Objective To explore the status of oxidative stress (OS) in the first-episode schizophrenia patients (FEP) and to examine the effects of antipsychotic drugs on oxidative stress of FEP. Methods The plasma total superox?ide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and total antioxidant capacity (T-AOC) were measured in forty-seven FEP (case group) and forty-three healthy volunteers (control group) before and after treatment. Eighteen cases completed 6-week treatment with risperidone (risperidone group) and twenty-five cases completed 6-week treatment with olanzapine (olanzapine group). Results The activity of T-SOD and GSH-Px were lower (P<0.05) and CAT was higher (P<0.05 ) while there was no significant difference in T-AOC (P>0.05) in FEP compared to the control group. Risperidone and olanzapine significantly improved T-SOD and T-AOC, respectively (P<0.05). There was no significant difference between the two groups in the changes of oxidative stress indicators after treatment (P>0.05). Conclusion FEP has alterations of antioxidant enzymes, which may be related to the pathogenesis of schizo?phrenia. Antipsychotics risperidone and olanzapine may improve the oxidative stress in FEP.

Objective To explore the cool execution function (CEF)and its influence factors before and after treatment in drug-na?ve, first-episode schizophrenics. Methods Twenty-one drug-naive, first-episode schizophrenics (patients group) and 25 healthy persons (control group) were interviewed by using the SCID. The severity of clinical symptoms was respectively assessed in patient group before treatment and after 8 weeks using the Positive and Negative Syndrome Scale (PANSS). The Trail-Marking Test A-B (TMT A-B) and Hanoi Tower Test (HTT) were conducted to assess cool executive function. Reaction time and the number of errors of TMT A-B’s and HTT’s reaction time and operative steps were recorded. Results Before treatment, the patient group’s reaction time was longer in HTT and TMT A-B than that in the control group's (P = 0.013;P = 0.000;P =0.001), respectively. Error number of TMT-B in the patient group was more than that in the control group (P =0.015); The operative steps of HTT and error number of TMT A were no statistical difference than those in the control group. After treatment, reaction time of TMT A reduced significantly than before treatment (P = 0.002);Before and after treatment , patients ’ reaction time of HTT and TMT B , operative steps of HTT and the error number of TMT A-B were all no statistical difference. Running multiple linear regression , reaction times of TMT-B was positively correlated with negative symptoms (β = 7.198,P = 0.012), and the error number of it was positively correlated with positive symptoms (β = 0.382,P = 0.024). Conclusions CEF in patients with drug-naive, first-episode schizophrenia is affected in a certain degree, especially the flexibility and attention transfer. Symptoms is the most serious influence factors. Treatment in sympotoms earlier is the important way to protect cool cognition.

OBJECTIVE: To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. MATERIALS AND METHODS: Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2-7 and L2-4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. RESULTS: The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2-5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62-0.94; males: r = 0.63-0.94) and lumbar vertebrae (males: r = 0.93-0.98; females: r = 0.82-0.97) were statistically significant at each age group. CONCLUSION: The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.
Aging ; Asian Continental Ancestry Group* ; Bone Density* ; Cervical Vertebrae ; Female ; Healthy Volunteers ; Humans ; Linear Models ; Lumbar Vertebrae* ; Male ; Sex Characteristics ; Spine

Objective:To evaluate the changes in electroencephalogram (EEG) during cognitive dysfunction induced by multiple inhalation of sevoflurane anesthesia in aged rats.Methods:Twenty-one SPF healthy male Sprague-Dawley rats, aged 20-22 months, weighing 450-550 g, were divided into 2 groups using a random number table method: control group (group C, n=8) and repeated inhalation of sevoflurane anesthesia group (group S, n=13). In group S, the rats were put into an anesthesia box and inhaled a mixture of 3% sevoflurane and 30% oxygen for anesthesia, the oxygen flow rate was set at 3 L/min, maintaining for 3 h, and anesthesia was performed once every week for 3 times in total.The rats only inhaled a mixture of 70% air and 30% oxygen in group C. Two weeks later, cognitive function was assessed using Morris water maze test, the EEG was collected and analyzed by the multi-channel physiological signal system, and the recording time of EEG signal was 30 min.The rats were sacrificed, and the brains were collected for determination of the count of apoptotic nerve cells (by TUNEL staining), and the apoptotic rate of nerve cells was calculated. Results:Compared with group C, the escape latency was significantly prolonged at 3rd and 4th days of training, the number of crossing the original platform was decreased at 5th day, the percentage of high-frequency waves was decreased, the percentage of low-frequency waves was increased, and the apoptosis rate of nerve cells was increased in group S ( P<0.05). Conclusion:The percentage of high-frequency waves is decreased, and the percentage of low-frequency waves is increased during cognitive dysfunction induced by multiple inhalation of sevoflurane anesthesia, which may be related to apoptosis in nerve cells of aged rats.

