Objective:To investigate effects of lentinan(LNT)on atherosclerosis(AS)plaque formation and adenosine 5'-mo-nophosphate-activated protein kinase(AMPK)signaling pathway in ApoE-/-mice.Methods:ApoE-/-mice were divided into model group,Lipitor group(5 mg/kg),LNT low(5 mg/kg),medium(10 mg/kg),high(20 mg/kg)dose groups,C57BL/6 mice of similar genetic background were as control group.After 12 weeks of intragastric administration,automatic biochemical analyzer was used to detect serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL-C)and high-density lipoprotein(HDL-C)levels;serum levels of IL-6 and IL-1β were detected by ELISA;oil red O staining was used to observe overall aortic plaque formation;HE staining was used to observe formation of plaque in aortic roots;AMPK pathway proteins expressions in aortawas were detected by Western blot.Results:Compared with control group,serum TC,TG,LDL-C,IL-6,IL-1β levels,aortic plaque area,aortic root plaque area,aortic tissue NLRP3,IL-6,IL-1β expressions were significantly increased in model group,p-AMPK/AMPK expression in aortic tissue and serum HDL-C level were reduced significantly(P<0.05);compared with model group,TC,TG,LDL-C,IL-6,IL-1β,aortic plaque area,aortic root plaque area,aortic tissues NLRP3,IL-6 and IL-1β expressions were reduced significantly in Lipitor group and medium,high dose LNT groups,p-AMPK/AMPK expression in aortic tissue and serum HDL-C level were increased significantly,difference between each dose of LNT was statistically significant(P<0.05);there was no significant difference between Lipitor group and LNT high-dose group(P>0.05).Conclusion:LNT may inhibit inflammatory response and formation of AS plaques in AS mouse by activating AMPK pathway.

Objective To explore the relationship between non-high density lipoprotein cholesterol(non-HDL-C)level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion.Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled.According to the results of DSA,LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assess-ment System.All patients were assigned to better LMC circulation group(score 2～4,n = 30)and worse LMC circulation group(score 0～1,n = 55),and the levels of non-HDL-C were compared between the two groups.Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group(P = 0.026,P = 0.010).non-HDL-C was an independent risk factor for the worse LMC circulation(OR = 3.019,95%CI:1.053～8.658,P = 0.04).LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level(r =-0.228,P = 0.036).The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638(95%CI:0.521～0.755,P = 0.036).Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation,and was a risk factor for worse LMC circulation.It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

OBJECTIVE To explore the effects of acteoside on hypoxia/reoxygena tion（H/R）-induced cardiomyocyte damage by regulating Rho family GTPase 3（Rnd3）/nuclear factor κB（NF-κB）pathway. METHODS The H 9c2 cardiomyocyte were divided into control group （no administration ，no modeling ），H/R group （only modeling ），H/R+AS-L group ，H/R+AS-M group ， H/R+AS-H group （10，30，90 μmol/L acteoside for above 3 groups firstly ，and then modeling ），H/R+pcDNA group [transfecting pcDNA （empty vector ） firstly，and then modeling] ，H/R + pcDNA-Rnd 3 group [overexpression of Rnd 3 by transfecting pcDNA-Rnd3（Rnd3 overexpression vector ）firstly，and then modeling] ，H/R+AS-H+si-NC group [transfecting si-NC （negative control）firstly，and then giving 90 μmol/L acteoside and modeling]，H/R+AS-H+si-Rnd3 group [inhibiting overexpression of Rnd 3 by transfecting si-Rnd 3 （Rnd3 small interfering RNA ） firstly，and then giving 90 μ mol/L acteoside and modeling]. After corresponding treatment ，the apoptotic rate ，release of lactate dehydrogenase （LDH），malondialdehyde（MDA）level，the activity of superoxide dismutase （SOD），the level of tumor necrosis factor α（TNF-α），interleukin 1β（IL-1β）and interleukin- 6（IL-6）， mRNA and protein expression of Rnd 3 and NF-κB subunit p65（NF-κB p65），the expression of aspartate proteolytic enzyme 3 （Cleaved Caspase- 3）protein and Cleaved Caspase- 9 protein were detected. RESULTS Different concentrations of acteoside could reduce the apoptotic rate of H/R-induced H 9c2 cardiomyocyte，the protein expressions of Cleaved Caspase- 3 and Cleaved Caspase-9，mRNA and protein expressions of NF-κB p65，the levels of LDH release and MDA ，TNF-α，IL-1β and IL-6，while increase the activity of SOD and mRNA and protein expressions of Rnd 3（P＜0.05），in a dose-dependent manner. Overexpression of Rnd 3 could decrease the apoptotic rate of H 9c2 cardiomyocyte，protein expressions of NF-κB p65，Cleaved Caspase- 3 and Cleaved Caspase- 9， the levels of LDH release ， MDA， TNF-α，IL-1β and IL-6，while increase the protein expression of Rnd 3 and the activity of SOD （P＜0.05）. The inhibition overexpression of Rnd 3 could weaken the inhibitory effects of acteoside on H/R-induced apoptosis of H 9c2 cardiomyocyte， oxidative stress and inflammatory reaction （P＜0.05）. CONCLUSIONS Acteoside could regulate Rnd 3/NF-κ B pathway by promoting the expression of Rnd 3 and inhibiting the expression of NF-κB p65，inhibit cardiomyocyte apoptosis ，oxidative stress and inflammation reaction so as to relieve the H/R-induced cardiomyocyte damage.

