ObjectiveTo study the protective effect of Shoutaiwan-containing serum on the human chorionic trophoblast cells （HTR-8/Svneo） exposed to hydrogen peroxide （H₂O₂） via the nuclear factor erythroid 2-related factor 2 （Nrf2） signaling pathway and to decipher the underlying mechanism. MethodThe H₂O₂ solutions of 25， 50， 100， 200， 400 μmol·L^-1 were used to treated the HTR-8/Svneo cells. The cell counting kit-8 （CCK-8） was employed to measure the proliferation of the cells and further determine the optimal concentration of H₂O₂ solution for modeling and the drug-containing serum. The cells were divided into a blank group， a model group， a dydrogesterone group， and a Shoutaiwan group. The effect of drug-containing serum on H₂O₂-induced proliferation of HTR-8/Svneo cells was detected by CCK-8 assay. The intracellular reactive oxygen species （ROS） in each group was determined by enzyme-linked immunosorbent assay （ELISA）. Western blot was employed to determine the protein levels of Nrf2， heme oxygenase-1 （HO-1）， quinone oxidoreductase 1 （NQO1）， cysteine-containing aspartate-specific protease-3 （Caspase-3）， and B cell lymphoma/leukemia-2 （Bcl-2）. Cellular immunofluorescence was employed to detect the expression of Nrf2 and Bcl-2. Real-time quantitative polymerase chain reaction （Real-time PCR） was carried out to examine the mRNA level of Nrf2， Caspase-3， and Bcl-2 associated X protein （Bax）. ResultThe optimal concentration of H₂O₂ for modeling was 50 μmol·L^-1， and the optimal concentration of drug-containing serum was 10%. Compared with the blank group， the modeling decreased the proliferation of cells （P<0.01）， increased the intracellular ROS （P<0.01）， down-regulated the protein levels of Nrf2， HO-1， NQO1， and Bcl-2 （P<0.05， P<0.01）， up-regulated the protein levels of Caspase-3 and Bax （P<0.01）， down-regulated the mRNA level of Nrf2 （P<0.01）， and up-regulated the mRNA levels of Caspase-3 and Bax （P<0.05， P<0.01）. Compared with the model group， Shoutaiwan-containing serum increased the proliferation of cells （P<0.01）， reduced the intracellular ROS （P<0.01）， up-regulated the protein levels of Nrf2， HO-1， NQO1， and Bcl-2 （P<0.01）， down-regulated the protein levels of Caspase-3 and Bax （P<0.05， P<0.01）， up-regulated the mRNA level of Nrf2 （P<0.05）， and down-regulated the mRNA levels of Caspase-3 and Bax （P<0.05， P<0.01）. ConclusionShoutaiwan-containing serum can inhibit H₂O₂-induced apoptosis by activating the Nrf2 signaling pathway and has protective effect on human chorionic trophoblast cells.

ObjectiveTo observe the effect of Zhuluan decoction on the ovarian reserve function of rats with cyclophosphamide-induced premature ovarian insufficiency， and explore the protective mechanism of Zhuluan decoction in the rat model of premature ovarian insufficiency based on the phosphatidylinositol-3-kinases/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway. MethodSixty female SD rats were randomly divided into normal group （n=10） and model group （n=50）. The model group was given intraperitoneal injection of cyclophosphamide （50 mg·kg^-1 loading dose on the 1^st day+8 mg·kg^-1 low-dose maintenance on the 2^nd–15^th days）. After successfully modeling， the rats were randomly divided into model group， positive drug （progynova） group （0.1 mg·kg^-1·d^-1）， and low-， medium-， and high-dose Zhuluan decoction groups （14， 28， 56 g·kg^-1·d^-1 ）， with 10 rats in each group. The model group and the normal group were given equal volume of distilled water by gavage， once a day， continuous administration for 21 d. The estrous cycle and body weight of rats in each group were detected， and the ovarian organ index and uterine organ index were calculated. The ovarian tissue pathology and ovarian follicle counts at all levels were determined by hematoxylin-eosin （HE） staining. The content of the serum antimullerian hormone （AMH）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and inhibin-B （INH-B） of rats was determined by enzyme-linked immunosorbent assay （ELISA）， and the protein expression levels of PI3K， Akt， mTOR in the rat ovarian tissue were determined by Western blot. The microtubule-associated protein 1 light chain 3B （LC3B） protein expression in the rat ovarian tissue was determined by immunohistochemistry. ResultAs compared with the blank group， the estrous cycle of rats in the model group was disordered， the body weight， ovarian organ index， and uterine organ index decreased， the number of primordial follicles decreased， and the number of secondary follicles and atretic follicles increased. In the model group， FSH increased （P<0.01）， LH increased （P<0.05）， AMH level decreased （P<0.05）， the protein expression levels of PI3K， Akt， and mTOR in the ovarian tissue decreased （P<0.01）， and the protein expression level of LC3B increased significantly （P<0.01）. As compared with the model group， the above indexes were improved in the progynova group and different doses of Zhuluan decoction groups， the content of AMH increased （P<0.05）， and FSH decreased （P<0.05）. In the progynova group and different doses of Zhuluan decoction groups， the protein expression level of LC3B decreased obviously （P<0.01）， and the protein expression levels of PI3K， Akt， and mTOR all showed an increasing trend. Moreover， there was a statistically significant difference in the progynova group and low- and medium-dose Zhuluan decoction groups （P<0.05）. ConclusionZhuluan decoction may inhibit the occurrence of excessive autophagy in ovarian granulosa cells by activating the PI3K/Akt/mTOR pathway， thereby reversing the effect of modeling on ovarian reserve in rats.

