Abstract Neonatal thoracoscopic correction of type III esophageal atresia requires the establishment of an artificial carbon dioxide pneumothorax in the affected thoracic cavity. At present, there is no suitable double-lumen endotracheal tube or bronchial occluder to be used in neonatal thoracoscopic surgery. Objectives: To research the influence of sevoflurane pretreatment on neonatal inflammatory response and pulmonary ventilation. Sixty neonates were randomized into 2 groups, group C, group S. Neonates in group S received sevoflurane inhalation at a concentration of 2% after endotracheal intubation until the establishment of pneumothorax, followed by a 10-min washout period, while those in group C only inhaled pure oxygen. Venous blood samples were collected from the subjects in the 2 groups from at 10 min before induction of anesthesia to 24 h after pneumothorax relief to determine the concentrations of serum interleukin (IL)-6, IL-8, and tumor necrosis factor α. Arterial blood gases were drawn from the radial artery at the above time points. The alveolar-arterial oxygen partial pressure difference, and respiratory index were calculated. Concentrations of IL-6, IL-8, and tumor necrosis factor α in serum were all lower in group S. Alveolar-arterial oxygen and respiratory index were also lower in group S. Duration of surgical intensive care unit stay, time of mechanical ventilation, and length of stay were all lower in group S. A concentration of 2% sevoflurane pretreatment may have a protective influence on the neonatal inflammatory response and pulmonary ventilation, which correct type III esophageal atresia by suppressing the inflammatory response under the thoracoscope.

Abstract Background: Postoperative cognitive dysfunction is widely recognized as severe postoperative central nervous dysfunction and has a significant impact on the ’patient’s physical and mental health. Methods: Postoperative models of tibial fracture in aged rats were established, including the control group, model group, CCL11 protein injection group, and saline injection group. Morris water maze test was used to detect the behavioral characteristics of rats. Enzyme-Linked Immunosorbent Assay was used or determine the content of CCL11 and CXCL10. Immunofluorescence staining was used to detect the distribution of CD14+CD163+macro-phages in colon tissues and CD11b+CCR3+microglia cells in hippocampal tissues. Western blot analyzed NOX1 and STAT3 expression in hippocampus tissues. Results: Water maze test results confirmed severe cognitive impairment in CCL11 rats. The content of CCL11 and CXCL10 in the CCL11 group was much higher than that of the model group. The distribution of macrophage and microglia cells in the CCL11 model group was greater than that in the model group and the saline group. The expression of NOX1 and STAT3 in the CCL11 group was higher compared with the model group. Conclusion: Abnormal macrophage function and excessive CCL11 secretion were observed in the rats with lower limb fractures after surgery. Postoperative central inflammation in rats with lower limb fracture induced postoperative cognitive dysfunction through the gut-brain axis molecular mechanism.

OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.

RESUMO OBJETIVO Explorar a associação do polimorfismo do gene fator neurotrófico derivado do cérebro (BDNF) com o endofenótipo cognitivo latente de transtorno de estresse pós-traumático (TEPT) após grandes desastres naturais na província de Hainan, China. MÉTODOS Um total de 300 doentes com TEPT e 150 controles saudáveis (HC) foi investigado pela escala de psicanálise para avaliar as suas funções cognitivas. A reação em cadeia polimerase (PCR) e a eletroforese em gel de poliacrilamida (Page) foram usadas para detectar o polimorfismo do gene BDNF. RESULTADOS Em termos de função cognitiva, as pontuações no grupo TEPT foram piores do que as do grupo HC (P<0,05 ou P<0,01). Houve uma diferença significativa na distribuição do genótipo de BDNF e frequência do alelo entre os dois grupos (P<0,05). Os endofenótipos de TEPT foram significativamente diferentes entre os genótipos de BDNF do grupo TEPT (P≤0,01). CONCLUSÃO Existe uma diferença estatisticamente significativa no polimorfismo do gene BDNF entre o TEPT e os grupos HC, e os alelos estão associados à incidência do TEPT. Assim, pode ser um fator de risco para TEPT.

SUMMARY OBJECTIVE To explore the association of brain-derived neurotrophic factor gene (BDNF) polymorphism with the latent cognitive endophenotype of posttraumatic stress disorder (PTSD) after major natural disasters in Hainan Province, China. METHODS A total of 300 patients with PTSD and 150 healthy controls (HC) were surveyed by psychoanalysis scale to assess their cognitive functions. Polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis (PAGE) were used to detect the BDNF gene polymorphism. RESULTS In terms of the cognitive function, the scores in the PTSD group were worse than those of the HC group (P < 0.05 or P < 0.01). There was a significant difference in the distribution of BDNF genotype and allele frequency between the two groups (P < 0.05). PTSD endophenotypes were significantly different among the BDNF genotypes in the PTSD group (P ≤ 0.01). CONCLUSION There is a statistically significant difference in the polymorphism of BDNF gene between PTSD and HC groups, and the alleles are associated with the incidence of PTSD. Thus, it may be a risk factor for PTSD.

