Objective:To evaluate the effect of selective cerebral mild hypothermia on the expression of histone deacetylase 1-3 (HDAC1-3) during focal cerebral ischemia-reperfusion (I/R) in rats.Methods:Sixty clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 240-260 g, were divided into 4 groups ( n=15 each) using a random number table method: sham operation group (S group), focal cerebral I/R group (I/R group), selective cerebral mild hypothermia group (SCH group), and normothermia group (N group). Only the cervical vessels were isolated in S group. In the other three groups, sutures were inserted into the internal carotid artery to block the middle cerebral artery for 2 h, and then the sutures were pulled out to restore perfusion for 24 h. A focal cerebral I/R model was prepared. Normal saline at 20 ℃ and 37 ℃ was infused into the internal carotid artery at a rate of 0.6 ml/min for 10 min starting from the time point immediately after removal of the sutures in SCH group and N group respectively. Cerebral temperature and rectal temperature were continuously monitored during the operation. The modified neurological severity score (mNSS) was assessed at 24 h of reperfusion. The rats were then sacrificed under deep anesthesia and brains were obtained for determination of cerebral infarct size (by TTC staining). The tissues of the cerebral ischemic penumbra were taken for determination of the apoptosis rate of neurons (by TUNEL method) and lactylation modification and expression of HDAC1-3 (by Western blot) and for observation of the morphology of neurons (by HE staining). Results:Compared with S group, the mNSS, cerebral infarct size and apoptosis rate of neurons were significantly increased, HDAC1-3 expression was down-regulated, and the lactylation modification was increased in the other three groups ( P<0.05). Compared with I/R and N groups, the mNSS, cerebral infarct size and apoptosis rate of neurons were significantly decreased, HDAC1-3 expression was up-regulated, and the lactylation modification was decreased in SCH group ( P<0.05). There was no statistically significant difference in the aforementioned parameters between I/R group and N group ( P>0.05). HE staining showed that the morphology of neurons was intact and well-defined in S group, a large number of cells with edema and irregularly solidified nuclei were found in I/R group and N group, and the nuclear shrinkage and morphological changes of neurons were alleviated in SCH group. Conclusions:The mechanism by which selective cerebral mild hypothermia alleviates cerebral I/R injury may be related to up-regulation of HDAC1-3 expression in rats.

SOCS3, a feedback inhibitor of the JAK/STAT signal pathway, negatively regulates axonal regrowth and inflammation in the central nervous system (CNS). Here, we demonstrated a distinct role of SOCS3 in the injured spinal cord of the gecko following tail amputation. Severing the gecko spinal cord did not evoke an inflammatory cascade except for an injury-stimulated elevation of the granulocyte/macrophage colony-stimulating factor (GM-CSF) and interferon gamma (IFN-γ) cytokines. Simultaneously, the expression of SOCS3 was upregulated in microglia, and unexpectedly not in neurons. Enforced expression of SOCS3 was sufficient to suppress the GM-CSF/IFN-γ-driven inflammatory responses through its KIR domain by attenuating the activities of JAK1 and JAK2. SOCS3 was also linked to GM-CSF/IFN-γ-induced cross-tolerance. Transfection of adenovirus overexpressing SOCS3 in the injured cord resulted in a significant decrease of inflammatory cytokines. These results reveal a distinct role of SOCS3 in the regenerating spinal cord, and provide new hints for CNS repair in mammals.

The protein encoded by the HOXC gene regulates multiple processes during embryonic development,including cell growth,differentiation,apoptosis,migration and angiogenesis.The HOXC gene is also involved in the occurrence and development of various human solid tumors,such as colorectal cancer,gastric cancer,liver cancer,breast cancer,endometrial cancer,etc.In addition,the HOXC gene is closely related to the clinical stage and distant metastasis of the tumor.Thus,the HOXC gene can be used as a biological predictor of tumor metastasis and prognosis.

Objective To explore the changes of depression in patients with lung cancer and their impacts on the survival period,so to provide evidence for psychological treatment of patients with lung cancer.Methods 339 lung cancer patients diagnosed and treated in our hospital and other hospital from 2010 to 2013 were included.The depression status of patients was diagnosed by the Depression Scale of Epidemiological Research Center and followed up every year.To observe the changes of depressive symptoms during the survival period,and to evaluate the impact of depressive symptoms on the survival rate of patients.Results Among 339 participants,133 (39％) had depression symptoms at baseline and an additional 71 (21％) developed new-onset depression symptoms during treatment.At baseline,depression symptoms were associated with increased mortality (hazard ratio [HR],1.19,95％ CI:1.04-1.34).Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up:never depression symptoms (n =135),new-onset depression symptoms (n =71),depression symptom remission (n =46),and persistent depression symptoms (n =87).HRs were as follows:new-onset depression symptoms,1.36 (95％ CI:1.12-1.61),depression symptom remission,1.11 (95％ CI:0.97-1.25),and persistent depression symptoms,1.33 (95％ CI:1.09-1.57).Conclusions Among patients with lung cancer,longitudinal changes in depression symptoms are associated with differences in mortality.Symptom remission is associated with a similar mortality rate as never having had depression,which is lower than that in persistent and new-onset depression symptoms.

