This study explores the mechanism of Guben Jiannao Liquid on Alzheimer's disease(AD) by regulating autophagy based on the liver kinase B1(LKB1)/adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) pathway. Male SD rats were randomly divided into the blank group, model group, low-dose and high-dose groups of Guben Jiannao Liquid, and rapamycin group, with 10 rats in each group. Except for the blank group, all other groups of rats were injected bilaterally in the hippocampus with β-amyloid(Aβ)_(1-42) to establish the AD model. The low-dose(6.21 g·kg~(-1)) and high-dose(12.42 g·kg~(-1)) groups of Guben Jiannao Liquid and rapamycin group(1 mg·kg~(-1)) were given the corresponding drugs by gavage, and the blank and model groups were given an equal volume of saline by gavage for four weeks. Morris water maze was used to test the learning and memory ability of rats in each group; hematoxylin-eosin(HE) and Nissl staining were used to observe the morphological and quantitative changes of neurons and Nissl bodies in the CA1 region of rat hippocampus; immunohistochemistry was utilized to detect Aβ-positive cell expression in the CA1 region of rat hippocampus; transmission electron microscopy was employed to observe ultrastructural changes in rat hippocampal tissue, and Western blot was used to examine the protein expression levels of LKB1, p-AMPK/AMPK, p-mTOR/mTOR, Beclin1, p62, and LC3-Ⅱ in the hippocampal tissue of the rats. The results showed that compared with those in the blank group, rats in the model group had elevated evasion latency and decreased number of platform transversal and residence time in the platform quadrant. The number of neurons in the hippocampal area was reduced, and the morphology was impaired. The average integral optical density value of Aβ-positive cells was elevated; the expression levels of LKB1, p-AMPK/AMPK, Beclin1, and LC3-Ⅱ were decreased, and the expression levels of p-mTOR/mTOR and p62 were increased. Compared with those in the model group, rats in the low-dose and high-dose groups of Guben Jiannao Liquid had shorter evasion latency, higher number of platform transversal, longer residence time in the platform quadrant, increased number of neurons, decreased expression of Aβ-positive cells and average integral optical density values, and increased number of autophagic lysosomes in hippocampal tissue. The expression levels of LKB1, Beclin1, and LC3-Ⅱ were elevated in the hippocampus of rats in the low-dose group of Guben Jiannao Liquid. The expression levels of LKB1, p-AMPK/AMPK, Beclin1, and LC3-Ⅱ were elevated in the hippocampal tissue of rats in the high-dose group of Guben Jiannao Liquid, and the expression levels of p-mTOR/mTOR and p62 were decreased. The findings suggest that Guben Jiannao Liquid can improve cognitive impairment in AD rats, and its mechanism of action may be related to the activation of the LKB1/AMPK/mTOR signaling pathway and the up-regulation of autophagy level.
Animals ; Alzheimer Disease/physiopathology* ; Male ; TOR Serine-Threonine Kinases/genetics* ; Autophagy/drug effects* ; Rats, Sprague-Dawley ; Protein Serine-Threonine Kinases/genetics* ; AMP-Activated Protein Kinases/genetics* ; Rats ; Drugs, Chinese Herbal/administration & dosage* ; Signal Transduction/drug effects* ; AMP-Activated Protein Kinase Kinases ; Humans ; Hippocampus/metabolism*

