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2024 Vol. 54, No. 4 Published: 2024-04-25   259 The effect of α-synuclein abnormal aggregation in red nucleus of mice on motor function and pain SONGYue,SU Ying, HE Yan, CHEN Jiangfan, GUO Wei. DOI: 10.3969/j.issn.2095-9400.2024.04.001 Objective: To clarify whether abnormal accumulation of α-synuclein (α-Syn) in the red nucleus (RN) can disturb motor and sensory. Methods: C57BL/6J mice were randomly divided into two groups: the control group (injected with a control virus in RN) and the experimental group (injected with a virus expressing α-Syn in RN). The open field test, the Rotarod test, the pole test and the wire hang test were used to evaluate the mice’s motor ability and muscle strength. And the mechanical and thermal stimulations were used to evaluate the threshold of pain. Results: Compared with the control group, the experimental group showed abnormal aggregation of α-Syn in the RN, which significantly damaged neurons. For the experimental mice, their movement distance (P<0.001) and movement time (P<0.001) of in the open field significantly increased, while the immobility time significantly reduced (P<0.001); their latency of the drop significantly reduced in the Rotarod test (P<0.05); the time to arrive at the bottom of the turn increased in the pole test (P<0.05); the normalized limb muscle strength and weight in the grip strength test increased (P<0.05); and the thermal withdrawal latency significantly decreased (P<0.05). Conclusion: Abnormal aggregation of α-Syn in RN of mice promotes their spontaneous movement, reduces their balance and coordination abilities, enhances their limb muscle strength, and increases their sensitivity to thermal stimuli. 2024 Vol. 54 (4): 259-265 [Abstract] ( 233 ) HTML (1 KB)  PDF (1930 KB)  ( 598 ) 266 Stromal vascular fraction promotes angiogenesis and fat graft survival in mice through the ANG-1/Tie-2 signaling pathway NI Binting, HE Yucang, LI Lei, XU Jinyu, LIU Zhaoyang, LI Liqun DOI: 10.3969/j.issn.2095-9400.2024.04.002 Objective: To investigate the mechanism of new blood vessel formation induced by stromal vascular fragment (SVF) after fat transplantation. Methods: We designed a fat transplantation model of nude mice, and set fat tissue transplantation animal model groups of control group, SVFs group and tyrosine kinase inhibitor (TKI) group. we used these methods of gross weighing, HE staining, Masson staining, Western blot and immunofluorescence staining to detect body mass, pathological manifestations, collagen deposition and protein expression of ANG-1, p-Tie-2, CD31, BAX and BCL-2 in each experimental group and made the statistical analysis to study the effect of SVFs on fat survival. Results: The quality of transplanted objects in SVFs group was significantly higher than that in control group (P<0.001). After TKI administration, the effect of SVFs on the fat mass of grafts was reversed, and the weight of grafts in TKI group was significantly lower than that in SVFs group (P<0.001). The collagen deposition around adipocytes in the SVFs group was significantly reduced, and the adipocytes in the TKI group became fragmented and incomplete. Compared with the control group, the expression levels of ANG-1 and p-Tie-2 in SVFs group were up-regulated, and the expression levels of CD31 protein were significantly increased (P<0.05). After TKI administration, the expression levels of p-Tie-2 and CD31 protein in TKI group were decreased compared with SVFs group (P<0.05). Compared with the control group, the expression of BAX in SVFs group was decreased and the expression of BCL-2 was increased (P<0.05). The expression of BAX in TKI group was increased and the expression of BCL-2 was decreased that compared with the SVFs group (P<0.05). Conclusion: SVFs can promote angiogenesis and inhibit apoptosis through ANG-1/Tie-2 signaling pathway, thereby improving the survival of transplanted fat. 2024 Vol. 54 (4): 266-273 [Abstract] ( 249 ) HTML (1 KB)  PDF (2582 KB)  ( 643 ) 274 The role of miR-29a/b/c in uveal melanoma cells and its underlying mechanism PAN Hongting, WANG Chao ZHU Xian, HOU Qiang DOI: 10.3969/j.issn.2095-9400.2024.04.003 Objective: To investigate the role of miR-29a/b/c in uveal melanoma (UM) cells and the related mechanism. Methods: Hsa-miR-29a/b/c or matrix