Adenosine 5'-monophosphate-activated protein activated protein kinase (AMPK), a heterotrimeric complex, is an important kinase to regulate glycolipid metabolism and energy balance involved in a variety physiological processes in human body. Many research indicated that the function and activity of AMPK were closely related to inflammation, diabetes and cancers. Recent reports show that inhibition of metformin (a first-line drug) on hepatic glucose in patients with hyperglycemia is associated with AMPK pathway, suggesting that targeting AMPK may be one of the effective strategies for the prevention and treatment of a variety of chronic diseases. Here, we review research progress on the structure, activation and regulation of AMPK in glycolipid metabolism to provide an insight into the basic and clinical research of diabetes therapy.
AMP-Activated Protein Kinases ; Adenosine ; Adenosine Monophosphate ; Energy Metabolism ; Enzyme Activation ; Glycolipids ; Humans

Objective To evaluate the predictive value of ultrasonography of the respiratory variability index of inferior vena cava internal diameter (IVC-RVI) in preoperative fluid responsiveness evaluation of hip fracture in geriatric patients.Methods A retrospective case-control study was used to analyze 39 cases of elderly hip fractures admitted to the Daping Hospital of Army Medical Center from August 2017 to February 2018,including 15 males and 24 females,aged 65-92 years [(80.9 ±7.9)years].The heart rate (HR),mean arterial pressure(MAP),cardiac output (CO),and cardiac stoke volume (SV)were recorded five minutes after the patient entered the operating room and within 5 minures after capacity load test.The inferior vena cave during expiration (IVCe) and inferior vena cave during inspiration (IVCi) were measured by ultrasound before and after volume load test and the difference in IVC-RVI was calculated.Volumetric positive group were the cases of SV change (△SV) ≥15％ (positive group,n =21),and volume negative group were the cases of △SV ＜ 15％ (negative group,n=18).The correlations between various ultrasonic parameters and SV were analyzed by comparing HR,MAP,CO,SV,SV,IVCe,IVCi and IVC-RVI before and after the capacity load test.The predictive value of IVC-RVI for preoperative volumetric reactivity in elderly patients with hip fractures was evaluated by using the receiver operative characteristic (ROC) curve and Pearson correlation analysis.Results Prior to the volumetric load test,no significant difference was observed between the two groups concerning HR,MAP,CO,SV,and IVCe (P ＞ 0.05),IVCi in the positive group was significantly smaller than that in the negative group (P ＜ 0.05),and IVC-RVI in the positive group was significantly larger than that in the negative group (P ＜ 0.05).After the volumetric load test,there was no statistically significant difference between the two groups in CO,IVCe,IVCi,and IVC-RVI (P ＞ 0.05),HR in the positive group was smaller than that in the negative group (P ＜ 0.05),and MAP and SV in the positive group were significantly larger than that in the negative group (P ＜ 0.05).Compared with that before capacity load test,MAP,CO,and SV in the positive group increased after the capacity load test (P ＜ 0.05),while the HR difference was not statistically significant (P ＞ 0.05).HR,MAP,CO,and SV showed no significant difference in the negative group before and after capacity test (P ＞ 0.05).IVC-RVI assessed the area under the curve (AUC) was 0.80 ± 0.08 for preoperative volumetric responsiveness in elderly hip fractures (P ＜ 0.05),with a critical point of 20.69％,sensitivity of 77.78％,and specificity of 76.19％.After Pearson correlation analysis,IVC-RVI was positively related to △SV (OR =0.367,P ＜ 0.05).Conclusion Ultrasonography of the respiratory variability of IVC can predict the preoperative fluid responsiveness of hip fracture in geriatric patients and guide for clinical rehydration.

