AIM To investigate the effects of serine/threonine protein phosphatases in regulation of cell signal transduction on voltage-gated potassium and calcium channels in cultured rat trigeminal ganglion (TRG) neurons. METHODS Whole-cell patch clamp technique was used to record the potassium and calcium currents from adult rat TRG neurons before and after perfusion of okadaic acid, a potent inhibitor of the serine/threonine protein phosphatases 1 and 2A. RESULTS Okadaic acid 1 μmol·L-1 inhibited transient outwards potassium currents (IA) by 28.6%, increased delay rectified potassium currents (IK) and calcium currents (ICa) by 22.7% and 20.0%, respectively. okadaic acid 1 μmol·L-1 produced significant hyperpolarizing shifts in the conductance-voltage (G-V) curves and inactivation curves of IA , also produced significant hyperpolarizing shifts in the G-V curves of IK, while it had no effect on the activation and inactivation kinetics of ICa. CONCLUSION Serine/threonine protein phosphatases 1 and 2A may be involved in the modulation of voltage-gated potassium and calcium channels on rat TRG neurons. In addition, voltage-gated potassium and calcium channels show different dependence on the dephosphorylation reactions of PP1 and PP2A phosphatases.

Objective To observe the clinical efficacy and reverse reactions of acupuncture combined with paroxetine hydrochloride in the treatment of mild or moderate depression. Methods The patients with mild or moderate depression (n=73) were randomly divided into control group (treated with paroxetine hydrochloride,n=33) and observation group (treated with acupuncture and paroxetine hydrochloride,n=40). The therapeutic course lasted for 6 weeks. The total score changes of Hamilton Depression Scale (HAMD) were observed before treatment and treated for 1, 2, 4 and 6 weeks. Rating Scale for Side Effects (SERS) was evaluated before treatment and treated for 2, 4, 6 weeks.Results The total effective rate of clinical efficacy in the observation group was 78.95% (30/38) and the control group was 68.75% (22/32), without significant difference between the two groups (P>0.05). The scores of HAMD decreased 4, 6 weeks after the treatment in the control group and 2, 4, 6 week after the treatment in the observation group compared with those in the same group before the treatment (P<0.05,P<0.01). There was a significant difference in HAMD scores between two groups after the treatment for 4 weeks (P<0.05). The scores of SERS showed a significant difference 4, 6 weeks after the treatment between the two groups (P<0.05).Conclusion Acupuncture can improve the curative effect of paroxetine hydrochloride and decrease its side effects in the treatment of depression.

OBJECTIVETo assess the influence of assisted reproductive technology(ART) on the incidence of fetal chromosomal abnormalities by analyzing spontaneous abortions during the first trimester following natural conception(NC) or assisted reproductive technology(ART).

METHODSThree hundred and fourteen chorionic villus samples of women with first trimester spontaneous abortion were collected. Cell culture and G-banding karyotyping analysis were carried out, which included 125 cases by in vitro fertilization(IVF), 87 cases by intracytoplasmic sperm injection(ICSI) and 102 cases by natural conception(NC).

RESULTSChromosomal aberrations were found in 167(53.2%) of the 314 cases. No significant difference was found in the spectrum of karyotypic abnormalities between NC and ART groups. The incidence of chromosomal abnormalities has increased along with the maternal age. Compared with the fresh embryo-transfer(ET) group, frozen-thawed embryo transfer(FET) group showed a slightly lower incidence of chromosomal abnormalities, albeit with no statistical significance(47.3% vs. 53.8%, P>0.05).

CONCLUSIONFetal chromosomal abnormalities are the main cause for spontaneous abortion during the first trimester regardless the ways of conception. Their incidence is associated with maternal age. FET is relatively safe as well as fresh ET. ART is a relatively safe treatment which does not increase the rate of fetal chromosomal abnormalities.

Background::Acute-on-chronic liver failure (ACLF) is a severe liver disease with complex pathogenesis. Clinical hypoglycemia is common in patients with ACLF and often predicts a worse prognosis. Accumulating evidence suggests that glucose metabolic disturbance, especially gluconeogenesis dysfunction, plays a critical role in the disease progression of ACLF. Lon protease-1 (LONP1) is a novel mediator of energy and glucose metabolism. However, whether gluconeogenesis is a potential mechanism through which LONP1 modulates ACLF remains unknown.Methods::In this study, we collected liver tissues from ACLF patients, established an ACLF mouse model with carbon tetrachloride (CCl 4), lipopolysaccharide (LPS), and D-galactose (D-gal), and constructed an in vitro hypoxia and hyperammonemia-triggered hepatocyte injury model. LONP1 overexpression and knockdown adenovirus were used to assess the protective effect of LONP1 on liver injury and gluconeogenesis regulation. Liver histopathology, biochemical index, mitochondrial morphology, cell viability and apoptosis, and the expression and activity of key gluconeogenic enzymes were detected to explore the underlying protective mechanisms of LONP1 in ACLF. Results::We found that LONP1 and the expressions of gluconeogenic enzymes were downregulated in clinical ACLF liver tissues. Furthermore, LONP1 overexpression remarkably attenuated liver injury, which was characterized by improved liver histopathological lesions and decreased serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in ACLF mice. Moreover, mitochondrial morphology was improved upon overexpression of LONP1. Meanwhile, the expression and activity of the key gluconeogenic enzymes were restored by LONP1 overexpression. Similarly, the hepatoprotective effect was also observed in the hepatocyte injury model, as evidenced by improved cell viability, reduced cell apoptosis, and improved gluconeogenesis level and activity, while LONP1 knockdown worsened liver injury and gluconeogenesis disorders.Conclusion::We demonstrated that gluconeogenesis dysfunction exists in ACLF, and LONP1 could ameliorate liver injury and improve gluconeogenic dysfunction, which would provide a promising therapeutic target for patients with ACLF.

