure (MAP), heart rate (HR), and central venous pressure (CVP) were recorded simultaneously. Cerebral perfusion pressure (CPP) was calculated by the equation (CPP=MAP-ICP). Results With increasing PEEP level, ICP increased and CPP fell in Group A; ICP fell, MAP and CPP increased in Group B; ICP fell, MAP and CPP increased in Group C. CVP increased in all groups, and the increment was significantly higher in Group C than the other two groups (P

Objective To explore the etiology,mechanism and treatment of diarrhea after(pancreatoduodenectomy).Methods Based on the clinical data of 159 cases of pancreatoduodenectomy(performed) in the recent one and half years,the pathogenesis of post-pancreatoduodenectomy diarrhea was(analyzed) and the effect of different treatments was observed.Results Seventy-one cases had diarrhea,with an incidence of 44.7%.Tweenty-two cases had bacterial infection of the intestinal tract and 4 cases had fungus infection.The incidence of infection was 36.6%.In 64 cases diarrhea was relieved with effective treatment,accounting for 90.1% of all cases.Seven cases with chronic diarrhea had additional treatment with oral pancreatic enzyme and symptoms were relieved 2 weeks after treatment.Conclusions Diarrhea is frequently observed in patients after pancreatoduodenectomy,and the majority of them can be cured with(treatment) selected according to the pathogenesis.

BACKGROUND:The main treatment of lumbar isthmic spondylolisthesis is the surgery, in a broader attempt to decompression, reduction, fixation and fusion of the lesioned segments. The golden standard of the treatment is biological fusion, while internal fixation is a reliable assistance for fusion therapy. ＜br> OBJECTIVE:To discuss the clinical value and curative effect of intervertebral fusion cage combined with pedicle screw systems for the treatment of lumbar isthmic spondylolisthesis. ＜br> METHODS:From March 2010 to March 2013, 21 cases of isthmic spondylolisthesis were treated with intervertebral fusion cage combined with pedicle screw systems, including 18 cases of spondylolisthesis of degree II and 3 cases of spondylolisthesis of degree III. Al patients were fol owed up regularly, taking JOA lumbago score and visual analog scale score as the objective evaluation criteria of pain in postoperative fol ow-ups. The curative effect was assessed by Macrab standard, and the functional recovery was evaluated based on indicators such as Prolo, and the spinal fusion rate was assessed according to Lenke criteria. Changes of slippage rate, slippage angle, sacral inclination angle and intervertebral space post height in preoperative and postoperative periods were evaluated by iconography data. ＜br> RESULTS AND CONCLUSION:Al the 21 patients with isthmic spondylolisthesis were fol owed up for 12-16 months. JOA lumbago score and vasual analog scale score of al patients were improved after treatment, and the difference was statistical y significant compared with before treatment (P=0.000). According to Macrab evaluation criteria, there were 17 excellent cases and 4 good cases. Each indicator evaluated by preoperative Prolo activities and symptom grading showed significant differences in preoperative and postoperative periods (P=0.003). Postoperative lumbar spondylolisthesis was basical y reset, the slippage angle was significantly reduced, the sacral inclination angle was increased, and the height of the intervertebral space was recovered basical y. Intervertebral fusion cage combined with pedicle screw systems was one of the effective strategies to treat lumbar isthmic spondylolisthesis.

Objective:　To analyze the prognosis of 2 284 cases with acute traumatic brain injury and discuss possible methods to improve the outcome of head injuries. 　　Methods:　The relationship between trauma cause, trauma severity and management and patients outcome was retrospectively analyzed. 　　Results:　Good recovery was achieved in 60.20%, moderate disability was 13.22%, severe disability 15.24%, vegetative status 0.31% and mortality 11.03%. The mortality was 1.07% in cases with GCS 15-13, 2.47% in cases with GCS 12-9, 13.29% in cases with GCS 8-6, and 57.4% in cases with GCS 5-3. 　　Conclusions:　To prevent hypoxia, remove intracranial hematoma as soon as possible, use standard large traumatic craniotomy and apply mild hypothermia may be useful means for improving the outcome of severely head injured patients.

OBJECTIVE: To investigate the protective effects of mild hypothermia (33-35 degrees C) on the outcome of patients with severe traumatic brain injury (TBI) (GCS<8). METHODS: Patients in the mild hypothermia group were cooled to 33-35 degrees C by cooling blanket with muscular relaxant, and patients in the normothermia group were maintained at 37-38 degrees C. RESULTS: The result showed that the mortality was 26.1% (6/23) in the mild hypothermia group and 58.3% (14/24) in the normothermia group respectively (P<0.05). The mild hypothermia also markedly reduced intracranial pressure (P<0.01 and inhibited hyperglycermia (P<0.05). No significant side-effects were found during hypothermic treatment. CONCLUSIONS: Our clinical data have demonstrated that mild hypothermia is a useful method for management of patients with severe traumatic brain injury.