Objective:To explore the value and technique details of the overlay reconstruction technique of angiography in surgical planning of scalp arteriovenous fistulas.Methods:The clinical data of patients admitted from February 2014 to April 2020 in the Neurosurgical Department of Second Affiliated Hospital of Soochow University with scalp arteriovenous fistulas were analyzed retrospectively. Preoperative angiography was carried out in all patients for diagnosis, and the angiographical data was obtained without injection of the contrast agent by the mode of XperCT Cereb. Fast HD followed by three-dimension rotation angiography (3DRA) with the contrast agent. The overlay reconstruction was achieved for surgical planning to demonstrate feeding arteries and drainage veins surrounding the fistula. Surgeries were conducted by resection or devascularization of the lesion. All patients were followed up in the out-patient clinic to assess the healing and to detect the symptomatic recurrence and scalp necrosis. The pathological changes of the lesion were observed by HE staining.Results:Five patients were enrolled in this study, including three males and two females aged from 10 to 60 years old (average 34.2-year-old). Pulsatile mass of local scalp was presented in all patients, one with a thin scalp. Five patients suffered from five scalp arteriovenous fistulas, including three on the right side and two on the left. Feeding arteries mainly originated from the superficial temporal artery were confirmed in four cases, and the posterior auricular artery in one case. Single venous drainage was noted in two cases, as well as multiple drainage veins in three cases. Three lesions were supplied by unilateral feeding arteries, while bilateral feeding arteries supplied the rest lesions. Two fistulas were treated by resection, two were treated by devascularization, and one was treated by resection with skin grafting. One lesion was fed by a single artery, three lesions were fed by two arteries, and one lesion was fed by three arteries. Three lesions were fed by unilateral arteries, and two lesions were fed by bilateral arteries. Single fistula was detected in one lesion and multiple fistulas in four lesions. Single drainage was confirmed in two lesions, doubled drainages in two lesions, and tripledrainages in one lesion. All patients experienced surgical treatment in one stage.Two patients underwent complete resection of the lesion, two with complete devascularization, and one with autologous thigh skin grafting after resection. Postoperative pathological examination demonstrated dilated and congested vascular lumen, which was consistent with arteriovenous fistula. All patients healed well after surgery. With13-87 months follow-up, no recurrence and necrosis were noted. Two were reexamined by cerebral angiography, which showed no recurrence.Conclusions:Digital subtraction angiography facilitates the diagnosis of scalp arteriovenous fistula accurately and effectively. The overlay reconstruction technique of angiography is crucial for precise localization of fistula shunt and the surrounding feeders and drainages, which is helpful for surgical planning.

Objective:To explore the value and technique details of the overlay reconstruction technique of angiography in surgical planning of scalp arteriovenous fistulas.Methods:The clinical data of patients admitted from February 2014 to April 2020 in the Neurosurgical Department of Second Affiliated Hospital of Soochow University with scalp arteriovenous fistulas were analyzed retrospectively. Preoperative angiography was carried out in all patients for diagnosis, and the angiographical data was obtained without injection of the contrast agent by the mode of XperCT Cereb. Fast HD followed by three-dimension rotation angiography (3DRA) with the contrast agent. The overlay reconstruction was achieved for surgical planning to demonstrate feeding arteries and drainage veins surrounding the fistula. Surgeries were conducted by resection or devascularization of the lesion. All patients were followed up in the out-patient clinic to assess the healing and to detect the symptomatic recurrence and scalp necrosis. The pathological changes of the lesion were observed by HE staining.Results:Five patients were enrolled in this study, including three males and two females aged from 10 to 60 years old (average 34.2-year-old). Pulsatile mass of local scalp was presented in all patients, one with a thin scalp. Five patients suffered from five scalp arteriovenous fistulas, including three on the right side and two on the left. Feeding arteries mainly originated from the superficial temporal artery were confirmed in four cases, and the posterior auricular artery in one case. Single venous drainage was noted in two cases, as well as multiple drainage veins in three cases. Three lesions were supplied by unilateral feeding arteries, while bilateral feeding arteries supplied the rest lesions. Two fistulas were treated by resection, two were treated by devascularization, and one was treated by resection with skin grafting. One lesion was fed by a single artery, three lesions were fed by two arteries, and one lesion was fed by three arteries. Three lesions were fed by unilateral arteries, and two lesions were fed by bilateral arteries. Single fistula was detected in one lesion and multiple fistulas in four lesions. Single drainage was confirmed in two lesions, doubled drainages in two lesions, and tripledrainages in one lesion. All patients experienced surgical treatment in one stage.Two patients underwent complete resection of the lesion, two with complete devascularization, and one with autologous thigh skin grafting after resection. Postoperative pathological examination demonstrated dilated and congested vascular lumen, which was consistent with arteriovenous fistula. All patients healed well after surgery. With13-87 months follow-up, no recurrence and necrosis were noted. Two were reexamined by cerebral angiography, which showed no recurrence.Conclusions:Digital subtraction angiography facilitates the diagnosis of scalp arteriovenous fistula accurately and effectively. The overlay reconstruction technique of angiography is crucial for precise localization of fistula shunt and the surrounding feeders and drainages, which is helpful for surgical planning.