metalloproteinase 2 (MMP2)-specific siRNA were transfected into UM cells by lipofectamine reagent. The proliferative and invasive potential of UM cells were evaluated by MTS and Matrigel Transwell assay respectively. MMP2 mRNA level was detected by Semi-quantitative PCR assay, and ELISA assay was used to measure the MMP2 secretion in the cell culture of supernatant of UM cells. Results: Transfection of miR-29a/b/c inhibited the proliferation (P<0.05) and invasive ability (P<0.05) of UM cells. MiR-29a/b/c could inhibit the expression of MMP2 at the protein level (P<0.05) instead of the mRNA level. Interfering MMP2 in UM cells inhibited the invasive ability (P<0.05) of UM cells. Conclusion: MiR-29a/b/ c inhibits the proliferative and invasive ability of UM cells. MiR-29a/b/c reduces the secretion of its downstream target protein MMP2, and the knockdown MMP2 in UM cells inhibits cell invasion. 2024 Vol. 54 (4): 274-278，286 [Abstract] ( 171 ) HTML (1 KB)  PDF (2442 KB)  ( 607 ) 279 Pathogen spectrum of acute respiratory tract infections in hospitalized children of Wenzhou city from 2021 to 2022: A single-center analysis HUANG Yifan, QI Xinyi, LIU Xiujing, XIE Zhendi, YU Jian, CHEN Zhanguo DOI: 10.3969/j.issn.2095-9400.2024.04.004 Objective: To analyze the changes of common respiratory pathogens in hospitalized children with respiratory tract infections (ARIs) in Wenzhou between 2021 and 2022, and provide reference for accurate diagnosis, treatment, prevention and control of ARIs. Methods: The results of 13 respiratory pathogens in hospitalized children with ARIs admitted to the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from January 2021 to December 2022 were retrospectively analyzed. The pathogen spectrum characteristics of ARIs patients in 2021 and 2022 as well as the differences in genders, ages, seasons, and pathogen infection patterns were compared and analyzed. Results: The total positive rate of pathogens in 2021 and 2022 was 70.74% (3 477/4 915) and 70.74% (6 099/8 622), respectively. The top five main pathogens have evolved from human rhinovirus (HRV), human respiratory syncytial virus (HRSV), human parainfluenza virus (HPIV), human adenovirus (HADV) and human metapneumovirus (HMPV) in 2021 to HRV, mycoplasma pneumoniae (Mp), HRSV, HADV, and HMPV. Compared with 2021, the positive rates of MP, HADV, and HMPV in 2022 were significantly higher than in 2021, while HRV, HRSV, and HPIV were significantly lower than in 2021(all P<0.01). In 2022, the overall positive rate of respiratory pathogens in boys was slightly higher than that in girls, with the highest detection in the 2-<4-year-old group and in summer (all P<0.01). Compared with 2021, there was an outbreak trend of Mp infection in 2022, which was most obvious in summer, especially in the 7-14-year age group. The onset age of different major pathogens tends to be younger or older, and the high incidence season is, to some extent, advanced or prolonged in time or exchanged in season. In 2022, single infection increased significantly, while multiple infection decreased significantly, and multiple infection was mainly from HRV+Mp. Conclusion: The pathogen spectrum of hospitalized children with ARIs in Wenzhou in 2022 showed great differences from that in 2021. Low- aged children are still the focus population of prevention and control. The increasing infection rates of Mp, HADV and HMPV and the outbreak of H3N2 influenza A virus should be of great concern. It is recommended that the etiological surveillance of ARIs should be continuously strengthened. 2024 Vol. 54 (4): 279-286 [Abstract] ( 242 ) HTML (1 KB)  PDF (1711 KB)  ( 676 ) 287 miR-152-3p via AKT/GSK-3β/Nrf2 signaling pathway promoting neuronal ferroptosis in rats with cerebral hemorrhage WANG Yunhui, ZHANG Xiaofeng. DOI: 10.3969/j.issn.2095-9400.2024.04.005 Objective: To explore how miR-152-3p influences neuronal ferroptosis in rats with intracerebral hemorrhage (ICH) through the Akt /GSK-3β/Nrf2 signaling pathway. Methods: Rat neuronal cells were used to create an in vitro ICH model, induced by oxygenated hemoglobin (oxyHb) stimulation. These cells were treated with either a miR-152-3p inhibitor, a PIK3CA inhibitor, or both. Cell apoptosis was assessed using flow cytometry. The expression level of relevant genes and proteins was measured through RT-qPCR