1.In Vitro and in vivo Component Identification of Danshenyin Based on UPLC-Q-TOF-MS/MS
Sitong ZHANG ; Xianrun HU ; Wenkang LIU ; Jinchun LEI ; Xuemei CHENG ; Xiaojun WU ; Wansheng CHEN ; Manlin LI ; Changhong WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):175-183
ObjectiveTo elucidate the chemical composition of Danshenyin and its blood components in rats after oral administration. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS) coupled with PeakView 1.2 software was used to systematically characterize and identify the components of Danshenyin aqueous extract and its migratory components in rat blood after oral administration based on the retention time, quasi-molecular ion peaks, secondary fragmentation ions, and literature reports, and a preliminary compounds identification of Salviae Miltiorrhizae Radix et Rhizoma aqueous extract, the co-decoction of Santali Albi Lignum and Amomi Fructus was carried out to attribute the chemical constituents of the aqueous extract of Danshenyin. ResultsA total of 73 compounds, including 21 phenolic acids, 23 diterpenes, 6 flavonoids, 7 organic acids, 3 volatile oils and 13 others, were identified from the aqueous extract of Danshenyin. And 36 prototypes and 15 metabolites were identified in rat plasma, the major metabolic pathways included reduction, hydration, hydroxylation, demethylation, methylation, sulfation and others, these metabolites were mainly derived from tanshinones and salvianolic acids. ConclusionThe main blood components of the aqueous extract of Danshenyin are salvianolic acids and tanshinones, which may be the material basis of the efficacy. This study can provide reference for pharmacological research, quality control, and clinical application of Danshenyin.
2.Effects of Vitamin B12 on Behaviors,Brain Monoamine Neurotransmitters,and Brain-Derived Neurotrophic Factor in Depressive Rats
Jing CHEN ; Jinchun LIU ; Pengjie ZHANG ; Shenqi ZHANG
Journal of Sichuan University (Medical Sciences) 2025;56(1):206-214
Objective To investigate the behavioral changes and monoamine neurotransmitter levels in a rat model of chronic unpredictable mild stress(CUMS)-induced depression and explore the potential effects of Vitamin B12(VitB12)on CUMS model rats and the underlying mechanisms.Methods A total of 72 Sprague-Dawley(SD)rats were randomly assigned to 3 groups,a control group,a CUMS group(subjected to three weeks of CUMS),and a CUMS+VitB12 group(CUMS rats receiving microinjections of VitB12 in the neck).The body mass of the rats was measured,and behavioral assessments were conducted using the sucrose preference test,open field test,and forced swimming test.High-performance liquid chromatography(HPLC)was used to analyze the levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA),in each group of rats.Hematoxylin-eosin(HE)staining was performed to observe pathological changes in hippocampal neurons.Western blot was performed to detect the expression of signal pathway-related proteins,including brain-derived neurotrophic factor(BDNF),tropomyosin receptor kinase B(TrkB),and cyclic adenosine monophosphate(cAMP)response element-binding protein(CREB)in the hippocampal tissue.Results Starting from week 5,rats in the CUMS group exhibited lower average body mass compared to the control group,while the CUMS+VitB12 group showed a significant increase in body mass compared to the CUMS group(P<0.05).At weeks 3 and 6,sucrose preference of rats in the CUMS group was significantly lower than that in the control group(P<0.001).At week 3,sucrose consumption in the CUMS+VitB12 group was significantly higher than that in the CUMS group(P<0.01),with a more pronounced increase observed in week 6(P<0.001).Starting from week 4,the CUMS group showed reduced scores in grid crossing,grooming,and rearing activities in the open field test compared to the control group,indicating reduced locomotor activity and exploratory behavior(P<0.001).The CUMS+VitB12 group showed improved behavioral performance compared to the CUMS group(P<0.01,P<0.001).In the forced swimming test at weeks 3 and 6,the immobility time of rats in the CUMS group was significantly longer than that in the control group(P<0.01).At week 6,the immobility time of rats in the CUMS+VitB12 group was significantly shorter compared to that of the CUMS group(P<0.01).HPLC results showed that the levels of 5-HT,NE,and DA in