ObjectiveTo investigate the pharmacodynamic effects of Houshihei San （HSHS） recorded with the effects of treating wind and limb heaviness on muscle tissue injury after middle cerebral artery occlusion （MCAO） in rats through the ferroptosis pathway. MethodsThirty SD male rats were selected and randomly grouped as follows： sham， MCAO， deferoxamine mesylate， high-dose HSHS （HSHS-H， 0.54 g·kg^-1）， and low-dose HSHS （HSHS-L， 0.27 g·kg^-1）， with 6 rats in each group. A laser scattering system was used to evaluate the stability of the MCAO model， and rats were administrated with corresponding agents by gavage for 7 days. During the administration period， behavioral， imaging and other methods were used to systematically evaluate the skeletal muscle tissue injury after MCAO and the therapeutic effect in each administration group. Hematoxylin-eosin staining was employed to evaluate the cross-section of muscle cells. Subsequently， immunohistochemistry was used to detect tumor suppressor p53 and glutathione peroxidase 4 （GPX4） in the soleus tissue. Western blot was employed to determine the protein levels of p53， GPX4， myogenic differentiation 1 （MyoD1）， nuclear factor E₂-related factor 2 （Nrf2）， Myostatin， solute carrier family 7 member 11 （SLC7A11）， muscle ring-finger protein-1 （MuRF1）， and muscle atrophy F-box protein （MAFbx） to verify the therapeutic effect in each group. ResultsCompared with the MCAO group， HSHS enhanced the locomotor ability and promoted muscle regeneration， which suggested that the pharmacological effects of HSHS were related to the inhibition of muscle tissue ferroptosis to reduce the expression of muscle atrophy factors. Behavioral and imaging results suggested that compared with the MCAO group， HSHS ameliorated neurological impairments in rats on day 7 （P<0.01）， enhanced 5-min locomotor distance and postural control （P<0.01）， strengthened grasping power and promoted muscle growth （P<0.01）， stabilized skeletal muscle length and weight （P<0.01）， and increased the cross-section of muscle cells （P<0.01）. Compared with the MCAO group， HSHS promoted the increases in glutathione and superoxide dismutase content and inhibited the increase in malondialdehyde content （P<0.05，P<0.01）. Ferroptosis pathway-related assays suggested that HSHS reduced the p53-positive cells and increased the GPX4-positive cells （P<0.01）. HSHS ameliorated muscle function decline after stroke by promoting the expression of GPX4， Nrf2， SLC7A11， and MyoD1 and inhibiting the expression of p53， Myostatin， MurRF1， and MAFbx to reduce ferroptosis in the muscle （P<0.01）. ConclusionHSHS， prepared with reference to the method in the Synopsis of Golden Chamber， can simultaneously reduce the myolysis and increase the protein synthesis in the skeletal muscle tissue after ischemic stroke by regulating the ferroptosis pathway.

Objective To explore the value of quantitative chest CT in early diagnosis of chronic obstructive pulmonary disease(COPD).Methods The clinical data of 138 cases of COPD high-risk patients in Shanghai community and COPD high-risk respondents in outpatient clinic of Zhongshan Hospital,Fudan University from September 20,2013 to May 20,2014 were retrospectively analyzed.All high-risk participants underwent pulmonary function and chest CT examination at baseline and 1 year later.Chest CT images were imported into quantitative CT analysis software to collect quantitative CT data.These participants were divided into COPD group(n=40)and non-COPD group(n=98)based on their lung functions after 1 year.The differences in baseline lung function and quantitative CT measurements between the two groups were compared.Binary logistic regression was used to analyze the predictors of COPD in high-risk individuals after 1 year of follow-up,and the efficacy of the logistic regression model was evaluated by ROC curve.Results There were no significant differences in gender,body mass index(BMI),the percentage value of forced expiratory volume in 1 second predicted(FEV1%pred),airway wall area ratio(WA%),total airway count(TAC),and airway wall thickness(WT)between the two groups at baseline.Compared to the non-COPD group,the square root of the tracheal wall area at 10 mm from the inner circumference of the airway(Pi10),(3.43[3.30,3.54]vs 3.23[3.15,3.36],P＜0.001),and the percentage area of low attenuation regions below ﹣950 HU(LAA%﹣950),(2.06[0.32,6.29]vs 0.57[0.25,1.89],P=0.015)were significantly higher in the COPD group.The mean lung density(MLD)in the COPD group was lower than that in the non-COPD group([﹣799.89±35.62]vs[﹣783.60±43.52],P=0.038).Binary logistic regression analysis indicated that age and Pi10 were risk factors for COPD(P＜0.05),with an area under the ROC curve of 0.791(95%CI 0.714-0.868).Conclusions In the COPD high-risk population with normal lung function,patients with elevated Pi10 and LAA%﹣950 have a higher incidence of COPD one year later,suggesting that quantitative chest CT measurements such as Pi10 and LAA%﹣950 can assist clinicians in identifying early-stage COPD.

