Objective To investigate the change of glucose metabolism in warm ischemia/reperfusion injured kidney of rabbits in vivo by microdialysis and real-time electrochemical detection.Methods A total of 20 New Zealand rabbits were divided into experiment and control groups(10 in each).After anesthesia by intravenous injection of barbitone,an oblique incision under the 12th rid was made in the animals to expose the right kidney and the right renal artery and vein.Afterwards,a microdialysis probe was placed into the dorsal renal cortex along the long axle of the kidney.After 60 minutes to equilibrate,an electrochemical detection system was used to continuously determine the concentration of glucose in the renal cortex before ischemia.Then,ischemia/reperfusion injury model was established by clamping the renal pedicle for 60 minutes followed by perfusion for 60 minutes.The control group received the same intervention without clamping the renal pedicle.The glucose concentration of the microdialysis samples were analyzed before,during,and after the ischemia.Results The reaction of the glucose electrode to the electric current was linearly correlated with the concentrations of glucose,and the rate of microdialysis probe recycling was(63.6?2.1)%.The concentration of glucose in the renal cortical interstitial samples were(1.89?0.37),(0.69?0.12),and(0.62?0.14)mmol/L respectively before,during,and after the warm ischemia.During the ischemia phase,the mean concentration of glucose decreased by(36.7?2.4)% from the base level(LSD test,P=0.000).The glucose concentration of the experimental group was significantly lower than that in the control at both ischemia and reperfusion phases(t=-11.975,P=0.000;t=-11.993,P=0.000,respectively).Conclusions In vivo microdialysis combined with electrochemical detection provides a sensitive and real-time method for measuring the glucose concentration in warm ischemia/reperfusion injured kidney,which can suggest the ischemic condition of the renal cortex.

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in tumor tissue on analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain. Methods One hundred and fifty advanced cancer patients with pain aged 51-64 yr weighing 54-65 kg were included in this study. The expression of P-gp was negative in the tumor tissue in 50 patients (group M1 and B1, n = 25 each) and positive in 100 patients (group M2 ,M3 ,and B2 ,B3, n =25 each). The PCA regimen for the 6 groups were listed in the table .Pain was assessed with VAS scores (0 = no pain, 10 = worst pain) and venous blood samples were taken for determination of blood morphine/buprenorphine concentrations at 4, 12, 24 and 48 h of PCIA. Results The six groups were comparable with respect to age, body weight, M/F sex ratio, types of cancer, baseline pain level and education. The analgesic efficacy of morphine and buprenorphine was better ( VAS scores were significantly lower)in P-gp expression negative patients (group M1 and B1 ) than in P-gp expression positive patients (group M2 and B2 ). Higher doses of morphine and buprenorphine provided better analgesic efficacy in P-gp expression positive patients in group M3 and B3 than in group M2 and B2. Plasma morphine and buprenorphine concentrations were comparable between group M1 , B1 and M2, B2 and were significantly higher in group M3 and B3 at each time point. Conclusion Positive P-gp expression in the tumor tissue can decrease the analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain.

Objective To summarize the imaging features of intra-pancreatic accessory spleen (IPAS)with multidetector computed tomography (MDCT) and improve the awareness and correct diagnosis of IPAS.Methods MDCT images of seven consecutive patients with surgically and pathologically confirmed IPAS were reviewed retrospectively.The investigated features included the location,size,shape,margin,density,and enhancement of the lesions.Results Four patients were male and three were female with a mean age of 49 years old.All the lesions were located at the dorsal side of parenchyma under the capsule of pancreatic tail.Three lesions were in round-like shape,and 4 in oval shape and all were well-defined.All the lesions were mass-like without necrosis and calcification.The maximum diameter of lesion ranged from 0.9 ～ 1.8 cm with a mean value of 1.4 cm.Compared with pancreatic parenchyma,the density of lesions were homogeneous on unenhanced CT,in arterial phase,slightly increased heterogeneous density was observed in 3 patients,slightly increased homogeneous density was observed in 4 patients.All the lesions appeared as slightly increased homogeneous density in portal phase.The CT value in unenhanced phase ranged from 50 ～ 61 Hu with a mean number of 55 Hu; and it ranged from 80 ～ 110 Hu with a mean number of 97 Hu in arterial phase; and the corresponding value was from 99 ～ 120 Hu with a mean number of 102 Hu in portal phase.Among the three patients underwent MDCT angiography,neither artery nor vein was compressed or invaded,and there was no vessel connected with lesions.Conclusions IPAS has some MDCT characteristics.For small solid mass in pancreatic tail,if the density and enhancement pattern is similar to that of spleen,the diagnosis of IPAS should be considered.

