A recent study reported that nobiletin is an active ingredient in Fructus Aurantii immaturus and Pericarpium Citri Reticulatae, which may be capable of preventing ischemic stroke. Therefore, the present study aimed to determine the neuroprotective effects of nobiletin, and to evaluate whether it could ameliorate isoflurane‑induced cognitive impairment via antioxidant, anti‑inflammatory and anti‑apoptotic effects in aging rats. Male Sprague‑Dawley rats (age, 18 months) were used to analyze the neuroprotective effects of nobiletin. Morris water maze test was used to determine cognitive competence. Enzyme‑linked immunosorbent assay and western blot analysis were also used to quantify nuclear factor‑κB, tumor necrosis factor (TNF)‑α, IL‑1β, IL‑6, glutathione, (GSH), GSH‑peroxidase, superoxide dismutase and malondialdehyde concentration and relevant protein expression levels Cognitive competence was increased in isoflurane-treated rats following treatment with nobiletin. In addition, as expected, nobiletin exerted antioxidant, anti-inflammatory and anti‑apoptotic effects on isoflurane‑induced cognitive impairment in aging rats. Treatment with nobiletin induced the activation of phosphorylated (p)‑Akt, p‑cAMP response element binding protein (CREB) and brain‑derived neurotrophic factor (BDNF) protein expression and reduced the levels of B‑cell lymphoma 2‑associated X protein (Bax) in isoflurane‑induced rats. In conclusion, the present study demonstrated that nobiletin may ameliorate isoflurane-induced cognitive impairment through antioxidant, anti‑inflammatory and anti‑apoptotic effects via modulation of Akt, Bax, p‑CREB and BDNF in aging rats. These findings provide support for the molecular mechanisms underlying the effects of nobiletin treatment on isoflurane-induced damage.

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Background: Few studies comprehensively compared the performance of magnetic resonance elastography (MRE) and transient elastography (TE) in the diagnosis of liver fibrosis. Therefore, we conducted a metaanalysis to evaluate and compare the diagnostic efficacy of these 2 techniques in patients with hepatic fibrosis in order to gain a better understanding of their overall diagnostic performance and aid in maximizing their clinical utility.Methods: Systematic literature searches of the PubMed, EmBase, Cocharane Library, and China National Knowledge Infrastructure databases were carried out to identify studies that applied MRE and TE in the diagnosis of liver fibrosis. The combined sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (ORs) were estimated using a bivariate random effects model. Review Manager 5.2 was used to analyze the selected articles, and forest plot, sensitivity, and bias analyses were performed for the included literature. To determine the diagnostic efficacy of MRE and TE for liver fibrosis, pooled sensitivity and specificity analyses were conducted.Results: Eight studies met the inclusion criteria. In the diagnosis of stage F0-F1 liver fibrosis, MRE showed higher sensitivity than TE (OR =0.62, 95% CI: 0.41-0.95, P=0.03). MRE also showed higher specificity than TE for diagnosing stage F2-F4 liver fibrosis (OR =0.41, 95% CI: 0.27-0.62, P<0.0001).There was no difference in the sensitivity of MRE and Te to F2-F4 hepatic fibrosis and the specificity of MRE and Te to F0-F1 hepatic fibrosis.Conclusions: In terms of sensitivity and specificity, MRE is superior to TE in diagnosing different stages of liver fibrosis to a certain extent. MRE may be a useful, noninvasive method for the assessment of liver fibrosis in patients with chronic liver disease.

Background: Hepatocellular carcinoma (HCC) has become the third leading cause of cancer-related death worldwide, and its incidence rate is increasing. Magnetic resonance elastography (MRE) can indirectly realize the accurate non-invasive evaluation of liver reserve function in HCC patients. In this study, we aimed to evaluate the effectiveness of MRE in the diagnosis of HCC patients.Methods: We searched globally-recognized electronic databases, such as PubMed, EMBASE, China National Knowledge Infrastructure, and Cochrane Central, for relevant literature on MRE prediction of HCC. The diagnostic performance of all studies was quantitatively summarized using a bivariate random effects model including heterogeneity analysis, receiver operating characteristic (ROC) curve, and bias determination.Results: The diagnostic accuracy of MRE for HCC was based on 1,735 patients. The sensitivity (31-100%) was lower than the specificity (81-94%). The overall sensitivity was 64% [95% confidence interval (CI): 46-79%; I 2 =92.44%], and the overall specificity was 85% (95% CI: 82-88%; I 2 =67.86%). Limited publication bias was observed in this study, and the sensitivity analysis showed that the study was robust. Discussion:The results of our meta-analysis show that MRE has moderate sensitivity and excellent specificity in the detection of HCC. MRE can be an effective diagnostic tool for HCC and can provide strong support for the selection of clinical treatment methods and prognostic judgment.

Objective: To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions. Methods: From January 2017 to January 2019, 70 patients with carotid atherosclerotic plaque lesions in our hospital were selected as the research object. All patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral CT reconstruction mode. Taking the results of coronary angiography as the “gold standard”, the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed. Results: Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques. The accuracy of Spectral CT examination of carotid artery plaque was 87.14% (61/70), sensitivity was 90.91% (30/33), specificity was 83.78% (31/37), and the positive predictive value was 83.33% (30 /36), the negative predictive value is 91.76% (31/34), which is higher than that of cervical vascular ultrasonography (61.43%, 60.61%, 56.76%, 57.89%, 65.63%), the difference is statistically significant (P<0.05). Conclusion: The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy, sensitivity and specificity, is more significant and can provide a more reliable and effective imaging basis.