Pneumothorax prediction using a foraging and hunting based ant colony optimizer assisted support vector machine

Although PNLB is generally considered safe, it is still invasive and risky. Pneumothorax, the most common complication of lung puncture, can cause shortness of breath, chest pain, and even life-threatening. Therefore, the auxiliary diagnosis for pneumothorax is of great clinical interest. This paper proposes an ant colony optimizer with slime mould foraging behavior and collaborative hunting, called SCACO, in which slime mould foraging behavior is combined to improve the convergence accuracy and solution quality of ACOR. Then the ability of ACO to jump out of the local optimum is optimized by an adaptive collaborative hunting strategy when trapped in the local optimum. As a first step toward Pneumothorax diagnostic prediction, we suggested an SVM classifier based on bSCACO (bSCACO-SVM), which uses the proposed SCACO's binary version as the basis for its feature selection algorithms. To demonstrate the SCACO performance, we first used the slime mould foraging behavior and adaptive cooperative hunting strategy, then compared SCACO with nine basic algorithms and nine variants, respectively. Finally, we verified bSCACO-SVM on various widely used public datasets and applied it to the Pneumothorax prediction issue, showing that it has robust classification prediction capacity and can be successfully employed for tuberculous pleural effusion diagnostic prediction.

A grade-based search adaptive random slime mould optimizer for lupus nephritis image segmentation

The segmentation of medical images is a crucial and demanding step in medical image processing that offers a solid foundation for subsequent extraction and analysis of medical image data. Although multi-threshold image segmentation is the most used and specialized basic image segmentation technique, it is computationally demanding and often produces subpar segmentation results, hence restricting its application. To solve this issue, this work develops a multi-strategy-driven slime mould algorithm (RWGSMA) for multi-threshold image segmentation. Specifically, the random spare strategy, the double adaptive weigh strategy, and the grade-based search strategy are used to improve the performance of SMA, resulting in an enhanced SMA version. The random spare strategy is mainly used to accelerate the convergence rate of the algorithm. To prevent SMA from falling towards the local optimum, the double adaptive weights are also applied. The grade-based search approach has also been developed to boost convergence performance. This study evaluates the efficacy of RWGSMA from many viewpoints using 30 test suites from IEEE CEC2017 to effectively demonstrate the importance of these techniques in RWGSMA. In addition, numerous typical images were used to show RWGSMA's segmentation performance. Using the multi-threshold segmentation approach with 2D Kapur's entropy as the RWGSMA fitness function, the suggested algorithm was then used to segment instances of lupus nephritis. The experimental findings demonstrate that the suggested RWGSMA beats numerous similar rivals, suggesting that it has a great deal of promise for segmenting histopathological images.

Gaussian bare-bone slime mould algorithm: performance optimization and case studies on truss structures

The slime mould algorithm (SMA) is a new meta-heuristic algorithm recently proposed. The algorithm is inspired by the foraging behavior of polycephalus slime moulds. It simulates the behavior and morphological changes of slime moulds during foraging through adaptive weights. Although the original SMA's performance is better than most swarm intelligence algorithms, it still has shortcomings, such as quickly falling into local optimal values and insufficient exploitation. This paper proposes a Gaussian barebone mutation enhanced SMA (GBSMA) to alleviate the original SMA's shortcomings. First of all, the Gaussian function in the Gaussian barebone accelerates the convergence while also expanding the search space, which improves the algorithm exploration and exploitation capabilities. Secondly, the differential evolution (DE) update strategy in the Gaussian barebone, using rand as the guiding vector. It also enhances the algorithm's global search performance to a certain extent. Also, the greedy selection is introduced on this basis, which prevents individuals from performing invalid position updates. In the IEEE CEC2017 test function, the proposed GBSMA is compared with a variety of meta-heuristic algorithms to verify the performance of GBSMA. Besides, GBSMA is applied to solve truss structure optimization problems. Experimental results show that the convergence speed and solution accuracy of the proposed GBSMA are significantly better than the original SMA and other similar products.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10462-022-10370-7.

