Objective To study the effect and possible mechanism of diazoxide on myocardial ischemia/reperfusion (I/R) injury in diabetic rats, and the influence of insulin intervention which aims to maintain blood sugar levels within the normal range on the protective function of cardiomyocytes. Methods 126 health male Sprague-Dawley (SD) rats were intraperitoneally injected with one dose of 60 mg/kg streptozotocin (STZ) to reproduce diabetic model. The diabetic rats were randomly divided into seven groups, with 18 rats in each group. Myocardial I/R model was established by 30 minutes ligation of the left anterior descending branch of the coronary artery, and 120 minutes blood circulation recover. Sham group was only threaded without ligation. Rats in I/R group, diazoxide group (DZ group), and Ottawa vine penicillin (WNT) group were infused intravenously with 2 mL of 0.1% dimethyl sulphoxide (DMSO), DZ (7 mg/kg), and WNT (15 μg/kg), respectively, after 25 minutes of ischemia. Sham group was only injected with 2 mL of 0.1% DMSO. DZ+WNT group was infused with WNT 5 minutes before the injection of DZ. Insulin intervention (RI) group received a continuous insulin infusion to maintain the blood sugar at the level of 4-6 mmol/L. RI+DZ group was infused with DZ after ischemia for 25 minutes based on blood sugar control. Hemodynamic parameters in each group were monitored continuously. The pathological changes of myocardium were observed with hematoxylin and eosin (HE) staining. The expressions of phosphorylated protein kinase B (p-Akt) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β) were determined by Western Blot. Results Compared with sham group, the cardiac functions of the intervention groups were significantly decreased, and severe myocardial injury was observed. Compared with I/R group, the cardiac functions of intervention groups were not obviously improved. However, after insulin intervention by which blood sugar was maintained within normal range, the cardiac function and myocardial injury were further aggravated. Compared with sham group (the expression value of sham group was set as 1), the expressions of p-Akt in other groups including I/R group, DZ group, RI group, and RI+DZ group showed no statistically significant difference (gray value: 1.07±0.09, 1.03±0.07, 1.07±0.07, 1.02±0.08 vs. 1.00, all P > 0.05). However, the expressions of p-Akt were decreased in WNT group and DZ+WNT group as compared with those of sham group and I/R group (gray value: 0.54±0.06, 0.51±0.05 vs. 1.00 and 1.07±0.09, all P < 0.05). The expressions of p-GSK-3βshowed no statistically significant difference in I/R group, DZ group, WNT group, and DZ+WNT group as compared with sham group (gray value: 0.97±0.08, 1.00±0.11, 0.98±0.06, 0.97±0.09 vs. 1.00, all P > 0.05). However, the expression of pGSK-3β was increased in RI group, RI+DZ group as compared with sham group and I/R group (gray value: 1.68±0.08, 1.70±0.05 vs. 1.00 and 0.97±0.08, all P < 0.05), and it was significantly higher in RI+DZ group than that of DZ group (gray value: 1.70±0.05 vs. 1.00±0.11, P < 0.05). Conclusions Diazoxide after myocardial injury could not protect the myocardium from I/R injury in diabetic rats, and did not trigger the activation of the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Insulin intervention by which blood sugar was maintaine d within the normal range exacerbates myocardial I/R injury in diabetic rats.