Objective:In order to accurately evaluate the postoperative rehabilitation of gynecological robotic surgery, a prediction model for evaluating postanesthesia care unit (PACU) extubation time and hospital stay in gynecological robotic surgery was established.Methods:The clinical data of gynecological patients who underwent robotic surgery in Xiangya Third Hospital of Central South University from October 2015 to May 2017 were retrospectively analyzed, and the data were screened to evaluate the postoperative recovery of patients from two aspects: PACU extubation time and postoperative hospital stay. Binary logistic regression was used to screen out the factors affecting PACU extubation time and postoperative hospital stay, and the prediction model was preliminarily established and verified.Results:Finally, there were 456 patients and 30 variables analyzed in the binary logistics regression. According to these variables, the prediction model of the postoperative recovery evaluation after gynecological robotic surgical procedures was established. Among them, age, intraoperative amount of atracurium and midazolam were independent risk factors affecting PACU extubation time (all P<0.05). American Society of Anesthesiologists (ASA) grade, intraoperative amount of midazolam, intraoperative bleeding and operation time were independent risk factors affecting postoperative hospital stay (all P<0.05). All models passed Hosmer lemeshow test (all P>0.05); The areas under the receiver operating characteristic curve (ROC) were 0.647 and 0.806, respectively. Conclusions:The prediction model of PACU extubation time and the postoperative hospitalization time has been established.

Objective:To investigate the safety and efficacy of drug-eluting stents(DES)in patients with acute coronary syndrome(ACS)complicated with diabetes and multivessel disease.Methods:A total of 80 patients with ACS who received XIENCE V Everolimus stent implantation in the heart center of the 82nd army hospital from January 2017 to October 2018 were retrospectively enrolled and analyzed.Patients were divided into the diabetic group(35 cases)and the non-diabetic group(45 cases)according to whether they were complicated with diabetes or mltivessel lesions.Stent implantation status within 12 months after PCI were compared between the groups.Results:(1)All stents were successfully implanted in the two groups.After coronary angiography re-examination within 12 months, there were no significant differences in the rate of stent restenosis(0.0% vs 2.2%), non-fatal myocardial infarction(2.9% vs.2.2%), or MACEs(2.9% vs.4.4%)between the diabetic and non-diabetic groups(all P>0.05). No patients died from cardiogenic causes in the two groups.(2)During the follow-up period, one patient was hospitalized for acute myocardial infarction in the diabetic group and one case died of an ascending aorta rupture. Conclusions:The safety and efficacy of XIENCE V DES in patients with diabetes and multivessel lesions are good, and the incidence of MACEs is low.

