The central amygdala (CeA) is a crucial modulator of emotional, behavioral, and autonomic functions, including cardiovascular responses. Despite its importance, the specific circuit by which the CeA modulates blood pressure remains insufficiently explored. Our investigations demonstrate that photostimulation of GABAergic neurons in the centromedial amygdala (CeM^GABA), as opposed to those in the centrolateral amygdala (CeL), produces a depressor response in both anesthetized and freely-moving mice. In addition, activation of CeM^GABA axonal terminals projecting to the nucleus tractus solitarius (NTS) significantly reduces blood pressure. These CeM^GABA neurons form synaptic connections with NTS neurons, allowing for the modulation of cardiovascular responses by influencing the caudal or rostral ventrolateral medulla. Furthermore, CeM^GABA neurons targeting the NTS receive dense inputs from the CeL. Consequently, stimulation of CeM^GABA neurons elicits hypotension through the CeM-NTS circuit, offering deeper insights into the cardiovascular responses associated with emotions and behaviors.
Animals ; GABAergic Neurons/physiology* ; Male ; Central Amygdaloid Nucleus/physiopathology* ; Hypotension/physiopathology* ; Mice ; Blood Pressure/physiology* ; Mice, Inbred C57BL ; Solitary Nucleus/physiology* ; Photic Stimulation ; Neural Pathways/physiology*

Objective To explore the early detection value of estimated glucose disposal rate(eGDR)for non-alcoholic fatty liver disease(NAFLD),providing a simple tool for precise clinical intervention.Methods A cross-sectional analysis was conducted on totally 3 262 participants with complete data from the National Health and Nutrition Survey Database of the United States from 2007 to 2018.Univariate regression and multivariate logistic regression analyses were used to explore the correlation between the estimated glucose treatment rate and the incidence of non-alcoholic fatty liver disease.Subgroup analysis,restricted cubic spline and threshold effect analysis were conducted to investigate the potential factor influences and nonlinear relationships.Result Among all the included populations,948 cases(25.29%)were diagnosed with NAFLD,and the number gradually decreased with the increase of the estimated glucose treatment rate(P<0.001).Multivariate logistic regression showed that the estimated grape processing rate was negatively correlated with non-alcoholic fatty liver disease(OR=0.86,95%CI:0.83～0.88,P<0.001),and when the estimated glucose processing rate was≥10.246,it could significantly reduce the risk of non-alcoholic fatty liver disease(OR=0.20,95%CI:0.10～0.39,P<0.001),and stratified analysis further confirmed this result.Conclusion The eGDR is significantly associated with the incidence risk of NAFLD.A higher eGDR indicates a lower risk of NAFLD.This implies that in clinical practice,the risk of disease detection can be quantified through this indicator,thereby identifying potential patients earlier and initiating intervention.Countermeasures As decision-makers,they should strengthen public health education on non-alcoholic fatty liver disease,reduce health risks by promoting healthy diets and lifestyle interventions,and pay attention to the cardiovascular health of high-risk groups for non-alcoholic fatty liver disease.At the same time,promote the research and application of drugs,and dynamically adjust policies through continuous disease monitoring to comprehensively reduce the burden of non-alcoholic fatty liver disease.

Self-limiting epilepsy syndrome（SeLES）can be classified into two types based on age of onset：one occurring in the neonatal to infant period and the other in the childhood period.These diseases can exhibit complete remission within a specific age range，or be completely controlled with anti-seizure drugs.Children with SeLES typically have normal cognition or only mild cognitive impairment.In recent years，advancements in genetic testing technology have led to a better understanding of the genetic etiologies of SeLES，offering more possibilities for precision treatment.This article aims to explore the role of genetic factors in SeLES，providing reference for the diagnosis，precise drug selection，and prognosis of this type of hereditary epilepsy syndrome，in order to provide theoretical support for the long-term management of patients，and improve their quality of life.

OBJECTIVE: To observe and compare the shoulder joint function, complications and clinical effects of hemiarthroplasty and open reduction and locking plate in the treatment of comminuted proximal humeral fracture (Neer IV) with 3D printing technique. METHODS: From March 2012 to April 2018, 31 middle age and elderly patients with comminuted proximal humeral fractures (Neer IV) were treated, including 4 males and 27 females, aged from 55 to 94 years old with an average age of 71 years, with a course of 1 to 3 years. Among them, 20 cases were treated with open reduction and locking plate internal fixation (ORIF group) and 11 cases were treated with lower half shoulder replacement (HA group) assisted by 3D printing technology. Using CT data and Mimics software of Materialise Company in Belgium, the reconstruction of fracture was simulated on computer. The height of fracture end to humeral head, the height of tubercle to humeral head, the angle of humeral head backward obliquity were measured to assist the hemiarthroplasty. Follow-up and X-ray examination were performed, the incidence of complications were observed, and Neer score was used for the shoulder joint function. RESULTS: Thirty-one patients were followed up for 1 to 3 years with an average of 2 years. In HA group, there was no prosthesis loosening, fracture and subsidence, the head of artificial humerus was intact, the fracture of nodules and nodules did not heal in 1 case, Neer score was 84.18±3.55; in ORIF group, there were 8 cases of proximal humerus bone resorption, 1 case of fracture nonunion, 1 case of internal fixation loosening, Neer score was 55.91±10.78; there was significant difference in Neer score of shoulder joint function between the two groups(<0.05). CONCLUSIONS Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures, which promise minimal incision, protect sural nerve, ensure quality of tendon anastomosis and fixation, and is a ideal method for repairing acute closed Achilles tendon ruptures.
Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; Humans ; Male ; Middle Aged ; Shoulder ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo investigate the preliminary effects of modified percutaneous compression plate in treating femoral neck fractures of Pauwels type III.

