Objective To investigate the mechanism of effects of histone deacetylase 3(HDAC3)on re-nal fibrosis in mice with unilateral ureteral obstruction(UUO)by regulating CIC-5.Methods A UUO mouse model was constructed,and intervention was performed on the expression of HDAC3 and CIC-5 in mice.A UUO mouse model was constructed and the mice were divided into the following groups:sham-operated group(Sham group),UUO group(UUO model mice without any treatment),sh-NC group(UUO model mice injec-ted with sh-NC via tail vein),sh-HDAC3 group(UUO model mice injected with sh-HDAC3 via tail vein),HDAC3 overexpression group(UUO model mice injected with HDAC3 overexpression vector via tail vein),and HDAC3+CIC-5 overexpression group(UUO model mice injected with HDAC3 and CIC-5 overexpression vectors via tail vein),with 5 mice in each group.Intervention was performed on the expression of HDAC3 and CIC-5 in the mice.HE staining and Masson staining were used to detect the pathological changes of mouse kidney tissue.The expression of renal fibrosis markers(α-SMA,Collagen-Ⅰ,MMP2)in mouse kidney tissue was detected by RT-qPCR and Western blot.The levels of blood urea nitrogen(BUN)and creatinine(Cr)in the serum of mice were detected by an automatic biochemical analyzer.Results UUO mice showed obvious renal tissue damage and increased fibrosis.The mRNA and protein expression levels of CIC-5 in the renal tis-sue of the UUO group were lower than those in the Sham group,while the mRNA and protein expression lev-els of HDAC3 were higher(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Collagen-I,and MMP2 were higher in the UUO group than in the Sham group(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Collegan-Ⅰ,and MMP2 were lower in the sh-HDAC3 group than in the sh-NC group(P<0.05).The BUN,Cr levels,and the mRNA and protein ex-pression levels of α-SMA,Collegan-Ⅰ,and MMP2 were higher in the HDAC3 group than in the Sham group and UUO group(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Col-legan-Ⅰ,and MMP2 were lower in the HDAC3+CIC-5 group than in the HDAC3 group(P<0.05).Conclu-sion HDAC3 inhibits the expression of CIC-5 by regulating its acetylation,thereby promoting renal fibrosis in UUO mice.Inhibiting the expression of HDAC3 is expected to be an effective way to improve UUO renal fibrosis.

Objective To explore the effect of CT slice thickness on the reproducibility of radiomic features in urinary stones.Methods A retrospective analysis was performed on 30 cases of stones diagnosed by urinary CT.Thin-slice(1 mm)images were reconstructed into two groups of images with thicknesses of 2 mm and 5 mm.Two radiologists conducted manual segmentation independently and then extracted features.The reproducibility of the radiomic features was calculated using the concordance correlation coefficient(CCC).Results Under different slice thickness conditions by the same radiologist,the average CCC of all groups was less than 0.85(P＜0.05).For radiologist A,the proportion of stone features with CCC＜0.85 were 50.13％,79.91％,and 82.38％in the 1 mm vs 2 mm group,2 mm vs 5 mm group,and 1 mm vs 5 mm group,respectively.Corresponding values for radiologist B were 44.55％,79.47％and 82.32％,respectively.Among the seven categories of radiomic features,the morphological features with CCC＜0.85 was 100％in the 1 mm vs 5 mm group.Conclusion CT slice thickness significantly affected the reproducibility of radiomic features in urinary stones,with the greatest effect observed in morphological features.Thin-slice imaging demonstrated more stable reproducibility of stone characteristics.

Objective : To explore the relationship between geriatric nutritional risk index( GNRI) and perioperative nutritional status，postoperative recovery and complications in elderly patients with gastric cancer． Methods : In this retrospective study，212 elderly patients ( aged ≥60 years ) with gastric cancer who underwent gastrectomy were recruited．GNRI was used to retrospectively assess the patients' preoperative nutritional status ，and analyze the relationship between GNRI and perioperative nutritional status，postoperative recovery and complications．The ROC curve was applied to explore the value of GNRI in predicting postoperative complications. Results : The inci- dence of preoperative nutritional risk in elderly patients undergoing gastric cancer surgery was 45. 07%．Compared with the patients whose GNRI＞98 points，the patients whose GNRI≤98 points had different degrees of decrease in serum total protein，albumin，prealbumin，hemoglobin and lymphocyte counts before surgery，day 1 and day 5－8 after surgery (P ＜0. 05) ．The patients whose GNRI ＜92 points had longer postoperative hospital stay than those with GNRI＞98 points (P＜0. 05) ．With the decrease of GNRI scores，the incidence of complications showed an upward trend(P＜0. 001) ．The multivariate analysis of the relationship between GNRI and postoperative complica- tions showed that TNM staging of III －IV and GNRI ＜92 points were independent risk factors for complications. GNRI had a good predictive value for the occurrence of complications (AUC = 0. 639，95% CI : 0. 570－0. 703，P = 0. 001，Cut-off value : 92. 21) ． Conclusion GNRI can be used for preoperative nutritional assessment for eld- erly gastric cancer patients．Patients with GNRI＜92. 21 points should be actively given nutritional therapy to im- prove perioperative nutritional status，speed up postoperative recovery，and reduce the occurrence of complications.