An efficient multi-threshold image segmentation for skin cancer using boosting whale optimizer

Due to the terrible manifestations of skin cancer, it seriously disturbs the quality of life status and health of patients, so we needs treatment plans to detect it early and avoid it causing more harm to patients. Medical disease image threshold segmentation technique can well extract the region of interest and effectively assist in disease recognition. Moreover, in multi-threshold image segmentation, the selection of the threshold set determines the image segmentation quality. Among the common threshold selection methods, the selection based on metaheuristic algorithm has the advantages of simplicity, easy implementation and avoidable local optimization. However, different algorithms have different performances for different medical disease images. For example, the Whale Optimization Algorithm (WOA) does not give a satisfactory performance for thresholding skin cancer images. We propose an improved WOA (LCWOA) in which the Levy operator and chaotic random mutation strategy are introduced to enhance the ability of the algorithm to jump out of the local optimum and to explore the search space. Comparing with different existing WOA variants on the CEC2014 function set, our proposed and improved algorithm improves the efficiency of the search. Experimental results show that our method outperforms the extant WOA variants in terms of optimization performances, improving the convergence accuracy and velocity. The method is also applied to solve the threshold selection in the skin cancer image segmentation problem, and LCWOA also gives excellent performance in obtaining optimal segmentation results.

Chaotic simulated annealing multi-verse optimization enhanced kernel extreme learning machine for medical diagnosis

Classification models such as Multi-Verse Optimization (MVO) play a vital role in disease diagnosis. To improve the efficiency and accuracy of MVO, in this paper, the defects of MVO are mitigated and the improved MVO is combined with kernel extreme learning machine (KELM) for effective disease diagnosis. Although MVO obtains some relatively good results on some problems of interest, it suffers from slow convergence speed and local optima entrapment for some many-sided basins, especially multi-modal problems with high dimensions. To solve these shortcomings, in this study, a new chaotic simulated annealing overhaul of MVO (CSAMVO) is proposed. Based on MVO, two approaches are adopted to offer a relatively stable and efficient convergence speed. Specifically, a chaotic intensification mechanism (CIP) is applied to the optimal universe evaluation stage to increase the depth of the universe search. After obtaining relatively satisfactory results, the simulated annealing algorithm (SA) is employed to reinforce the capability of MVO to avoid local optima. To evaluate its performance, the proposed CSAMVO approach was compared with a wide range of classical algorithms on thirty-nine benchmark functions. The results show that the improved MVO outperforms the other algorithms in terms of solution quality and convergence speed. Furthermore, based on CSAMVO, a hybrid KELM model termed CSAMVO-KELM is established for disease diagnosis. To evaluate its effectiveness, the new hybrid system was compared with a multitude of competitive classifiers on two disease diagnosis problems. The results demonstrate that the proposed CSAMVO-assisted classifier can find solutions with better learning potential and higher predictive performance.

STRAP reduces endoplasmic reticulum stress and apoptosis in cardiomyocytes and attenuates myocardial ischemia-reperfusion injury by activating PI3K/PDK1/Akt signaling pathway

OBJECTIVE

Myocardial ischemia-reperfusion injury (MIRI) is a common problem in heart-related diseases. The aim of this study was to explore the protective effects of STRAP on cardiomyocytes in the MIRI process and its mechanisms.

MATERIALS AND METHODS

We used SD rats to construct a MIRI model and increased the expression of STRAP in myocardial tissue by Entranster to detect the effect of STRAP on rat myocardial tissue. In addition, we cultured rat cardiomyocyte cell line H9c2 cells and constructed a hypoxia-reoxygenation model to detect the protective effect of STRAP on H9c2 cells. LY294002, an inhibitor of the PI3K/PDK1/Akt signaling pathway, was used to validate the mechanism by which STRAP protects cardiomyocytes.

RESULTS

Overexpression of STRAP significantly reduced the activity of MDA in myocardial tissue and increased the activity of SOD. STRAP also substantially lowered CK and LDH levels in rat serum and increased Na+-K+-ATPase and Ca2+-Mg2+-ATPase activity. In addition, overexpression of STRAP considerably reduced endoplasmic reticulum stress (ERS) and apoptosis levels in H9c2 cells. However, LY294002 attenuated the protective effect of STRAP on cardiomyocytes.

CONCLUSIONS

STRAP reduces ERS and apoptosis in cardiomyocytes by activating the PI3K/PDK1/Akt signaling pathway, thereby reducing myocardial MIRI.

