Intracerebral hemorrhage (ICH) is a hemorrhagic cerebrovascular disease with high incidence and mortality. Oxidative stress response plays an important role in the pathological and physiological processes of ICH, and is also a potential effective target for clinical treatment. In this paper, the pathogenesis of oxidative stress after ICH, mechanism of nerve and vascular injury in oxidative stress, and detection and treatment of oxidative stress are reviewed in order to provide references for basic research and clinical practice in ICH.

Objective:To investigate the changes of intestinal flora and its clinical significance in children with Helicobacter pylori (Hp)-positive duodenal ulcer before and after Hp eradication treatment. Methods:A total of 98 children with duodenal ulcer admitted to Ji′nan Second Maternal and Child Health Hospital from January 2018 to December 2020 were selected and divided into Hp infection group and Hp uninfected group according to whether they had Hp infection.Stools of Hp infection group were collected before treatment, treatment for 7 days, treatment for 14 days, and 30 days after treatment withdrawal for 16S rDNA sequencing.The independent samples t test was used to compare the detection of intestinal flora in the Hp infection group and the Hp uninfected group.Paired t test was used to compare the detection of intestinal flora in the Hp infection group before and after treatment.Nonparametric test was used to compare the bacterial diversity [diversity (Shannon, Simpson) index and richness (Chao 1) index] of Hp infection group and Hp uninfected group and the flora diversity of Hp infection group before and after treatment. Results:There was no significant difference in the detected numbers of Bifidobacterium [(5.92±1.85) lg copies/g feces vs.(6.58±2.01) lg copies/g feces], Lactobacillus [(4.89±1.35) lg copies/g feces vs.(4.47±1.59) lg copies/g feces], Bacteroides [(8.42±2.12) lg copies/g feces vs.(8.01±2.20) lg copies/g feces], Clostridium perfringens[(5.90±1.90) lg copies/g feces vs.(5.88±2.01) lg copies/g feces], Enterococcus[(5.41±1.27) lg copies/g feces vs.(5.02±1.48) lg copies/g feces], Enterobacter[(5.01±1.80) lg copies/g feces vs.(5.37±1.47) lg copies/g feces], and yeast [(5.90±1.85) lg copies/g feces vs.(5.88±2.01) lg copies /g feces] in the Hp infection group and the Hp uninfected group (all P>0.05). There was no statistically significant difference between the Shannon index (3.84±0.52 vs.3.90±0.45), Simpson index (0.16±0.04 vs.0.15±0.05), and Chao 1 index (178.52±40.22 vs.185.32±42.47) of the intestinal flora diversity between the Hp infection group and the Hp uninfected group (all P>0.05). Compared with before treatment, the number of Bifidobacterium, Lactobacillus and Bacteroides detected in the Hp infection group decreased at different times after treatment (all P<0.05). Compared with treatment for 7 days and treatment for 14 days, the number of Bifidobacterium [(4.54±1.78) lg copies/g feces vs.(4.20±1.22) lg copies/g feces vs.(5.21±1.55) lg copies/g feces], Lactobacillus [(4.01±1.20) lg copies/g feces vs.(3.89±1.32) lg copies/g feces vs.(4.43±1.10) lg copies/g feces], and Bacteroides [(6.78±1.88) lg copies/g feces vs.(6.55±1.90) lg copies/g feces vs.(7.68±2.00) lg copies/g feces] detected increased after 30 days of treatment (all P<0.05). There was no statistically significant difference in the number of Clostridium perfringens, Enterococcus, Enterobacter and yeast detected in Hp infection group at different times before and after treatment (all P>0.05). Compared with before treatment, the Shannon index and Chao 1 index at different time after treatment decreased, and the Simpson index increased (all P<0.05). Compared with treatment for 7 days and treatment for 14 days, the Shannon index (2.85±0.45 vs.2.57±0.48 vs.3.20±0.50) and Chao 1 index (148.45±32.33 vs.140.32±30.47 vs.160.42±38.42) increased, and Simpson index (0.25±0.06 vs.0.27±0.08 vs.0.19±0.05) decreased 30 days after treatment (all P<0.05). Conclusions:Hp infection has no significant effect on the intestinal flora of children with duodenal ulcer.Anti-Hp treatment can lead to imbalance of intestinal flora and decrease of intestinal flora diversity.The effect of a large number of antibiotics on intestinal flora should be considered in anti Hp treatment.

