Objective To observe the effect of MnCl2 on glutamate-glutamine cycle(Glu-Gln cycle) and apoptosis of dissociated striatum cells and to approach the antagonism of riluzole to the neurotoxicity of MnCl2.Methods Twenty-seven Wistar rats were randomly divided into 3 groups, 9 in each.The first group was the control group and the second group was the single MnCl2 exposure group.Both of the groups were injected with 0.9% NaCl subcutaneously(sc).The third group was the intervention group and was injected with 21.35 ?mol/kg riluzole(sc).Two hours later, the rats in the control group were the given 0.9% NaCl intraperitoneally(ip) injection, the second and third groups were injected with 200 ?mol/kg MnCl2(ip), five times a week, for 4 weeks.Twenty-four hours after the last injection, 6 rats in each group were killed and the contents of Glu and Gln, the activities of glutamine synthetase(GS) and phosphate activated glutaminase(PAG) in the striatum of the rats were determined.The apoptosis of the dissociated striatum cells was detected in the other rats in each group by flow cytometry(FCM) technique.Results Compared with the control group, in MnCl2 group, the content of Glu increased and Gln content decreased significantly(P

Objective:To provide recommendations for further improvement of resident standardization training in Shenzhen according to carrying on the appraisal to the present stage of the training work. Methods:A self-designed questionnaire was used to investigate resident trainees. Results:We had collected 870 questionnaires with 86. 8% ef-fectively received rate. The resident trainees’ degree of satisfaction to the base conditions and management is more than 50%. While the degree of satisfaction to the training program is 33. 3%. Compared with the outside training base , the training conditions and management level is poor and lower in local training base. The effect of training pro-gram is better in outside training group than local group. Conclusions: Basement management, assessment, training schedule and trainees’ payment need to be improved.

Objective To evaluate the ability of further discriminating diagnosis of the headchest lead electrocardiogram (HCECG) in elderly patients with abnormal Q waves in routine lead electrocardiogram (RLECG) in inferior lead. Methods The 55 male patients, aged 65-88 years,with abnormal Q waves in both lead Ⅲ and aVF were selected and divided into two groups: myocardial infarction (MI) group and non-MI group, according to if the patient had a history of acute MI. All the patients accepted examination of coronary computed tomographic angiography (CTA) and ultrasound cardiogram, those with Wolff-Parkinson-White syndrome and myocardial hypertrophy were excluded.The 30 individuals of control group had no abnormal Q waves in lead Ⅱ , Ⅲ and aVF. HCECG and RLECG were recorded simultaneously in respective groups and occurrence rate of Q waves in correlative leads Ⅱ, Ⅲ, aVF and HL3, H0, HR3 were matched and compared, sensitivity and specificity were compared in respective leads. Results There were serious stenosis in 22 patients (100%) in MI group, and there were mild stenosis in 10 (30. 3%) and moderate stenosis in 23 patients (69.7%) in non-MI group. There was no significant difference between HCECG and RLECG in occurrence rate of Q waves in MI group (P＞ 0. 05 ). Non-MI group left anterior axillary line, Ⅱ ,Ⅲ, right anterior axillary line, near the anterior midline, aVF without Q wave and exclusion of old MI diagnostic specificity were 100%, 97.0%(32/33), 97.0% (32/33), 15.2% (5/33), 100%, 39.4%( 13/33)respectively. Conclusions Pseudo-changes are rarely found in HCECG and there is a higher degree of conformity in HCECG with coronary lesions, therefore HCECG may be used to discriminate whether the inferior abnormal Q waves occurred in RLECG are truly abnormal or not.

Circulating tumor cells (CTC) and circulating tumor DNA(ctDNA)are cancer cells that detach from their primary site to circularity system or other body fluids,which hold the promise of monitoring of tumor evolution and therapeutic efficacy and improving prognosis for patients.With the rapid development of detection technologies of CTCs and ctDNA,the sensitivity and specificity of current assays had significant improved.CTCs can be detected by use of cytometry,immunofluorescence analysis and genedetection and the detection methods of ctDNA mainly based on PCR and the next generation sequencing.As the developing of various methods and platforms were developed for detecting the circulating tumor cells and circulating tumor DNA,it is necessary to use the detection technology flexibly according to the research purpose and provide more assistance for the diagnosis and treatment of tumor.

