OBJECTIVE To investigate the ameliorative effect and mechanism of short-acting exenatide on diabetic cognitive dysfunction. METHODS Spontaneously diabetic db / db mice were randomly divided into model group （normal saline） and exenatide group （50 μg/kg）， with db / m mice as the normal control group （normal saline）， with 8 mice in each group. Mice in each group were subcutaneously injected with corresponding drugs or normal saline twice daily for 8 consecutive weeks. Body weight and fasting blood glucose were measured at a fixed time every week. Cognitive function was evaluated by Morris water maze test. The levels of oxidative st ress indicators [malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH） ] ， cyclic adenosine monophosphate （cAMP） and protein kinase A （PKA） were detected in hippocampus tissue of mice. The hippocampal neuronal HT22 cells of mice were divided into control group （25 mmol/L glucose）， high glucose group （125 mmol/L glucose）， high glucose+exenatide group （125 mmol/L glucose+20 nmol/L exenatide）， high glucose+exenatide+H89 （PKA inhibitor） group （125 mmol/L glucose+20 nmol/L exenatide+10 μmol/L H89）， and high glucose+H89 group （125 mmol/L glucose+10 μmol/L H89）. After 48 h of intervention with corresponding solutions/culture medium， the levels of oxidative stress indicators， cAMP and PKA， the activities of mitochondrial respiratory enzymes Ⅱ and Ⅳ， and the phosphorylation level of dynamin-related protein 1 （Drp1） were measured. RESULTS Animal experiments showed that compared with the normal control group， the model group exhibited significantly increased body weight， fasting blood glucose and MDA level in the hippocampus （ P ＜0.05）， as well as significantly prolonged escape latency （ P ＜0.05）； swimming speed significantly slowed down， the time spent in the target quadrant， the number of platform crossings， and the levels of SOD， GSH， cAMP and PKA in the hippocampus were significantly decreased （ P ＜0.05）. Compared with model group， all the above indicators （except for swimming speed） in the exenatide group were significantly reversed （ P ＜0.05）. Cell experiments showed that compared with high glucose group， the high glucose+exenatide group had significantly decreased MDA level （ P ＜0.05）， and significantly increased levels of SOD， GSH， cAMP and PKA， the activities of mitochondrial respiratory enzymes Ⅱ and Ⅳ， and phosphorylation level of Drp1 （ P ＜0.05）. Compared with high glucose+exenatide group， the above indicators in the high glucose+exenatide+H89 group were significantly reversed （ P ＜0.05）. CONCLUSIONS Short-acting exenatide can activate the cAMP/PKA pathway， promote Drp1 phosphorylation， and increase the activities of mitochondrial respiratory enzymes， thereby maintaining mitochondrial stability， reducing oxidative stress injury， and ultimately improving diabetic cognitive dysfunction.

[Objective]To explore the traditional Chinese accessory culture reflected in traditional Chinese medicine(TCM)herbal sachet of Dragon Boat Festival,and to promote the international dissemination of excellent traditional Chinese culture.[Methods]Taking the TCM herbal sachet of Dragon Boat Festival as the research object,the study employed the historical tracing and literature analysis method to systematically collect,organize and analyze the relevant literatures in different eras.It traced the historical origins of the TCM herbal sachet and analyzed its aesthetic manifestations.Meanwhile,using the interdisciplinary method and comparative method,the study elaborated its health-promoting benefits based on TCM,and explored the cultural connotations from the perspectives of sociology and folklore studies.[Results]As an accessory,the TCM herbal sachet of Dragon Boat Festival has a long history,diverse forms,exquisite craftsmanship and embodies specific cultural connotations through traditional aesthetics.Combined with TCM theory,it has formed a culturally meaningful health care and healing model through aromatherapy and clothing therapy.As a part of the clothing etiquette system,it plays a role in maintaining social relationships.[Conclusion]The TCM herbal sachet of Dragon Boat Festival is an important material carrier of intangible cultural heritage.It not only possesses aesthetic value,but also has health-promoting benefits as well as social and cultural significance,reflecting the cultural connotation of medicinal-decorative integration.It is a shared seasonal ritual and cultural memory of the Chinese nation,which reflects the long history and rich practical applications of traditional Chinese accessories and embodies the Chinese cultural emphasis on the harmonious unity of man and nature.

