AIM: To study the effects of metformin on the pressure overload-induced cardiac hypertrophy in rats. METHODS: Transverse aortic constriction (TAC) model of rat was made through laparotomy. One week after TAC surgery, the rats were randomly divided into 5 groups (n=8 in each group) and were administered with the corresponding drugs orally every day for 8 weeks: sham group (sham surgery, administered with 2 mL distilled water);TAC group (TAC rats, administered with 2 mL distilled water);metformin(MET) group (TAC rats, administered with MET at dose of 300 mg·kg~(-1)·d~(-1));MN group [TAC rats, administered with MET at dose of 300 mg·kg~(-1)·d~(-1) plus NOS inhibitor, NG-nitro-L-arginine methyl ester (L-NAME) 50 mg·kg~(-1)·d~(-1)] and L-NAME group (TAC rats, administered with L-NAME at dose of 50 mg·kg~(-1)·d~(-1)). After treated for 8 weeks, the echocardiography, hemodynamics, the ratio of heart weight to body weight (HW/BW) and histological examination of the heart were performed. The levels of myocardial AMP-activated protein kinase subunit α (AMPKα), p-AMPKα~(Thr172), endothelial nitric oxide synthase (eNOS) and p-eNOS~(Ser1177) were detected by Western blotting. Plasma and myocardial nitric oxide (NO) were detected biochemically. RESULTS: After 8 weeks treatment, the wall thickness of left ventricle, the heart weight/body weight ratio (HW/BW), and the left ventricular myocardial perivascular fibrosis and myocardial interstitial fibrosis of the animals in TAC group were significantly increased as compared to those in sham rats. Treatment with MET for 8 weeks significantly attenuated left ventricular hypertrophy and improved cardiac function in TAC rats. These effects of MET were mostly abolished by L-NAME. Molecular biology and biochemical testing revealed that the levels of left ventricular myocardial p-AMPKα~(Thr172) and p-eNOS~(Ser1177), as well as the levels of myocardial and serum NO were significantly increased in MET group. CONCLUSION: Long-term MET treatment significantly inhibits the cardiac hypertrophy and the myocardial fibrosis and improves the cardiac functions in pressure-overload rats. The anti-hypertrophic effects of MET may be mediated via activation of AMPK-eNOS signaling pathway.

BACKGROUNDTo detect quantitatively HCMV DNA in peripheral blood leukocytes to monitor the status of HCMV infection, evaluate the effectiveness of antiviral treatment with ganciclovir (GCV) combined with intravenous immunoglobulin (IVIG) and find out the relationship among the HCMV DNA levels, the state of infection and the clinical outcome.The long-term goal of the study was to establish a molecular diagnostic standard for HCMV infection in children.

METHODS45 cases of suspected HCMV-infected children were examined by PCR, ELISA and fluorescent quantitative (FQ)-PCR, respectively. Twenty five HCMV hepatitis cases of the 45 were randomly assigned to a treated group or a control group. Both groups were treated with prednisone, glucurone, Luminal and Xiaoyanlidanpian. But the treated group was given with GCV+IVIG in addition. Each infant of the two groups was checked with FQ-PCR at the five time points.

RESULTSThe positive rates of PCR, ELISA and FQ-PCR were 60.00%, 33.33% and 66.67%,their sensitivities were 84.38%, 46.88% and 93.75%, respectively. There was no significant difference in viral DNA copy numbers between the two groups before being treated (P>0.05), but there was significant difference between HCMV hepatitis and normal infants (P<0.001). Although viral load of both groups decreased in both groups, the viral load of the treated group decreased more significantly. The level of HCMV DNA fell to 103 copies/ml at second time point while that of the control group fell to the same level after third time point. The differences between the two groups at each time point were statistically significant (P<0.001). The results of 135 person times testing indicated that 103 copies/ml of FQ-PCR can be taken as a critical value for prediction of active HCMV infection.

CONCLUSIONSFQ-PCR may be one of the effective methods for diagnosis of HCMV disease; it can offer a key index in the diagnosis of HCMV active infection; dynamic detection of HCMV viral load can play a role not only in monitoring antiviral therapy, but also in evaluating the development and prognosis of HCMV disease.