Objective: To detect norovirus (NoV) GⅠ.1- and GⅡ.4-specific IgG, IgA and histo-blood group antigen (HBGA)-blocking antibodies in healthy populations of all age groups in China for better understanding the epidemiological features of norovirus in China from a serological point of view and providing basic data for vaccine development and clinical trial design. Methods: Indirect ELISA and HBGA-blocking assay were used to detect NoV-specific IgG, IgA and HBGA-blocking antibodies in serum samples collected from healthy natural populations (n=839, aged from six months to 88 years old) in Guangzhou, Fuyang and Yantai. The results were statistically analyzed. Results: The total positive rates of NoV GⅠ.1- and GⅡ.4-specific IgG antibodies were 91.9% and 93.0%. The positive rates of GⅠ.1- and GⅡ.4-specific IgA antibodies were 48.6% and 75.6%, and the titers of HBGA-blocking antibodies to GⅠ.1 and GⅡ.4 norovirus were 5.04 (95%CI: 4.63-5.49) and 18.15 (95%CI: 16.11-20.44). The positive rates of IgG and IgA antibodies generally showed an increasing trend with age. The positive rates of GⅠ.1- and GⅡ.4-specific IgG antibodies ranged from 79.2% to 100.0% and 76.7% to 100.0% in different age groups. They were 81.7% and 85.0% in the age group of 0.5-<1 year, 79.2% and 76.7% in the age group of 1-<2 years, and 98.1% and 96.3% in the age group of 12-<18 years, and maintained at 96% and 98% in the older age groups. The positive rates of GⅠ.1-specific IgA antibody ranged from 11.7% to 93.8% in different age groups and rapidly increased with age. It was 11.7% in the age group of 0.5-<1 year, and reached 93.3% in people aged 45-<60 years and 93.8% in people aged ≥60 years. The positive rates of GⅡ.4-specific IgA antibody ranged from 50.8% to 88.8% in different age groups with 50.8% in people aged 0.5-<1 year, and 86.7%-90.7% in people aged 12-<18 years and older. The titer of GⅠ.1 HBGA-blocking antibody generally increased with age. The antibody titer in populations aged 0.5-<12 years old was lower than that in those aged 18 years and above (GMT: 2.98-4.07 vs 8.21-11.62, P<0.001), and the titer in people of 12-<18 years old was lower than that in those of 45 years old and above (GMT: 5.21 vs 11.03-11.62, P<0.05). No obvious change with age was observed in the titer of GⅡ.4 HBGA-blocking antibody excepting the significant difference between populations of 2-<5 and 22-<45 years old (GMT: 26.73 vs 11.87, P<0.01). Conclusions This study revealed the characteristics of serum NoV GⅠ.1- and GⅡ.4-specific IgG, IgA and HBGA blocking antibodies in populations of different age groups in central and eastern China through analyzing their positive rates and titers and provided preliminary seroepidemiological data for the development of NoV vaccines in China.