Kangfu Xiaoyan Suppository is widely used in the treatment of gynecological inflammatory diseases. Long-term clinical application and a certain amount of research evidences show that Kangfu Xiaoyan Suppository can alleviate the clinical symptoms of pelvic inflammatory diseases,reduce the recurrence rate,and relieve sequelae,with a better safety and economic characteristics. As a type of nationally protected traditional Chinese medicine and type B medicine included in medical insurance,it has been selected as a Chinese patent medicine for rectal administration. It was included in the Guidelines for diagnosis and treatment of common gynecological diseases of traditional Chinese medicine published by the Chinese Academy of Traditional Chinese Medicine in 2012,the Pelvic inflammatory diseases diagnosis and treatment guidelines issued by the Infectious Diseases Collaborative Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association in 2014,and the group standard of Single use of traditional Chinese medicine/combined antibiot guidelines for clinical practice-pelvic inflammatory diseases of the Chinese Academy of Traditional Chinese Medicine in 2017. To further enhance clinicians' understanding of the drug and better guide its rational clinical use,experts from the field of gynecology of traditional Chinese and Western medicine were invited to develop and compile this expert consensus. This consensus takes full account of clinical evidences and expert clinical experience,and form recommendations for clinical problems based on evidences and consensus recommendations for clinical problems without evidence by nominal grouping method. The expert consensus is mainly formed in the consideration of six factors: quality of evidence,economy,efficacy,adverse reactions,patient acceptability and others. Based on clinical research evidences and expert experience,this consensus provides a preliminary reference for the clinical use of the drug in a concise and clear format. However,evidence-based support is still required in a large number of high-quality studies,and this consensus will be revised in the future according to new clinical problems and the update of evidence-based evidence in practical application.
Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Humans ; Medicine, Chinese Traditional ; Nonprescription Drugs ; Pelvic Inflammatory Disease/drug therapy* ; Suppositories

Objective To analyze the changes of serum fatty acid synthase (FAS),carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) in patients with gastric cancer and its clinical diagnostic value.Methods Forty five patients with gastric cancer and 45 patients with benign gastric cancer treated in our hospital from January 2016 to December 2016 were enrolled in this study.Forty five healthy subjects were enrolled in this study.The levels of FAS,CEA,and CA72-4 in three groups were analyzed.Results The levels of FAS,CEA,and CA72-4 in patients with gasttric cancer [(12.73 ± 5.48) mg/L,(31.36 ± 14.51) ng/ml,and (39.32 ± 18.76) U/ml] were significantly higher than those in benign gastric cancer group [(2.26 ± 1.15) ng/L,(3.24 ± 1.47) ng/ml,and (3.75 ± 1.69) U/ml],and normal control group [(1.83 ± 0.92) mg/L,(2.71 ± 1.54) ng/ml,and (3.13 ± 1.82) U/ml] (P ＜ 0.05).FAS,CEA,and CA72-4 levels in patients with lymph node metastasis of gastric cancer [(13.58 ± 6.09) mg/L,(6.25 ± 11.54) ng/ml,and (41.31 ± 13.67) U/ml] were significantly higher than those without lymph node metastasis [(9.21 ± 5.42) mg/L,(28.38 ± 9.72) ng/ml,and (26.75 ± 11.86) U/ml] (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly lower than that in combined detection,the specificity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly higher than that in combination test (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with lymph node metastasis was significantly lower than that in combination test,and the specificity of FAS,CEA and CA72-4 was significantly higher than that of combined detection (P ＜ 0.05).Conclusions FAS,CEA,and CA72-4 can be used as indicators of gastric cancer and diagnosis of lymph node metastasis.Combined detection of three indexes can improve the diagnostic sensitivity and have good clinical significance.

