Objective To discuss the application of the"rotating guidewire and correcting the filter recovery hook direction technique"("rotation-correction loop technique"for short),a technique invented by the authors in clinical practice,in the retrieval of complex inferior vena cava filter(IVCF),and to discuss its technical skills and advantages.Methods The clinical data of 417 patients carrying an IVCF,who were admitted to the Department of Vascular Surgery of Second Hospital of Shanxi Medical University of China to retrieve IVCF between January 2022 and December 2022,were retrospectively analyzed.Taking the time spent on the retrieval of IVCF and the intraoperative radiation dose as the evaluation indicators,the advantages and disadvantages of the standard filter retrieval technique,the"rotation-correction loop technique"and the other loop-assisted techniques were compared.Results Both the intraoperative radiation dose and the time spent on the retrieval of IVCF using"rotation-correction loop technique"were remarkably lower than those of other loop-assisted techniques(P＜0.000 1).Conclusion For the retrieval of complex IVCF,especially for the IVCF which is heavily tilted and/or its recovered hook is attached to the vascular wall,the use of"rotation-correction loop technique"can shorten the time spent on the the retrieval of IVCF and reduce the intraoperative radiation dose.This technique carries high safety and practicability,the device is simple and it can be manipulated by single physician,which is conducive to clinical application and promotion.(J Intervent Radiol,2024,33:289-294)

Objective:To explore the effects of Ginkgo biloba on regulating NF-E2-related factor 2 (Nrf2)-Kelch-like ECH-associated protein 1 (Keap1)-antioxidant response element (ARE) signaling pathway in liver injury induced by coal-burning-borne endemic arsenic poisoning in rats.Methods:Group design method was adopted, according to body weight (80-100 g), a total of 30 Wistar rats were divided into 5 groups (6 rats in each group, half males and half females) by random number table method. The normal control group was fed with normal diet ad libitum for 4.5 months; the Ginkgo biloba control group was fed with Ginkgo biloba (25 mg/kg, 6 d/week) for 1.5 months after normal feeding for 3 months; the drinking water arsenic poisoning group and the arsenic contaminated grain group were fed respectively with 100 mg/L arsenic trioxide (As 2O 3) solution and 100 mg/kg arsenic-containing feed for 3 months, and then fed with normal diet for 1.5 months; the Ginkgo biloba treatment group was fed with 100 mg/kg arsenic-containing feed for 3 months, and then was given Ginkgo biloba (25 mg/kg, 6 d/week) for 1.5 months. After sacrificing the animals, the content of malondialdehyde (MDA), the activity of copper zinc superoxide dismutase (SOD1) and the activity of glutathione peroxidase (GPx) in serum were detected by thiobarbituric acid colorimetry, xanthine oxidase method and dimercaptodinitrobenzoic acid reduction method, respectively. The mRNA and protein expressions of indicator genes of Nrf2-Keap1-ARE signaling pathway in liver tissues were detected by quantitative real-time PCR, immunohistochemistry and Western blotting. Correlation between the indexes was analyzed by Pearson. Results:In drinking water arsenic poisoning group, arsenic contaminated grain group and Ginkgo biloba treatment group, the contents of MDA in serum were (3.54±0.51), (3.83±0.87) and (2.93±0.84) μmol/L, respectively, which were higher than that in normal control group [(1.85±0.36) μmol/L, P < 0.05]; and SOD1 activities [(68.21±4.37), (64.53±9.96), (73.09±5.43) U/ml] and GPx activities [(486.41±40.45), (458.24±42.25), (539.79±79.43) U/L] in serum were lower than those in normal control group [(81.47±5.73) U/ml, (747.86±80.33) U/L, P < 0.05]. Compared with the arsenic contaminated grain group, the content of MDA in serum in Ginkgo biloba treatment group was decreased, the activities of SOD1 and GPx in serum were increased ( P < 0.05). Compared with normal control group, the mRNA expressions of SOD1 and GPx1 in the liver tissues in drinking water arsenic poisoning group, arsenic contaminated grain group and Ginkgo biloba treatment group were significantly higher ( P < 0.05). Compared with arsenic contaminated grain