[Objective]To explore the traditional Chinese accessory culture reflected in traditional Chinese medicine(TCM)herbal sachet of Dragon Boat Festival,and to promote the international dissemination of excellent traditional Chinese culture.[Methods]Taking the TCM herbal sachet of Dragon Boat Festival as the research object,the study employed the historical tracing and literature analysis method to systematically collect,organize and analyze the relevant literatures in different eras.It traced the historical origins of the TCM herbal sachet and analyzed its aesthetic manifestations.Meanwhile,using the interdisciplinary method and comparative method,the study elaborated its health-promoting benefits based on TCM,and explored the cultural connotations from the perspectives of sociology and folklore studies.[Results]As an accessory,the TCM herbal sachet of Dragon Boat Festival has a long history,diverse forms,exquisite craftsmanship and embodies specific cultural connotations through traditional aesthetics.Combined with TCM theory,it has formed a culturally meaningful health care and healing model through aromatherapy and clothing therapy.As a part of the clothing etiquette system,it plays a role in maintaining social relationships.[Conclusion]The TCM herbal sachet of Dragon Boat Festival is an important material carrier of intangible cultural heritage.It not only possesses aesthetic value,but also has health-promoting benefits as well as social and cultural significance,reflecting the cultural connotation of medicinal-decorative integration.It is a shared seasonal ritual and cultural memory of the Chinese nation,which reflects the long history and rich practical applications of traditional Chinese accessories and embodies the Chinese cultural emphasis on the harmonious unity of man and nature.

Objective To investigate the relationship between plasma cell mastitis and prolactin. Methods The relationship between the lesion area , degree of inverted nipple and prolactin level of 228 plasma cell mastitis patients were observed , as well as their prolactin level before and after treatment , to explore the factors that influence relapse. Results There was no significant statistical relationship between prolactin level and lesions area and degree of inverted nipple. Prolactin level before and after treatment were statistically different (t =2.347,P = 0.02). Menstrual status, nipple status, comorbidities, lesion area and prolactin level were considered, only prolactin level was related with disease recurrence (P = 0.038). Conclusion prolactin level could significantly reduced as the disease cured , but elevated prolactin may lead to relapse of the disease.

Purpose To investigate the expression of polo-like kinase 1 (Plk1) and Cyclin B1, p21WAF1in cervical carcinoma, and to determine the relationship between the expression of the three proteins and tumor clinicopathological features. Methods The expres-sion of Plk1, Cyclin B1 and p21WAF1 was detected in 102 cases of cervical carcinoma, 20 cases of (cervical intraepithelial neoplasia, CIN) , and 20 cases of nomal cervical tissues by the technique of tissue chip and immunohistochemical staining of EliVision. Statistical analyses of the data were performed with SPSS 19. 0 software. Results The positive rates of Plk1 in cervical carcinoma and CIN were 70. 5%, 55. 0%, respectively, which were significantly higher than normal cervical tissues (10%) (P<0. 01);The positive rates of Cyclin B1 in cervical carcinoma and CIN were 52. 9% and 30. 0%, respectively, which were significantly higher than normal cervical tissues (10%)(P <0.01); The positive rates of p21WAF1 in cervical carcinoma and CIN were 23.5% and 10.0%, respectively, which were significantly higher than normal cervical tissues ( 0 ) ( P<0. 01 ) . There were no significant differences between cervical carcinoma and CIN in the positive rates of Plk1, Cyclin B1 and p21WAF1. The expression of Plk1 was associated with the depth of carci-noma invasion (P<0. 05), that of Cyclin B1 was associated with lymph node metastases and the depth of carcinoma invasion (P<0. 05)and that of p21WAF1 in cervical carcinoma was associated with histological grade (P<0. 05). In cervical carcinoma, the expres-sion of Plk1 was positively correlated with Cyclin B1 (rs =0. 297, P=0. 002) and negatively correlated with p21WAF1(rs = -0. 403, P<0. 001). Conclusion The expression of Plk1, Cyclin B1 and p21WAF1 is involved in the occurrence and development of cervical carcinoma, and the former two are also related with prognosis of cervical carcinoma. The combination of the three would provide a new target for clinical treatment.

OBJECTIVETo evaluate the effect of different immune status on the incidence of hepatic lesions in patients with hepatitis B virus (HBV) infection undergoing anti-tuberculosis therapy.

METHODSThe PubMed (1966-2013), Embase (1966-2013), Wanfang (1998-2013), Chinese National Knowledge Infrastructure (CNKI; 1997-2013), and Chinese Biomedical (CBMdisc; 1860-2013) literature databases were searched for case-control studies of hepatic lesions in patients undergoing anti-tuberculosis therapy with or without concomitant HBV infection. The HBV patients were divided into subgroups according to hepatitis B e antigen (HBeAg) positivity or negativity, all members of the control group were HBsAg⁻. The data from all 7 studies included in the meta-analysis were extracted and analysed using RevMan5.2 soft-ware.

