Objective To investigate the effects of meridian massage on mitochondrial autophagy in ischemic stroke rats through the hypoxia-inducible factor-1α(HIF-1α)/BCL2/adenovirus E1B 19kDa interacting protein 3(BNIP3)pathway.Methods The ischemic model was made by blocking the right middle cerebral artery(MCA)of rats with thread embolism.The ischemic stroke rats with successful modeling were divided into model group,massage group,pathway agonist group,pathway inhibitor group and massage+inhibitor group.The rats in the blank control group received routine massage at non-meridian acupoints(including Baihui,Fengfu and Renzhong).The massage group was treated with circulation massage(including Biguan,Taichong,Fenglong and Zusanli),the pathway agonist group was treated with HIF-1α/BNIP3 activator,the pathway inhibitor group was treated with HIF-1α/BNIP3 inhibitor,and the massage+inhibitor group was treated with combination of circulation massage and HIF-1α/BNIP3 inhibitor.Another 10 healthy rats were selected for sham operation intervention,which only separated the blood vessels without inserting the plug.Neurological deficits were evaluated through the Zea Longa scoring system;TTC brain smear staining was used to determine the volume of cerebral infarction and the degree of hemispheric swelling in rats.The pathological changes of rat hippocampal tissue were observed by HE staining;Immunofluorescence was used to detect the expressions of HIF-1α and BNIP3 in rat brain tissue;The number of autophagosomes in the hippocampal region was observed by transmission electron microscopy.Western blot was used to detect the protein expressions related to autophagy(LC3B),apoptosis(Beclin-1),and HIF-1α/BNIP3 signaling pathways in mitochondria of brain tissue.Results ① The fluorescence expression intensity of HIF-1α and BNIP3 in hippocampus of model group was increased compared with that of sham group(P<0.05);The fluorescence expression intensity of HIF-1α and BNIP3 in hippocampus of massage group was significantly increased compared with that of model group(P<0.05).② Compared with model group,cerebral hemisphere swelling,nerve function deficit score and cerebral infarction volume in inhibitor group were increased(P<0.05);The levels of cerebral hemisphere swelling,nerve function deficit score and cerebral infarction volume in agonist group were decreased(P<0.05).The protein expressions of Beclin-1 and LC3B in agonist group were increased(P<0.05).The protein expressions of Beclin-1 and LC3B in inhibitor group were decreased(P<0.05).③ Compared with the massage group,the hippocampal cells in the massage+inhibitor group were more dispersed,the number of cells decreased,edema appeared,and tissue was damaged.④ Compared with model group,the protein expressions of LC3B,HIF-1α,Beclin-1 and BNIP3 in massage group were increased(P<0.05);The protein expressions of LC3B,HIF-1α,Beclin-1 and BNIP3 in massage+inhibitor group were decreased(P<0.05).Conclusion In the treatment of ischemic stroke,meridian massage can activate HIF-1α/BNIP3 signaling pathway,and then promote brain mitochondrial autophagy to improve nerve function,which provides a theoretical basis for the subsequent application of meridian massage in the clinical treatment of ischemic stroke patients.

Objective To investigate the effects of meridian massage on mitochondrial autophagy in ischemic stroke rats through the hypoxia-inducible factor-1α(HIF-1α)/BCL2/adenovirus E1B 19kDa interacting protein 3(BNIP3)pathway.Methods The ischemic model was made by blocking the right middle cerebral artery(MCA)of rats with thread embolism.The ischemic stroke rats with successful modeling were divided into model group,massage group,pathway agonist group,pathway inhibitor group and massage+inhibitor group.The rats in the blank control group received routine massage at non-meridian acupoints(including Baihui,Fengfu and Renzhong).The massage group was treated with circulation massage(including Biguan,Taichong,Fenglong and Zusanli),the pathway agonist group was treated with HIF-1α/BNIP3 activator,the pathway inhibitor group was treated with HIF-1α/BNIP3 inhibitor,and the massage+inhibitor group was treated with combination of circulation massage and HIF-1α/BNIP3 inhibitor.Another 10 healthy rats were selected for sham operation intervention,which only separated the blood vessels without inserting the plug.Neurological deficits were evaluated through the Zea Longa scoring system;TTC brain smear staining was used to determine the volume of cerebral infarction and the degree of hemispheric swelling in rats.The pathological changes of rat hippocampal tissue were observed by HE staining;Immunofluorescence was used to detect the expressions of HIF-1α and BNIP3 in rat brain tissue;The number of autophagosomes in the hippocampal region was observed by transmission electron microscopy.Western blot was used to detect the protein expressions related to autophagy(LC3B),apoptosis(Beclin-1),and HIF-1α/BNIP3 signaling pathways in mitochondria of brain tissue.Results ① The fluorescence expression intensity of HIF-1α and BNIP3 in hippocampus of model group was increased compared with that of sham group(P<0.05);The fluorescence expression intensity of HIF-1α and BNIP3 in hippocampus of massage group was significantly increased compared with that of model group(P<0.05).② Compared with model group,cerebral hemisphere swelling,nerve function deficit score and cerebral infarction volume in inhibitor group were increased(P<0.05);The levels of cerebral hemisphere swelling,nerve function deficit score and cerebral infarction volume in agonist group were decreased(P<0.05).The protein expressions of Beclin-1 and LC3B in agonist group were increased(P<0.05).The protein expressions of Beclin-1 and LC3B in inhibitor group were decreased(P<0.05).③ Compared with the massage group,the hippocampal cells in the massage+inhibitor group were more dispersed,the number of cells decreased,edema appeared,and tissue was damaged.④ Compared with model group,the protein expressions of LC3B,HIF-1α,Beclin-1 and BNIP3 in massage group were increased(P<0.05);The protein expressions of LC3B,HIF-1α,Beclin-1 and BNIP3 in massage+inhibitor group were decreased(P<0.05).Conclusion In the treatment of ischemic stroke,meridian massage can activate HIF-1α/BNIP3 signaling pathway,and then promote brain mitochondrial autophagy to improve nerve function,which provides a theoretical basis for the subsequent application of meridian massage in the clinical treatment of ischemic stroke patients.