Objective To investigate the application value of biological mesh in the pelvic floor reconstruction of extralevator abdominoperineal excision (ELAPE) for advanced low rectal cancer (RC).Methods The retrospective cohort study was conducted.The clinicopathological data of 228 patients with advanced low RC who underwent ELAPE in the Beijing Chaoyang Hospital of Capital Medical University between August 2008 and December 2016 were collected.Of 228 patients,174 using biological mesh closure and 54 using primary closure were respectively allocated into the biological mesh group and primary closure group.Observation indicators:(1)intra-and post-operative situations;(2) postoperative complications (including short-term and long-term complications);(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications,tumor recurrence or metastasis and overall survival up to December,2017.Measurement data with normal distribution were represented as（ x） ±s,and comparison between groups was analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was analyzed using the nonparametric test.Comparisons of count data were evaluated by the chi-square test or Fisher exact probability.Results (1)Intra-and post-operative situations:all the patients underwent successful ELAPE.The perineal operation time,time of indwelling perineal drainage-tube and hospital expenses were respectively (60 ± 50)minutes,(11.6 ± 2.4) days,(57 781± 11 337) yuan in the biological mesh group and (50±21) minutes,(8.9± 1.7) days,(53 714± 13 395)yuan in the primary closure group,with statistically significant differences between groups (t =3.327,7.691,-2.203,P＜0.05).The total operation time and duration of postoperative hospital stay were respectively (242±53) minutes,(13.0±5.0) days in the biological mesh group and (228±51) minutes,(12.0±5.0) days in the primary closure group,with no statistically significant difference between groups (t =1.701,1.309,P＞0.05).(2) Postoperative complications:26 and 19 patients in the biological mesh group and primary closure group had respectively perineal wound complications (1 patient combined with multiple complications),showing a statistically significant difference between groups (x2 =10.660,P＜0.05).The perineal wound infection,perineal hernia and disruption of perineal wound were respectively detected in 20,6,1 patients in the biological mesh group and 12,7,3 patients in the primary closure group,showing statistically significant differences between groups (x2 =3.931,5.282,P＜0.05).(3) Follow-up and survival situations:174 patients in the biological mesh group were followed up for 64 months (range,13-112 months),and 54 patients in the primary closure group were followed up for 51 months (range,23-76 months).The local recurrence rate,distal metastasis rate and overall survival rate were respectively 5.17％ (9/174),20.11％ (35/174),77.59％ (135/174) in the biological mesh group and 7.41％(4/54),24.07％(13/54),79.63％(43/54) in the primary closure group,with no statistically significant difference between groups (x2 =0.080,0.389,0.101,P＞0.05).Conclusions The biological mesh in the pelvic floor reconstruction of ELAPE for advanced low RC is safe and feasible.Compared with primary closure,biological mesh closure will extend perineal operation time and time of indwelling perineal drainage-tube,and increase hospital expenses,but doesn't affect total operation time and duration of postoperative hospital stay,meanwhile,it can also reduce the overall perineal wound complications,especially in perineal wound infection,perineal hernia and disruption of perineal wound.

Objective To compare the clinical value of early enteral nutrition and parenteral nutrition therapy in postoperative patients of cholangiocarcinoma.Methods 56 cases of cholangiocarcinoma patients were randomly divided into early enteral nutrition group (EPN group) and parenteral nutrition group (PN group).All patients received nutritional support on the basis of metabolic support.Leukocyte count and neutrophil percentage decrease rate,total bilirubin decrease rate and hepatase (valley-C conversion) were counted at 3 and 7 days after operation.The decrease rate of aminase and glutamic oxaloacetic transaminase,recovery time of intestinal function (anal exhaust and defecation),incidence rate of surgical site infection (abdominal cavity and wound),hospitalization time after operation,incidence rate of bile leakage and hospitalization cost were compared between the two groups.Results The recovery time of intestinal function [(51.2 ±4.4) h],the decrease rate of leukocyte count (0.438 7 ±0.191 5) and neutrophil ratio (0.179 5 ± 0.046 1),the decrease rate of bilirubin (0.502 5 ± 0.153 5),alanine aminotransferase (ALT) (0.688 1 ±0.113 3),aspartate aminotransferase (AST) (0.617 0 ± 0.178 8) and hospitalization expenses [(87 852.37 ±9 127.04)yuan] in EPN group were better than those in PN group [(72.0 ± 12.9)h,0.090 5 ±0.120 3,0.083 4 ±0.036 8,0.201 5 ±0.077 8,0.251 6 ±0.419 0,0.230 9 ± 0.437,(109 036.69 ± 7 949.71) yuan,P ＜ 0.05].However,the incidence of abdominal distension (42.31％) was higher than that of PN group (13.33％,P ＜ 0.05).The incidence of bile leakage (7.69％) was not significantly different from that of PN group (13.33％,P ＞0.05).Conclusions Early enteral nutrition has obvious advantages in postoperative recovery of patients with cholangiocarcinoma.

