Objective To explore the value of plasma soluble urokinase-type plasminogen activator receptor (suPAR),urinary neutrophil gelatinase associated apolipoprotein (NGAL) and urinary kidney injury molecule-1 (KIM-1) in the early diagnosis of adult with cardiac surgery-associated acute kidney injury (CSA-AKI). Methods A prospective case-control study was conducted with consecutively recruited 170 patients undergoing cardiac surgery with cardiopulmonary bypass in the Department of Cardiac Surgery, the First Affiliated Hospital of Army Medical University from March 2020 to February 2021. Venous blood and urine were collected before operation, 2 hours, 2 days and 7 days after operation, and the levels of plasma suPAR, urine NGAL and urine KIM-1 were detected by enzyme linked immunosobent assay (ELISA). According to the occurrence of AKI 7 days after operation, the patients were divided into AKI group (n=34) and non-AKI group (n=136). The levels of plasma suPAR, urinary NGAL and urinary KIM-1 were compared between the two groups. The risk factors of CSA-AKI were analyzed by logistic regression,and the value of plasma suPAR, urine NGAL and KIM-1 for the early diagnosis of CSA-AKI was evaluated by receiver operating characteristic (ROC) curve. Results The level of plasma suPAR was significantly higher in AKI group than that in non-AKI group(P<0.01). The levels of urinary KIM-1 at 2 h after operation and urinary NGAL at 2 h and 7 d after operation were significantly higher in AKI group than those in non-AKI group (P<0.05). ROC analysis showed that the area under curve (AUC) of preoperative plasma suPAR, postoperative 2 h plasma suPAR, urine Kim-1 and urine NGAL diagnosed CSA-AKI were 0.683, 0.717, 0.643 and 0.631, respectively. The AUC area which combined detection of postoperative 2 h plasma suPAR + postoperative 2 h urine KIM-1+ 2 h urine NGAL was the largest (AUC=0.793, 95%CI 0.708-0.879, P<0.001), and the sensitivity and the specificity were 64.71%and 82.35%. Logistic regression analysis showed that after adjusting for sex, preoperative left ventricular ejection fraction (LVEF),albumin (ALB), postoperative 2 h creatinine, postoperative 2 h estimated glomerular filtration rate (eGFR), postoperative 2 h blood urea nitrogen (BUN), postoperative 2 h KIM-1 and postoperative 2 h NGAL, postoperative 2 h suPAR was still an independent risk factor for CSA-AKI. Conclusion Plasma suPAR, urine NGAL and urine Kim-1 can be used for early diagnosis of CSA-AKI.The diagnostic efficacy of plasma suPAR at 2 hours after operation is the best when detected alone. Combined detection of plasma suPAR, urine NGAL and urine Kim-1 at 2 hours after operation can further improve the diagnostic efficiency of CSA-AKI.