group, the mRNA expressions of SOD1 and GPx1 in the liver tissue in Ginkgo biloba treatment group were increased ( P < 0.05). Compared with the normal control group, the protein expression of SOD1 in liver tissue in arsenic contaminated grain group was decreased ( P < 0.05), the protein expressions of GPx1 were decreased in the liver tissues in drinking water arsenic poisoning group, arsenic contaminated grain group and Ginkgo biloba treatment group ( P < 0.05). Compared with the arsenic contaminated grain group, the protein expressions of SOD1 and GPx1 were increased in the liver tissue in Ginkgo biloba treatment group ( P < 0.05). Compared with the normal control group and arsenic contaminated grain group, the protein expression of Keap1 was decreased in the liver tissue in Ginkgo biloba treatment group ( P < 0.05). Compared with the normal control group, the protein expressions of Nrf2 and phosphorylation of Nrf2 (pNrf2) were increased in the cytoplasm in drinking water arsenic poisoning group, arsenic contaminated grain group and Ginkgo biloba treatment group ( P < 0.05). Compared with the arsenic contaminated grain group, the protein expression of pNrf2 was decreased in the cytoplasm in Ginkgo biloba treatment group ( P < 0.05). The protein expressions of Nrf2 and pNrf2 in the nucleus in drinking water arsenic poisoning group, arsenic contaminated grain group and Ginkgo biloba treatment group were also higher than those in normal control group ( P < 0.05). Compared with the arsenic contaminated grain group, the protein expressions of Nrf2 and pNrf2 were increased in the nucleus in Ginkgo biloba treatment group ( P < 0.05). The results of correlation analysis revealed that the protein expressions of Nrf2 and pNrf2 in the nucleus were negatively correlated with Keap1 protein expression ( r=-0.523,-0.401, P < 0.05), and positively correlated with the mRNA expressions of SOD1 and GPx1 ( r=0.658, 0.530, 0.555, 0.603, P < 0.05). In addition, the protein expressions of SOD1 and GPx1 were positively correlated with their enzyme activities ( r=0.472, 0.629, P < 0.05). Conclusions:Arsenic could induce oxidative stress and liver injury. Ginkgo biloba could reduce the protein expression of Keap1, and promote nuclear translocation of Nrf2, which might induce the up-regulation of mRNA expressions of SOD1 and GPx1, and partially reverse the posttranscriptional regulation of arsenic on SOD1 and GPx1, and then increase their protein expressions and enzyme activities, thereby improve arsenic induced oxidative stress and liver injury.

Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.

Objective To observe the expression of Protein Kinase C Delta (PKCδ) and NF-E2-related factor 2 (Nrf2) in the liver of arsenic poisoning rats induced by coal-burning,and explore their roles.Methods According to body weight (80-100 g),thirty Wistar rats (half male half female) were divided into five groups of 6 each using random number table method,the control group,and drinking arsenic,low,medium and high arsenic contaminated grain groups.The control group was fed normally for 3 months;drinking arsenic,low,medium and high arsenic contaminated grain groups were fed respectively with 100 mg/L As2O3 solution and different concentrations of arsenic-containing feed (25,50 and 100 mg/kg).At the end of the experiment period,non-anticoagulant whole blood 2 ml from peripheral vein was collected.Malondialdehyde (MDA) contents,activities of superoxide dismutase 1 (SOD1) and glutathione peroxidase (GPx) were detected.After sacrificing the animals,the liver was separated and then diacylglycerol (DAG) contents,mRNA and protein expressions of PKCδ and Nrf2 were determined,and the correlation was analyzed by Pearson.Results There were significant differences in serum MDA contents,SOD1 and GPx activities among groups (F =26.441,3.327,120.645,P ＜ 0.05).The serum MDA contents in arsenic-exposed groups were higher than that of the control group (P ＜ 0.05).However,activities of SOD1 and GPx1 were lower than those in the control group (P ＜ 0.05).There were significant differences in liver DAG contents,Nrf2 mRNA expression levels among groups (F =8.237,8.656,P ＜ 0.05).DAG contents in the liver tissues of the drinking arsenic,low,medium and high arsenic contaminated grain groups were respectively (2.67 ± 0.25),(2.36 ± 0.19),(2.54 ± 0.22) and (2.69 ± 0.32) μg/L,which were significantly higher than that in the control group [(2.05 ± 0.24) μg/L,P ＜ 0.05].The expression levels of Nrf2 mRNA in liver tissue were respectively 1.16 ± 0.09,1.09 ± 1.20,1.14 ± 0.15 and 1.27 ± 0.16,which were higher than that in the control group (0.94 ± 0.08,P ＜ 0.05).There were significant differences in the expression of pPKCδ protein in the cell membrane and cytoplasm of liver tissue between groups (F =15.925,6.699,P ＜ 0.05).The protein expression levels of pPKCδ in the cell membrane of liver tissue were 0.49 ± 0.06,0.33 ± 0.05,0.37 ± 0.06 and 0.50 ± 0.08,respectively,which were significantly higher than that in the control group (0.28 ± 0.04,P ＜ 0.05).The protein expression levels of pPKCδ in the cytoplasm were 0.38 ± 0.06,0.31 ± 0.05,0.35 ± 0.05 and 0.36 ± 0.05,respectively,which were higher than that in the control group (0.24 ± 0.05,P ＜ 0.05).There were significant differences in the expression of Nrf2 and pNrf2 in cytoplasm and nucleus of liver tissues among groups (F =9.024,9.709,10.396,25.532,P ＜ 0.05).The protein expression levels of Nrf2 in the cytoplasm were respectively 0.76 ± 0.09,0.58 ± 0.07,0.64 ± 0.09 and 0.73 ± 0.07,which were higher than that of the control group (0.52 ± 0.08,P ＜ 0.05),except the low arsenic contaminated grain group.The protein expression levels of pNrf2 in the cytoplasm were respectively 0.50 ± 0.07,0.43 ± 0.06,0.48 ± 0.06 and 0.54 ± 0.07,which were higher than that in the control group (0.32 ± 0.06,P ＜ 0.05).The expression levels of Nrf2 protein in the nucleus were respectively 0.44 ± 0.07,0.41 ± 0.06,0.47 ± 0.06 and 0.54 ± 0.09,which were higher than that in the control group (0.30 ± 0.05,P ＜ 0.05).The protein expression levels of pNrf2 in the nucleus were respectively 0.35 ± 0.04,0.29 ± 0.04,0.41 ± 0.05 and 0.43 ± 0.06,which were higher than that in the control group (0.20 ± 0.03,P ＜ 0.05).The correlation analysis showed that DAG contents and the protein expression of pPKCδ in the cell membrane and the cytoplasm were positively correlated (r =0.663,0.604,P ＜ 0.05).Furthermore,the protein expression of pPKCδ in the cell membrane and pNrf2 in the cytoplasm and nucleus were also positively correlated (r =0.642,0.670,P＜ 0.05).Conclusions Arsenic could induce oxidative stress liver injury,and upregulate the mRNA and protein expression of Nrf2.Moreover,arsenic could also increase the protein expression of pPKCδ and DAG content,and then promote pPKCδ membrane transposition,phosphorylate Nrf2,and induce its nuclear transposition,which could regulate oxidative stress reaction.

Objective The bispectral index (BIS) was introduced into the sedation strategy of critical patients in intensive care unit (ICU) and replaced the Richmond agitation sedation scale (RASS).The ventilation time,ICU length of stay,and 90-day mortality were compared between the two groups of patients who performed early goal-directed sedation (EGDS) or standard traditional directed sedation (STDS) strategies.Methods A prospective controlled study of severe patients with mechanical ventilation ≥48 h in ICU (20 cases from April 2016 to May 2017,46 cases from June 2017 to April 2018) were randomly divided into EGDS or STDS group.There were no significant differences in age,gender,and acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ) score between the two groups in the two periods.The correlation between RASS and BIS was analyzed in the first period.The BIS of the patients in a RASS range of (-2-1) was 73.65 ± 7.87 in the EGDS group,and that of RASS range of (-3--1) was 64.14 ± 7.25 in the STDS group.The above BIS was applied to the two sedation strategies in the second period respectively.The ventilation time,ICU length of stay,and 90-day mortality were recorded.Results There was no significant difference in the ventilation time between the two groups [(164.12 ± 137.96) h and (155.33 ±64.86)h,P =0.08].ICU length of stay of the EGDS group was longer than that of the STDS group.The 90-day mortality of the EGDS group was higher than that of the STDS group.Conclusions Correlations between RASS and BIS were found in this study,and BIS can be used for sedation assessment in ICU patients.Large sample study is still needed to compare EGDS and STDS with BIS.

