BACKGROUND:Indolepropionic acid has been shown to reduce diabetes-induced central nervous system inflammation.However,there is a lack of research on whether to inhibit microglia M1 polarization for the treatment of spinal cord injury. OBJECTIVE:To investigate the mechanism of indolepropionic acid inhibition of microglial cell M1 polarization for the treatment of spinal cord injury through cell and animal experiments. METHODS:(1)In vitro experiments:BV2 cell viability was assessed using the CCK-8 assay to determine optimal concentrations of indolepropionic acid.Subsequently,BV2 cells were categorized into control group,administration group(50 μmol/L indolepropionic acid),lipopolysaccharide group(100 ng/mL lipopolysaccharide),and treatment group(100 ng/mL lipopolysaccharide + 50 μmol/L indolepropionic acid).Nitric oxide content was quantified using the Griess method.Real-time quantitative PCR and western blot assay were employed to measure mRNA and protein levels of pro-inflammatory factors.Cell immunofluorescence staining was conducted to assess inducible nitric oxide synthase expression.The Seahorse assay was employed to assess glycolytic stress levels in BV2 cells.(2)In vivo experiments:30 SD rats were randomly divided into three groups:sham surgery group,spinal cord injury group,and indolepropionic acid group.Motor function recovery in rats after spinal cord injury was assessed using BBB scoring and the inclined plane test.Immunofluorescence staining of spinal cord tissue was conducted to evaluate the expression of inducible nitric oxide synthase in microglial cells.ELISA was employed to measure protein expression levels of the pro-inflammatory cytokines interleukin-1β and tumor necrosis factor-α in spinal cord tissue. RESULTS AND CONCLUSION:(1)In vitro experiments:Indolepropionic acid exhibited significant suppression of BV2 cell viability when its concentration exceeded 50 μmol/L.Indolepropionic acid achieved this by inhibiting the activation of the nuclear factor κB signaling pathway,thereby suppressing the mRNA and protein expression levels of pro-inflammatory cytokines(interleukin-1β and tumor necrosis factor-α),as well as the M1 polarization marker,inducible nitric oxide synthase,in BV2 cells.Additionally,indolepropionic acid notably reduced the glycolytic level in BV2 cells induced by lipopolysaccharides.(2)In vivo experiments:Following indolepropionic acid intervention in spinal cord injury rats,there was a noticeable increase in BBB scores and the inclined plane test angle.There was also a significant decrease in the number of M1-polarized microglial cells in spinal cord tissue,accompanied by a marked reduction in the protein expression levels of pro-inflammatory cytokines(interleukin-1β and tumor necrosis factor-α).(3)These results conclude that indolepropionic acid promotes functional recovery after spinal cord injury by improving the inflammatory microenvironment through inhibition of microglia M1 polarization.

OBJECTIVE: We propose a sparse-view helical CT iterative reconstruction algorithm based on projection of convex set tensor total generalized variation minimization (TTGV-POCS) to reduce the X-ray dose of helical CT scanning. METHODS: The three-dimensional volume data of helical CT reconstruction was viewed as the third-order tensor. The tensor generalized total variation (TTGV) was used to describe the structural sparsity of the three-dimensional image. The POCS iterative reconstruction framework was adopted to achieve a robust result of sparse-view helical CT reconstruction. The TTGV-POCS algorithm fully used the structural sparsity of first-order and second-order derivation and the correlation between the slices of helical CT image data to effectively suppress artifacts and noise in the image of sparse-view reconstruction and better preserve image edge information. RESULTS: The experimental results of XCAT phantom and patient scan data showed that the TTGVPOCS algorithm had better performance in reducing noise, removing artifacts and maintaining edges than the existing reconstruction algorithms. Comparison of the sparse-view reconstruction results of XCAT phantom data with 144 exposure views showed that the TTGV-POCS algorithm proposed herein increased the PSNR quantitative index by 9.17%-15.24% compared with the experimental comparison algorithm; the FSIM quantitative index was increased by 1.27%-9.30%. CONCLUSIONS The TTGV-POCS algorithm can effectively improve the image quality of helical CT sparse-view reconstruction and reduce the radiation dose of helical CT examination to improve the clinical imaging diagnosis.

