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.

Objective To investigate the risk factors of complicating splanchnic venous thrombosis (SVT) in severe acute pancreatitis (SAP) in order to guide clinic for conducting early prevention.Methods A total of 173 patients with SAP admitted and treated in this hospital from January 2018 to December 2022 were selected and divided into the non-complicating SVT group (n=143) and complicating SVT group (n=30) ac-cording to whether having secondary SVT or not.The general data and various clinical treatment and examina-tion-related data were collected.The multi-factor logistic regression was used to analyze the risk factors of complicating SVT in SAP.Results Shock (P<0.001),pancreatic cyst (P=0.002),tracheal intubation (P<0.001),proportion of abnormal renal function (P=0.014),total bilirubin (P=0.049),direct bilirubin (P=0.018),AST (P=0.011),procalcitonin (P=0.021),thrombin time (P=0.024),D-dimer (P=0.003),MCTSI score (P<0.001) and APACHE Ⅱ score (P<0.001) had statistical difference between the two groups.The multivariate logistic regression analysis showed that pancreatic cyst (OR=2.700,95％CI:1.022-7.134,P=0.045) and APACHE Ⅱ score increase (OR=1.137,95％CI:1.002-1.290,P=0.047) were the independent risk factors for complicating SVT in SAP.Conclusion Pancreatic cysts and APACHE Ⅱ score increase are the independent risk factors for complicating SVT in SAP.These patients require close fol-low-up and timely intervention and treatment.

Type Ⅳ hiatal hernia with a high risk usually presents sudden or suddenly worsening epigas-tric pain,vomiting,and dysphagia.It is not conducive to early diagnosis and treatment when symptoms are atypi-cal.Type Ⅳ hiatal hernia with severe anemia is rare.This article reports an atypical case of typeⅣhiatal hernia with melena and severe anemia as the main manifestations,aiming to improve clinicians'identification of the atypical clinical presentations of type Ⅳ hiatal hernia.

Early upper gastrointestinal cancer screening skills teaching is the vacancy and difficulty of endoscopic teaching and training. In this study, a standardized training program was set up for endoscopic physicians who had mastered the basic gastroscopy techniques. The training period was 12 weeks, including theoretical training, early cancer awareness training, standardized gastroscopy operation technology, endoscopic diagnosis of early esophageal and gastric cancer, and theoretical and skill examination. After passing the examination, trainees can participate in early cancer case competition. According to questionnaire survey, 100%(15/15) of trainees thought that standardized training was necessary for improving the detection rate of early upper gastrointestinal cancer, and it could significantly improve the trainees' diagnosis level. Therefore, the overall setting of the standardized training process for the diagnosis of early upper gastrointestinal cancer in our center is generally reasonable, which is worthy of further promotion.

Objectives:To study the computed tomography features of banded adhesions(BA) and matted adhesions(MA) of adhesive small bowel obstruction(ASBO).Methods:We enrolled 150 patients operated on for ASBO. According to intraoperated findings, ASBO were classified into those caused by BA or MA. A multivariable logistic regression was established to analyze independent risk factors on Computed Tomography features.Results:There were significant differences in closed-loop sign (36.8% vs. 14.3%, P=0.002) mesenteric haziness (43.7% vs. 17.5%, P=0.001), beak sign (48.3% vs. 17.5%, P<0.001), fat notch sign (39.1% vs. 9.5%, P<0.001) and peritoneal fluid (54.0% vs. 34.9%, P=0.015) between the two groups. The presence of beak sign [ OR=6.15, 95% CI (2.55-14.84), P<0.001], fat notch sign [ OR=6.19, 95% CI (2.16-17.82), P=0.001] and mesenteric haziness [ OR=3.34, 95% CI (1.34-8.32), P=0.009] were independent risk factors with BA. Conclusion:Beak sign, fat notch sign and mesenteric haziness were independent risk factors for diagnosing BA.

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.

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 explore the molecular mechanism of miR-17-5p regulating the proliferation and invasion of nasopharyngeal carcinoma cells by regulating the expression of breast cancer metastasis suppressor 1 like (BRMS1-like or BRMS1L) gene. Methods:A total of 40 cases of nasopharyngeal carcinoma tissues and corresponding paracancerous tissues resected from nasopharyngeal carcinoma patients, who were admitted to the General Hospital of Pingdingshan Shenma Medical Group during January 2014 to December 2017, were included in this study; in addition, nasopharyngeal carcinoma cell lines CNE 2, HONE 1, C666-1 and nasopharyngeal immortalized epithelial cell line NP69 were also collected for this study. The expression of miR-17-5p in nasopharyngeal carcinoma tissues and cell lines was detected by qPCR. The targeted relationship between BRMS1L and miR-17-5p was predicted by the StarBase and verified by the Dual luciferase reporter gene assay. Effects of transfection of miR-17-5p mimics and inhibitors on the expression of BRMS1Lin CNE2 cells were detected by WB assay. CCK-8, Transwell and Flow cytometry were used to detect the effects of miR-17-5p/BRMS1L axis on the proliferation, migration, invasion and apoptosis of CNE 2 cells. Results: miR-17-5p was highly expressed in nasopharyngeal carcinoma tissues and cell lines (P<0.05 or P<0.01). Knockdown of miR-17-5p significantly inhibited proliferation, invasion and migration of CNE2 cells but promoted apoptosis (P<0.05 or P<0.01); miR-17-5p targeted BRMS1Land down-regulated its expression. Over-expression of BRMS1Lsignificantly inhibited the proliferation, invasion and migration of CNE2 cells but promoted apoptosis (all P<0.01); while simultaneous over-expression of miR-17-5p and BRMS1L reversed the above effects (all P<0.01). Conclusion: miR-17-5p promoted proliferation, invasion, migration and inhibited apoptosis of CNE 2 cells by down-regulating the expression of BRMS1L.

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 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.