Antiviral Agents ; therapeutic use ; Cytomegalovirus ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; drug therapy ; DNA, Viral ; blood ; Ganciclovir ; therapeutic use ; Humans ; Infant ; Infant, Newborn ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Treatment Outcome

Objective: To analyze the burden indicators and trend predictions of eating disorders in Chinese adolescents aged 10-24 years from 1990 to 2019, so as to provide a reference for the prevention and control of eating disorders among adolescents. Methods: According to the latest data of the Global Burden of Disease Study(GBD) 2019 database classified by gender, age group and other indicators, the Joinpoint regression model and bayesian age period cohort model(BAPC) were used to analyze and predict the incidence rate, prevalence and disabilityadjusted life year (DALY) rate of eating disorders among Chinese adolescents aged 10 to 24 years old, and explore the trend of the disease burden of eating disorders in this population in the past three decades. Results: From 1990 to 2019, the overall crude incidence rate of eating disorders among adolescents in China increased from 278.93/105 to 422.27/105, and the crude incidence rate increased from 122.63/105 to 198.80/105, and the crude DALY rate increased from 26.67/105 to 43.50/105. In terms of gender, the standardized incidence rate, standardized prevalence rate and standardized DALY rate of eating disorders of boys and girls all showed an upward trend（boys：AAPC=1.52%，1.84%，1.86%，girls：AAPC=1.28%，1.74%，1.77%，P＜0.05）. The standardized incidence rate, standardized prevalence rate and standardized DALY rate of boys with eating disorders (54.97%, 68.88%, 69.75%) were higher than those of girls (44.26%, 64.48%, 65.56%), and the differences were statistically significant (χ2=201.45, 35.02, 34.55, P<0.05). In terms of age groups, the incidence rate of the 15-19yearold age group (524.10/105) was higher than that of other age groups (10-14yearold age:251.17/105, 20-24yearold age:476.49/105) (χ2=156.87, P<0.05), the prevalence rate of the 20-24yearold age group (278.67/105) and the DALY rate (60.83/105) were higher than those of other age groups (10-14yearold age:81.79/105,18.02/105, 15-19yearold age:221.81/105,48.59/105) (χ2=204.50,197.14, P<0.05). BAPC prediction model showed that in the future, the incidence rate of eating disorders among adolescents in China would still show an upward trend, but the prevalence rate and DALY rate would show a steady downward trend, which might reach 516.43/105, 188.41/105 and 41.23/105 respectively in 2030. Conclusions The burden of eating disorders among adolescents in China continues to increase, with boys and those aged 15-19 years being the key populations for prevention and treatment. All sectors of society should actively take relevant measures and pay attention to the prevention and treatment of adolescent eating disorders.

Objective To investigate the expressions of miR-21 in clinical lung tissues,serum of lung cancer patients and X-ray irradiated A549 cells in vitro and in vivo.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and pulmonary metastasis model of lung cancer in nude mice was established to detect the expression of miR-21 in vitro and in vivo,as well as in clinical lung tissues of different pathological types serum sample of lung cancer patients and NSCLC patients whether or not received radiotherapy.The survival rate was further analyzed in the above mention NSCLC patients.Results The miR-21 expressions was up-regulated in 60.0％ of tissue samples of NSCLC patients,and it was up-regulated in 50.5％ serum samples of lung cancer patients (52 out of 103).The miR-21 expressions in lung adenocarcinoma and squamous cell carcinoma had significant difference (x2 =5.766,P ＜ 0.05).In the serum samples of 87 NSCLC patients,miR-21 was detected in 66.7％ samples from the patients of radiotherapy but only 39.6％ of patients without radiotherapy (x2 =6.321,P ＜ 0.05).Kaplan-Meier curves showed that the survival rate of patients with low miR-21 expression was higher than that with high miR-21 expression (P ＜ 0.05).Multivariate Cox regression analysis demonstrated that the miR-21 expression,regional lymph node metastasis and radiotherapy were independent prognostic factors for NSCLC patients.The expression of miR-21 was up-regulated significantly in X-ray irradiated A549 cells at different time-points after irradiation (t =-7.552--1.206,P ＜ 0.05).Furthermore,the expression of miR-21was up-regulated in the serum and lung of nude mice (t =-47.845--2.356,P ＜ 0.05).Conclusions The X-ray irradiation could up-regulate the expression of miR-21 in A549 cells in vitro and in vivo,which might be correlated with the enhanced metastasis of A549 cells.

