ObjectiveTo reveal the molecular mechanism of Angong Niuhuangwan（AGNH） in improving traumatic brain injury（TBI） based on single cell sequencing. MethodSeventy-five male SD rats were randomly divided into the sham group， model group， piracetam group（3.6 g·kg^-1）， AGNH low- and high-dose groups（0.09， 0.27 g·kg^-1）， with 15 rats in each group. In addition to the sham group， the other 4 groups used the modified Feeney free-fall impact method to prepare TBI model， and the drugs were administered by gavage immediately after modeling， 24 hours later， the modified neurological deficit score（mNSS） was performed， and brain tissue was isolated to determine the degree of cerebral edema. Hematoxylin-eosin（HE） staining was used to observe the injury degree in the cortex， CA1 region and CA3 region of brain tissue. The expression levels of cyclooxygenase-2（COX-2）， interferon regulatory factor 1（IRF1）， Janus kinase 2（JAK2） and suppressor of cytokine signaling 3（SOCS3） were observed by immunofluorescence（IF） staining. The levels of interleukin（IL）-6， IL-18， IL-1β， IL-17A， tumor necrosis factor-α（TNF-α）， Caspase-1 and nucleotide binding oligomerization domain（NOD）-like receptor heat protein domain associated protein 3（NLRP3） inflammasome were determined by enzyme-linked immunosorbent assay（ELISA）. The regulation of AGNH on each cell population was analyzed by single cell sequencing， and differentially expressed genes were analyzed by Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG）， which led to construct microglia differentially expressed gene network to search for the key targets， and validated by ELISA and IF. ResultCompared with the sham group， the mNSS and brain water content were significantly increased in the model group（P<0.01）. Compared with the model group， mNSS and brain water content in the low and high dose AGNH groups were decreased（P<0.05，P<0.01）. HE staining results showed that compared with the sham group， the cells in the cerebral cortex and hippocampus of rats in the model group were seriously lost， and the cells were arranged loosely（P<0.01）. Compared with the model group， AGNH could significantly increase the density of neurons in the CA1 and CA3 regions of the cerebral cortex and hippocampus， making the arrangement more compact， as well as improved cell morphology（P<0.05，P<0.01）. ELISA and IF staining showed that AGNH could reduce the levels of Caspase-1， IL-17A， TNF-α， NLRP3 and COX-2 in brain tissue of TBI rats（P<0.05， P<0.01）. A total of 13 cell subsets were identified by single cell sequencing， among which microglia played an important role in neuroimmunity. The results of GO enrichment analysis of differentially expressed genes in microglia showed that AGNH improved TBI in response to inflammation and TNF-α. KEGG enriched IL-17 signaling pathway， TNF signaling pathway， Toll-like receptor signaling pathway， etc. The results of network analysis showed that the key targets of AGNH in regulating TBI might be IL-6， IL-1β， JAK2， SOCS3， IRF1. IF and ELISA verification results showed that compared with the sham group， SOCS3 expression in microglia was decreased in the model group， and the expressions of IL-6， IL-1β， JAK2 and IRF1 were increased（P<0.01）. Compared with the model group， AGNH could increase the expression of SOCS3， decrease the expression of IL-6， IL-1β， JAK2， IRF1 （P<0.05， P<0.01）. ConclusionAGNH can reduce the degree of brain edema and brain injury， decrease the expression of inflammatory factors， and inhibit the expression of NLRP3 and its downstream Caspase-1 in TBI rats， which may act on the targets of IL-6， IL-1β， JAK2， IRF1 and SOCS3 in microglia.

Hepatic fibrosis (HF) is a self-healing pathological process after all kinds of chronic liver injuries and can cause diseases such as liver cirrhosis and liver cancer. The Wnt signaling pathway is highly conserved in species evolution and widely exists in invertebrates and vertebrates, and many studies have confirmed that the Wnt signaling pathway is closely associated with the development and progression of HF. This article reviews the mechanisms of the classical and non-classical Wnt signaling pathways in regulating hepatic stellate cells, hepatic macrophages, and hepatic progenitor cells, so as to provide new ideas for subsequent studies on the mechanism of the Wnt signaling pathway in regulating HF and further exploration of therapeutic targets that can reverse HF.

Acute respiratory distress syndrome(ARDS) refers to non-cardiac respiratory failure caused by various internal and external factors in the lung, and is a common clinical critical illness.As in adults, lung-protective ventilation strategies combined with pharmacological support remain the mainstay of treatment for children with ARDS.A large number of clinical studies have been carried out on drug therapy, and some progress has been made.This article reviewed alveolar surfactants, hormones, nitric oxide, angiotensin converting enzyme 2, immune nutrition, etc., in order to provide references for subsequent treatment.