Adult ; Coronary Restenosis ; surgery ; Drug-Eluting Stents ; Humans ; Male ; Sirolimus ; therapeutic use

BACKGROUNDThe Fc receptor associated pathway might improve the immune responses against hepatitis B virus (HBV) as previously described by us. In addition, the Flt3 ligand (FL) has been reported to potentiate antigen presenting cells in vivo and may act as a potential adjuvant to boost antigen-specific immune responses. In this study, the immune efficacies of a set of fusion proteins of HBsAg and Fc and/or FL were evaluated in HBsAg transgenic mice.

METHODSThe fusion proteins composed of HBsAg and the Fc domain of murine IgG1 (HBsAg-Fc) and/or the Flt3 ligand, and yeast-derived recombinant HBsAg were used as immunogen to immunize HBsAg transgenic mice, respectively. Serum and liver HBsAg levels, serum anti-HBsAg and cytokine profile, and the activities of alanine aminotransferase (ALT)/AST were investigated after immunization.

RESULTSAfter six injections, the most pronounced decrease in serum and liver HBsAg levels was observed in the HBsAg-Fc immunized group. In addition, serum Th1 cytokines and ALT/AST activities were highest in this group, indicating an effective induction of a favorable cellular immune response. Interestingly, the fusion protein containing HBsAg-Fc and the Flt3 ligand stimulated an alternative Th1-type immune response featured with high level productions of tumor necrosis factor α (TNF-α) and monocyte chemoabstractant protein 1 (MCP-1), causing a more severe cytotoxicity in hepatocytes while showed less effective in reducing serum HBsAg level.

CONCLUSIONHBsAg-Fc is effective in eliciting both the humoral and cellular immune responses against HBsAg in HBsAg transgenic mice, which makes it a potential immunogen for the immunotherapy of chronic hepatitis B.

Animals ; Chemokine CCL2 ; metabolism ; Cytokines ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B Surface Antigens ; genetics ; immunology ; metabolism ; Immunity, Cellular ; immunology ; Immunity, Humoral ; immunology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Receptors, Fc ; genetics ; immunology ; metabolism ; Recombinant Fusion Proteins ; genetics ; immunology ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To validate the feasibility of applying ground-based spatial disorientation training scenarios to aeromedical training of Chinese military pilots and to provide reference values for assessing its effects. Methods Eighty healthy pilots performed ground-based spatial disorientation training on the basic of previously established aeromedical training profiles of Chinese Air Force and the scenarios applied by North Atlantic Treaty Organization (NATO) were referenced. Somatogyral illusion and Coriolis illusion were induced by VTS-0 type electric rotating chair, while circular vection and autokinetic illusion were induced by VTS-Ⅲ type vestibular function examination system. During the illusion demonstrations, the response parameters of illusion, including the latent period and the duration of induced illusions were recorded. Results The induced rate of somatogyral illusion, Coriolis illusion, circular vection and autokinetic illusion was 100.0%, 90.7%, 72.50% and 49.2% respectively. The induce rate of vestibular illusions was higher than that of visual illusions (χ2=5.01, P<0.05). The duration of somatogyral illusion, Coriolis illusion (rolling sensation) and Coriolis illusion (tumbling sensation) was (8.4±4.5) s, (4.9±2.3) s and (5.4±3.0) s respectively, while the latent period of circular vection and autokinetic illusion was (34.8±19.0) s and (42.8±15.2) s respectively. The response reference value corresponding to the duration of somatogyral illusion, Coriolis illusion (rolling sensation) and Coriolis illusion (tumbling sensation) was respectively not more than 17.4 s, 11.4 s and between 0.3 and 9.5 s, while the response reference value for the latent period of circular vection and autokinetic illusion was respectively not more than 72.8 s and within the range from 12.4 to 73.2 s. Conclusions Somatogyral illusion, Coriolis illusion, circular vection and autokinetic illusion training scenarios can be demonstrated by the existing ground-based training devices of Chinese military pilots and the training is feasible and effective for aeromedical training of Chinese military pilots. We hope that response reference values can be used in assessing the effect of ground-based spatial disorientation training.