OBJECTIVE:To investigate therapeutic efficacy of bifidobacteria triple viable bacteria combined with infliximab in the treatment of moderate and severe ulcerative colitis(UC),and its effects on immune function. METHODS:Seventy-two UC pa-tients were selected from gastroenterology department of the First Affiliated Hospital of Chongqing Medical University during Jun. 2009 to Jan. 2015. They was divided into single group and combination group according to therapy plan,with 36 cases in each group. Single group was given infliximab 5 mg/kg,ivgtt,on 0,2nd,6th,8th week. Combination group was additionally given bi-fidobacteria triple viable bacteria 420 mg,tid. Both groups were treated for consercutive 2 months. Clinical efficacies were com-pared between 2 groups as well as the levels of humoral immunity and T cell function. The occurrence of ADR was observed in 2 groups. RESULTS:Clinical response rate of combination group was 86.11%,which was significantly higher than 52.78% of single group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in humoral immunity and T cell function between 2 groups(P>0.05). After treatment,the levels of CD4+ and CD4+/CD8+ were significantly increased in both 2 groups,while the levels of CD8+,Th1 and Th2 were significantly decreased;the combination group was significantly better than the control group,with statistical significance (P<0.05);there was no statistical significance in CD3+ between 2 groups before and after treatment(P>0.05). After treatment,the levels of IgA and IgG were increased significantly in 2 groups,and the level of C3 was decreased significantly;the combination group was significantly better than the control group,with statistical significance (P<0.05);there was no statistical significance in IgM content and C4 level between 2 groups before and after treatment (P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Bifidobacteria triple viable bacteria combined with infliximab shows significant therapeutic efficacy in the treatment of moderate and severe UC, and can significantly improve humoral immunity function and the recovery of T cell level,with good safety.

Objective To investigate the effects of levosimendan on percutaneous coronary intervention ( PCI) in patients with ischemic heart failure. Methods From January 2013 to June 2016,eighty patients with ischemic heart failure undergoing coronary intervention in Pingdingshan People′s Hospital No. 1 were randomly divided into treatment group ( 40 cases) and control group ( 40 cases) . The treatment group was treated with levosimendan on the basis of routine medicine 2 days before operation,and the control group was given routine medication before operation. The baseline clinical data, operative success rate, complications, left ventricular ejection fraction ( LVEF%) after 1 month, 6 min walking distance, plasma brain natriuretic peptide ( BNP ) , creatinine and other cardiac and renal functions were observed and compared between the two groups. Results The differences of the baseline clinical characteristics including age (65. 5±3. 9 vs. 63. 9±3. 6),male (26 cases (65. 0%) vs. 23 cases (57. 5%) ),hypertension (21 cases (52. 5%) vs. 19 cases (47. 5%) ),diabetes (17 cases ( 42. 5%) vs. 14 cases ( 35. 0%) ) , hyperlipidaemia ( 30 cases ( 75. 0%) vs. 29 cases ( 72. 5%) ) , smoking (21 cases (52. 5%) vs. 19 cases (47. 5%) ),COPD (7 cases (17. 5%) vs. 6 cases (15. 0)%), LDL?C ( (4. 5±1. 0) mmol/L vs. (4. 4±1. 1) mmol/L),BMI ( (25. 9±3. 3) vs. (25. 6±3. 5) ) were not significant (t/χ2=1. 30,0. 47,0. 20,0. 47,0. 07,0. 20,0. 09,0. 49,0. 39,P=0. 20,0. 49,0. 66,0. 49,0. 80, 0. 66,0. 76, 0. 63, 0. 70 ) . There was no significant difference in coronary artery lesion between two groups, including single vessel lesion (11 cases (27. 5%) vs. 15 cases (37. 5%) ),double vessel lesion ( (22 cases ( 55. 0%) vs. 19 cases ( 47. 5%) ) ,three vessel lesion ( ( 7 cases ( 17. 5%) vs. 6 cases ( 15. 0%) ) and left main coronary artery disease (7 cases (17. 5%) vs. 6 cases (15. 0%) ) (Z=-0. 88,P=0. 38). The time of percutaneous coronary intervention ( ( 51. 0±8. 6) min vs. (49. 6 ±9. 6) min),the time of X?ray exposure ( (20. 3±7. 0) min vs. (18. 4±5. 6) min),material consumption ( (123. 2±16. 6) ml vs. (117. 3±25. 1) ml) between two groups have no difference ( t/χ2=0. 70,1. 39,1. 24,P=0. 49,0. 17,0. 22) . There were significant differences between the two groups in the success rate of operation ( 38 cases ( 95. 0%) vs. 31cases ( 77. 5%) , heart failure ( 1 cases ( 2. 5%) vs. 6cases ( 15. 0%) ) and complications ( 2 cases ( 5. 0%) vs. 11 cases (27. 5%) ) (χ2=5. 17,3. 91,7. 44,P=0. 02,<0. 05,<0. 01). Compared with the control group,the treatment group had greater advancement in LVEF,6 min walking distance,BNP and creatinine level at one month after operation ( F=6. 10,63. 60,51. 00,348. 00,P=0. 02,<0. 01,<0. 01,<0. 01) . Conclusion Levosimendan can effectively improve the heart function and renal function, improve the success rate of PCI in patients with ischemic heart failure and reduce the incidence of complications.