Objective To investigate the sedative effects and the adverse reactions in the elderly patients received different speed of dexmedetomidine (Dex) intravenous infusion. Methods Eighty elderly cases were randomly divided into four groups. Group D0 was the control group, while the group D1, D2 and D3 were the trial groups. The heart rates, blood pressure, SpO2, Ramsay sedation score and Narcotrend value were recorded. Results The sedation onset time of the D2, D3 group was faster than those in the D0 and D1 groups (P <0.05, respectively), and the duration of sedation in groups D2 and D3 were significantly longer than that in the D0 and D1 groups (P < 0.05). Among the four groups, no significant differences in the incidence of hypotension or bradycardia needed vasopressors or atropine to treat and oxygen saturation were shown (P > 0.05). Conclusion Intravenous infusion of Dex by doses of 0.75 ~ 1.0 μg/(kg·h) during hip surgery in the elderly patients under spinal anesthesia could lead to a safe and effective sedation.

Objective:To research on the immune recognition mechanism of synthetic pyrethroids and generic specific antibody.Methods:We studied on quantitative structure-activity relationship ( QSAR ) of synthetic pyrethroids and their analogs as well as antibody activity ( IC50:fifty percent inhibition concentration ) using stepwise multiple linear regression method.Based on calculating structure descriptors of synthetic pyrethroids and their analogs , two-demensional QSAR ( 2D-QSAR ) model was established.The main factors affecting antibody activity were screened using 2D-QSAR,and predictive ability of QSAR models were evaluated by the method of leave-one-out( LOO) cross-validation.Meanwhile, the structure parameters of synthetic pyrethroid fragments were calculated and then analyzed using partial least squares ( PLS) assay.And then hologram QSAR ( H-QSAR) model was constructed on molecular substructure and antibody activity.The fragments contribution to antibody activity were illustrated by encoding different colors.Results:Decision coefficent (R2) of 2D-QSAR model and HQSAR model were 0.920 and 0.917 individually,cross-validation coefficient ( Q2 ) of two QSAR models were 0.875 and 0.660 respectively ,which showed two models had good predictive abil-ity.The result from 2D-QSAR model was also obtained that smaller was hydrophobicity of pyrethroids , easier was recognized by antibody.In addition,the optimum HQSAR model was constructed after we tried many combinations of these parameters .The fragment size in optimum HQSAR model was between 4 to 10,a hologram length was 61,optimum principle component was 4,and the fragment type of B/C/Ch was selected.However ,the fingerprint encoded results of synthetic pyrethroids weren′t consistent completely with exper-imental IC50 values.Conclusion:Hydrophobicity of synthetic pyrethroids is the largest correlation factors in antibody recognization .

Objective To explore the relationship between plasma homocysteine levels and diabetic retinopathy (DR).MethodIn 40 DR patients and 63 non-DR patients,the indexes including plasma homocysteine concentrations,duration of diabetes,ages,blood pressure,preprandial blood glucose(PBG),plasma GHbA,e,plasma lipids,serum folie acid and semm vitamin B12 were analyzed.ResultsPlasma homocysteine level was significantly higher in DR patients (12.9μmol/L) than that in non-DR patients (7.8μ.mol/L) (P＜0.01),and the relationship remained significant correlation after adjusted for duration of diabetes,GHbA1c,ages,serum folic acid and serum vitamin B12(OR = 1.23,P＜0.05).ConclusionHyperhomocysteinimia is a risk factor and an independent predieator of DR.

Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.

