Sepsis is a life-threatening clinical syndrome characterized by organ dysfunction caused by dysregulation of the body's immune response to infection, and is the primary cause of acute kidney injury in critically ill patients. Sepsis induced AKI (S-AKI) is a common clinical critical illness with a high mortality rate and is closely associated with the clinical outcome of critically ill patients. At present, the clinical diagnosis of AKI is still based on the traditional indicators such as serum creatinine and urine output, but it is easily interfered by age, gender, drugs and other factors, and cannot accurately and sensitively reflect the renal damage of patients, so that some AKI patients lose the best time for treatment. Therefore, some biomarkers with strong sensitivity and high specificity are urgently needed in the clinic to help the diagnosis of AKI, so as to take active therapeutic measures to alleviate the prognosis of AKI.Numerous studies have shown that microRNAs (miRNAs) are involved in the development of S-AKI. Therefore, miRNAs can not only be early diagnostic markers of S-AKI, but also have important potential value for the treatment and prognosis of S-AKI. In this paper, we review the potential value of miRNA for the diagnosis, prognosis and treatment of S-AKI.

Objective To investigate the safety and efficacy of rescue stenting after failure of endovascular treatment for acute cerebral large artery occlusive infarction, and compare the differences of safety and efficacy between bridged treatment and direct endovascular treatment in acute cerebral large artery occlusive infarction. Methods The clinical data of 60 patients with acute cerebral large artery occlusive infarction who underwent rescue stenting after failure of endovascular treatment in our hospital form March 2015 to March 2018 were retrospectively analyzed; 26 patients underwent bridged treatment+rescue stenting (bridged treatment group), while 34 patients underwent direct endovascular treatment+rescue stenting (direct treatment group). The recanalization degree immediately after the treatment was evaluated by Modified Thrombolysis in Cerebral Infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was performed 24 h and 5-7 d after the treatment, and modified Rankin Scale (mRS) was applied 90 d after treatment to evaluate the neurological functions. In addition, incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage (SICH) and postoperative mortality within 90 d of treatment were calculated. Results (1) Among the 60 patients, 55 patients (91.7％) had revascularization (mTICI 2b-3) immediately after the rescue stenting. NIHSS scores before rescue stenting and NIHSS scores 24 h after rescue stenting (17.50 [15.00, 24.00) vs. 12.00 [8.25, 19.00]) showed statistically significant differences (P<0.05). Twenty-nine patients (48.3％) obtained satisfactory prognosis 90 d after rescue stenting (mRS scores≤2), 9 patients (15.0％) suffered SICH after rescue stenting, and 9 patients died (15.0％). (2) The immediate revascularization rate (92.3％ vs. 91.2％), NIHSS scores 24 h and 5-7 d after surgery (12.00 [7.75, 18.00] vs. 14.50 [10.00, 22.00] and 8.00 [3.00, 12.50] vs. 10.50 [6.75, 16.75]), good prognosis rate 90 d after treatment (57.7％ vs. 41.2％), postoperative SICH incidence (19.2％ vs. 11.8％), and mortality (11.5％ vs. 17.7％) in the bridged treatment group and direct treatment group were not significantly different (P>0.05). Conclusion Rescue stenting is safe and effective for patients with acute cerebral large artery occlusive infarction, no matter it is by bridged treatment or direct intravascular treatment; and the two methods show no significant differences in safety and efficacy

Objective To compare the safety and effectiveness of intravenous thrombolysis treatment in large artery atherosclerosis (LAA) and cardioembolic (CE) strokes in patients with acute anterior circulation ischemic stroke.Methods Two hundred and thirty-eight patients with acute anterior circulation ischemic stroke, admitted to and treated with intravenous thrombolysis in our hospital from January 2017 to June 2018 were chosen in our study. These patients were divided into either a LAA group (n=158) or a CE group (n=80) according to etiological subtypes. The differences in baseline data and outcomes 90 d after the onset between the two groups were compared. Baseline data of patients in the good outcome group and the poor outcome group were compared and independent risk factors for poor outcome were determined by multivariate Logistic regression analysis.Results As compared with the patients from the LAA group, patients from the CE group had older age and higher proportion of patients combined with atrial fibrillation, with significant differences (P<0.05); there were no statistically significant differences in the good outcome rate, mortality rate and incidence of symptomatic intracranial hemorrhage between the two groups (P>0.05). Among the 238 patients, 112 were into the good outcome group and 126 were into the poor outcome group; as compared with patients from the poor outcome group, patients from the good outcome group had younger age, and lower National Institute of Health Stroke Scale (NIHSS) scores and lower levels of fasting blood glucose before and after thrombolysis, with statistically significant differences (P<0.05); multivariate Logistic regression analysis showed that older age (odds ratio [OR]=1.040, 95％ confidence interval [CI]: 1.010-1.071,P=0.008) and higher NIHSS scores 24 h after thrombolysis (OR=1.259, 95％CI: 1.175-1.350,P=0.000) were independently associated with poor outcome.Conclusion The outcomes of intravenous thrombolysis in patients with acute anterior ischemic stroke are only associated with age and severity of stroke, and not associated with TOAST etiological subtypes; intravenous thrombolysis for cardiogenic stroke is safe and effective.