Objective To investigate the effect of SE-hBCG on the immunogenicity of recombinant cytomegalovirus glycoprotein B (CgB) and freeze-dried rabies human vaccine (Rab). Methods A total of 145 SPF female BALB/c mice aged 6-8 weeks were selected for the following experiments. In experiment one, five groups of mice (five mice per group) received intramuscular injections of 0.2 ml of SE, SE-hBCG, CgB, SE+CgB or SE-hBCG+CgB three times (at week 0, 2 and 4), respectively.Two weeks after the last immunization was the endpoint of this experiment. In experiment two, four groups of mice (30 mice per group) received two intraperitoneally injections at week 0 and 1 with 0.2 ml of PBS, Rab, SE+Rab or SE-hBCG+Rab, respectively.Samples were collected at 4, 8, 10, 12, 14, 35 days after the first immunization. Spleen lymphocytes of mice were isolated after homogenizing spleens. The enzyme-linked immunosorbent spot assay (ELISPOT) was used to detect the number of antigen-specific IFN-γ and IL-4-secreting spot forming cells (IFN-γ-SFC or IL-4-SFC). Sera were harvested from eyeball blood. Antigen-specific IgG was detected using ELISA. Results SE-hBCG induced mice to produce CgB-specific Th1 responses as mice immunized with SE-hBCG produced greater numbers of IFN-γ-SFC than mice immunized with SE (266.0±87.9 vs. 104.5±28.8, P<0.05). Mice immunized with SE-hBCG adjuvanted CgB vaccines produced higher levels of CgB-specific IgG antibodies (18 800.0±2396.0) and greater numbers of IFN-γ-SFC (440.5±38.4) than mice immunized with CgB (3333.0±737.9 for CgB-specific IgG antibody titer and 189.2±21.4 for IFN-γ-SFC, P<0.05). Four days after the first immunization, SE or SE-hBCG adjuvanted Rab vaccines induced low-level anti-Rab IgG antibodies (OD₄₅₀≤0.2). Anti-Rab IgG antibodies of mice immunized with Rab, SE or SE-hBCG adjuvanted Rab peaked 12 days after the first immunization. Mice immunized with SE-hBCG adjuvanted Rab vaccines produced higher levels of anti-Rab IgG antibodies 8, 10, 14, and 35 days (1700.0±200.0, 19 400.0±1661.3, 23 000±358.9, 23 600.0±6038.2, respectively)after the first immunization than mice immunized with Rab (310.0±97.9, 6730.0±1655.4, 6000.0±1655.6, 4400.0±1655.5,respectively, P<0.05) and greater numbers of IFN-γ-SFC 4, 8, 14 and 35 days (110.8±52.5, 213.0±29.7, 105.2±33.7,80.4±36.8, respectively) after the first immunization than mice immunized with PBS (6.4±3.5, 32.2±12.9, 11.4±5.1, 4.4±2.5,respectively, P<0.05). Conclusion SE-hBCG could enhance the immunogenicity of CgB and Rab, and it is likely to become an immunopotentiator.

Objective To investigate the effect and mechanism of lncRNA NEAT1 activating PI3K/Akt signaling pathway on the influence of Alzheimer's disease (AD) PC12 model cells apoptosis induced by Aβ_25-35. Methods PC12 cells were induced with Aβ_25-35 of concentrations 0, 5, 10 and 20 μmol/L to construct AD cell model. PC12 cells were treated with 5 μmol/L Aβ_25-35, and the relative expression level of lncRNA NEAT1 was detected by qRT-PCR at the time points 24, 48 and 72 hours,respectively. PC12 cells were divided into: (1) control group, lncRNA NEAT1 knockdown group, si-NC group, empty body group and lncRNA NEAT1 overexpression group. Among them the cells in control group were not treated anyway; in the other four groups were cultured with Opti-MEM medium containing si-lncRNA NEAT1, si-NC, pcDNA3.1-NC and pcDNA3.1-lncRNA NEAT1 and transfected for 8 hours, and then treated with 20 μmol/L Aβ_25-35; qRT-PCR was used to detect the relative expression level of lncRNA NEAT1; CCK-8 was used to detect the cell viability; flow cytometry was used to detect the apoptosis of PC12 cells, and the proliferation of PC12 cells was reflected by the ratio of G₁ to G₂ phase of cell cycle; the inflammatory factors interleukin-1β (IL-1β),IL-6, IL-18, and tumor necrosis factor-α (TNF-α) in cell supernatant were detected by ELISA. (2) control group, empty body group,and lncRNA NEAT1 overexpression group, Western blotting was used to detect the relative expression levels of p-PI3K and p-Akt.(3) control group, si-NC group, lncRNA NEAT1 knockdown group, empty body group, lncRNA NEAT1 overexpression group, and lncRNA NEAT1 overexpression+LY294002 group. Cells in lncRNA NEAT1 overexpression+LY294002 group were transfected with pcDNA3.1-lncRNA NEAT1, and 10 μmol/L P13K pathway inhibitor LY294002 were added, and then flow cytometry was used to detect the apoptosis of PC12 cells. Results Different concentrations of Aβ_25-35 could significantly inhibit the expression of lncRNA NEAT1 in a concentration-dependent manner (P=0.001). Compared with empty body group, the relative expression level of lncRNA NEAT1, the cell proliferation rate, and the proportion of cells in G₂ phase of lncRNA NEAT1 overexpression group increased, the cell apoptosis rate and the proportion of cells in G₁ phase decreased (P<0.05). Compared with si-NC group, the relative expression level of lncRNA NEAT1, the cell proliferation rate, and the proportion of cells in G₂ phase of lncRNA NEAT1 knockdown group decreased, the cell apoptosis rate and the proportion of cells in G₁ phase increased (P<0.05). ELISA results showed that, compared with empty body group, the levels of inflammatory factors IL-1β, IL-6, IL-18, and TNF-α decreased significantly in lncRNA NEAT1 overexpression group (P<0.05); compared with si-NC group, the levels of inflammatory factors IL-1β, IL-6, IL-18 and TNF-α increased significantly in lncRNA NEAT1 knockdown group (P<0.05). Western blotting results showed that, compared with empty body group, the expression levels of signal pathway related proteins p-PI3K and p-Akt increased in lncRNA NEAT1 overexpression group (p-PI3K: 0.86±0.05 vs. 0.15±0.02, P=0.003; p-Akt: 0.86±0.06 vs. 0.11±0.04, P=0.000). Compared with lncRNA NEAT1 overexpression group, the apoptosis rate in lncRNA NEAT1 overexpression+LY294002 group increased obviously (9.00%±0.10%vs. 5.13%±0.21%, P=0.004). Conclusion lncRNA NEAT1 can promote Aβ_25-35 induced PC12 cell proliferation and inhibit cell apoptosis by regulating PI3K/Akt pathway.