Objective To explore the effect of QizhiJiangtang Capsule on the insulin resistance (IR)in the diabetic rats,and to clarify the action mechanism.Methods The diabetes rat models were induced by high fat diet combined with STZ injection.The successful models of the rats were randomly divided into diabetes group (DM), ShenqiJiangtang Granule group (SQ)and high (QJH),middle-(QJM),low (QJL)doses of QizhiJiangtang Capsule groups;at the same time control group (NC)was established. The drug concentrations in high, middle and low-doses of QizhiJiangtang Capsules groups were 1.35, 0.68, and 0.34 g · kg-1 respectively;and the concentration of ShenqiJiangtang Granule was 0.27 g·kg-1.After the diabetic model was established successfully, the rats were treated for 8 weeks on the basis of drug dose.Then the levels of fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (IRI)and biochemical indexes related to lipid metabolism of the rats were measured using blood glucose detector and automatic biochemistry analyser.The gene expression of insulin receptor substrate-1 (IRS-1),phosphatidyl inositol 3-kinase (PI3K),and glucose transporter 4 (GLUT4)in liver tissue were examined by Real Time PCR.The levels of tumor necrosis factorα(TNF-α)and adiponectin (ADPN)in serum were detected using ELISA.Results Compared with control group,the levels of FBG,FINS and IRI of the rats in diabetes group were significantly increased (P<0.05 or P<0.01 );the serum total cholesterol (TC), triglyceride (TG)and low density lipoprotein (LDL)levels were significantly increased (P<0.05 ), while the serum high-density lipoprotein (HDL)level was significantly decreased (P<0.05);the mRNA expression levels of IRS-1,PI3K and GLUT4 in liver tissue were decreased (P<0.05);the level of serum TNF-αwas increased (P<0.05),but the ADPN level was decreased (P<0.05).Compared with diabetes group,the FBG level and IRI of the rats in QizhiJiangtang Capsule and ShenqiJiangtang Granule groups were significantly decreased (P<0.01);the levels of FINS of the rats middle and high doses of in QizhiJiangtang Capsule groups and ShenqiJiangtang Granule group were significantly decreased (P<0.05);the levels of serum TC,TG and LDL of the rats in middle dose of QizhiJiangtang Capsule group and ShenqiJiangtang Granule group were significantly decreased (P<0.05 or P<0.01),but the HDL level was increased (P<0.05);the mRBA expression lvels of IRS-1,PI3K and GLUT4 inliver tissue were increased (P<0.05);the levels of serum TNF-αof the rats in middle dose of QizhiJiangtang Capsule group and Shenqijiangtang Granule group were significantly decreased (P<0.05),but the serum ADPN levels were increased (P<0.05 ). Conclusion QizhiJiangtang Capsule can significantly improve the IR in the diabetic rats,and the pharmacological mechanisms are related to adapting the blood lipid component and insulin signal transduction pathways.

Purpose: To generate the under-sampling pattern using a self-supervised learning framework based on a graph convolutional network. Materials and Methods: We first decoded the k-space data into the graph and put it into the network. After the processing of graph convolution layers and graph pooling layers, the network generated the under-sampling pattern for MR reconstruction.We trained the network on the simulated brain dataset enabled by the selfsupervised learning strategy. We did simulation along with the in vivo brain and liver experiments under different noise levels and accelerating factors to compare the performance between the proposed method and traditional methods using the PSNR and SSIM index. Results: The simulation experiments showed that the proposed method can achieve the best performance with low accelerating factors (2 and 3) at all noise levels and in high accelerating factors (4 and 5) at high noise levels (50 and 70 dB). In in vivo experiments, the proposed method attained the highest PSNR and SSIM in the brain dataset as well as in the liver dataset after fine tuning on a small liver dataset. Conclusion The self-supervised learning framework based on a graph convolutional network was able to design the under-sampling mask for MR reconstruction. The superior performance in the simulation and in vivo experiments demonstrated the feasibility and flexibility of the proposed method and its potential in clinical use.

BACKGROUND:In recent years,the treatment of anterior cruciate ligament injury has become more and more mature.However,there are still disputes about the timing of surgery,the choice of surgical methods,the choice of grafts,and the methods to promote graft healing after anterior cruciate ligament injury. OBJECTIVE:To summarize the latest research progress of surgical timing,surgical methods,graft selection and methods to promote graft healing after anterior cruciate ligament injury,and to find new treatment directions for anterior cruciate ligament injury. METHODS:Relevant articles concerning anterior cruciate ligament injury were retrieved from PubMed,CNKI,WanFang Date,VIP,SinoMed,ScienceDirect,Springer and Cochrane Library.After the screening,72 related articles were finally included. RESULTS AND CONCLUSION:(1)Surgical timing:Compared with delayed anterior cruciate ligament reconstruction,early reconstruction can reduce meniscus injury,elevate quality of life,and improve functional recovery.However,it is still uncertain whether the different operation timing will accelerate cartilage injury.(2)Surgical methods:Arthroscopic anterior cruciate ligament reconstruction is a common surgical method for anterior cruciate ligament injury.Dynamic internal stabilization repair of anterior cruciate ligament can bring similar results to traditional anterior cruciate ligament reconstruction in short-term and long-term effects.(3)Graft selection:Autogenous hamstring tendon is the first choice of anterior cruciate ligament graft,while bone-patellar tendon-bone grafts and allografts are the secondary choices.(4)Among the methods to promote graft healing,suture band strengthening can increase knee joint stability and ensure graft healing.Stem cells promote the tendon-bone healing of grafts through anti-inflammatory action,angiogenesis,inhibition of osteolysis and promotion of chondrocyte differentiation.Preserving the residual end of the anterior cruciate ligament can maintain the stability of the knee joint,promote the recovery of proprioception,and provide a prerequisite for the healing of the graft.The effectiveness of platelet-rich plasma in promoting graft healing remains to be discussed.However,biomaterials,gene therapy,stem cell application and other methods to promote tendon healing remain in the stage of molecular and animal researches.Clinical transformation is also needed in the future.