OBJECTIVETo investigate the role of oxidative stress in impaired intermediate-conductance Ca(2+)-activated potassium channels (IKCa)- and small-conductance Ca(2+)-activated potassium channels (SKCa)-mediated relaxation in diabetic resistance arteries.

METHODSRat diabetic model was induced by a high fat and high glucose diet and streptozotocin (STZ) injection. Endothelial function of mesenteric arteries was assessed with the use of wire myography. The expression levels of IKCa and SKCa in cultured human umbilical vein endothelial cells (HUVECs) treated with H2O2 and/or antioxidant alpha lipoic acid (ALA) were measured using Western blotting.

RESULTSIKCa- and SKCa-mediated vasodilatation in response to acetylcholine was impaired in the third-order mesenteric arterioles of diabetic rats. In cultured HUVECs, H2O2 significantly decreased the protein expression of IKCa and SKCa. ALA alleviated the impairment of both vasodilatation function of the mesenteric arterioles ex vivo and enhanced the expression of IKCa and SKCa challenged with H2O2 in cultured HUVECs.

CONCLUSIONOur data demonstrated for the first time that impaired IKCa- and SKCa-mediated vasodilatation in diabetes was induced, at least in part, by oxidative stress via down-regulation of IKCa and SKCa channels.

Animals ; Cells, Cultured ; Diabetes Mellitus, Experimental ; metabolism ; physiopathology ; Human Umbilical Vein Endothelial Cells ; drug effects ; pathology ; Humans ; Hydrogen Peroxide ; pharmacology ; Intermediate-Conductance Calcium-Activated Potassium Channels ; metabolism ; Male ; Mesenteric Arteries ; physiopathology ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Small-Conductance Calcium-Activated Potassium Channels ; metabolism ; Thioctic Acid ; pharmacology ; Vasodilation

Objective: To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Methods: Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Results: Eighteen males and 8 females were finally recruited with median age of 6-73 (37.3±19.6) years. The average time from onset to biopsy was 44 days (median course was 30 days). All patients had acute manifestations with muscle pain and/or weakness. Serum creatine kinase was between 1 648-92 660 U/L. Muscle biopsies showed nonspecific changes in 12 cases (a few with type 2 muscle fiber atrophy, slight deposition of lipid droplets), 10 cases with necrotizing myopathy (muscle fiber necrosis and regeneration). Toxic neurogenic damages were seen in 2 cases (type 1 and type 2 angular atrophic muscle fibers with group change), lipid storage disease in 1 case (lipid droplets deposit significantly) and idiopathic inflammatory myopathy in 1 case (muscle fiber necrosis and regeneration, with lymphocyte infiltration). The etiology of non-specific pathological changes included short-term strenuous exercise in 6 patients, poisoning in two, chronic kidney disease in one, viral infection in one, hypothyroidism in one and unknown reason in one. As to patients with necrotizing myopathy, seven were poisoning or drug-related, one with hyperthyroidism, two with unknown reason. Conclusions Among the numerous causes of rhabdomyolysis, exercise usually links nonspecific skeletal muscle changes and poisoning or drug-related disorders are commonly associated with necrotic myopathy. Rhabdomyolysis induced by primary myopathy is rare.

