Objective:To explore the clinical application value of pre-breathing mode in double-low imaging of 320-slices computed tomography(CT)for pulmonary artery.Methods:A total of 100 patients who underwent CT pulmonary angiography(CTPA)for suspected pulmonary embolism(PE)in Liuzhou People's Hospital from July 2021 to September 2022 were prospectively selected as the research subjects and they were randomly divided into observation group and control group,with 50 cases in each group.The patients of the control group adopted conventional breathing mode(the breathing password was activated after reaching the threshold,and the scan was triggered after 6 s),while the patients of the observation group adopted the pre-breathing mode(the breathing password was activated after 1 or 2 seconds,and the scan was triggered after reaching the threshold).Both two groups adopted double low-technique scan of 320 slices CT.The differences in delay time,radiation dose,the points of subjective and objective image quality,and other indicators were compared between the two groups.Results:The volume CT dose index(CTDIvol),dose length product(DLP),effective dose(ED)and delay time of the observation group were significantly lower than those of the control group(t=76.230,30.225,12.282,7.088,P<0.05),respectively.The comparison of the subjective points of image qualities between the two groups indicated that there were 25 cases with 5 points,23 cases with 4 points and 2 cases with 3 points in the observation group,and there were 21 cases with 5 points,26 cases with 4 points and 3 cases with 3 points in the control group.There was no significant difference in the averagely subjective points of image qualities between two groups(P>0.05).The signal-to-noise ratio(SNR)and signal to noise ratio(CNR)of the observation group were significantly lower than those of the control group,and the noise level(SD)of the observation group was significantly higher than that of the control group(t=25.441,23.886、11.426,P<0.05),respectively.The CT values of the artery trunk of right pulmonary,artery branch of right pulmonary,artery trunk of left pulmonary and artery branch of left pulmonary in the observation group were significantly higher than those in the control group(t=2.256,2.225,2.042,2.277,P<0.05),respectively.Conclusion:The pre-breathing mode can effectively improve CTPA image quality,and reduce radiation dose and the dosage of contrast agent,which clinical application effect is significant.It is worth learning.

Objective:To investigate the effects of different levels of ophthalmic surgical stimulation on blood glucose in patients with type 2 diabetes mellitus(T2DM).Methods:From Mar to Oct 2021,236 patients with T2DM who underwent ophthalmic surgery in our hospital were enrolled,including 71 cases of secondary surgery,89 cases of tertiary surgery,and 76 cases of quaternary surgery.According to the operation time,the 236 patients were divided into groups A(＜60 min),B(60-120 min)and C(＞120 min).The preoperative and postoperative blood glucose levels were compared in patients with different levels of surgery,and in groups A,B and C.Results:The postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery,and it was higher than that before surgery in quaternary surgery(P＜0.05).The fluctuation value of blood glucose in secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In groups A,B and C,the postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery(P＜0.05).In group A,there was no significant difference in the blood glucose before and after surgery in quaternary surgery(P＞0.05),and in groups B and C,the postoperative blood glucose was higher than that before surgery in quaternary surgery(P＜0.05).In group A,there was no difference in the fluctuation value of blood glucose at different levels of surgery(P＞0.05).In group B,the fluctuation value of blood glucose in patients with secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In group C,the fluctuation value of blood glucose in patients with tertiary and quaternary surgery was higher than that in patients with secondary surgery(P＜0.05).Conclusions:For ophthalmic surgery patients with T2DM,the postoperative blood glucose values of patients undergoing secondary and tertiary surgery generally show a downward trend,while the postoperative blood glucose value of patients undergoing quaternary surgery generally shows an upward trend.It is suggested that clinical workers should actively manage the perioperative blood glucose of patients with high-level surgery.

OBJECTIVETo investigate the expression of the Toll-like receptor-4 (TLR-4) in temporo-mandibular joint synovitis in rats, and to discuss the correlation between the expression of TLR-4 and the synovitis.

METHODSSixty male wistar rats were randomly divided into five groups, 12 each. Group A was the control group in which the rats were given normal diet.In Group B, the rats' bilateral masseter muscles were cut off (masseter resection group). In Group C, An cast metal crown were bonded on the mandibular right first molar of each rat (occlusal interference group). In Group D, occlusal pad were bonded on maxillary molars of each rat (occlusal dimension increase group). In Group E, rats' bilateral masseter muscles were re-sected and occlusal pads were bonded on their maxillary molars (masseter resection and occlusal dimension increase group). Pathological changes of synovium were observed using hematoxylin and eosin (HE) stains and pathology scores were evaluated. The expression of TLR- 4 were determined by immunohistochemical stains, and the expression of TLR-4 mRNA were determined by real-time PCR. The correlation between the expression of TLR-4, TLR-4 mRNA and the pathological score were analyzed using Spearman analysis.

RESULTSThe pathological scores of Group A-E were 0.5 ± 0.5, 2.5 ± 1.0, 2.7 ± 1.0, 3.0 ± 0.9, 5.3 ± 1.2 respectively. The expression of TLR-4 were (3.2 ± 1.5)%, (16.± 2.6)%, (15.8 ± 2.1)%, (17.5 ± 2.4)%, (38.2 ± 4.4) %. The expression of TLR-4 mRNA were 1.07 ± 0.09, 2.12 ± 0.33, 2.07 ± 0.29, 2.17 ± 0.34, 4.53 ± 0.46. Compared with group A, groups B- E showed significant higher pathology score (P < 0.05) and increased expression of both TLR-4 (P < 0.05) and TLR-4 mRNA (P < 0.05). An significant positive correlation was found between the expression of TLR- 4 and the pathology score (r = 0.785, P < 0.05), and between the expression of TLR- 4 mRNA and the pathology score (r = 0.720, P < 0.05).