BACKGROUND: miRNA-136-5 p plays a crucial regulatory role in pathological changes, inflammatory response and regeneration after spinal cord injury. OBJECTIVE: To investigate the effect of miRNA-136-5 p on the expression of cytokines in serum and NF-κB protein in spinal cord in rats with spinal cord injury and to explore the molecular mechanism. METHODS: Thirty-six male Sprague-Dawley rats, of SPF grade were provided by Laboratory Animal Center of Guangxi Medical University. The lentiviral vector system was prepared and transfected into spinal cord injured rats. Thirty-six rat models of spinal cord injury were established by modified Allen's method. Basso Beattie Bresnahan scores were performed. Rats were randomly divided into normal control, modeling (LV-ctrl plus spinal cord injury), overexpression (spinal cord injury plus LV-miRNA-136-5 p), and inhibition (spinal cord injury plus LV-sponge) groups (n=9/group). Seven days before surgery and the day of surgery, the overexpression and inhibition groups were continuously injected with the lentivirus suspension into the injured area, and the normal control and modeling groups were injected with the same amount of normal saline. Three rats were sacrificed at 1, 3 and 7 days, and blood and spinal cord tissues were taken. The levels of interleukin-1β, interleukion-6 and interferon-α in rat serum were determined by ELISA. The expression of NF-κB protein was detected by western blot assay and double immunofluorescence. RESULTS AND CONCLUSION: (1) There was no significant difference in preoperative Basso Beattie Bresnahan scores (P＞ 0.05). In the modeling group, the rats showed prone walking, vary degrees of urinary retention, and spinal shock, with complete loss of function of both hind limbs and muscle strength of 0. (2) Compared with the normal control group, the levels of inflammatory factors in the other groups were increased significantly (P ＜ 0.05). The expression levels of inflammatory factors were highest in the overexpression group, followed by modeling group, and lowest in the inhibition group. (3) Results of western blot assay and double immunofluorescence showed that the expression level of NF-κB protein in the modeling, overexpression and inhibition groups was significantly higher than that in the normal control group (P ＜ 0.05), and the level was highest in the overexpression group. (4) In summary, miRNA-136-5 p can affect inflammatory factors and NF-κB in rats with acute spinal cord injury.

BACKGROUND: Change of microenvironment after acute spinal cord injury is the main factor causing secondary injury, so it is of great significance to investigate the changes of microenvironment after acute spinal cord injury for clinical diagnosis and treatment. OBJECTIVE: To investigate the expression levels and clinical significance of interleukin-6, brain derived neurotrophic factor, basic fibroblast growth factor, neurotrophin-3 and neurotrophin-4 in peripheral blood within 48 hours after acute spinal cord injury. METHODS: Twenty-nine patients with acute spinal cord injury admitted at the Department of Spinal Osteopathia, the First Affiliated Hospital of Guangxi Medical University from October 2016 to June 2018 were enrolled, and were divided into two groups according to American Spinal Injury Association impairment scale: complete spinal cord injury (n=11) and incomplete spinal cord injury (n=18). Thirteen patients with avascular necrosis of the femoral head were selected as controls. The expression levels of interleukin-6, brain derived neurotrophic factor, basic fibroblast growth factor, neurotrophin-3 and neurotrophin-4 in peripheral blood of 42 patients were determined by ELISA and compared. RESULTS AND CONCLUSION: The ELISA results showed that the expression levels of interleukin-6, brain derived neurotrophic factor, basic fibroblast growth factor, neurotrophin-3 and neurotrophin-4 in peripheral blood in the spinal cord injury group were significantly higher than those in the control group (P ＜ 0.05). The expression levels of all above cytokines in the complete spinal cord injury group were significantly higher than those in the incomplete spinal cord injury group (P ＜ 0.05). In summary, increased expression of interleukin-6, brain derived neurotrophic factor, basic fibroblast growth factor, neurotrophin-3, neurotrophin-4 after acute spinal cord injury indicates that it may participate in the important pathophysiological process after acute spinal cord injury.

Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4％,48. 9％,39. 3％,and 30. 9％,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5％,41.5％,35.2％,and 30％,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.

Objective To investigate the clinical features, laboratory diagnostics, treatments, and prognosis of neonates infected with influenza. Methods The clinical data of 16 neonates diagnosed as influenza admitted to the neonatal ward from January 2015 to May 2017 were retrospectively analyzed. Results Of the 16 neonates, 11 were male and 5 were female. Mean age was 18.5 days. 75% (12/16) of them were reported to be exposed to family members with common cold- like symptoms before hospitalization. Clinical manifestations included nasal obstruction (11/16), fever (10/16), cough (10/16), and rhinorrhea (8/16). Influenza antigen rapid detection (colloidal gold method) was positive in all cases. Influenza immunofluorescence assays were performed in 15 cases, only 6.67% (1/15) was positive. Sputum culture was performed in 13 cases, 8 of which were positive. Of them, 75% (12/16) neonates were diagnosed with pneumonia. Only 12.5% (2/16) neonates were treated with neuraminidase inhibitor. All cases recovered well and were discharged after antibiotic treatment. Conclusions Neonates contacted with family members displaying common cold-like symptoms should be examined for influenza in time. The common clinical manifestations include catarrhal symptoms, fever and cough. The sensitivity of the influenza immunofluorescence assay is lower as compared with the colloidal gold method. Pneumonia may often be developed in neonatal influenza. The prognosis of neonatal influenza is satisfactory if treated.