Objective To investigate the association between β2-adrenergic receptor gene polymorphism and coronary atherosclerotic heart disease, and to provide reference for clinical disease prevention and treatment.MethodsThe clinical data of 200 patients with coronary atherosclerotic heart disease confirmed by coronary angiography were selected and included in the study group, and 200 healthy subjects without coronary atherosclerotic heart disease group.The polymorphism of β2 adrenergic receptor gene was detected and the frequency of each gene was analyzed.ResultsThe genotype frequencies of β2-adrenergic receptor gene were in accordance with Hardy-Weinberg equilibrium, the difference was not statistically significant.According to dominant genetic model, the frequency of AA+AG was 46.0% vs 58.0% lower than that of the control group, and had statistical significance, The genotype frequency of GG genotype in study group was significantly lower than that in control group 14.0% vs 26.0%, χ2=26.20, P=0.00.The frequency of GG genotype in study group was significantly higher than that in control group 54.0% vs 42.0%, χ2=5.76, P=0.01.The frequency of A gene was 38.0% compared with 44.0% in control group, χ2=1.48, P=0.22;the frequency of AA gene in study group was 30.0%, and the frequency of gene A was 38.0%, compared with 56.0% Compared with 32.0% in the control group, χ2=0.18, P=0.66.ConclusionThe A/G polymorphism of β2-adrenergic receptor gene is closely related to the clinical pathogenesis of coronary atherosclerotic heart disease, and the A allele may be a protective factor in patients with coronary atherosclerotic heart disease.

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in the tumor tissue on the analgesic efficacy of fentanyl and lornoxicam in patients with cancer pain. Methods One hundred advanced cancer patients with pain aged 49-64 yr weighing $$-65 kg were included in this study. The expression of Pgp was positive in the tumor tissue in 50 patients (groups F1 and L1, n = 25 each) and negative in 50 patients (groups F2 and L2, n = 25 each). The patients in 4 groups received 48 h of pstient-controlled intravenous analgesia (PCIA). A loading dose of fentanyl 0.05 mg was administered before PCIA was started in groups F1 and F2 .The PCIA solution contained fentanyl 1 mg and droperidol 5 mg in 100 ml of normal saline in groups Ft and F2, or lomoxicam 64 mg and droperidol 5 mg in 100 ml of normal saline in groups L1 and L2. The PCA pump was set to deliver a background infusion of 2 ml/h and a bolus dose of 0.5 ml at 15 min lockout interval. Pain was assessed with VAS scores (0 = no pain, 10 = worst pain), and VAS score was maintained at ≤3 during PCIA. Flurbiprofen 50 mg was injected intravenously when VAS score≥4 and the consumption of flurbiprofen was recorded. The consumption of fentanyl and lornoxicam during PCIA was recorded. Blood samples from the internal jugular vein were taken at the beginning of PCIA (T0), and at 4, 12, 24, 48 h of PCIA (T1-4) for determination of blood fentanyl and lornoxicam concentrations. Results Flurbiprofen was not used in groups F2, L1 and L2. The consumption of flurbiprofen was ( 184 ± 41 ) mg in group F1 . There was no significant difference in the consumption of fentanyl during PCIA between groups F1 and F2 ( P ＞ 0.05). Blood fentanyl concentrations were not detected at all the time points in groups F1 and F2 . The VAS score during PCIA ≤ 3 in groups L1 and L2, and there was no significant difference in blood concentrations of lornoxicam at each time point and the consumption of lornoxicam during PCIA between groups L1 and L2 ( P ＞ 0.05). Conclusion Positive P-gp expression in the tunor tissue can decrease the analgesic efficacy of fentanyl, but exerts no effect on the analgesic efficacy of lornoxicam in patients with cancer pain.