CONCLUSIONSTLR-4 may be closely associated with the development of the synovitis of TMJ of rats.

Animals ; Male ; Masseter Muscle ; RNA, Messenger ; Rats ; Rats, Wistar ; Synovial Membrane ; Synovitis ; metabolism ; Temporomandibular Joint ; metabolism ; Toll-Like Receptor 4 ; biosynthesis

OBJECTIVETo investigate the changes of peroxisome proliferator- activated receptor-γ coactivator -1α (PGC-1α) mRNA and cytoapoptosis in the rats' masseter muscle which had been influenced by unilateral chewing, and to explore the theoretical foundation of changes in masticatory muscles induced by unilateral chewing.

METHODSThe animal models were established by extracting the Wistar rats' left maxillary molars. Thirty- six female Wistar rats were randomly divided into four groups of 2, 4, 6 and 8 weeks, nine each. In each group there were six rats with molar extracted and three as control. The Ca²⁺ level was detected by atomic spectrophotometric method. The relative expression of PGC-1α mRNA was detected by real- time fluorescent quantitative PCR. The apoptosis index was detected by Hoechst staining.

RESULTSThe Ca²⁺ level in the muscle on the extraction side were significantly higher than that in the controls in the beginning stage of unilateral chewing, and reached the peak at the 4th week [(43.62 ± 2.36) µg/g]. The relative expressions of PGC-1α increased from the beginning and reached the maximum level at the 4th week [extraction side: (1.57 ± 0.10); non-extraction side: (1.92 ± 0.06)], while the relative expressions of PGC-1α in 6 and 8 weeks decreased gradually [extraction side: (1.06 ± 0.08), (1.08 ± 0.07); non- extraction side: (1.09 ± 0.10), (1.11 ± 0.08)]. The changes of apoptosis index on non- extraction side increased continually and peaked at the 6th week [(38.56 ± 1.64)%].

CONCLUSIONSPGC-1α and cytoapoptosis played important roles in different stages of tissue remodeling induced by unilateral chewing.

Animals ; Apoptosis ; Female ; Masseter Muscle ; cytology ; metabolism ; Mastication ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; RNA, Messenger ; RNA-Binding Proteins ; Rats ; Rats, Wistar ; Transcription Factors ; metabolism

OBJECTIVE To compare anti-ischemic stroke （IS） effect of different extraction parts from Gastrodia elata， and to provide reference for screening the anti-IS effective parts of G. elata. METHODS G. elata was extracted and separated by ethanol reflux extraction and ethyl acetate extraction. The rat model of diffuse cerebral thrombosis was induced by internal carotid artery injection of arachidonic acid （AA）； the anti-IS effect of G. elata powder， ethanol extract of G. elata， residue of ethanol extract of G. elata， ethyl acetate extract of G. elata， residue of ethyl acetate extract of G. elata， gastrodin and aspirin （positive control drug） were investigated with the content of Evans blue （EB） in the ischemic brain tissue as index. RESULTS Compared with model group， aspirin， ethanol extract of G. elata and ethyl acetate extract of G. elata could significantly decrease the content of EB in the ischemic brain tissue of model rats （P＜0.05）. G. elata powder had the tendency to reduce the content of EB in the ischemic brain tissue of model rats， without statistical significance （P＞0.05）. The residue of ethanol extract of G. elata， residue of ethyl acetate extract of G. elata and gastrodin had little effect on the content of EB in the ischemic brain tissue of model rats. CONCLUSIONS Both ethanol extract of G. elata and ethyl acetate extract of G. elata have anti-IS effects， which are stronger than that of G. elata powder.

Direct acid hydrolysis of Dioscorea zingiberensis rhizomes for preparation of diosgenin is wildly used in the traditional industry， which uses a large amount of inorganic acid catalysts， with high wastewater discharge and serious environmental pollution. Therefore， exploring clean and efficient preparation methods and processes has become an inevitable choice to realize the sustainable development of industrial production of diosgenin. Herein， the author reviewed and analyzed the research progress and problems of enzymatic hydrolysis， microbial transformation and modified acid hydrolysis in the preparation of diosgenin from D. zingiberensis rhizomes during the last ten years， and their application prospects are analyzed. Enzymatic hydrolysis has mild reaction conditions， but the yield of diosgenin is low， the economic cost is high， and the purification process of active enzyme is complicated. Microorganism shows specific activity to the substrate and high efficiency for diosgenin production， and microbial transformation is clean and environmentally friendly， but microbial transformation is time-consuming and the metabolic intermediates are complicated. For the modified acid hydrolysis， two-phase acid hydrolysis can reduce the amount of acid catalyst， and sulfonic acid-functionalized ionic liquid displays good recyclable performance by replacing the traditional inorganic acid， however， the wastewater discharge should still be considered. Solid acid catalysts are non-corrosive and easy to be recycled， but the need to use ethanol as the reaction solvent has certain safety hazards， and the catalyst preparation process is cumbersome. In conclusion， exploring clean and efficient conversion methods is an important research trend for preparation of diosgenin from D. zingiberensis rhizomes. For the enzymatic hydrolysis， the key glycoside hydrolases in the bioconversion process should be explored in depth， the conversion pathway of enzymatic saponins and enzyme specificity should be fully elucidated， and efforts should be made to improve the efficiency of enzymatic hydrolysis. For the microbial transformation， we should accelerate its industrial application process based on selecting and breeding efficient transformation strains， and optimizing stable transformation systems and processes， and in-depth investigation of the mechanism of microbial transformation， fully elucidating the specific key hydrolases and its catalytic properties， and striving to improve the efficiency of microbial transformation. For the modified acid hydrolysis， novel acid catalytic system with simple structure， stable performance and good biodegradability should be explored and applied， which can effectively solve the problems of environmental pollution and production safety.