Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.

Objective To analyze the differences in static balance plantar pressure characteristics between female adolescent idiopathic scoliosis(AIS)patients with moderate Lenke 3CN and healthy adolescents of the same age,and provide a scientific basis for scoliosis screening,assessment,treatment,and prognosis evaluation.Methods A total of 30 female patients with moderate Lenke 3CN AIS as the AIS group and 30 healthy female adolescents of the same age as the control group were selected,respectively.The plantar pressure data of the subjects were collected,and the characteristics of equilibrium plantar pressure distributions in two groups were comparatively analyzed.Results Regarding the plantar pressure characteristics,the average pressure(P<0.05)and hindfoot pressure(P<0.05)of the left and right foot in the AIS group were significantly greater than those of the control group,the forefoot pressure was significantly lower than that of the control group(P<0.05),and the symmetry index(SI)of both feet was significantly greater than that of the control group(P<0.05).The plantar pressure of the left foot in the AIS group was significantly larger than that of the control group in the medial mid-foot area and 1st toe area(P<0.05),and significantly smaller than that of the control group in the 1st,2nd,3rd,4th and 5th metatarsal areas(P<0.05);the plantar pressure of the right foot in the AIS group was significantly greater than that of the control group in the medial heel area and the1st toe area(P<0.05),and significantly smaller than that of the control group in the lateral mid-foot area,the 3rd,4th,5th metatarsal area and 3rd,4th,5th toe area(P<0.05);and the plantar pressure in the right foot of the AIS group was significantly smaller than that of the control group in the medial heel area and 1st toe area(P<0.05).The plantar pressures at lateral midfoot area,the 3rd,4th,5th metatarsal area and the 3rd,4th,5th toe area of the right foot were significantly larger than those of the control group(P<0.05).Regarding the center of pressure(COP),the length of the COP trajectory,the ellipse area of the 95%confidence interval,the maximum distance of COP left-right movement(COP-X),and the maximum distance of COP anterior-posterior movement(COP-Y)of the AIS group were significantly larger than those of the control group(P<0.05).Conclusions There are significant differences in static balance plantar pressure characteristics between female AIS patients with moderate Lenke 3CN and healthy female adolescents of the same age,with foot pressure favoring the side of the lateral convexity,poorer symmetry and stability of the feet,and weaker balance control.

Objective To investigate the predictive value of Cys C and AT Ⅲ for CIAKI in elderly hypertensive patients with AMI after PCI.Methods A total of 911 elderly hypertensive patients with AMI undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2019 to May 2023 were consecutively enrolled,and then randomly divided into a training group(731 cases)and a validation group(180 cases)in a ratio of 8∶2.According to the diagnostic criteria of CIAKI defined by the European Society of Urogenital Radiology,the patients of the training group were further divided into CIAKI subgroup(n=91)and non-CIAKI sub-group(n=640).The basic clinical data were compared between the CIAKI and non-CIAKI sub-groups and between the training and validation groups.Multivariate logistic regression analysis was used.ROC curve was drawn to analyze the predictive value of Cys C,ATⅢ and their combina-tion for CIAKI.Results Fasting blood glucose,TG,Cys C,and diuretics were independent risk factors(OR=1.116,95％CI:1.009-1.235;OR=1.786,95％CI:1.363-2.339;OR=13.360,95％CI:4.462-39.999;OR=10.606,95％CI:4.110-27.370),while LVEF and AT Ⅲ were protective factors(OR=0.932,95％CI:0.897-0.968;OR=0.949,95％CI:0.929-0.969)for CIAKI in eld-erly hypertensive patients after emergency PCI.The AUC value of Cys C and AT Ⅲ combined to-gether in predicting CIAKI after emergency PCI was 0.818(95％CI:0.773-0.863,P＜0.01),which was better than either of them alone.When Cys C level ≥1.10 mg/L,the risk of CIAKI was increased with the increment of the level;when AT Ⅲ ≥69％,the risk of CIAKI was decreased with the increase of AT Ⅲ level.Conclusion High Cys C level and low AT Ⅲ level are independ-ent risk factors for CIAKI,and their combination can improve the accuracy of predicting CIAKI after emergency PCI in elderly patients with hypertensive AMI.