RESULTSPatients with HBV infection who were undergoing anti-tuberculosis therapy had a higher risk factor than the control patients (OR =5.81, 95% CI =[4.26, 7.39]). The HBV patients with HBeAg positivity who were undergoing anti-tuberculosis therapy had a high risk factor than the HBV patients with HBeAg negativity (OR =2.56, 95% CI=[1.90, 3.44]).

CONCLUSIONHBV infection is a risk factor for hepatic lesions when undergoing anti-tuberculosis therapy, and HBeAg-positive status may put a patient at higher risk.

Antitubercular Agents ; adverse effects ; therapeutic use ; Hepatitis B ; complications ; pathology ; Hepatitis B e Antigens ; blood ; Humans ; Liver ; drug effects ; pathology ; Tuberculosis ; complications ; drug therapy ; pathology

OBJECTIVE: To evaluate the mid-term prognostic value of procalcitonin (PCT), endotoxin and common inflammatory markers combining the model for end-stage liver disease (MELD) score in patients with chronic severe hepatitis. METHODS: A total of 124 chronic severe hepatitis patients were enrolled, who were hospitalized in the Department of Infectious Diseases, Xiangya Hospital, Central South University from May 2011 to December 2011. Indexes of inflammation, liver and kidney function tests and MELD were determined within 24 h after the admission, and blood samples were collected for measurement of endotoxin , procalcitonin (PCT), and C-reactin protein (CRP). The outcome was confirmed after discharge follow-up at the end of the 3rd month. According to the outcome, the 124 patients were divided into a survival group (n=58) and a death group(n=66). RESULTS: 1) Of the 124 patients, 66 died and 58 survived, with statistical difference in age, MELD score, white blood cell (WBC), polymorphonuclear (PMN), CRP and PCT by single factor analysis between the 2 groups(P<0.05). Binary logistic regression analysis indicated that age, MELD scores and PCT were highly correlated with the outcome (OR=1.07, 1.42 and 1.02 respectively, P<0.05), which could be used to predict the 3 month mid-term mortality of chronic severe hepatitis. 2)There was significant correlation between the MELD scores and the mid-term mortality. Age was positively correlated with the MELD score, and Pearson's correlation coefficient was 0.21 (P<0.05). PCT was also positively correlated with the MELD, and Spearman's correlation coefficient was 0.54 (P<0.01). 3)According to the receiver operation characteristic (ROC) curve analysis , the area under the curve (AUC) of MELD score and PCT were 0.91 and 0.77 respectively, higher than those of other indexes (P<0.01). When the MELD score was up to 30.09 or higher, the predicted mortality risk among these tested patients was the highest(82.26%). The mortality risk predicted by PCT combining MELD score and PCT alone was lower than by MELD score alone (75.00%), but the specificity of MELD score combining PCT was 100%, and the positive prediction value was 1.00. CONCLUSION Endotoxin and common inflammatory markers (WBC, PMN, and CRP) are not reliable indicators to predict the prognosis in patients with chronic-severe hepatitis. MELD score is significantly correlated with the outcome of mid-term chronic severe hepatitis, PCT and age are both positively correlated with the MELD score. PCT and age combining MELD score can be used to predict the 3 month mid-term mortality of chronic severe hepatitis. MELD score has better prognostic value than PCT. MELD score combining PCT can improve the specificity of prediction.
Adult ; Age Factors ; C-Reactive Protein ; metabolism ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; End Stage Liver Disease ; diagnosis ; mortality ; Endotoxins ; blood ; Female ; Hepatitis, Chronic ; diagnosis ; mortality ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Protein Precursors ; blood ; ROC Curve ; Severity of Illness Index ; Survival Analysis