Objective To explore the radiological features of intracerebroventricular central neurocytoma and so as to improve the diagnosis of this disease. Methods Thirty patients with pathologically confirmed intra-cerebroventricular central neurocytoma in Nanfang Hospital in past 7 years were analyzed retrospectively for their clinical,radiological and pathological features combined with literatures review. Results Lesions of central neuro-cytoma located at the Monro's foramen areas,the anterior horns and bodies of lateral ventricles.Twenty eight of the patients underwent MRI(with 4 patients received MRS)and 11 patients underwent CT.All cases revealed unilateral or bilateral hydrocephalus of the lateral ventricles and ventriculomegaly.Plain CT revealed heterogeneous isodensity or slighly high density lesions with multiple cystic degeneration,necrosis and calcification while a few lesions(4 le-sions)showed hemorrhage.Heterogeneous isointense or mild hypointense were demonstrated on T1-weight MRI and heterogeneous isointense or slightly hyperintense on T2-weight MRI.Multiple cystic degeneration(always showed as distinctive "soap bubble sign"), necrosis and calcification could also be found within the tumor. The solid compo-nent of tumor revealed slightly high to high signal intensity on DWI while the cystic and necrosis components showed low signal intensity.Most of the tumors showed mild to moderate enhancement with vessels passing through on contrast scan. All cases with 1H MRS showed with obviously increased in Cho peak and decreased in Cr and NAA peaks.In immunohistochemical assay,most of the tumors revealed positive expressions of Neu-N,Synaptophy-sin, GFAP and hypo-level Ki-67. Conclusions The intracerebroventricular central neurocytoma has some typical imaging manifestations.Comprehensive analysis of CT and MRI can be conducive to preoperative diagnosis and dif-ferential diagnosis with other tumors in the lateral ventricle.

Objective To explore the CT findings of gistric schwannoma and analyze the misdiagnosis causes to improve the diagnosis accuracy of the disease. Methods The findings of CT imaging in 15 cases with pathologically proved gistric schwannoma were reviewed restrospectively ,and relevant literatures were reviewed. Results In those 15 cases,3 were men,12 were women,the oldest was 61,the youngest was 33,and the medi-an age was 53.10 cases were located in the greater curvature side of gastric body ,2 cases in the gastric cardia ,3 cases in the diatal.14 cases underwent CT plain and contrast-enhanced scanning while 1 case only underwent CT plain. The 15 cases were single,round lumps with equable density. The performance of 14 routine enhancement scan was characterized by mild uniform strengthing of The arterial period ,further Strengthening of the venous phase,and mild prolonged delay. Conclusion The CT fingings of gistric schwannoma has certain characteristics. It usually occurred in gastric body with single type of circular lump and often presents with equable density. Homo-geneous progressive enhancement on dynamic CT is a characteristic finding of gistric schwannoma.

Objective To explore the CT findings of gistric schwannoma and analyze the misdiagnosis causes to improve the diagnosis accuracy of the disease. Methods The findings of CT imaging in 15 cases with pathologically proved gistric schwannoma were reviewed restrospectively ,and relevant literatures were reviewed. Results In those 15 cases,3 were men,12 were women,the oldest was 61,the youngest was 33,and the medi-an age was 53.10 cases were located in the greater curvature side of gastric body ,2 cases in the gastric cardia ,3 cases in the diatal.14 cases underwent CT plain and contrast-enhanced scanning while 1 case only underwent CT plain. The 15 cases were single,round lumps with equable density. The performance of 14 routine enhancement scan was characterized by mild uniform strengthing of The arterial period ,further Strengthening of the venous phase,and mild prolonged delay. Conclusion The CT fingings of gistric schwannoma has certain characteristics. It usually occurred in gastric body with single type of circular lump and often presents with equable density. Homo-geneous progressive enhancement on dynamic CT is a characteristic finding of gistric schwannoma.

Objective To explore the imaging radiological and clinicopathological characteristics of benign fibrous histiocytoma (BFH) of bone, in order to improve the imaging diagnostic accuracy of the disease Methods Radiological and clinical data of 16 patients with BFH confirmedbypathology were retrospectively analyzed , and relevant literatures were reviewed. Results The X-ray findings of 14 BFHpatients were osteolytic lesion , expansive destruction of bone,without soft tissue involvement, 10 with residual apophysis,9 with osteosclerosis marginal; CT was performed on 2 patients. Expansive destruction of bone and soft tissue densities were seen inside the loops , 1 case remarkable enhancement of the lesion. MRI was performed on 9 patients and 5 cases showed long T1 and T2 signal intensity; 1case showed equal T1 and long T2 signal intensity in cystic part and equal T1 and T2 signal intensity in the solid part. One patient had pathological fracture, and the surrounding soft tissue invaded, showing equal T1 and long T2 signal intensity. Two lesions located at spinous process of cervical vertebra , showing long T1 short T2 and equal T1 and T2 signal intensity. Linear low signal separation shadow in T1 and T2 could be seen in 6 cases. Long T1 and short T2 sclerotic ring were seen in 4 cases. Solid part of tumor and linear separator were obviously enhanced. Conclusions The radiological findings of benign fibrous histioeytoma of bone indicate some characteristics. The combination with X-ray , CT and MRI examination is helpful to improve the diagnostic accuracy of the disease before operation.