Objective To discuss the application of spectral CT imaging in evaluating the early therapeutic response of 125I seed interstitial brachytherapy for pancreatic carcinoma in experimental nude mice.Methods BxPC-3 human pancreatic cancer cell xenografts were subcutaneously inoculated at the dorsal part of the limbs in 16 BABL/c nude mice. When the tumor developed to the size of 1-1.5 cm, the tumor-bearing mice were randomly divided into the study group (n=8,receiving implantation of 125I seeds of 1.0 mCi) and the control group (n=8,receiving implantation of ghost shell particles of 0 mCi). Two weeks after the procedure, plain spectral CT scan as well as enhanced multiphase (10 s, 25 s and 60 s) spectral CT scan were performed to obtain multi-phasic image series. The contrast-to-noise ratio (CNR) and iodine concentration (IC) inside the lesions were determined, and the normalized iodine concentrations (nIC) of tumor were thus obtained. Immunohistochemical staining of tumor was used to measure microvessel density (MVD) within the tumor;the correlation between nIC and MVD was analyzed. Results The lesion's nICs measured on each of three phases (10 s,25 s and 60 s) in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). MVD count in the study group was lower than that in the control group, the difference was statistically significant (t=5.957,P<0.01). A parallel linear correlation existed between nIC obtained from each phase of three phases and MVD count (r=0.63,P<0.000 1;r=0.51,P=0.002;and r=0.48,P=0.001 7 for 10 s, 25 s and 60 s phases respectively). Conclusion Spectral CT imaging is an effective method for evaluating the therapeutic effect of 125I seed interstitial brachytherapy for pancreatic carcinoma of experimental mice.

Objective To retrospectively analyze imaging features of multi-slica computed tomography (MSCT) and clinical characteristics of male patients with pancreas solid pseudopapillary tumor (SPT) and compare with that of female patients.Methods From November 2000 to October 2012,clinical data of 18 male patients and 94 female patients underwent MSCT examination and pathological diagnosed as SPT were retrospectively analyzed.Clinical characteristics and imaging features of MSCT of male and female patients with SPT were analyzed,which included lesion location,size,shape,encapsulation,calcification,internal composition,density and enhancement pattern of tumors.Rank sum test or x2 test was performed for statistical analysis.Results The median age of male patients with SPT was significantly older than that of female patients (39.0 (15.0,67.0) years vs 27.5 (11.0,63.0) years; U=2.865,P =0.005).There were no significant differences in clinical manifestation,lesion location and composition ratio of benign and malignant tumors between male and female patients with SPT (all P＞0.05).Imaging of MSCT indicated that the median maximum tumor diameter of male patients with SPT was significantly shorter than that of female patients (5.1 (1.0,11.6) cm vs 7.9 (2.5,18.7) cm; U=3.161,P=0.002).Solid tumors were more common in male patients compared with female patients (9/18 vs 5.3％ (5/94) ; x2 =30.606,P＜0.01).Conclusions The imaging features of male patients with SPT are different with those of females.For pancreas lesion in males,if imaging of MSCT shows more solid composition,small lesion and with typical enhancement patterns of SPT,the possibility of SPT should be considered.

Objective: To understand the characteristics of injuries among rural children, and to determine the relationships between school-level factors with anxiety among injury-prone children, to provide a reference for making effective measures to prevent and control the injuries. Methods: A cross-sectional survey was conducted in the Qingxin District of Qingyuan City. Six primary schools and middle schools were randomly selected from two towns. A total of 5 250 students in grades 3-9 were investigated. Students filled out the questionnaire themselves. Screen for Child Anxiety Related Emotional Disorders (SCARED) was used to assess anxiety. Results: Among the 770 rural children who suffered injuries during the past year, the leading cause of injury was falling(44.62%), falling at home(29.61%), getting injuried in low limbs(29.45%), getting injuried by oneself (41.00%) and mainly unintentional injuries(68.66%) . About 35.06% of children reported anxiety symptoms. Approximately 14.94% of children were injury-prone type. Significant differences in educational stage, boarding school, fighting involvement, and somatization/panic between injury-prone children were found in control group(P<0.05). The robust Poisson-GEE model showed that primary school students in high grade and middle grade, fighting with classmates, somatic/panic associated with injury risk (PR value was 2.11, 1.75, 1.58 and 1.58, respectively). Conclusion Injury-prone children in rural are affected by school-level factors as well as anxiety symptoms. In addition to safety education, mental health promotion and prevention of school bullying should be adopted in schools.