Objective To explore the effects of probiotics on intestinal function, nutritional status and inflammatory response in critically ill patients with enteral nutrition (EN) support. Methods A total of 90 critically ill patients admitted to Intensive Care Unit (ICU) of the First Affiliated Hospital of Anhui Medical University from July 2016 to November 2018 were enrolled, and they were divided into a probiotics combined with EN group (27 cases) and an simple EN group (63 cases) according to random number table method. The patients in the simple EN group were treated with conventional nutrient preparations such as fresubin or fresubin energy fibre; the patients in probiotics combined with EN group were supplemented with probiotics on the basis of conventional EN support for consecutive 7 days in both groups. The changes of gastrointestinal function, nutritional index and inflammatory response index after treatment were observed in both groups. Results After treatment, the subjective global assessment (SGA) method was used to identify the gradation of the patients, it was shown that the proportion of SGA-B grade patients in simple EN group had an upward trend; while the proportion of SGA-B grade patients in probiotics combined with EN group had no significant change; and there was no significant difference in the proportion of SGA-B patients between simple EN group and probiotics combined with EN group after treatment [20.6% (13/63) vs. 7.4% (2/27),P > 0.05]. Compared with those before treatment, the levels of hemoglobin (Hb), white blood cell count (WBC), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-12) in both groups were significantly decreased, while the levels of albumin (Alb), pre-albumin (PA), total lymphocyte count (TLC) in both groups were increased after treatment, and the changes of Hb, TNF-α, IL-6 in probiotics combined with EN group were more significant than those in the simple EN group [Hb (g/L): 95.0 (78.0, 107.0) vs. 93.0 (80.0, 107.0), TNF-α (pg/L): 21.2±4.0 vs. 28.0±5.7, IL-6 (pg/L): 161.3±37.6 vs. 186.2±51.8];the differences in levels of Hb, CRP, TNF-α before and after treatment between the probiotics combined with EN group and simple EN group were statistically significant [Hb (g/L): 1.0 (-4.0, 12.0) vs. 11.0 (1.0, 20.0), CRP (mg/L): 44.3 (13.7, 57.7) vs. 7.5 (-20.1, 62.4), TNF-α (pg/L): 13.3±6.3 vs. 7.9±5.5, all P < 0.05]. There were no statistical significant differences in the other indicators between the two groups (all P > 0.05). Conclusion Probiotics can improve the gastrointestinal function and inflammatory status of critically ill patients with EN support, regretfully, in a short term, the improvement of nutritional status of such patients is not obvious, but probiotics has certain significance in preventing the risk of aggravation of malnutrition and reduction of Hb level.

