Objective: To investigate the hypoglycemic targets of Polygonum capitatum. Methods: Human liver cancer HepG2 cells were adopted to detect the supernatant culture medium glucose content, and the effect on PPAR-α and GLUT4 gene expression was investigated by qRT-PCR after treatment of P. capitatum extracts (PCB). INS-1 cells similar to islet β cells, divided into drug protection group and repair group, were adopted to determine the cell proliferation activity by MTT; The intracellular SOD and MDA levels were measured by biochemical method; The Cyt C and Caspase-3 protein expression levels were detected by Western blotting. Adopting maltose as substrate of α-glycosidase enzyme inhibition model, the inhibitory efficiency of PCB on glycosidic enzyme was determined. Results: PCB group significantly promoted the absorption of HepG2 cells to supernatant glucose and increased the expression of PPAR-α and GLUT4 genes significantly. Aim at protection and repair of INS-1 cells, PCB group significantly increased cell vitality and SOD level, reduced MDA level compared with model group, and at the same time significantly reduced Cyt C and Caspase-3 protein expression levels. PCB had inhibitory activity to α-glycosidase enzymes, with IC50 of 11.53 mg/mL. Conclusion: PCB could significantly increase the PPAR-α and GLUT4 genes expression to promote the absorption of HepG2 cells to supernatant glucose by blocking the Cyt C-Caspase-3 pathways to reduce apoptosis of islet cells which were damaged by STZ and by raising SOD and declining MDA to improve INS-1 cell oxidative stress; What’s more it has inhibitory activity to α-glycosidase enzymes.

OBJECTIVETo evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on the growth of granulation tissue and macrophage polarization in chronic venous leg ulcers.

METHODSThiry-four patients with chronic venous leg ulcers hospitalized in our department from December 2010 to July 2014 were divided into VSD group ( A, n = 11) , VSD + irrigation group ( B, n = 11) , and VSD + oxygen loaded fluid irrigation group ( C, n = 12) according to the random number table. After admissian, debridement was performed, and granulation tissue in the center of the wound was harvested during the operation. After dehridement, the patients in group A were treated with VSD only (negative pressure from -30 to -25 kPa, the same below) ; the patients in group B were treated with VSD combining irrigation of normal saline; the patients in group C were treated with VSD combining normal saline loaded with oxygen irrigation (flow of 1 L/min) . On post treatment day (PTD) 7, the VSD devices were removed. Cross observation was conducted before debridement and on PTD 7. On PTD 7, the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining and Masson staining, following calculation of granulation tissue coverage rate. After debridement but before the negative pressure therapy (hereinafter referred to as before treatment) and on PTD 7, partial pressure of oxygen of the skin around the wound was measured by transcutaneous tissue oxygen tension survey meter. On PTD 7, expression of vascular endothelial growth factor (VECF) was determined with immunohistochemistry. Before treatment and on PTD 7, cells with double positive expressions of induced nitric oxide synthase plus CD68 ( type I macro- phage) and arginase 1 plus CD68 ( type II macrophage) were observed with immunofluorescence staining and quantified. Data were processed with Fisher's exact test, one-way analysis of variance, covariance analysis, paired test, and LSD test.

RESULTS(1) The gross observation showed that before debridement there was a certain amount of necrotic tissue and little granulation tissue in the wounds of patients in all the 3 groups. On PTD 7, new granulation tissue was found in the wounds of patients in all the 3 groups, and in group C its amount was the largest. (2) On PTD 7, the granulation tissue coverage rate of wounds in pa- tients of group C was higher than that of group A or B ( P <0.05 or P <0.01). (3) On PTD 7, HE staining showed that there appeared more abundant new born microvessels and fibroblasts in the wounds of patients in group C than those in groups A and B; Masson staining showed that there was more abundant fresh collagen distributed orderly in the wounds of patients in group C compared with group A or B. (4) On PTD 7, it was found that partial pressure of oxygen of the skin around the wounds in patients of group C [(40.7 +/- 4.1) mmHg, 1 mmHg = 0.133 kPa] was higher than that of group A [ (35.0 +/- 3.1) mmHg] or B [(35.4 +/- 2.7) mmHg, with P values below 0.01]; the partial pressure of oxygen of the skin around the wounds of patients in all the 3 groups was increased significantly compared with that before treatment (with values from 10.38 to 22.52, P values below 0.01). (5) On PTD 7, the expression of VECF in the wounds of patients in group C was higher than that in group A or B ( P <0.05 or P < 0.01). (6) On PTD 7, the number of type I macrophages in granulation tissue of patients was respectively 14.3 +/- 2.3, 11.5 +/- 3.0, and 10.7 +/- 2.3 per 400 times vision field in groups A , B, and C ( F = 25.14, P < 0.01), while the number in group C was less than that in group A or B ( P < 0.05 or P < 0.01). Compared with that before treatment, the number of type I macrophages was significantly decreased on PTD 7 in all the 3 groups (with values from 14.76 to 23. 73, P values below 0. 01). On PTD 7, the number of type II macrophages in granulation tissue of patients was respectively 32.7 +/- 3.2, 35.1 +/- 3.3 , and 41.3 +/- 3.2 per 400 times vision field in groups A, B, and C ( F = 81.10, P < 0.01), and the number in group C was lager than that in group A or B ( with P values below 0. 01). Compared with that before treatment, the number of type II macrophages in all the 3 groups was significantly increased (with t values from -69.34 to -47.95, P values below 0.01).