Objective:To investigate the clinical value of referral colposcopy in cervical high-risk human papillomavirus (HR-HPV) positive women in cervical cancer screening.Methods:Totally 2 445 cases, which were referred for colposcopic cervical biopsy for cervical HR-HPV positive in Karamay Central Hospital from January 2018 to November 2021 were collected. The status of cervical HR-HPV positive transferred colposcopy in different situations to identify high-grade squamous intraepithelial lesions (HSIL) and above (HISL+ ) was analyzed. The value of referral colposcopy in cervical HR-HPV positive women under different conditions was evaluated.Results:2 445 HR-HPV positive women were referred for colposcopic cervical biopsy, which confirmed 1 447 cases of negative for intraepithelial lesion or malignancy (NILM), 362 cases of low grade squamous intraepithelia lesion (LSIL), 510 cases of HSIL and 126 cases of squamous cell carcinoma (SCC); The complete coincidence rate between colposcopy diagnosis and pathological diagnosis was 67.08%(1 640/2 445), and the Kappa value of consistency test was 0.489. The sensitivity and specificity of colposcopy in the diagnosis of LSIL+ were 91.28% and 69.38%, and HSIL+ were 74.52% and 93.15%. The detection rates of HSIL+ in HPV16/18 positive and other 12 HPV positive patients with abnormal cervical liquid based cytology (TCT) were 64.78%(103/159) and 78.79%(364/462), respectively. The positive rates of HPV16/18 and 12 other HPV positive HSIL+ with normal TCT were 16.46%(82/498) and 6.56%(87/1 326), respectively. The rate of detecting HSIL+ in abnormal areas under colposcopy was 44.69%(534/1 195), and that in routine biopsy was 8.16%(102/1 250).Conclusions:Among the referred for colposcopic cases, the detection rate of HSIL+ was higher in cases with cervical HR-HPV positive and TCT abnormalities. Colposcopy has obvious value in identifying cervical lesions. The accurate diagnosis of cervical lesions is based on cervical biopsy under colposcopy.

Objective    To analyze the risk factors for neurological complications after emergency surgery of acute type A aortic dissection. Methods    The clinical data of 51 patients with acute Stanford type A aortic dissection who were admitted to Shanghai Delta Hospital from October 2018 to May 2019 were retrospectively analyzed. There were 37 males (72.5%) and 14 females (27.5%), aged 29-85 (55.1±12.3) years. The patients were divided into two groups, including a N1 group (n=12, patients with postoperative neurological insufficiency) and a N0 group (n=39, patients without postoperative neurological insufficiency). The clinical data of the two groups were compared and analyzed. Results    There were statistical differences in age (62.6±11.2 years vs. 51.7±11.4 years, P=0.003), preoperative D-dimer (21.7±9.2 μg/L vs.10.8±10.7 μg/L, P=0.001), tracheal intubation time (78.7±104.0 min vs. 19.6±31.8 min, P=0.003), ICU stay time (204.1±154.8 min vs. 110.8±139.9 min, P=0.037) and preoperative coagulation factor activity R (4.0±1.5 vs. 5.1±1.6, P=0.022). Preoperative coagulation factor activity R was the independent risk factor for neurological insufficiency after emergency (OR=2.013, 95%CI 1.008-4.021, P=0.047). Conclusion    For patients with pre-emergent acute aortic dissection who are older (over 62.6-64.5 years), with reduced coagulation factor R (less than 4.0), it is recommended to take more active brain protection measures to reduce the occurrence of postoperative neurological complications in patients with acute aortic dissection, and further improve the quality of life.

Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless, few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine (METH) dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Twenty-nine male long-term METH addicts (for > 3 years) were randomly assigned to high-frequency (10 Hz, n = 15) or sham (n = 14) rTMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz rTMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz rTMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz rTMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the post-error slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency rTMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.
Adjustment Disorders ; etiology ; therapy ; Adult ; Amphetamine-Related Disorders ; complications ; therapy ; Case-Control Studies ; Central Nervous System Stimulants ; adverse effects ; Choice Behavior ; physiology ; Functional Laterality ; Humans ; Male ; Methamphetamine ; adverse effects ; Middle Aged ; Prefrontal Cortex ; physiology ; Reaction Time ; physiology ; Transcranial Magnetic Stimulation ; methods ; Young Adult

OBJECTIVETo observe the multiple symptom distribution, severity and quality of life of female pelvic floor dysfunction(FPFD) patients with constipation as chief complaint.

METHODSOne hundred FPFD patients with constipation as chief complaint from Speciaty Outpatient Clinic, Pelvic Floor Center of Nanjing Municipal Hospital of Traditional Chinese Medicine between September 2015 and February 2017 were retrospectively enrolled in this study. A comprehensive medical history questionnaire survey and systematical evaluation of severity and quality of life of these patients with constipation was conducted. Constipation scoring system scale (CSS) and patient-assessment of constipation quality of life questionnaire (PAC-QOL) were applied to evaluate the constipation. Other scales included: (1)pain visual analogue scale (VAS) and short form-36 questionnaire (SF-36): if combined with chronic functional anal rectal pain; (2) international consultation on incontinence questionnaire-short form (ICIQ-SF) and urinary incontinence quality of life questionnaires (I-QOL):if combined with urinary incontinence; (3) fecal incontinence severity score scale (Wexner-FIS) and fecal incontinence quality of life questionnaire (FI-QOL):if combined with fecal incontinence.

