AIM To explore the effects of Kaixin Powder (Polygalae Radix,Ginseng Radix et Rhizoma,Poria and Acori tatarinowii Rhizoma) on hippocampal long-term potentiation (LTP) in vivo in APP/PS1 transgenic mice and expression of PSD-95 in hippocampus CA1 area and cerebral cortex.METHODS Thirty-two 3-monthold male APP/PS1 mice were randomly divided into model group,Donepezil [0.75 mg/(kg · d)] group,Kaixin Powder [1.5,3 g/(kg · d)] groups.C57/BL6 mice were used as the control group.Kaixin Powder and Donepezil were administered to the APP/PS1 mice for three months,respectively.Afterwards,the LTP in vivo was recorded in a perforant pathway-dentate gyrus in the hippocampus.Immunohistochemical method was used for measuring the expression of PSD-95 in hippocampus CA1 area and cerebral cortex.RESULTS The fEPSPs slopes were significantly decreased in the model group as compared with the control group.Kaixin Powder or Donepezil treatment significantly enhanced the fEPSPs slopes in the model group.The average optical density of PSD-95 positive cells in hippocampus CA1 area and cerebral cortex was obviously decreased in the model group.Donepezil increased the average optical density of PSD-95 positive cells in hippocampus CA1 area.Kaixin Powder [1.5 g/(kg · d)] increased the average optical density of PSD-95 positive cells in hippocampus CA1 area and cerebral cortex.Kaixin Powder [3 g/(kg · d)] increased the average optical density of PSD-95 positive cells in cerebral cortex.CONCLUSION Kaixin Powder can promote the LTP formation in APP/PS1 transgenic mice and enhance synaptic plasticity,which may be related to the regulation of protein expression of PSD-95.

Objective To investigate the value of strain rate imaging(SRI) in estimating the changes of left ventricular regional myocardial function in patients with coronary artery disease before and after coronary artery bypass grafting operation. Methods In sixteen patients with coronary artery disease, echoeardiography was performed 3 days before, 12 days after and 3 months after coronary artery bypass grafting operation respectively. SRI was used to quantitatively analyze the regional myocardial function of left ventricular wall. One hundred and ninety-two segments of left ventricular myocardium were analyzed in the study. The left ventricular myocardium was divided into segments with normal(152 segments) and abnormal(40 segments) wall motion according to two-dimensional echocardiography before the operation. Results Peak strain rate during systolic and early diastolic contraction (SRs, SRe) was not statistically significant between segments with normal and abnormal wall motion before operation. In segments with abnormal wall motion,myocardial peak strain rate of atrial contraction (SRa) was increased three months after operation comparing with three days before operation (P<0.05). In segments with normal wall motion,the absolute values of SRs,SRa and SRe were increased three months after operation comparing with three days before operation (P<0.05 and 0.01 ). SRs was increased three months after operation comparing with 12 days after operation (P<0.05 ). Conclusions SRI can be used to evaluate the functional changes of left ventricular regional myocardium quantitatively after coronary artery bypass grafting operation.