Objective To investigate the endogenous carnosine,glutathione system and oxidative stress level in serum of patients with diabetic cardiomyopathy(DCM),and the potential relationships among them.Meth-ods The serum of 102 healthy people,96 patients with type 2 diabetes mellitus and 74 patients with diabetic car-diomyopathy in the third affiliated hospital of QiQihar Medical University were enrolled.Carnosine content was mea-sured by ELISA.T-GSH,GSH and GSSG were detected by using micro-enzyme labeling assay.GSH-Px,GST and GRAC were detected by using colorimetry. The content of NO was detected by nitrate reduction method. The con-tent of H2O2was detected by using molybdic acid coloring method. The activities of NOS and CAT was determined by colorimetry. Results Compared with the healthy control group,the average level of human serum carnosine, GSH content,GRAC,GSH/GSSG ratio,GST activity and T-SH content in the DM and DCM group were signifi-cantly reduced(P < 0.05,respectively). NO content,H2O2and iNOS activity were increased,but CAT activity was decreased in DCM group.Conclusion Decreases of levels of serum carnosine and glutathione(GSH)and the imbalance of redox state were observed in patients with diabetic cardiomyopathy,which may promote the occur-rence and development of the diabetic cardiomyopathy.

Objective:To explore the screening scheme of gastric cancer in large-scale natural population in Wuxi.Methods:From December 2016 to December 2019, 105 865 residents of 19 communities (villages) in six streets of Xinwu District, Wuxi were randomly enrolled in this study by random number table. A household epidemiological questionnaire survey was conducted among 50 063 target population subjects (aged 40-69), and then, respondents were divided into four categories, category Ⅰ: HP (-), PG (-); category Ⅱ: HP (+ ), PG (-); category Ⅲ: HP (+ ), PG (+ ); category Ⅳ: HP (-), PG (+ )according to the serological Helicobacter pylori ( HP) antibodies and pepsinogen (PG) test results. People in category Ⅲ and Ⅳ were all selected into group C and group D respectively, then individuals 3 times of group D were randomly selected from category Ⅰ to assign to group A, and individuals 3 times of group C from category Ⅱwere assigned to group B in the same way. Remaining individuals in category Ⅰ and Ⅱ who had first-degree family history of gastric cancer were also included in group A and group B, respectively. Endoscopic and pathological examination were performed on the above enrolled subjects for high grade intraepithelialneoplasia (HGIN), early gastric cancer and gastric cancer. Results:Of the 50 063 target subjects, 31 508 questionnaires were finally collected, with a participation rate of 62.9%. A total of 19 745 people were tested for serology, and the participation rate was 39.4% (19 745/50 063). Serological results showed that there were 11 152 people (56.48%) in category Ⅰ, 8 170 (41.38%) in category Ⅱ, 124 (0.63%) in category Ⅲ, and 299 (1.51%) in category Ⅳ. According to the exclusion criteria and principle of voluntariness, 3 400 individuals were candidates to undergo gastroscopy. Finally, a total of 2 389 people came to the hospital for gastroscopy, 1 263 in group A, 814 in group B, 86 in group C and 226 in group D, with an overall response rate of 70.3% (2 389/3 400), target population participation rate of 4.8% (389/50 063), and the overall population participation rate of 2.3% (2 389/105 865). In the 2 389 cases, there were 32 cases (1.34%) of HGIN and gastric cancer by gastroscopy and biopsy pathology, among which 1 case (3.125%) aged 40-49, 9 (28.125%) aged 50-59, and 22 (68.750%) aged 60-69. Among the 32 cases, 25 cases (78.13%)were pathologically confirmed as having HGIN or early gastric cancer by endoscopic submucosal dissection or surgical operation. By eliminating 810 people (including 3 gastric cancer) without first-degree family history with gastric cancer in group Ⅰ and Ⅱ, and increasing the gastroscopy screening age to 50 years (exluding 214 people aged 40-49, including 1 gastric cancer), the number of people who should undergo gastroscopy could be reduced from 2 389 to 1 365, and 28 cases of HGIN or gastric cancer were still detected, including 22 HGIN or early gastric cancer.Conclusion:Gastroscopy after the screening with epidemiological, serological tests, age and first-degree relative with gastric cancer family history is suitable for gastric cancer screening in Wuxi. Based on Chinese national conditions, a new community gastric cancer screening program is recommended in Wuxi considering cost-effectiveness, which includes those over 50 years old, serological PG (+ ) and first-degree relatives with family history of gastric cancer.