[Analysis of causes and treatment methods of complication of early acute kidney injury in four severely burned patients]

Objective: To analyze the causes of complication of early acute kidney injury (AKI) in four severely burned patients, and to explore the related treatment methods. Methods: The clinical data of 4 patients with severe burn complicated with early AKI admitted to Guangzhou Red Cross Hospital Affiliated to Medical College of Jinan University (hereinafter referred to as our hospital) from June 2014 to December 2017 were retrospectively analyzed. All the patients were male, aged 23-33 (30±5) years old, with depth of burns ranged from deep partial-thickness to full-thickness, complicated with myofascial compartment syndrome of extremities and varying degrees of striated muscle injury, and treated in other hospitals before transfer to our hospital. The patients were numbered from small to large according to the total burn area. The total burn area of patients No. 1, 2, 3, and 4 was 10%, 80%, 90%, and 95% total body surface area respectively, their occurrence time of early AKI was 48, 11, 29, and 48 hours after injury respectively, and their time of arriving our hospital was 60, 11, 29, and 144 hours after injury respectively. Hypovolemic shock occurred in patients No. 2 and 3 at admission to our hospital. All the patients received continuous renal replacement therapy (CRRT) after admission to our hospital. Under the support of hemodynamic monitoring and organ function monitoring, the limbs complicated with myofascial compartment syndrome were incised, thorough decompression exploration was performed, and necrotic muscle tissue was removed or amputation was performed. After escharectomy and decompression of limbs, fresh granulation wounds were formed by temporarily covering wounds with Jieya dressing skin or pig skin, multiple debridements, and vacuum sealing drainage. Fresh granulation wounds and other wounds underwent staged eschar excision and shaving were covered with autologous Meek skin graft, particulate skin graft, reticular skin graft and small skin graft respectively. The treatment outcome, CRRT time, operation times, time of recovery of serum creatinine and myoglobin, length of hospital stay, and follow-up were recorded. Results: All the 4 patients were cured after transfer to our hospital. Among them, totally 5 limbs of patients No. 1 and No. 4 underwent amputation because of complication of myofascial compartment syndrome and a large amount of necrotic muscle which could not be preserved. Patients No. 1, 2, 3, and 4 were treated with CRRT for 19, 35, 14, and 25 days respectively and performed with operation for 5, 6, 10, 8 times respectively. Serum creatinine of patients No. 1, 2, 3, and 4 returned to normal on 22, 35, 37, and 48 days after transfer respectively, and their serum myoglobin returned to normal on 18, 28, 25, and 30 days after transfer respectively. Patients No. 1, 2, 3, and 4 were hospitalized for 52, 105, 148, and 156 days and discharged after basic wound healing. Follow-up for 1 to 36 months showed no abnormal renal function in 4 patients. Conclusions: The early AKI in patients No. 1 and 4 was caused by rhabdomyolysis after severe burn complicated with myofascial compartment syndrome, while that of the other 2 cases were also related to hypovolemic shock and poor renal perfusion. The success rate of early AKI treatment in severely burned patients can be effectively improved by removing the causes of diseases at the same time of CRRT and actively treating burn wounds under the support of organ function and hemodynamic monitoring.

[Clinical analysis of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery]

Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary. Results: One patient died of false aneurysm due to the sternal sinus tract infection, there were no peri-operative death for all the left 52 patients. Forty-five patients had primary healing and 7 patients had secondary healing. All the patients became total recovery within 3-12 weeks after operation and maintained well during the 5-18 months' follow-up. Conclusions: For the patients with chronic sternal osteomyelitis, operative therapy should be performed as soon as possible once the diagnosis is confirmed. Combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation is confirmed to be effective and secure.

[The expression of SnoN in human hypertrophic scar fibroblasts and the mechanism of its participation in hypertrophic scar formation]