Objective To validate the feasibility of applying ground-based spatial disorientation training scenarios to aeromedical training of Chinese military pilots and to provide reference values for assessing its effects. Methods Eighty healthy pilots performed ground-based spatial disorientation training on the basic of previously established aeromedical training profiles of Chinese Air Force and the scenarios applied by North Atlantic Treaty Organization (NATO) were referenced. Somatogyral illusion and Coriolis illusion were induced by VTS-0 type electric rotating chair, while circular vection and autokinetic illusion were induced by VTS-Ⅲ type vestibular function examination system. During the illusion demonstrations, the response parameters of illusion, including the latent period and the duration of induced illusions were recorded. Results The induced rate of somatogyral illusion, Coriolis illusion, circular vection and autokinetic illusion was 100.0%, 90.7%, 72.50% and 49.2% respectively. The induce rate of vestibular illusions was higher than that of visual illusions (χ2=5.01, P<0.05). The duration of somatogyral illusion, Coriolis illusion (rolling sensation) and Coriolis illusion (tumbling sensation) was (8.4±4.5) s, (4.9±2.3) s and (5.4±3.0) s respectively, while the latent period of circular vection and autokinetic illusion was (34.8±19.0) s and (42.8±15.2) s respectively. The response reference value corresponding to the duration of somatogyral illusion, Coriolis illusion (rolling sensation) and Coriolis illusion (tumbling sensation) was respectively not more than 17.4 s, 11.4 s and between 0.3 and 9.5 s, while the response reference value for the latent period of circular vection and autokinetic illusion was respectively not more than 72.8 s and within the range from 12.4 to 73.2 s. Conclusions Somatogyral illusion, Coriolis illusion, circular vection and autokinetic illusion training scenarios can be demonstrated by the existing ground-based training devices of Chinese military pilots and the training is feasible and effective for aeromedical training of Chinese military pilots. We hope that response reference values can be used in assessing the effect of ground-based spatial disorientation training.

Objective To explore effectiveness of improving the abilities of instrument visual spatial orientation (IVSO) training for high performance fighter pilots. Methods An IVSO training device was developed.Based on the principles of computer graphics and characteristics of cognition,4 kinds of instrument flight condition patterns were adopted as training profiles.Eleven pilots were trained along these four training profiles for five times,include recognizing and flying by instrument and head-up display respectively in complicated flight sortie or with interference.The reaction time,rate of correct operation,deviation angle of attitude and the adjunctive task completion rate were recorded and compared. Results In pre-and post-IVSO training,the reaction times got with instrument and head-up display in complicated flight sortie were (1.42±0.24)s vs.(0.99±0.13)s and(1.54±0.29)s vs.(1.05±0.12)s respectively while the rates of correct operations were 53.91%±9.12%vs.90.00%±5.88%and 73.09%±12.02%vs.89.18%±6.10% respectively.Deviation angles of roll and pitch in maintaining flight attitude by instrument training were 3.25°±0.60°vs.2.07°±0.25°and 2.41°±0.63°vs.1.87°±0.30°respectively,comparing to 3.08°±1.03°vs.2.06°±0.35°and 2.84°±0.67°vs.1.99°±0.20°in attitude maintenance by head-up display.Adjunctive task correct rates with believing instrument and head-up display were 63.90%±11.15%vs.88.27%±10.23%and 59.73%±12.81%vs.82.09%±9.62% respectively.All differences between pre-and post-IVSO trainings are statistically significant (t=2.47 to 11.03,P<0.01 or P<0.05). Conclusions The adopted instrument flight training can remarkably improve pilot's IVSO abilities.