Objective To explore the clinical differences between patients with early-onset myasthenia gravis (EOMG)and those with late-onset myasthenia gravis(LOMG).Methods This was a retrospective study enrolling 157 MG patients.Based on the age of onset,patients were divided into the EOMG group(n=85)and the LOMG group(n =72).The groups were compared on clinical characteristics,including clinical manifestations,MG classification,electrophysiological findings on repetitive nerve stimulation(RNS),single fiber electromyography(SFEMG),levels of antibody against acetylcholine receptors(Ach-R Ab),antibody to muscle-specific kinase(MuSK Ab),titin antibody(Titin Ab),ryanodine receptor antibody(RyR Ab),thyroid function,thymectomy,thymus pathology and responses to treatment.Results The mean ages of onset were markedly different [(40.9 ± 9.7) years vs.(62.0 ± 12.2) years,P＜ 0.05] between the EOMG and LOMG groups.The LOMG group was associated with a significantly higher rate of the ocular form(50.0 ％,n=36 vs.32.9％,n=28,P＜0.05),a lower rate of the general form(50.0％,n=36 vs.67.1％,n=57,P＜0.05),and an increased risk of bulbar involvement(41.7％ n=30 vs.23.5％,n=20,P＜0.05)than those in the EOMG group.There was no significant difference in positive rates of RNAS and SFEMG,and levels of AChR Ab,MuSK Ab and double serum negative(DSN)MG between the groups (P＞0.05).Moreover,patients in the EOMG group were more likely to have abnormal thyroid function and higher percentages of receiving steroids,tacrolimus,plasma exchange therapy,and thymectomy (P＜ 0.05).Conclusions The clinical profiles of LOMG are different from those of EOMG in clinical manifestations,thyroid function,thymectomy frequency,striational antibody levels and disease-modifying drug options.

BACKGROUND/AIMS: Gastric hypersensitivity contributes to abdominal pain in patients with functional dyspepsia. Recent studies showed that hormones induced by stress are correlated with visceral hypersensitivity. However, the precise mechanisms underlying gastric hypersensitivity remain largely unknown. The aim of the present study was designed to investigate the roles of corticosterone (CORT) on excitability of dorsal root ganglion (DRG) neurons innervating the stomach. METHODS: DRG neurons innervating the stomach were labeled by DiI injection into the stomach wall. Patch clamp recordings were employed to examine neural excitability and voltage-gated sodium channel currents. Electromyograph technique was used to determine the responses of neck muscles to gastric distension. RESULTS: Incubation of acutely isolated DRG neurons with CORT significantly depolarized action potential threshold and enhanced the number of action potentials induced by current stimulation of the neuron. Under voltage-clamp mode, incubation of CORT enhanced voltage-gated sodium current density of the recorded neurons. Pre-incubation of GF109203X, an inhibitor of protein kinase C, blocked the CORT-induced hyperexcitability and potentiation of sodium currents. However, pre-incubation of H-89, an inhibitor of protein kinase A, did not alter the sodium current density. More importantly, intraperitoneal injection of CORT produced gastric hypersensitivity of healthy rats, which was blocked by pre-administration of GF109203X but not H-89. CONCLUSIONS: Our data strongly suggest that CORT rapidly enhanced neuronal excitability and sodium channel functions, which is most likely mediated by protein kinase C but not protein kinase A signaling pathway in DRG neurons innervating the stomach, thus underlying the gastric hypersensitivity induced by CORT injection.
Abdominal Pain ; Action Potentials ; Animals ; Corticosterone ; Cyclic AMP-Dependent Protein Kinases ; Diagnosis-Related Groups ; Dyspepsia ; Ganglia ; Ganglia, Spinal* ; Humans ; Hypersensitivity ; Injections, Intraperitoneal ; Neck Muscles ; Neurons ; Protein Kinase C* ; Protein Kinases* ; Rats* ; Sodium ; Sodium Channels ; Spinal Nerve Roots* ; Stomach* ; Visceral Pain

Objective To evaluate the efficacy of the systemic photodynamic therapy (SPDT)for treating leukemia using a Brown Norway myeloid leukemia (BNML) rat model.Methods The BNML rat model was established by injecting green fluorescent protein (GFP)-LT12 cells into the tail vein.After GFP-LT12 injection,the early-SPDT group,mid-SPDT group and late-SPDT group were treated with SPDT at 5,10 and 15 days,the negative control group was fed as usually,and the Ara-c positive control group was treated with Ara-c at 7 days.The GFP-LT12 cells were traced by a fluorescence imaging system.The GFP-LT12 cells in the tissues and organs were detected by flow cytometry.The levels of IFN-γ,IL-1α,IL-1β,IL-2,IL-4,IL-6,IL-10 and TNF-α in serum were detected by milliplex rat cytokine 9 kits.Results Compared with the negative control group,the survival times of the rats in the earlySPDT group,mid-SPDT group and the late-SPDT group were prolonged (all P＜0.05).The ratios of GFP-LT12 cells in pulp and liver were decreased in the late-SPDT group.The levels of IL-1β,IL-10,TNF-α and IFN-γin serum of the late-SPDT group were decreased (all P＜0.05).Conclusion The SPDT is an effective method for the treatment of leukemia,and the anti-tumor immune effect may play a key role in this process.

