Objective To investigate the effect of brachial plexus block on stress response in patients who underwent shoulder arthroscopic surgery.Methods A total of 150 patients with shoulder arthritis who underwent shoulder arthroscopic surgery in the Shanghai Fifth People's Hospital,Fudan University from December 2021 to December 2022 were selected as the study subjects.All patients were divided into the control group and the observation group by random number table method,with 75 cases in each group.Patients in the control group were given general anesthesia,while patients in the observation group were given brachial plexus block on the basis of the control group.The mean arterial pressure(MAP),heart rate(HR),norepinephrine(NE),cortisol(Cor)before operation(T0),10 minutes after operation(T1),30 minutes after operation(T2),at the end of operation(T3)and 30 minutes after extubation(T4)of the two groups were compared.The transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)before and 3 days after operation of the two groups were compared.The visual analogue scale(VAS)scores at postoperative wakefulness and 6,12 and 24 hours after operation of the two groups were compared.Results Compared with T0,the levels of MAP and HR at T1,T2,T3,and T4 in the observation group and the control group were obviously decreased(P<0.01),the levels of NE and Cor were obviously increased(P<0.01),while the levels of MAP,HR,NE,and Cor at T1,T2,T3,and T4 in the observation group were obviously lower than those in the control group(P<0.01).The levels of TGF-β1,TNF-α,and CRP 3 days after operation in the observation group and the control group were obviously increased compared with those before operation (P<0. 01), and the above indicators after operation in the observation group were obviously lower than those in the control group (P<0. 01). The VAS scores at postoperative wakefulness and 6, 12 and 24 hours after operation in the observation group were obviously lower than those in the control group (P<0. 01). Conclusion Ultrasound-guided brachial plexus block by interscalene approach can ensure the stability of the vital signs of patients with shoulder arthritis during shoulder arthroscopic surgery, alleviate pain, reduce stress, and reduce inflammatory response.

Objective To explore the characteristics and correlation of the chin and airway in females with skeletal Class Ⅱ mandibular retraction for reference for clinical diagnosis and therapy.Methods This study was approved by the hospital Medical Ethics Committee.Forty cases of skeletal Class Ⅱ mandibular retraction adult females with aver-age angle were selected as the research group,and sixty cases of skeletal Class Ⅰ patients with average angle were se-lected as the control group.Cone-beam computed tomography(CBCT)images for all subjects were analyzed using three-dimensional modeling software.Measurements included the chin morphology,position,and upper airway morphology.Results Compared with skeletal Class Ⅰ patients,patients with skeletal Class Ⅱ mandibular retraction had smaller an-terior chin thickness,base bone volume,chin total volume,and larger chin angle,chin depression,chin curvature,and alveolar area with statistically significant differences(P＜0.05).Gn-V,Gn-H,Po-NB distance,and facial angle were smaller,and the Y-axis angle was larger in patients with skeletal Class Ⅱ mandibular retraction with statistically signifi-cant differences(P＜0.05).Upper airway total volume,transverse and sagittal diameter of the glossopharynx upper boundary were smaller in patients with skeletal Class Ⅱ mandibular retraction with statistically significant differences(P＜0.05).The correlation analysis between the morphology and position of the chin and the morphology of the upper airway in patients with Class Ⅱ mandibular retraction showed that there was a negative correlation between chin angle and laryngopharynx length in patients with Class Ⅱ mandibular retraction(r=-0.277,P＜0.01).There was a negative correlation between Po-NB distance and palatopharyngeal length(r=-0.222,P＜0.05).Chin height(r=-0.261,P＜0.01)and basal bone area(r=-0.225,P＜0.05)were negatively correlated with the transverse diameter of the palato-pharyngeal upper boundary.The minimum chin thickness(r=0.245,P＜0.05),chin angle(r=0.249,P＜0.05),and al-veolar area(r=0.213,P＜0.05)were positively correlated with the sagittal diameter of the palatopharyngeal upper boundary.Gn-V(r=0.217,P＜0.05)and Po-NB distance(r=0.208,P＜0.05)were positively correlated with the trans-verse diameter of the glossopharynx upper boundary.Anterior chin thickness was negatively correlated with the sagittal diameter of the laryngopharynx upper boundary(r=-0.211,P＜0.05).Chin depression was negatively correlated with the sagittal diameter of the laryngopharynx lower boundary(r=-0.237,P＜0.05).Chin curvature was positively corre-lated with the transverse diameter of the laryngopharynx lower boundary(r=0.231,P＜0.05).Conclusion Patients with skeletal Class Ⅱ mandibular retraction exhibit thinner chins.The sagittal position of the chin is backward,and the vertical position is upward.Patients with skeletal Class Ⅱ mandibular retraction have a narrow glossopharyngeal airway.There is a correlation between the morphology and position of the chin and the morphology of the upper airway in pa-tients with Class Ⅱ mandibular retraction.