and Western blot. Nrf2 protein nuclear translocation was examined via cellular immunofluorescence. Additionally, a dual-luciferase reporter assay was conducted to investigate the interaction between miR-152-3p and PIK3CA. Results: In the ICH cell model, transfection with the miR-152-3p inhibitor significantly reduced apoptosis rate (P<0.01). This treatment also notably increased the expression levels of SLC7A11, GPx4, PIK3CA, and Nrf2 proteins, as well as the p-AKT/AKT ratio, while decreasing GSK-3β protein levels (P<0.01). Furthermore, Nrf2 protein nuclear translocation was significantly enhanced (P<0.01). However, these effects were mitigated upon PIK3CA inhibitor treatment. The luciferase reporter assay confirmed that miR-152-3p could target and regulate PIK3CA. Conclusion: miR-152-3p, through the Akt/GSK-3β/Nrf2 signaling pathway, promotes neuronal ferroptosis in rats experiencing intracerebral hemorrhage. 2024 Vol. 54 (4): 287-295，301 [Abstract] ( 226 ) HTML (1 KB)  PDF (6865 KB)  ( 517 ) 296 Risk factors of malignant cerebral edema after mechanical thrombectomy in acute ischemic stroke ZHANG Xiaoqin, LUO Zhixian, GUO Wenjun, ZHOU Xiaojun, XIA Nengzhi, HONG Weifeng. DOI: 10.3969/j.issn.2095-9400.2024.04.006 Objective: To investigate the risk factors of malignant cerebral edema (MCE) after mechanical thrombectomy in patients with acute ischemic stroke (AIS) and risk factors for MCE. Methods: AIS patients who underwent mechanical thrombectomy and achieved complete vascular recanalization in the First Affiliated Hospital of Wenzhou Medical University from August 2018 to June 2022 were retrospectively collected. All patients were divided into MCE group (n=89) and non-MCE group (n=311) according to whether MCE occurred after operation. Multivariate logistic regression analysis was used to determine the independent risk factors for MCE after mechanical thrombectomy in AIS patients. Results: A total of 400 AIS patients with complete recanalization after mechanical thrombectomy were included in this study. Among them, 277 patients were males and 123 were females, aged (68.09±12.17) years. After mechanical thrombectomy, AIS patients in the MCE group had higher diastolic blood pressure than non-MCE group, with significant difference (P<0.05). At the same time, the ASPECT score of MCE group was lower than that of non-MCE group, and it is more likely to occur in the position of anterior circulation. Multivariate Logistic regression analysis showed that diastolic blood pressure (OR=1.022, 95%CI=1.005-1.039, P=0.010), ASPECT score (OR=0.742, 95%CI=0.655-0.840, P<0.001), NIHSS score (OR=1.043, 95%CI=1.004-1.083, P=0.031) and anterior circulation thrombus (OR=8.942, 95%CI=2.595- 30.816, P=0.001) were independent influencing factors for MCE. Conclusion: Preoperative low ASPECT score,high NIHSS score and anterior circulation thrombus were independent risk factors for MCE in patients with AIS after mechanical thrombectomy. The risk of MCE increases with the postoperative diastolic blood pressure. Postoperative blood pressure management, especially reducing diastolic blood pressure, may reduce the risk of MCE. 2024 Vol. 54 (4): 296-301 [Abstract] ( 193 ) HTML (1 KB)  PDF (1475 KB)  ( 614 ) 302 The effect of high-frequency repetitive transcranial magnetic stimulation on negative symptoms, serum BDNF and VEGF levels in patients with chronic schizophrenia CHEN Yining, LIU Jiahong, YE Han,LIAN Yichen, SHI Sumi, YANG Zhiying CHEN Chuchu, SUN Xiaoxiao, PAN Anle. DOI: 10.3969/j.issn.2095-9400.2024.04.007 Objective: To investigate the impact of high-frequency repetitive transcranial magnetic stimulation (rTMS) on negative symptoms, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor(VEGF) in patients with chronic schizophrenia, and to further analyze the relationship between negative symptom improvement and changes in BDNF and VEGF levels during the treatment of rTMS. Methods: Sixty patients with chronic schizophrenia hospitalized in the Affiliated Kangning Hospital of Wenzhou Medical University from January 2018 to October 2022 were recruited and randomly assigned, according to their serial number, into a real stimulation group and a sham stimulation group with 30 cases in each. The positive and negative syndrome scale (PANSS) was used to assess the mental symptoms of the patients