Objective: To investigate the expression of SnoN in human hypertrophic scar fibroblasts and the mechanism of its participation in hypertrophic scar formation. Methods: Eight patients with hypertrophic scar after burn in need of surgery were admitted in our unit from January to October 2013, and then hypertrophic scar tissue and normal skin tissue of full-thickness skin donor site resected by surgery of the patients were collected. Hypertrophic scar fibroblasts and normal skin fibroblasts of patients were isolated with method of explant culture and then sub-cultured. Cells of the third to fifth passage were used in the following experiments. (1) The protein expressions of SnoN of hypertrophic scar fibroblasts and normal skin fibroblasts were assessed with Western blotting. (2) The mRNA expressions of SnoN of another batch of hypertrophic scar fibroblasts and normal skin fibroblasts were determined with reverse transcription polymerase chain reaction. (3) Another batch of hypertrophic scar fibroblasts and normal skin fibroblasts were treated with 10 ng/mL transforming growth factor beta1 (TGF-β(1)) for 30 min, 1 h, 2 h, and 6 h, respectively, and then the protein expressions and mRNA expressions of SnoN of untreated cells and treated cells were detected as above. Data were processed with one way analysis of variance and independent sample t test. Results: (1) The protein expression of SnoN of hypertrophic scar fibroblasts was 0.020±0.003, significantly lower than that of normal skin fibroblasts (0.032±0.005, t=7.19, P<0.05). (2) The mRNA expression of SnoN of hypertrophic scar fibroblasts was 0.407±0.157, with no significant difference from that of normal skin fibroblasts (0.339±0.095, t=-1.29, P>0.05). (3) The protein expression of SnoN of normal skin fibroblasts was increased in a time-dependent fashion with the TGF-β(1) stimulation, and the protein expressions of SnoN of cells treated with TGF-β(1) for 30 min, 1 h, 2 h, and 6 h were significantly higher than those of untreated cells (with t values from 2.27 to 27.89, P values below 0.05). The protein expression of SnoN of hypertrophic scar fibroblasts was decreased in a time-dependent fashion with the TGF-β(1) stimulation, and the protein expressions of SnoN of cells treated with TGF-β(1) for 30 min, 1 h, 2 h, and 6 h were obviously lower than those of untreated cells (with t values from 10.80 to 13.85, P values below 0.05). (4) The mRNA expressions of SnoN of normal skin fibroblasts and hypertrophic scar fibroblasts were both increased in a time-dependent fashion with the TGF-β(1) stimulation, and the mRNA expressions of SnoN of the two types of cells treated with TGF-β(1) for 30 min, 1 h, 2 h, and 6 h were both significantly higher than those of untreated cells (with t values from 18.16 to 58.22, P values below 0.05). Conclusions: The protein expression of SnoN in hypertrophic scar fibroblasts is reduced, which weakens its inhibitory effect on TGF-β(1) signal, thus amplifying the TGF-β(1) signal, and it may participate in the formation of hypertrophic scar.

[Effects of silencing Smad ubiquitination regulatory factor 2 on the function of human hypertrophic scar-derived fibroblasts]

Objective: To explore the effects of silencing Smad ubiquitination regulatory factor 2 (Smurf2) on the secretion of transforming growth factor beta 1 (TGF-β(1)), alpha-smooth muscle actin (α-SMA), and collagen type Ⅰ by human hypertrophic scar-derived fibroblasts. Methods: The human normal skin-derived fibroblasts and hypertrophic scar-derived fibroblasts were cultured with explant culture technique from the normal skin and hypertrophic scar tissue, which was obtained from 9 patients with hypertrophic scars after burn. Two kinds of fibroblasts of the third passage were both divided into 6 groups according to the random number table, with 9 wells in each group. Fibroblasts in blank control group were cultured for 72 h without transfection of any small interfering RNA (siRNA), fibroblasts in negative control group were for cultured for 72 h after transfected with non-target siRNA, fibroblasts in Smurf2 siRNA group were cultured for 72 h after transfected with 100 nmol/L Smurf2 siRNA, fibroblasts in blank control+ TGF-β(1) group were cultured for 72 h without transfection of any siRNA and then treated with 10 ng/mL TGF-β(1) for 6 h, fibroblasts in negative control+ TGF-β(1) group were cultured for 72 h after transfected with non-target siRNA and then treated with 10 ng/mL TGF-β(1) for 6 h, fibroblasts in Smurf2 siRNA+ TGF-β(1) group were cultured for 72 h after transfected with Smurf2 siRNA and then treated with 10 ng/mL TGF-β(1) for 6 h. (1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group, negative control group, and Smurf2 siRNA group were assessed by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR), respectively. (2) The content of TGF-β(1) in the cell culture supernatant of the two kinds of cells in blank control group and Smurf2 siRNA group was determined by enzyme-linked immunosorbent assay (ELISA). (3) The protein expression levels of α-SMA of the two kinds of cells in the 6 groups were assessed by Western blotting. The content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in the 6 groups was determined by ELISA. (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in the 6 groups were assessed by RT-PCR. The sample numbers of each group in the above experiments were all 9. Data were processed with analysis of variance of factorial design and Bonferroni test. Results: (1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in Smurf2 siRNA group were significantly lower than those in blank control group and negative control group (with P values below 0.05). The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group and negative control group were close (with P values above 0.05). (2) The content of TGF-β(1) in the cell culture supernatant of hypertrophic scar-derived fibroblasts in blank control group and Smurf2 siRNA group was respectively (4.34±0.56) and (2.14±0.28) pg/mL, which was significantly higher than (1.52±0.20) and (1.41±0.18) pg/mL of normal skin-derived fibroblasts respectively (with P values below 0.05). In hypertrophic scar-derived fibroblasts, the content of TGF-β(1) in the cell culture supernatant in Smurf2 siRNA group was significantly lower than that in blank control group (P<0.05). In normal skin-derived fibroblasts, the content of TGF-β(1) in the cell culture supernatant in Smurf2 siRNA group was close to that in blank control group (P>0.05). (3) The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in blank control+ TGF-β(1) group were significantly higher than those in blank control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in negative control+ TGF-β(1) group were significantly higher than those in negative control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA+ TGF-β(1) group were significantly lower than those in blank control+ TGF-β(1) group and negative control+ TGF-β(1) group (with P values below 0.05). (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in blank control+ TGF-β(1) group were significantly higher than those in blank control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in negative control+ TGF-β(1) group were significantly higher than those in negative control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA+ TGF-β(1) group were significantly lower than those in blank control+ TGF-β(1) group and negative control+ TGF-β(1) group (with P values below 0.05). Conclusions: Silencing Smurf2 in human hypertrophic scar-derived fibroblasts can reduce the autocrine of TGF-β(1) and inhibit the TGF-β(1)-induced α-SMA expression and collagen type Ⅰ synthesis.

