GDF15 negatively regulates chemosensitivity via TGFBR2-AKT pathway-dependent metabolism in esophageal squamous cell carcinoma / 医学前沿

Treating patients with esophageal squamous cell carcinoma (ESCC) is challenging due to the high chemoresistance. Growth differentiation factor 15 (GDF15) is crucial in the development of various types of tumors and negatively related to the prognosis of ESCC patients according to our previous research. In this study, the link between GDF15 and chemotherapy resistance in ESCC was further explored. The relationship between GDF15 and the chemotherapy response was investigated through in vitro and in vivo studies. ESCC patients with high levels of GDF15 expression showed an inferior chemotherapeutic response. GDF15 improved the tolerance of ESCC cell lines to low-dose cisplatin by regulating AKT phosphorylation via TGFBR2. Through an in vivo study, we further validated that the anti-GDF15 antibody improved the tumor inhibition effect of cisplatin. Metabolomics showed that GDF15 could alter cellular metabolism and enhance the expression of UGT1A. AKT and TGFBR2 inhibition resulted in the reversal of the GDF15-induced expression of UGT1A, indicating that TGFBR2-AKT pathway-dependent metabolic pathways were involved in the resistance of ESCC cells to cisplatin. The present investigation suggests that a high level of GDF15 expression leads to ESCC chemoresistance and that GDF15 can be targeted during chemotherapy, resulting in beneficial therapeutic outcomes.

Advances in the study of the pathogenesis of squamous cell carcinoma / 中国综合临床

Squamous cell carcinoma, which originates from squamous epithelium or tissue that undergoes squamous epithelial metaplasia, is one of the most common pathological types of solid human carcinoma. Although squamous cell carcinoma can occur in different anatomical locations, its pathogenesis has commonalities and distinctive features. Genetic mutations and abnormal expression of squamous differentiation markers, epigenetic modifications regulating target gene expression, and tumor microenvironment inducing immune escape of cancer cells are all involved in the development of squamous cell carcinoma. At present, great progress has been made in the research on the pathogenesis of squamous cell carcinoma. This article, combined with relevant research in recent years, reviews the pathogenesis of squamous cell carcinoma in terms of genome changes, epigenetic changes, non coding RNA regulation, tumor microenvironment changes and risk factor induction, so as to provide reference for the prevention and treatment of squamous cell carcinoma.

Advances in minimally invasive treatment of upper gastrointestinal bleeding in liver cirrhosis / 临床肝胆病杂志

Liver cirrhosis is a common chronic liver disease in clinical practice, and the main causes of this disease include virus, alcohol, and immunity. Patients may experience a variety of complications in the late stage of liver cirrhosis, including upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, and liver cancer, among which upper gastrointestinal bleeding is the main cause of death, and therefore, the control and prevention of upper gastrointestinal bleeding caused by liver cirrhosis is the key to reducing mortality rate and prolonging survival time. This article summarizes the commonly used minimally invasive methods for the treatment of upper gastrointestinal bleeding in liver cirrhosis and analyzes the indications for different treatment methods and related advances, so as to provide a reference for clinicians to choose the most suitable treatment regimen for the patient, thereby improving the survival rate of patients.

Recommendations for diagnosis and treatment of systemic sclerosis in China / 中华内科杂志

Systemic sclerosis (SSc) is an autoimmune rheumatic disease that is characterized by skin fibrosis with multi-organ involvement. In China, the standardized diagnosis and treatment for SSc is still lacking. Based on the diagnosis criteria and guidelines from China and abroad, Chinese Rheumatology Association developed the current standardization of diagnosis and treatment for SSc. The purposes of this guideline are to standardize clinical management for SSc in China, to interpret the key evaluation tools for SSc, and to recommend therapeutic principle and strategies.