Objective To explore the effects and the possible mechanism of Gingko biloba on liver injury due to arsenic poisoning in rats,and to provide experimental evidence for prevention and treatment of arsenic poisoning.Methods The corn powder baked by high arsenic coal was served as the main raw material to make feed containing arsenic.Forty healthy Wistar rats were randomly divided into 5 groups according to their body weights,including control group A,arsenic poisoning group,control group B,natural recovery group and Ginkgo biloba treatment group,eight rats in each group,half male and half female.The control group A rats were fed with normal diet ad libitum for 3.0 months;the arsenic poisoning group rats were freely given feed containing arsenic (100 mg/kg) for 3.0 months;the control group B rats were fed with normal diet ad libitum for 4.5 months;the natural recovery group rats were freely given arsenic (100 mg/kg) feed for 3.0 months,and then given a normal diet for 1.5 months;Ginkgo biloba treatment rats ingested arsenic feed for 3.0 months,and then give Ginkgo biloba solution (25 mg/kg) orally,6 d/week for 1.5 months,then back to normal diet.The content of arsenic in urine,liver,as well as the liver function indices [alanine aminotransferase (ALT),aspartate transaminase (AST),total bile acids (TBA),gamma glutamyl aminopeptidase (GGT),glutathione S-transferase (GSTs)] and the oxidative stress indexes [superoxide dismutase (SOD),glutathione peroxidase (GPx),thiol (-SH),malondialdehyde （MDA)] of liver homogenate,were measured.Results The arsenic content of urine and liver (geometric mean) of the rats in arsenic poisoning group (2 991.24 μg/g Cr,4.29 μg/g) were significantly higher than those in control group A (91.59 μg/g Cr,1.00 μg/g).Urinary arsenic and liver arsenic levels of rats in natural recovery and Ginkgo biloba treatment groups (467.39,334.48 μg/g Cr;,3.15,1.88 μg/g) were higher than those in control group B (99.54 μg/g Cr,0.85 μg/g).The arsenic contents of urine of the rats in natural recovery group,the arsenic contents of urine and liver of rats of Ginkgo biloba treatment group were all lower than those in arsenic poisoning group.The differences were significant (all P ＜ 0.05).The activity/contents of AST,TBA,GGT,GSTs of rats in arsenic poisoning group [(212.88 ± 29.76) U/L,(19.19 ± 4.33) μmol/L,(1.73 ± 0.50) U/L,(196.21 ± 47.38) U/L] were all significantly higher than those in control group A [(142.63 ± 24.20) U/L,(6.23 ± 2.95) μmol/L,(0.77 ± 0.32) U/L,(142.86 ± 28.58) U/L].The activity/contents of TBA,GGT,GSTs in natural recovery group were (17.07 ± 3.92) μ,mol/L,(1.47 ± 0.57) U/L and (178.06 ± 27.37) U/L;and the contents of TBA in Ginkgo biloba treatment group were (13.60 ± 3.00) μmol/L;which were all higher than those in control group B [(7.55 ± 2.45) μmol/L,(0.74 ± 0.51) U/L,(145.17 ± 28.59) U/L].The activity of AST in natural recovery group [(137.44 ± 23.20) U/L],the activity/contents of AST,TBA,GGT and GSTs in Ginkgo biloba treatment group[(129.63 ± 31.25) U/L,(13.60 ± 3.00) μmol/L,(1.15 ± 0.48) U/L,(155.64 ± 20.79) U/L,respectively] were all lower than those in arsenic poisoning group.The content of TBA in Ginkgo biloba treatment group was lower than that of natural recovery group.The differences of those indexes were all significant (all P ＜ 0.05).The activity/contents of SOD,GPx and-SH in arsenic poisoning group [(46.34 ± 11.39),(275.16 ± 92.00) U/mg prot and (0.08 ± 0.02) μmol/mg prot] were all significantly lower than those in control group A [(75.52 ± 8.72),(1 351.01 ± 395.96) U/mg prot,(0.13 ± 0.01) μmol/mg prot].The activity of SOD and GPx in natural recovery group [(42.44 ± 9.58),(694.87 ± 187.01) U/mg prot] were all lower than those in control group B [(68.17 ± 11.11),(1 342.80 ± 185.04) U/mg prot].The activity of GPx in natural recovery group,the activity/contents of SOD,GPx,-SH in Ginkgo biloba treatment group [(63.90 ± 10.44),(1 283.28 ± 373.87) U/mg prot,(0.12-± 0.02) μmol/mg prot] were all higher than those in arsenic poisoning group.The contents of SOD,GPx,-SH in Ginkgo biloba treatment group were higher than those of natural recovery group.The content of MDA in arsenic poisoning group [(3.05 ± 0.94) nmol/mg prot] was higher than that in control group A [(1.67 ± 0.55) nmol/mg prot].The content of MDA of rats in natural recovery and Ginkgo biloba treatment groups were (2.22 ± 0.93),(1.77 ± 0.37) nmol/mg prot,which were lower than those in the arsenic poisoning group.The differences of the above indexes were all significant (all P ＜ 0.05).Conclusion Ginkgo biloba can reduce the accumulation of arsenic in the liver and ameliorate lipid peroxidation,relieve liver injury effectively in rats caused by coal-burning arsenic.

Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.

Objective To examine the association between the polymorphisms of apolipoprotein E gene (APOE) and geriatric depression (GD),and then conduct an exploratory investigation to analyse whether the APOE polymorphisms would relate to the depressive syndrome severity,the cognitive function,or the level of serum lipid in patients.Methods Participants,including 120 GD patients and 120 normal controls were enrolled to detect the two single nucleotide polymorphisms of APOE,rs7412 and rs429358 using the technology of SNP site testing.The frequency differences of genotype and allele were compared between the two groups.Then the association between APOE polymorphisms and clinical or demographic data of patients were clarified.The relationship between clinical or demographic data,and the cognitive function of GD patients were investigated using the Logistic multiple regression analysis.Results The frequency of APOE genotype and allele showed no significant difference between the two groups(P＞0.05).Patients carrying e4 allen had significantly lower total scores of Man-Machine System Engineering((22.38±2.22) vs (25.28±2.28),t=3.091,P＜0.01) and higher levels of TC (t=2.225,P＜ 0.05) and LDL(t=2.728,P＜0.01) compared with those without ε4 allen.The specific symptoms of patients carrying e4 allen were cognitive impairment(load 0.902) and retardant factors(load 0.695),while patients without ε4 allen had characteristic symptoms of anxiety(load 0.990) and weight factors(load 0.864).Ranked by the effect power,the risk factors of cognitive impairment of GD patients are ε4(b'=1.097) and then TCTC (b'=0.401).Conclusions APOE may not modulate the susceptibility to GD.Patients carrying ε4 allen have severer cognitive impairment and higher levels of serum lipid.The different genotypes may lead to different clinical symptoms.

Objective To study the expression and enzyme activity of thioredoxin reductase 1 (TrxR1) in liver and peripheral blood of human and rats exposed to airborne arsenic through coal-burning as well as its role in liver injury of coal-burning-borne arsenic poisoning.Methods This study was divided into 2 parts.Part 1 was a population study:133 local residents exposed to airborne arsenic through coal-burning were selected as arsenic exposure groups including a non-patient group (25 cases),no obvious hepatopathy group (38 cases),mild (43 cases) and moderate to severe hepatopathy groups (27 cases) from areas affected by endemic arsenism in Guizhou Province.Thirty-four healthy residents from arsenic not affected areas were selected as controls.Peripheral blood samples were collected from all these people.The expression of TrxR1 mRNA was determined by real-time fluorescence quantitative PCR (qPCR),and enzyme activity of TrxR was tested by visible spectrophotometry.Part 2 was an animal experiment study:Thirty Wistar rats,weighing about 80-100 g,were divided into control group,drinking-waterborne arsenic poisoning group and coal-burning-borne arsenic poisoning group (including low,medium and high arsenic contaminated grain groups) by means of a table of random number according to body mass,6 rats in each group.The control group was fed with normal diet for 3 months; drinking-water-borne arsenic poisoning group and coal-burning-borne arsenic poisoning group were fed with 10 mg/kg As2O3 solution and different concentrations(25,50,100 mg/kg) of arsenic-containing feed,respectively,for 3 months.The expression of TrxR1 mRNA was determined by qPCR; protein expression level of TrxR1 in liver tissue was detected by immunohistochemistry,and enzyme activity of TrxR