Objective:To investigate the clinical results of decompression preserving proximal upper laminae combined with lumbar instrumental fusion in the treatment of lumbar degenerative diseases and the prevention of adjacent segment degeneration (ASD).Methods:A retrospective analysis was conducted on 124 patients (the reserved group) with lumbar degeneration who underwent compression preserving proximal upper laminae combined with fusion surgery involving upper half of the lamina, upper half of the spinous process, adjacent facets, and interspinous ligament at Nanjing Drum Tower Hospital between March 2018 and February 2020. These patients were followed up for more than 2 years. Additionally, 130 patients who underwent traditional total laminectomy decompression combined with fusion surgery from January 2016 to February 2018 were selected as the control group (total laminectomy group). In the reserved group, there were 60 males and 64 females, aged 58.3±10.3 years, including 50 cases of giant lumbar disc herniation, 11 cases of lumbar disc herniation with ossification, 10 cases of simple lumbar spinal stenosis, and 53 cases of degenerative lumbar spondylolisthesis. Total laminectomy group comprised 62 males and 68 females, aged 59.6±9.2 years, with 51 cases of giant lumbar disc herniation, 13 cases of lumbar disc herniation with ossification, 11 cases of simple lumbar spinal stenosis, and 55 cases of degenerative lumbar spondylolisthesis. The number of operative segments, operative time, intraoperative blood loss, postoperative hospital stay, complications, extent of laminectomy, dural sac area, and sagittal spinopelvic parameters were compared between the two groups. Fusion status, adjacent segment stability, and the incidence of ASD were assessed at the last follow-up. Oswestry disability index (ODI) and visual analogue scale (VAS) for back and leg were used to evaluate clinical effectiveness.Results:The follow-up time was 30.5±5.4 months in the reserved group and 31.0±5.8 months in total laminectomy group, and the difference was not statistically significant ( t=0.63, P=0.528). In patients undergoing single segment surgery, the operation time (173.6±47.3 min), blood loss (351.7±102.0 ml) and postoperative hospital stay (7.8±3.1 d) in the reserved group were lower than those in total laminectomy group (196.2±34.2 min, 401.9±97.2 ml, 9.9±3.6 d, respectively), and the differences were statistically significant ( t=2.93, P=0.004; t=2.69, P=0.008; t=3.26, P<0.001). The dural sac area in both groups was significantly improved after surgery, but the extent of laminectomy in the reserved group (22.8±4.5 mm) was smaller than that in total laminectomy group (29.5±4.8 mm), and the difference was statistically significant ( t=7.62, P<0.001). The above indicators of the patients with two segment or three segments in the reserved group were better than those in total resection group, with a statistically significant difference ( P<0.05). PI, PT, SS, and LL showed significant improvement in both groups compared to preoperative values ( P<0.05), with no statistically significant differences between the groups ( P>0.05). At the last follow-up, both groups achieved Bridwell I or II fusion level. The proportion of adjacent vertebral instability in the reserved group (11.3%, 14/124) was lower than that in total laminectomy group (22.3%, 29/130), and the difference was statistically significant (χ 2=5.48, P=0.019). The total incidence of ASD in the reserved group (20.9%, 26/124) was lower than that in total laminectomy group (36.2%, 47/130), and the difference was statistically significant (χ 2=7.15, P=0.008). R-ASD (16.9%, 21/124), S-ASD (4.0%, 5/124) and O-ASD (0, 0/124) in the reserved group were lower than those in total laminectomy group [(25.4% (33/130), 9.3% (12/130) and 1.5% (2/130), respectively)], and the difference was statistically significant (χ 2=8.20, P=0.027). ODI and VAS of back and leg were significantly reduced in both groups compared to preoperative values, and the differences were statistically significant ( P<0.05). There were no significant differences in ODI and VAS scores of back and leg in the reserved group compared with total laminectomy group at 3 months, 1 year, and the last follow-up ( P>0.05). Conclusion:Decompression with preservation of the upper half of the lamina can reduce intraoperative blood loss, shorten operation time and postoperative hospital stay, achieve comparable decompression effects to traditional decompression surgery, and effectively reduce the occurrence of adjacent segment instability and ASD.