Objective:To explore indicators related to visceral fat index by constructing a random forest model.Methods:In this cross-sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in-service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set ( n=411) and a test set ( n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results:The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C-peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up-mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions:The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function.

Objective:To investigate the role of microRNA-187-5p (miR-187-5p) on osteoporosis (OP) as well as the related molecular mechanism.Methods:The level of miR-187-5p and tartrate-resistant acid phosphatase (TRAP, the osteoclast marker) was quantitatively detected in TRANKL-induced OP group and control (con) group by reverse transcription-quantitative PCR (RT-qPCR) ; Cell counting kit 8 (CCK8) was used to measure the viability of murine macrophage cell line (RAW264.7) ; Western blot was used to detect the expression of p65 and TNFα. Moreover, the dual luciferase reporter assays was applied to detect the interaction between miR-187-5p and p65.Results:The osteoclast proliferation determined by CCK8 and the mRNA level of TRAP detected by RT-qPCR demonstrated that the growth of osteoclast was inhibited in OP group compared with that in con group ( P=0.008; P=0.017) , which reversed by miR-187-5p mimic stimulation ( P=0.023; P=0.037) . The miR-187-5p was lowly expressed in OP group compared with that in con group ( P=0.031) ,which was increased by miR-187-5p mimic treatment compared with miR-187-5p NC treatment ( P=0.041) . Moreover, western blot indicated that the protein level of p65 and TNFα in OP group were up-regulated compared with that in con group ( P=0.034; P=0.024) , which restored by the miR-187-5p mimic co-incubation ( P=0.028; P=0.036) . Moreover, the RT-qPCR indicated that the mRNA level of p65 in OP group was also increased compared with that in con group ( P=0.039) , and the miR-187-5p mimic co-incubation decreased the mRNA level of p65, compared with miR-187-5p NC group ( P=0.025) . The dual luciferase reporter assays indicated that there was an interaction between miR-187-5p and p65. Conclusion:miR-187-5p alleviates OP through inhibiting the activity of osteoclast via RANKL/NFκB signaling

Objective:To investigate the effect of mitochondrial division of GABAergic neurons in substantia nigra pars reticulata(SNr)on motor dysfunction in mice with acute hepatic encephalopathy(AHE).Methods:AHE mice model was established by intraperitoneal injection of thioacetamide(TAA).The changes of liver lobules in AHE mice were observed by hematoxylin-eosin(HE)staining.The changes of serum aspartate aminotransferase(AST),alanine aminotransferase(ALT)and blood ammonia in AHE mice were detected by biochemical detection kit.Then,the motor function of AHE mice was observed by rod fatigue test,elevated cross maze test and open field test.Furthermore,the changes of mitochondrial area,perimeter,roundness and other morphological indicators in SNr of AHE mice were ob-served and analyzed by transmission electron microscopy.The expression of mitochondrial division and fusion related molecules in SNr of AHE mice was observed by Western Blot.Then,the expression of mitochondrial dynamic related protein 1(DRP1)in SNr of AHE mice was targeted by AAV virus.The mitochondrial membrane potential(MMP),ATP and reactive oxygen species(ROS)in SNr were detected by fluorescence enzyme marker,and the changes of motor function of mice were observed.Results:Compared with the control group,the motor function of AHE mice was signifi-cantly decreased,the mitochondrial division of SNr was significantly enhanced,and the expression of mitochondrial divi-sion related proteins was significantly increased.The MMP in SNr of AHE mice was significantly decreased,the ATP of cells was decreased,and the ROS was increased.After targeted inhibition of DRP1 expression in SNr of AHE mice,the movement was improved;further observation found that after the mitochondrial division in SNr of AHE mice was inhibi-ted,the MMP was significantly increased,the ATP of cells was increased,and the ROS was decreased,which demon-strated that the mitochondrial function was significantly improved.Conclusion:Targeted inhibition of mitochondrial di-vision of GABAergic neurons in SNr of AHE mice can improve mitochondrial morphology and function,thus alleviating their movement disorders.