before treatment and 24 weeks after treatment, and meanwhile serum BDNF and VEGF were detected. Results: After 24 weeks of treatment, the real stimulation group exhibited lower scores of positive and negative symptom and higher serum levels of BDNF and VEGF (P<0.05), compared with sham stimulation group. The real stimulation group demonstrated significantly higher score difference of positive and negative symptom, as well as serum BDNF and VEGF levels, compared with the sham stimulation group (P<0.05). Pearson correlation analysis revealed that there was significant positive correlation between the changes in serum BDNF levels and negative symptom scores in the real stimulation group(r=0.478, P<0.01) after treatment. In addition, linear regression analysis demonstrated the difference of serum BDNF levels had a statistically significant effect on the difference of symptom scores (β=0.457, t=2.536, P<0.05) in real stimulation group after treatment. Conclusion: The improvement of negative symptoms in patients with chronic schizophrenia following high-frequency rTMS may be associated with changes in serum BDNF levels 2024 Vol. 54 (4): 302-306 [Abstract] ( 182 ) HTML (1 KB)  PDF (1354 KB)  ( 572 ) 307 Efficacy of selective vidian neurectomy combined with functional endoscopic sinus surgery in the treatment of eosinosinusitis with nasal polyps ZHENG Lei, WANG Jie, WANG Xiaoqiong, LI Ruoqi, WANG Yijia, YE Yufeng, LIU Xuejun, NI Liyan, ZHENG Bo. DOI: 10.3969/j.issn.2095-9400.2024.04.008 Objective: To assess the efficacy of selective vidian neurectomy combined with functional endoscopic sinus surgery in the management of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). Methods: Sixty-two patients diagnosed with ECRSwNP who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University from May 2019 to May 2021 underwent concurrent surgical treatment. Based on patient preferences, participants were divided into two groups: the experimental group (undergoing selective vidian neurectomy combined with nasal endoscopy) and the control group (undergoing simple nasal endoscopy), consisting of 32 and 30 cases, respectively. Evaluation measures, including the sinonasal outcome test-22 (SNOT-22), the patient subjective visual analog scale (VAS), the nasal endoscopy Lund-Kennedy scoe, and the sinus CT Lund-Mackay score, were utilized to assess disease severity before surgery and one year after, and to compare the recurrence rate between two groups. Results: Compared with preoperation, postoperative SNOT-22 scores, VAS scores, and nasal endoscopy Lund-Kennedy scores decreased in both groups (P<5). However, the experimental group showed more significant reduction than the control group, with statistical significance (P<0.05). The recurrence rate in the experimental group was lower than in the control group one year after surgery, with a statistically significant difference (P<0.05). Compared with preoperation, the sinus CT Lund-Mackay scores in both groups decreased one year after surgery (P<0.05), but the difference between the two groups was not significant (P>0.05). Conclusion: Selective vidian neurectomy combined with functionalendoscopic sinus surgery proves to be an effective approach for managing ECRSwNP. The combined method results in improved postoperative symptoms, enhanced quality of life, and reduced recurrence rate. 2024 Vol. 54 (4): 307-311，317 [Abstract] ( 180 ) HTML (1 KB)  PDF (1532 KB)  ( 626 ) 312 Clinical efficacy of lower limb exercise training based on immersive VR technology on lower limb function in stroke patients ZHU Meili, XU Huajing, WEN Lina, WANG Jiaojian, JIANG Songhe DOI: 10.3969/j.issn.2095-9400.2024.04.009 Objective: To explore the clinical efficacy of immersive virtual reality (VR) combined with lower limb exercise training on the lower limb function of stroke patients and their quality of life. Methods:Patients with initial stroke who received inpatient rehabilitation treatment at the Rehabilitation Department of the First People’s Hospital of Yongkang from December 2022 to November 2023 were selected as the study subjects. A total of 60 patients who met the inclusion criteria were randomly assigned to the control group (n=30) and VR group (n=30). Both groups received routine drugs and routine rehabilitation treatment. On this basis, the control group