Objective To construct a eukaryotic expression system of IFN-λ,examine the expression of IFN-λand evaluate its bio-functions including anti-proliferation and anti-viral activity.Methods The genes of human IFN-λ1 /2 (hIFN-λ1 /2)were cloned from the mRNA of poly I∶C treated HuH-7 cells.The PCR product was examined with DNA sequencing.The genes of IFN-λ1 /2 were sub-cloned into pcDNA3 vector.The correct insertion of the gene IFN-λ1 /2 was identified with enzyme digestion.The constructed pcDNA3-IFN-λ1 /2 plasmids were transfected into COS-7 cells and IFN-λ1 /2 protein was checked in the supernatant and lysis of transfected cells using Western blotting analysis.The human esophageal carcinoma YES5 and T.Tn cells were treated with the IFN-λ1 /2 from the transfected cells and the proliferation of carcinoma cells were measured with CCK-8 kit.In the treated carcinoma cells,the apoptosis and antivirus related molecules such as caspase-3,ISG15 and MxA was analyzed with Western blotting or Quantitative real time PCR.Results The sequence of hIFN-λ1 /2 fragment matched that of the gene bank and the gene of the cytokines was inserted into pcDNA3 vector correctly.With Western blotting analysis,IFN-λ1 /2 protein was detected in the pcDNA3-IFN-λ1 /2 transfected COS-7 cells.The IFN-λ1 /2 from the transfected COS-7 cells inhibited the growth of YES5 and T.Tn cells, activated apoptosis related caspase-3,and up-regulated the anti-virus gene expression of ISG15 and MxA.Conclusion COS-7 cells can express IFN-λ1 /2 after transfection with pcDNA3-IFN-λ1 /2,suggesting that eukaryotic expression system of IFN-λis established.IFN-λ1 /2 from the system can perform bio-functions,such as proliferation inhibition,apoptosis induction and anti-viral gene up-regulation,which indicates that the system can contribute to further investigations of IFN-λbio-activity and its clinical application.

OBJECTIVETo discuss the application of right-inferior-posterior "artery first" approach in laparoscopic pancreaticoduodenectomy.

METHODSClinical data of 17 patients who underwent laparoscopic pancreaticoduodenectomy through right-inferior-posterior "artery first" approach in our department from February 2014 to April 2015 were retrospectively analyzed. The operation began at the inferior flexure of duodenum. After entering the Toldt's space, the left renal vein (LRV) was revealed and the root of superior mesenteric artery (SMA) was exposed just above the LRV. SMA was dissected along its trunk till the horizontal part of duodenum.

RESULTSOf these 17 cases, adenocarcinoma of pancreatic head was observed in 5 cases, adenosquamous carcinoma in 2 cases, mucinous cycstic neoplasm in 1 case, adenocarcinoma of lower common bile duct in 4 cases, and duodenal papilla cancer in 5 cases. Fifteen cases were accomplished successfully with laparoscopy and 2 cases were converted to open approach. The average operating time was (320 ± 85) min and mean intraoperative blood loss was (305 ± 175) ml. The cutting margins were tumor negative in all the patients. The average number of harvested lymph node was 15.4 ± 6.5. Postoperative complication occurred in 5 cases. Two cases of bile leakage and 2 cases of pancreatic fistula were cured with conservative treatment. One case of delayed abdominal hemorrhage was resolved with reoperation.

CONCLUSIONRight-inferior-posterior "artery first" approach is safe and feasible in laparoscopic pancreaticoduodenectomy.

Adenocarcinoma ; Duodenal Neoplasms ; Duodenum ; Humans ; Laparoscopy ; Mesenteric Artery, Superior ; Operative Time ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Complications ; Retrospective Studies

OBJECTIVE: Ambulance personnel who witness trauma experienced by patients have been reported to experience positive changes, known as vicarious posttraumatic growth (VPTG). We examined VPTG and its relationship with social support and resilience among ambulance personnel. METHODS: The sample (n=227) was recruited from six emergency centers in China. The measures included the Posttraumatic Growth Inventory (PTGI), the Social Support Rating Scale (SSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structure Equation Modeling (SEM) and the bootstrapping procedure were used to examine indirect effects. RESULTS: The participants' mean score for VPTG was 68.96 (SD=15.51). Social support had significant direct effects on resilience (β=0.51, p < 0.001) and VPTG (β=0.25, p=0.001), and resilience (β=0.58, p < 0.001) had a significant direct effect on VPTG. Furthermore, social support had a significant indirect effect (0.51×0.58=0.30, p < 0.001) on VPTG through resilience. CONCLUSION: Although the nature of the work of ambulance personnel is not expected to change, the negative effects of the trauma they encounter can be reduced by providing them with more support resources and interventions to foster their resilience, which in turn, promote VPTG.
Ambulances* ; China* ; Emergencies ; Humans

