OBJECTIVES: To explore the mechanisms of Qingre Lidan Jiedu Recipe (QLJR) for improving cognitive dysfunction in rats with high copper load. METHODS: Seventy-five male SD rats were randomized into normal control group, model group, QLJR group, penicillamine (PCA) group, and QLJR+ PCA group. Except for those in the control group, all the rats were fed a high-copper diet for 12 weeks. The effects of the treatments on cognitive function of the rats were assessed using the Barnes maze and passive avoidance tests. Hippocampal expressions of NIX, FUNDC1 and LC3 of the rats were detected using Western blotting and immunofluorescence staining, and changes in mitochondrial morphology were observed with transmission electron microscopy. RESULTS: Behavioral tests showed prolonged target hole latency, shortened latency to enter the dark chamber, and increased error counts of the rats in the model group, which were significantly improved in QLJR+PCA group; the error counts were significantly lower in QLJR+PCA group than in either QLJR or PCA group. Among all the groups, the hippocampal expressions of NIX and FUNDC1 were the lowest and LC3 I/II expression the highest in the model group; NIX and FUNDC1 expressions were significantly higher and LC3 I expression was lower in QLJR+PCA group than in QLJR group and PCA group. Immunofluorescence staining revealed weakened NIX and FUNDC1 expressions and enhanced LC3 expression in the hippocampus of the rats in the model group as compared with those in the normal control and QLJR+PCA groups, but their expressions did not differ significantly between QLJR and PCA groups. The rats in the model group showed obvious structural disarray of the mitochondria, which were improved in all the treatment groups. CONCLUSIONS QLJR improves cognitive dysfunction in rats with high copper load possibly by regulating mitophagy.
Animals ; Male ; Rats, Sprague-Dawley ; Rats ; Drugs, Chinese Herbal/therapeutic use* ; Copper/toxicity* ; Mitophagy/drug effects* ; Hippocampus/drug effects* ; Cognition Disorders/drug therapy* ; Cognitive Dysfunction/chemically induced*

Aim To explore the mechanism of oxidized lipoprotein(a)(oxLp(a))inducing pyroptosis of vascu-lar endothelial cells.Methods After incubating human umbilical vein endothelial cells(HUVEC)with 100 mg/L ox-Lp(a)for 24 hours,Western blot and RT-qPCR was used to detect pyroptosis related proteins,pro-inflammatory cytokines,mitochondrial related proteins NRF1,NRF2,PGC-1α and mitochondrial gene cytochrome b(CYTB),ELISA was used to detect the levels of inflammatory factors,scanning electron microscopy was used to detect cell membrane rup-ture,transmission electron microscopy was used to detect mitochondrial morphology,Hoechst33342/PI staining was used to detect cell apoptosis,MitoSOX probe was used to detect mitochondrial reactive oxygen species(mtROS),Flu-4AM probe was used to detect calcium ions,JC-1 probe was used to detect mitochondrial membrane potential(MMP),and Calcein AM staining was used to detect mitochondrial permeability transition pore(mPTP).Transfecting HUVEC with CYTB overexpressing lentivirus and analyzing its effects on oxLp(a)induced pyroptosis and mitochondrial function.Results After treatment with oxLp(a),the expression of NLRP3,pro-Caspase-1,Caspase-1,GSDMD and GSDMD-N proteins re-lated to pyroptosis were significantly increased(P＜0.05);the protein and mRNA levels of CYTB and pro-inflammatory cy-tokine IL-1β,IL-18 were significantly increased(P＜0.05).Small pores appeared on the cell membrane,the percentage of PI stained positive cells significantly increased(P＜0.05).OxLp(a)significantly inhibited the expression of mito-chondrial related proteins NRF1,NRF2 and PGC-1α,and the expression of mitochondrial gene CYTB,promoted an in-crease in mtROS generation,Ca2+overload,a decrease in ATP levels,a decrease in MMP,an increase in mPTP values,and abnormal mitochondrial morphology.After transfection with pHelper 2.0 lentivirus vector overexpressing CYTB,it was found that oxLp(a)induced HUVEC pyroptosis and mitochondrial morphological and functional abnormalities were par-tially reversed by overexpression of CYTB.Conclusion oxLp(a)promotes mitochondrial morphological and functional abnormalities and induces HUVEC pyroptosis by downregulating CYTB.

