Objective To observe the dynamic changes of TNF-α,IL-1β,IL-6,IL-10,and expressions of Notch-1,NF-κB mRNA and their protein levels in the brain tissue of septic mice and intervention effects of intrathecal injection of lentiviral vector of miR-34a gene for regulating Notch-1/NF-κB signaling pathway.Methods A total of 54 mice of clean grade were divided randomly (random number) into four groups,namely sham group (n =9),in which sham-operated laparotomy was performed;CLP group (n=15),in which the cecum ligation operation (CLP) was performed;NC group (n =15),in which intrathecal injection of lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day;intervention group (n =15),in wihch intrathecal injection of miR-34a lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day.The mice of four groups were sacrificed 24 h after modeling or operation.The changes of behavior of mice was observed and the neurological scores were assessed 24 h after CLP.The levels of TNF-α,IL-1β,IL-6 and IL-10 in the brain were measured by ELISA method.The mRNA expression and protein levels of Notch-1 and NF-κB in the brain tissue were measured by real-time PCR and Western blot method,respectively.Pathological changes of brain tissue were observed under light microscope.Results The neurological scores,the cerebral TNF-α,IL-6 levels,the mRNA expression and protein level of NF-κB (P＜0.01),and IL-1β levels (P ＜0.05) in CLP group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level and the mRNA expression and protein level of Notch-1 (P ＜ 0.01) in CLP group 24 h after modeling were lower than those in sham group.The neurological scores,the cerebral TNF-α and IL-1β levels,and the protein level of NF-κB (P ＜0.01),and IL-6 (P ＜ 0.05) in NC group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level,the mRNA expression and protein level of Notch1 in NC group 24 h after modeling were lower than those in sham group.There were no significant difference in neurological socres,IL-1β and IL-6 levels between intervention group and CLP group (P ＞ 0.05).The IL-10 level (P ＜ 0.05) and the mRNA expression (P ＜ 0.05) and protein level (P ＜ 0.01) of Notch-1 in intervention group 24 h after modeling were lower than those in CLP group.There were no significant difference in biomarkers between NC group and CLP group (P ＞ 0.05).The degree of cerebral damage found under light microscope was also ameliorated in intervention group compared with CLP group 24 h after modeling.Conclusions The effects of miR-34a via regulating Notch-1/NF-κB signaling pathway on brain function exerts cerebral protective effects in septic mice.

Objective To investigate the variation of middle cerebral arteries of rats in depression model by using 3D-TOF sequence on 3.0T MR.Methods Forty SD rats were randomly divided into control group and depressive group with 20 in each.Compared with control group,depressive group were handled according to the demand of rat depression model.Rats were scanned by 3.0T MR on 0th,4th,6th,8th week respectively.Using Mimics software,the variation of middle cerebral arteries were described and analysed.Results Compared with the control group,the middle cerebral arteries of depressive group rats changed along with the increase of time.On the 4th week,the diameter of the middle cerebral arteries of rats decreased significantly (the diameter of left middle cerebral arteries:control group (0.31 ±0.05) mm,depressive group (0.28±0.04) mm,t=2.76,P＜0.05 ; the diameter of right middle cerebral arteries:control group (0.30 ± 0.05) mm,depressive group (0.27± 0.03) mm,t =2.61,P＜ 0.05).On the 6th week,the length of the middle cerebral arteries of rats decreased significantly (the length of left middle cerebral arteries:control group (5.6± 0.77) mm,depressive group (4.9 ± 0.73) mm,t =2.84,P＜ 0.05 ; the length of right middle cerebral arteries:control group(5.5±0.76) mm,depressive group(4.8±0.72) mm,t=3.11,P ＜0.05).On the 8th week,the diameter and length of the middle cerebral arteries of rats decreased more significantly (the diameter of left middle cerebral arteries:control group (0.31 ±0.05) mm,depressive group (0.22±0.02) mm,t =5.50,P＜ 0.01 ; the diameter of right middle cerebral arteries:control group (0.30 ± 0.04) mm,depressive group (0.21 ±0.02) mm,t=5.57,P＜0.01 ; the length of left middle cerebral arteries:control group (5.6±0.78) mm,depressive group (4.3±0.70)mm,t=5.49,P＜0.01 ;the length of right middle cerebral arteries:control group (5.5 ± 0.79) mm,depressive group (4.2±0.71)mm,t=5.45,P＜0.01).Conclusion The variation of middle cerebral arteries of depressive rats reveals the relationship between brain vessels and depression in a certain extent.

