ObjectiveTo explore the effect of modified Ditan Decoction （涤痰汤） on chronic intermittent hypoxia cognitive function and the potential function mechanism. MethodsTwenty-four Sprague-Dawley （SD） rats were randomly divided into a normal group， a model group， and a modified Ditan Decoction group， with eight rats in each group. Rats in the modified Ditan Decoction group were administered the decoction by gavage at 14.8 ml/（kg·d）， while the normal group and the model group received the same dose of normal saline. Thirty minutes after daily gavage， the rats in all three groups were placed in an intermittent hypoxia chamber. The oxygen concentration for the model group and the modified Ditan Decoction group was adjusted daily for 8 hours using a computer program to establish the model， while the normal group was exposed to the same airflow rate of ambient air. The intervention was continued for 12 weeks to establish a chronic intermittent hypoxia rat model. The Y-maze test was used to evaluate spatial working memory in the rats. Resting-state functional magnetic resonance imaging （rs-fMRI） was performed to detect whole-brain regional homogeneity （ReHo） and seed-based functional connectivity （FC）. Brain regions showing significant differences in rs-fMRI were selected for further analysis. Immunofluorescence was used to detect β-amyloid （Aβ） deposition and the number of ionized calcium-binding adapter molecule 1 （IBA1）-positive microglial cells. Immunohistochemistry was employed to assess the expression of synaptophysin （SYP）， the excitatory synapse marker vesicular glutamate transporter 1 （Vglut1）， and the inhibitory synapse marker vesicular γ-aminobutyric acid transporter （VGAT）. ResultsCompared with the normal group， the model group showed a reduced spontaneous alternation rate in the Y-maze test. The smoothed Z-score standardized regional homogeneity （SzReHo） value in the left entorhinal cortex significantly increased， and the FC value from this seed point to the left basal forebrain significantly reduced. Additionally， the model group exhibited significantly higher Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， decreased expression of SYP， Vglut1， and VGAT， along with an increased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. Compared to the model group， the modified Ditan Decoction group demonstrated an increased spontaneous alternation rate， a significantly reduced SzReHo value in the left entorhinal cortex， and a significantly increased FC value from this region to the left basal forebrain. Furthermore， this group showed significantly lower Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， increased levels of SYP， Vglut1， and VGAT， and a decreased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. ConclusionModified Ditan Decoction can reconstruct the projection from the left basal forebrain to the entorhinal cortex in chronic intermittent hypoxia， thereby reducing Aβ aggregation and excessive microglial activation in the left entorhinal cortex. This process improves the excitation/inhibition imbalance caused by synaptic remodeling， ultimately enhancing cognitive function in rats of chronic intermittent hypoxia.

Abstract Glutamate receptors are widely distributed in the central nervous system(CNS) and participate in the delivery of excitatory neurotransmitters, including ionotropic glutamate receptors and metabotropic glutamate receptors. Metabotropic glutamate receptors(mGluRs) regulate neuronal excitability and synaptic plasticity, and are classified into group Ⅰ, Ⅱ and Ⅲ. The roles of group Ⅰ mGluRs in psychiatric and neurodegenerative diseases have been extensively studied, especially in the pathological progression of acute brain injury. Several studies have shown that group Ⅰ mGluRs can be involved in eliminating inflammatory damage, suppressing cell apoptosis, regulating neural network disorders, and promoting brain function recovery after acute brain injury. Therefore, group Ⅰ mGluRs have the potential to be effective targets for the treatment of acute brain injury. This paper reviews the distribution and function of group Ⅰ mGluRs in CNS, the pathological role in acute brain injury, and explore the potential of the development of drugs targeting group Ⅰ mGluRs.