Objective:To explore the effect of chronic intermittent hypoxia(CIH)on learning and memory dysfunc-tion in rats,as well as the expression of high mobility group box-1(HMGB1)and nuclear transcription factor-KB(NF-κB)in the hippocampus region.Methods:The CIH rat model was established,and forty SD rats were randomly divid-ed into four groups:normoxia group,hypoxia for 4 weeks group(CIH4 group),hypoxia for 8 weeks group(CIH8 group),and hypoxia for 12 weeks group(CIH12 group).Morris water maze was used to assess the learning memory ability of rats,and immunohistochemistry and ELISA were used to detect the expression of HMGB1 and NF-κB in the hippocampus of rats.Results:Compared with the normoxia group,the CIH12 and CIH8 groups had longer escape la-tency,the number of crossing the platform and the residence time in the quadrant of the platform were significantly shortened,but there was no significant difference in the CIH4 group.Additionally,there was no significant expression of HMGB1 and NF-κB in the hippocampal region of the normoxia group,but little expression was observed in CIH4 group,and significantly expressed in CIH8 group and CIH12 group,and the expression of CIH12 group was significantly higher than that of CIH8 group.Conclusion:CIH can lead to a decline in learning and memory function in rats,and the longer time of intermittent hypoxia led to the more significant effect on their learning and memory function.In addi-tion,CIH also leads to increased expression levels of HMGB1 and NF-κB in the hippocampus region,and the expres-sion increased more significantly after hypoxia for 12 weeks,comparing to hypoxia for 8 weeks.

Objective    To explore the treatment outcome of carotid endarterectomy combined with vertebral artery transposition in patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery. Methods    From June 2017 to September 2020, patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery treated with carotid endarterectomy combined with vertebral artery transposition in Fuwai Hospital were retrospectively analyzed. Results    Finally 12 patients were enrolled, including 10 males and 2 females with an average age of 67.8±6.0 years. Twelve patients were successfully operated and the follow-up time was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 83.5%±11.8% to 24.9%±14.3% (P<0.001). The stenosis degree of carotid artery decreased from 85.6%±11.0% to 0% (P<0.001). Postoperative follow-up showed that the symptoms of symptomatic patients before surgery improved. The 1-year and 3-year patency rates were 100.0%, and there were no peripheral nerve injury complications, perioperative deaths or strokes. Conclusion    Carotid endarterectomy combined with vertebral artery transposition can treat ipsilateral carotid artery  stenosis and vertebral artery stenosis at the same time, improve blood supply to the brain, improve patients' symptoms and has high promotion value.

Objective:To investigate the clinical effect of the transverse rectus abdominismuscle (TRAM) on reconstruction of the breast.Methods:The clinical data of 23 patients receiving TRAM breast reconstruction in our department from Jan. 2018 to Dec. 2019 were retrospectively analyzed.Results:The operation time of 23 patients ranged from 240 to 360 mins, andthe average time was about 300 mins. Intraoperative bleeding was about 120 to 200 ml, with an average of 170 ml. All the flaps survived successfully, but 2 cases were complicated with local fat necrosis. The postoperative period was between 6 and 12 months. No local tumor recurrence or metastasis was found inall patients during postoperative follow-up, and the breast shape was maintained in good condition.Conclusion:TRAM can make up for the regret of breast loss caused by breast cancer in female patients. It can bring confidence in life and work to female patients, and the technology is safe and reliable, which is worthy of promotion.

BIA-ALCL often occurs 7-10 years after breast reconstruction surgery with breast implants and its incidence is about 23-33 per million. The most common symptoms include breast swelling with seroma, breast mass and lymphadenopathy. It’s assumed that BIA-ALCL is associated with immune response induced by textured breast implants with clonal expansion of local CD30 + T cell, some gene mutations such as JAK1 and STAT3 mutations as well as pathogen infections. Currently, ultrasonography, cytological and immunological tests of exudate as well as biopsy of breast mass are commonly applied for diagnosis. From the perspective of oncology, we propose the following suggestions: (1) We should be alert to the risk of missed diagnosis in the current medical environment, and clinical information is suggested to be collected especially for Asian patients. (2) Due to the low incidence and good prognosis of BIA-ALCL, those who have used textured implants don’t need to be over-worried. (3) It is suggested that researches about manufacturing technology of textured breast implants, JAK-STAT mutations and pathogen infections should be carried out to explore the pathogenic mechanisms of BIA-ALCL, and multi-disciplinary cooperation should be advocated to cope with the diagnosis and treatment of this disease.

BIA-ALCL often occurs 7-10 years after breast reconstruction surgery with breast implants and its incidence is about 23-33 per million. The most common symptoms include breast swelling with seroma, breast mass and lymphadenopathy. It’s assumed that BIA-ALCL is associated with immune response induced by textured breast implants with clonal expansion of local CD30 + T cell, some gene mutations such as JAK1 and STAT3 mutations as well as pathogen infections. Currently, ultrasonography, cytological and immunological tests of exudate as well as biopsy of breast mass are commonly applied for diagnosis. From the perspective of oncology, we propose the following suggestions: (1) We should be alert to the risk of missed diagnosis in the current medical environment, and clinical information is suggested to be collected especially for Asian patients. (2) Due to the low incidence and good prognosis of BIA-ALCL, those who have used textured implants don’t need to be over-worried. (3) It is suggested that researches about manufacturing technology of textured breast implants, JAK-STAT mutations and pathogen infections should be carried out to explore the pathogenic mechanisms of BIA-ALCL, and multi-disciplinary cooperation should be advocated to cope with the diagnosis and treatment of this disease.

