OBJECTIVES: The neurotoxicity of carbon monoxide (CO) to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Our previous study found that retinoic acid (RA) can suppress the neurotoxic effects of CO. This study further explores, in vivo and in vitro, the molecular mechanisms by which RA alleviates CO-induced central nervous system damage. METHODS: A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO, and a DEACMP animal model was established in adult Kunming mice. Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and Annexin V/propidium iodide (PI) double staining. The transcriptional and protein expression of each gene was detected using real-time fluorescence quantitative PCR (RT-qPCR) and Western blotting. Long noncoding RNA (lncRNA) SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes. In DEACMP mice, SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression. RESULTS: RA at 10 and 20 μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes, downregulation of SNHG15 and LINGO-1, and upregulation of brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) (all P<0.05). Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity (all P<0.05). Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels (all P<0.05). Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP (all P<0.05). CONCLUSIONS RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes, thereby reducing central nervous system injury and exerting neuroprotective effects. LncRNA SNHG15 and LINGO-1 are key molecules mediating RA-induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway. These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.
Animals ; RNA, Long Noncoding/physiology* ; Brain-Derived Neurotrophic Factor/genetics* ; Carbon Monoxide Poisoning/complications* ; Mice ; Tretinoin/pharmacology* ; Nerve Tissue Proteins/metabolism* ; Membrane Proteins/metabolism* ; Apoptosis/drug effects* ; Hippocampus/cytology* ; Receptor, trkB/metabolism* ; Neurons/drug effects* ; Male ; Brain Diseases/etiology* ; Oligodendroglia/drug effects* ; Signal Transduction ; Cell Line

Objective:Delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)is the most severe complication of carbon monoxide poisoning,which seriously endangers patients'quality of life.This study aims to investigate the efficacy of hyperbaric oxygen(HBO2)on improving dementia symptoms in patients with DEACMP. Methods:A retrospective analysis was performed on DEACMP patients,who visited Xiangya Hospital,Central South University from June 2014 to June 2020.Among them,patients who received conventional drug treatment combined with HBO2 treatment were included in an HBO2 group,while those who only received conventional drug treatment were included in a control group.HBO2 was administered once daily.Patients in the HBO2 group received 6 courses of treatment,with each course consisting of 10 sessions.The Hasegawa Dementia Scale(HDS)was used to diagnose dementia,and the Clinical Dementia Rating(CDR)was used to grade the severity of dementia for DEACMP.The Alzheimer's Disease Assessment Scale-Cognitive Section(ADAS-Cog),the Functional Activities Questionnaire(FAQ),the Neuropsychiatric Inventory(NPI),and the Clinician's Interview-Based Impression of Change-Plus Caregiver Input(CIBIC-Plus)were performed to assess cognitive function,ability to perform activities of daily living(ADL),behavioral and psychological symptoms,and overall function.The study further analyzed the results of objective examinations related to patients'dementia symptoms,including magnetic resonance imaging detection of white matter lesions and abnormal electroencephalogram(EEG).The changes of the above indicators before and after treatment,as well as the differences between the 2 groups after treatment were compared. Results:There was no significant difference in the HDS score and CDR grading between the 2 groups before treatment(both P＞0.05).After treatment,the score of ADAS-Cog,FAQ,NPI,and CIBIC Plus grading of the 2 groups were significantly improved,and the improvement of the above indicators in the HBO2 group was greater than that in the control group(all P＜0.05).The effective rate of the HBO2 group in treating DEACMP was significantly higher than that of the control group(89.47% vs 65.87%,P＜0.05).The objective examination results(white matter lesions and abnormal EEG)showed that the recovery of patients in the HBO2 group was better than that in the control group. Conclusion:Hyperbaric oxygen can significantly relieve the symptoms of dementia in patients with DEACMP.

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

Objective:To investigate the clinicopathological features of central nervous system (CNS) mesenchymal chondrosarcoma (MCS).Methods:Nine cases of CNS MCS were collected at the First Affiliated Hospital of Fujian Medical University from September 2010 to September 2020. The clinical,imaging,histopathological and immunohistochemical features were reviewed. NCOA2 gene rearrangement was evaluated by fluorescence in situ hybridization (FISH).Results:There were three male and six female patients, with age range of 1 to 59 years (median 31 years). Six cases were intracranial and three cases were intraspinal, and the tumors showed dural attachment. They were often diagnosed as meningioma basing on preoperative imaging. Microscopically, the tumors showed a characteristic biphasic histologic pattern composed of undifferentiated mesenchymal small cells and well-differentiated hyaline cartilage islands. The small cells area were positive for SOX9 (9/9), CD99 (8/9), and without BRG1 and INI1 deletion. The cartilaginous component expressed SOX9 (9/9) and S-100 protein (8/9). NCOA2 gene break apart signal was identified in five cases (5/5). Eight patients were followed up for 4-124 months. Three patients (3/8) had recurrences within one year and two patients died of the tumor.Conclusions:CNS MCS is an extremely rare malignant neoplasm with a propensity to dural involvement. Preoperative imaging has low diagnostic accuracy. CNS MCS should be differentiated from other CNS small round cell tumors and chondrosarcoma. FISH detection of NCOA2 gene rearrangement will assist the diagnosis of MCS.