the cerebral cortex of rats in the CUMS group were significantly lower than those in the control group(P<0.01,P<0.001),while these neurotransmitter levels were significantly higher in the CUMS+VitB12 group compared to those in the CUMS group(P<0.05,P<0.01).HE staining results showed that the number of hippocampal cells in the CUMS group was significantly reduced,with shrunken nuclei,while the CUMS+VitB12 group showed an increased number of neurons with intact morphology compared to the CUMS group(P<0.05).Western blot analysis showed that the expression levels of BDNF,TrkB,and CREB proteins in the hippocampus were significantly lower in rats in the CUMS group than those in the control group(P<0.05),while the expression levels of BDNF,TrkB,and phosphorylated CREB(p-CREB)were significantly higher in the CUMS+VitB12 group compared to the CUMS group(P<0.05).Conclusion In CUMS rats,the levels of monoamine neurotransmitters(5-HT,NE,and DA)in the cerebral cortex of the brain are decreased,accompanied by a decrease in neuronal cells,which results in anxiety-and depression-like behaviors.VitB12 can upregulate the levels of these neurotransmitters,ameliorate the cytopathological conditions,and regulate the BDNF/TrkB/p-CREB signaling pathway,thereby alleviating depressive symptoms.
3.Application of holographic imaging digital localization technology in robotic partial nephrectomy for completely endophytic renal tumor
Zhengsheng LIU ; Shuaishuai SONG ; Xuegang WANG ; Kaiyan ZHANG ; Wei LI ; Zhun WU ; Bin CHEN ; Tao WANG ; Jinchun XING
Chinese Journal of Urology 2025;46(5):376-382
Objective:To evaluate the clinical value of holographic imaging-based digital localization technology in robot-assisted partial nephrectomy(RAPN)for the treatment of completely endophytic renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 23 patients with completely endophytic renal tumors who underwent RAPN at the First Affiliated Hospital of Xiamen University between December 2022 and December 2024. Patients were divided into two groups based on the use of holographic imaging:the holographic imaging group(16 cases)and the conventional group(7 cases). There was no statistically significant difference between the holographic imaging group and the conventional group in terms of age[(41.9 ± 13.4)years vs.(46.9 ± 13.4)years],body mass index[(25.6 ± 4.8)kg/m2 vs.(24.7 ± 3.1)kg/m2],maximum tumor diameter[(3.1 ± 0.9)cm vs.(3.0 ± 9.0)cm],tumor volume[(13.2 ± 9.0)cm3 vs.(34.9 ± 9.9)cm3],R.E.N.A.L. score[(9.4 ± 1.2)points vs.(9.9 ± 0.7)points],PADUA score[(10.4 ± 0.7)points vs.(9.4 ± 0.7)points],proportion of T 1a stage patients[12 cases(75.0%)vs. 6 cases(85.7%)]and preoperative serum creatinine[(67.4 ± 9.5)μmol/L vs.(78.0 ± 16.0)μmol/L]. In the holographic group,holographic models were reconstructed based on preoperative enhanced CT or MRI images and used for preoperative planning and intraoperative localization. In the conventional group,surgeons relied on preoperative CT or MRI images for cognitive fusion during RAPN. Perioperative parameters such as warm ischemia time,operative time,tumor localization time,positive surgical margin rate,and renal function were compared between the two groups. Results:The operative time in the holographic group was significantly shorter than that in the conventional group[(152.8 ± 12.9)min vs.(218.4 ± 105.5)min, P = 0.001]. Warm ischemia time[(26.9 ± 3.4)min vs.(30.7 ± 3.8)min, P < 0.001],localization time[(4.2 ± 0.9)min vs.(8.9 ± 1.7)min, P < 0.001],and estimated blood loss[(47.0 ± 17.7)ml vs.(128.6 ± 87.8)ml, P < 0.001]were also significantly lower in the holographic group. In the conventional group,one patient underwent radical nephrectomy,while no patient in the holographic imaging group required conversion to radical nephrectomy. No cases of positive surgical margins were identified in either group. Serum creatinine levels measured one month after surgery showed no statistically significant differences between the two groups[(79.5 ± 15.7)μmol /L vs.(104.9 ± 22.5)μmol /L]. Conclusions:The application of holographic imaging-based digital localization technology in RAPN for completely endophytic renal tumors significantly reduces operative time,localization time,warm ischemia time,and intraoperative blood loss. This technology improves surgical efficiency and success rates,offering distinct clinical advantages.