Objective:To evaluate the accuracy of diffusion weighted magnetic resonance imaging (DWI-MRI) combined with high resolution temporal bone CT (HRCT) in the location diagnosis of middle ear cholesteatoma and its value in the postoperative follow-up.Methods:134 patients with inital cholesteatoma and 22 patients with suspected recurrent cholesteatoma were selected for HRCT, conventional MRI and DWI examination. Based on the intraoperative and pathological diagnosis, DWI and HRCT images were combined to evaluate the consistency between the lesion location and invasion area of the initial cholesteatoma and intraoperative lesions. The results of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were statistically analyzed to evaluate their diagnostic efficacy.Results:The accuracy rate of DWI combined with HRCT was 90.3%.The sensitivity, specificity, positive predictive value and negative predictive value of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were 27.8%, 75.0%, 83.3%, 18.8% and 100%, 75.0%, 94.7% and 100%, respectively, and the Kappa values consistent with the pathological results were 0.024 and 0.843, respectively. Chi-square test confirmed that there were differences in the diagnosis between groups ( P<0.001). Conclusions:Combined with the high sensitivity of DWI and the high resolution of HRCT, the accuracy of preoperative positioning of the newly diagnosed cholesteatoma can be improved and surgery strategy can be guided. DWI is also of high diagnostic value for recurrent cholesteatoma in the middle ear.

Objective It has been increasingly realized that perioperative nutritional support plays an important role in improving clinical outcomes in children with congenital heart disease ( CHD) undergoing cardiopulmonary bypass surgery.The purpose of this review was to examine the nutritional conditions in perioperative CHD children and the main problems in nutri-tional management in the cardiac intensive care unit ( CICU) , based on which further directions were proposed .We found that preoperative malnutrition is common .This limited research of energy and protein is further compounded by the complex meta-bolic alterations with hyper-metabolism, hyper-catabolism and hypo-anabolism in the early postoperative course.Knowledge a-bout energy and protein metabolism and requirements in post-CPB children remains much limited .The current nutritional rec-ommendations in the CICU are based on little evidence .Insufficient energy and protein supply to meet demands remains a norm in the immediate postoperative period .The commonly used predictive equations do not provide accurate estimate of energy re-quirement in individual patients during the highly dynamic postoperative course .Indirect calorimetry can provide the best esti-mate of energy requirements for CHD infants .Nitrogen balance is recommended to assess the minimal protein requirement . During the early postoperative period, daily measurements of resting energy expenditure using indirect calorimetry and nitrogen balance in each individual child are essential to optimize energy and protein supply to meet requirements .A paradigm should be shifted toward individualized nutrition prescription in the context of a specific CICU feeding algorithm .

OBJECTIVE: To investigate the effects of Kangfuxin solution combined with Chuangyangling and gelatin sponge on dry socket disease in patients with type 2 diabetes mellitus after the extraction of impacted teeth. METHODS: A total of 85 patients with impacted teeth and type 2 diabetes mellitus during Jan. 2016-Jan. 2017 were divided into group A (29 cases), B (25 cases), C (31 cases) according to random number table. All patients were treated with turbine drill method; in group A, Kangfuxin solution + Absorbable gelatin sponge was used to fill the wound site; in group B, Chuangyangling+compound preparation of Kangfuxin solution and gelatin sponge were used to fill the wound site; in group C, the wounds were filled with gauze but without any drugs. All patients received routine anti-infective treatment after surgery for 5-7 d. The time of impacted teeth extraction was observed in 3 groups; granulation tissue coverage integrity rate of tooth socket and the incidence of dry socket disease 7 d after surgery, the incidence of other postoperative complications, treatment cost, satisfaction scores were also comparod. RESULTS: There was no statistical significance in the time of impacted teeth extraction or treatment cost among 3 groups (P＞0. 05). Seven days after surgery, granulation tissue coverage integrity of tooth socket and satisfaction scores were in descending order: group B＞group A＞group C; the incidence of dry sockets were in ascending order: group B＜group A＜group C, with statistical significance (P＜0. 05). The incidence of other postoperative complications as bleeding, pain, swelling, limitation of mouth opening in group A and B were significantly lower than group C, with statistical significance (尸＜0. 05). There were no statistical significance between group A and B (P＞0. 05). CONCLUSIONS: Kangfuxin solution combined with Chuangyangling and gelatin sponge can effectively increase granulation tissue coverage integrity of tooth socket, and reduce the incidence of dry socket disease and other postoperative complications in patients with type 2 diabetes mellitus, but do not increase economic burden of patients and obtain high patient satisfaction.