Objective To investigate the clinical effect of hyperbaric oxygen (HBO) on the patients with androgenetic alopecia (AGA).Methods A total of 71 patients with AGA admitted into the Xiangya Hospital from January 2014 to December 2016 were enrolled for the study,and were divided into the HBO group (n =38) and control group (n =33),according to different treatment methods.The patients in the control group were treated with conventional drugs,while the patients in the HBO group received HBO therapy in addition to the treatment received by the control group.Following 6 courses of treatment,therapeutic effects were compared between the patients of the 2 groups.Therapeutic effects were evaluated by using hair loss and new hair growth scores,Dermatology Life Questionnaire Index (DLQI) and Hamilton Depression Rating Scale (HAMD),and the levels of free testosterone (FT) and 5α-dihydrotestosterone (5α-DHT) were detected before and after treatment.Results Following 6 courses of treatment,the therapeutic efficacy of the HBO group (90.91％) was significantly higher than that of the control group (70.53％)(P ＜ 0.05),As compared with the scores before treatment,the hair loss scores of the 2 groups all decreased obviously,and the scores of the HBO group were considerably lower than those of the control group,with statistical significance (P ＜ 0.05 or P ＜0.01).As compared with the scores before treatment,the new hair growth scores of the 2 groups all decreased obviously,and the scores of the HBO group were obviously lower than those of the control group,also with statistical significance (P ＜ 0.05 or P ＜ 0.01).The DLQI scores of the 2 groups all significantly elevated,and those of the HBO group were markedly higher than those of the control group,with statistical significance (P ＜0.05 or P ＜0.01).The HAMD scores of the 2 groups all decreased significantly,and those of the HBO group were obviously lower than those of the control group,also with statistical significance (P ＜ 0.01).After 6 courses of treatment,the levels of FT and DHT in the patients of the 2 groups all considerably dropped,as compared with those before treatment (P ＜ 0.01).However,after HBO treatment,no significant differences could be noted in the levels of FT and DHT in the HBO group,as compared with the control group (P ＞ 0.05).Conclusion Comprehensive HBO therapy could further improve clinical efficacy on the patients with AGA,reduce hair loss,increase new hair growth,improve the emotion of the patients with depression,and could ultimately increase their daily life quality.

Objective To investigate the clinical effect of hyperbaric oxygen (HBO) on the patients with androgenetic alopecia (AGA).Methods A total of 71 patients with AGA admitted into the Xiangya Hospital from January 2014 to December 2016 were enrolled for the study,and were divided into the HBO group (n =38) and control group (n =33),according to different treatment methods.The patients in the control group were treated with conventional drugs,while the patients in the HBO group received HBO therapy in addition to the treatment received by the control group.Following 6 courses of treatment,therapeutic effects were compared between the patients of the 2 groups.Therapeutic effects were evaluated by using hair loss and new hair growth scores,Dermatology Life Questionnaire Index (DLQI) and Hamilton Depression Rating Scale (HAMD),and the levels of free testosterone (FT) and 5α-dihydrotestosterone (5α-DHT) were detected before and after treatment.Results Following 6 courses of treatment,the therapeutic efficacy of the HBO group (90.91％) was significantly higher than that of the control group (70.53％)(P ＜ 0.05),As compared with the scores before treatment,the hair loss scores of the 2 groups all decreased obviously,and the scores of the HBO group were considerably lower than those of the control group,with statistical significance (P ＜ 0.05 or P ＜0.01).As compared with the scores before treatment,the new hair growth scores of the 2 groups all decreased obviously,and the scores of the HBO group were obviously lower than those of the control group,also with statistical significance (P ＜ 0.05 or P ＜ 0.01).The DLQI scores of the 2 groups all significantly elevated,and those of the HBO group were markedly higher than those of the control group,with statistical significance (P ＜0.05 or P ＜0.01).The HAMD scores of the 2 groups all decreased significantly,and those of the HBO group were obviously lower than those of the control group,also with statistical significance (P ＜ 0.01).After 6 courses of treatment,the levels of FT and DHT in the patients of the 2 groups all considerably dropped,as compared with those before treatment (P ＜ 0.01).However,after HBO treatment,no significant differences could be noted in the levels of FT and DHT in the HBO group,as compared with the control group (P ＞ 0.05).Conclusion Comprehensive HBO therapy could further improve clinical efficacy on the patients with AGA,reduce hair loss,increase new hair growth,improve the emotion of the patients with depression,and could ultimately increase their daily life quality.