4.Application of holographic imaging digital localization technology in robotic partial nephrectomy for completely endophytic renal tumor
Zhengsheng LIU ; Shuaishuai SONG ; Xuegang WANG ; Kaiyan ZHANG ; Wei LI ; Zhun WU ; Bin CHEN ; Tao WANG ; Jinchun XING
Chinese Journal of Urology 2025;46(5):376-382
Objective:To evaluate the clinical value of holographic imaging-based digital localization technology in robot-assisted partial nephrectomy(RAPN)for the treatment of completely endophytic renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 23 patients with completely endophytic renal tumors who underwent RAPN at the First Affiliated Hospital of Xiamen University between December 2022 and December 2024. Patients were divided into two groups based on the use of holographic imaging:the holographic imaging group(16 cases)and the conventional group(7 cases). There was no statistically significant difference between the holographic imaging group and the conventional group in terms of age[(41.9 ± 13.4)years vs.(46.9 ± 13.4)years],body mass index[(25.6 ± 4.8)kg/m2 vs.(24.7 ± 3.1)kg/m2],maximum tumor diameter[(3.1 ± 0.9)cm vs.(3.0 ± 9.0)cm],tumor volume[(13.2 ± 9.0)cm3 vs.(34.9 ± 9.9)cm3],R.E.N.A.L. score[(9.4 ± 1.2)points vs.(9.9 ± 0.7)points],PADUA score[(10.4 ± 0.7)points vs.(9.4 ± 0.7)points],proportion of T 1a stage patients[12 cases(75.0%)vs. 6 cases(85.7%)]and preoperative serum creatinine[(67.4 ± 9.5)μmol/L vs.(78.0 ± 16.0)μmol/L]. In the holographic group,holographic models were reconstructed based on preoperative enhanced CT or MRI images and used for preoperative planning and intraoperative localization. In the conventional group,surgeons relied on preoperative CT or MRI images for cognitive fusion during RAPN. Perioperative parameters such as warm ischemia time,operative time,tumor localization time,positive surgical margin rate,and renal function were compared between the two groups. Results:The operative time in the holographic group was significantly shorter than that in the conventional group[(152.8 ± 12.9)min vs.(218.4 ± 105.5)min, P = 0.001]. Warm ischemia time[(26.9 ± 3.4)min vs.(30.7 ± 3.8)min, P < 0.001],localization time[(4.2 ± 0.9)min vs.(8.9 ± 1.7)min, P < 0.001],and estimated blood loss[(47.0 ± 17.7)ml vs.(128.6 ± 87.8)ml, P < 0.001]were also significantly lower in the holographic group. In the conventional group,one patient underwent radical nephrectomy,while no patient in the holographic imaging group required conversion to radical nephrectomy. No cases of positive surgical margins were identified in either group. Serum creatinine levels measured one month after surgery showed no statistically significant differences between the two groups[(79.5 ± 15.7)μmol /L vs.(104.9 ± 22.5)μmol /L]. Conclusions:The application of holographic imaging-based digital localization technology in RAPN for completely endophytic renal tumors significantly reduces operative time,localization time,warm ischemia time,and intraoperative blood loss. This technology improves surgical efficiency and success rates,offering distinct clinical advantages.
