Objective To investigate the effects and mechanisms of hydroxychloroquine sulfate (HCQ) on pulmonary fibrosis through the PI3K/AKt/mTOR signalling pathway. Methods Paraquat intraperitoneal injection was used to establish a mouse model of pulmonary fibrosis. Thirty-six SPF C57BL/6J female mice were randomly divided into a blank group, a paraquat group (20 mg/kg) and a HCQ intervention group. The HCQ intervention group was divided into two subgroups (10 mg/kg and 30 mg/kg) according to different doses. The general condition and body weight changes of mice were observed. twenty-one days later, lung tissues were stained with hematoxylin-eosin and Masson’s pathological staining, and the content of inflammatory factors (IL-1β, IL-6, TNF-α) and hydroxyproline (HYP) were detected by ELISA. Alpha-smooth muscle actin (α-SMA), E-cadherin (E-cad), the expression levels of PI3K/Akt/mTOR pathway-related proteins, phosphatidylinositol 3 kinase (PI3K) and protein kinase B (AKt), and mammalian target of rapamycin (mTOR) were detected by Western blot. The gene expression levels of α-SMA and E-cad were detected by q-PCR. Results Compared with the blank group, the mice in the paraquat group had lower body weight, worse general condition, higher serum levels of inflammatory factors, increased lung structure destruction and collagen deposition, significantly increased HYP content, and higher expression level of PI3K/AKt/mTOR signaling pathway related proteins (all P<0.05). The expression levels of E-cad protein and gene decreased, α-SMA protein and gene increased (all P<0.05). While the HCQ intervention group improved the degree of pulmonary fibrosis in different degrees, and the relevant indexes of PI3K/AKt/mTOR signaling pathway decreased compared with the paraquat group (all P<0.05). Conclusion HCQ can ameliorate paraquat-induced pulmonary fibrosis by inhibiting the PI3K/AKt/mTOR signaling pathway.
ObjectiveTo investigate safety and feasibility of laparoscopic common bile duct exploration (LCBDE) without preoperative prophylactic gastrointestinal decompression.MethodsA prospective study was conducted on the patients with choledocholithiasis and cholecystolithiasis scheduled to undergo LCBDE plus laparoscopic cholecystectomy in this hospital from January 2016 to December 2017. All the patients were randomly divided into a gastrointestinal decompression group and a non-gastrointestinal decompression group by the same researcher according to the random number table method. The general conditions, intraoperative status and postoperative status of patients in the two groups were compared.ResultsA total of 286 patients were enrolled in this study, including 120 in the non-gastrointestinal decompression group and 166 in the gastrointestinal decompression group. There were no significant differences in the general data such as the age, gender, smoking history, drinking history, preoperative complications, results of preoperative laboratory examination, and preoperative anesthesia score between the two groups (P>0.050). The time of oral feeding in the non-gastrointestinal decompression group was significantly earlier than that in the gastrointestinal decompression group (t=2.181, P=0.030). There were no significant differences in the bleeding volume, operative time, anal ventilation time, total hospitalization time, and postoperative hospitalization time between the two groups (P>0.050). The incidences of nausea/vomiting and poor appetite in the non-gastrointestinal decompression were significantly lower than those in the gastrointestinal decompression group (χ2=5.098, P=0.024; χ2=4.905, P=0.027). There were no significant differences in the incidences of other complications between the two groups (P>0.050).ConclusionFrom results of this study, prophylactic gastrointestinal decompression should not be recommended for patients undergoing LCBDE.
ObjectiveTo analyze the diagnosis status and epidemiological characteristics of anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) in the Sichuan province of China. MethodsIn the retrospective survey study, data of cases suspected as autoimmune encephalitis in Sichuan province from January 2012 to February 2017 were collected from the third-party test center.The diagnosis status and epidemiological characteristics of anti-NMDAR encephalitis were analyzed. Results① A total of 1 714 cases had been suspected as autoimmune encephalitis with anti NMDA receptor antibodies tested.In hospitals of capital city, cerebrospinal fluid or serum of 1 511 cases were tested since 2012.In other cities, 203 cases were tested since 2014.Hospitals with anti NMDA receptor antibodies tested increased by year.The cases distributed in the department of neurology, psychology, pychiatric, ICU, pediatrics, geriatrics, otolaryngology, infection, the mergency department and pneumology.② Cases with anti NMDA receptor antibodies tested increased by year.A total of 155 cases were confirmed as anti-NMDAR encephalitis, with the average onset age of (27.9±12.0) years ranged from 9 years to 77 years, including 89 women and 66 male.The female average age were (26.5±11.31) years, while the male were(29.0±13.0) years.③ Among the 155 confirmed cases, 127 cases with detailed clinical data were analyzed further.Seizure and behavior disorder were the main symptoms at onset.Among the 127 cases, 107 cases were misdiagnosed at their first hospital visit, with the misdiagnose rate of 84.3%.18 cases were reported with tumors (17 female), mainly with teratoma(11/17). ConclusionIn Sichuan province, the doctors of hospitals in non-capital city should strengthen the identification of autoimmune encephalitis.Anti-NMDAR encephalitis could be misdiagnosed easily and non-neurological physicians should also take attention;