Objective:To investigate whether hypoxia induces endoplasmic reticulum stress (ERS) through inositol-dependent enzyme 1α (IRE1α) and activates JNK pathway to participate in the proliferation and apoptosis of pulmonary artery smooth muscle cells in mice.Methods:Mouse pulmonary artery smooth muscle cell line (MPASMCs) was cultured in vitro to establish the hypoxic MPASMCs model. The expression of hypoxia-inducible factor-1α (HIF-1α), glucose-regulated protein 78 (GRP78) and JNK pathway genes were detected. The expression of IRE1α was knocked down by siRNA transfection, JNK pathway specific inhibitor 1, 9-pyrazoxanolone and pyrazoxanolone (SP600125) was used to inhibit JNK pathway, and XBP-1s plasmid was transfected to increase the expression of XBP-1s. CCK8 assay and proliferating cell nuclear antigen (PCNA) protein detection were used to observe the cell proliferation. Cell apoptosis was detected by flow cytometry and the expression of B-cell lymphoma-2 (BCL-2) and BCL-2 associated X protein (BAX) protein.Results:HIF-1αexpression was significantly up-regulated in MPASMCs cultured under hypoxia. The expression of GRP78, phosphorylated IRE1α (P-IRE1α) and phosphorylated JNK (P-JNK) increased after hypoxia, indicating that ERS and JNK pathways mediated by IRE1α were activated. When IRE1α expression was inhibited by si-IRE1a, the expression of P-JNK decreased, indicating that JNK pathway was inhibited. The expression of PCNA protein was up-regulated in the hypoxia group, and CCK8 assay indicated that the cell proliferation was up-regulated. The expression of BAX and BCL-2 protein were down-regulated in the hypoxia group, and the level of apoptosis was down-regulated. The above changes were delayed after SiIRE1a inhibited the expression of IRE1α. Treatment with SP600125 could also partially delay the pro-proliferation and anti-apoptosis changes induced by hypoxia. Overexpression of XBP-1s under normoxia activated the JNK pathway, accompanied by hypoxia-like changes.Conclusions:Hypoxia activates IRE1α-mediated endoplasmic reticulum stress, which promotes the proliferation and inhibits apoptosis of pulmonary artery smooth muscle cells through JNK pathway in mice.

Sarcomatoid carcinoma of the renal pelvis accounts for a very low percentage of malignant tumors in the renal pelvis and has a poor prognosis. This article reported a patient with sarcomatoid carcinoma of the renal pelvis. The patient presented with macroscopic hematuria as the first symptom, and CT suggested left renal occupancy, unilateral nephrectomy was performed, and pathology suggested sarcomatoid carcinoma of the renal pelvis. Three weeks after surgery, a follow-up CT showed tumor recurrence. Programmed death 1(PD-1)inhibitor was given once every 3 weeks. Repeated CT examination after 24 weeks of continuous treatment suggested that the recurrent tumor disappeared. The patients was followed-up for 42 months without tumor recurrence or metastasis.

Objective To explore the effect of Rhizoma corydalis on the immune escape of Epstein-Barr virus(EBV)positive gastric cancer cells and its mechanism of targeting CXCL17 to affect immune escape of EBV-positive gastric cancer cells.Methods GEO2R online analysis software was used to screen differentially expressed genes in EBV-positive gastric cancer tissues.EBV-negative AGS gastric cancer cells and EBV-positive SUN-719 gastric cancer cells were used for the experiments.RT-qPCR and Western blotting were used to detect the expression of CXCL17in EBV-negative and EBV-positive gastric cancer cells.Transfection of CXCL17 siRNA into EBV-positive gastric cancer cells,detection of PD-L1 expression through Western blotting,coculture of EBV-positive gastric cancer cells with T cells,detection of cell viability using the CCK-8 assay,and detection of cell apoptosis rate through flow cytometry were conducted.EBV-positive gastric cancer cells were treated with different concentrations of a Rhizoma corydalis extract(2,4,and 8 μg/mL).The expression of CXCL17and PD-L1 was detected through Western blotting,and EBV-positive gastric cancer cells were cocultured with T cells.Cell viability was determined using CCK-8,and cell apoptosis rate through flow cytometry.The CXCL17overexpression plasmid was transfected into EBV-positive gastric cancer cells treated with Rhizoma corydalis extract(8μg/mL).The expression of PD-L1 and p-AMPK was detected through Western blotting,and EBV-positive gastric cancer cells were cocultured with T cells.Cell viability was determined using CCK-8,and cell apoptosis rate with flow cytometry.Results CXCL17 expression was upregulated in EBV-positive gastric cancer tissues and cells(P<0.05).Silencing of CXCL17reduced the expression of PD-L1 in EBV-positive gastric cancer cells,inhibited the proliferation of EBV-positive gastric cancer cells cocultured with T cells,and promoted cell apoptosis(P<0.05).Rhizoma corydalis treat-ment reduced the expression of CXCL17 and PD-L1 in EBV-positive gastric cancer cells,inhibited the proliferation of EBV-positive gas-tric cancer cells cocultured with T cells,and promoted apoptosis(P<0.05).Overexpression of CXCL17reversed the inhibitory effect of the Rhizoma corydalis treatment on PD-L1 expression and cell proliferation in EBV-positive gastric cancer cells,as well as the promoting effect of cell apoptosis(P<0.05).Overexpression of CXCL17also reduced the expression of p-AMPK in EBV-positive gastric cancer cells treated with Rhizoma corydalis(P<0.05).Conclusion CXCL17 expression is upregulated in EBV-positive gastric cancer cells,and Rhizoma corydalis inhibits immune escape in gastric cancer cells by downregulating CXCL17 expression in EBV-positive gastric cancer cells,which may be related to the activation of the AMPK signaling pathway.