Objective To investigate the distribution characteristics and changing tendency of urinary tract stones.Methods From January 2011 to May 2017,clinical data of 15 269 patients treated in our center was retrospectively reviewed.The stone components were detected by the automatic stone infrared spectroscopy system and the predominant components were recorded.There were 9 019 male patients and 6 250 female patients.The patients were divided into four groups according to their age,including group A ≤ 18 years;group B 19-40 years;group C 41-60 years;and group D ＞ 60 years.Compared the distribution characteristics of urinary tract stones of patient in different groups of sex,age and calendar year.Results Calcium oxalate stones were more prevalent in males than females [6 221 (69.0％)vs.3 582 (57.3％),P ＜ 0.001],but calcium phosphate stones [210 (3.4％) vs.210 (2.3％)],magnesium ammonium phosphate stones [230(3.7％) vs.165 (1.8％)] and carbonate apatite stones [1 328 (21.3％) vs.1 030 (11.4％)] were more common in females than males (P ＜ 0.001,respectively).The proportion of uric acid stones in group D [679(20.7％)] was higher than that in group A [23(9.1％)],group B[260(7.9％)],group C [1 163 (13.8％)] (P ＜0.001,respectively).The peak of carbonate apatite stones was showed in group B [652(19.7％)] (P＜0.001,respectively).Ammonium urate stones [9(3.5％)] and cystine stones [36 (14.2％)] were more frequent in group A(P ＜0.001,respectively).In adults,the percentage of uric acid stones increased with age,such as group B [260(7.9％)],group C [1 163(13.8％)],group D [679 (20.7％)].And the carbonated apatite stones decreased with age,such as group B [652 (19.7％)],group C [1 270(15.1％)],group D [416(12.7％)] (P ＜0.001,respectively).Further analysis showed the proportion of calc ium oxalate (OR =0.944,95 ％ CI 0.927-0.962,P ＜ 0.001),ammonium urate stones (OR =0.854,95％ CI 0.742-0.982,P =0.027) decreased,while calcium phosphate (OR =1.192,95％ CI 1.127-1.261,P ＜0.001),uric acid (OR =1.042,95％ CI 1.015-1.069,P =0.002) and ammonium magnesium phosphate (OR =1.078,95％ CI 1.019-1.141,P =0.009) stones increased with time.Conclusions The distribution of stones was different in genders and age.Calcium oxalate stones were more common in male patients,while ammonium magnesium phosphate and carbonate apatite stones were more common in female patients.Uric acid stones were more frequent in patients older than 60,while carbonate apatite were more frequent in the 19-40 age group.The proportion of calcium oxalate and ammonium urate stones showed a downward trend,whereas calcium phosphate,uric acid and magnesium ammonium phosphate stones increased with time.

OBJECTIVE: To explore the method of the controlled synechiae technique to maintain the stability of middle turbinate (MT), reduce the incidence of middle meatus synechia formation and improve the treatment effect of endoscopy surgery. METHOD: Eighty-six patients with chronic sinusitis were randomly divided into control group and treatment group in this study. In control group, the patients received extended nasal packing in middle meatus until 1 week after surgery. In treatment group, the patients received the controlled synechiae technique. RESULT: The MT position was described as stable, slight drifting laterally and synechia formation. And the incidence of synechia between MT and the nasal lateral wall was 29.4% and 14.9% in control group and treatment group,respectively. The differences were significant (P < 0.05). CONCLUSION For those patients with anatomic variation, destruction or weak supporting structures resulted from previous surgery, the controlled synechiae technique is very useful in preventing lateralization of the middle turbinate after endoscopy surgery.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; methods ; Postoperative Complications ; prevention & control ; Suture Techniques ; Tissue Adhesions ; Turbinates ; surgery ; Young Adult

Objective To investigate the effects of morroniside on hydrogen peroxide (H2O2)-induced calcium overload and cytotoxicity in SH-SY5Y neuroblastoma cells. Methods SH-SY5Y cells were pre-incubated with morroniside 1, 10, or 100 μmol/L for 24 h prior to exposure to H2O2 300~500 μmol/L for 18 h. The cytosolic free calcium concentration and LDH release were determined. Results The H2O2-induced cytosolic free calcium concentration decreased in the cells pre-incubated with morroniside 10 or 100 μmol/L, while the LDH release level decreased in the cells pre-incubated with morroniside 1, 10 or 100 μmol/L, comparison with the cells exposed H2O2 along. Conclusion Morroniside effects neuroprotection against H2O2-induced calcium overload and cytotoxicity in SH-SY5Y cell.

Objective To give a clear definition of professional exposure to HIV and map out the preventive strategies. Methods To propose the preventive strategies for preventing professional exposure to HIV according to the relative knowledge and the practical nursing measures. Results The preventive strategies include the recognition from the administrative authority, care about the exposure suits for preventing HIV , the establishment of a reasonable by law, properly handling the wound when exposure happen and report the accident to local CDC and arrange HIV test at 4,8,12 week and 6 month after exposures. Conclusions The medical staff lack the knowledge of preventing professional exposure to HIV, the intensive training is urgently needed. It is better to involve the professional HIV exposure as one of the professional injuries by law in order to relieve the medical staff′s anxieties about HIV exposure during the course of working.