5.Relationship between mean platelet volume/lymphocyte ratio and left atrial thrombosis in elderly patients with nonvalvular atrial fibrillation
Bin LI ; Jinchun WANG ; Zhibin WANG ; Bin ZHANG ; Yalan MAO ; Yaqi ZHANG
International Journal of Laboratory Medicine 2024;45(6):681-685
Objective To investigate the relationship between mean platelet volume/lymphocyte ratio(MPVLR)and left atrial thrombosis in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 178 elderly patients with NVAF admitted to the hospital from January 2019 to December 2022 were enrolled in the study.The patients were divided into thrombosis group(28 cases)and non-throm-bosis group(150 cases)according to the left atrial thrombosis judged by using esophageal echocardiography(TEE).The white blood cell count(WBC),red blood cell count(RBC),lymphocyte count,lymphocyte pro-portion,platelet count(PLT)and mean platelet volume(MPV)were detected by automatic blood cell analy-zer,and MPVLR was calculated.The liver and kidney function indicators and blood lipid indicators were detec-ted by automatic biochemical analyzer.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of MPV,lymphocyte ratio and MPVLR for left atrial thrombosis in NVAF patients.Multiva-riate Logistic regression was used to analyze the influencing factors of left atrial thrombosis in elderly NVAF patients.Results MPV,lymphocyte proportion and MPVLR in the thrombosis group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of MPV,lymphocyte ratio and MPVLR for predicting left atrial thrombosis in NVAF patients were 0.821(95%CI:0.764-0.882),0.771(95%CI:0.714-0.842)and 0.901(95%CI:0.861-0.949).respectively.The course of disease in the thrombosis group was longer than that in the non-thrombosis group,the proportion of patients with chronic heart failure,the proportion of patients with stroke,CH A2DS2-VASc score,LAEF,LAD,LVEDV,MPVLR,serum uric acid,MPV,lymphocyte proportion and MPVLR were higher than those in the non-thrombosis group,and LVEF was lower than that in the non-thrombosis group,the differences were statistically significant(P<0.05).Multivariate Logistic regression a-nalysis showed that disease duration ≥1.93 years(OR=3.050,95%CI:1.928-4.824),chronic heart failure(OR=3.333,95%CI:1.808-6.144),MPVLR≥3.10(OR=3.873,95%CI:1.734-8.650)were independ-ent risk factors for left atrial thrombosis in elderly NVAF patients(P<0.05).Conclusion The increase of MPVLR is associated with left atrial thrombosis in elderly patients with NVAF,and it can be used as a an in-dicator to predict left atrial thrombosis in patients with NVAF.
6.Efficacy and safety of CM310 in moderate-to-severe atopic dermatitis: A multicenter, randomized, double-blind, placebo-controlled phase 2b trial
Yan ZHAO ; Jianzhong ZHANG ; Bin YANG ; Jingyi LI ; Yangfeng DING ; Liming WU ; Litao ZHANG ; Jinyan WANG ; Xiaohong ZHU ; Furen ZHANG ; Xiaohua TAO ; Yumei LI ; Chunlei ZHANG ; Linfeng LI ; Jianyun LU ; Qingchun DIAO ; Qianjin LU ; Xiaoyong MAN ; Fuqiu LI ; Xiujuan XIA ; Hao CHENG ; Yingmin JIA ; Guoqing ZHAO ; Jinchun YAN ; Bo CHEN
Chinese Medical Journal 2024;137(2):200-208
Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.