Objective To investigate the clinical utility of critical nutrients nutrition risk assessment (Nutric score) in neurological critical ill patients,laying the foundation for clinical nutrition support.Methods From July 2016 to March 2017,59 ICU patients with neurological critical ill in the First Affiliated Hospital of Anhui Medical University were divided into low score group (Nutric score 0-4) and high score group (Nutric score 5-9) according to Nutric score system.On the first and seventh day after ICU admission,the body mass index(BMI),triceps skinfold thickness (TSF),mid-upper ann circumference (MAC) and mid-upper ann muscle circumference (MAMC) were measured.The serum albumin(ALB),prealbumin (PA),hemoglobin (Hb) and lymphocyte (LY) were detected as nutritional indicators.And at the same time,recorded the 28-day outcomes,and made the SGA evaluation.Results At the first day admission in ICU,there were no statistically significant differences between the two groups in TSF,MAC and MAMC (all P ＞0.05).But at the seventh day,the TSF,MAC,MAMC of the high score group were (0.943 ± 0.484) cm,(24.143 ± 3.203) cm,(21.187 ± 2.625) cm,respectively,which were significantly lower than those of the low score group [(1.185 ± 0.403) cm,(26.981 ± 2.731) cm,(23.265 ± 2.327) cm],there were statistically significant differences between the two groups (t =2.090,3.672,3.223,all P ＜ 0.05).At the first day after admission,the serum levels of ALB and Hb in the high score group were (34.5 ± 7.3)g/L,(103.68 ± 13.5)g/L,which of the low score group were (39.0 ± 6.9) g/L,(122.29 ± 20.4) g/L,respectively,and there were statistically significant differences between the two groups(t =2.466,4.168,all P ＜ 0.05).And at the seventh day after admission,the serum levels of ALB,PA,Hb and Ly in the high score group were (30.6 ± 5.1) g/L,(146.0 ± 77.0) mg/L,(83.9 ± 11.9) g/L,(1.123 ± 0.535) x 109/L,respectively,which were significantly lower than those in the low score group [(35.8 ± 5.5) g/L,(209.9 ± 105.1) mg/L,(105.8 ± 19.2) g/L,(1.709 ± 1.377) x 109/L].Compared with the first day after admission,the ALB,Hb levels in the two groups at the seventh day after admission were significantly decreased (t =2.29,2.002,5.817,3.286,all P ＜0.05);the PA level in the low score group had no statistically significant difference at the seventh day after admission,but the PA level in the high score group was decreased significantly (t =2.024,P ＜ 0.05).The incidence rate of malnutrition,mortality of the high score group were 32.1％,32.1％,respectively,which were significantly higher than those in the low score group (9.7％,6.5％) (x2 =4.583,6.402,all P ＜ 0.05).Conclusion The Nutric score system can be used in the purpose of early nutrition assessment in neurological critical ill patients,and it is benefit for clinical early nutritional support.

Objective To observe changes of hippocampal levels of pro-inflammatory cytokines in rats with neuropathic pain-induced depression, and to explore the relationship between hippocampal levels of pro-inflammatory cytokines and severity of depression.Methods Twenty-eight adult male rats were randomly divided into two groups: group sham (n=14) and spared nerve injury (group SNI) (n=14).Mechanical withdrawal thresholds (MWT) were measured 1 day before and 7, 14 and 21 days after operation.Sucrose preference test and forced swim test were tested 1-3 days before and 21-23 days after operation.After test, hippocampus was collected.The hippocampal levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) were measured by ELISA.Correlational relationships between hippocampal levels of pro-inflammatory cytokines and sucrose preference were evaluated.Results Compared with group sham, MWT was decreased 7, 14, 21 days after operation (P<0.001).Group SNI displayed decreased sucrose preference 21 days after operation (P<0.01) and increased immobility time in FST 23 days after operation (P<0.05).The levels of IL-6 and TNF-α were increased in hippocampus (P<0.05 or P<0.01).No significant difference was observed in IL-1β.The hippocampal levels of IL-1β (r2=0.60,P<0.01), IL-6 (r2=0.55,P<0.01) and TNF-α(r2=0.60,P<0.01) were negatively correlated with sucrose preference.Conclusion The hippocampal levels of pro-inflammatory cytokines IL-6 and TNF-α are increased in rats with depression induced by neuropathic pain, and the levels of hippocampal pro-inflammatory cytokines are negatively correlated with the severity of depression.

Objective To investigate the expression levels of regulator of G-protein signaling 4 (RGS4) in pediatric nephroblastoma and pericancerous tissues, and explore the relationship between RGS4 and the occurrence and development of pediatric nephroblastoma. Methods Thirty-seven samples of pediatric nephroblastoma tissues and 8 samples of pericancerous tissues were collected after surgery to detect the expression of RGS4 protein by immunohistochemistry. Another 8 samples of fresh cancer tissues and corresponding pericancerous tissues were collected to detect the mRNA and protein levels of RGS4 by qRT-PCR and Western blot assay, respectively. Results Immunohistochemistry results showed that RGS4 protein was positively expressed both in pediatric nephroblastoma and pericancerous tissues, and its high expression rate was lower in pediatric nephroblastoma than that in pericancerous tissues [(37.83%(14/37) vs. 87.5%(7/8),χ2=4.675, P<0.05]. The expression level of RGS4 mRNA was significantly lower in pediatric nephroblastoma than that in pericancerous tissues (1.064 ± 0.549 vs. 5.374 ± 0.735, t=13.290, n=8, P < 0.01). Western blot results showed that the expression level of RGS4 protein was lower in pediatric nephroblastoma than that of pericancerous tissues (0.301±0.092 vs. 0.779 ± 0.041, t=13.424, n=8, P < 0.01). Conclusion The expression level of RGS4 is down-regulated in pediatric nephroblastoma, which may be related to the occurrence and development of pediatric nephroblastoma.

