[Objective]To explore the regulatory mechanism of hypoxia exposure on carbon metabolism pathway in spleen of mice.[Methods]C57BL/6 mice were raised at altitudes of 400 m and 4 200 m,with 5 mice in each group.After 30 days,spleen tissues were aseptically removed for analysis of differentially expressed genes,proteins,and metabolites using transcriptome sequencing,proteomics,and non-targeted metabolomics.GO and KEGG enrichment analysis were conducted to explore key pathways.The key genes and protein in the pathway were validated by RT-qPCR and Western blot.[Results]Transcriptome sequencing revealed a significant difference in the expression of 4 213 genes in hypoxic exposure,of which 1 947 were up-regulated and 2 266 were down-regulated.The analysis of differentially expressed proteins showed that 166 proteins were up-regulated and 39 proteins were down-regulated.The results of non-targeted metabolomics showed that 133 different metabolites were screened under high altitude hypoxia condition,of which 95 were up-regulated and 38 were down-regulated.KEGG enrichment analysis showed that differentially expressed genes,differentially expressed proteins and differentially expressed metabolites were enriched into the carbon metabolic pathway.Therefore,the key genes and proteins in the carbon metabolic pathway were verified.The mRNA and protein expressions of PGAM2、ENO3、PRPS2、PGLS、RPE、IDH3A、SUCLA2 and MDH2 were significantly down-regulated in the carbon metabolism pathway.[Conclusion]Low oxygen environment at high altitude weakens glycolysis,tricarboxylic acid cycle and pentose phosphate pathway by inhibiting the carbon metabolism pathway of the body,resulting in oxidative stress and energy metabolism imbalance.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.

Objective To investigate the risk factors for the formation of infectious stones among residents in western Fujian Province and construct a nomogram model for preoperative prediction of the risk of infectious stones. Methods Clinical data of 204 patients who received treatment for urinary tract stones at Longyan People′s Hospital Affiliated to Xiamen Medical University from October 2021 to November 2023 were analyzed. All patients underwent stone composition analysis. Univariate and multivariate Logistic regression analysis were used to screen independent risk factors for infectious stones, construct a nomogram model for predicting the risk of infectious stones, and the discriminative power and accuracy of the model was evaluated. Results Based on the results of stone composition analysis, 204 patients were divided into infectious stone group(56 cases) and non-infectious stone group(148 cases). Univariate and multivariate Logistic regression analysis showed that female (OR=2.602, 95%CI, 0.766 to 8.842, P=0.039), diabetes (OR=9.751, 95%CI, 2.547 to 17.332, P=0.001), long diameter of stones (OR=1.123, 95%CI, 1.046 to 4.207, P=0.031), moderate to severe hydronephrosis (OR=4.173, 95%CI, 1.256 to 13.865, P=0.020), high urine pH value (OR=6.078, 95%CI, 1.922 to 19.216, P=0.002), and positive urine culture (OR=6.060, 95%CI, 1.398 to 16.262, P=0.016) were independent risk factors for infectious stones. A nomogram model for predicting the risk of infectious stones was constructed based on independent risk factors. The area under the curve of this model for predicting infectious stones was 0.860, which was significantly larger than the area under the curve predicted by gender, diabetes, stone long diameter, degree of hydronephrosis, urine pH value, and urine culture results (P < 0.05). The model was validated by 1 000 internal resampling, with an average absolute error of 1.8%, indicating a high consistency between the predicted risk of infectious stones and the actual situation. Conclusion Female, diabetes, long diameter of stones, moderate to severe hydronephrosis, high urine pH value, and positive urine culture are independent risk factors for infectious stones among residents in western Fujian Province. The nomogram model constructed based on these factors can predict the risk of infectious stones preoperatively with high predictive efficiency.