After the publication of pituitary adenoma classification (2017) by WHO, a more detailed classification of pituitary adenomas is performed. This review focuses on the related treatment methods and deficiencies of current new classification of eosinophilic lineage pituitary adenomas, such as growth hormone cell adenoma, prolactin cell adenoma, and thyroid stimulating hormone cell adenoma. Through the analysis and research of gene mutations, gene transcriptional changes and epigenetics, we hope to search for potential therapeutic targets from the perspective of molecular biology to find new therapeutic methods.

Objective: To investigate the antimicrobial resistance and molecular epidemiology of foodborne Yersinia (Y.) enterocolitica in Pudong New District of Shanghai. Methods: Four kinds of raw food samples were collected in retail circulation sites in Pudong from 2012 to 2016. Cold enrichment method was used to isolate Y. enterocolitica and further detection of biotype, serotype, virulent genes, antimicrobial susceptibility of the isolates and pulsed field gel electrophoresis (PFGE) were conducted. Results: A total of 3 900 raw food samples were collected during this period, including poultry product (n=590), livestock product (n=1 074), aquatic product (n=1 488), vegetable (n=748), in which 111 (2.8%) were contaminated by Y. enterocolitica. The detection rates of Y. enterocolitica in poultry product samples (5.3%, 31/590) and livestock product samples (4.5%, 48/1 074) were higher than those in aquatic product samples (1.6%, 24/1 488) and vegetable samples (1.1%, 8/748). The predominant biotype was 1A (95.5%) and predominant serotype was O∶8 (42.3%). All the strains lacked ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. Seventy six (68.5%) strains harbored ystB gene, in which 35 (31.5%) belonged to 1A/O∶8/ystB pattern. Most strains were resistant to ampicillin (74.8%) and amoxicillin/clavulanic acid (70.3%), and non-sensitive rate to Cefoxitin was over 50.0%. No third generation cephalosporin or fluoroquinolone resistant strains were detected, but 38.7% (43/111) strains were multidrug resistant (MDR). Serotype O∶8 and O∶5 strains had 44 and 18 PFGE patterns, respectively. Conclusions The main foodborne exposure sources of Y. enterocolitica in raw food were poultry and livestock products in Pudong New District. 1A/O∶8/ystB was the predominant pattern with potential pathogenicity despite lacks of typical pathogenic virulent genes. The antimicrobial resistant rates of Y. enterocolitica were at a low level, but MDR strains still existed. Molecular types of the isolates showed highly genetic diversity.

Objective To understand the regional epidemiology and antibiotic resistance pattern of diarrheagenic E .coli infection in children ,and to clarify the pathogenic association between diarrheagenic E .coli infection and childhood diarrhea .Methods Totally 680 diarrheal children in the outpatient setting and 680 non-diarrheal control children were enrolled prospectively .The stool samples were collected and the potential enteric pathogens were detected .Minimal inhibitory concentration (MIC) method was used to determine the antimicrobial susceptibility for diarrheagenic E .coli isolates .Results The isolation rates of diarrheagenic E .coli in diarrhea group and control group were 15 .6％ and 13 .1％ ,respecitvely ,and diarrheagenic E .coli was the most commonly detected enteric bacteria .Multivariate logistic regression analysis adjusted for age suggested no clinical association between diarrhea and infection with enteropathogenic E .coli (EPEC) (aOR=1 .2 ,95％ CI:0 .8-1 .8) ,enteroadhesive E .coli (EAEC) (aOR=1 .1 ,95％ CI:0 .7 -1 .6) and enterotoxigenic E .coli (ETEC) (aOR= 1 .8 ,95％ CI:0 .5 -6 .2) . Among 199 diarrheagenic E .coli strains ,the rates of resistance to ampicillin ,tetracycline ,trimethoprim-sulfamethoxazole ,azithromycin ,and ceftriaxone were 63 .8％ ,55 .8％ ,48 .2％ ,34 .2％ and 26 .6％ , respectively ,while the rates of resistance to ciprofloxacin , amoxicillin-clavulanate and cefoxitin were 4 .5％ ,1 .5％ and 0 .5％ ,respectively .Conclusions Diarrheagenic E .coli is the most common enteric bacteria detected in the stool samples from children with and without diarrhea in this study . The pathogenic role of infections with EPEC ,EAEC and ETEC in childhood diarrhea is not determined .EHEC and EIEC are rarely detected and further studies are needed to clarify the pathogenic association between infection with EHEC ,EIEC and childhood diarrhea .