Objective:To differentiate the methamphetamine users according to the developmental stages of addictive behavior, and explore the characteristics of different stages in order to provid a theoretical reference for our clinical intervention.Methods:Take the male methamphetamine users in compulsory detoxification institute whom were admitted from September 2018 to December 2019 as research objects.All the objects were asked to complete clinical diagnosis, interview and questionnaire evaluation in one week.According to the developmental stages of addictive behavior, the subjects were divided into occasional use group ( n=51), regular use group ( n=95) and compulsive use group ( n=157).All subjects were evaluated using visual analogue scale(VAS), Barrett impulsiveness scale(BIS)and CogState scale.SPSS 20.0 software was used for statistical analysis, AVOVA or Kruskal-Wallis H test was used for group comparison.Multiple Logistic regression analysis was used to explore the factors associated with the development of addictive behavior. Results:(1)The compulsive use group had higher cumulative duration(24(8, 48), 12(4, 24), 22(10, 36)), average dose(6.6±3.8, 2.8±1.4, 4.5±3.4) and craving score(1(0, 5), 0(0, 1), 1(0, 3)) than the other two groups(all P<0.05).And individuals in compulsive use group had more previous heroin use experience(20.4%, 9.8%, 14.8%, P<0.05).The regular use group had more withdrawal times than the other two groups(1(1, 3), 1(0, 1), 1(1, 2), P<0.05).The total scores of Barrett impulsiveness scale(42.8±13.3, 34.5±13.6, 36.1±14.9) and the scores in all dimensions in the compulsive use group were significantly higher than those in the other two groups(motor impulsiveness: 37.5±15.8, 27.8±13.4, 29.2±17.8; attentional impulsiveness: 43.2±18.0, 39.4±17.0, 37.2±18.1; non-planning impulsiveness: 47.2±19.8, 38.8±18.7, 40.7±20.8; P<0.05) .In the compulsive use users, the ISL(16.50±4.87, 19.30±4.78, 18.33±4.91) and SEC(0.76±0.21, 0.89±0.22, 0.81±0.21) scores about cognitive assessment were significantly lower than other two groups(both P<0.05).(2)The results of multiple Logistic regression analysis showed that cumulative duration ( β=0.022, OR=1.022, 95% CI: 1.003-1.042), dosage( β=0.625, OR=1.869, 95% CI: 1.196-2.921), craving ( β=0.194, OR=1.214, 95% CI: 1.002-1.215), the total scores of Barrett impulse scale( β=0.036, OR=1.037, 95% CI: 1.013-1.061), scores of non-planning impulsiveness( β=0.040, OR=1.041, 95% CI: 1.004-1.038), scores of motor impulsiveness( β=0.033, OR=1.214, 95% CI: 1.001-1.068) were associated with the periodic grouping of addictions. Conclusions:Addictive behavior is a progressive process and methamphetamine users at different stages have different characteristics in substance use, impulsiveness and cognitive function.The development of addictive behavior is associated with the time, dosage and craving of substance use, as well as the personality impulsivity of users.And the compulsive users suffered more cognitive impairment than the other two groups. The methamphetamine users should be identified dynamically and targeted therapeutic intervention measures should be carried out to block the addictive process to achieve the goal of harm reduction.

Objective To investigate the clinical significance and distribution of different rotational displacements on the sagittal plane in unstable pelvic fractures radiologically.Methods We retrospectively reviewed 82 patients with unilateral pelvic fracture who had been treated at our department from June 2005 to June 2015.They were 48 men and 34 women,with an average age of 43 ± 18 years.By Tile classification,there were 48 cases of type B and 34 cases of type C.Their rotational displacements on the sagittal plane of the pelvic ring were determined on the anteroposterior X-ray films of the pelvis by measuring the changed distances from the top of iliac crest to the lowest point of ischial tuberosity and to the pubic tubercle.The data were recorded for analysis of different displacements and their clinical significance.Results Of all the 82 patients,based on the preoperative radiographic evidence,36 (43.9％) showed sagittal plane rotational displacement.Of them,28 (77.8％) showed supination displacement and 8 (22.2％) pronation displacement.The preoperative CT three-dimensional reconstruction confirmed the findings from the X-ray films.Twenty-one of the 48 cases of Tile type B (43.8％) and 15 of the 34 cases of Tile type C (44.1％) showed sagittal plane rotational displacement.The success rate of closed reduction was,respectively,66.7％ (24/36) in the 36 cases with sagittal plane rotational displacement,62.5％ (5/8) in those with pronation displacement and 67.9％ (19/28) in those with supination displacement,all significantly lower than the total success rate of closed reduction in this cohort(84.1％).Conclusions The sagittal plane rotational (pronation and supination) displacement of pelvic fracture can be determined by measuring special points and lines on the anteroposterior radiographs of the pelvis.The supination displacement on the sagittal plane is more common.The unstable pelvic fracture with sagittal plane rotational displacement is more difficult to reduce.