Objective To investigate the potential relationship among brain vessels,hippocampus tissue and cell morphology in depressive rat model.Methods According to the weight-atching principle,thirty SD rats were randomly divided into control group (n =15) and depressive group (n =15).Compared with the control group,the depressive group was handled according to the demand of depressive rat model.After rats were scanned by 3.0 magnetic resonance on the 0th,2nd,4th,6th,8th week,respectively,hippocampus was picked out,taken photos and stained by HE.Microscopeat was used to observe hippocampus cell morphology and brain vessels,and hippocampus was described and analysed by Mimics software.Results Diameter and length of the middle cerebral arteries of the model group decreased with time increasing.Compared with the control group,these changes in the model group were significantly different on the 8th week (left:control group (0.31 ± 0.04),(5.53 ± 0.62) mm,depressive group (0.25±0.02),(4.64±0.61) mm,t =5.20,5.48 respectively,both P＜0.01;right:control group (0.30±0.03),(5.59 ±0.64) mm,depressive group (0.24 ±0.03),(4.72 ±0.67) mm,t =3.96,4.85 respectively,both P ＜ 0.01).The cells morphology of hippocampus was also changed with stimulation time increasing.The numbers of cell in DG area,CA1 area and CA3 area were decreased,with cell shrank,cells nuclear stained strongly and arranged loosely.Besides,the volume of hippocampus tissue in the depressive group also changed correspondingly with time.On the 8th week,it was significantly different (left:control group (40.62 ±2.32) mm3,depressive group (34.18 ±2.25) mm3,t =7.72,P＜0.01;right:control group (40.47 ±2.25) mm3,depressive group (35.63 ±2.48) mm3,t =5.60,P ＜0.01).Conclusion With stress time increasing,brain vessels,hippocampus tissue and cell morphology in depressive rats change obviously,indicating certain correlation among them.

BACKGROUNDThe trachea, bronchus, blood vessel and left atrium plasty can maximumly remove tumor tissus and preserve the functional pulmonary tissues so as to improve patients' quality of life and prolong their survival.

METHODSFrom January 1990 to August 2004, 125 patients with lung cancer underwent trachea, bronchus, bloood vessel and left atrium plasty.

RESULTSThere were 116 patients who underwent bronchoplasty, in which angioplasty was performed concurrently in 26 cases. And reconstruction of superior vena cava was performed in 3 patients, and left atrium plasty in 6 patients. Three patients died after operation.

CONCLUSIONSTrachea, bronchus, blood vessel and left atrium plasty may be a promising direction in thoracic surgery.

Objective To explore the therapeutic effect of drinking water test combined with swallowing training on cerebral infarction patients with dysphagia.Methods A total of 68 cerebral infarction patients with dysphagia in our department were randomly divided into observation group and control group.The control group was given routine nursing,while the observation group was given drinking water test to guide diet,and systemic swallowing function training on the basis of the control group.The therapeutic effects,feeding conditions and VSD scale scores were compared after 1 month of intervention between the two groups.Results The drinking water test score in the observation group was lower than that in the control group,and the total effective rate of the swallowing function improvement was higher than that in the control group,the differences were statistically significant (P ＜ 0.05).The FOIS score in the observation group was higher,and the score of VSD scale was lower than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Drinking water test combined with swallowing training can effectively improve the swallowing function of patients with dysphagia after cerebral infarction,and is beneficial to the normal diet of the patients.