Objective    To investigate the clinical safety and feasibility of thoracic sympathectomy in the treatment of palmar hyperhidrosis based on ambulatory surgery. Methods    A retrospective analysis of 74 patients who underwent thoracoscopic sympathectomy in the Department of Thoracic Surgery of the First People's Hospital of Yunnan Province from January 2017 to April 2021 was performed, including 35 males and 39 females aged 12-38 (21.32±4.13) years. Patients were divided into two groups according to different treatments. There were 34 patients in a control group (adopting traditional surgery), and 40 patients in an observation group (adopting ambulatory surgery). The clinical effects of the two groups were compared. Results    No massive bleeding, conversion to thoracotomy, postoperative pneumo-thorax or severe pneumonia occured in all patients. Univariate analysis of intraoperative indexes showed that the two groups had no statistical difference in total hospitalization cost, operation time, anesthesia time or postoperative waiting time (P>0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group (P<0.05). The time of postoperative out of bed and recovery of walking capacity and the incidence of electrolyte disturbance in the observation group were shorter or lower than those in the control group (P<0.05). There was no statistical difference in white blood count, neutrophils count or postoperative 24 h pulse oxygen saturation fluctuation peak between the two groups (P>0.05). Conclusion    Based on the optimized diagnosis and treatment model, thoraco-scopic sympathectomy with laryngeal mask airway which is performed during ambulatory surgery, is feasible and worth popularizing in thoracic surgery.

Objective    To investigate the feasibility and safety of non-intubation anesthesia in thoracic surgery. Methods    From September 2017 to December 2019, 296 patients were operated at department of thoracic surgery in our hospital. There were 167 males and 129 females with an average age of 50.69±12.95 years, ranging from 16 to 76 years. The patients were divided into two groups according to whether they were intubated: 150 patients were in a non-intubation group, including 83 males and 67 females with an average age of 49.91±13.59 years, ranging from 16 to 76 years, and 146 patients were in an intubation group including 84 males and 62 females with an average age of 51.49±12.26 years, ranging from 16 to 74 years. Intraoperative data, postoperative recovery, inflammatory response of the two groups were compared. Results    There was no statistical difference between the two groups in operation time, blood loss, the lowest oxygen saturation or other indicators (P>0.05). But the highest partial pressure of carbon dioxide of the non-intubation group was higher than that of the intubation group (P=0.012). The non-intubation group was superior to the intubation group in postoperative recovery and inflammatory response (P<0.05). Conclusion    The non-intubation anesthesia is safe and maneuverable in thoracic surgery, and it has some advantages in accelerating postoperative rehabilitation.

OBJECTIVE: To investigate the effect of curcumin on dopamine neurons in Parkinson's disease (PD) and its mechanism. METHODS: SH-SY5Y human neuroblastoma cells were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to establish the PD cell model. The model cells were treated with curcumin and/or autophagy inhibitor 3-MA. After 48 h of drug treatment, the number of surviving dopamine neurons was detected by tyrosine hydroxylase immunofluorescence method. Western blotting was used to detect protein expression of α-Synuclein (α-Syn), transcription factor EB (TFEB) and autophagy-related proteins lysosome-associated membrane protein 2A (LAMP2A) and microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ); RT-PCR was used to detect mRNA expression of α-Syn. RESULTS: Compared with MPTP model group, curcumin increased the number of surviving dopamine neurons(<0.01), decreased both protein expression and mRNA expression of α-Syn (all <0.01), and increased protein expression of TFEB, LAMP2A and LC3-Ⅱ (all <0.01). When curcumin and 3-MA were given concurrently, the number of surviving dopamine neurons, protein expression of TFEB, LAMP2A and LC3-Ⅱ increased (<0.05 or <0.01), and both protein expression and mRNA expression of α-Syn decreased (<0.05 or <0.01) compared with MPTP model group; but the number of surviving dopamine neurons and protein expression of LAMP2A and LC3-Ⅱ decreased compared with curcumin group (all <0.05). CONCLUSIONS Curcumin exerts protective effect on dopamine neurons in PD, which may be associated with enhancing autophagy and promoting the clearance of α-Syn.
Animals ; Cell Line ; Curcumin ; pharmacology ; Dopaminergic Neurons ; drug effects ; Humans ; Mice ; Mice, Inbred C57BL ; Parkinson Disease ; alpha-Synuclein ; metabolism