Objective:To investigate the effect of histone deacetylase inhibitor trichostatin A(TSA) on the lipopolysaccharide(LPS)-induced injury and apoptosis of human microvascular endothelial cell(HMEC).Methods:HMECs were used as research cells to establish LPS-induced septic cell model, which were divided into three groups according to different treatments: control group (150 μL of phosphate buffer), LPS group (150 μL of 5 μg/mL LPS), LPS+ TSA group (150 μL of 5 μg/mL LPS and 500 μg/L TSA). After cells of each group were cultured for 24 h and 48 h, the concentration of lactate dehydrogenase(LDH)in the culture supernatant was detected by enzyme-linked immunosorbent assay and the apoptosis rate of HMECs was detected by Annexin V-FTTC/PI staining, then comparison between different groups were made.Results:Compared with the control group, LDH concentration in LPS group increased significantly at 24 h[(4.67±1.27) ng/L vs. (11.57±0.83) ng/L ] and 48 h[(7.93±0.80) ng/L vs. (12.72±0.89) ng/L ]; Compared with LPS group, LDH concentration in LPS + TSA group decreased significantly at 24 h[(6.01±0.29) ng/L ] and 48 h[(5.96±0.27) ng/L ], and the differences were statistically significant ( P<0.05). Compared with the control group, the apoptosis rates of HMEC cells in LPS group were significantly higher at 24 h[(0.92±0.89)% vs. (1.66±0.09)% ] and 48 h[(1.09±0.14)% vs. (5.01±0.16)%]; Compared with LPS group, the apoptosis rate of HMEC cells in LPS + TSA group significantly decreased at 24 h[(1.36±0.01)% ] and 48 h[(4.19±0.23)% ], the differences were statistically significant ( P<0.05). Conclusion:TSA has the protective effect of reducing cell injury and apoptosis in sepsis.

BACKGROUND: LINC01234, a long noncoding RNA (lncRNA), is overexpressed in several cancers, including colorectal cancer (CRC). We investigated the role of LINC01234 in CRC development and confirmed its correlation with Krüppel-like factor 6 (KLF6), a tumor suppressor gene that is dysregulated in CRC. METHODS: We tested mRNA levels using quantitative reverse transcription PCR (qRT-PCR). Tissue samples from patients with CRC, inflammatory bowel disease (IBD), hyperplastic polyp, and adenoma were included. Correlations between clinicopathological parameters, overall survival (OS) rate, and LINC01234 were analyzed using Kruskal-Wallis H test. Additionally, cell proliferation, apoptosis, and tumor formation in nude mice were tested to investigate the mechanism of LINC01234. Western blotting was used to determine protein levels. RESULTS: LINC01234 expression was significantly upregulated in CRC tissues and CRC cell lines than in non-tumor tissues and normal epithelial cells, respectively. LINC01234 was associated with high tumor stage, larger tumor size, and metastasis. Patients with higher LINC01234 expression showed reduced OS. Cell proliferation was inhibited by LINC01234 knockdown, whereas apoptosis was enhanced. Mice injected with SW480 cells with LINC01234 knockdown displayed decreased tumor volume, weight, and Ki-67 levels compared with those injected with control cells. KLF6 was negatively regulated by LINC01234. Overexpression of KLF6 showed effects similar to those observed following LINC01234 knockdown on cell proliferation and apoptosis. CONCLUSIONS LINC01234 could be a prognostic biomarker in CRC patients. Upregulation of LINC01234 in CRC promotes tumor development through negative regulation of KLF6.

Objective To evaluate the postoperative imaging features of lung ultrasound on patients undergoing lung transplantation ,and to provide the evidence for diagnosis and therapy . Methods Between October 2016 and March 2017 ,51 patients undergoing lung transplantation ( unilateral:37 ,bilateral:14 ) admitted to the ICU in Wuxi People′s Hospital were examined by bedside lung ultrasound ,and imaging features were analyzed . Results The main features on ultrasound of 51 patients undergoing lung transplantation were:①Pneumothorax :The A-line arising at the pleural line was shown in all of 51 patients , mainly on anterolateral parts of the chest wall initially ,then fade away towards anterosuperior parts over time . ② Hydrothorax :An anechoic fluid collection was detected ( up to 50 mm in width ) ,and became narrow over time in most patients . A mass of floccules or progressive growth of pleural effusion indicated the need for emergency surgery ,and were confirmed bleeding after surgery . ③Subcutaneous emphysema:The E-line was detected mainly in anterior and lateral parts around the surgical incision of postoperative patients ,and gradually fade away over time . ④Pulmonary edema:On the first postoperative day ,multiple B-lines were shown in 49 cases ,lung consolidation in 36 cases ( mainly in the inferior and inferoposterior parts) ,lung consolidation sonographic air bronchogram in 12 cases . Then the area of consolidation and B-lines reduced ,the air bronchogram sign became more prevalent ,and the shred sign appeared on the border of consolidation over time . Conclusions The imaging features of lung ultrasound provides clinic diagnostic and therapeutic value for postoperative patients undergoing lung transplantation .