Objective To study the microanatomic structure of the subtemporal transtentorial approach to the lateral side of the brainstem,and to provide anatomical information that will assist clinicians to perform surgeries on the lateral,circumferential,and petroclival regions of the brainstem.Methods Anatomical investigations were conducted on 8 cadaveric head specimens(16 sides)using the infratemporal transtentorial approach.The heads were tilted to one side,with the zygomatic arch at its highest point.Then,a horseshoe incision was made above the auricle.The incision extended from the midpoint of the zygomatic arch to one third of the mesolateral length of the transverse sinus,with the flap turned towards the temporal part.After removing the bone,the arachnoid and the soft meninges were carefully stripped under the microscope.The exposure range of the surgical approach was observed and the positional relationships of relevant nerves and blood vessels in the approach were clarified.Important structures were photographed and the relevant parameters were measured.Results The upper edge of the zygomatic arch root could be used to accurately locate the base of the middle cranial fossa.The average distances of the star point to the apex of mastoid,the star point to the superior ridge of external auditory canal,the anterior angle of parietomastoid suture to the superior ridge of external auditory canal,and the anterior angle of parietomastoid suture to the star point of the 10 adult skull specimens were 47.23 mm,45.27 mm,26.16 mm,and 23.08 mm,respectively.The subtemporal approach could fully expose the area from as high as the posterior clinoid process to as low as the petrous ridge and the arcuate protuberance after cutting through the cerebellar tentorium.The approach makes it possible to handle lesions on the ventral or lateral sides of the middle clivus,the cistern ambiens,the midbrain,midbrain,and pons.In addition,the approach can significantly expand the exposure area of the upper part of the tentorium cerebelli through cheekbone excision and expand the exposure range of the lower part of the tentorium cerebelli through rock bone grinding technology.The total length of the trochlear nerve,distance of the trochlear nerve to the tentorial edge of cerebellum,length of its shape in the tentorial mezzanine,and its lower part of entering into the tentorium cerebelli to the petrosal ridge were(16.95±4.74)mm,(1.27±0.73)mm,(5.72±1.37)mm,and(4.51±0.39)mm,respectively.The cerebellar tentorium could be safely opened through the posterior clinoid process or arcuate protrusion for localization.The oculomotor nerve could serve as an anatomical landmark to locate the posterior cerebral artery and superior cerebellar artery.Conclusion Through microanatomic investigation,the exposure range and intraoperative difficulties of the infratemporal transtentorial approach can be clarified,which facilitates clinicians to accurately and safely plan surgical methods and reduce surgical complications.

Hemorrhagic transformation (HT) is a serious complication after acute ischemic stroke, leading to increased adverse outcomes and mortality. In recent years, there has been an increasing number of studies in predicting HT occurrence, but most of the existing studies have focused on patients accepted reperfusion therapy, and few studies have predicted spontaneous HT. This article provides a review of epidemiology, risk factors, and available prediction models for prediction of spontaneous HT after acute ischemic stroke.

Objective:To analyze the distribution characteristics of plasma renin concentration (PRC) in patients with aldosterone-producing adenoma (APA) and its impact on diagnosis.Methods:In this retrospective case series, clinical data from 200 patients with APA (80 men and 120 women; mean age 45.6 years) in the First Affiliated Hospital of Chongqing Medical University from November 2013 to January 2022 were evaluated. PRC was determined by automated chemiluminescence immunoassay. The distribution characteristics of PRC were analyzed, and 8.2 mU/L was used as the low renin cutoff to evaluate whether renin was suppressed.Results:The median PRC was 1.6 mU/L (range, 0.4-41.5 mU/L). There were 116 patients with APA with PRC of ≤2 mU/L, 41 patients with 28.2 mU/L) in 8.0% (16/200) of the patients with APA. And PRC was not suppressed in 2.5% (5/200) of the patients with APA, resulting in a primary aldosteronism negative screening outcome.Conclusions:Although most patients with APA have low PRC, there are a small number (8%) of patients whose PRC has not been fully suppressed, which can lead to missed diagnoses during primary aldosteronism screening. While primary aldosteronism is highly suspected, further investigations are required to determine the diagnosis, even if PRC is not fully suppressed at screening.

Stroke is a common disease with high incidence worldwide. Ischemic stroke (IS) is a major subtype of stroke. IS, a complex polygenic disease, is affected by a variety of environmental and genetic factors. Therefore, understanding the genetic risk factors for IS is an important step to clarify the pathogenesis, optimize the prevention strategy and determine new therapeutic targets of IS. Two genome wide association studies (GWASs) in 2012 and 2015 showed that there were risk loci on chromosome 6p21.1 associated with IS, but the results of subsequent replication studies were controversial. Moreover, the exploration of biological function and molecular mechanism of genetic variants on chromosome 6p21.1 affecting IS susceptibility is in the initial stage. This paper reviews the studies on the correlation between genetic variation in chromosome 6P21.1 region and IS susceptibility, in order to further clarify its mechanism in IS and provide theoretical basis for prevention and treatment of IS.