Objective To investigate the protective effect of umbilical cord mesenchymal stem cells (UCMSCs) on traumatic brain injury (TBI) in rats.Methods Thirty healthy Sprague-Dawley rats (10 rats for each group) were randomly divided into normal control group (normal),model group (injection of saline after TBI) and UCMSCs transplantation group (injection of UCMSCs after TBI).The rats in experimental groups were sacrificed on the 10th day after UCMSCs transplantation.The percentage of UCMSCs in brain tissue was detected by flow cytometry.The pathological changes of brain tissue were observed by hematoxylin-eosin (HE) staining method.The expressions of vascular endothelial growth factor (VEGF),glial fibrillary acidic protein (GFAP) and brain-derived neurotrophic factor (BDNF) in brain tissue were measured by immunohistochemistry and immunofluorescence double staining.The neurological deficit was evaluated by neurological deficit degree.Results The percentage of CD90,CD73 and CD105 cells in the UCMSCs transplantation group was significandtly higher than that in the model group (0.4％ vs 0.1％,P＜0.05).The results of HE staining showed that the brain injury of the transplanted group was alleviated compared with the model group (P＜0.05).The VEGF of the brain tissue in injury area in the UCMSCs transplantation group was higher than that in the model group (P＜0.05).The number of GFAP and BDNF positive cells in the UCMSCs transplantation group was higher than that in the model group (P＜0.05),and the neurological deficit score was also higher than that in the model group (P＜0.05).Conclusions UCMSCs transplantation for the treatment of TBI rats can effectively reduce the vascular damage in the injury area and promote nerve recovery.

Objective To explore the clinical efficacy and outcomes of thrombus aspiration in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PPCI). Methods A total of 664 cases of STEMI patients undergoing PPCI from Tianjin Chest Hospital from January 2013 to March 2015 were retrospectively analyzed. Patients were divided into two groups:primary PCI after thrombus aspiration group and conventional primary PCI without thromobus aspiration group. The base-line clinical characteristics, and the procedure of percutaneous coronary intervention were similar between two groups. The TIMI flow, LVEF, one-month outcomes and 12-month outcomes were compared between two groups. Results There were significant higher TIMI flow, LVEF in primary PCI after thrombus aspiration group than those of conventional primary PCI without thromobus aspiration group (P<0.05). At one-month follow-up, there were no significant differences in major adverse cardiac events (MACE) between the two groups. At 12-month follow- up, there were no significant differences in cardiovascular death, recurrent myocardial infarction and new hospitalization between two groups. The incidence of recurrent angina was significantly higher in non-aspiration group than that in aspiration group (P<0.05). There were the better survival functions without MACE in aspiration group than that of control group. Conclusion Thrombus aspiration, as an adjunctive method to primary PCI for STEMI, may improve TIMI flow, have beneficial effects on LVEF and reduce the incidence of recurrent angina at 12-month follow up.

For engineering an efficient butanol-producing Escherichia coli strain, many efforts have been paid on the known genes or pathways based on current knowledge. However, many genes in the genome could also contribute to butanol production in an unexpected way. In this work, we used Tn5 transposon to construct a mutant library including 1 196 strains in a previously engineered butanol-producing E. coli strain. To screen the strains with improved titer of butanol production, we developed a high-throughput method for pyruvate detection based on dinitrophenylhydrazine reaction using 96-well microplate reader, because pyruvate is the precursor of butanol and its concentration is inversely correlated with butanol in the fermentation broth. Using this method, we successfully screened three mutants with increased butanol titer. The insertion sites of Tn5 transposon was in the ORFs of pykA, tdk, and cadC by inverse PCR and sequencing. These found genes would be efficient targets for further strain improvement. And the genome scanning strategy described here will be helpful for other microbial cell factory construction.
Butanols ; chemistry ; DNA Transposable Elements ; Escherichia coli ; metabolism ; Fermentation ; Gene Library ; Hydrazines ; Industrial Microbiology ; Mutagenesis ; Open Reading Frames ; Organisms, Genetically Modified ; Polymerase Chain Reaction ; Pyruvic Acid ; chemistry

The manuscript introduced the overview, training objectives, policy advantages, training process,curriculum, examination of the Australian College in Rural and Remote Medicine and further contrasted that with China's domestics.The authors held that Australia's training is better targeted due to its colleges tailored to this end;the training duration for general practitioners of rural and remote areas is longer,and the training schedule is reasonable;the curriculum design and training content are more targeted;and the homogeneous training is better achieved as its examination is run by the college in a standardized manner.The authors therefore hold that China should develop detailed regulations for general practitioners from rural and remote areas and explore the feasibility of setting up second-level disciplines institutes for internal medicine, surgery, gynecology and obstetrics, pediatrics and general at national and provincial level.