Influence of the intake of different oils on non-alcoholic fatty liver disease / 临床肝胆病杂志

At present, there are no universally accepted hepatoprotective drugs that are recommended for the conventional treatment of nonalcoholic fatty liver disease (NAFLD), and the main prevention and treatment methods for NAFLD include diet control, exercise, and weight-loss surgery. Diet control is the most basic intervention method, and scientific and reasonable dietary guidance is of particular importance. This article briefly summarizes the influence of several kinds of oils commonly contained in diet on hepatic steatosis, inflammation, and oxidative stress of NAFLD, and it is pointed out that fish oil, olive oil, virgin coconut oil, and pine nut oil are beneficial to NAFLD, while excessive intake of lard and palm oil will aggravate NAFLD.

Influence of the intake of different oils on non-alcoholic fatty liver disease / 临床肝胆病杂志

At present, there are no universally accepted hepatoprotective drugs that are recommended for the conventional treatment of nonalcoholic fatty liver disease (NAFLD), and the main prevention and treatment methods for NAFLD include diet control, exercise, and weight-loss surgery. Diet control is the most basic intervention method, and scientific and reasonable dietary guidance is of particular importance. This article briefly summarizes the influence of several kinds of oils commonly contained in diet on hepatic steatosis, inflammation, and oxidative stress of NAFLD, and it is pointed out that fish oil, olive oil, virgin coconut oil, and pine nut oil are beneficial to NAFLD, while excessive intake of lard and palm oil will aggravate NAFLD.

Immune Mechanism of Tumor Cell Lysate Combined with IL-2 Preventing Melanoma and Inhibiting Tumor Growth / 肿瘤防治研究

Objective To investigate the preventive and inhibitory effects of tumor cell lysate(TCL) combined with IL-2 on melanoma and the potential immune mechanism. Methods The B16F10 melanoma TCL cell were prepared using an ultrasonic disruptor. Twenty-four C57BL/6 mice were randomly divided into four groups which were immunized with PBS, IL-2, TCL and TCL+IL-2 for three weeks, and contra lateral tumors were implanted in the fourth week. We observed onset time of tumor and tumor size, collected peripheral blood continuously and monitored the expression of CD4+T and CD8+T cell subsets dynamically by flow cytometry. Spleen and tumor tissues of mice were also tested for CD4+T and CD8+T cell subsets by flow cytometry and immunohistochemistry, respectively. Results The preventive immunization of the TCL+IL-2 group significantly delayed the onset time of tumor (P=0.034); moreover, the tumor volume (P=0.023) and tumor weight (P=0.0015) were also significantly smaller than those in the control group. The expression of CD8+T cell subsets in the TCL+IL-2 group and the TCL-only group were significantly higher than that in the control group (P=0.0016, P=0.012). However, the CD4+T cell subsets of the TCL+IL-2 group decreased after tumor implantation, compared with the control group (P=0.0089). The expression of CD4+T and CD8+T cell subsets in spleen and tumor tissues were as same as those in peripheral blood. Conclusion The tumor vaccine of TCL combined with IL-2 could prevent the occurrence of melanoma in mouse and effectively inhibit tumor growth by activating CD8+T cells.

Bioactive A-ring rearranged limonoids from the root barks of

Screening active natural products, rapid identification, and accurate isolation are of great important for modern natural lead compounds discovery. We hereby reported the isolation of seven new neotecleanin-type limonoids (-), seven new limonoids with 5-oxatricyclo[5.4.0.11., 4.]hendecane ring system (-), and two new precursors (-) together with four known limonoids (-) from the root barks of . Their structures, including their absolute configurations, were elucidated based on analyses of HR-ESI-MS, 1D/2D NMR, ECD spectrum calculations and single-crystal X-ray diffraction techniques. Compounds , , , , , , showed significant anti-inflammatory activities in LPS-induced RAW 264.7 cell line, BV2 microglial cells, and -stimulated THP-1 human monocytic cells. Walrobsin M () exhibited anti-inflammatory activity with IC value of 7.96±0.36 μmol/L, and down-regulated phosphorylation levels of ERK and p38 in a dose-dependent manner.