was supplemented with the lower limb exercise training and the VR group was combined with VR technology during the exercise training, with a duration of 20 minutes per day, 5 times a week for 3 weeks. The lower limb motor function, walking ability and daily living ability of the patients were evaluated by the Fugl-Meyer assessment of the lower extremities (FMA-LE), functional ambulation category (FAC), the Berg balance scale (BBS) and the Barthel index (BI). Results: Prior to the treatment, there was no notable discrepancy in the baseline value or scale scores between the two groups. Over 3 weeks of training, both groups improved significantly in the scores of FMA-LE, FAC, BBS and BI, compared with those before treatment, showing statistical difference (P<0.05). Ater the treatment, the FMA-LE, FAC, BBS, and BI scores in the VR group significantly improved, compared with those in the control group, showing statistical difference (P<0.05).Conclusion: The combination of immersive VR technology with exercise training can significantly improve thelower limb function and quality of life in stroke hemiplegic patients. 2024 Vol. 54 (4): 312-317 [Abstract] ( 294 ) HTML (1 KB)  PDF (1477 KB)  ( 494 ) 318 Clinical effect of negative pressure closed drainage combined with gluteus maximus myocutaneous flap preserving superficial branch of superior gluteal artery in the repair of stage IV sacrococcygeal pressure sore XIA Weidong, TU Zhuolong, ZHAO Sheng, MIU Aimei, LIU Zhengjun, LIN Cai. DOI: 10.3969/j.issn.2095-9400.2024.04.010 Objective: To investigate the clinical effect of negative pressure closed drainage combined with gluteus maximus rotary musculoflap preserving the superficial branch of superior gluteal artery in the repair of sacrococcygeal pressure sore. Methods: A total of 12 patients with sacrococcygeal pressure sore from the First Affiliated Hospital of Wenzhou Medical University from June 2019 to October 2023 were selected, including 7 males and 5 females, aged 31-86 years old. After admission, the wound was repaired with a gluteus maximus myocutaneous flap preserving the superficial branch of the superior gluteus artery 4-7 days later. The survival an complications of the skin flap were observed. The shape of the skin flap and the recurrence of pressure sore were observed. Results: All the 12 patients in this group developed stage Ⅳ pressure sores due to long-term bedridden sacrococcygeal compression. The causes of pressure sores included paraplegia in 5 patients and long-term bedridden for various reasons in 7 patients including 2 patients with cerebral infarction sequela, 3 patients with Parkinson’s disease, 1 patient with Alzheimer’s disease, and 1 patient with femoral neck fracture. The course of disease ranged from 2 weeks to 8 years, and the wound area after debridement ranged from 5.0 cm×5.0 cm to 10.0 cm×12.0 cm. All the 12 cases were completely alive after operation, and there was no flap necrosis, venous congestion or wound border cracking. After 2-6 months of follow-up, the flap shape was good, the sacrococcygeal soft tissue full, and the pressure sore did not recur. Conclusion: The gluteus maximus rotator myocutaneous flap with preservation of the superficial branch of the superior gluteal artery has reliable blood supply, simplein design and operation. The flap has a large repair area, and it does not need to cut off the superficial branch of the superior gluteal artery, and the donor site can generally be sutured directly, thus having an excellent effect in repairing sacrococcygeal pressure ulcer. 2024 Vol. 54 (4): 318-322 [Abstract] ( 188 ) HTML (1 KB)  PDF (1737 KB)  ( 495 ) 323 Clinical analysis of patients with multiple myeloma involving the pancreas Ying Shuangwei, Yu Yijian, Zhang Jie, Shen Jian, Yang Yan, Zhu Xiayin, Shao Yanping, Guo Qunyi. DOI: 10.3969/j.issn.2095-9400.2024.04.011 Objective: To investigate the epidemiology, pathogenesis, clinical manifestations, treatment and prognosis of multiple myeloma (MM) involving the pancreas. Methods: We retrospectively analyzed the clinical manifestations, treatment and prognosis of 4 patients with MM involving the pancreas admitted to Taizhou Hospital, Zhejiang Province, from October 2011 to October 2021, and reviewed the relevant literature. Results: Four patients, 3 male and 2 female aged 53 to 