Objective To investigate the MSCT imaging of anterior mediastinal primary malignant tumors , and to improve the accuracy of diagnosis. Methods The imaging and clinical data of forty-five patients with anterior mediastinal primary malignant tumors were retrospectively analyzed. Results Among all forty-five cases, there were seventeen thymic carcinomas , and cystic and necrotic earas were seen in all cases. Fourteen were malignant lymphomas with a single irregular soft tissue mass or multiple merged nodules. There were enlarge lymph nodes around the tumors and (or) in other parts of the body. Twelve cases were malignant germinomas, the levels of rinary human chorionic gonadotropin (HCG) or blood armour fetuin (AFP) were abnormal in ten cases, and calcifications were seen in four cases and fat composition was observed in three cases. One malignant solitary fibrous tumor was observed on the left side of the anterior-superior mediastinum with cystic degeneration and necrosis. One was neuroendocrine carcinoma with clear boundary , cystic degeneration and necrosis , after enhanced scanning , it showed ring-shaped reinforcement. Conclusion Anterior mediastinal primary malignant tumors have certain characteristics of MSCT findings , in combination with clinical information , which can help the diagnosis and efficacy evaluation.

Objective Mediastinal primary small cell neuroendocrine carcinoma ( MPSCNC) is a rare neoplasm of high ma-lignant potential mostly affecting elderly and middle-aged males, which has a high rate of misdiagnosis because of its unidentified histo-genesis and lack of obvious characteristic imaging findings .This study was to investigate the CT findings and pathologic features of MP-SCNC, so as to improve the recognition and diagnostic accuracy of the disease . Methods We retrospectively analyzed the imaging and clinicopathologic data about 4 cases of pathologically confirmed MPSCNC and reviewed relevant literature . Results Of the 4 tumors, 2 were located in the anterior-middle-superior mediastinum , 1 in the anterior-superior mediastinum , and the other in the mid-dle-superior mediastinum .Three of them exhibited irregular shape , unclear boundary , and inhomogeneous density , with low-density cyst degeneration and necrosis , of which two had scattered punctate calcifications .Enhanced scanning revealed moderate uneven en-hancement in 3 cases and ring-shaped enhancement the other .Pathological findings showed small tumor cells with marked pleomor-phism, little cytoplasm, pale chromatin, inconspicuous or absent nucleoli , and obvious mitotic figures.Immunochemistry manifested positive CgA, Syn, and CK in all the 4 cases, positive NSE, CD56, and Ki-67 in 3 cases, and positive epithelial membrane antigen in 1. Conclusion A tumor located in the anterior-middle mediastinum with scattered punctate calcifications and compressing or inva-ding the adjacent mediastinal structures should be suspected as a small cell neuroendocrine carcinoma . However , definite diagnosis should be based on histopathologic and immunohistochemical exami-nations .

Objective To investigate the effect of dexmedetomidine on the stress responses during wakeup test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.Methods Thirty-six ASA physical status Ⅰ or Ⅱ patients,undergoing cerebral functional area operation requiring wake-up test,aged 18-60 yr,weighing 50-70kg,were randomly divided into control group (group C) or dexmedetomidine group (group D) with 18 cases in each group.Dexmedetomidine 0.8 μg/kg was infused over 10 min before induction of anesthesia followed by infusion at 0.4 μg·kg-1 · h-1 in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with target-controlled infusion of propofol and remifentanil and iv injection of cisatracurium.At 30 min prior to wake-up test,target-controlled infusion of propofol and application of mulscle relaxants were stopped,the target plasma concentration of remifentanil was decreased to 1 ng/ml,and in group D the infusion rate of dexmedetomidine was decreased to 0.1 μg·kg 1· h-1.Anesthesia time and consumption of anesthetics before wake-up test,wake-up time,and development of complications and intraoperative awareness during wake-up test were recorded.At 30 min prior to wake-up test (T1),immediately after wake-up (T2),at 5 min after wake-up (T3),and at 10 min after the anesthetic depth was deepened (T4),HR,mean arterial pressure and BIS value were recorded and blood samples were taken for determination of plasma concentrations of epinephrine (E) and norepinephrine (NE).Results Compared with group C,the consumption of propofol and remifentanil was significantly reduced before wake-up,the incidence of hypertension was decreased during wake-up test,and HR and plasma E and NE concentrations were decreased at each time point (P ＜ 0.05),and no significant difference in mean arterial pressure and BIS value was found in group D (P ＞ 0.05).Tachycardia,restlessness,bucking and awareness were not observed during wake-up test in group D.Conclusion Dexmedetomidine can inhibit the stress responses during wake-up test and raise the quality of wake-up test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.