Ischemic stroke is a common disease of the nervous system,and its early diagnoses and treatments,prognoses become global concerns.In the event of stroke,the blood flow reperfusion in the ischemic area can be achieved by establishing arterial recanalization or collateral circulation.Moreover,the degree of collateral circulation compensatory plays an important role in the pathophysiology of occurrence,development and outcomes of ischemic stroke.A comprehensive assessment of collateral circulation in clinical practice is the key to the treatment of isehemic stroke.This paper summarizes the imaging assessment techniques of collateral circulation.

Objective To explore the cool execution function (CEF)and its influence factors before and after treatment in drug-na?ve, first-episode schizophrenics. Methods Twenty-one drug-naive, first-episode schizophrenics (patients group) and 25 healthy persons (control group) were interviewed by using the SCID. The severity of clinical symptoms was respectively assessed in patient group before treatment and after 8 weeks using the Positive and Negative Syndrome Scale (PANSS). The Trail-Marking Test A-B (TMT A-B) and Hanoi Tower Test (HTT) were conducted to assess cool executive function. Reaction time and the number of errors of TMT A-B’s and HTT’s reaction time and operative steps were recorded. Results Before treatment, the patient group’s reaction time was longer in HTT and TMT A-B than that in the control group's (P = 0.013;P = 0.000;P =0.001), respectively. Error number of TMT-B in the patient group was more than that in the control group (P =0.015); The operative steps of HTT and error number of TMT A were no statistical difference than those in the control group. After treatment, reaction time of TMT A reduced significantly than before treatment (P = 0.002);Before and after treatment , patients ’ reaction time of HTT and TMT B , operative steps of HTT and the error number of TMT A-B were all no statistical difference. Running multiple linear regression , reaction times of TMT-B was positively correlated with negative symptoms (β = 7.198,P = 0.012), and the error number of it was positively correlated with positive symptoms (β = 0.382,P = 0.024). Conclusions CEF in patients with drug-naive, first-episode schizophrenia is affected in a certain degree, especially the flexibility and attention transfer. Symptoms is the most serious influence factors. Treatment in sympotoms earlier is the important way to protect cool cognition.

Objective To study the mechanism that glial cell line-derived neurotrophic factor (GDNF)promotes human glio-ma cells proliferation.Methods We divided glioma samples into two groups,including low-grade glioma group and high-grade glio-ma group,while cerebral contusion patients were treated as the control group,12 cases in each group.C6 glioma cell lines were di-vided into three groups,such as GDNF group,BSA(bovine serum albumin)group and control group.CCK-8 (cell counting kit-8) was used to detect the cell proliferation,while Western blot was used to detect the expression of AKT,p-AKT,β-catenin and p-β-catenin in each group.Results Comparing with the control group,the expression levels of AKT,p-AKT,β-catenin and p-β-catenin in glioma group had a significantly increased (P <0.05).Meanwhile,the high-grade gliomas group also had a significant increase in those more than low-grade gliomas group (P <0.05).CCK-8 test showed that the cell proliferation in GDNF group was significant-ly higher than the control group (P <0.05),and the expression levels of p-AKT,β-catenin and p-β-catenin proteins all had a signifi-cant increase (P <0.05).However,the expression level of AKT had no obvious difference.Conclusion GDNF might promote the proliferation of glioma cells by up-regulating the expression of p-AKT,β-catenin and p-β-catenin.

Objective To observe the expression pattern of caspase-3 and HCLS1-associated protein X-1 (HAX-1) at different time after cerebral contusion in rat, and explore the new method for estimating the injury interval. Methods The cerebral contusion model was established using adult SD male rats. Then the rats were randomly allocated into 8 groups: 2 h, 6 h, 12 h, 1 d, 3 d, and 7 d after cerebral con-tusion, sham-operation and normal control. Expression of caspase-3 and HAX-1 protein after cerebral contusion in rat was detected by Western blotting. Laser scanning confocal microscope was used to ob-serve the number of HAX-1 positive cells and TUNEL-stained cells after cerebral contusion. Results The expression of caspase-3 increased parallelly with the time after cerebral contusion and reached the peak value on 3 d. The expression of caspase-3 decreased gradually and still maintained a high level expression on 7 d (P<0.05). The expression of HAX-1 positive cell went up after injury, and reached the peak value at 6 h (P<0.05), then turned down gradually after 12 h and went out of detection after 3 d. The number of TUNEL-stained cells increased obviously at 2 h and reached the peak value on 3 d. The number of TUNEL-stained apoptotic cells decreased gradually and still maintained a high level expres-sion on 7 d (P<0.05). Conclusion The expression of caspase-3 and HAX-1 after cerebral contusion has time sequential regularity, which may provide new evidence for forensic diagnosis of cerebral contusion interval.