Objective To compare the clinical and ultrasound features of Klebsiella pneumoniae liver abscess(KPLA) in dia‐betes mellitus(DM ) patients with different levels of HbA1c .Methods Totally 146 patients with diabetes mellitus of Klebsiella pneumoniae liver abscesses(KPLA‐DM )were divided into three groups on the basis of their levels of HbA1c:complete glycemic controlled (HbA1c≤7% );good glycemic controlled (7% < HbA1c≤9% );bad glycemic controlled (HbA1c>9% ) .The patients′characteristics ,clinical features ,ultrasound features and complications among the three groups were compared .Results Compared with patients in complete glycemic controlled group and good glycemic controlled group ,patients in bad glycemic controlled group had lower onset age and longer length of hospital stay(P<0 .05) ,are more susceptible to underlying diseases such as hyperlipoi‐demia and chronic renal failure(P<0 .05) ,had more life‐threatening clinical crisis ,and had higher infection rate(P<0 .05) .KPLA‐DM could be characterized by patchy ,mass like enhancement echoultrasound image .Patients in bad glycemic controlled group al‐so had higher risk of biliary pneumatosis ,hepatic venous thrombosis and gas‐forming pyogenic liver abscess than other two groups (P<0 .05) .Conclusion The ultrasound image of KPLA has characteristics .The occurrence of hepatic venous thrombosis and gas‐forming observed by ultrasound is associated with bad glucose control in KPLA‐DM patients ,which suggests that there may be oth‐er complications such as metastatic infection .

Objective To explore development status in different types of the hand bone and its developmental characteristics with Poland syndrome.Methods There were 32 cases with Poland's syndrome who accepted bilateral hand X-ray examination in Department of Hand Surgery,Beijing Jishuitan Hospital from February 2013 to August 2014.There were 24 male and 8 female patients aged from 1.0 to 15.0 years with median age of 2.4 years.Right hand deformity was 23 cases and left hand deformity was 9 cases.According to Tanner-Whitehouse skeletal age scoring system,20 bones (radius and ulna,7 carpal bones,11 metacarpal and phalangeal bones) selected from the affected and contralateral limb respectively,were evaluated.Besides,hand deformity of the cases was classified into 5 types based on relevant literature.Each bone was given an individual age using the references of Greulich-Pyle chart.The average of all individual ages was taken as gross bone age,the average of individual ages of radius and ulna was taken as bone age of long bones,the average of individual ages of carpal bone was taken as bone age of carpal bones,and the average of individual age of metacarpal and phalangeal bones was taken as bone age of short bones.The delay of bone age was evaluated by correlation test,while the curve of cubic equation was used for analyzing the variance of skeletal development with age.Results The delay of long bone age of patients with Poland's syndrome in this study were 0-1.9 years ((0.5 ±0.5) years),0-2.2 years ((0.7 ±0.5)years) for carpal bone,0.5-2.0 years((0.6 ±0.4) years)for short bone and 0.1-1.7 years((0.6 ±0.4)years) for gross bone.Twelve cases in type Ⅱ hand deformity,15 cases in type Ⅲ and 5 cases in type Ⅳ.The delay of bone ages,including long bone age,carpal bone age,short bone age and gross bone age,was not related with gender and side(all P ＞ 0.05),but related with degree of deformity(F =3.663-12.971,P =0.000-0.038).Conclusion Compared with normal upper limb,the bone age in the affected limb in Poland's syndrome is delayed and it is correlated with gender,age and the extent of hand deformity and negative with side.

