OBJECTIVES: Neuropathic pain (NP) is one of the most common forms of chronic pain, yet current treatment options are limited in effectiveness. Peripheral nerve injury activates spinal microglia, altering their inflammatory response and phagocytic functions, which contributes to the progression of NP. Most current research on NP focuses on microglial inflammation, with relatively little attention to their phagocytic function. Early growth response factor 2 (EGR2) has been shown to regulate microglial phagocytosis, but its specific role in NP remains unclear. This study aims to investigate how EGR2 modulates microglial phagocytosis and its involvement in NP, with the goal of identifying potential therapeutic targets. METHODS: Adult male Sprague-Dawley (SD) rats were used to establish a chronic constriction injury (CCI) model of the sciatic nerve. Pain behaviors were assessed on days 1, 3, 7, 10, and 14 post-surgery to confirm successful model induction. The temporal and spatial expression of EGR2 in the spinal cord was examined using real-time quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. Adeno-associated virus (AAV) was used to overexpress EGR2 in the spinal cord, and behavioral assessments were performed to evaluate the effects of EGR2 modulation of NP. CCI and lipopolysaccharide (LPS) models were established in animals and microglial cell lines, respectively, and changes in phagocytic activity were measured using RT-qPCR and fluorescent latex bead uptake assays. After confirming the involvement of microglial phagocytosis in NP, AAV was used to overexpress EGR2 in both in vivo and in vitro models, and phagocytic activity was further evaluated. Finally, eukaryotic transcriptome sequencing was conducted to screen differentially expressed mRNAs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses to identify potential downstream effectors of EGR2. RESULTS: The CCI model successfully induced NP. Following CCI, EGR2 expression in the spinal cord was upregulated in parallel with NP development. Overexpression of EGR2 via spinal AAV injection enhanced microglial phagocytic activity and increased pain hypersensitivity in rats. Both animal and cellular models showed that CCI or LPS stimulation enhanced microglial phagocytosis, which was further amplified by EGR2 overexpression. Transcriptomic analysis of spinal cord tissues from CCI rats overexpressing EGR2 revealed upregulation of numerous genes associated with microglial phagocytosis and pain regulation. Among them, Lag3 emerged as a potential downstream target of EGR2. CONCLUSIONS EGR2 contributes to the maintenance of NP by enhancing microglial phagocytosis in the spinal dorsal horn.
Animals ; Microglia/metabolism* ; Phagocytosis/physiology* ; Rats, Sprague-Dawley ; Neuralgia/physiopathology* ; Early Growth Response Protein 2/metabolism* ; Male ; Rats ; Spinal Cord/metabolism* ; Sciatic Nerve/injuries*

Objective: To analyze the spatial temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022,so as to provide a scientific basis for tuberculosis prevention and control in schools. Methods: Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran s I) and local indicators of spatial audocorrelation(LISA). Results: A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/ 100 000 . The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture. Conclusions The epidemic situation of pulmonary tuberculosis among high school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.

Objective To explore the clinicopathological characters of T2 gastric cancer and the value of MSCT in the preop‐erative TNM staging of T2 gastric cancer .Methods A total of 93 patients with T2 gastric cancer were included in our study and un‐derwent preoperative MSCT staging ,who were confirmed by pathologic results .Then the results were compared with those of path‐ologic TNM staging .Also the clinicopathological features of the T2 gastric cancer were analyzed .Results There were no statistical‐ly significant differences in the clinicopathological characters among T2a and T2b patients (P>0 .05) .Comparing with pathologic TNM stage ,the T staging accuracy of MSCT was 91 .40% (85/93) ,the N staging accuracies of CT was 66 .67% (62/93) ,in which , 68 .18% (30/44) ,65 .00% (26/40) ,60 .00% (3/5) and 75 .00% (3/4) were for pN0 ,pN1 ,pN2 and pN3 .And the TNM staging ac‐curacies of CT was 67 .74% (63/93) ,in which ,68 .18% (30/44) ,64 .10% (25/39) ,60 .00% (3/5) and 100% (5/5) were for stageⅠ ,Ⅱ ,Ⅲ and Ⅳ .Conclusion There are no significant different on clinicopathology features among T2a and T2b patients .MSCT can clearly determine the preoperative TNM staging of T2 gastric cancer .