CONCLUSIONSVSD combined with irrigation of oxygen loaded fluid can raise the partial pressure of oxygen of the skin around the wounds effectively, promoting the transition of macrophages from type I to type II, thus it may promote the growth of granulation tissue, resulting in a better recipient for skin grafting or epithelization.

Debridement ; Drainage ; Granulation Tissue ; Humans ; Leg Ulcer ; etiology ; surgery ; Macrophages ; Microvessels ; Negative-Pressure Wound Therapy ; methods ; Nitric Oxide Synthase Type II ; Oxygen ; Skin ; Skin Transplantation ; Skin Ulcer ; Surgical Flaps ; Treatment Outcome ; Vacuum ; Vascular Endothelial Growth Factor A ; Veins ; Wound Healing

Bile acids are the main products of the cholesterol degradation in the liver. They promote the absorption and transportation of the intestinal lipids. Diverse bile acid receptors are widely distributed in human tissues and organs, including farnesoid X receptor (FXR) and Takeda G protein receptor (TGR5). The expression pattern of different bile acid receptors and their different affinities to various bile acids as their ligands determines their pleiotropic downstream effects, including regulating bile acid synthesis and transportation, immune and metabolism homeostasis. In addition, the bile acid pool includes components derived from both host and gut microbiota, which collaboratively contribute to the bile acid signaling activation in different compartments. Therefore, bile acid pool represents an information hub allowing the crosstalk between the host and gut microbiome and hereby modulating host metabolic homeostasis and gut microbiome symbiosis. This article reviews the recent advances in the field of bile acid regulation and the related mechanisms of bile acid signaling pathway to maintain metabolic homeostasis.

Objective: To explore the safety of elective therapeutic cardiac catheterization in congenital heart disease (CHD) children with recent upper respiratory tract infection (URI) (within two weeks), so as to provide guidance for clinical anesthesia management. Methods: A total of 140 CHD children of American Society of Anesthesiologist (ASA) II~III undergoing tracheal intubation general anesthesia for elective therapeutic cardiac catheterization, aged 3 months to 15 years, were divided into URI group and non-URI group according to history of recent URI. The incidence of perioperative respiratory adverse events (PRAEs) [i.e. laryngospasm, bronchospasm, breath holding ≥ 15 s, pulse blood oxygen saturation (SpO2)<95%( ≥ 10 s), cough, and glossoptosis] and postoperative dysphoria, fever, copious sputum, and vomiting within 24 h after operation were observed and compared. Results: Compared with non-URI group, recent URI increased significantly the overall incidence of PRAEs (any complications of PRAEs) (P=0.001), particularly the incidence of SpO2<95% (P=0.014) and cough (P=0.000). Compared with children aged from 4-15 in URI group, the overall incidence of PRAEs (P=0.003), SpO2<95% (P=0.018), and cough (P=0.027) of children younger than 3 years increased significantly. Besides, compared with non-URI group, recent URI increased significantly the incidence of postoperative copious sputum (P=0.002). Conclusion: Recent URI increases significantly the incidence of perioperative complications in CHD children undergoing elective therapeutic cardiac catheterization. These complications are short and easily managed, and no serious adverse events occurred in CHD children.