Objective:To investigated the clinical, biochemical, and immunohistological characteristics of patients with aldosterone producing adenoma(APA)and different gene mutations.Methods:The clinical and biochemical data of 206 patients with APA who received unilateral adrenalectomy were collected. Sanger sequencing was used to identify the mutation in the hot-point of KCNJ5 and other genes. The tumor samples were stained by 11β-hydroxylase(CYP11B1)and aldosterone synthase(CYP11B2), which was quantified by McCarty′s H-score system.Results:The gene mutations were identified in 166 out of 206(80.6%)patients with APA, of which 158 cases were KCNJ5 mutation, 2 ATP1A1 mutation, 5 ATP2B3 mutation, and 1 CTNNB1 mutation. Age, duration of hypertension, and serum potassium in APA patients with genetic mutant were significantly lower than those without genetic mutation( P<0.05) while the proportion of female, systolic blood pressure, diastolic blood pressure, aldosterone/renin ratio(ARR), and plasma aldosterone concentration(PAC)post saline infusion test(SIT)were significantly higher( P<0.05). Subgroup analysis showed that age, duration of hypertension, systolic blood pressure, and proportion of left ventricular hypertrophy in APA patients with ATP1A1 and ATP2B3 mutations were significantly higher than those with KCNJ5 mutation( P<0.05)while the PAC post SIT and tumor diameter were significantly lower( P<0.05). The positive rates of CYP11B2 in APA with different mutations were not significantly different. The H-score of CYP11B1 was significantly higher [160.0(127.5, 193.5) vs 80.0(27.5, 152.3), P=0.020] and the H-score of CYP11B2 was significantly lower [155.0(123.0, 190.0) vs 240.0(140.0, 270.0), P<0.01] in APA with KCNJ5 mutation compared with those with ATPase mutation. Conclusion:The types of genetic mutation are closely correlated with the clinical, biochemical, and immunohistological phenotypes in patients with APA.

Objective To evaluate the clinical application of SWI and DTI of MRI in the diagnosis and prognosis of diffuse axonal injury (DAI).Methods A retrospective case series study was conducted on the clinical data of 16 patients with DAI admitted from January 2015 to December 2017.There were nine males and seven females,aged (56.3 ± 4.1) years.According to Glasgow Coma Scale (GCS),there were seven patients with 3-8 points,eight with 9-12 points,and one with 13 points.All patients received head CT examination on admission and then received head MRI examination within one week to record the number of lesions on T1WI,T2WI,DWI,and SWI in CT and MRI examination.On the DTI sequence,five regions including the subcortical white matter,the corpus callosum,the thalamus,the cerebellum,and the brain stem were selected for measurement of the apparent diffusion coefficient (ADC) and partial fraction of anisotropy (FA) values.The Glasgow outcome scale (GOS) was evaluated 6 months after injury.The linear correlation between ADC,FA values,GCS,and GOS on admission and after 6 months were analyzed.Results The statistical analysis of CT,T1WI,T2WI,DWI and SWI in 16 patients showed that the detection rates of DAI lesions were 25.6％ (43/168),30.4％ (51/168),44.0％ (74/168),51.8％ (87/168),and 100％,respectively (P ＜0.01).The ADC values of the subcortical white matter,the corpus callosum,the thalamus,the cerebellum,and the brain stem were 0.830 ± 0.148,0.536 ± 0.169,0.838 ± 0.596,0.708 ± 0.157,and 0.713 ± 0.135,respectively,and FA values were 0.487 ± 0.103,0.142 ± 0.040,0.293 ± 0.089,0.212 ± 0.045,and 0.366 ± 0.797,respectively.The GCS on admission was (8.9 ± 3.3)points,and GOS was (4.2 ± 1.0)points six months after injury.The correlation analysis showed that the ADC value and FA value of subcortical white matter and cerebellum were not related to GCS and GOS (P ＞ 0.05).The correlation strength of ADC values in each region with the GCS score in descending order was the thalamus,the corpus callosum,and the brain stem (P ＜ 0.05 or 0.01);for ADC with the GOS score,it was the corpus callosum,the thalamus and the brain stem (P ＜0.05 or 0.01);for FA with GCS and GOS scores,it was thalamus,corpus callosum,and brainstem (P ＜ 0.05 or 0.01).Conclusion The SWI has better sensitivity to detect DAI lesions than CT and conventional MRI sequences.DTI can accurately,objectively and visually detect the integrity of cerebral white matter fibers.Both SWI and DTI can help make early diagnosis and evaluate the prognosis of DAI patients accurately.

Objective To investigate the history, current situation and ecological environment of Chongqing wild and cultivated Fritillaria taipaiensis resources; To provide references for protection and industrial development of Fritillaria taipaiensis resources. Methods Data query, on-the-spot investigation and follow-up survey were used in the study. Results Chongqing Fritillaria taipaiensis was in the medical records since 1843. Now 5 counties have wild Fritillaria taipaiensis resources and 6 districts have cultivated Fritillaria taipaiensis resources, with 6 typical ecological types. Conclusion Chongqing wild Fritillaria taipaiensis resources are wide distributed and with long history of medical usage. Chongqing is the original producing area of Fritillaria taipaiensis, which has been destroyed by human factors. Fritillaria taipaiensis resources in several districts have become extinct, however, the cultivated Fritillaria taipaiensis resources is developing rapidly.