OBJECTIVE To explore the effect and mechanism of Buyang huanwu decoction （BYHWD） on mitochondrial dynamics in rats with cerebral ischemia-reperfusion injury （CIRI）. METHODS CIRI rats were randomly divided into CIRI group， low-dose BYHWD （L-BYHWD， intragastric administration of 3.15 mg/kg BYHWD） group， high-dose BYHWD （H-BYHWD， intragastric administration of 12.60 mg/kg BYHWD） group， positive control （intraperitoneal administration of 150 mg/kg Extract of Ginkgo biloba leaves injection） group， H-BYHWD+solvent control （intragastric administration of 12.60 mg/kg BYHWD+ intraperitoneal injection of 20 mg/kg DMSO） group and H-BYHWD+Compound C （intragastric administration of 12.60 mg/kg BYHWD+intraperitoneal injection of 20 mg/kg Compound C） group， with 15 rats in each group. Additionally， 15 rats were assigned to the sham operation group. All rats received the corresponding medications or saline solution via intragastric administration or intraperitoneal injection once daily for 4 consecutive weeks. After the last administration， the cerebral infarct volume of rats was measured； the ultrastructure of mitochondria in endothelial cells in the ischemic penumbra （IP） region was observed； the mitochondrial membrane potential was evaluated； the fluorescence colocalization area ratio of optic atrophy 1 （OPA1） to cluster of differentiation 31 （CD31） in the IP region was detected； the expressions of mitofusin 2 （MFN2）， OPA1， mitochondrial fission 1 protein （Fis1）， and proteins related to the AMP-activated protein kinase （AMPK）/dynamin-related protein 1 （Drp1） pathway in the IP region were determined. RESULTS Compared with the sham operation group， mitochondria in endothelial cells of the IP region in brain tissue of rats in the CIRI group were swollen， mostly spherical， with fractured cristae and severe vacuolation； the percentage of cerebral infarct volume， Fis1 expression level and phosphorylation level of Drp1 were increased significantly （P＜0.05）， while mitochondrial membrane potential in the IP region， fluorescence colocalization area ratio of OPA1 to CD31， the expressions levels of MFN2 and OPA1， and phosphorylation level of AMPK were significantly decreased （P＜0.05）. These indicators were improved in the L-BYHWD group， H-BYHWD group， and positive control group， M025） compared with the CIRI group （P＜0.05）. Compared with the H-BYHWD group and H-BYHWD+solvent control group， the above indicators of rats in the H-BYHWD+Compound C group showed significant reversal（P＜0.05）. There was no statistically significant difference in the above indicators between the H-BYHWD+solvent control group and the H-BYHWD group （P＞0.05）. CONCLUSIONS BYHWD may improve CIRI by activating the AMPK/Drp1 pathway and ameliorating mitochondrial dynamic disorders.

Metabotropic glutamate receptor 5 (mGluR5) encephalitis is a rare type of anti-cell surface antigen antibody encephalitis mediated by autoimmune mechanisms. This article reported a case of anti-mGluR5 encephalitis. The patient was a 25-year-old young man with a history of Hodgkin′s lymphoma. Due to tumor recurrence, he developed encephalitis symptoms including fever, headache, mental and behavioral abnormalities, memory loss, consciousness disturbance, and seizures after checkpoint immunosuppressive therapy. He was finally diagnosed as anti-mGluR5 encephalitis by positive serum anti-mGluR5 antibodies. Finally, the symptoms alleviated after treatment with hormones and gamma globulin.

Objective:To investigate the value of jugulo-omohyoid lymph nodes(JOHLN) for the prediction of lateral cervical lymph nodes metastasis behind internal jugular vein in patients with papillary thyroid carcinoma(PTC) and its clinical significance.Methods:The clinical data of 220 patients who underwent lateral neck dissection in our center were retrospectively analyzed, and the early warning effect and clinical significance of JOHLN on lymph node metastasis of the posterior internal jugular vein were analyzed.Results:In this study, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of JOHLN for predicting lymph node metastasis in the posterior group of internal jugular vein were 83.5%, 46.4%, 82.0%, 49.1%, and 74.1%, respectively. The accuracy rate for JOHLN prediction of upper tumor was 84.3%; In this study, side neck skip metastasis was found in 11 cases, all of which were JOHLN metastasis, upper tumors were found in 9 cases and 2 were located in the middle. Among the skip metastases, 6 cases had lymph node metastasis in the posterior group of internal jugular vein, and they were all upper tumors.Conclusions:JOHLN can effectively predict the risk of lateral neck metastasis. Especially for the upper PTC, preoperative evaluation of JOHLN can help decision-making of lateral neck lymph node dissection.