Objective To investigate the effect and mechanism of total parenteral nutrition (TPN) on the myocardial injury of young rats. Methods Twenty-four male young Sprague-Dawley rats aged 6 to 8 weeks were randomly divided into 4 groups (6 each): normal group, control group, TPN-7 d group and TPN-14 d group. Rats in normal group were not placed into tubes and had free food and water. Rats in control group were catheterized through the right jugular vein and continuously infused with normal saline, free food and water. Those in TPN group were catheterized through the right jugular vein and continuously infused with TPN nutrient solution and abstained from food and water. Rats in the 4 groups were killed and their myocardial tissue were obtained on the 14th, 14th, 7th and 14th day after the establishment of the model, respectively. HE staining was performed to observe the pathological changes of myocardial tissue, TUNEL staining was used to observe the apoptosis of myocardial tissue, the contents of malondialdehyde (MDA) and hydrogen peroxide (H₂O₂) in myocardial tissue were detected by ELISA, the expression of myeloperoxidase (MPO) in myocardial tissue was detected by qRT-PCR, Western blotting and immunofluorescence staining. Results The 50% of myocardial tissue of rats in TPN-7 d group were slightly damaged, and all the rats in TPN-14 d group were slightly to severely damaged. Compared with normal group and control group, the cardiomyocytes apoptosis rate in the TPN groups increased significantly (P<0.05), MDA and H₂O₂ contents increased markedly (P<0.05), the expressions of MPO mRNA, protein and immunofluorescence increased (P<0.05). The apoptotic rate, H₂O₂ content, MPO protein and immunofluorescence expression were higher in TPN-14 d group than those in TPN-7 d group (P<0.05). Conclusions TPN over 1 week can cause myocardial injury in young rats, and the degree of injury increases with the extension of TPN. Oxidative stress may be one of the mechanisms of the injury.

Objective To explore the relationship between the reproductive factors (such as the number of pregnancy,number of birth, abortion, lactation, menarche age, menopausal age and childbearing years) and female type 2 diabetes mellitus(T2DM). Methods Based on the data of cohort study REACTION in Lanzhou, an epidemiological investigation was performed among residents aged 40-75 years in Tianqingjiayuan, Zhangguang and Wuquanshan communities of Lanzhou City in May 2011.Reproductive history and menstrual history were determined by questionnaire. A total of 7094 women were with complete investigation data, including 2963 with normal baseline glucose tolerance who were followed up for 5 years for the occurrence of outcome event T2DM; Logistic regression and Cox risk regression analysis were employed to explore the relation between reproductive related factors and female T2DM. Results The risk of T2DM obviously increased in women with more gestational number and parturient times, especially when the gestational number and parturient times were more than 3, the risk of T2DM increased about 1.6 times, and the impact of parturient times was more significant on female T2DM (Pregnancy number 2, 3, ≥4, HR: 1.08, 1.26, 1.60; 95%CI 0.68-1.72, 1.07-1.99, 1.01-2.45; P=0.000. Parturient times 2, 3, ≥4, HR: 1.21, 1.60, 1.65; 95%CI 1.08-1.69, 1.09-2.78, 1.11-2.43; P=0.000). Abortions did not affect the incidence of female T2DM, and there was no correlation between the cumulative level of estrogen (menarche age, menopause age, childbearing years) and female T2DM. In addition, lactation was a better protective factor for women from T2DM, and may reduced the risk of female T2DM by about 30% (HR=0.70, 95%CI 0.46-0.96, P=0.001). Conclusions Pregnancy and parturient times were the risk factors of T2DM in women. With the increase of pregnancy and parturient times, the risk of T2DM increased significantly; Lactation is the protective factor of female T2DM.