Investigation of in-patient neonatal death at 18 hospitals in Henan Province / 中华围产医学杂志

Objective To investigate the situation and the causes of neonatal death in Henan Province.Methods This study retrospectively analyzed the clinical data of 277 neonates who died at 18 hospitals in Henan Province in 2017.Distribution and causes of neonatal deaths,differences between perinatal conditions of premature and term/post-term infants,causes of early (＜ 7 d) and late (7-28 d) neonatal deaths and the differences in neonatal death cases between Maternal and Child Health Care Hospitals and General/Children's Hospitals were analyzed.We used t,rank-sum and Chi-square test (or corrected Chi-square test,or Fisher's exact test) for statistical analysis.Results (1) A total of 50 993 newboms were admitted to the 18 hospitals in 2017,297 of which died with a mortality of 5.82‰.After excluding 20 cases with uncertain birth or maternal pregnancy history or clinical data,277 cases with complete data were analyzed.Among them,168 (60.6％) were preterm neonates and 109 (39.4％) were term/post-term ones.Early and late neonatal deaths accounted for 74.0％ (205 cases) and 26.0％ (72 cases),respectively.(2) The top five causes of neonatal deaths were infection (78 cases,28.2％),asphyxia (54 cases,19.5％),neonatal respiratory distress syndrome (NRDS,33 cases,11.9％),severe congenital malformations (26 cases,9.4％) including cyanotic congenital heart diseases,digestive malformations,airway malformations and neural tube defects and pulmonary hemorrhage (23 cases,8.3％).Among them,the top three causes of early neonatal deaths were asphyxia (48 cases,23.4％),infection (43 cases,21.0％) and NRDS (33 cases,16.1％),while the main causes of late neonatal deaths were infection (35 cases,48.6％),major congenital malformations (9 cases,12.5％) and chromosome abnormities/inherited metabolic diseases (7 cases,9.7％).(3) Maternal complications during pregnancy accounted for 79.1％ (219 cases) and the predominant types were pregnancy-induced hypertension (43 cases,19.6％),followed by infection (36 cases,16.4％),placental-related conditions (32 cases,14.6％),gestational diabetes mellitus (23 cases,10.5％),hypothyroidism (20 cases,9.1％),fetal distress (18,8.2％),twin-twin transfusion syndrome (10 cases,4.6％) and cholestasis syndrome (9 cases,4.1％).(4) Compared with the term/post-term cases,the preterm cases had higher proportions of multiple births [27.4％ (46/168) vs 6.4％ (9/109),x2=14.016,P ＜ 0.05],assisted reproduction [7.1％ (12/168) vs 0.9％ (1/109),x2=4.421,P ＜ 0.05] and maternal hypertensive disorders of pregnancy [21.4％ (36/1 68) vs 6.4％ (7/109),x2=11.353,P ＜ 0.05],infection [16.7％ (28/168) vs 7.3％ (8/109),x2=4.295,P ＜ 0.05] and twin-to-twin transfusion syndrome [6.0％ (10/168) vs 0.0％ (0/109),x2=6.707,P ＜ 0.05].(5) Among all the early neonatal deaths,preterm cases had a higher incidence of NRDS than term/post-term neonates [20.3％ (27/133) vs 8.3％ (6/72),x2=1 1.937,P ＜ 0.05],but lower incidence of meconium aspiration syndrome (MAS),severe congenital malformations and chromosome abnormalities/inherited metabolic diseases [0.8％ (1/133) vs 5.6％ (4/72),x2=4.508;3.8％ (5/133) vs 16.7％ (12/72),x2=10.233;1.5％ (2/133) vs 6.9％ (5/72),~=4.172;all P ＜ 0.05].Among the late neonatal deaths,the incidence of severe intracranial hemorrhage in preterm infants was higher than that in term/post-term neonates [7.1％ (3/42) vs 0.0％ (0/30),x2=2.205,P ＜ 0.05].(6) Compared with the cases in General/Children's Hospitals,those in Maternal and Child Health Care Hospitals showed a higher proportion of preterm neonatal deaths [67.3％ (105/156) vs 52.1％ (63/121),x2=6.010,P ＜ 0.05],younger gestational age [(32.8±5.3) weeks vs (34.6±4.9) weeks,t=3.072,P ＜ 0.05],lower birth weight [(2 132.6± 1 014.5) g vs (2 409.4±987.3) g,t=-2.513,P ＜ 0.05],and higher average age of death [M(P25-P75),3 (1-8) d vs 2 (1-4) d,Z=3.710,P ＜ 0.05].Conclusions Neonatal death occurs mainly within one week after birth in those with maternal complications.Late preterm deaths and term/post-term cases account for nearly half of total neonatal deaths.The causes of death for preterm and term/post-term newborns vary with postnatal age.Infection,asphyxia and severe congenital malformations are important causes of neonatal deaths.