Objective To evaluate the influence of telephone follow-up on treatment compliance behavior of patients with coronary heart disease by conducting a Meta-analysis. Methods Data collection, which was relevant RCTs and experimental study about telephone follow-up on treatment compliance behavior of patients with coronary heart disease, were selected from CNKI, VIP, Wan-Fang databases and PubMed from January 2006 to October 2014. The quality of studies was critically appraised, and data were extracted by two reviewers independently. Meta-analysis was performed by the Review Manager 5. 2 software (RevMan 5. 2). Results Totally 11 studies, which involved 2 717 patients ( the intervention group concluded 1 360 patients and the control group concluded 1 357 patients ) , were analyzed. Meta-analysis showed that telephone follow-up could enhance compliance behavior of patients with coronary heart disease, including reasonable diet [ OR =4.43,95%CI(2.60,7. 53),P <0. 000 01], functional exercise [OR =5. 28,95%CI(2. 92,9. 55),P <0. 000 01], medicine taking as doctors′ suggestions [OR=8. 44,95%CI(3. 82,18. 61),P<0. 000 01] and regular reexamination [OR =6. 79,95%CI(3. 20,14. 41),P <0. 000 01]. Conclusions The education conducted in patients with coronary heart disease through telephone follow-up can help to improve treatment compliance at a certain extent. However, because the low quality of methodology for studies and insufficient evidence, the summary should be check by large sampling, multicenter and high quality RCTs.

Objective To explore the effects of home-based exercise rehabilitation on anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI),and to improve both mental health and heart rehabilitation of the patients.Methods Totals of 108 patients who were diagnosed with CHD in Renmin hospital of Wuhan university and should have received PCI were recruited into the study from December 2013 to December 2015. The participants were randomly divided into two groups:intervention group (n=54) and control group (n=54). Based on the routine nursing care and discharged education,the intervention group also received home-based exercise rehabilitation with regular follow-up and supervision for exercise. The basic information,self-rating anxiety scale (SAS) and exercise situation were documented and assessed before the intervention,as well as three months and six months after the intervention.Results 48 patients in the experimental group and 46 patients in the control group completed the study. Within the group effect:the SAS had a significant difference (P<0.05) but exercise related indicators (i.e. heart rate,SBP,DBP,sports days) showed no difference between the two groups (P>0.05). Within the time effect:both SAS and exercise related indicators demonstrated statistical differences between each time point (P<0.05). The interaction effects between time and group existed in SAS,SBP,DBP,and sports days (P<0.05),except for heart rate (P>0.05). The intervention group patients performed better exercise compliance (i.e. frequency,duration,intensity,self-protection,warm-up and relaxation exercise) after a six-month intervention,compared with the compliance before the intervention (P<0.05).Conclusions Home-based exercise rehabilitation can effectively alleviate patients' anxiety,and can also improve patients' cardiovascular function and reduce their blood pressure. The regular telephone follow-up and health education can better improve patients' adherence to the home-based exercise rehabilitation.

Objective To study the effects of the myristoyl-glycine modified peptide which derived from the second intracellular loop of sphingosine 1-phosphate receptor 3 (S1PR3) on activation of mitogenactivated protein kinases (MAPKs) pathway.Methods The phosphorylation levels of JNK and ERK in THP-1 cells were detected by western blot after GPS-725.017 stimulation.Statistical data analysis was conducted by multivariate analysis of variance.Results Western blot showed that 10 min after 30 μmol/L or 50 μmol/L GPS-725.017 stimulated,phosphorylation of ERK significantly increased in comparison with the solvent-treated group [30 μmol/L group:(3.10 ± 0.27) vs.(7.98 ± 0.45),P ＜ 0.01;50 μmol/L group:(4.78 ±0.44) vs.(25.98 ±2.32),P ＜0.01];after 50 μmol/L GPS-725.017 stimulated THP-1 cells for 5 min,10 min,20 min or 30 min,p-ERK or p-JNK level raised at different time points (P ＜0.01vs.solvent group).Conclusions GPS-725.017,a kind of myristoyl-glycine modified peptide derived from S1 PR3,could traverse cytomembrane and activate MAPKs pathway.This study provides an implication of targeting S1PR3 for clinical therapy on inflammatory diseases or sepsis.