RESULTSThe mean age of 100 FPFD patients was (57.9±13.9) (24-89) years and the mean disease course was (7.0±8.2)(0.5-40.0) years. Seventy-five cases (75%) were complicated with anal pain, 70 with urinary incontinence, 37 with rectocele, 19 with nocturia, 11 with urinary frequency, 10 with defecation incontinence. Complication with only one symptom was observed in 20 cases (20%), and with two or more symptoms was observed in 80 cases (80%). Pelvic floor relaxation syndrome patients were dominant (58 cases, 58%). The severity of constipation (CSS) was 6-22 (13.89±3.79) points and the quality of life (PAC-QOL) was 45-133 (87.13±18.57) points in FPFD patients. VAS and SF-36 of patients combined with chronic functional anal rectal pain were 1-8 (3.0±1.9) points and 14.4-137.0(71.5±31.4) points respectively. ICIQ-SF and I-QOL of patients combined with urinary incontinence were 1-17 (6.1±3.6) points and 52-110 (90.0±15.8) points respectively. Wexner-FIS and FI-QOL of patients combined with fecal incontinence were 1-11 (4.4±3.0) points and 52-116 (83.4±23.3) points respectively.

CONCLUSIONSThe symptoms of FPFD patients with constipation as chief complaint are complex. They are mainly complicated with anal diseases, then urinary incontinence, and mostly with more than 2 symptoms. Their quality of life is poor.

Adult ; Aged ; Aged, 80 and over ; Constipation ; etiology ; Fecal Incontinence ; etiology ; Female ; Humans ; Middle Aged ; Pelvic Floor ; Pelvic Floor Disorders ; complications ; diagnosis ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult

Aim To investigate the effect of Ding''s herb enema prescription on intestinal tissue related target in rat colitis induced by dextran sulfate sodium(DSS), and to elucidate the mechanism of Ding''s herb enema prescription in improving the intestinal inflammation and intestinal fibrosis.Methods Rats were fed with 3.5％ DSS.The rats were randomly divided into positive drug group, model group, Control group, and Ding''s herb enema prescription group.The positive drug group was treated with mesalazine enema, and Ding''s herb enema prescription group was treated with Ding''s herb enema prescription.The colon mucosa was taken once a day for 6 weeks.The changes of intestinal inflammatory response and intestinal fibrosis related proteins were detected by GSR-CAA-67 antibody protein array, and the differentially expressed proteins were screened out.Results Eight proteins showed statistical differences, including IFN-γ, erythropoietin(EPO), TIMP-2, TIM-1, IL-6, TIMP-1, TNF-α, IL-22 (P<0.05).On the other hand, Ding''s herb enema prescription and mesalazine significantly antagonized the effect of IL-6 and TIMP-1 (P<0.05).The antagonized effect of Ding''s embolization enema on TNF-α and IL-22 was also significant(P<0.05), but mesalazine had no similar effect (P>0.05).Conclusions Ding''s herb enema prescription has the effect of multiple targets, which may improve the intestinal inflammatory response and intestinal fibrosis to achieve the purpose of treatment of ulcerative colitis(UC).

OBJECTIVETo observe the short- and long-term efficacy of acupuncture combined with biofeedback in the treatment of functional anorectal pain (FARP).

METHODSClinical data of 142 patients who met the functional gastrointestinal disorders and functional anorectal pain based on criteria of Rome III( undergoing acupuncture with biofeedback therapy from August 2010 to November 2015 in Pelvic Floor Center of The Third Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed. Telephone and outpatient clinic recheck were used as standard follow-up. The clinical effect of short-term and long-term data collected from the disease-based database was evaluated with visual analogue pain scale (VAS) (0-10 points), short form health survey questionnaire (SF-36) (0-148 points). The overall satisfaction and effectiveness (VAS was >30%) were evaluated at the end of treatment (short-term) and during follow-up (long-term).

RESULTSThe effective follow-up data were obtained from 71.1%(101/142) of patients and the median follow-up time was 28(3-67) months. The VAS of 101 cases was 6.09±1.78, 1.99±1.89 and 3.55±2.60 before treatment, at the end of treatment and during follow-up respectively. Though the VAS during follow-up was higher than that at the end of treatment, but still significantly lower than that before treatment(P<0.05). The SF-36 score of 31 patients was 82.0±16.9, 94.0±15.1 and 88.1±15.3 before treatment, at the end of treatment and during follow-up respectively. Though the SF-36 score during follow-up was lower compared to at the end of treatment, but still significantly higher compared to before treatment (P<0.05). The effective rates were 85.9%(122/142) at the end of treatment and 75.2%(76/101) during follow-up, and the satisfactory rates were 92.3%(131/142) and 84.2%(85/101), respectively.