Objective To detect the expressions of endocan,vascular endothelial growth factor (VEGF),and matrix metalloproteinase-9 (MMP-9) and their significances in pituitary tumor tissues.Methods (1) Eighty pituitary tumor specimens,collected during surgical resection and after pathological examination confirmation in our hospital from January 2005 to December 2014,were used in our experiment;40 of them were from patients with pituitary adenomas apoplexy and 40 of them were without apoplexy;the expressions ofendocan,VEGF and MMP-9 in these pituitary tumor tissues were detect by immunohistochemical methods.(2) Twenty patients with pituitary tumor,performed surgical resection and pathological examination confirmation in our hospital from January 2015 to October 2015,chosen,and their tumor specimens were used in our experiment;10 of them were from patients with pituitary adenomas apoplexy and 10 of them were without apoplexy;the endocan mRNA expression in these pituitary tumor tissues were detect by reverse translation-PCR (RT-PCR).Results (1) Thirty-one,33 and 30 specimens in apoplexy group had positive expressions of endocan,VEGF and VEGF;24,26 and 20 specimens in non-apoplexy group had positive expressions of endocan,VEGF and VEGF;as compared with those in the non-apoplexy group,the immunorective scale (IRS) scores of protein expressions of endocan,VEGF and VEGF in apoplexy group were significantly higher (P＜0.05);endocan and VEGF protein expressions were positively correlated (r=0.555,P=0.000);endocan and MMP-9 protein expressions were positively correlated (r=0.423,P=0.006);VEGF and MMP-9 protein expressions were positively correlated (r=0.621,P=0.000).(2) The endocan mRNA expression in apoplexy group was significantly higher than that in non-apoplexy group ([17.53 ±8.95] × 10-3 vs.[4.67±3.03]×10-3,P＜0.05).Conclusion Endocan,VEGF and MMP-9 proteins may play important roles in the process of pituitary adenoma apoplexy.

Objective To evaluate the efficiency of thyroid ultrasound grading formulated by American Thyroid Association (ATA) and fine-needle aspiration (FNA) biopsy in diagnosing benign and malignant thyroid nodules.Methods A retrospective analysis of 357 thyroid nodules in 342 patients underwent surgical excision or FNA biopsy after thyroid ultrasound was performed.All ultrasonograms were graded according to ATA diagnosis guideline for thyroid nodule versi on 2015.The diagnostic efficiency of ATA grading and FNA biopsy were evaluated comparing with postoperative pathological results.Results There were 248 of 357 thyroid nodules confirmed with postoperative pathology,including 233 malignant and 15 benign nodules.The diagnostic accuracy,sensitivity,specificity,positive and negative predictive value of ATA guideline in diagnosis of malignant thyroid nodules was 88.31％ (219/248),90.99％ (213/233),46.67％ (7/15),96.36％ (212/220)and 25.00％ (7/28),respectively,while of FNA biopsy was 98.81％ (83/84),100％ (75/75),88.89 ％ (8/9),98.68％ (75/76) and 100％ (8/8),respectively.The area under the curve (AUC) of ROC was 0.653 and 0.944 for ATA grading and FNA biopsy,respectively (Z=2.397,P=0.017).Conclusion ATA guideline has high diagnostic value in differential diagnosis of thyroid nodules,while FNA may be more effective in diagnosis of thyroid nodules.