This study was designed to investigate the potential protective effect of isopimpinelline against para-chlorophenylalanine(PCPA)-induced pineal gland damage in rats.Forty male Sprague-Dawley(SD)rats were divided into four groups(n=10 each):a normal group,a model group,a melatonin-treated group(10 mg/kg),and an isopimpinelline-treated group(1.5 mg/kg).All groups,except for the normal,received intraperitoneal injection of PCPA(450 mg/kg)to induce pineal gland damage.Subsequent treatments were administered orally for 7 days.Sleep latency and duration were evaluated on the sixth day using the pentobarbital sodium sleep synergy test.After the treatment period,serum melatonin levels and pineal gland inflammation markers were assessed alongside oxidative and antioxidative parameters.Histological examinations of the pineal gland were conducted,and the expression of proteins related to the Nrf2 and NF-κB signaling pathways were quantified.Data showed that isopimpinelline alleviates the structural damage in the pineal gland of model rats,significantly elevated serum melatonin levels,and markedly improved sleep latency and duration(P＜0.05).Isopimpinelline activated the Nrf2 signaling pathway by inhibiting Keap1 expression,which facilitated the nuclear translocation of Nrf2 and upregulated the antioxidant proteins NQO1 and HO-1,thereby mitigating oxidative stress in the pineal gland(P＜0.05).Furthermore,isopimpinelline significantly reduced the levels of pro-inflammatory cytokines IL-2,TNF-α and IL-6.Isopimpinelline also suppressed the NF-κB signaling pathway,reducing the expression of NF-κB p65,IKKβ,and p-IKKβ proteins,as well as the nuclear translocation of NF-κB p65(P＜0.05),thereby providing anti-inflammatory benefits.In conclusion,isopimpinelline could protect pineal gland from damage by activating the Nrf2 signaling pathway and inhibiting the NF-κB pathway.

Objective To explore the feasibility of tracing the source of human biological samples by microbiome,and provide new ideas for case investigation.Methods Biological samples from buccal mucosa,foot arch,armpit and other parts of 10 volunteers were collected for three consecutive months.The microbial community structure of the samples was confirmed by using the 16SrRNA gene sequence information.And the microbial community diversity analysis and random forest classification prediction model were carried out.Results There were significant differences in the microbial community structure of the three parts of human body.In this study,a prediction model of random forest classification with an accuracy of more than 90%was successfully constructed.Conclusion In this study,a classification and prediction model based on the microbiome information of human biological samples was constructed to judge the source location,which broadened the forensic application scenarios of human microorganisms.

Objective To investigate the association between serum alkaline phosphatase (ALP) and type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD). Methods A total of 599 patients with T2DM who were hospitalized in Department of Endocrinology, Affiliated Hospital of Jiangsu University, from July 2016 to December 2018 were enrolled as subjects. According to the presence or absence of NAFLD, the patients were divided into NAFLD group with 286 patients and non-NAFLD group with 313 patients, and according to the results of abdominal ultrasound, the patients with NAFLD were divided into mild group with 111 patients, moderate group with 105 patients, and severe group with 70 patients. General clinical data were compared between groups. The independent samples t - test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between three groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between three groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation between ALP and clinical indices, and a logistic regression analysis was used to investigate the influencing factors for NAFLD. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher proportion of patients with history of hypertension ( χ 2 =7.864, P < 0.05), systolic blood pressure ( t =-2.226, P < 0.05), diastolic blood pressure ( t =-3.800, P < 0.05), body mass index (BMI) ( t =-11.842, P < 0.05), waist circumference (WC) ( t =-9.150, P < 0.05), fasting insulin (FINS) ( Z =-6.173, P < 0.05), fasting C-peptide ( t =-5.419, P < 0.05), serum uric acid ( t =-4.957, P < 0.05), low-density lipoprotein cholesterol ( t =-2.702, P < 0.05), triglyceride ( Z =-9.376, P < 0.05), total cholesterol (TC) ( t =-3.016, P < 0.05), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) ( Z =-5.794, P < 0.05), alanine aminotransferase (ALT) ( Z =-6.737, P < 0.05), aspartate aminotransferase (AST) ( Z =-4.389, P < 0.05), gamma-glutamyl transpeptidase (GGT) ( Z =-7.764, P < 0.05), and ALP ( t =-2.833, P < 0.05), as well as significantly lower age ( t =2.184, P < 0.05) and high-density lipoprotein cholesterol ( Z =-5.273, P < 0.05). The severity of NAFLD (mild, moderate or severe) was positively correlated with age ( r s =0.140, P < 0.05), BMI ( r s =0.239, P < 0.05), WC ( r s =0.222, P < 0.05), FINS ( r s =0.191, P < 0.05), HOMA-IR ( r s =0.218, P < 0.05), ALT ( r s =0.188, P < 0.05), AST ( r s =0.279, P < 0.05), GGT ( r s =0.202, P < 0.05), and ALP ( r s =0.361, P < 0.05). In the patients with T2DM and NAFLD, ALP was positively correlated with HbAlc ( r =0.149, P < 0.05), fasting plasma glucose ( r =0.146, P < 0.05), HOMA-IR ( r s =0.132, P < 0.05), TC ( r =0.151, P < 0.05), ALT ( r s =0.210, P < 0.05), AST ( r s =0.192, P < 0.05), and GGT ( r s =0.297, P < 0.05). The logistic regression analysis showed that ALP was an influencing factor for NAFLD in patients with T2DM (odds ratio=1.013, 95% confidence interval: 1.004-1.023, P < 0.05). Conclusion Elevated serum ALP is a risk factor for T2DM with NAFLD and is closely associated with hyperglycemia, insulin resistance, and hyperlipemia, and ALP may play a role in the development and progression of T2DM and NAFLD.