64, of whom 3 were IgG/λ type and 1 was IgG/κ type; 2 were IA and 2 IIIA (DS staging system); 2 were II and 2 were III (ISS staging system). The interval between the diagnosis of MM involving the pancreas and MM was 16.3~92.2 months. None of the four cases had extramedullary disease (EMD) at the time of initial diagnosis of MM, but had EMD at other sites before or at the time of pancreatic involvement. Three cases had fatigue, icteric sclera, and lumbago at the time of pancreatic involvement, and one case had no discomfort; three cases had elevated amylase, and 2 had elevated bilirubin; CA199 was elevated in 2 cases. The head of the pancreas was involved in all four cases; the tail was involved in 2 cases and the pancreatic body in one case; the pancreatic lesions were easy to be missed on ultrasound through the abdomen, and the lesions appeared to be slightly hypointense on CT plain scan, mildly intensified after enhancement, and had an elevated SUV value on PET/CT. In 2 cases, the expression of CD56 was significantly downregulated in both the bone marrow and the EMD (thoracic and abdominal fluid, pancres). Chemotherapy with proteasome inhibitors combined with lenalidomide or anthracycline/platinum agents was given after diagnosis, which achieved shortterm efficacy. Overall survival was only 1.7-7.8 months after diagnosis of pancreatic involvement, and 3 of them died of severe infections. Conclusion: Pancreatic involvement secondary to MM is rare, which occurs at different stages of MM and is often accompanied with or later than other EMD. Its presence often suggests the end-stage ofMM. The decreased expression of CD56 may be related to its development. Without effective treatment currently, the efficacy might be improved by the combination of novel drugs. 2024 Vol. 54 (4): 323-327 [Abstract] ( 191 ) HTML (1 KB)  PDF (1462 KB)  ( 493 ) 335 The construction of large-scale instrument experimental technical teams in medical universities: practice and exploration WANG Haiyan, GAO Hongchang DOI: 10.3969/j.issn.2095-9400.2024.04.014 The technical team of large-scale instrument experiment is the key factor in the high-quality development of large-scale instrument platform in universities, and they are also the key force for the platform to effectively play a supporting role in talent cultivation, social services and scientific research. This article, taking Wenzhou Medical University as an example, analyzes the main problems in the construction of large-scale instrument experimental technical team in universities. Combined with practical situations, it systemically summarizes how experimental technical teams on large-scale instrument platform in the university have been constructed as an exploration, which aims to promote the efficiency improvement of large-scale instrument platforms and to provide reference for other medical universities 2024 Vol. 54 (4): 335-339 [Abstract] ( 155 ) HTML (1 KB)  PDF (1425 KB)  ( 533 ) 340 The relationship between sense of calling and professional commitment among medical college students:The mediating role of career self-efficiency and the moderating role of learning motivation XU Qian, TIAN Wenwen, DING Ningning, ZHU Beilei DOI: 10.3969/j.issn.2095-9400.2024.04.015 Objective: A moderated mediation model was constructed to investigate the mediating role of career self-efficiency in the relationship between calling and professional commitment and the moderating role of learning motivation. Methods: A questionnaire was used to investigate the calling, professional commitment, career self-efficiency and learning motivation of 2 780 college students. Results: The calling had a significant positive predictive effect on professional commitment; Career self-efficiency played a mediating role in the relationship between calling and professional commitment; Learning motivation moderated the mediating effect of career self-efficiency between calling and professional commitment. Conclusion: Professional mission is an important factor affecting professional commitment, and it is an effective way to enhance professional commitment of medical college students by enhancing professional efficacy and learning motivation. 2024 Vol. 54 (4): 340-344,封三 [Abstract] ( 211 ) HTML (1 KB)  PDF (1453 KB)  ( 656 )

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