Deep brain stimulation(DBS),including optical stimulation and electrical stimulation,has been demonstrated considerable value in exploring pathological brain activity and developing treatments for neural disorders.Advances in DBS microsystems based on implantable microelectrode array(MEA)probes have opened up new opportunities for closed-loop DBS(CL-DBS)in situ.This technology can be used to detect damaged brain circuits and test the therapeutic potential for modulating the output of these circuits in a variety of diseases simultaneously.Despite the success and rapid utilization of MEA probe-based CL-DBS microsystems,key challenges,including excessive wired communication,need to be urgently resolved.In this review,we considered recent advances in MEA probe-based wireless CL-DBS microsystems and outlined the major issues and promising prospects in this field.This technology has the potential to offer novel therapeutic options for psychiatric disorders in the future.

Objective To investigate the effect of a modified preputial flap urethroplasty in twostage treatment of severe hypospadias.Methods The clinical characteristics of the severe hypospadias patients (41 cases) who underwent the staged urethroplasty by using the procedure of preset urethral plate with preputial flap from January 2015 to December 2016 were analyzed retrospectively.We used a modified method (modified group,23 cases):Form the distal urethra with the transected distal urethral plate by using tubularize incised plate (TIP) procedure during the first stage operation,after completely straightened the penis,urethral plate was preseted with transverse preputial flap at the penis shaft.While in the traditional group (18 cases),urethral plate was preseted with preputial flap by using Bracka procedure after transecting urethral plate.The corresponding missing part of urethra underwent urethroplasty at the second stage operation six months later.The patients in the modified group were 9 to 18 months old,and the median age was 13 months;meatus were located at the penis shaft in 10 cases,scrotum in 12 cases,perineum in 1 case.The patients in the traditional group were 9 to 18 months old,and the median age was 13 months;meatus were located at the penis shaft in 6 cases,scrotum in 10 cases,and perineum in 2 cases.There was no statistic difference in age and meatus position between the two groups.Results During the first stage operation,distal urethra was repaired by 13-19 mm,with an average of (14.5 ± 1.3) mm,and the proximal urethra was repaired by 0-6 mm,with an average of (3.1 ± 2.4) mm at the modified group.While at the traditional group,the length of proximal urethra was repaired of 0-9 mm,with an average of (5.6:±:2.9) mm.The urethral length required for reconstruction was measured during the second stage operation,with an average of (26.3:t:4.4) mm in the modified group and (40.5 ± 3.3) mm in the traditional group (P ＜ 0.05).There were 3 case of urethral stricture after removed the catheter,with 2 cases in the modified group and 1 case in the traditional group.Postoperative follow-up was 2 to 3 years,with an average of 2.4 years.There were 3 cases (3/23,13.0％) of urethral fistula in the modified group and 3 cases (3/18,16.7％) in the traditional group.Ascended testis occured in 2 patients in the traditional group after operation.No case of urethrostenosis,diverticulum,chordee or concealed pennis was recorded.There was no significant difference in postoperative complications between the two groups (P ＞ 0.05).Conclusions The modified staged preputial flap method shorten the new forming urethra by making full use of its own materials at the second stage operation,which was helpful to reduce complications.

