Cerebral ischemia-reperfusion injury(CIRI)is an important component of ischemic stroke,specifically referring to the phenomenon where reperfusion exacerbates tissue damage after the restoration of blood flow.The underlying mechanisms involve factors such as free radical damage,calcium overload,and in-flammatory damage.Currently,there are no particularly effective treatments for this injury clinically.Phos-phatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling is a classical cellular pathway that regulates downstream substrates through Akt phosphorylation to regulate cell growth,differentiation,and apoptosis.Studies have shown that PI3K/Akt is involved in regulating multiple forms of programmed cell death inclu-ding apoptosis within the organism,and this pathway plays a role in antioxidant stress and anti-inflammatory responses during the process of combating CIRI.This review summarizes recent advances of PI3K/Akt path-way in CIRI regulation,this paper provides new ideas and reference for basic and clinical research.

Objective To discuss the technical advantages of MRI image fusion technology in guiding percutaneous balloon compression(PBC)for trigeminal neuralgia(TN).Methods The clinical data of 13 patients with TN,who received MRI image fusion technology-guided PBC from November 2022 to July 2023,were retrospectively analyzed.The MRI images of the trigeminal nerve obtained one week before surgery were fused with the intraoperative DynaCT images of the skull base so as to simultaneously display the Meckel s cave and foramen ovale,and under the 3-D view the optimal puncture path was determined.The needle was positioned at the entry point of the skin,than the skin was cut open with a sharp surgical blade and the needle was inserted to the foramen ovale area to a predetermined depth.Lateral skull base fluoroscopy and DynaCT scan were used to check that the puncture needle tip was placed into the foramen ovale.Than the puncture needle was replaced by a fine guiding-needle and it was pushed into the Meckel's cave.Under the dual guidance of lateral fluoroscopy and fusion image,the balloon was push forward and was filled with iodine contrast media to compress the trigeminal ganglion within the Meckel's cave.After completion of the treatment,the balloon and puncture needle were removed and manual oppression was applied on the face to achieve hemostasis.Results Immediately after PBC,the pain was relieved in all patients.No permanent or serious complications occurred.One patient had a relapse 3 months after PBC and a second PBC procedure had to be carried out.No obvious pain recurrence was observed in the remaining patients during follow-up period.During the surgery,the mean number of foramen ovale puncturing was(1.31±0.46)times,the mean X-ray exposure time was(8.64±5.66)min,and the mean cumulative dose of X-ray was(570.29±257.15)mGy.After PBC,12 patients(92.31％)developed facial numbness and one patient(7.69％)developed facial pain,all of which were healed after treatment.Conclusion MRI image fusion technology can improve the visualization and accuracy of PBC procedure.It can also reduce the number of puncturing,decrease the radiation exposure dose,and improve the surgical ability of young doctors.Therefore,MRI image fusion technology should be further developed and applied in clinical practice.

Objective To observe the efficacy of self-guided attention network for detecting responsible lesions related to cerebral palsy(CP)in children with periventricular white matter injury(PVWMI).Methods Totally 383 children with PVWMI were retrospectively enrolled and divided into CP group(n=243)and non-CP group(n=140),while 214 children without obvious brain abnormality on brain MRI were taken as control group.ROI of 4 key anatomical structures related to CP,i.e.centrum semiovale,posterior limb of internal capsule,cerebral peduncle and thalamus were delineated on T1WI,while responsible lesions related to CP within the key anatomical structures were labeled on T2WI,and the images were then registrated and used as input of the networks.ResNet34 network was adopted combined with attention and self-guided networks to train the network for detecting responsible lesions related to CP in children with PVWMI,and their efficacies were evaluated.The optimal network was screened,and its efficacy for segmenting the key anatomical structures was evaluated.Results Self-guided attention network was the optimal network,its area under the curve(AUC)for detecting lesions was 0.794-0.914,and the Dice similarity coefficient for segmenting the key anatomical structures was 0.702-0.764.Conclusion Self-guided attention network could be used for preliminarily detecting responsible lesions related to CP in children with PVWMI.

Objective To observe the efficacy of self-guided attention network for detecting responsible lesions related to cerebral palsy(CP)in children with periventricular white matter injury(PVWMI).Methods Totally 383 children with PVWMI were retrospectively enrolled and divided into CP group(n=243)and non-CP group(n=140),while 214 children without obvious brain abnormality on brain MRI were taken as control group.ROI of 4 key anatomical structures related to CP,i.e.centrum semiovale,posterior limb of internal capsule,cerebral peduncle and thalamus were delineated on T1WI,while responsible lesions related to CP within the key anatomical structures were labeled on T2WI,and the images were then registrated and used as input of the networks.ResNet34 network was adopted combined with attention and self-guided networks to train the network for detecting responsible lesions related to CP in children with PVWMI,and their efficacies were evaluated.The optimal network was screened,and its efficacy for segmenting the key anatomical structures was evaluated.Results Self-guided attention network was the optimal network,its area under the curve(AUC)for detecting lesions was 0.794-0.914,and the Dice similarity coefficient for segmenting the key anatomical structures was 0.702-0.764.Conclusion Self-guided attention network could be used for preliminarily detecting responsible lesions related to CP in children with PVWMI.