ObjectiveTo evaluate the neuroprotective effect of gradient perfusion-rewarming after deep hypothermia circulatory arrest (DHCA) in piglets.Methods12 Shanghai piglets (3-4 weeks old) were randomly divided into two groups of A (experiment group) and B (control group),average weight (9.78 ±0.93)kg.Animal CPB model is completed with microinvasive technique.DHCA duration is 90 min in two groups.During the rewarming period,group A was rewarmed with gradient perfusion strategy,maintain the temperature for 15 min every 5 ℃ elevation of the core temperature.Group B was rewarmed according normal consistent rewarming strategy.PH-stat management is adopt in both groups.Blood gas analysis,rectal temperature,heart rate,ECG,blood flow rate of carotid artery,glumatic acid/aspartate level of jugular vein and protein NFB of brain tissue are monitored during and/or after the cardiopulmonary bypass (CPB).ResultsDuration of rewarming in group A is (67.3 ± 7.8) min,and (41.8 ± 3.6)min in group B (P ＜ 0.05).Sample collected at the beginning of CPB,15 min of rewarming,30 min of rewarming and 45 min of rewarming show that there is no difference between the blood flow rate at 15 min of rewarming; difference are shown at the 30 min and 45 min of rewarming (P ＜ 0.5 ).High performance liquid chromatography ( HPLC ) analysis show the obvious difference of glumatic acid level of jugular vein at 30 min of rewarming and 45 min of rewarming ( P ＜ 0.5),this kind of difference of aspartate can only be seen at the 45 min of rewarming.Histologic evaluation shows gradient rewarming has a better effect on preservation of CA1 area neuron in hippocampus,however,Immunohistochemistry doesn't find the same effect.ConclusionControlled gradient perfusion-rewarming strategy can improve the neuroprotective effect during DHCA,keeping the balance of the blood flow,cerebral local temperature and brain metabolism might be the mechanism.

Objective To compare clinical outcomes of double-bundle and single-bundle in individualized arthroscopic anatomical reconstruction of anterior cruciate ligament (ACL) . Methods The clinical data of 117 patients were reviewed who had received double-bundle or single-bundle arthroscopic ACL reconstruction from March 2007 through September 2009 in our hospital and had undergone complete follow-up. Of them, 35 cases had single-bundle ACL reconstruction and 82 double-bundle reconstruction. In the single-bundle group(group A), there were 31 men and 4 women, aged 28. 6 ±5. 1 years. In the double-bundle group(group B), there were 73 men and 9 women, aged 27. 6 ±5. 4 years. The 2 groups were comparable in the preoperative demographic data ( P > 0. 05). To evaluate the outcomes, Lachman and Pivot Shift exams , KT-2000, Lysholm and IKDC (International Knee Documentation Committee) scores, were adopted. Results The 117 patients received a mean follow-up of 15 months (from 11 to 25 months). The Lachman test showed 88. 6% (31/35) were normal in group A and 95. 1% (78/82) were normal in group B.The pivot-shift test showed 88. 6%(31/35) were normal in group A and 96. 3% (79/82) were normal in group B. Group A had a mean Lysholm score of 93. 4 ± 8. 2 and group B a mean Lysholm score of 93. 7 ±7. 0. There were no significant differences between the 2 groups in the above indexes ( P > 0. 05). By IKDC score, 71. 4% (25/135) were normal in group A and 93. 9% (77/82) were normal in group B. The KT-2000 test showed a mean of 1. 4 ± 0. 6 mm in group A and a mean of 1. 1 ± 0. 5 mm in group B. These 2 values were significantly different between the 2 groups ( P < 0. 05). Conclusions The individualized arthroscopic double-bundle anatomical reconstruction of ACL can maximally restore the anteroposterior and rotational stability. Arrangement of the ACL insertion site on the femoral and tibial side, three-portal technique and ruler application are keys for individualized anatomical double-bundle ACL reconstruction.

Objective To investigate clinical features and antifungal therapeutic effect of chronic severe hepatitis (CSH) patients with invasive fungal infection (IFI), and to improve the diagnosis and treatment.Methods Clinical manifestation, blood routine, imageology and mycetology characteristic, antifungal treatment perscription and therapeutic effect of 79 CSH patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared between fluconazole and voriconazole. Results Thirteen (16.5%) patients received glucocorticoid or other immunodepressants for a relatively long time, 40 (50.6%) patients had invasive operation, and 61 (77.2 %) patients were administered 1-6 kinds of broad-spectrum antibiotics. Seventy-three patients had fever. Leucocytes and neutrophilic granulocyte increased in 96.2% of the patients. Lung (31.6%), intestinal tract (26.2%) and oral cavity (14%) infections were common. Fungus was found in 70.9% of the patients. Candida albicans (40.9%) and aspergillus (21.1%) were often seen. Halo signs and crescent signs on lung CT were relatively specific in 40% of the patients with fungal pneumonia. Voriconazole was more effective than fluconazole(71.4% vs. 39.0%, P<0.05). Twelve patients with lung aspergillus infection were administered voriconazole, 8 (66.7%) patients of whom was effective, and the other 4 (33.3%) patients died. Conclusion There are high risk factors in major CSH patients with IFI. The most common clinical manifestations of CSH patients with IFI are fever, leukocytosis, lung and intestinal tract infection. Candida albicans and aspergillus infection are common. Voriconazole is more effective than fluconazole, and can increase the survival rate of CSH patients with IFI.