Objective To evaluate the accuracy of applying functional near-infrared spectroscopy (fNIRS) for measurement of short-term heart rate variability (HRV). Methods Sixteen college students were recruited from Wuhan University and surrounding universities as the volunteer subjects from October 2020 to September 2021. The short-term HRV of subjects in resting state was simultaneously measured with electrocardiogram (ECG) and fNIRS. The consistency of the results measured with fNIRS on the forehead and at the finger was evaluated; and the accuracy of fNIRS measurements was assessed using the result of ECG measurement as the golden standard. Results No statistically significant differences existed between the fNIRS measurements on the forehead and at the finger in these short-term HRV parameters including sympathetic nervous system index(SNS index), parasympathetic nervous system index (PNS index), pressure index, Mean RR, standard deviation of normal-to-normal RR intervals (SDNN), triangular interpolation of normal-to-normal intervals (TINN), approximate entropy (ApEn) and sample entropy (SampEn). Excepting for the entropy parameters (ApEn: P<0.05 and SampEn: P<0.01) that are for measuring the complexity of time series, no statistically significant differences were observed in most short-term HRV parameters (PNS index, SNS index, pressure index, Mean RR, SDNN and TINN) between the fNIRS measurements and the ECG golden standard. Conclusion With satisfactory accuracy, it is feasible to use fNIRS in measuring short-term HRV.

Objective To investigate the predictive value of continuous non-invasive arterial pressure monitor (CNAP)combined with passive leg raising (PLR) test for volume responsiveness assessment in patients with septic shock. Methods Prospective and observational study was performed in the patients with septic shock admitted to the Fourth Department of Intensive Care Unit (ICU) of Fujian Provincial Hospital from July 2019 to July 2020. Subclavian venous catheter was indwelled in each patient, then the hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP),cardiac output (CO) and pulse pressure variability (PPV) were measured non-invasively by CNAP before and after PLR and volume expansion (VE) test. The changes of CO during PLR test (ΔCO_PLR) and VE test (ΔCO_VE) were calculated respectively. Patients were classified as responder group or non-responder group according to the ΔCO_VE increased ≥15% or not after VE test. Moreover,Pearson's test was used for the correlation analysis. The roles of ΔCO_PLR and PPV before VE test in predicting volume responsiveness were evaluated by receiver operating characteristic (ROC) curve. Results A total of 40 VE tests in these 36 patients were evaluated and resulting in 18 responder group and 22 non-responder group. There was no significant difference between two groups in the hemodynamics parameters before PLR and VE test (P>0.05). Both in responder group and non-responder group, there was no significant change in HR and MAP after PLR and VE test (P>0.05). After PLR, CVP did not change significantly in the two groups(P>0.05). CVP after VE test increased significantly in the two groups (P<0.05), but there was no significant difference between the two groups (P>0.05). CO was obviously increased after PLR and VE test in the two groups (P<0.05). In responder group, CO after PLR and VE test were significantly higher than those in non-responder group [(6.01±1.28) L/min vs. (5.16±1.22) L/min,(6.31±1.33) L/min vs. (5.15±1.39) L/min, P<0.05]. Besides, the ΔCO_PLR and ΔCO_VE in responder group were significantly higher than those in non-responder group (21.21%±8.54% vs. 10.76%±4.94%, 26.32%±8.64% vs. 9.44%±3.45%, P<0.05).Correlation analysis showed that the ΔCO_PLR was positively related to ΔCO_VE (r=0.820, P<0.05), while the PPV before VE test was unrelated to ΔCO_VE (r=0.194, P>0.05). Furthermore, the area under the ROC curve (AUC) of ΔCO_PLR and PPV predicting volume responsiveness were 0.855 (95%CI 0.707-0.946, P<0.05) and 0.525 (95%CI 0.362-0.685, P>0.05) respectively. The sensitivity and specificity of ΔCO_PLR ≥13.95% to predict volume responsiveness in patients with septic shock were 83.3% and 81.8%, respectively. Conclusion ΔCO_PLR measured by CNAP can predict the volume responsiveness in patients with septic shock and it is reliable to guide further fluid resuscitation.