Objective To investigate the therapy of DHS,PFNA and Intertan nail for the treatment in elderly patients with intertrochanteric femoral fractures.Methods One hundred and one elderly patients with intertrochanteric fractures were collected.Thirty-four cases of them were undertaken DHS (DHS group),33 cases for PFNA (PFNA group),and 34 cases for Intertan nail (INTERTAN group).Operative time,blood loss and complications were observed.Results The Operative time of patients in DHS,PFNA and Intertan groups were (85.1 ± 8.9) min,(63.1 ± 8.2) min,(57.9 ± 9.2) min respectively and the difference was significant (F=12.761,P＜0.001).The blood loss amount in DHS group were (350.1 ±80.2)ml,lower that those in PFNA and Intertan groups ((137.5 ± 35.4) ml and (125.2 ± 38.2) ml,F =20.462,P ＜ 0.001).Meanwhile,the postoperative drainage in DHS group was (125.3 ± 20.4) ml,significantly higher than PFNA group and INTERTAN group ((69.4 ± 9.2) ml and (74.6 ± 10.4) ml; F =15.871,P ＜0.001).Operative time,blood loss amount in INTERTAN group were less than that in PFNA group,but no significant difference (P ＞0.05).Nonunion in DHS group was significantly higher than the other two groups (8.82％ vs 0％ and 0％,x2 =6.092,P =0.047).Excellent rate in DHS group,PFNA group and Intertan group were 82.3％ (28/ 34),87.8％ (29/33),85.3％ (29/34) respectively,and there was no significant difference (x2 =0.591,P ＞ 0.05).Conclusion Compared with DHS,Intertan nail and PFNA have advantage of shorter operative time,stronger anti-rotation capability and less various postoperative complication rates,thus they are more suitable for elderly osteoporotic intertrochanteric fracture.

BACKGROUND:Epidural analgesia has been considered a gold standard for postoperative analgesia in the lower limbs. Its outcomes are accurate and adverse reactions are few, so it can be used in the clinic. However, this method has adverse reactions such as hypotension and urine retention. Low molecular weight heparin should be used after operation, which can increase the possibility of epidural hematoma, and limits its application to epidural analgesia in the clinic. At present, few studies concerned ultrasound guided continuous fascia iliaca compartment block technology.
OBJECTIVE:To evaluate the efficacy of postoperative pain relief and the joint rehabilitation between a continuous fascia iliaca compartment block and a continuous epidural analgesia for patients undergoing total hip arthroplasty.
METHODS:A total of 60 patients undergoing a selective total hip arthroplasty were assigned to continuous fascia iliaca compartment block group and continuous epidural analgesia group (n=30). Al patients in both groups received a pre-fluence before general anesthesia. Continuous fascia iliaca compartment block group were injected with 0.25%ropivacaine 30 mL via iliac fascia gap. Continuous epidural analgesia group received 0.20%ropivacaine 10 mL via epidural catheter, indwel ing catheter. When the analgesic effect was identified, anesthesia intubation was carried out. After operation, medicine was given via iliac fascia and epidural analgesia pump in both groups respectively. Postoperative analgesia in single dose was not given. If pain could not be endured, analgesia would be rescued (parecoxib 20-40 mg/time) according to pain degree. Visual analogue scale scores, supplemental analgesia of parecoxib, complication of anesthesia, Harris hip joint scores, day of first walk, and duration of hospital stay were recorded.
RESULTS AND CONCLUSION:No significant difference in visual analogue scale scores, supplemental analgesia, Harris hip joint scores and duration of hospital stay was detected. Day of first walk was earlier in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. The complications were apparently lower in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. These data indicated that after total hip arthroplasty, two kinds of analgesia methods could provide satisfactory postoperative outcomes. Hip joint was perfectly recovered. However, the complications of continuous fascia iliaca compartment block were less, and helpful to patients’ early off-bed activities, and could be considered as a good choice for analgesia after total hip arthroplasty.

The pretreatment of raw materials is necessary for ethanol production from lignocellulose, however, a variety of compounds which inhibit the fermenting microorganism such as Saccharomyces cerevisiae are inevitably formed in this bioprocess. Based on their chemical properties, the inhibitors are usually divided into three major groups: weak acids, furaldehydes and phenolic compounds. These compounds negatively affect the growth of S. cerevisiae, ethanol yield and productivity, which is one of the significant hurdles for the development of large-scale ethanol production from lignocellulose. We address here the origins of the three kinds of inhibitors and their mechanisms to S. cerevisiae. We also discuss the strategies of improving the fermentation performance of yeast, including detoxification of the pretreated substrates, enhancement of yeast tolerance and also fermentation control to reduce the effects of the inhibitors. The methods used in enhancing the yeast tolerance are traditional mutagenic breeding integrated with strains evolution under the suitable selective pressure, and metabolic engineering by introducing and/or overexpressing genes encoding enzymes such as furfural reductase, laccase and phenylacrylic acid decarboxylase, that confer the S. cerevisiae strains resistance towards specific inhibitors.
Acids ; pharmacology ; Drug Resistance, Microbial ; Ethanol ; analysis ; metabolism ; Fermentation ; drug effects ; Furaldehyde ; pharmacology ; Lignin ; metabolism ; Saccharomyces cerevisiae ; drug effects ; growth & development ; metabolism