CIRBP protects H9C2 cells against myocardial ischemia through inhibition of NF-κB pathway

Myocardial ischemia is a major cause of death and remains a disease with extremely deficient clinical therapies and a major problem worldwide. Cold inducible RNA-binding protein (CIRBP) is reported to be involved in multiple pathological processes, including myocardial ischemia. However, the molecular mechanisms of myocardial ischemia remain elusive. Here, we first overexpressed CIRBP by transfection of pc-CIRBP (pcDNA3.1 containing coding sequenced for CIRBP) and silenced CIRBP by transfection of small interfering RNA targeting CIRBP (siCIRBP). pcDNA3.1 and the negative control of siCIRBP (siNC) were transfected into H9C2 cells to act as controls. We then constructed a cell model of myocardial ischemia through culturing cells in serum-free medium with hypoxia in H9C2 cells. Subsequently, AlamarBlue assay, flow cytometry and western blot analysis were used, respectively, to assess cell viability, reactive oxygen species (ROS) level and apoptosis, and expression levels of IκBα, p65 and Bcl-3. We demonstrated that CIRBP overexpression promoted cell proliferation (P<0.001), inhibited cell apoptosis (P<0.05), reduced ROS level (P<0.001), down-regulated phosphorylated levels of IκBα and p65 (P<0.01 or P<0.001), and up-regulated expression of Bcl-3 (P<0.001) in H9C2 cells with myocardial ischemia. The influence of CIRBP knockdown yielded opposite results. Our study revealed that CIRBP could protect H9C2 cells against myocardial ischemia through inhibition of NF-κB pathway.

A Truncated Nuclear Norm Regularization Method Based on Weighted Residual Error for Matrix Completion

Low-rank matrix completion aims to recover a matrix from a small subset of its entries and has received much attention in the field of computer vision. Most existing methods formulate the task as a low-rank matrix approximation problem. A truncated nuclear norm has recently been proposed as a better approximation to the rank of matrix than a nuclear norm. The corresponding optimization method, truncated nuclear norm regularization (TNNR), converges better than the nuclear norm minimization-based methods. However, it is not robust to the number of subtracted singular values and requires a large number of iterations to converge. In this paper, a TNNR method based on weighted residual error (TNNR-WRE) for matrix completion and its extension model (ETNNR-WRE) are proposed. TNNR-WRE assigns different weights to the rows of the residual error matrix in an augmented Lagrange function to accelerate the convergence of the TNNR method. The ETNNR-WRE is much more robust to the number of subtracted singular values than the TNNR-WRE, TNNR alternating direction method of multipliers, and TNNR accelerated proximal gradient with Line search methods. Experimental results using both synthetic and real visual data sets show that the proposed TNNR-WRE and ETNNR-WRE methods perform better than TNNR and Iteratively Reweighted Nuclear Norm (IRNN) methods.