METHODSFrom March 2012 to March 2016, 35 patients with femoral neck fracture were treated by closed reduction and internal fixation with a modified percutaneous compression plate, including 21 males and 14 females with an average age of 45 years old ranging from 23 to 62 years old. The anatomical position of fracture was divided into 8 cases of lower head type, 27 cases of head and neck. According to the Garden classification, there were 8 cases of type II, 18 of type III, and 9 of type IV fractures. All patients were closed injury. The general information, reduction quality, fracture healing time, postoperative complications were recorded and evaluated. Harris scoring was used to evaluate the hip joint function.

RESULTSAll patients were followed up for 15 to 24 months with an average of 20 months. All the incisions were primary healing. The reduction quality of the femoral neck fracture was evaluated according to the Garden's alignment Index, and the quality of reduction was grade I reduction in 29 cases and grade II reduction in 6 cases. No nonunion, femoral avascular necrosis, implant failure and hip varus was observed during follow-up. Harris score was(92.70±4.60) points at final follow-up, the results of the treatment was evaluated as excellent in 26 cases, good in 8 cases, fair in 1 case. No complications such as internal fixation loosening, nail breaking, and heterotopic ossification occurred.

CONCLUSIONSInternal fixation with modified percutaneous compression plate has an advantages of decreased trauma, simple operation, rigid fixation, good function outcome, and low risk of complications.

Objective To investigate the effect of extracellular histones (EH) on intestinal mucosal barrier function in mice and the correlation of EH with the pathogenesis of sepsis.Methods Twenty male C57BL/6 mice were assigned into experiment group (n =10) and control group (n =10) according to the random number table.Same dose (50 mg/kg) of EH and saline were administered through the caudal vein of mice in experiment and control groups respectively.Blood and intestinal samples in each group were collected 3 h after the administration.Morphology of intestinal mucosal tissue was detected by light scope and transmission electron microscope.Expressions of tight junction related proteins (ZO-1,Occludin and Claudin-1) were detected by western blot.Plasma levels of diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) were determined by ELISA method.Plasma level of endotoxin (ET) was determined by limulus test.Results Under transmission electron microscope,experiment group showed disorganized microvilli of intestinal epithelial cells with partially twisted,broken and lost,unclear tight junctions,and widened cellular space.Under light scope,experiment group showed substantial inflammatory cell infiltration in the intestinal wall,disorganized intestinal villi,edema and hemorrhage of mucosa and submucosa,and edematous goblet cells.Experimental versus control group showed significant reduction in levels of Claudin-1 (0.587 7 ±0.060 6 vs.0.677 2 ±0.038 3),Occludin (0.1277±0.0857vs.0.4306±0.0869) and ZO-1 (0.393 3±0.080 8 vs.0.812 8± 0.096 3) (P ＜ 0.05).Experimental versus control group showed significantly up-regulated plasma levels of DAO [(1.61 ±0.20) U/ml vs.(0.69 ± 0.15) U/ml],I-FABP [(548.5 ± 36.8) EU/ml vs.(178.8±26.9) EU/ml] andET [(0.182±0.076) EU/mlvs.(0.091 ±0.029) EU/ml](P＜0.05).Conclusion EH can obviously impair the integrity of intestinal mucosal barrier in mice and hence induce endotoxin translocation.

OBJECTIVETo explore the diagnosis and treatment of tarsometatarsal joint complex injury (TJC).

METHODSFrom January 2007 to January 2009,16 patients with tarsometatarsal joint complex injury were treated with open reduction and internal fixation. There were 12 males and 4 females, ranging in age from 21 to 45 years with an average of 34.1 years. Seven cases were left and 9 cases were right and all injuries caused by direct violence. Four cases caused by traffic accident 5 by fall from high and 7 by crush injury. Intercuneiform dislocation were in 11 cases, naviculocuneiform joint dislocation in 3 cases and cuboid fracture in 2 cases. All the cases were three column injuries. According to the situation of exploring and the stability, screw fixation was used for intertarsal joint, internal and middle column tarsometatarsal joint, the Kirschner wire fixation for external column and miniature plate fixation for comminuted fracture of metatarsal bones and compressible fracture of cuboid. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional scale was used to evaluate the clinical effect.

RESULTSAll the patients were followed up,the duration ranged from 6 to 18 months(averaged 12.6 months). According to the score system of AOFAS,the total score was (74.6+/-10.4 ) points, including pain items of (29.3+/-5.9), the score of functional items of (32.4+/-5.6) points, and power lines of (12.9+/-2.6). All the incisions were primarily healed without infection, skin necrosis,fixture broken or loosen. Three cases received arthrodesis due to osteoarthritis. Four cases were followed up continually because they only had the radiologic osteoarthritis without pain.

CONCLUSIONAnatomical reduction and stable fixation is the key point of the treatment of tarsometatarsal joint complex injury. Open reduction and internal fixation at the first stage is good for secondary arthrodesis.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery

Adult ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Spinal Cord Injuries ; surgery ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

Aged ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Rotator Cuff ; surgery ; Rotator Cuff Injuries

Adult ; Casts, Surgical ; Diagnostic Errors ; Female ; Fractures, Bone ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Humans ; Male ; Metatarsus ; diagnostic imaging ; injuries ; surgery ; Middle Aged ; Tomography, X-Ray Computed