Objective:To analyze the application of indocyanine green (ICG) fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods:Data of 15 patients undergoing laparoscopic surgery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from June 2022 to March 2023 were retrospectively analyzed, including 13 males and 2 females, aged (67.0±8.6) years. ICG were intraoperatively injected to visualize the lesion and guide surgical resection. The surgical methods, postoperative pathology, ICG fluorescence imaging and tumor margins were reviewd.Results:Among the patients, seven underwent laparoscopic pancreaticoduodenectomy, seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy, and one conversed to open pancreaticoduodenectomy due to combined superior mesenteric vein reconstruction. Postoperative pathology confirmed pancreatic moderately differentiated adenocarcinoma in nine cases, pancreatic moderately-low differentiated adenocarcinoma in four cases, pancreatic follicular cell carcinoma in one case, and inflammatory lesion in one case. Negative surgical margins were confirmed in all cases. Pancreatic lesion were visualized in 14 cases (fluorescent delineation of the tumor capsule) but not well visualized in one case (with moderately differentiated adenocarcinoma). In the case of inflammatory disease, the lesion parenchyma were visualized.Conclusion:ICG injection in laparoscopic surgery enables visualization of pancreatic tumor, which facilitates tumor localization and margin determination.

Objective:To evaluate the efficacy and safety of endoscopic biliary drainage for biliary fistula.Methods:Data of consecutive 409 biliary fistula patients who were treated and diagnosed at the First Medical Center of Chinese PLA General Hospital from November 2002 to November 2022 were reviewed, and 53 patients who received endoscopic retrograde cholangiopancreatography (ERCP) drainage were finally included. General information, procedural conditions, clinical outcomes and adverse events were analyzed. The patients were categorized into two groups: the endoscopic retrograde biliary drainage (ERBD) group ( n=46) and the endoscopic nasobiliary drainage (ENBD) group ( n=7). Procedural characteristics, operation outcomes, and operation time were compared between the two groups. Results:There were 36 males and 17 females, with the age of 52.2±12.7 years, among whom 58.5% (31/53) were secondary to cholecystectomy. Clinical success was achieved in 83.0% (44/53) patients, with the operation time of 27.0 (13.5, 33.5) minutes and the treatment session of 1 (1, 2). The time to resolution was 89 (47, 161) days. The success rate of ERCP for low-grade biliary fistula was higher compared with that of high-grade biliary fistula [96.4% (27/28) VS 68.0% (17/25), χ2=7.57, P=0.006]. Bridging drainage achieved higher success rate compared with that of non-bridging drainage [91.7% (33/36) VS 64.7% (11/17), χ2=5.95, P=0.015], while different diameters of stents (≥10 Fr VS <10 Fr) achieved similar success rate [81.8% (27/33) VS 84.6% (11/13), χ2=0.05, P=0.822]. Adverse events occurred in 10 patients (18.9%), including 6 pancreatitis, 2 bleeding, 1 cholangitis and 1 death. Except for 1 death, 9 other adverse events were mild and managed with conservative treatment without interventions. There was no significant difference in clinical success rate [6/7 VS 82.6% (38/46), χ2=0.04, P=0.838] or the median operation time [28.0 min VS 23.0 min, Z=0.38, P=0.774] between ENBD group and ERBD group. Conclusion:Endoscopic biliary drainage is safe and effective for biliary fistula. ENBD and ERBD have comparable clinical efficacy. ERCP for low-grade biliary fistula may achieve a higher success rate, and bridging drainage may facilitate fistula resolution.