Objective To observe the changes in intradiscal internal internal pressure before and after percutaneous nucleoplasty (PN) in the patients with discogenic low back pain (DLBP),and to explore the mechanism of PN for alleviating DLBP.Methods Thirty patients definitely diagnosed as DLBP undergoing PN in the orthopedic department of this hospital from June 2023 to October 2023 were selected.The internal pressure of the lumbar disc was measured before and after the surgery.The visual analog scale (VAS),Japa-nese orthopedic association score (JOA) and Oswestry disability index (ODI) were used to assess the pain level of the patients before operation and at postoperative 1 d,1 month,3 months.The surgical efficacy was e-valuated by using the modified MacNab criteria.The linear correlation analysis was used to observe the relation-ship between the internal pressure of lumbar disc and changes in each pain score,and the factors possibly affecting postoperative effect was analyzed by using the multivariate logistic regression analysis.Results Compared with be-fore the surgery,the immediate postoperative internal pressure of lumbar disc in the patients was significantly decreased.The JOA scores at postoperative 1 d,1 month and 3 months were significantly increased,while the VAS and ODI scores were significantly decreased,and the differences were statistically significant (P<0.05). The excellent rates of surgical efficacy at postoperative 1 d,1 month and 3 months were 66.7％,73.3％ and 63.3％,respectively.The internal pressure of lumbar disc difference value between before operation and on postoperative 1 d and internal pressure of lumbar disc decrease rate had no significant correlation with the change value of each pain score (P>0.05).The multivariate logistic regression analysis showed that the dis-ease duration and the decrease rate of internal pressure of lumbar disc were the influencing factors of clinical efficacy in PN (P<0.05).Conclusion The occurrence of DLBP may be related with the increase of internal pressure of lumbar disc.PN could effectively reduce internal pressure of lumbar disc and achieve the goal of pain relief.

Objective:To evaluate the effect of orexin A on morphine-induced gastrointestinal dysfunction in mice.Methods:Forty SPF C57B/6 mice, aged 6-8 weeks, half male and half female, weighing 18-22 g, were divided into 5 groups ( n=8 each) using a random number table method: control group (group C), morphine group (group M) and morphine + different doses of orexin A groups (MOH, MOM and MOL groups). Normal saline 8 ml/kg was subcutaneously injected daily in group C, morphine 6 mg/kg was subcutaneously injected daily in the other four groups, and orexin A 75, 50 and 25 μg/kg were subcutaneously injected daily for 10 days at the same time in MOH, MOM and MOL groups.The fetal water content was calculated and averaged daily.After the last administration, the mice were gavaged with black nutrient paste, and the gastric emptying rate and small intestinal propulsion rate were detected 30 min later.Blood samples were collected from the orbit, and the concentration of serum gastrin (GAS) was detected by enzyme-linked immunosorbent assay.The mice were then sacrificed, and colon tissues were removed for determination of c-kit positive cell area (by immunohistochemistry) and expression of c-kit, substance P (SP) and neural nitric oxide synthase (nNOS) in colon tissues (by Western blot). Results:Compared with group C, the rate of fecal water content, gastric emptying rate, small intestinal propulsion rate and serum GAS concentration were significantly decreased, the area of c-kit positive cells was decreased, and the expression of c-kit and SP was down-regulated, and the expression of nNOS was up-regulated in group M ( P<0.05). Compared with group M, the small intestinal propulsive rate and serum GAS concentration were significantly increased, and the area of c-kit positive cells was increased, and the expression of c-kit was up-regulated in group MOH, the rate of fecal water content, gastric emptying rate, small intestinal propulsion rate and serum GAS concentration were significantly increased, the area of c-kit positive cells was increased, and the expression of c-kit and SP was up-regulated, and the expression of nNOS was down-regulated in group MOM, and the serum GAS concentration and c-kit positive cell area were significantly increased in group MOL ( P<0.05). Conclusions:Orexin A 50 μg/kg can effectively alleviate the gastrointestinal dysfunction induced by morphine in mice, and the mechanism may be related to promotion of GAS secretion, interstitial cells of Cajal growth and SP release and inhibition of NO release.