Abstract Objective: To perform a systematic review and meta-analysis of studies comparing coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and medical treatment (MT) in patients with chronic total occlusions (CTOs). Methods: We identified eligible observational studies published in the China National Knowledge Infrastructure database, PubMed, Excerpta Medica database, Google Scholar, Cochrane Library, Web of Science, and "Clinical trials" registration from 1999 to October 2018. Main outcome measures were all-cause mortality, cardiac death, major adverse cardiac events (MACEs), and myocardial infarction (MI). Results: There were eight observational studies including 6985 patients. Patients' mean age was 64.4 years. Mean follow-up time was 4.3 years. Comparing with MT (2958 patients), PCI (3157 patients) presented decreased all-cause mortality (odd ratio [OR]: 0.46, 95% confidence interval [CI]: 0.36-0.60; P<0.001), cardiac death (OR: 0.40, 95% CI: 0.31-0.52; P<0.001), MACE (OR: 0.55, 95% CI: 0.43-0.71; P<0.001), and MI (OR: 0.40, 95% CI: 0.26-0.62; P<0.001). Comparing with MT, CABG (613 patients) presented lower all-cause mortality (OR: 0.50, 95% CI: 0.36-0.69; P<0.001) and MACE (OR: 0.50, 95% CI: 0.26-0.96; P=0.04), but not lower MI (OR: 0.23, 95% CI: 0.03-1.54; P=0.13) and cardiac death (OR: 0.83, 95% CI: 0.51-1.35). Comparing with CABG, PCI did not present decreased risk for those outcomes. Conclusions: PCI or CABG was associated with better clinical outcome in patients with CTO than MT. PCI is not better than CABG in decreasing mortality, MI, cardiac death, and MACE in coronary CTO patients.

ABSTRACT The objective of this study was to evaluate the effects of maternal dietary intake on the amino acid and fatty acid contents in eggs during the laying period. An experiment with a 2×2 factorial design was conducted with two maternal dietary intake levels (100 and 75% of dietary intake recommended by the Chinese Ministry of Agriculture) and two broiler lines (fat and lean line). A total of 384 hens of fat line and 384 hens of lean line at 23 weeks of age were included in the experiment. Each line was randomly divided into two treatments (n = 192 in each treatment, with 12 replications), and each replication included 16 birds. The treatments were LN (lean line and normal maternal dietary intake, n = 192), LL (lean line and low maternal dietary intake, n = 192), FN (fat line and normal maternal dietary intake, n = 192), and FL (fat line and low maternal dietary intake, n = 192). The amino acid and fatty acid contents in eggs were tested (50 weeks of age). The fat line had higher levels of arginine, aspartic acid, glycine, histidine, leucine, methionine, and threonine in the egg albumen than the lean line. Low maternal dietary intake increased the cystine deposition in egg yolks. There were interactions between maternal dietary intake and line on the deposition of trans-oleic acid, docosanoic acid, and total fatty acid in egg yolks. Low maternal dietary intake increased the deposition of tetradecenoic and linolenic acids and the ratio of total polyunsaturated fatty acids to total saturated fatty acid in egg yolks but decreased the deposition of docosanoic acid. Maternal dietary intake and line affect the amino acid and fatty acid profiles in eggs.

Duplex Ni-P-TiO2/Ni-P coatings were electrodeposited onto brass substrates. High phosphorus Ni-P coatings were plated as the inner layer to improve the corrosion resistance, while low phosphorus sol-enhanced Ni-P-TiO2 coatings were deposited on the top to strengthen the mechanical property. The microstructure, morphology, mechanical property and corrosion resistance of coatings were investigated systematically. The results show that duplex coatings exhibit both excellent mechanical property and good corrosion resistance. The hardness was further improved from ~545 HV50 of duplex Ni-P/Ni-P coating to ~622 HV50 of duplex Ni-P-12.5mL/L TiO2/Ni-P coating, while the hardness of single Ni-P coating was only ~387 HV50. The corrosion resistance of duplex coatings improved significantly by adding a suitable amount of TiO2 sol. Duplex Ni-P-12.5mL/L TiO2/Ni-P coating presented the highest corrosion resistance. However, adding excessive quantities of sol (more than 12.5mL/L) caused nanoparticle agglomeration and created a porous structure in the outer layer, deteriorating the properties of coatings.

Our previous study has shown that reduced insulin resistance (IR) was one of the possible mechanisms for the therapeutic effect of silibinin on non-alcoholic fatty liver disease (NAFLD) in rats. In the present study, we investigated the pathways of silibinin in regulating hepatic glucose production and IR amelioration. Forty-five 4- to 6-week-old male Sprague Dawley rats were divided into a control group, an HFD group (high-fat diet for 6 weeks) and an HFD + silibinin group (high-fat diet + 0.5 mg kg-1·day-1 silibinin, starting at the beginning of the protocol). Both subcutaneous and visceral fat was measured. Homeostasis model assessment-IR index (HOMA-IR), intraperitoneal glucose tolerance test and insulin tolerance test (ITT) were performed. The expression of adipose triglyceride lipase (ATGL) and of genes associated with hepatic gluconeogenesis was evaluated. Silibinin intervention significantly protected liver function, down-regulated serum fat, and improved IR, as shown by decreased HOMA-IR and increased ITT slope. Silibinin markedly prevented visceral obesity by reducing visceral fat, enhanced lipolysis by up-regulating ATGL expression and inhibited gluconeogenesis by down-regulating associated genes such as Forkhead box O1, phosphoenolpyruvate carboxykinase and glucose-6-phosphatase. Silibinin was effective in ameliorating IR in NAFLD rats. Reduction of visceral obesity, enhancement of lipolysis and inhibition of gluconeogenesis might be the underlying mechanisms.