Microsatellite instability (MSI) is caused by the deficiency of DNA mismatch repair (MMR) protein, which is closely related to the occurrence, development, prognosis and efficacy prediction of various tumors. MSI-high (MSI-H) and mismatch repair protein deficiency (dMMR) might be a predictor factor for the good prognosis of patients with gastric cancer, and a negative predictor factor for the chemotherapy efficacy of resectable gastric cancer. MSI-H/dMMR can be used as a marker for predicting the effective treatment outcome of immune checkpoint inhibitors in advanced gastric cancer, however, the predictive role in palliative chemotherapy of advanced gastric cancer is still unclear. This paper reviews the progress of the association of MSI/MMR with prognosis and efficacy prediction in gastric cancer.

Objective To investigate the endogenous carnosine,glutathione system and oxidative stress level in serum of patients with diabetic cardiomyopathy(DCM),and the potential relationships among them.Meth-ods The serum of 102 healthy people,96 patients with type 2 diabetes mellitus and 74 patients with diabetic car-diomyopathy in the third affiliated hospital of QiQihar Medical University were enrolled.Carnosine content was mea-sured by ELISA.T-GSH,GSH and GSSG were detected by using micro-enzyme labeling assay.GSH-Px,GST and GRAC were detected by using colorimetry. The content of NO was detected by nitrate reduction method. The con-tent of H2O2was detected by using molybdic acid coloring method. The activities of NOS and CAT was determined by colorimetry. Results Compared with the healthy control group,the average level of human serum carnosine, GSH content,GRAC,GSH/GSSG ratio,GST activity and T-SH content in the DM and DCM group were signifi-cantly reduced(P < 0.05,respectively). NO content,H2O2and iNOS activity were increased,but CAT activity was decreased in DCM group.Conclusion Decreases of levels of serum carnosine and glutathione(GSH)and the imbalance of redox state were observed in patients with diabetic cardiomyopathy,which may promote the occur-rence and development of the diabetic cardiomyopathy.

Objective To explore the relationship of serum ubiquitin carboxy terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) with brain injury in preterm infants. Methods A total of 130 premature infants with gestational age <34 weeks from August 2014 to October 2016 were recruited. Blood samples were collected at 6 h and 72 h after birth. The levels of serum UCH-L1 and GFAP were detected by ELISA method. According to the results of cranial ultrasound and MRI examination, the premature infants were divided into white matter damage (WMD) group, periventricular intraventricular hemorrhage (PVH-IVH) group, and no brain injury group. The levels of serum UCH-L1 and GFAP in preterm infants between the three groups, mild to severe brain injury were compared. Results At 6 h and 72 h after birth, the levels of serum UCH-L1 and GFAP among no brain injury group, PVH-IVH group and WMD group were significantly different (all P <0.001). The level of serum UCH-L1 and GFAP were the highest in the WMD group and the lowest in no brain injury group at both 6 h and 72 h after birth. The levels of serum UCH-L1 at 72 h after birth were significantly lower than those at 6 h after birth in PVH-IVH group and WMD group, while the levels of serum GFAP at 72 h after birth were significantly higher than those at 6 h after birth in both of the two groups (all P<0.05). The levels of serum UCH-L1 and GFAP in severe PVH-IVH group and severe WMD group were significantly higher than those in the mild group at 6 h and 72 h after birth (all P<0.05). Conclusions The levels of serum UCH-L1 and GFAP in preterm infants can be used as sensitive markers for early evaluation of brain injury, which can help determine the severity of brain injury in preterm infants.

Objective:To establish a fast method for the generation of immature dendritic cells(DCs) from human peripheral blood mononuclear cells(hPBMCs) in vitro.Methods: High purity human CD14+ monocytes were collected using density Ficoll gradient centrifugation and MACS beads sorting system.iDCs(Immature DC) were induced after cultured with rhGM-CSF and rhIL-4 on the fourth day.Fluorescence activated cell sorting(FACS) was used to identify cell surface markers(CCR5) and capabilities of antigen uptake of iDCs on the fourth day.Ordinary optical microscope,scanning electron microscopy and transmission electron microscopy were used to observe surface and internal structure of iDCs on the fourth day of culture conditions.Results: FACS result shows that the purity of CD14+ monocytes collected from hPBMCs were more than 94%.The antigen uptake capability and CD195 of iDCs was detected on the fourth day of cultured conditions.Typical surface and internal structure characteristics of iDCs were observed.Conclusion: Rapid induction culture is an effective method for obtaining a large number of iDC with typical characteristics in vitro,and can be used for further experimental study.