Apparent diffusion coefficients of normal uterus in premenopausal women with 3 T MRI

AIM

To investigate the apparent diffusion coefficient (ADC) values of the normal uterine cervical zonal structures (cervical epithelium, the junctional zone, and myometrium) during different phases of the menstrual cycle among premenopausal women in different age groups.

MATERIALS AND METHODS

Seventy healthy women, who were divided into three age groups (group A, 24 women in their twenties; group B, 23 women in their thirties; group C, 23 women in their forties), underwent 3 T magnetic resonance imaging (MRI) with T2-weighted and diffusion-weighted imaging (DWI) during the mid-proliferative and the mid-secretory phases.

RESULTS

The ADC values of each cervical zonal structure were significantly different from one another (p < 0.001). The ADC values of the epithelium and junctional zones were both lower during the mid-secretory phase than those during the mid-proliferative phase in each age group (p < 0.05). There were no significant differences in the ADC values of any of the cervical zones among the three age groups for a given phase (p > 0.05).

CONCLUSION

ADC values of normal cervical epithelium and the junctional zone change with different phases of the menstrual cycle, which should be taken into consideration when early cervical disease is detected, when monitoring treatment response, and differentiating early tumour recurrence.

Quetiapine Ameliorates Anxiety-Like Behavior and Cognitive Impairments in Stressed Rats: Implications for the Treatment of Posttraumatic Stress Disorder

The purpose of this study was to determine preventive and protective effects of chronic orally administration with quetiapine (QUE) against anxiety-like behavior and cognitive impairments in rats exposed to the enhanced single prolonged stress (ESPS), an animal model that is used to study post-traumatic stress disorder (PTSD), and to detect changes in the expression of cortical phosphorylated p44/42 extracellular-regulated protein kinase (pERK1/2). Before or after exposure to ESPS paradigm, consisting of 2-h constraint, 20-min forced swimming, etherinduced loss of consciousness, and an electric foot shock, rats were given orally QUE (10 mg/kg daily) for 14 days. Animals were then tested in the open field (OF), elevated plus-maze (EPM), and Morris water maze (MWM). Brains were removed for immunohistochemical staining of pERK1/2. ESPS exposure resulted in pronounced anxiety-like behavior compared to unexposed animals. ESPS-exposed animals also displayed marked learning and spatial memory impairments. However, QUE treatment (both before and after ESPS exposure) significantly ameliorated anxiety-like behavior, learning and spatial memory impairments. ESPS also markedly reduced the expression of pERK1/2 in the prefrontal cortex, medial amygdala nucleus, and cingulate gyrus. Both before and after ESPS exposure QUE treatments significantly elevated the reduced pERK1/2 expression in the three brain regions. QUE has preventive and protective effects against stress-associated symptoms and the changes in pERK1/2 functions may be associated with the pathophysiology of traumatic stress and the therapeutic efficacy of anti-PTSD therapy.

Evaluation of glucose metabolic disorder: insulin resistance and insulin receptors in critically ill children

OBJECTIVE

To explore the pathogenesis of glucose metabolic disorder and insulin resistance in critically ill children under severe stress.

METHODS

To test glucose, lactate, glucagon, insulin, c-peptide, cortisol levels in 50 critically ill children. While we measured 125I-insulin binding to erythrocytes of 13 critically ill children who had hyperglycemia and hyperinsulinemia. Glucose and lactate were measured biochemically. Insulin, c-peptide, cortisol and glucagon were determined by RIA. Erythrocytes insulin receptor was detected by insulin radioreceptor assay.

RESULTS

Glucose, lactate, insulin, c-peptide, glucagon, cortisol, insulin/glucose, insulin/glucagon ratio in patients were higher than those in normal controls (P < 0.05). As compared with normal controls, the maximum 125I-insulin bound and insulin receptor number per cell were significantly lower (P < 0.01). But there was no difference of mean value in receptor affinity (P > 0.05).

CONCLUSIONS

Hyperglycemia is common in critically ill children during stress, which may be attributed to hormones disturbance and tissure insulin resistance. Insulin receptor defect due to comprehensive factors was one of the important causes for insulin resistance. The blood glucose level can be used as an predicting index in ICU.