Objective To evaluate the safety and effectiveness of enhanced recovery after surgery (ERAS) in laparoscopic radical gastrectomy for gastric cancer.Methods From May 2015 to July 2017,149 patients with gastric cancer in our department were prospectively enrolled and randomly divided into the ERAS group (n =75) and control group (n =74).Results In ERAS group compared to control group,the time to first passage of flatus was (51 ± 11)vs.(62 ± 11)h,first feeding time (46 ± 12) vs.(68 ±20)h,gastric tube removal time (13 ± 12)h vs.(70 ± 16) h,pain score on the first day after surgery (3.9 ±1.3) vs.(5.2 ±0.9),C-reaction protein level (8.5 ±2.6) mg/L vs.(10.1 ±3.0)mg/L,post-op hospital stay (6.9 ± 2.9) d vs.(11.2 ± 3.5) d,were all significantly different (all P ＜ 0.05).The postoperative complication rates was 25％ vs.28％ respectively,(x2 =0.101,P =0.750).Conclusions Enhanced recovery after surgery can promote the postoperative recovery and shorten the time of hospitalization in laparoscopic-assisted radical gastrectomy for gastric cancer.

Objective To identify the risk factors for postoperative complications after radical resection of rectal cancer, and study the influence of high ligation of the inferior mesenteric artery on postoperative complications of rectal cancer. Methods Clinical data of the patients who underwent radical resection of rectal cancer in the Affiliated Hospital of North Sichuan Medical College from January 2011 to December 2015 were analyzed. The χ 2test and t test were used for all the data. Results A total of 431 patients with rectal cancer were included, of which 80 cases were excluded, and finally 351 cases met the standard. Among them, 196 cases were in high ligation group, and 155 cases were in low ligation group. The total incidence of postoperative complications was 20.4 %(40/196) in the high ligation group and 27.1 %(42/155)in the low ligation group respectively,the difference of which was not statistically significant(χ2=1.336, P= 0.245). The incidence of anastomotic leakage was 10.2 % (20/196) in the high ligation group and 7.7 % (12/155) in the low ligation group respectively, and there was no significant difference between them (χ2=0.529, P= 0.467). Logistic regression analysis revealed that gender (OR= 2.102, 95 % CI 1.278-3.459, P=0.003), body mass index (OR= 2.492, 95 % CI 1.070-5.800, P= 0.027), with or without anemia before surgery(OR=2.203,95 % CI 1.085-4.472,P=0.029), and location of tumor(OR=2.861, 95 % CI 1.288-16.007,P=0.019) were independent risk factors for postoperative complications. Conclusions High ligation of the inferior mesenteric artery does not increase the incidence of postoperative complications after radical resection of rectal cancer. Anastomotic leakage after rectal cancer resection is related to gender, body mass index,with or without anemia before surgery,and location of tumor.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

Background/Aims: The World Health Organization set the goal of eliminating hepatitis C virus (HCV) by 2030, with 80% and 65% reductions in HCV incidence and mortality rates, respectively. We aimed to evaluate the health benefits, cost-effectiveness and return on investment (ROI) of HCV elimination. Methods: Using an HCV transmission compartmental model, we evaluated the benefits and costs of different strategies combining screening and treatment for Chinese populations. We identified strategies to achieve HCV elimination and calculated the incremental cost-effectiveness ratios (ICERs) per disability-adjusted life year (DALY) averted for 2022–2030 to identify the optimal elimination strategy. Furthermore, we estimated the ROI by 2050 by comparing the required investment with the economic productivity gains from reduced HCV incidence and deaths. Results: The strategy that results in the most significant health benefits involves conducting annual primary screening at a rate of 14%, re-screening people who inject drugs annually and the general population every five years, and treating 95% of those diagnosed (P14-R4-T95), preventing approximately 5.75 and 0.44 million HCV infections and deaths, respectively, during 2022–2030. At a willingness-to-pay threshold of $12,615, the P14-R4-T95 strategy is the most cost-effective, with an ICER of $5,449/DALY. By 2050, this strategy would have a net benefit of $120,997 million (ROI=0.868). Conclusions Achieving HCV elimination in China by 2030 will require significant investment in large-scale universal screening and treatment, but it will yield substantial health and economic benefits and is cost-effective.

AIM: To observe the anesthetic effect of nalbuphine used in ultrasound-guided transvaginal oocyte retrieval and its effect on embryo quality and pregnancy outcome. METHODS: Four-hundred patients who underwent ultrasound-guided transvaginal oocyte retrieval were randomly divided into two groups (n=200): nalbuphine group (N group) and control group (C group). The patients were in the bladder lithotomy position. Patients in N group were given nalbuphine 0.1 mg/kg intravenously 2 minutes before induction of anesthesia, patients in C group were given normal saline intravenously, and patients in both groups were induced with propofol 1.5 mg/kg. The patients were kept breathing spontaneously, and they were given intravenous injections of propofol (2 mg•kg