7.Meta-analysis of endoscopic mucosal resection with ligation device and endoscopic submucosal dissection in treatment of rectal neuroendocrine neoplasm ( ≤ 10 mm)
Xu WANG ; Yongchun FU ; Jinchun ZHANG
China Journal of Endoscopy 2024;30(12):43-54
Objective To evaluate the safety and effectiveness of endoscopic mucosal resection with ligation device (EMR-L) and endoscopic submucosal dissection (ESD) for the rectal neuroendocrine neoplasm (rNEN) ( ≤ 10 mm).Methods Databases such as the Cochrane Library,PubMed,Embase,Web of Science,SinoMed,China National Knowledge Infrastructure,Weipu and Wanfang database were searched by computer.The retrieval time limit was December 13,2023.The literatures on the efficacy of EMR-L and ESD in treatment of rNEN patients were collected.Two researchers independently screened the literatures and extracted the data,evaluated the methodological quality by Newcastle-Ottawa Scale (NOS).The Rev Man 5.3 software was used for Meta-analysis and funnel plot,and STATA 18.0 was used for publication bias detection.Results 14 literatures were included in the study involving 1,234 patients,including 488 patients in the EMR-L group,518 patients in the ESD group and other operation types 228 cases.Meta-analysis showed that there was no significant difference in histological complete resection rate between the EMR-L group and the ESD group (O(R)=1.24,95%CI:0.54~2.86,P=0.610);The difference was not statistically significant of lesion diameter (WMD=-0.27,95%CI:-0.77~0.23,P=0.290);The operative time of EMR-L group was significantly shorter than that of ESD (WMD=-12.71,95%CI:-17.51~-7.92,P=0.000);There was no significant difference in the positive rate of horizontal and vertical margins between groups (P>0.05).There were no significant differences in the incidence of total complications,postoperative delayed bleeding and intestinal perforation among the groups (P>0.05).Conclusion Compared with ESD,the treatment of rNEN with diameter ≤ 10 mm by EMR-L is comparable effective and save more time.EMR-L is suitable for extensive using because of simple technical requirements for surgical instruments and endoscopists.
8.Meta-analysis of endoscopic mucosal resection with ligation device and endoscopic submucosal dissection in treatment of rectal neuroendocrine neoplasm ( ≤ 10 mm)
Xu WANG ; Yongchun FU ; Jinchun ZHANG
China Journal of Endoscopy 2024;30(12):43-54
Objective To evaluate the safety and effectiveness of endoscopic mucosal resection with ligation device (EMR-L) and endoscopic submucosal dissection (ESD) for the rectal neuroendocrine neoplasm (rNEN) ( ≤ 10 mm).Methods Databases such as the Cochrane Library,PubMed,Embase,Web of Science,SinoMed,China National Knowledge Infrastructure,Weipu and Wanfang database were searched by computer.The retrieval time limit was December 13,2023.The literatures on the efficacy of EMR-L and ESD in treatment of rNEN patients were collected.Two researchers independently screened the literatures and extracted the data,evaluated the methodological quality by Newcastle-Ottawa Scale (NOS).The Rev Man 5.3 software was used for Meta-analysis and funnel plot,and STATA 18.0 was used for publication bias detection.Results 14 literatures were included in the study involving 1,234 patients,including 488 patients in the EMR-L group,518 patients in the ESD group and other operation types 228 cases.Meta-analysis showed that there was no significant difference in histological complete resection rate between the EMR-L group and the ESD group (O(R)=1.24,95%CI:0.54~2.86,P=0.610);The difference was not statistically significant of lesion diameter (WMD=-0.27,95%CI:-0.77~0.23,P=0.290);The operative time of EMR-L group was significantly shorter than that of ESD (WMD=-12.71,95%CI:-17.51~-7.92,P=0.000);There was no significant difference in the positive rate of horizontal and vertical margins between groups (P>0.05).There were no significant differences in the incidence of total complications,postoperative delayed bleeding and intestinal perforation among the groups (P>0.05).Conclusion Compared with ESD,the treatment of rNEN with diameter ≤ 10 mm by EMR-L is comparable effective and save more time.EMR-L is suitable for extensive using because of simple technical requirements for surgical instruments and endoscopists.