Objective To explore development status in different types of the hand bone and its developmental characteristics with Poland syndrome.Methods There were 32 cases with Poland's syndrome who accepted bilateral hand X-ray examination in Department of Hand Surgery,Beijing Jishuitan Hospital from February 2013 to August 2014.There were 24 male and 8 female patients aged from 1.0 to 15.0 years with median age of 2.4 years.Right hand deformity was 23 cases and left hand deformity was 9 cases.According to Tanner-Whitehouse skeletal age scoring system,20 bones (radius and ulna,7 carpal bones,11 metacarpal and phalangeal bones) selected from the affected and contralateral limb respectively,were evaluated.Besides,hand deformity of the cases was classified into 5 types based on relevant literature.Each bone was given an individual age using the references of Greulich-Pyle chart.The average of all individual ages was taken as gross bone age,the average of individual ages of radius and ulna was taken as bone age of long bones,the average of individual ages of carpal bone was taken as bone age of carpal bones,and the average of individual age of metacarpal and phalangeal bones was taken as bone age of short bones.The delay of bone age was evaluated by correlation test,while the curve of cubic equation was used for analyzing the variance of skeletal development with age.Results The delay of long bone age of patients with Poland's syndrome in this study were 0-1.9 years ((0.5 ±0.5) years),0-2.2 years ((0.7 ±0.5)years) for carpal bone,0.5-2.0 years((0.6 ±0.4) years)for short bone and 0.1-1.7 years((0.6 ±0.4)years) for gross bone.Twelve cases in type Ⅱ hand deformity,15 cases in type Ⅲ and 5 cases in type Ⅳ.The delay of bone ages,including long bone age,carpal bone age,short bone age and gross bone age,was not related with gender and side(all P ＞ 0.05),but related with degree of deformity(F =3.663-12.971,P =0.000-0.038).Conclusion Compared with normal upper limb,the bone age in the affected limb in Poland's syndrome is delayed and it is correlated with gender,age and the extent of hand deformity and negative with side.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of BI-RADS-US 4 breast lesions.Methods A total of 123 lesions underwent CEUS.The CEUS features of lesions were categorized into 5 malignant or benign indexes respectively,lesions displaying any two of the five features were diagnosed as malignant or benign.The diagnostic effect of CEUS for BI-RADS-US 4 lesion was analyzed according to the pathological results as the gold standard.Results CEUS of the 123 BI-RADS-US 4 breast lesions indicated that 75 lesions were malignant while 48 were benign.Pathological results confirmed that there were 72 malignant lesions and 51 benign.The proportions of malignant lesions in 4A category,4B category and 4C category were 16.2 ％,58.5 ％ and 93.3 ％ respectively.The accuracy,sensitivity,specificity,positive predictive value,and negative and positive predictive value of CEUS for the diagnosis of BI-RADS-US 4 lesions were calculated as 92.7％,95.8％,88.2％,92.0％ and 93.7 ％ respectively.Lesions showing false positive in CEUS mainly needed surgical treatment,such as fibroma with active growth mesen-chyme,intraductal papilloma and granulomatous mastitts.Conclusions Surgical treatment rather than aspiration biopsy are suggested for those diagnosed being malignant in CEUS of the BI-RADS-US-4 lesions,as they can be treated as BI-RADS5 lesions.Short-term visit or aspiration biopsy are suggested for BI-RADS-US-4 lesions diagnosed being benign in CEUS.

ObjectiveTo study the correlation between contrast-enhanced ultrasound (CEUS) features and Nottingham prognostic index (NPI) in patients with breast carcinoma. Methods The ultrasound features and microvascular imaging manifestation of 91 breast carcinomas confirmed by pathology were retrospectively analyzed.NPI was typically stratified into 3 major groups:NPI ＜ 3.4 ( n =19 ), NPI:3.4-5.4 ( n =52 ) and NPI ＞5.4(n =21 ). Results With the increase of NPI, the rate of heterogeneous enhancement, perfusion defects, edge enhancement higher than center enhancement, and unclear border increased.The difference among the 3 groups had statistical significance (P ＜ 0.05 ).There was no significant difference in enhancement order among the 3 groups ( P ＞ 0.05 ).The lesions of the 3 groups were mainly “high enhancement” and there was no significant difference among the 3 groups ( P ＞ 0.05 ).With the increase of NPI, the rate of early enhancement and late regression increased.The difference among the 3 groups had statistical significance ( P ＜ 0.05 ).With the increase of NPI, the rate of enlarged and twisted vessels as well as peripheral vessel burr increased.There was significant difference among the 3 groups ( P ＜ 0.05 ).ConclusionCEUS festures and microvescular architecture pattern of breast carcinoma are related to NPI, which is useful in predicating the prognosis of breast carcinoma.