Objective:Based on the data compilation and analysis of the disease burden of esophageal cancer attributed to alcohol consumption in China over the past three decades(1990-2019),this study aims to explore how to strengthen the formulation and management of public health policies to control the disease burden caused by this disease. Methods:Based on the data from the Global Burden of Disease(GBD)2019 study database,indicators such as mortality rate and disability-adjusted life years(DALYs)were used to assess the disease burden of esophageal cancer attributed to alcohol consumption in China.Joinpoint regression software and the age-period-cohort model were employed to analyze the trends in disease burden and mortality rates over time by age,period,and cohort.Bayesian age-period-cohort analysis was used to predict the mortality rates of esophageal cancer attributed to alcohol consumption in China from 2020 to 2030. Results:From 1990 to 2019,the number of deaths from esophageal cancer attributed to alcohol consumption increased from 33 800 cases to 61 900 cases,while the standardized mortality rate decreased from 3.95 per 100 000 to 3.04 per 100 000.DALYs increased from 934 000 person-years to 1 512 600 person-years,and the DALYs rate decreased from 101.36 per 100 000 to 71.39 per 100 000.In 2019,both the number of deaths and DALYs reached their peak in the age group of 65-69 years with 58 800 deaths and a standardized mortality rate of 6.21 per 100 000 for males,and 3 100 deaths and a standardized mortality rate of 0.31 per 100 000 for females.Both the mortality rates and the DALYs rates increased with age.The Joinpoint regression analysis showed that the average annual percentage change(AAPC)of mortality rates attributed to alcohol consumption-related esophageal cancer was-0.97%[95%confidence interval(CI):-1.2%--0.8%],with an AAPC of-2.32%(95%CI:-2.6%--2.1%)for females and-0.81%(95%CI:-1.0%-0.6%)for males.The age-period-cohort analysis of mortality rates attributed to alcohol consumption-related esophageal cancer showed a net drift of-1.301%(95%CI:-1.577%--1.025%,P＜0.05).It is predicted that the burden of esophageal cancer mortality attributed to alcohol consumption will steadily increase during the period of 2020-2030. Conclusion:Compared to the overall trend of esophageal cancer burden,the burden of esophageal cancer attributed to alcohol consumption is declining at a slower rate.The burden of the disease is higher in the male population than that in females,and higher in the middle-aged and elderly population compared to the younger population.It is expected that in the coming years,the burden of esophageal cancer mortality attributed to alcohol consumption in China will steadily increase,suggesting that while focusing on the intervention for males and the middle-aged and elderly population,relevant departments should also strengthen health education in the entire population,formulate public health policies,and raise awareness of early prevention and risk factors of esophageal cancer among residents.

Objective To investigate the resting brain functional connectivity in patients with post-stroke cognitive impairment (PSCI).Methods From January, 2020 to January, 2021, 24 PSCI patients were divided into mild group (n=12) and moderate group (n=12) according to Mini-Mental State Examination and Montreal Cognitive Assessment scores; and other ten healthy controls (control group) were included. All the subjects were scanned with 64-channel functional near-infrared spectroscopy in resting for six minutes. The data were analyzed with NirSpark 1.6.12 and SPSS 26.0.Results Using deoxyhemoglobin, the functional connectivity between bilateral hemispheres reduced in the moderate group compared with those in the control group (t=-2.763, P=0.024), especially for the functional connectivity between sensorimotor cortexes (F=12.674, P=0.031).Conclusion Functional connectivity between hemispheres decreases in PSCI patients, especially between sensorimotor cortexes.