Objective　To investigate the clinical manifestations and diagnosis of the diseases with the imaging characteristics of pachymeningeal enhancement on magnetic resonance imaging （MRI），in order to improve the understanding of the diseases with pachymeningeal enhancement on MRI. Methods　The clinical data and auxiliary examination results of 5 patients with pachymeningeal enhancement on MRI from February 2017 to October 2019 were analyzed retrospectively，and the characteristics of each patient were analyzed. Results　MRI was similar in all five patients. All of them showed pachymeningeal enhancement，but the clinical diagnosis was different：1 case was idiopathic hypertrophic pachymeningitis；1 case was IgG4-related hypertrophic pachymeningitis；1 case was intracranial hypotension syndrome；1 case was cerebral venous sinus thrombosis；1 case was meningoma. Conclusions　The etiology，treatment and prognosis of diseases with pachymeningeal enhancement on MRI are complex，history and other auxiliary examination should be combined carefully to identify the diagnosis，avoiding misdiagnosis.

Objective To compare the biomechanical characteristics of new assembly of locking compression plate (NALCP) and locking compression plate (LCP) in internal fixation of femoral shaft comminuted fractures.Methods The preparation of a femoral shaft wedge fracture model (AO type 32-C2.1),six pairs of (12) femoral specimens were collected and divided into two groups randomly,with six in each group.The Group A was made up of the new assembly of locking compression plate fixation model (NALCP),and Group B the locking compression plate fixation model (LCP).The biomechanical properties of steel plates in two groups were tested by axial loading and torsional loading tests.The relative maximum displacement of fracture blocks in two groups on the X,Y and Z axes (the coronal axis was set as X axis,through the medial and lateral femur;the transverse axis was set as Z axis,through the femoral intercondylar fossa,perpendicular to the X axis;the sagittal axis was set as Y axis,perpendicular to the X and Z axis),the maximum strain,and the average strain of the steel plate were recorded.Strain distribution nephogram was produced,and the axial loading fatigue test results of Group A were recorded.Results Axial loading test:the relative maximum displacement of fracture in Group A on X,Y and Z axis were smaller than those in Group B (P ＜0.05 or 0.01);the main strain of Group A was greater than that of Group B (P ＜0.01);there was no significant difference in the average strain between Group A and Group B (P ＞ 0.05).Torsional loading test:The relative maximum displacement of fracture in Group A on X and Z axis was smaller than that of Group B (P ＜ 0.01);there was no statistically significant difference between the two groups on the Y axis (P ＞ 0.05);the main strain of plate in Group A was greater than that in Group B (P ＜ 0.01);there was no statistically significant difference in the average strain between Group A and Group B (P ＞ 0.05).There was no obvious difference in strain distribution between the two groups.In Group A,the fatigue test of axial cyclic loading was performed for 1 million times,and the NALCP was intact without deformation,loosening,or rupture.Conclusion NALCP can provide strong mechanical stability for comminuted femoral fracture.The design of bridge steel plate is reasonable,which can effectively avoid stress concentration,reduce the stress shielding of steel plate,and facilitate bone healing.

Objective To compare the stress and its distribution between our self-designed new assembly of locking compression plate (NALCP) of low elastic modulus versus conventional locking compression plate (LCP) in fixation of femoral comminuted fractures.Methods Six pairs of cadaveric femur were used to create models of middle femoral comminuted fracture.The femoral fracture models were fixated respectively by NALCP of Ti2448 with low elastic modulus (E =30 Gpa) (NALCP group) and conventional LCP of Ti-6Al-4V with high elastic modulus (E =110 Gpa) (LCP group).Axial and torsion loads were applied on the models in the 2 groups to simulate those on one leg when a person slowly walks.The relative maximum displacements on the X,Y and Z axes of fracture fragments,and the maximum and average strains of the plate were recorded in the 2 groups.Nephograms of strain distribution were made for the 2 groups.The results of fatigue test under axial loads were recorded for NALCP group.Results Both the axial and torsion loading tests showed significantly larger principal and average strains in NACLP group than in LCP group (P ＜ 0.05).However,there were no significant differences between the 2 groups in the relative maximum displacements of fracture fragments on X,Y or Z axis (P ＞ 0.05).The plate strain nephograms for the 2 groups showed consistent strain distributions.The plates in NALCP group survived 1,000,000 fatigue tests under axial loads,without any deformation,loosening or breakage.Conclusion As our NALCP of low elastic modulus may be better in stress transmission and distribution,it can effectively reduce the effect of stress-shielding and promote bone healing.