Objective To investigate whether curcumin protects dopamine neurons in Parkinson's disease (PD) by activating autophagy and discuss its specific mechanism.Methods In vitro,SH-SY5Y human neuroblastoma cells were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPP+) to induce PD cell models.In vivo,C57BL/6 male mice were performed intraperitoneal injection of 30 mg/kg 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) once daily for 7 d continuously to establish PD models.SH-SY5Y human neuroblastoma cells and C57BL/6 male mice were,respectively,divided into normal control group,model group,curcumin group,curcumin and 3-methyladenine (3-MA) group,and 3-MA group.Curcumin was used as intervention treatment,and 3-MA,an autophagy inhibitor,was used individually or concurrently with curcumin as intervention controls:curcumin (40 μmol/L),curcumin (40 μmol/L)+3-MA (4 mmol/L),and 3-MA (4 mmol/L) were added into the cells of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPP+ addition;curcumin (80 mg/kg),curcumin (80 mg/kg)+3-MA (2 mg/kg),and 3-MA (2 mg/kg) were added into the mice of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPTP injection once daily.In the normal control group,sterile saline was injected into the abdomen simultaneously (30 rmL/kg).In cell groups,after 48 h of drug treatment,the number of surviving dopamine neurons was detected by tyrosine hydroxylase (TH) immunofluorescence;Western blotting was used to detect protein expressions of α-synuclein (α-Syn),and autophagy related proteins lysosome-associated membrane protein 2A (LAMP2A) and microtubule-associated protein 1 light chain 3 (LC3);transcription factor EB (TFEB) levels in the cytoplasm and nucleus were detected separately by Western blotting;reverse transcription (RT)-PCR was used to detect the α-Syn mRNA expression.In mice groups,14 d after the last injection,mice were sacrificed and sections ofmidbrain nigra were gained for detection of TH level by immunohistochemistry,expressions of α-Syn and LC3 were detected by Western blotting.Results (1) As compared with model group,curcumin group had significantly larger number of surviving dopamine neurons both in vitro and in vivo,significantly decreased α-Syn protein and mRNA expressions in vitro,and significantly decreased α-Syn protein expression in vivo (P＜0.05);curcumin group had statistically increased LAMP2A and LC3-Ⅱ protein expressions in vitro and LC3-Ⅱ protein expression in vivo as compared with model group (P＜0.05).(2) As compared with curcumin group,curcumin and 3-MA group had statistically smaller number of surviving dopamine neurons in vitro and in vivo,and statistically increased α-Syn protein expression in vitro (P＜0.05).(3) In vitro,as compared with model group,curcumin group had significantly increased TFEB protein expression in nucleus (P＜0.05),and curcumin and 3-MA group had statistically increased TFEB protein expression in cytoplasm and statistically decreased TFEB protein expression in nucleus (P＜0.05).Conclusion Curcumin has protective effect on dopamine neurons of PD;one of the main mechanisms is that curcumin can activate the autophagy function and promote the clearance of α-Syn;increasing the TFEB expression,promoting the transfer of TFEB to nucleus to perform the transcription function,and then promoting the synthesis of autolysosome may be the main ways to activate the autophagy function.

Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.