Objective To observe the protective effects of Diazoxide (DZ) on myocardial ischemia and reperfusion (I/R) in non-diabetic rats with stressed hyperglycemia and to explore its possible mechanism. Methods The stressed hyperglycemia (SHG) myocardical I/R model was prepared by ligation of the left anterior descending branch of the coronary artery for 30 minutes and reperfusion for 120 minutes on the healthy adult Sprague-Dawley (SD) rats. Blood sugar was required up to 10 mmol/L in the qualified animal model after ischemia for 30 minutes. The 48 successful model rats were randomly divided into 4 groups (12 in each group): I/R group, low, medium and high dose DZ treated group (LIPO group, MIPO group, HIPO group). Sham-operated group (sham group) was only threaded without deligation. I/R group, LIPO group, MIPO group and HIPO group were challenged to 0.1% dimethyl sulfoxide (DMSO), DZ (0.1% DMSO dissolved) 4, 7, 10 mg/kg for 2 mL, respectively after ischemia for 25 minutes. Hemodynamics indicators were continuously monitored. After reperfusion for 120 minutes, blood glucose, serum creatine kinase (CK) concentration and lactate dehydrogenase (LDH) activity were detected, myocardial infarction area was analyzed by triphenyltetrazolium chloride (TTC) staining, myocardial ultrastructure was observed by electron microscope, expressions of phosphorylated protein kinase B (p-Akt) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β) were detected by Western Blot. Results Compared with sham group, I/R group had an elevated blood glucose, decreased heart rate (HR), systolic diastolic dysfunction, increased myocardial enzymes. Obvious necrosis of myocardium, myocardial tissue edema, mitochondria swelling, cristae, disappearing glycogen granules were observed under electron microscope with TTC staining. After reperfusion for 120 minutes, comparing with I/R group, blood glucose of HIPO group was significantly increased (mmol/L: 16.93±3.22 vs. 14.65±3.61, P < 0.05); the maximum rate of left ventricle internal pressure drop (-dp/dt max) of LIPO group was improved (mmHg/s: -1 055±16 vs. -982±10, P < 0.05) and the infarct size was evidently shrunk [(32.45±3.54)% vs. (41.30±3.21)%, P < 0.05]; left ventricular systolic pressure (LVSP) of MIPO group and HIPO group [LVSP (mmHg, 1 mmHg = 0.133 kPa): 60±2, 74±4 vs. 54±4], left ventricular end-diastolic pressure [LVEDP (mmHg): 24.6±1.5, 18.9±1.3 vs. 27.9±1.6], the maximum rate of left ventricle internal pressure were increased [+dp/dt max (mmHg/s): 1 049±37, 1 262±75 vs. 975±17], and -dp/dt max (mmHg/s: -1 068±21, -1 321±63 vs. -982±10) were improved in different degrees (all P < 0.05); CK (kU/L: 10.7±0.5, 11.0±1.3 vs. 12.9±1.0), LDH (kU/L: 6.8±0.2, 7.8±0.1 vs. 8.8±0.1) was evidently decreased (all P < 0.05), infarct size was smaller [(31.24±2.45)%, (30.81±2.68)% vs. (41.3±3.21)%, all P < 0.05], electron microscope showed that the myocardial injury was repaired. After reperfusion for 120 minutes, compared with sham group, expressions of p-Akt and p-GSK-3β in I/R group have obviously reduced (grey value: 0 vs. 0.187±0.018, 0.110±0.045 vs. 0.200±0.081, both P < 0.05). Compared with I/R group, expressions of p-Akt in HIPO group and p-GSK-3β in LIPO group, MIPO group and HIPO group were obviously increased (grey value: 0.101±0.009 vs. 0; 0.180±0.057, 0.270±0.062, 0.280±0.039 vs. 0.110±0.045, all P < 0.05). But there were significant increase in MIPO group and HIPO group. There was no significant difference in HR among different treatment groups. Conclusions I/R with SHG can significantly inhibit the activity of PI3K/Akt-GSK-3β signaling pathways, middle and high dose of DZ has a protective effect on I/R myocardium complicating with SHG, and middle dose will not lead to evident increase of blood glucose; DZ may act on GSK-3β through PI3K/Akt-GSK-3β signaling pathways, phosphorylate it and inhibit its activity, so as to develop the cardioprotective effect.