Objective:To compare the effects of drug-loaded microsphere TACE (D-TACE) and iodinated oil emulsion TACE (cTACE) on liver fibrosis in the treatment of advanced hepatocellular carcinoma (HCC).Methods:Clinical data of 113 patients with HCC treated with D-TACE or cTACE at the First Affiliated Hospital of Zhengzhou University from October 2019 to September 2020 were retrospectively analyzed, including 96 males and 17 females, aged (56.8±9.8) years old. According to treatment protocol, patients were divided into two groups: the D-TACE group ( n=57) and the cTACE group ( n=56). Liver fibrosis panel, fibrosis index (FIB-4), aspartate aminotransferase to platelet ratio index (APRI), and liver stiffness measurement (LSM) were compared between the groups at four timepoints: pre-treatment, one month after the first TACE, one month after the second TACE, and 12 months after the first TACE. Follow-ups were conducted through outpatient visits or telephone reviews to assess patient survivals. Data including the progression-free survival (PFS) and number of TACE sessions were compared between the two groups. Results:The D-TACE group received 2.84±1.12 sessions of treatment during the observation period, compared to 4.05±1.44 sessions of cTACE group ( t=4.94, P<0.001). The median PFS in D-TACE and cTACE groups were 10.0 and 5.0 months, respectively ( P<0.001). At one month after the second TACE and at 12 months after the first TACE, patients in cTACE group had a higher serum levels of fibrosis markers including hyaluronic acid, type IV collagen, type III procollagen N peptide and laminin than those in D-TACE group (all P<0.05). At the same timepoints, patients in cTACE group also had higher APRI, FIB-4 and LSM than those in D-TACE group (all P<0.05). Conclusion:Compared to cTACE, patients in D-TACE group received fewer sessions of treatment during the first year after initial TACE, and the degree of liver fibrosis was also lower in D-TACE group.

Objective To study clinical data retrospectively and demonstrate the optimal injection site of adductor canal block by performing a cadaveric study.Methods Clinical part:clinical data from 19 patients,11 males and 8 females,aged 21 85 years,ASA physical status Ⅰ-Ⅲ,who received ultrasound guided adductor canal block were retrospectively collected.Among whom 9 received a mid-distance injection of 10 ml of 0.5％ ropivacaine and 10 received an injection of the same medication at the outlet of adductor canal.The primary endpoint was complete absence of cold sensation to ice cube on the medial side of calf at 30 minutes and 24 hours after injection.Cadaveric part:40 lower limbs,20 males and 20 females,were finally analyzed in the study.The distances from the anterior superior iliac spine (ASIS) to the medial tibial condyle,from ASIS to the entrance of the adductor canal,from ASIS to the exit of the canal (adductor tendinous opening),from ASIS to the site where sa phenous nerve emerges through the aponeurotic covering were measured respectively.The length of adductor canal,the relative location of adductor canal and the site where saphenous nerve pierces in the lower limbs were calculated.Results Clinical part:all 19 cases were successfully recorded with complete absence of cold sensation at 30 minutes after injection of local anesthetic and complete sensory recovery at 24 hours after injection.Cadaveric part:in all specimens,saphenous nerve enters adductor canal and coursed down until emerging at very close to the distal end of the canal with the saphenous branch of descending genicular artery.The length of the adductor canal was (10.0±2.1) cm.The entrance and the exit of adductor canal and the emerging site of the saphenous nerve located along the (54.7±3.0) ％,(76.0％±3.8) ％ and (74.1±3.2) ％ of sartorius muscle,respectively.Conclusion Performing ultrasound-guided adductor canal block at either the outlet of adductor canal or mid-distance of thigh can achieve comparable blockade of saphenous nerve.Cadaveric study implicated that the optimal injection site for adductor canal block should be the lower one-third of sartorius muscle.Ultrasound-guided injection of local anesthetics next to the descending genicular artery may possibly become a promising new method of saphenous nerve block.