Objective Detrusor overactivity (DO) is one known cause of overactive bladder (OAB) symptoms in benign prostatic hyperplasia (BPH).In this study,OAB symptoms suggestive of DO in BPH were treated with α1-blocker monotherapy or α1-blocker and antimuscarinics add-on therapy,and the efficacy and safety were assessed.Methods BPH patients who suffered from OAB symptoms for at least 3 month were enrolled in a prospective self-control study from August 2010 to April 2012.The inclusion criteria are total international prostate symptom score (IPSS) ≥8,OAB Symptom Score (OABSS) ≥3,OABSS urgency score ≥2,Postvoid residual volume (PVR) ＜ 100 ml,and maximum urinary flow rate (Qmax) ≥ 5 ml/s.All the patients who met the inclusion criteria were treated with α1-blocker ( tamsulosin 0.2 mg/day or doxazosin 4 mg/day) for 2 weeks.After 2 weeks,patients with no symptomatic improvement ( OABSS≥3) underwent pressure-flow test,and those whose Pdet≥ 40 cm H2O and DO presented more than one time were added antimuscarinics (solifenacin 5 mg/day or tolterodine 4 mg/day) for an additional 2 weeks.OABSS,IPSS,QOL,Qmax and PVR were re-evaluated every 2 weeks.Results Ninety-four cases of BPH/OAB patients met the inclusion criteria and completed 4 weeks treatment.The baseline of total OABSS was 7.0 ± 1.3,IPSS was 17.0 ± 1.7,QOL was 5.0 ±0.7,Qmax was (8.8 ±2.5) ml/s and PVR was (86.0 ± 16.5) ml.After 2 weeks treatment with α1-blocker alone,OABSS was 5.2 ± 0.8,IPSS was 14.2 ± 1.9,QOLwas4.O±0.8,Qmaxwas (11.4±2.4) ml/s and PVR was (67.9±12.9) ml.After another2 weeks treatment with α1-blocker plus antimuscarinics,OABSS was 3.1 ± 0.8,IPSS was 11.1 ± 1.9,QOL was 3.1 ± 0.7,Qmax was ( 10.8 ± 2.4) ml/s and PVR was (71.8 ± 11.9 ) ml.Compared with baseline values,OABSS,IPSS,QOL,Qmax and PVR significantly improved (P ＜ 0.01 ) in α1-blocker monotherapy group and α1-blocker plus antimuscarinic group.The improvement of OABSS,IPSS,QOL scores of α1-blocker plus antimuscarinic group were greater than α1-blocker monotherapy group (p ＜ 0.05 ),while Qmax and PVR showed no differences between the two groups.No acute urinary retention (AUR) was deteted.Conclusion Both of α1-blocker monotherapy and α1-blocker with antimuscarinics add-on therapy can improve OAB symptoms.

Objective To establish a stable HCV full-length genome replication cell model which is labeled with reporter gene and easyly to quantify intracellular HCV proteins and RNA level. Methodsneo gene was inserted into Luc-JC1 to make Luc-JC construct. Luc-JC RNA was obtained by in vitro transcription and then delivered into Huh7 cells by transfection. G418-resistant clones of Huh7 cells were obtained by selection. Clones of HCV full-length genome replication cell were confirmed by luciferase activity assay, Western blot and cleaveage of eYFP-MAVS by HCV NS3/4A protease. Then, HCV replication cell colonies were treated by different dose IFN-α in order to observe the change of luciferase activity, HCV protein and RNA level. Results At 3-4 weeks post-transfection, visible colonies were selected and stained by crystal violet. Luciferase activity and HCV NS3, NS5A protein were detected by luciferase activity assay and Western blot, respectively. Subcellular localization of eYFP-MAVS transferred from mitochondria to cytoplasms by cleavage of NS3/4A protease in cell colonies. Luciferase activity, HCV protein and RNA diminished obviously after IFN-α treatment. Conclusion A stable HCV full-length genome replication cell model labeled by reporter gene was successfully established and reporter activity can be used to indicate level of HCV proteins and RNA in cells. This cell model is a useful tool for the study on HCV pathogenesis and the screening of antiviral drugs.