OBJECTIVE To analyze the research status， hotspots and trends in the research of intravenous thrombolytic drugs in the treatment of acute ischemic stroke. METHODS The original studies related to intravenous thrombolytic drugs for acute ischemic stroke were collected by searching the Web of Science core database； the authors， countries/regions， institutions and keywords of the literature were visualized and analyzed using CiteSpace 6.1.R6 software. RESULTS A total of 1 810 articles were included， and the number of articles published showed an increasing trend year by year， with the United States （556 articles） having the largest number of articles， and China ranking the second （339 articles， with centrality of 0）. The most published author was Ahmed of Sweden （32 articles）， and the most published institution was the University of Calgary in Canada （80 articles）. The current research status and hotspots were mainly the application and therapeutic exploration of new thrombolytic drugs， and the frontier and development trend were the adverse prognosis of neurological deterioration and hemorrhagic transformation accompanied by intravenous thrombolytic drug treatment. CONCLUSIONS The research hotspots and frontier about intravenous thrombolytic drugs for acute ischemic stroke are mainly the third generation of intravenous tissue plasminogen activator， and the exploration of new intravenous thrombolytic drugs and their safety and effectiveness will be the future research hotspots. Chinese scholars and research teams should strengthen cooperation and exchanges with other countries， which can be strengthened by carrying out multi-center clinical trials.

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

Objective To investigate the changes of bone mineral density (BMD) in human immunodeficiency virus (HIV)-infected patients in Changsha,and take intervention measures to prevent the occurrence of osteoporosis and fracture.Methods A total of 278 HIV-infected patients and 154 cases of healthy adults from March 2011 to May 2015 were selected.Dual energy X-ray absorptiometry (DXA) was used to detect BMD,T-score and Z-score of all the research objects,including the whole body,lumbar spine (L2～4),and left hip joint.The height and weight were measured at the same time.Results The HIV infection group had an average age of (31.53 ± 8.56) years old,and the healthy control group was (34.45 ± 8.22) years old.Height between two groups had no significant difference.The average weight of HIV infection group was 6.93 kg [95％ CI,-9.01,-4.97;P ＜0.001] lighter than that in the normal control group.BMD,T-score and Z-score of HIV infection group were significantly lower than those in norrmal control group (P ＜ 0.001).The occurrence rate of osteopenia (Z ≤-1.0)and osteoporosis (Z ≤-2.0)in HIV infection group were correspondingly 43.53％ ～ 54.68％ and 9.71％ ～23.74％,which is about 4 times of that in the healthy control group (14.28％ ～ 20.13％,0.65％ ～ 5.84％).Conclusions The average body weight of HIV-infected patients was significantly lower than that of normal control group,and the incidence of osteopenia and osteoporosis in HIV-infected group was significantly higher than that in normal control group.

Objective To explore the role and clinical significance of GSTM 3 ( glutathione S-trans-ferase mu 3) expression in prostate cancer (PCa). Methods We had used the two-dimensional fluores-cence difference gel electrophoresis ( 2D-DIGE) and mass spectral analysis to further verify the microarray data of mRNA expression profiling discovered .GSTM3 mRNA level was detected by Rael-time Quantitative PCR ( RT-QPCR) in 28 pairs of prostate cancer tissue and benign tissue .The relationship of GSTM 3 level with the serum PSA level and the clinical feature of PCa were analyzed . Results In 2D-DIGE study, we found that the expression of GSTM 3 protein in adjacent tissues was significantly higher than that in PCa tis-sues (P<0.05).RT-QPCR results showed that GSTM3 in adjacent tissues (8.12±0.51) was significantly higher than that in PCa tissues (7.18±0.54) (P<0.05).There was no significant difference of GSTM3 ex-pression in different serum PSA packets ( P>0.05) and prostate cancer clinical pathological parameters ( P>0.05). Conclusions GSTM3 expression is down-regulated in PCa tissues, and we may identify PCa by detecting the GSTM 3 expression .