9.Comparison of the efficacy and safety of ShuoTong ureteroscopy and flexible ureteroscopy in the treatment of upper ureteral calculi with CT numberical value greater than 1000 HU
Longhui LAI ; Wenzhao ZHANG ; Dawei LIN ; Peide BAI ; Zhengsheng LIU ; Tao WANG ; Shu CUI ; Zhiping WANG ; Jinchun XING ; Bin CHEN
Chinese Journal of Urology 2023;44(2):115-120
Objective:To compare the clinical efficacy and safety of Shuo Tong ureteroscopy(ST-URS) and flexible ureteroscope(FURS)combined with holmium laser lithotripsy in the treatment of upper ureteral calculi with CT numerical value ≥ 1000 HU.Methods:A retrospective analysis of the clinical data of patients of upper ureteral calculi with CT numberical value≥1000 HU in the First Affiliated Hospital of Xiamen University was made from January 2018 to November 2020.There were 61 cases treated with ShuoTong ureteroscopy holmium laser lithotripsy (ST-URS group), including 45 males and 16 females, with 40 on the left and 21 on the right, age of(48.3±12.7) years, body mass index of(24.7±2.7)kg/m 2, the diameter of stone of(1.50±0.45)cm, and the CT numberical value of(1 288.8±179.0)(1 017-1 738)HU. There were 87 cases were treated with flexible ureteroscopy holmium laser lithotripsy (FURS group), including 58 males and 29 females, with 56 on the left and 31 on the right, age of(48.5±13.0) years, body mass index of(24.1±3.8)kg/m 2, the stone diameter of(1.45±0.40)cm, and the CT numberical value of(1 311.3±188.9)(1 009-1 817)HU. There were no significant differences in gender, age, body mass index, the location of stone, the diameter of stone and the CT numberical value of stone( P>0.05)between the two groups. For ST-URS group, a rigid ureteral channel sheath and standard mirror(F7.5/11.5)were placed under direct vision, exiting the standard mirror, leaving the channel sheath, inserting a lithotripsy mirror(F4.5/6.5)and a holmium laser[Power: 8-30 W(0.4-1.0 J/20-30 Hz)], and withdrawing the stone fragments after crushing the stone by "nibbling method" . For FURS group, a hard ureteroscope(F8/9.8)was used to explore the lesion side of the ureter, inserting a guide wire and placing a soft ureteral sheath, then inserting a flexible ureteroscope(F8)for holmium laser lithotripsy, and useing a stone basket to remove larger stone fragments. Ureteral stent was routinely indwelled after the operation. On the day 1 and 1 month after the operation, imaging examinations were performed to evaluate the stone-free rate. No residual stones or the diameter of stone was ≤0.4 cm and no urinary tract infection or any symptoms were defined as stone free. The operation time, blood loss, success rate of stage Ⅰ ureteral access sheath placement, incidence of postoperative complications, stone-free rate(SFR) at 1 day after operation, SFR at 1 month after operation, postoperative hospital stay and hospitalization costs were compared between the two groups. According to the size of calculi, the 2 groups were divided into 2 subgroups(≥1.5 cm and <1.5 cm)in order to make further analysis. The operation time, stone-free rate(SFR) at day 1 after operation and SFR at 1 month after operation were compared between the two groups. Results:The operation time of the ST-URS group was shorter than the FURS group(40.10 min vs. 49.43 min, P=0.020), and the incidence of postoperative complications was lower than the FURS group[3.28%(2/61)vs. 13.79%(12/87), P=0.031]. The SFR at day 1 after operation was significantly higher than the FURS group[60.7%(37/61)vs. 25.3%(22/87), P<0.01], and the hospitalization cost was lower than that of the FURS group(27 686 yuan vs. 32 281 yuan, P<0.010). There were no significant differences in the blood loss[(4.92±9.51)ml vs.(3.95±6.04)ml, P=0.452], success rate of stageⅠureteral access sheath placement[ 96.7%(59/61)vs. 96.6%(84/87), P=1.000], SFR at 1 month after operation[81.97%(50/61) vs. 75.86%(66/87), P=0.375] and postoperative hospital stay[(2.5±1.4)d vs.(2.4±0.8)d, P=0.543] between the two groups. When the size of calculi was ≥1.5cm, the operation time of the ST-URS group was shorter than the FURS group (43.67 min vs 55.00 min), the SFR at 1 day after operation was higher than the FURS group[40.00%(12/30)vs. 9.38%(3/32)], and the above differences are all statistically significant ( P<0.05). Conclusions:Compared with the FURS, for the treatment of upper ureteral calculi with CT numerical value ≥1000 HU, the ST-URS has shorter in operative time, lower in hospitalization cost and incidence of postoperative complications and higher SFR at day 1 after operation. The ST-URS is a safe and effective surgical technique, which is superior in the treatment of larger(≥1.5 cm) stones.