Phosphodiesterase 4 (PDE4) is an important member of the phosphodiesterase enzyme family that specifically catalyzes the hydrolysis of cyclic adenosine monophosphate (cAMP), activates the downstream phosphorylation cascade pathway by altering cAMP concentration, and is strongly associated with multiple diseases. Inhibition of PDE4 is clinically investigated as a therapeutic strategy in a broad range of disease areas, including respiratory system diseases, autoimmune disorders, central nervous system diseases, and dermatological conditions. However, the incidence of adverse reactions such as nausea and vomiting is relatively high in the marketed PDE4 inhibitors, which has stalled their clinical development. In this review, we provide an overview of the clinical progression and safety issues of the marketed PDE4 inhibitors. We also review the main causes underlying PDE4-mediated adverse effects by combining the structural analysis of the PDE4 protein, the mechanism of action of PDE4 inhibitors, and the related side effect mechanism research, aiming to provide a reference for the development of safe and effective PDE4 inhibitors.

ObjectiveTo take COVID-19 as an example to understand the sense of security and anxiety of students in Sichuan province under major public crisis events， and to provide references for psychological education and intervention under the situation of normalized COVID-19 prevention and control. MethodsIn June 2020， a total of 7 319 students from colleges， middle schools and primary schools in Sichuan province were surveyed via Wenjuanxing platform by Security-Insecurity Questionnaire （S-I） and Self-rating Anxiety Scale （SAS）. ResultsThe SAS score of students in Sichuan province was （41.52±9.90）， and the S-I score was （29.88±11.60）， the S-I score of male students was higher than that of female students， and the SAS score was lower than that of female students， the differences were statistically significant （t=5.961， -2.430， P<0.01）. There were significant differences in the total scores of S-I and SAS among students in different academic stages （F=122.579， 60.950， P<0.01）. The total score of S-I and the scores of each dimension were negatively correlated with SAS score （r=-0.553~-0.471， P<0.01）. Linear regression analysis showed that the regression model fitted well （adjusted R²=0.274）， and the model was statistically significant （F=40.802， P<0.01）. Emotional security （β=-0.441， P<0.01） was a significant negative predictor of anxiety. ConclusionUnder major public crisis events， students have a high level of anxiety and a low sense of security. Anxiety and security level are significantly different regarding different genders and school levels. Security has a negative predictive effect on anxiety.