Objective:To investigate the influences of abnormal white matter micro-structures and stressful life events in relapse status of patients with major depressive disorder (MDD).Methods:A prospective sutdy was performed; 108 patients with MDD were chosen as study subjects in our hospital from May 2017 to June 2018. All subjects underwent MR imaging scanning, and were followed up for 2 years after treatment (once every 3 months). Their relapse status were assessed by 4 th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The degrees of depression and existence and level of stressful life events in MDD patients were assessed by Hamilton Depression Rating Scale (HDRS) and Life Events Scale (LES). The differences of clinical data and white matter micro-structures between relapse and non-relapse patients were compared. Binary Logistic regression analysis was used to determine the independent influencing factors for MDD relapse. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of influencing factors in MDD relapse. The correlations of white matter fractional anisotropy (FA) values with follow-up HDRS scores and follow-up LES scores were analyzed by Pearson correlation analysis. Results:In the end, 92 patients were enrolled in the study, including 38 relapse patients and 54 non-relapse patients. As compared with those in the non-relapse group, patients in the relapse group showed younger onset age, higher incidence of disease onset, longer course of disease, higher LES scores (baseline), and higher HDRS and LES scores (follow-up), with significant differences ( P<0.05). FA values of the right superior longitudinal fasciculus and corpus callosum in the relapse patients were significantly decreased as compared with those in the non-relapse patients ( P<0.05). Binary Logistic regression analysis showed that FA values of the right superior longitudinal fasciculus ( OR=0.350, 95%CI: 0.168-0.728, P=0.005) and FA values of the corpus callosum ( OR=0.646, 95%CI: 0.438-0.951, P=0.027), and LES scores (follow-up) ( OR=1.483, 95%CI: 1.226-1.793, P=0.000) were independent influencing factors for relapse in MDD patients. ROC curve showed that the area under curve (AUC) of FA values of the right superior longitudinal fasciculus, FA values of the corpus callosum, and LES scores (follow-up) to predict MDD relapse were 0.655, 0.661 and 0.841, respectively. Correlation analysis showed that FA values of the superior right longitudinal fasciculus and FA values of the corpus callosum were significantly negatively correlated with HDRS scores (follow-up) ( r=-0.470, P=0.000; r=-0.398, P=0.004), and LES scores (follow-up) were significantly positively correlated with HDRS scores (follow-up) ( r=0.429, P=0.000). Conclusion:Abnormal white matter micro-structures and stressful life events are closely related to the relapse of MDD.

Objective To explore the therapeutic effect of drinking water test combined with swallowing training on cerebral infarction patients with dysphagia.Methods A total of 68 cerebral infarction patients with dysphagia in our department were randomly divided into observation group and control group.The control group was given routine nursing,while the observation group was given drinking water test to guide diet,and systemic swallowing function training on the basis of the control group.The therapeutic effects,feeding conditions and VSD scale scores were compared after 1 month of intervention between the two groups.Results The drinking water test score in the observation group was lower than that in the control group,and the total effective rate of the swallowing function improvement was higher than that in the control group,the differences were statistically significant (P ＜ 0.05).The FOIS score in the observation group was higher,and the score of VSD scale was lower than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Drinking water test combined with swallowing training can effectively improve the swallowing function of patients with dysphagia after cerebral infarction,and is beneficial to the normal diet of the patients.

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.

OBJECTIVE To explore the current status and safety of medication in pregnant patients, and explore the working mode and data accumulation of the pregnancy medication consultation clinic. METHODS All pregnant women who received consultations at the Pregnancy and Lactation Medication Consultation Clinic of the First Affiliated Hospital of Zhejiang University School of Medicine from October 2021 to December 2022 were selected as the study subjects. Their names, ages, contact information, last menstrual period, and medication use during pregnancy were recorded, and the medication profile and safety of the study population were evaluated. Organized the intervention measures of clinical pharmacists and conducted follow-up studies on their pregnancy outcomes. RESULTS A total of 179 consultation pregnant women were included, and 80% of the patients in the study population used drugs in the unknown pregnancy state, with 3 drugs per capita. The most common reason for drug use was upper respiratory tract infection. The three types of drugs with the highest use rate were traditional Chinese patent medicines, antibacterial drugs, antipyretic and analgesic drugs. The usage rate of B-grade drugs in the study population was the highest, accounting for 51.3%; 8.4% of patients used X-grade medication. One hundred and fifty-one cases were followed up, with a loss of follow-up rate of 15.6%. The recommended acceptance rate of drug risk assessment given by pharmacists for patients was 95.4%. There were 98.7% of patients believe that pregnancy counseling clinics were helpful and could effectively alleviate anxiety. CONCLUSION Pregnancy medication consultation clinics can provide patients with scientific and personalized medication guidance and popular science education, and have significant effects in alleviating anxiety and depression in pregnant women.

OBJECTIVE: To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.
Betacoronavirus ; isolation & purification ; Colonic Neoplasms ; complications ; surgery ; Coronavirus Infections ; complications ; therapy ; Disease Management ; Humans ; Pandemics ; Pneumonia, Viral ; complications ; therapy ; Treatment Outcome