10.Relationship between mechanism underlying antidepressant effect of S-ketamine and hippocampal GABA BR in mice
Jiawei CHEN ; Yubin JIANG ; Min JIA ; Yibao ZHANG ; Jinchun SHEN ; Jianjun YANG ; Zhiqiang ZHOU
Chinese Journal of Anesthesiology 2023;43(2):196-200
Objective:To evaluate the relationship between the mechanism underlying the antidepressant effect of S-ketamine and hippocampal gamma-aminobutyric acid B receptor (GABA BR) in mice. Methods:A total of 54 male C57BL/6(B6) mice, aged 8 weeks, weighing 25-30 g, were used in this study. Forty mice were selected to develop the depression model by chronic social defeat stress. Twenty-six depression-susceptible mice were screened out by social avoidance test at day 11 after developing the model and divided into 2 groups ( n=13 each) by a random number table method: depression-susceptible group (Sus group) and depression-susceptible + S-ketamine group (Sus + S-ket group). The remaining 14 mice served as control group (C group). Starting from day 12 after developing the model, S-ketamine 10 mg/kg was intraperitoneally injected every day for 3 consecutive days in Sus+ S-ket group, while the equal volume of normal saline was given instead in C group and Sus group. The open field test was performed at 1 h after the last administration, and the total distance of movement was recorded. The forced swimming test was performed at 1 day after the open field test, and the immobile time was recorded. The sucrose preference test was performed to calculate the proportion of sucrose consumption at 1 day after the forced swimming test. One hour after the end of behavioral test, mice were sacrificed, and the hippocampal tissues were removed. Western blot was used to detect the expression of GABA BR1, GABA BR2, mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), phosphorylated TrkB (p-TrkB), glutamate receptor 1 (GluR1) and postsynaptic dense protein 95 (PSD95). The p-mTOR/mTOR ratio and p-TrkB/TrkB ratio were calculated. The fluorescence intensity of BDNF in hippocampal CA1 region was detected by immunofluorescence. The number of dendritic spines in hippocampal CA1 region was measured by Golgi staining. Results:In the open field test, no statistically significant difference in the total distance was detected among the three groups ( P>0.05). Compared with C group, the immobile time in the forced swimming test was significantly prolonged, the proportion of sucrose consumption was decreased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was down-regulated, and the ratios of p-mTOR/mTOR and p-TrkB/TrkB were decreased, the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were decreased in Sus group ( P<0.05), and no significant change was found in the parameters mentioned above in Sus+ S-ket group ( P>0.05). Compared with Sus group, the immobile time in the forced swimming test was significantly shortened, the proportion of sucrose consumption was increased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was up-regulated, the ratios of p-mTOR/mTOR and p-TrkB/TrkB were increased, and the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were increased in Sus+ S-ket group ( P<0.05). Conclusions:The mechanism underlying the antidepressant effect of S-ketamine may be related to up-regulation of hippocampal GABA BR expression, activation of mTOR-BDNF signaling pathway, and improvement in synaptic plasticity in mice.

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