Background and purpose: Radiation therapy has entered the era of precise radiotherapy. Set-up error becomes important factor affecting the effects of radiotherapy. The aim of this study was to analyze the set-up accuracy of the in-house developed technique of body plate with vacuum cushion and thermoplastic mask (Group A) and the conventional technique of arm support (Group B) in thoracic tumor radiotherapy. Methods: A total of 19 patients with thoracic tumor were enrolled in this study and randomly separated into Group A and Group B. The patients of Group A underwent the secondary set-up: align the marker on vacuum cushion and patient's body to the room laser, cover the patient's body with thermoplastic mask and align the marker on the mask to the room laser. The patients of Group B were directly setup by aligning the marker on the patient's body to the room laser. The kilo-voltage cone beam computed tomography (KV-CBCT) was performed on each patient to collect the pre- and post-treatment CBCT images. The CBCT images were registered to the planning CT to analyze the translational error of Group A and Group B. Results: The pre-treatment set-up errors of Group A vs Group B were (1.06±0.58) vs (1.82±0.82) mm in left and right (LR) direction, (1.31±0.40) vs (2.18±1.20) mm in superior and inferior (SI) direction, and (1.28±0.66) vs (2.94±1.81) mm in anterior and posterior (AP) direction. The post-treatment set-up errors of Group A vs Group B were (0.86±0.54) vs (1.29±0.58) mm in LR direction, (1.07±0.58) vs (1.08±0.45) mm in SI direction, and (0.98±0.53) vs (1.56±0.63) mm in AP direction.Conclusion: The in-house developed immobilization technique of body plate with vacuum cushion and thermoplastic mask was more accurate and reproducible than the conventional immobilization technique of arm support in thoracic tumor radiotherapy.

Objective To investigate the relationship of c erbB2 with endocrine therapy and prognosis, to investigate the rapid and effective method to detect c erbB2 alteration in breast carcinoma(BC).Metheds Semi quantitative PCR was used to detect the amplification of c erbB2, and immunohistochemistry was used to detect the expression of protein of c erbB2. 58 cases of BC were followed up .Results There was significant relationship between c erbB2 protein overexpression and gene amplification(P

Objective To investigate the miRNA expression profiles in rectal cancer tissues and their associations with clinical pathological stage, depth of tumor invasion, and lymph node metastasis, and to evaluate the potential of miRNA as diagnostic and prognostic markers of rectal cancer. Methods Human miRNA microarray was used to profile miRNA expression in rectal cancer tissues and matched adjacent normal tissues (n=71). The up-regulated miR-93-5p and down-regulated miR-27a-3p were screened out, and the top differentially expressed miRNA were validated by quantitative real-time polymerase chain reaction ( qRT-PCR) . The relationship between the expression of miRNA and clinical parameters was analyzed by ANOVA and Spearman correlation. Results The expression of miR-27a-3p was down-regulated in miRNA microarray, but was up-regulated in qRT-PCR analysis;the data were relatively discrete. The expression of miR-93-5p was up-regulated in both miRNA microarray and qRT-PCR analysis;the expression level of miR-93-5p in rectal cancer tissues was 3165 times that in adjacent normal tissues ( P=00058);the expression level was correlated with tumor volume ( P= 0004 ) , and was positively correlated with the level of carcinoembryonic antigen ( CEA) before treatment ( P=0001) and the number of lymph nodes metastases (rs=0534, P=0005). Conclusions There is a differential miRNA expression pattern between rectal cancer tissues and matched adjacent normal tissues. The miR-93-5p is highly up-regulated in rectal cancer tissues and may serve as a diagnostic and prognostic marker of rectal cancer.