Objective To explore the mutual relationship between serum uric acid (SUA) level with metabolic syndrome (MD) and its factors among the physical examination population.Methods A total of 8 285 people undergoing the physical check-up in a hospital in 2013 were selected by sampling and conducted the physical measurement and biochemical detection;the subjects were grouped according to the MS diagnostic standard,gender and SUA.Then the correlation between SUA and MS was analyzed.Results The age,BMI,SBP,DBP,FPG,TG and SUA in the MS patients were significantly higher than those in the patients without MS,while the HDL-C level was significantly lower.The occurrence rate of MS in males was higher than females.With the increase of MS factors,the SUA level showed the overall rising trend;the multiple stepwise regression analysis indicated that BMI,DBP and TG were positively correlated with SUA,and the HDL-C level was negatively correlated with the SUA level.The regression equation was Y =-2.135 + 0.066X1 +0.010X2 +0.155X3-0.379X4;the MS detection rate in the HUA group was higher than that in the non-HUA group;in the single factor Logistic regression analysis,the SUA level was significantly related with the MS occurrence (OR=1.007,95％CI 0.006-1.007,P＜0.05),in the SUA diagnostic value for M,AUC in male and female were 0.608 (95 ％CI 0.582-0.634,P＜0.01) and 0.744 (95 ％CI 0.705-0.783,P＜0.01) respectively,the MS best critical diagnostic points in male and female were 360.5 and 256.5,the corresponding diagnostic sensitivities in male and female were 46.49％ and 71.94％,the specificities in male and female were 69.94％ and 69.94％ respectively.Conclusion The SUA level is closely associated with MS,and SUA level has a good predictive effect for MS.

Objective: To understand social anxiety of Tibetan adolescents aged 10-15 years old in high altitude areas and its correlation with sleep duration, so as to provide a reference and support for social anxiety prevention and mental health interventions for Tibetan adolescents in high altitude areas. Methods: A total of 2 426 Tibetan adolescents from the Lhasa, Chamdo, and Nagchu regions of Tibet were surveyed. From April to June 2022, basic demographics, social anxiety, and sleep status were obtained and analyzed using class based, stratified whole group sampling, and the correlations detected between the two were analyzed by logistic regression analysis. Results: The average social anxiety score of Tibetan adolescents aged 10-15 years in high altitude areas was (6.51±4.32), and the detection rate of social anxiety was 5.23%. The mean sleep duration was (7.42±1.18) hours/day. The differences were statistically significant when compared across gender, overweight/obesity status, level of physically activity, and sleep duration ( χ 2=19.44, 14.39, 7.83, 7.21, P <0.05). After adjusting for relevant variables, the Logistic regression analysis showed that sleep deprivation among boys ( OR =2.91, 95% CI =1.82-4.61), sleep deprivation among girls ( OR = 3.51 , 95% CI =2.01-6.04), and overall sleep deprivation among Tibetan adolescents ( OR =3.12, 95% CI =1.91-4.58) were positively associated with social anxiety( P <0.01). Conclusions A positive association was found between social anxiety and sleep deprivation, indicating that social anxiety is an issue among Tibetan adolescents living in high altitude regions. Sufficient sleep duration plays a positive protective role in reducing social anxiety among Tibetan adolescents in high altitude areas, and the findings provide a reference for future mental health interventions.

Objective To evaluate the effectiveness and safety of three different doses of oxycodone hydrochloride injection in treatment of postoperative uterus contraction pain after painless artificial abortion surgery.Methods A total of 150 early pregnancy patients with painless artificial abortion surgery were randomly divided into Q1 group (oxycodone 0.04 mg/kg),Q2 group (oxycodone 0.07 mg/kg) and Q3 group (oxycodone 0.1 mg/kg),50 cases in each group.Another 50 patients refused to sign the informed consent were selected as group N.The uterine contraction pain score at the time points of immediately after recovery and 10,30,and 60 min after recovery were recorded in four groups,and postoperative satisfaction degree were recorded as well.Preoperative degree of dysmenorrhea,surgery time,propofol dosage,postoperative recovery time,agitation and strength were recorded.At the time points of before administration (To),loss of eyelash reflex (T1),uterine cavity operation (T2),postoperative wake (T3),the heart rate (HR),mean arterial pressure (MAP),respiratory rate (RR) and pulse oxygen saturation (SpO2) were recorded.The incidence of adverse reactions such as dizziness,nausea and vomiting,cognitive impairment,sweating,skin itching,urinary retention,respiratory suppression were recorded.Results The VAS of uterus contraction pain in Group Q2 and Q3 were significantly lower than Group Q1 and Group N (P ＜ 0.05).The satisfaction degree of the patients after surgery in Group Q2 and Q3 were significantly higher than Group Q1 and Group N (P ＜ 0.05).The dose of propofol and recovery time in Group Q2 and Q3 were significantly lower than Group Q1 and group N (P ＜ 0.05).There was no significant difference between the four groups in the age,weight,dysmenorrhea,operation time,nausea and vomiting,vital signs,dizziness and cognitive dysfunction (P ＞ 0.05).There were no adverse reactions such as restlessness,pruritus,sweating,urinary retention,respiratory depression in the 4 groups.Conclusion 0.07 mg/kg oxycodone hydrochloride injection for patients with painless artificial abortion surgery can get perfect analgesic effect and high satisfaction degree,so it is worthy of clinical application.