Depression has become one of the most important causes of disability worldwide. Although traditional treatment methods such as drug therapy, physical therapy and psychological intervention have positive effects, they still have limitations such as high treatment cost, high drug side effects, high recurrence rate and poor compliance. Exercise therapy, as a treatment recommended by many guidelines, has many advantages such as simple and convenient, few side effects, and strong persistence. Studies have shown that exercise can relieve depression through a variety of mechanisms, but there is still a lack of effective targets for the treatment of depression. Microglia is an innate immune cell in the central nervous system. In recent years, the role of microglia in neuroinflammation in depression and other mental diseases has attracted more and more attention. Thus, microglia may be a key target for exercise to alleviate depression. This article discusses the relationship between exercise and microglia phenotypes as well as depression, and proposes future research directions on microglia-mediated exercise to improve depression, in order to provide new ideas and directions for the clinical treatment of depression.

OBJECTIVEThe three-dimensional (3D) structure of left atrial appendage (LAA) in atrial fibrillation patients were reconstructed by Mimics 3D imaging system, aiming at guiding for selection of both the size and location of the closure devices and making preliminary risk assessment of LAA closure with Watchman system.

METHODSInclusion criteria were: ten voluntary patients with both atrial fibrillation and indication for LAA closure aging from 40 to 85 years old with contraindication for oral anticoagulants or unwillingness to take long-term oral anticoagulation therapy from May to December 2014. 3D reconstruction of LAA was preoperatively made by Mimics 3D imaging system. With the Mimics 3D reconstruction model and the results of both transesophageal echocardiography (TEE) and LAA radiography, the size and location for the closure device were chosen. The devices were planted at the ostium of the LAA.

RESULTSTen atrial fibrillation patients were enrolled (average age: (66.3±11.9) years old) and all successfully implanted with the Watchman LAA closure devices. Nine of them were with non-valvular atrial fibrillation with average CHADS2-VAS score (3.2±1.7) and HAS-BLED score (2.7±1.6). The rest one was a valvular atrial fibrillation patient with the history of the percutaneous balloon mitral valvuloplasty (PBMV) without surgical indications of mitral valve replacement (MVR). There was no blood leakage around the device by regular postoperative TEE and LAA radiography examinations. There were no complications of bleeding, embolism, or stroke through both at peri-operative period and at 1 month follow-up post procedure.

CONCLUSIONPreoperative Mimics 3D reconstruction of LAA by Mimics 3D imaging system among atrial fibrillation patients provides essential information guiding the successful LAA closures.

Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; Atrial Appendage ; surgery ; Atrial Fibrillation ; surgery ; Cardiac Surgical Procedures ; Contraindications ; Echocardiography, Transesophageal ; Embolism ; Humans ; Imaging, Three-Dimensional ; Middle Aged ; Prostheses and Implants ; Prosthesis Implantation ; Stroke ; Treatment Outcome

OBJECTIVETo assess complement-mediated myocardial injury on isolated guinea pig working hearts and cardioprotective effects of CD59.

METHODSUsing a modified Langendorff apparatus, isolated guinea-pig working hearts were perfused with a modified Krebs Henseleit buffer containing 3% heat-inactivated human plasma and zymosan (IPZ) (control) (n = 10), 3% normal human plasma and zymosan (NPZ) (n = 10), or 3% normal human plasma and zymosan and 1.5 microg/ml CD59 (NPZC) (n = 10), respectively. Epicardial electrocardiogram (ECG), cardiac output (CO), coronary arterial flow (CF), maximum left ventricular developed pressure (LVP(max)), maximum left ventricular developed pressure increase rate (+ dp/dt(max)), maximum left ventricular developed pressure decrease rate (- dp/dt(max)) and heart rate (HR) were recorded at 0, 15, 30, 45 and 60 min of treatment. After the experiment, immunohistochemical examination was performed to detect the presence of C3a or C5b-9 in the myocardium of the isolated hearts.

RESULTSCompared the IPZ group, hearts treated with NPZ showed a slight depression on ST segments of epicardial ECG at 15 min, a significant elevation between 30 min to 60 min, a decrease in CF, CO, LVP(max), + dp/dt(max) and - dp/dt(max), and an increase in HR at 15 min. The observed alterations in CF, CO, LVP(max), + dp/dt(max) and - dp/dt(max) remained decreased, while the HR remained increased until the end of the protocol. The all above parameters of hearts treated with NPZC were similar to the control group (IPZ) at any given time. Immunohistochemical examination showed positive signals of C3a and C5b-9 in the myocardium of hearts treated with NPZ. C3a was positive in NPZC, and C3a and C5b-9 were negative in IPZ.

CONCLUSIONSActivated human complements directly damage isolated guinea pig working hearts, and CD59 offers a significant protection against the injuries.

Animals ; CD59 Antigens ; pharmacology ; Complement C3a ; antagonists & inhibitors ; metabolism ; Complement Inactivator Proteins ; pharmacology ; Electrocardiography ; Guinea Pigs ; Heart ; drug effects ; physiology ; Immunohistochemistry ; In Vitro Techniques ; Male ; Myocardium ; metabolism ; pathology ; Time Factors

Objective To study the effects of vagus nerve stimulation (VNS) on brain tissue tumor necrosis factor-α (TNF-o),interleukin-1β (IL-1β) and IL-10 levels in serum and brain tissues after blast brain injury in rabbits.Methods Twenty New Zealand white male rabbits were randomly divided into sham-operated group (n=6),traumatic brain injury (TBI) group (n=10),TBI+VNS group (n=8).Rabbit brain blast injury models of TBI group and TBI+VNS group were established; and the right cervical vagus nerves of the rabbits in TBI+VNS group were stimulated (10 V,5 HZ,5 ms,20 min).The TNF-α,IL-1β and IL-10 changes in the serum (6 h after injury) and brain tissues (24 h after injury) and the water content in the injured brain tissues were observed and recorded.Results The TNF-α and IL-1β levels in the serum and brain tissues,the water content in the brain tissues of the TBI group were significantly higher than those in the sham-operated group and TBI+VNS group (P＜0.05); the IL-10 level in the TBI+VNS group was significantly higher than that in the sham-operated group and TBI group (P＜0.05).Conclusion VNS can reduce the brain edema degree by increasing the IL-10 level and decreasing the TNF-α and IL-1 β levels,which plays a key role in brain protection effect after brain blast injury in rabbits.

Echocardiogram is vital for the diagnosis of cardiac disease. The heart has complex hemodynamics requiring an advanced ultrasound imaging mode. Cardiac ultrasound vector flow imaging is capable of measuring the actual magnitude and direction of the blood flow velocity, obtaining the quantitative parameters of hemodynamics, and then providing more information for clinical research and diagnosis. This study mainly reviewed several different vector flow imaging techniques for cardiac flow and presented the implementation difficulties, and proposed a diverging wave based high frame rate cardiac ultrasound vector flow imaging. The study discussed the limitation of current ultrasound technology used in the cardiac flow measurement, analyzed and demonstrated the specific reasons for these implementation difficulties and the potential future development.
Blood Flow Velocity ; Heart/physiology* ; Hemodynamics ; Ultrasonography

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.