Objective To investigate the effect of replacing a smaller-size catheter after tubularized incised plate (TIP) urethroplasty on postoperative urethral complications.Methods The data of 116 hypospadias patients underwent TIP urethroplasty performed by the same urologist in our hospital from January 2014 to December 2017 were retrospectively analyzed.The age of patients ranged from 0.5-15.4 years,with the median age of 1.5 years.Meatal location was distal in 47 (39.5％),midshaft in 62 (52.1％) and proximal in 10(8.4％) patients.Unhealthy urethral plate occurred in 49 (42.2％) patients.F8 catheter was used for urethroplasty in 92 (79.3 ％) patients,F10 in 17 (14.7％),and F12 in 7 (6.0％).According to the pattern of urinary diversion,patients were divided into two groups.Conventional catheter group in 56 patients (group A):the catheter was chosen in as large size as possible for urethroplasty without tension.Replace a smaller-size catheter group in 60 patients (group B):replace a smaller-size catheter after urethroplasty on the basis of group A.There were no statistically significant differences in age,meatal location and catheter size between the two groups (P ＞ 0.05).Results The mean follow up was 23 months (range 6-66 months).There were 73(62.9％) cases of orifice overflow during indwelling catheterization.There were 5 (4.3％) patients needed further reoperation result from postoperative urethral complications,including 4 cases of fistula and 1 case of meatal stenosis.The process of replacing a smaller-size catheter after urethroplasty in group B was simple and without adverse reactions.There were 15 (26.8％) cases of orifice overflow in group A and 58 (96.7％) in group B.There were statistically significant differences in orifice overflow between the two groups (P ＜ 0.05).There were 5 (8.9％) cases of postoperative urethral complications in group A and 0 case in group B.There were statistically significant differences in postoperative urethral complications (P ＜ 0.05).Conclusions The process of replacing a smaller-size catheter after TIP urethroplasty in was simple and subsequently contributed to less postoperative urethral complications.The results of replacing a smaller-size catheter after TIP urethroplasty were superior to that of no replacing conventionally.

Objective To investigate the application of pedicled tunica vaginalis flap cover new urethra in redo and second-stage hypospadias repair.Methods Retrospective analysis was performed in 45 redo hypospadias repair cases,aged from 1 year 3 months to 9 years 4 months (median 5 years 3month).All patients were divided into urethral dehiscence after hypospadias repair (group A) and the second stage surgery of two-stage hypospadias repair (group B) based on medical history.According to the site of dehiscence,the group A were further divided into midshaft urethral dehiscence (A1) and glans and distal urethral dehiscence with urethral opening located on midshaft (A2).After new urethra was completed,the appropriate size of the pedicledtunica vaginalis flap was transferred to cover the new urethra.Results There was no scrotal hematoma occurred in all 45 cases,and somecomplications occurred,including scrotal swelling in 1 case,high-riding testicle in 2 cases,penile clockwise torsion in 1 case,urethrocutaneous fistula in 6 cases.All the 45 cases were followed up for 1 to 4 years,with mean of 1.8 years.One more urethrocutaneous fistula occurred in group A2 and 1 more urethrocutaneous fistula with urethral stricture occurred in group B.There was no penile curvature and urethral diverticulum occurred in all cases.Conclusions Pedicled tunica vaginalis flap could be used as waterproofing layer to cover new urethra in redo hypospadias repair and presented a low incidence rate of postoperative complications.

Urine samples from diabetic and healthy subjects were detected by H4 protein chip and surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS).Some significantly differential proteins between diabetic and controls were found.Four top-scored protein peaks were finally selected as the potential "fingerprints" for detection of early diabetic nephropathy by artificial neural network (ANN) classifier.

OBJECTIVETo evaluate the clinical efficacy of a new formulation of albendazole emulsion (AbzE) in cases of liver cystic hydatidosis.

METHODSTwo regimens of AbzE (10 mg.kg(-1).d(-1) and 12.5 mg.kg(-1).d(-1)) were given to 212 patients with liver cystic hydatidosis in courses ranging from 3 months to more than one year. Assessment of drug efficacy was essentially based on imaging signs with ultrasonography as the main tool. Assessments were performed at the end of different courses and in the follow-up study of 1 - 4 years after the cessation of therapy.

RESULTSAt the end of therapeutic courses, the overall cure rate of the 212 cases was 74.5%, with a 99.1% effective rate. In the follow-up study, the cure rate was 83.1%, effective rate was 89.3%, ineffective rate was 0.6%, and recurrence rate was 10.2%. The highest cure rate was observed in cases receiving AbzE 12.5 mg.kg(-1).d(-1) for 9 months. Retreatment of recurrent cases with AbzE obtained satisfactory results.

CONCLUSIONSAbzE surpassed other currently used antihydatidosis drugs or formulations with its promising efficacy and mild side effects, and could be recommended as a drug of choice in the treatment of cystic hydatidosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albendazole ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; Echinococcosis, Hepatic ; drug therapy ; Emulsions ; Female ; Humans ; Male ; Middle Aged