Objective To investigate the risk factors for the occurrence of cerebral infarction in patients with capsular warning syndrome (CWS). Methods Consecutive patients with transient ischemic attack (TIA) meeting the CWS clinical manifestations were col ected retrospectively. They were divided into either a cerebral infarction group or a non-cerebral infarction group according to the brain diffusion weighted imaging findings. The independent risk factors for patients with CWS were identified through the comparison of demographic and baseline clinical data. Results A total of 39 patients were enrol ed, including 25 males (64. 1%) and 14 females (35. 9%), and their mean age was 58. 9 ± 10. 3 years. There were 21 patients in the cerebral infarction group and 18 in the non-cerebral infarction group. Compared with the non-cerebral infarction group, the age of patients in the cerebral infarction group was older (62. 5 ± 9. 3 years vs. 54. 8 ± 10. 2 years;t=2. 470, P=0. 018). The constituent ratio of the patients with a history of previous stroke or transient ischemic attack was higher (33. 3% vs. 5. 6%; P=0. 049), the fasting blood glucose level was higher (8. 2 ± 3. 2 mmol/L vs. 6. 0 ± 1. 3 mmol/L; t=2. 748, P=0. 009), and ABCD2 score was higher (5. 2 ± 1. 1 vs. 3. 5 ± 1. 1;t=4. 734, P<0. 001). Multivariate logistic regression analysis showed that the ABCD2 score was an independent risk factor for cerebral infarction in patients with CWS (odds ratio, 4. 529, 95% confidence interval 1. 233-16. 627;P=0. 023). Conclusions The higher ABCD2 score was an independent risk factor for the occurrence of cerebral infarction in patients with CWS. It can be used as an evaluation tool for predicting the risk of cerebral infarction in patients with CWS.

ObjectiveTo study the role of L-arginine/nitric oxide (NO) pathway in the antidepressant effects of ketamine.MethodsForty two male Wistar rats (200-250 g) were equally randomized into 7 groups ( n =6 ):control group ( C group ),L-Arginine ( a precursor of NO ) group ( LA group),L-NAME ( an non-selectivity inhibitor of NO synthase) group ( LN group),ketamine 3 mg/kg group ( K3 group),ketamine 10 mg/kg group (K10 group),L-Arginine + ketamine 10 mg/kg group(LAK10 group),L-NAME + ketamine 3 mg/kg group (LNK3 group).The forced swimming test (FST) of 15 min (pre-test session) was used to establish a rat depression model,then twenty-four hours later FST (test session) was carried out of 6 min and the immobility time in last 5 min was recorded. All the groups were pretreated with saline 1.0 ml,L-arginine 750 mg/kg or L-NAME 30 mg/kg 90 min before FST.Saline 1.0 ml,ketamine 3.0 mg/kg or ketamine 10.0 mg/kg were injected 60 min before FST.The content of hippocampal NO was detected immediately after ethology measurement.ResultsCompared with C group (immobility time:( 139.0 ± 27.6)s),the immobility time decreased significantly (( 85.5 ± 34.2),(91.3 ±31.6)s) in K10 group and LNK3 group (P＜0.05),K3 group,LA group,LAK10 group and LN group had no significant difference (P＞0.05) ;compared with C group ( (0.61 ±0.21 ) μmol/gProt),the content of NO increased in LA group ( ( 1.09 ±0.39) μmol/gProt) and decreased in K10 group and LNK3 group significantly( (0.28 ± 0.12),(0.31 ± 0.14 ) μmol/gProt) (P ＜ 0.05 ),K3 group,LAK10 group and LN group had no significant difference (P ＞ 0.05).ConclusionThe antidepressant effects of ketamine are related to the suppression of L-arginine/nitric oxide pathway.

Objective To investigate the effects of different doses of ketamine on brain-derived neurotrophic factor (BDNF) and tyrosine receptor Idnase B (TrkB) in the hippocampus in mentally depressed rats.Methods Fifty male Wistar rats weighing 180-220 g were randomly divided into 5 groups ( n = 10 each): group control (group C) and groups K1-4 ketamine 2.5, 5.0, 10.0 and 20.0 mg/kg. On the 1st day the animals were forced to swim for 15 min. On the 2nd day ketamine 2.5, 5.0, 10.0 and 20.0 mg/kg were given iniraperitoneally in groups K1-4 respectively at 30 min after administration. The immobility time of the rats during the forced swimming test was recorded. The animals were then decapitated. The hippocampus was harvested for determination of BDNF and TrkB levels. Results Ketamine significantly decreased the immobility time during forced swimming test in a dose-dependent manner. The BDNF and TrkB levels in the hippocampus were significantly increased in K, and K4 groups as compared with group C, and K1 and K2 groups. Conclusion The increased levels of BDNF and TrkB in the hippocampus are involved in the dose-dependent antidepressant effect of ketamine.