Objective To analyze the chromosome karyotype and Y chromosome microdeletion of male infertility. Methods Retrospective analysis of the clinical test data of 550 infertile patients who were treated at the Reproductive Center of the Sixth Medical Center of Chinese PLA General Hospital from September 2018 to December 2020. Among them, there were 187 patients of azoospermia and 363 patients of oligozoospermia (90 patients of very severe oligospermia, 101 patients of severe oligospermia, 172 patients of mild to moderate oligozoospermia). Two hundred and forty-six normal males were included as controls.Everyone underwent peripheral blood chromosome karyotype and Y chromosome microdeletion examinations. Among them, 156 patients of azoospermia, 70 patients of very severe oligospermia, 75 patients of severe oligospermia and 75 patients of normal men were tested for sex hormones [luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), testosterone (T)].The sex hormone levels of different sperm concentrations and Y chromosome microdeletion population were compared. Results Among 550 infertile patients and 246 normal men, there were 62 patients of karyotype abnormalities or chromosomal normal polymorphisms, among which: 28 patients of chromosomal abnormalities; 34 patients of chromosomal normal polymorphisms. A total of 38 patients of Y chromosome microdeletion were detected in 550 infertile patients, 17 patients of azoospermia, 18 patients of very severe oligospermia, 2 patients of severe oligospermia and, 1 patient of mild to moderate oligospermia, AZFc region deletion is the most common type. In patients with azoospermia, very severe oligospermia and severe oligospermia, the level of FSH in those with Y chromosome microdeletion is higher than that of those without Y chromosome microdeletion (P=0.032). Conclusions Chromosomal abnormalities can occur in male infertile patients. The incidence of Y chromosome microdeletion is relatively high in male infertile patients. Genetic examination can help to determine whether they have genetic diseases, so as to choose appropriate treatment methods and assisted reproduction methods.

With the persistent increase of global temperature, the incidence of heatstroke is rising yearly. The impairment of the intestinal barrier function induced by heat stroke leads to endotoxemia. Systemic inflammatory response syndrome and multiple organ dysfunction syndrome ensue, which are the main causes of heat stroke death. And heat stroke is characterized by rapid deterioration and extremely high fatality. However, unlike other critical diseases, heat stroke is preventable and controllable.According to domestic and foreign researches, dietary supplements can enhance the intestinal barrier and alleviate the inflammatory response in heat stroke. This article reviews the research progress of dietary supplements in the protection of heat stroke and its mechanism in recent years, hoping to provide the reference for the prevention and treatment of heat stroke.

Due to the wide application of noninvasive angiography in the health examination or central nervous system disease treatment, more and more pilots with asymptomatic and unruptured intracranial aneurysms (UIAs) have been found. Most asymptomatic UIAs are still in "static phase" for a long time, but a few of them can grow gradually, even rupture and bleed suddenly,which may have the risk of disability in the sky. The risk factors of rupture for UIAs include patient's factors, aneurysm's factors,hemodynamics and flight related factors. Interventions include medical treatment, intracranial aneurysm clipping and endovascular treatment. The selection of the treatments need to weigh the risk of aneurysm rupture and surgical complications of UIAs. At present, there are no opinions and aeromedical evaluation criteria for asymptomatic UIAs in pilots nationally and internationally.Therefore, it is necessary to conduct multidisciplinary and individual assessment.