Objective To study the clinical features,treatment and prognosis of neonatal hand-foot-mouth disease.Methods Neonatal hand-foot-mouth disease patients admitted from July 2014 to May 2016 were retrospectively studied.EV71,CA16 and universal enterovirus were detected from newborn swabs by RT-PCR.Results A total of 8 neonatal patients with hand-foot-mouth diseases,6 boys and 2 girls were diagnosed at an age ranged from 7-26 days.Of them,7 patients had exposure history.Clinical manifestations including rash (8 cases),fever (6 cases),irritability (4 cases) and vomiting (1 case),nobody suffered convulsions.The results of RT-PCR showed pathogen enterovirus not-EV71 and not-CA16.There were 5 cases of pulmonary infection treated with antibiotic therapy.All of the 8 cases had a good prognosis.Conclusions Most of the handfoot-mouth diseases had exposure history without specific clinical manifestations.They had not-EV71 and not-CA16 intestinal virus infection,some patients had pulmonary infection.Therefore,neonatal hand-foot-mouth diseases need more clinical attention.

Objective To explore whether hypertonic saline would partake in regulating Notch signaling in microglia in experimentally induced cerebral ischemic rats.Methods Male SD rats were randomly divided into sham group, cerebral ischemia group, normal saline group ( NS group ) , 10%hypertonic saline group (10%HS group) , the model of cerebral ischemia were established in all rats except the sham group by using middle cerebral artery occlusion ( MCAO) .After 2 hours of MCAO, the rats were through reperfusion for 24 h.In addition, rats in the normal saline group and 10% HS group were respectively treated with a continuous intravenous injection of normal saline (0.3 mL/h) and 10%HS (0.3 mL/h) by tail vein for 24 h.Immunofluorescence methods, RT-PCR and Western blot were used to detect the expression of Notch1 and intracellular Notch receptor domain ( NICD) .All data was analyzed by one-way analysis of variance ( ANOVA) , The intergroup comparisons were analyzed by the least-significant-difference (LSD) tests.Differences were considered statistically significant if P<0.05.Results Immunofluorescence showed that the expression of Notch1 and NICD were significantly increased in the microglia around peri-ischemia area in cerebral ischemia group and normal saline group compared to sham group;the expression of Notch1 and NICD in the microglia around peri-ischemia area were significantly reduced in 10% HS group compared to ischemia group and NS group.RT-PCR showed that the mRNA expression of Notch1 was significantly increased in ischemia group and NS group compared to sham group ( sham group: 1.000 ± 0.076; ischemia group: 2.203 ±0.283; NS group: 1.616 ±0.185; P <0.01 ); however, it was significantly reduced in 10% HS group compared to ischemia group and NS group ( ischemia group:2.203 ±0.283; NS group: 1.616 ±0.185; 10%HS group: 1.202 ±0.177; P <0.05 ) .Western blot showed that the protein expression of Notch1 was significantly increased in ischemia group and NS group compared to sham group ( sham group: 0.290 ±0.079; ischemia group: 0.750 ±0.029; NS group:0.765 ±0.182;P<0.01);but was significantly reduced in 10%HS group compared to ischemia group and NS group ( ischemia group:0.750 ±0.029; NS group:0.765 ±0.182;10%HS group:0.390 ±0.195;P<0.05 ) .The protein expression of NICD was significantly increased in ischemia group and NS group compared to sham group ( sham group: 0.401 ±0.196; ischemia group: 0.906 ±0.359; NS group:0.847 ±0.153;P<0.01);but was significantly reduced in 10%HS group compared to ischemia group and NS group ( ischemia group:0.906 ±0.359; NS group:0.847 ±0.153;10%HS group:0.561 ±0.165;P<0.05 ) .Conclusion Our results suggest that HS markedly suppresses Notch signaling in microglia around the ischemia tissue area in experimental induced cerebral ischemic rats.

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .

Objective To explore the advantages and disadvantages of helicopter emergency medical services of South China in the long-distance transport for critical patients.Methods A total of 30 patients who received helicopter emergency medical services by Guangdong Generral Hospital from August 2004 to December 2014 were selected as the observation group,and the other 30 patients with similar conditions who received ground emergency medical services were selected as the control group.To analyses the difference between the two groups in the disease,transport distance,transportation time,costs and compliction by χ2-test,t-test and nonparametric test according types of data.Results There were significantly difference between two groups in transport distances (km) [578.0 (313.0,707.5)vs.214.5 (101.5,313.5),P <0.05],set-up time (min) [95.7 (56.7,133.4)vs.10.7 (6.8,15.7),P <0.05],transportation time (min) [112.3 (64.3,152.4) vs.146.8 (67.8,217.5),P <0.05],costs (yuan/h) [14378.5 (9887.0,16348.5)vs.557.0 (356.5, 787.5),P <0.05]and the distance/total time value [2.8 (1.3,4.8)vs.1.4 (0.8,2.8),P <0.05]. There was no significantly difference in the incidence of complications between two groups (χ2 =0.058,P >0.05).Conclusions Helicopter emergency medical services could shorten the transportation time of critical patients on long distance transportation,and improve the efficiency of first-aid.However,there were many disadvantages that need to be improved in the helicopter emergency medical service of China.