Objective To compare the effectiveness and feasibility of oral tracheal intubation with Clarus video stylet,HPHJ-A video laryngoscope and Airtraq laryngoscope and in snoring pa-tients.Methods Ninety patients undergoing elective snoring surgery with general anesthesia,3 9 males and 51 females,aged 22-55 years,BMI 25-29 kg/m2,ASA physical status Ⅰ-Ⅲ,were ran-domly divided into three equal-sized groups (n=30):Clarus Video Stylet group (group C),HPHJ-A video laryngoscope group (group H)and Airtraq laryngoscope group (group A).The time of success-ful endotracheal intubation and the success rate of initial intubation of all groups were observed.The mean arterial pressure (MAP),heart rate(HR)and Rate-pressure product(RPP)were also monitored before induction of anesthesia(T0),before tracheal intubation(T1),at 0 min(T2),1 min (T3),and 3 min (T4)after intubation,as well as the throat injury and hemorrhage were noted. Results Patients in group C were successful intubated.Two patients in group H and one patient in group A with failed intubation were successfully intubated by using Clarus video stylet.The time re-quired for successful intubation in group C was longer than groups H and A (P<0.05).Compared with T0,the increasing of hemodynamic parameters (MAP,HR,RPP)after induction of all groups were significant(P<0.05).Compared with T1,the HR,MAP and RPP were increased significantly at T2in all groups (P<0.05).Compared with T1,the MAP and RPP were increased significantly at T3in all groups,and the HR were increased significantly at T3in groups H and A (P<0.05).There was no significant difference in the HR between T1and T3in group C.The increase in the HR and RPP at T2 was lower in group C than that in both the groups H and A (P <0.05).The changes of hemodynamic parameters were no significant among the three groups at other time.The differences of sore throat score and hemorrhage were no significant.Conclusion Compared with HPHJ-A video laryngoscope and Airtraq laryngoscope,Clarus video stylet for guiding oral tracheal intubation in snoring patients have less influence on hemodynamic parameters,and have no limited mouth opening. But Clarus Video Stylet spends longer intubating times,and has no obvious advantages on preventing throat injury.

Objective:To analyze the clinical characteristics, imaging, myopathology and outcomes of patients with COVID-19 related autoimmune myopathy.Methods:The clinical features, serum creatine kinase (CK), myositis antibodies, muscle magnetic resonance imaging, myopathology and therapy of 5 patients with COVID-19 related autoimmune myopathy diagnosed in Peking University First Hospital from December 2022 to April 2023 were collected. The effects of the therapy after a short term follow up were analyzed.Results:Among the 5 patients, there were 3 males and 2 females, with onset age of 42-86 years. All patients presented with proximal muscle weakness in the recovery term of COVID-19. Myalgia was noted in 3 cases, dysphagia in 1, skin damage in 2, interstitial lung disease in 1. The serum CK of the 5 patients was 1 663-16 000 IU/L, 1 patient had anti-3-hydroxy-3-methylglutaryl-CoA reductase autoantibodies and 1 patient had anti-signal recognition particle autoantibodies. The electromyography showed myogenic lesions in all patients. Muscle magnetic resonance imaging showed diffuse muscle edema in all patients, myofascial edema in 3 and subcutaneous-tissue edema in 3. The muscle biopsies in 4 patients revealed necrotic myopathy,with high P62 expression in muscle fibers. The electromicroscopy of 2 patients revealed vacuolated mitochondria and intranuclear tubulofilamentous inclusions in muscle fibers. Four patients were treated with glucocorticoids, of whom 2 patients combined with intravenous immunoglobulin, tacrolimus or cyclophosphamide. One case had close monitoring without drug therapy. They showed significant improvement, but the CK was still abnormal in 4 patients.Conclusions:COVID-19 leads to immune mediated myopathy. The manifestation of patients is characterized by proximal predominant weakness and high creatine kinase level. Muscle magnetic resonance imaging shows diffuse muscle edema. The muscle biopsies reveal necrotic myopathy. The effectiveness of immunosuppression needs to be further studied.

Objective: Alport syndrome was an inherited kidney disease caused by the mutation of COL4A3, COL4A4, or COL4A5. Whole-exome sequencing was used to detect the mutations on these genes for the molecular diagnosis of Alport syndrome. Methods: A 6-year-old girl found accidentally with microscopic hematuria at the age of 4. The clinical data and blood sample of the family including proband, parents, brothers, and sisters were collected. Whole exome sequencing was conducted using their genomic DNAs. Results: A novel heterozygous frameshift mutation c.1826delC (p.Pro609Glnfs*44) was found in the exon 25 of the COL4A4 (NM_000092) in the proband, the father, and the sister, showing an autosomal dominant inheritance pattern of Alport syndrome. This mutation of COL4A4 was confirmed by mutation analysis, and the mutation of c.1826delC was verified by Sanger sequencing. No mutations on COL4A3 and COL4A5 were detected in this family. And the mother and brother are normal wide-type. Conclusions This novel mutation is a valuable addition to the current genetic profile of Alport syndrome, and provide us a better understanding of the disease. Whole-exome sequencing is a power tool to identify the novel mutations of inherited disease and contribute to the molecular diagnosis of disease.