ObjectiveTo assess the screening ability of two new anthropometric indices： a body shape index （ABSI） and body roundness index （BRI） for metabolic associated fatty liver disease （MAFLD） in adults， and to determine the optimal cut-off value. MethodsBased on the valid baseline data collected from March 2018 to October 2019 in Dongguan City， Guangdong Province by South China Cohort （SCC） project， a total of 9 214 adults were included， with physical examination， ultrasound and laboratory tests. MAFLD was diagnosed according to the consensus statement of international experts. Body mass index （BMI）， waist circumference （WC） and waist-height-ratio （WHtR） were used as reference to evaluate the screening ability of ABSI and BRI. Spearman rank test and logistic regression model were used to compare the correlation between each index and MAFLD. The receiver operating characteristic curve （ROC） was used to compare the area under the curve （AUC）. ResultsThe prevalence of MAFLD was 31.41%， which increased linearly across the quartile of each index except ABSI. There was a positive correlation between each index and MAFLD but ABSI was the weakest （r_s=0.069 in males and r_s=0.045 in females） while BRI was stronger （r_s=0.409 in males and r_s=0.413 in females）. A multivariate logistic regression analysis of the presence of MAFLD for the highest quartile vs. the lowest quartile of each anthropometric measure， showed that ABSI had the lowest OR without statistical significance. The OR and 95%CI was 1.09 （0.85， 1.41） in males and 0.90 （0.74， 1.08） in females， respectively. BRI was similar to WHtR， and BMI had the strongest association whose OR and 95%CI was 61.15 （35.12， 106.47） in males and 20.07 （15.24， 26.43） in females， respectively. ABSI had the lowest AUC for MAFLD （0.55 in males and 0.53 in females） and the cut-off value was respectively 0.080 5 in males and 0.078 2 in females. BRI had a higher AUC （0.77 in males and 0.75 in females）， equal to WHtR and similar to WC （0.79 in males and 0.77 in females） but lower than BMI （0.81 in males and 0.79 in females）. The optimal cut-off value for BRI was 4.10 in males and 4.51 in females. BRI also showed a certain screening ability on MAFLD in lean/normal weight population （0.73 in males and 0.69 in females）， patients with diabetes （0.73 in males and 0.71 in females） and subjects with lean/normal weight and metabolic dysfunction （0.60 in males and 0.55 in females）. ConclusionsBRI can effectively identify MAFLD （AUC>0.7） and the optimal cut-off value is 4.10 for males and 4.51 for females， while ABSI performs poorly. Considering the screening on MAFLD in population with different characteristics， BRI shows a potential for use in early screening of MAFLD.

ObjectiveTo assess the screening ability of two new anthropometric indices： a body shape index （ABSI） and body roundness index （BRI） for metabolic associated fatty liver disease （MAFLD） in adults， and to determine the optimal cut-off value. MethodsBased on the valid baseline data collected from March 2018 to October 2019 in Dongguan City， Guangdong Province by South China Cohort （SCC） project， a total of 9 214 adults were included， with physical examination， ultrasound and laboratory tests. MAFLD was diagnosed according to the consensus statement of international experts. Body mass index （BMI）， waist circumference （WC） and waist-height-ratio （WHtR） were used as reference to evaluate the screening ability of ABSI and BRI. Spearman rank test and logistic regression model were used to compare the correlation between each index and MAFLD. The receiver operating characteristic curve （ROC） was used to compare the area under the curve （AUC）. ResultsThe prevalence of MAFLD was 31.41%， which increased linearly across the quartile of each index except ABSI. There was a positive correlation between each index and MAFLD but ABSI was the weakest （r_s=0.069 in males and r_s=0.045 in females） while BRI was stronger （r_s=0.409 in males and r_s=0.413 in females）. A multivariate logistic regression analysis of the presence of MAFLD for the highest quartile vs. the lowest quartile of each anthropometric measure， showed that ABSI had the lowest OR without statistical significance. The OR and 95%CI was 1.09 （0.85， 1.41） in males and 0.90 （0.74， 1.08） in females， respectively. BRI was similar to WHtR， and BMI had the strongest association whose OR and 95%CI was 61.15 （35.12， 106.47） in males and 20.07 （15.24， 26.43） in females， respectively. ABSI had the lowest AUC for MAFLD （0.55 in males and 0.53 in females） and the cut-off value was respectively 0.080 5 in males and 0.078 2 in females. BRI had a higher AUC （0.77 in males and 0.75 in females）， equal to WHtR and similar to WC （0.79 in males and 0.77 in females） but lower than BMI （0.81 in males and 0.79 in females）. The optimal cut-off value for BRI was 4.10 in males and 4.51 in females. BRI also showed a certain screening ability on MAFLD in lean/normal weight population （0.73 in males and 0.69 in females）， patients with diabetes （0.73 in males and 0.71 in females） and subjects with lean/normal weight and metabolic dysfunction （0.60 in males and 0.55 in females）. ConclusionsBRI can effectively identify MAFLD （AUC>0.7） and the optimal cut-off value is 4.10 for males and 4.51 for females， while ABSI performs poorly. Considering the screening on MAFLD in population with different characteristics， BRI shows a potential for use in early screening of MAFLD.