in serum and liver tissue was tested by visible spectrophotometry.Results The mRNA expressions of TrxR1 in peripheral blood were 1.599 8 (1.128 9-2.156 8),1.469 3 (1.146 1-1.976 3),1.203 6 (0.463 1-1.816 2) and 0.912 3(0.631 8-1.535 0),respectively,among non-patient group,no obvious hepatopathy group,mild and moderate to severe hepatopathy groups.Compared to the control group[1.649 7(1.161 1-2.380 2)],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The enzyme activity of TrxR in peripheral blood was (3.12 ± 0.76),(2.81 ± 0.84),(2.52 ± 0.73),(2.42 ± 0.76)U/ml,respectively,in those corresponding groups.Compared to the control group [(3.02 ± 0.70)U/ml],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The mRNA expressions of TrxR1 in peripheral blood were 1.05 ± 0.14,1.18 ± 0.18,1.04 ± 0.10 and 0.97 ± 0.13,respectively,among drinking-water-borne arsenic poisoning group,low,medium and high arsenic contaminated grain groups; all of which were lower than that in the control group (1.23 ± 0.15,all P ＜ 0.05) except that of the low arsenic contaminated grain group.The mRNA expressions of TrxR1 in liver tissue were 0.78± 0.10,0.83 ± 0.10,0.79 ± 0.09 and 0.77 ± 0.11,respectively; all of which were lower than that in the control group (0.94 ± 0.12,all P ＜ 0.05).The protein expression of TrxR1 in liver tissue was 310.33 ± 38.81,312.50 ± 23.36,305.67 ± 20.57 and 298.17 ± 23.52,respectively,among the arsenic poisoning groups; all of which were lower than that in the control group (348.50 ± 32.35,all P ＜ 0.05).The enzyme activity of TrxR in serum was (4.22 ± 0.73),(4.86 ± 0.63),(4.04 ± 0.57),(3.73 ± 0.64)U/ml,respectively; all of which were lower than that in the control group [(9.52 ± 1.08)U/ml,all P ＜ 0.05].The enzyme activity of TrxR in liver tissue was (14.82 ± 1.67),(18.76 ± 2.76),(14.90 ± 2.17),(11.55 ± 1.74) U/mg,respectively; all of which were lower than that in the control group [(23.71 ± 3.05)U/mg,all P ＜ 0.05].Conclusion Arsenic aggravates liver injury of coal-burning arsenic poisoning through down-regulating the expressions of TrxR1 mRNA and protein and reducing its enzyme activity as well.

Objective To explore the anatomic characteristics of the peroneal perforator branches and its clinical application as vascularized flap transfer. Methods Twenty fresh cadaver specimen with 40 sides lower limbs were used in this study.Lead oxide gelatin was injected to the whole body,lower extremity radiaograph, spiral CT scan was then used to construct three demention visual model. The peroneal artery and its perforators were dissected,number of peferators,distance to fibular head,diameter and the length of the vascular pedicles were measured and analyzed. From July 2005 to October 2009, forty-three cases with skin defects were performed vascularized transfer in our study,surviving rate and postoperative function were followed up for 6 months to 2 years.Results Perforators were seen most at (9.80 ± 0.93)cm,(13.40 ±0.90) cm,(17.20 ± 1.13)cm,and (21.30 ± 0.77)cm beneath the fibular head with the artery branch diarneter(1.33 ± 0.39) mm,(1.30 ± 0.46)mm,(1.17 ± 0.30)mm,and (1.22 ± 0.23)mm,respectively,while the pedicle length was (5.87 ± 0.73)cm,(5.83 ± 1.73)cm,(5.44 ± 1.09)cm,and (5.10 ± 1.93) cm respectively.In clinic,42/43 free flaps survived.Postoperative outlook were satisfied except in 7 cases,the flaps looked bulky and needed secondary revision.All the donor calves showed good apperaence and function.Conclusion There are 4 regular perferators in lateral calf, while perforators in the middle 1/3 are bigger with relatively longer vascular pedicles which are appropriate for vascularized transfer.