UNLABELLEDBackround N-terminal pro-brain natriuretic peptide (NT-proBNP) is a reliable predictor in acute coronary artery disease (CAD). Little is known about patients with stable CAD, especially Chinese patients with CAD. The aim of the present study was to investigate the association of NT-proBNP levels with the severity of CAD in patients with normal left ventricular ejection fraction.

METHODSA total of 658 consecutive patients were divided into two groups based on angiograms: CAD group (n = 484) and angiographic normal control group (n = 174). The severity of CAD was evaluated by modified Gensini score, and its relationship with NT-proBNP was analyzed.

RESULTSThe prevalence of risk factors such as age, male gender, diabetes mellitus (DM), dyslipidemia, smoking, and family history of CAD in the CAD group were higher than that in the control group. In multivariate regression model analysis, age, gender, and DM were determinants of the presence of CAD. NT-pro BNP was found to be an independent predictor for CAD (OR:1.66 (95% CI: 1.06-2.61), P < 0.05). In a receiver operating characteristic (ROC) curve analysis, an NT-proBNP value of 641.15 pmol/L was identified as a cut-off value in the diagnosis or exclusion of CAD (area under curve (AUC) = 0.56, 95% CI: 0.51-0.61). Furthermore, NT-proBNP was positively correlated with Gensini score (r = 0.14, P < 0.001) in patients with CAD.

CONCLUSIONNT-proBNP was an independent predictor for Chinese patients with CAD, suggesting that the NT-proBNP level might be associated with the presence and the severity of CAD.

Coronary Disease ; blood ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Stroke Volume

Objective To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia (CAE). Methods A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups (elderly group, age≥ 65 years; non-elderly group, age < 65 years). The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were compared.Results The preva-lence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female (30.1%vs. 10.1%,P< 0.001), three-vessel disease (60.5%vs. 45.2%,P = 0.003) and localized ectasia (55.0%vs. 40.2%,P = 0.003). In addition, body mass index (20.90 ± 2.71 kg/m2vs. 22.31 ± 2.98 kg/m2,P < 0.001) and percentage of current smokers (45.0%vs. 64.6%,P < 0.001) were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group (88.0%vs. 96.0%,P = 0.002). But the 5-year event free survival rate failed to show a significant difference between the two groups (31.0%vs. 35.0%,P= 0.311).ConclusionThe prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be asso-ciated with increased mortality risk in the elderly.

Gallbladder carcinoma is the most common malignant tumor in biliary system,the early diagnosis rate is still very low and the prognosis is extremely poor.At present,the pathogenesis of gallbladder is not clear.Recently,with the development of the neoplastic stem cell research on gallbladder carcinoma,the latest study showed SP positive cells could be separated from the GBC-SD cell.Further more,related researches have shown that gallbladder respectively with CD133+ cells,CD44+ cells,CD133+ CD44+ cells had possessed the cloned formation ability,the stronger growth ability,the differentiation capacity and forming-tumor ability.In this review,we will discuss the research of the relationship between the gallbladder carcinoma and neoplastic stem cells.

Objective To investigate the relationship between acute cerebral infarction(CI)and matrix metalloproteinase-9(MMP-9)serum level and polymorphism(C-1562T)in Han population.Methods One hundred and one patients with acute CI from the department of neurology of Taizhou Hospital were included and 114 healthy persons were selected from physical examination as the control group.Serum MMP-9 level was measured by enzyme-linked immunosorbent assay(ELISA).At the same time.genotype was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)for the common C-1562T functional promoter polymorphism of the MMP-9 gene.The serum MMP-9 level and genotype frequencies of the MMP-9 gene between the patients and the control group were analyzed.Results The genotype frequencies of the MMP-9 gene C-1562T polymorphism of the two groups were in Hardy-Weinberg equilibrium.The results of individual polymorphisms analysis showed that the frequencies of CT and TT genotypes in the C-1562T polyporphismin were of no significant difference between the patients group with CI(13.9%)and the control group(13.2%).The frequencies of-1562T allele was of no statistical difference between the CI group(6.9%)and the control group(7.5%).But serum levels of MMP-9 in CI patients group((138.9±121.8)ng/ml)were significantly higher than in the control group((18.4±4.6)ng/ml,t=9.93,P=0.00).Conclusions Serum level of MMP-9 obviously is increased after ischemic stroke in 48 hours.But genetic polymorphism in MMP-9 promoter(C-1562T)has no definite relationship with MMP-9 genetic expression and CI in the Han population of China.Therefore,the relationship between genetic polymorphism in MMP-9 promoter(C-1562T)and ischemic stroke needs further investigation.