CONCLUSIONAcupuncture with biofeedback has significant short-term and long-term efficacy in treating functional anorectal pain, and its degree of satisfaction is high.

Objective More early esophageal cancers are treated by endoscopy.However,whether submucosal patients are suitahle for endoscopic treatment is still controversial,and few domestic researches were conducted in this area.The present study investigated the impact of submucosal invasion depth on lymph node metastasis.Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied.Submucosal invasion was equally categorized into inner one-third(sml),middle one-third(sm2),and deep one-third(sm3) invasion by pathologists.Demographics of patients,tumor characteristics,and surgical information were retrospectively collected through medical records.They were compared according to different submucosal invasions.Cancer characteristics and its association with LNM were analyzed by univariate and multivariate analysis.Results The study included 75 sml (29.1％),73 sm2(28.3％),and 110 sm3(42.6％) patients,and the rates of LNM were 12.0％ (9/75),11.0％ (8/73),20.9％ (23/110),respectively.sm3 might be associated with regional LN M (univariate analysis,P =0.041).Tumor volume ＞ 1.856 cm3 (P =0.022) and lymphovascular invasion (P =0.004) predicted LNM using multivariate analysis.Conclusion Submucosal ESCC showed a substantial rate of LNM and it seems that they are not suitable for endoscopic treatment.Depth of invasion was not an independent risk factor for LNM.

AIM:R-spondin 2 (Rspo2), one member of R-spondin family which contains four secreted proteins , plays an important role in skeletal muscle development .However, the impact of Rspo2 on vascular smooth muscle cell ( SMC) differentiation is little known . This study aims at revealing the role and mechanism of Rspo 2 on SMC differentiation from embryonic stem cells (ESCs).METHODS:A well-established model for studying SMC differentiation from ESCs were used , in which mouse embryonic stem cells ( ES-D3) were seeded on collagen IV-coated flasks and cultured in differentiation medium (DM) for 2, 4, 6 and 8 days.Smooth muscle specific markers, includingα-smooth muscle actin (α-SMA), SM22 and smooth muscle myosin heavy chain (SM-MHC), were detected to in-sure the successful model by qRT-PCR and Western blot .After 3-day pre-differentiation, ESCs were treated with recombinant Rspo 2 protein, overexpression plasmid or shRNA plasmid for 96 h, and the mRNA and protein expression of smooth muscle markers was detected.To explore the role of Rspo2 on SMC differentiation in vivo, 3-day predifferentiated ESCs (106 in 50μLα-MEM) incubated with Rspo2-overexpression plasmid were mixed with 50 μL of Matrigel ( Becton Dickinson Labware ) and then subcutaneously injected into C57BL/6J mice.After 12 days, mice were sacrificed and the implants were harvested for immunofluorescence staining , qRT-PCR and Western blot.Furthermore, electrophoretic mobility shift assay (EMSA), chromatin immunoprecipitation assay (ChIP) and lucif-erase reporter assay were performed to investigate the transcriptional activity of SMC differentiation related transcription factors , inclu-ding serum response factor (SRF), myocardin (MYO), myocyte-specific enhancer factor 2C (MEF-2C).Involvement of Rspo2 re-ceptor, leucine-rich repeat-containing, G-protein-coupled receptors (Lgr)4,5,6, and β-catenin pathway during Rspo2-induced MSC differentiation were also uncovered by overexpression or inhibition of the respective protein .RESULTS:Our results showed that Rspo 2 mRNA and protein expression was significantly and consistently increased during ESC differentiation towards SMCs .Recombinant Rs-po2 protein and enforced Rspo 2 expression in ESCs resulted in up-regulation of smooth muscle markers and transcription factors , while knockdown decreased the expression of these genes .Expectedly , Rspo2 overexpression also promotes SMC differentiation in vivo.
Mechanistically , our data showed that Rspo 2 could promote SRF binding to SM22 promoter region .Evidence also revealed that one of three Rspo2 receptors, LGR5, was up-regulated while the other two , LGR4 and LGR6, was down-regulated.Silencing of LGR5 inhibi-ted Rspo2-induced SMC differentiation, whereas knockdown of LGR4 had no impact.Finally, activation or inhibition of β-catenin could promote or inhibit SMC differentiation , respectively .CONCLUSION: Our findings demonstrate for the first time that Rspo 2 plays a positive role during smooth muscle cell differentiation from embryonic stem cells .We confirmed that Rspo 2 can up-regulate smooth muscle markers at transcription level .We also revealed Rspo promote smooth muscle cell differentiation through activation of LGR 5 re-ceptor and Wnt/β-catenin pathway .