Objective: To explore the impact factors of imaging quality of three-dimensional shear wave elastography (3D-SWE) for focal breast lesions. Methods: A total of 187 patients with focal breast lesions underwent 3D-SWE examination, and the imaging quality was classified into three grades, including Grade 1 (good), Grade 2 (common) and Grade 3 (poor). The impact of additional operating pressure, breast type, coupling agent thickness, and the location, size, depth as well as pathology of lesions on imaging quality were analyzed. Results: Grade 1 images were found in 105 (105/187, 56.15%) patients, Grade 2 images were observed in 59 (59/187, 31.55%) patients, while Grade 3 images were noticed in 23 (23/187, 12.30%) patients. Additional operating pressure, location, pathology, the maximum diameter of lesions, the largest vertical distance from deep side of the lesion to skin and the thickest fat layer in front of the lesion were the impact factors of 3D-SWE imaging quality (all P<0.05). Conclusion: The imaging quality of 3D-SWE is influenced by the additional operating pressure and the location, size, depth and pathology of lesions.

BACKGROUNDNeuroprotective strategies following cardiopulmonary resuscitation (CPR) are an important focus in emergency and critical care medicine. Matrix metalloproteinases (MMPs), especially MMP9 attracted much attention because of its function in focal brain ischemia/reperfusion injury. In the focal cerebral ischemia model in rats, SB-3CT can suppress the expression of MMP9, relieving brain edema, and there was no studies on global cerebral ischemia-reperfusion injury after CPR.

METHODSOne hundred and twenty rats were randomly assigned to sham-operated (n = 40), resuscitation treatment (n = 40), and resuscitation control (n = 40) groups. Sham-operated group rats were anesthetized only and intubated tracheally, while the resuscitation treatment and resuscitation control groups also received cardiac arrest by asphyxiation. In the resuscitation treatment group, SB-3CT was injected intraperitoneally after restoring spontaneous circulation (ROSC), defined as restoration of supraventricular rhythm and mean arterial pressure (MAP) > or = 60 mm Hg for more than 5 minutes. The resuscitation control group also implemented ROSC without injection of SB-3CT. The rats were executed and samples were taken immediately after death, then at 3, 9, 24, and 48 hours (n = 8). Brain tissue expression of MMP9 protein, MMP9 mRNA, water content, Evans blue content, TNF-alpha, IL-1, and IL-6 was measured, and the brain tissue ultramicrostructure studied with electron microscopy.

RESULTSIn the resuscitation control group, brain tissue expression of MMP9 protein and mRNA, water content, Evans blue content, TNF-alpha, IL-1, and IL-6 were significantly elevated at 3 hours, and peaked at 24 hours after resuscitation, when compared with the sham-operated group (P < 0.05). Tissue ultramicrostructure also changed in the resuscitation control group. By contrast, although all these indexes were increased in the resuscitation treatment group compared with the sham-operated group (P < 0.05), they were lower than in the resuscitation control group (P < 0.05).

CONCLUSIONSExpression of MMP9 protein and mRNA, water content, Evans blue content, TNF-alpha, IL-1, and IL-6 increased in rat brain tissue after CPR, indicating disruption of the blood-brain barrier and excess inflammatory reaction. MMP9 expression was reduced with SB-3CT, resulting in reduced brain injury.

Animals ; Blood-Brain Barrier ; drug effects ; Brain ; immunology ; ultrastructure ; Cardiopulmonary Resuscitation ; Cytokines ; analysis ; Heterocyclic Compounds, 1-Ring ; pharmacology ; Inflammation ; prevention & control ; Male ; Matrix Metalloproteinase 9 ; analysis ; genetics ; Matrix Metalloproteinase Inhibitors ; Neuroprotective Agents ; pharmacology ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Sulfones ; pharmacology

OBJECTIVETo investigate the effect of apatinib, a small-molecule vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor, on the proliferation of human acute myeloid leukemia HL-60 cells and explore the possible mechanism.

METHODSMTT assay was used to assess the cytotoxicity of apatinib in HL-60 cells. The apoptosis and cell cycle changes of the cells in response to apatinib treatment were analyzed by flow cytometry, and Western blotting was used to assay P-Akt and P-Erk1/2 expressions in the cells.

RESULTSApatinib significantly inhibited the proliferation of HL-60 cells in vitro with an IC(50) of 4.96∓0.32 µmol/L. Apatinib treatment significantly increased the apoptotic rate of the cells in a dose-dependent manner, but produced no significant effect on the cell cycle (P>0.05). Western blotting showed that the expressions of P-Akt and P-Erk1/2 decreased in HL-60 cells after a 48-h apatinib treatment.

CONCLUSIONApatinib inhibits the proliferation of HL-60 cells by inducing cell apoptosis probably through the mechanism of inhibiting the expressions of the Akt/Erk1/2 signal transduction pathway.

Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; HL-60 Cells ; Humans ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; Pyridines ; chemistry ; pharmacology

The technology of split liver transplantation is becoming increasingly mature with rapid development. During ex vivo splitting, the depletion of intracellular energy sources [such as adenosine triphosphate (ATP)] and other metabolic disorders may lead to cell damage and dysfunction, which will be aggravated by reperfusion injury of liver transplantation, clinically manifested as postoperative complications and transplantation failure. To further improve the quality of donor liver in ex vivo split liver transplantation, research teams at home and abroad apply machine perfusion to enhance the quality of donor liver. In this article, the research progresses worldwide on machine perfusion of donor liver in ex vivo split liver transplantation were reviewed, and the application and prospect of dual hypothermic oxygenated machine perfusion (D-HOPE) in ex vivo split liver transplantation were elucidated, aiming to provide reference for increasing the source of donor liver for ex vivo split liver transplantation and further resolving the current status of donorliver shortage.

【Objective】 To analyze characteristics of ocular surface damage in inactive mild and moderate-severe Graves' Orbitopathy(GO) . 【Methods】 In this retrospective study, the clinical characteristics of GO patients at Sun Yatsen Memorial Hospital between April 2017 and April 2019 were reviewed. Data were collected from 192 eyes of 192 cases. There were 121 eyes of 121 cases with mild GO, and 71 eyes of 71 cases with moderate-severe GO. All patients were divided into corneal-damage and non-corneal-damage groups. The ocular surface irritation, tear film breakup time(TFBUT), marginal reflex distance 1(MRD1), marginal reflex distance 2(MRD2), Schirmer's test Ⅱ, and proptosis of the two groups were compared. 【Results】 Grittiness(21 cases, 52.5%) and photophobia(23 cases, 57.5%) were higher, in cornealdamage group of inactive mild GO patients, compared with non-corneal-damage group(23 cases, 28.4%, 29 cases, 35.8%, respectively) (P ≤ 0.05); but there was no statistical difference in symptoms between the two groups of moderate-severe GO patients. There was statistical difference in increased MRD1 between corneal-damage group [5.1(S = 1.9) mm] and non-corneal-damagegroup [4.4(S = 1.5) mm] of inactive mild GO patients(P ≤ 0.05). Besides, decreased TFBUT in moderate-severe corneal-damage GO patients was 3.2(S = 2.3) s, shorter than non-corneal-damage group [6.2(S = 3.2) s, (P ≤ 0.05) ] . In corneal-damage groups, there was no significant difference in symptoms and signs between mild and moderate-severe GO. 【Conclusions】 Grittinessand photophobia are common symptoms in patients with mild GO ocular surface damage, and MRD1 is related with ocular surface damage. There is no difference in symptom between corneal-damage group and non-corneal-damage group of moderate-severe GO patients, and TFBUT is related with ocular surface damage.

OBJECTIVETo compare the efficacy of preemptive epidural analgesia combined with postoperative epidural analgesia, postoperative epidural analgesia alone and intravenous analgesia for postoperative pain relief and their effects on plasma interleukin-6 (IL-6) concentration following radical surgery for gastric carcinoma.

METHODSSixty-six patients with gastric carcinoma scheduled for gastrectomy were randomly divided into 3 groups, namely group P (n=22), group E (n=22) and group V (n=22), to receive preemptive epidural analgesia combined with postoperative epidural analgesia, exclusive postoperative epidural analgesia, and exclusive postoperative intravenous analgesia, respectively. Hemodynamic data were recorded for all the patients during the operation, and visual analogue scale (VAS) was used to assess the pain intensity at 4, 8, 16, 24, 48 and 72 h after surgery. Plasma IL-6 concentration was determined before surgery and at 24, 48, 72 h after surgery.

RESULTSNo significant changes occurred in the hemodynamics during the preoperative periods. VAS and IL-6 were lower in group P than in group E and V, and group E had lower measurement than group V (P<0.05).

CONCLUSIONPreemptive epidural analgesia combined with postoperative epidural analgesia provides more satisfactory pain relief and more effectively prevents IL-6 increment than exclusive epidural analgesia or intravenous analgesia after gastrectomy for gastric carcinoma.

Adult ; Amides ; administration & dosage ; Analgesia, Epidural ; methods ; Analgesics ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Gastrectomy ; methods ; Humans ; Infusions, Intravenous ; Interleukin-6 ; blood ; Male ; Middle Aged ; Morphine ; administration & dosage ; Pain, Postoperative ; drug therapy ; Stomach Neoplasms ; blood ; surgery ; Treatment Outcome