Objective To clarify the applied anatomy of Chinese female breasts,to improve the breast reduction mammoplasty,and to compare the quality of life in women with symptomatic macromastia before and after reduction mammoplasty with the modified round block technique.Methods The blood supply and innervation of the nipple-areolar complex were dissected in 6 Chinese adult females (12 breast specimens).Special attention was paid to the Würinger horizontal septum and the medial and lateral ligaments.The specific beneficial effects of reduction mammoplasty were evaluated with the modified round block technique,and a general questionnaire the Short Form-36 Health Survey Questionnaire (SF-36) was used in this study,which has good reliability and validity.The scores of the patients before and after the surgery were collected respectively.Results In 12 breast specimens,there existed Würinger horizontal septum and the medial and lateral ligaments.The blood supply and nerve innervation of nipple-areolar complex went along Würinger horizontal septum.In all the patients enrolled,SF-36 showed significant higher quality of life after the operation with regard to 7 of 8 investigated domains.Role of emotion increased most significantly.Increased self-esteem and increased personal and public self-consciousness after surgery were observed.Conclusions The incidence of postoperative complications is reduced after using the modified round block technique.Patients have a higher degree of satisfaction overall.These data are further evidence that breast hypertrophy is not solely an esthetic problem.The reduction mammoplasty with the modified round block technique is an ideal technique.

Objective:To analyze the efficacy of neuronavigation‐guided pure endoscopic endonasal transsphenoidal approach for the surgical removal of complex pituitary adenomas .Methods :The clinical data of 60 patients who received pure endoscopic endonasal transsphenoidal surgery for complex pituitary adenomas from Apr 2010 to Sep 2012 was retrospectively analyzed . These patients had one or more characteristics which including tumors more than 4 cm in size(34 patients) ,Knosp grade 3‐4(41 patients) ,recurrent or residual tumor(17 patients) .All patients received pure endoscopic endonasal transsphenoidal surgery and neuronavigation was used . Neuro‐ophthalmological , neuroimaging and endocrinological examination were performed postoperatively .Results:There were 33 nonfunctional adenomas and 27 functional adenomas .Overall ,the tumors were gross totally removed in 42 patients ,subtotal removed in 11 patients and partially removed in 7 patients .Postoperative visual acuity was improved in 32 patients ,endocrine remission was achieved in 8 patients .The gross total removal was achieved in 18 ,23 and 12 patients for tumors more than 4 cm in size ,Knosp grade 3‐4 adenomas ,recurrent or residual adenomas ,respectively .The postoperative complications included electrolyte disturbances in 4 patients ,cerebral spinal fluid leakage in 3 patients ,insipidus in 1 patient .And 1 patient had visual impairment ,hypopituitarism and hypersomnia caused by postoperative hemorrhage .And 5 patients had reoperation .Conclusions :Neuronavigation‐guided pure endoscopic endonasal transsphenoidal surgery is safe and effective for complex pituitary adenoma .The effectiveness of that approach for invasive pituitary adenomas (Knosp grade 4) and complex functional adenomas still need to be promoted .

Objective:To explore the strategies and key operation points of microsurgery in the treatment of meningioma in sagittal sinus and falx cerebri .Methods:The clinical data of 73 patients with meningioma in sagittal and beside cerebral falx were analyzed retrospectively .The tumors located in the anterior 1/3 segment of sagittal sinus or cerebral falx in 19 cases ,in the central 1/3 segment in 46 cases ,and in the posterior 1/3 segment in 8 cases .The base of tumors originated from the sagit‐tal sinus in 27 cases ,originated from the cerebral falx in 33 cases ,and involved with both the sagittal sinus and the falx cerebri in 13 cases .Microsurgery technique was applied to resect the tumors ,and to treat with sagittal sinus or falx cerebri invaded by tumor .Results:There were 24 cases of Simpson Grade I resection ,46 cases of Simpson Grade II resection ,and 3 cases of Simpson Grade III resection .No case died due to operation .No case suffered from severe cerebral edema or cerebral venous in‐farction .64 cases were followed up for 6 months to 7 years ,and tumors recurred in 6 cases (9 .3% ) .Conclusions:During the microsurgical operation for total resection of the meningioma in sagittal sinus and falx cerebri ,the correct treatment for involved sagittal sinus and falx cerebri ,as well as the protection for bridging venous ,is the key to achieve satisfactory effect of opera‐tion .

The Hedgehog (Hh) signaling pathway plays a central important role during embryo development of vertebrate,which participates in regulation of multiple basic life processes including cell proliferation,differentiation and tissue patterning.In normal adult physiology,the pathway is implicated in stem cell maintenance,tissue repair and regeneration.By now,more and more researches have been indicated that the Hh signaling pathway is related to the tumor growth promoting and survival capabilities.