Objective:To analyze the mutation sites and characteristics of phospholipase CE1( PLCE1) gene in children with primary nephrotic syndrome(PNS) in Zhuang, Guangxi, China, so as to explore the expression status of PLCE1 protein in peripheral blood of PNS patients. Methods:(1)Blood samples of 154 Zhuang children with PNS and 98 healthy children of Zhuang nationality from July 2015 to September 2017 in Affiliated Hospital of Youjiang Medical College for Nationalities were collected to sequence PLCE1 gene with FastTarget target gene capture method in the combination with next generation sequencing.Based on the comparison between mutation results and information from the database, the pathogenicity, phenotype and distribution characteristics of these mutation sites were discovered and appraised.(2)The concentration of PLCE1 protein in serum samples were measured by enzyme-linked immuno sorbent assay, then the data of PNS group and healthy control group were compared and analyzed statistically with SPSS 25.0. Results:(1)A total of 18 low-frequency mutations of PLCE1 were observed, 5 of them(c.670C>T, c.578T>C, c.923G>T, c.4916C>T, and c. 5927_5929del) were found only in the PNS group, and 3 of them occurred in both PNS group and healthy control group: c.176C>T, c.389T>C, and c. 4304C>T.Five newly discovered mutations (c.923G>T, c.958T>A, c.1151C>T, c.2341A>G, and c. 3592G>C)were discovered and only c. 923 G>T is pathogenic mutation of PLCE1.(2)The concentration of PLCE1 protein in healthy control group was 414.65 (231.20, 729.81) ng/L and the level of PLCE1 in PNS group was 237.84 (116.14, 535.85) ng/L, ( Z=-3.212, P<0.001), and the value of PNS group was lower than that in the healthy control group. Conclusions:(1)As a new pathogenic mutation of PLCE1, c.923G>T was found.(2)The phenotype of PLCE1 gene mutation in Zhuang children with PNS was diverse, and they may differ by race and region.(3) PLCE1 protein of serum may act as a protective protein to guarantee various life activities of cells by participating in multiple signal transduction pathways.

Objective:To explore the application value of asthma prediction index (API) in the management of young wheezing children in primary hospitals.Methods:From July 2014 to December 2016, 137 children with recurrent wheezing diagnosed and treated in the People's Hospital of Qidong were selected for API evaluation.Forty-six children with positive API (treatment group) were given standardized treatment for childhood asthma, 43 patients with API positive (observation group) and 48 patients with API negative (control group) were given routine treatment (intermittent anti-inflammatory and antiasthmatic treatment). All children were given breathing nursing education and management, followed up to observe breathing control.Results:One child in the treatment group was withdrawn from the cohort, and the complete remission rates in the treatment group, observation group and control group were 86.7% (39/45), 9.3% (4/43) and 43.8% (21/48), respectively.The complete response rate in the treatment group and control group was higher than that in the observation group, and the differences were statistically significant (χ 2=53.39, 14.78, all P<0.05). Conclusion:API can effectively help pediatricians in primary hospitals to manage young wheezing children and improve the complete remission rate.

Objective To investigate the molecular mechanism of solanine-induced apoptosis of prostate cancer cells Du145 and LNCaP.Methods The effects of solanine on the viability of Du145 and LNCaP cells were evaluated by MTT assay.The generation of intracellular reactive oxygen species (ROS) and solanine-induced apoptosis were measured by flow cytometry.The protein levels of p38 and p-p38 expressions were examined by Western blot.Results Solanine significantly inhibited the viability of Du145 and LNCaP cells in a dose-dependent manner (P＜0.01).The inhibition of solanine on cell viability was suppressed by the ROS scavenger NAC.ROS generation,apoptosis and phosphorylation of p38 were induced by treatment with solanine at 40 μmol/L for 24 h.The expression of p38 and solanine-induced apoptosis were suppressed by NAC and SB203580.Conclusion Solanine induces the apoptosis of human prostate cancer cell via the RO.S-p38 signaling pathway.

Matrix_assisted laser desorption ionization_time of flight tandem mass spectrometry ( MALDI_TOF/TOF MS) and electrospray ionization_quadrupole_time of flight mass spectrometry ( ESI_Q_TOF MS) were used to confirm the structure of cyclic lipopeptide daptomycin fastly. First, the relative molecular weight 1916. 7107 of daptomycin was measured by ESI with error 0. 0007. The sample’s doubly charged peak m/z 809. 848 was selected as precursor ion for ESI_MS/MS analysis, and the exocyclic amino acid sequence C9 H19 CO_Trp_Asn_Asp was successfully matched. Second, the experimental conditions of cleaving daptomycin by lithium hydroxide ( LiOH) were optimized and the ring_opened process was monitored by MALDI_TOF/TOF MS. After obtaining ring_opened product with purity of above 95%, the MS/MS measurements by MALDI and ESI were carried out. The b+and y+of ring_opened product were completely matched, which confirmed the amino acid sequence of daptomycin. Finally, ESI_MS/MS conditions of ring_opened product were further optimized to obtain more low mass fragment ions for analyzing the structure of fatty acid chain and the cleavage pattern of fat chain in mass spectrometry was proposed. The method was fast, convenient, accurate and reliable for identifying cyclic lipopeptide compounds.