Objective: To explore the safety and strategy of thoracic endovascular aortic repair (TEVAR) combining coronary artery bypass grafting (CABG) as one-stop performance in treating the patients with coronary artery disease (CAD) and thoracic aorta disease. Methods: A total of 20 patients received one-stop treatment of TEVAR combining CABG in our hospital from 2009-04 to 2016-01 were retrospectively analyzed. There were 18 male and the mean age of patients was (65.2±8.5, 51-82) years. The performance strategy and peri-operative management were studied. Results: There were 1/20 patient received 2 stents implantation in thoracic aorta and 19 received 1 stent in thoracic aorta those including 1 case with endovascular repair of abdominal aortic aneurysm, 1 with right iliac artery stent implantation and 1 with carotid endarterectomy at meanwhile. The average number of coronary artery bypass branch was (2.4±0.94, 1-4) and 10 (50%) patients received internal mammary artery grafting. The average in-hospital time in all 20 patients was (22.4±11.6, 8-58) days. There were 6 (30%) patients received blood transfusion; 1 (5%) having low cardiac output syndrome received extracorporeal membrane oxygenation (ECMO), then received the second thoracotomy for hemostasis due to excessive pleural effusion; 2 (10%) patients died at 30 days post-operation. 1 patient lost contact and 17 received clinical or telephone follow-up visit at the average of (13.4+13.6, 1-49) months; 2 patients died for cerebral hemorrhage at 12 and 49 months post-operation, the rest 15 had disappeared symptoms and improved quality of life, no operation related death occurred. Conclusion: TEVAR combining CABG as one-stop performance presented good mid-term effect in treating the patients with CAD and thoracic aorta disease; in otherwise, the operative time and risk might be increased by two step performance.

OBJECTIVE:To prepare Puerarin polymeric micelles and establish a method to determine its entrapment efficiency. METHODS:Puerarin polymeric micelles were prepared by film dispersion method. The polymeric micelles and free drug were sepa-rated by centrifugal-millipore filter filtration method. The entrapment efficiency of puerarin polymeric micelles was determined by HPLC. Diamonsil C18(2)column was used with 1% citric acid solution-methanol(65∶35)at the flow rate of 1 ml/min. The detec-tion wavelength was set at 250 nm,and column temperature was room temperature. RESULTS:The prepared polymeric micelles were spherical and spherical-like in shape with a mean particle size of 54.12 nm,polydispersity index of 0.122,Zeta potential of -13.60 mV;the linear range of puerarin was 2-10μg/ml(R2=0.999 4)with average recovery rate of 99.2%(RSD=0.9%,n=3). The re-covery rate of free drug was 95.3%(RSD=1.7%,n=3). The mean entrapment efficiency and drug-loading amount of puerarin were(35.5±2.12)% and(0.3±0.07)%,respectively(n=3). CONCLUSIONS:Film dispersion method is suitable for the prepara-tion of Puerarin polymeric micelles. Established method is convenient,accurate and reliable for the content and entrapment efficien-cy determination of Puerarin polymeric micelles.

Objective To investigate the impact of acute kidney injury ( AKI ) on early and long-term outcome using RIFLEcriteria in patients after acute type A dissection surgery.Methods Between January 2006 and June 2011, 286 cases a-cute type A dissection patients underwent deep hypothermic circulatory arrest surgery were retrospectively analyzed .Using RIFLEcriteria to classfy AKI to risk, injury and failure stages and comparing 30-day mortality, dialysis, ventilation time, ICU stay, hospital stay and cost, and three-year mortality.Multivariate analyses were performed to identify predictors of failure stage.Results AKI was detected in 160 patients(55.9%), and risk 85 cases(29.7%), injury 39 cases(13.6%), failure 36 cases(12.6%).Dialysis rate, ventilation time, ICU stay, cost, and 30-day mortality increased with worsening severity of renal injury, and these was significant increased in failure stage than other groups .There was no association between severity of renal injury and 3-year mortality.Multiple logistic regression showed that malperfusion syndrome ( OR =3.499, 95%CI:1.019-12.013, P=0.047) and WBC(OR=1.121, 95%CI:1.017 -1.237, P=0.022) were independent predictors of renal failure.Conclusion Postoperative mild and morderate acute kidney injury were common in acute type A dissection pa-tients.The severe acute kidney injury had association with poor early outcome .