Objective To assess the effectiveness and safety of paclitaxel-coated balloons for in-stent restenosis in patients aged 65 years and over.Methods Sixty elderly patients(≥65 years old)with in-stent restenosis were enrolled at the Department of Cardiology,the First Affiliated Hospital of Inner Mongolian Medical University.Based on different treatment methods for in-stent restenosis,patients were divided into the drug-eluting balloon(DEB,n=32)group and the drug-eluting stent(DES,n=28)group.The primary end point was late luminal loss,determined by angiography.Secondary end points included rates of restenosis and major adverse cardiac events (MACEs).Results Quantitative coronary angiography revealed no significant differences in baseline data At 3 months after treatment,the rate of MACEs was 28.6％ in the DES group and 12.5％ in the DEB group(P＜0.05).At 6 months after treatment,angiography showed that the (x)±s of insegment late luminal loss was(0.21±0.04)mm in the DES group versus(0.12±0.06)mm in the DEB group(P ＜0.05).Furthermore,7 of 28 patients (25 ％) in the DES group had restenosis,compared with 4 of 32 patients (12.5 ％)in the DEB group(P =0.03).Conclusions Paclitaxel-coated balloons for coronary in-stent restenosis in patients aged 65 years or over can significantly reduce the incidence of restenosis and lower the rate of MACEs.The procedure is safe with no serious complications,eliminates the need for additional stent implantation,and should be further assessed in future clinical trials.

Space reduction after the premature loss of the second primary molars is one of the important factors affecting the occurrence of malocclusion, often increasing the demand for orthodontic treatment. It has great significance to select and apply appropriate appliances to maintainthe space soon after the premature loss of the second primary molars. The space should be maintained until the adjacent teeth and the successors erupt successfully. This review summarizes the selection and clinical application of the space maintainer for the premature loss of the second primary molars in different periods, to improve dentists′ awareness of the importance of space maintainers and to provide advises for clinical choices.

Objective:To explore the mediating role of aging attitude and anxiety in the relationship between self-worth and depression among the elderly.Methods:From July to August 2022, a total of 536 elderly people in Shijiazhuang University for the Elderly were surveyed by the elderly self-worth scale, generalized anxiety disorder-7(GAD-7), attitudes to aging questionnaire(AAQ) and patient health questionnaire(PHQ-9). SPSS 26.0 software was used for descriptive statistics and correlation analysis.AMOS 24.0 was used to construct an intermediation model, and Bootstrap method was used for mediating effect testing.Results:(1)The score of self-worth was 101.00 (92.00, 112.00), the score of aging attitude was 92.00 (83.00, 101.75), the score of anxiety was 2.00(0, 6.00), and the score of depression was 2.00 (0, 5.00). (2)Self-worth was positively correlated with aging attitude ( r=0.67, P<0.01), while negatively correlated with anxiety ( r=-0.45, P<0.01) and depression ( r=-0.48, P<0.01). The aging attitude was negatively correlated with anxiety ( r=-0.41, P<0.01) and depression ( r=-0.41, P<0.01). Anxiety was positively correlated with depression ( r=0.71, P<0.01). (3)The indirect effect of aging attitude between self-worth and depression in the elderly was -0.016, accounting for 19.75% (-0.016/-0.081)of the total indirect effect.The indirect effect of anxiety between self-worth and depression in the elderly was -0.045, accounting for 55.56%(-0.045/-0.081) of the total indirect effect.The chain mediating effect of aging attitude and anxiety between self-worth and depression in the elderly was -0.020, accounting for 24.69%(-0.020/-0.081) of the total indirect effect. Conclusion:Aging attitude and anxiety play a chain mediating role between self-worth and depression in the elderly.