OBJECTIVE: To investigate whether the level of homocysteine in patients with postpartum depression is associated with depression index. METHODS: A total of 43 women with postpartum depression or with potential postpartum depression, who visited the psychological clinic of Maternal and Child Health Hospital of Hunan Province from June, 2012 to April, 2014, were enrolled in this study. They were evaluated by the Edinburgh Postnatal Depression Scale and Hamilton Depression Scale. Chinese Classification of Mental Disorder (the third edition) was used for their diagnosis. The depressive index was calculated by Edinburgh Postnatal Depression Scale, Hamilton Depression Scale, and clinical symptom scores, which was used to assess the level of depressive symptoms. The level of homocysteine in serum was detected by chemoluminescent method. Meanwhile, another 31 women, who visited the hospital without postpartum depression, were used as controls to compare with the 43 patients. RESULTS: The homocysteine level in the women with postpartum depression was significantly higher than that in the control group [(10.09 ± 3.59) μmol/L vs (8.57 ± 1.59) μmol/L, t=12.392, P=0.001]. The depression index was positively correlated with the level of homocysteine (r=0.231, P<0.05). CONCLUSION The level of serum homocysteine is associated with postpartum depression, suggesting that the level of serum homocysteine might be a risk biomarker for postpartum depression.
Asian Continental Ancestry Group ; Case-Control Studies ; Depression, Postpartum ; blood ; Female ; Homocysteine ; blood ; Humans ; Psychiatric Status Rating Scales

Objective.The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. Methods. From 1984 to 1997, 56 cases of congenital choledochal cyst were reviewed. Among them, 8 patients were male, 48 patients were female, the age ranges from 12 to 50 years old with an average of 26.3.Results.The main clinical manifestation includes jaundice, abdominal pain and abdominal mass. All of them were confirmed by ultrasonography, while 39 cases were performed ERCP and PTC with the same diagnosis. Fifty-one patients were performed cystectomy and hepatojejunostomy, two cases were performed cystjejunostomy because of diffused angioma and severe hemorrhage respectively, external drainage was performed in one case with emergent cholangitis, the other two cases were reported malignancy through biopsy and operation was abandoned.Conclusions. Ultrasound diagnostics is essential to accurately diagnose the cyst, preoperative ERCP is helpful for differentiating pancreatic duct from bile duct, while MRCP is a reliable method; cystectomy and cholangiojejunostomy is recommended, laparoscopic procedure is becoming more and more accepted.

Objective. To improve the recognition of diagnosis and treatment of gallbladder cancer.Methods. Retrospective analysis of 52 cases of gallbladder carcinoma in our hospital from 1988 to 1998.Results. Preoperative diagnostic rate was 90.3%, of which 12 cases (23%) were early stage of carcinoma. The total operation resection rate was 55.8%, for which only 17.8% were advance stage of carcinoma.Conclution.The early diagnosis is the key factor of increasing treatment successful rate. The following are the symptoms that raise our special attention to carcinoma of gallbladder: (1) Age over 50 have recurrent cholecystitis and with past history of gallstone; (2) Congenital malformation of bile duct; (3) Local thickening and irregularity of gallbladder wall; (4) Polypoid lesion larger than 1cm inside gallbladder; (5) Atrophic gallbladder; (6) Intraluminal stone of gallbladder does not move when change in body position; (7) Regional lymph node enlargement.

Objectives.The aim of this paper is to describe the clinical characteristics, diagnostic procedure and operative management of Mirrizi syndrome.Methods.Sixteen cases of Mirrizi syndrome were selected and reviewed from 1987 to 1997.Results.In the 16 cases,6 cases were male,10 cases were female,the average age was 62.7 years old.Ten cases were diagnosed to be Mirrizi syndrome preoperatively(62.5%);3 cases were considered to bile duct tumor,the other 3 cases were emergency,they were confirmed the diagnosis after the operation.Conclusions.Ultrasound is recommended as the first choice of screening method, while ERCP may confirm the diagnosis.Surgical approach is considered to be the choice and technical procedures are suggested to prevent intraoperative injury and to repair defects of the common bile duct.

To investigate the effect and mechanism of intravascular brachytherapy with 192 Ir on expression of type I collagen after angioplasty. Restenosis model of domestic miniswine was employed.After angioplasty, the iliac arteries were randomized to brachytherapy group ( n =6) , which were treated with 20 25Gy of 192 Ir, and control group ( n =18). The target vessels were harvested at the 12 th week and the 24 th week after angioplasty. Immunohistochemistry and in situ hybridization were used to detect proteins of type I collagen, metalloproteinase 1 (MMP 1) and its tissue inhibitor (TIMP 1), and mRNA expression of type I collagen. The results showed that the protein and mRNA of type I collagen, and the ratios of TIMP 1/MMP 1 were lower in brachytherapy group than in control group. The peak of mRNA expression of type I collagen was at the 24 th week in control group and at the 12 th week in brachytherapy group, respectively. It suggested that intravascular brachytherapy with 192 Ir affects the metabolism of extracellular matrix by inhibiting the synthesis of type I collagen and regulating the activities of MMP 1 and TIMP 1.