Objective Establishment of orthotopic transplantation tumor model of human choriocarcinoma in nude mice. Methods Human choriocarcinoma cell line JAR was cultured and the single cell suspension was subcutaneously injected into five 8-week-old BALB / c nude mice to establish subcutaneous xenograft model. After subcutaneous tumor was formed in nude mice, the tumor tissue was taken under aseptic conditions and cut into 1 mm

Objective To investigate the expression of semaphorin 3A (Sema3A) and its receptor neuropilin-1 (NRP-1) in gastric cancer and its correlation with microvessel density (MVD), and then to explore the effect of recombinant human Sema3A on angiogenesis of gastric cancer and the associated mechanisms. Methods Forty cases of gastric cancer tissues and its corresponding adjacent normal tissues were used to detecte the expression of Sema3A, NRP-1 and MVD in tissues by immunohistochemistry method . The expression level of Sema3A in serum of gastric cancer patient group and normal control group were measured by Enzyme-linked immuno-sorbent assay (ELISA). Western blotting was used to detect the expression of Sema3A and NRP-1 in five gastric cancer cell lines (MGC-803,HGC-27,MKN-28,SGC-7901,MKN-45) and human gastric mucosal epithelial cell (GES-1). Transwell chamber was used to construct non-contact in vitro co-culture system, in which the effects of different concentrations of recombinant human Sema3A on angiogenesis in gastric cancer were analyzed by tube formation assay preliminarily. The expression levels of vascular endothelial growth factor receptor 2 (VEGFR2) and NRP-1 in co-culture system were detected by Western blotting. Results The expression levels of Sema3A in gastric cancer tissues, cell lines and patient serum were significantly lower than that in the control group(P<0. 05), while the expression of NRP-1 in gastric cancer tissues and MKN-28 cells was significantly increased, and both of them were associated with TNM staging of gastric cancer (P < 0. 05) . In vitro co-culture system, The tube forming abilities of human umbilical vein endothelial cell (HUVEC) were decreased in recombinant human Sema3A treated group, and this phenomenon was concentration dependent. The expression of VEGFR2 protein was down-regulated by recombinant human Sema3A. Conclusion The expression of Sema3A was decreased in gastric cancer tissues, cell lines and patient serum, and negatively correlated with microvessel density. The recombinant human Sema3A could inhibit the angiogenesis of gastric cancer in vitro, which may be related to down-regulation of VEGFR2 protein expression.

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

Objective To investigate diabetes-mediated changes in the neuromuscular pharmacodynamics of rocuronium in rats. Methods Diabetes mellitus was induced by a single injection of streptozotocin in rats.A total of 24 male SD rats were assigned to four groups using random number table:the normal control group,diabetic 2-week group,diabetic 4-week group,and diabetic 8-week group(6 rats per group).The sciatic nerve was stimulated in a rain-of-four(TOF)pattern,and the twitch tension changes in the tibialis anterior muscle were demonstrated by mechanomyography after intravenous injection of rocuronium in vivo.The time course characteristics of rocuronium,including onset time,and the recovery time from rocuronium injection to TOF ratio 75%(RT75%)and 90%(RT90%),were recorded,and half maximal inhibitory concentration(IC)values of rocuronium were determined using a four-parameter dose response curve. Results Compared with the normal controls,the diabetic rats had significantly prolonged onset time of rocuronium,while the RT75% and RT90% were decreased at all rocuronium doses(P<0.001).The time course changes became increasingly significant as the duration of diabetes lengthened(P<0.001).The IC and 95% confidence interval values for rocuronium in the normal control group,diabetic 2-week group,diabetic 4-week group,and diabetic 8-week group were 0.37(0.35-0.38)mg/kg,0.44(0.43-0.46)mg/kg,0.59(0.57-0.61)mg/kg,and 0.64(0.61-0.66)mg/kg,respectively.IC values were significantly higher in the diabetic groups vs.normal control(P<0.001)and gradually increased as the duration of diabetes lengthened(P<0.001).Conclusion Diabetes is associated with the rat skeletal muscle hyposensitivity to rocuronium,which is featured by prolonged onset time of rocuronium,decreased RT 75% and RT 90%,and right shift of the cumulative dose-response curve of rocuronium.
Animals ; Diabetes Mellitus, Experimental ; physiopathology ; Male ; Muscle, Skeletal ; drug effects ; Neuromuscular Nondepolarizing Agents ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rocuronium ; pharmacology