Follow-up study of 116 cases of transjugular intrahepatic portosystemic shunt in the treatment of cirrhotic portal hypertension / 中华肝脏病杂志

Objective@#To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods.@*Methods@#Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure. The incidence rate of hepatic encephalopathy, gastrointestinal bleeding, ascites and shunt dysfunctions were observed. Data were expressed as mean ± Standard deviation and analyzed by t-test. A chi-squared test was used for comparison between categorical variables.@*Results@#The success rate of TIPS operation was 97.41% (113/116). Two patients underwent prompt TIPS procedure due to active bleeding. Bleeding was successfully stopped. Portal venous pressure of 113 patients decreased from (42.73 ± 7.64) cmH2O to (24.92 ± 7.60) cmH2O, and the difference was statistically significant (P < 0.01). Twenty cases were of hepatic encephalopathy. Preoperative level of Child-pugh class C patients was more susceptible to hepatic encephalopathy within 3 months after procedure than class A and B. After TIPS procedure, there were 22 cases of gastrointestinal bleeding, 18 cases of shunt dysfunctions and 26 cases of disease related death.@*Conclusion@#Rational patient selection strategies can effectively reduce portal venous pressure, incidence of hepatic encephalopathy, improve mid-and long-term therapeutic effects, and provide opportunities for liver transplantation.

Data mining of esophageal squamous cell carcinoma from The Cancer Genome Atlas database / 中华肿瘤杂志

Objective@#To deeply investigate the gene expression profiles of esophageal squamous cell carcinoma (ESCC) and the relationship of gene expression levels with prognosis from The Cancer Genome Atlas (TCGA) database.@*Methods@#RNA-seq V2 data of 11 normal samples and 81 esophageal squamous cell carcinoma patients, and their corresponding clinical data were downloaded from The Cancer Genome Atlas database. Differentially expressed genes between normal and tumor samples were identified by using edgeR package. Gene function enrichment analyses of differentially expressed genes were conducted. A protein-protein interaction network based on differentially expressed genes was constructed by using STRING database and the hub genes were identified based on the created gene co-expression network. In addition, survival analysis was performed.@*Results@#Totally, 2 788 genes were identified as differential expression. Among these, 1 168 genes were up-regulated and 1 620 genes were down-regulated in tumor cases compared with normal samples. Up-regulated genes were enriched in cell cycle, DNA replication and mismatch repair pathways, while down-regulated genes were enriched in metabolic pathways. 707 genes and their 3 428 interactions were identified by protein-protein interaction analysis. Genes with copy number amplifications were considered to interact with other crucial genes. 10 co-expression modules were identified based on the gene co-expression network analysis and the ribosomal protein genes were illustrated to be correlated with tumor locations of ESCC patients (P=0.003). The 3-years survival rates of high and low expression of TNFRSF10B groups were 82.5% and 15.1%, respectively. Similarly, the 3-years survival rates of high and low expression of DDX18 groups were 82.4% and 15.2%, respectively. The survival differences stratified by these two genes were statistically significant (both P<0.1).@*Conclusions@#The analysis results of TCGA database showed that ribosomal protein genes are correlated with tumor locations of ESCC patients. Low expressions of TNFRSF10B and DDX18 are associated with poor prognose of ESCC patients. Consequently, TNFRSF10B and DDX18 may serve as predictive markers for ESCC patients.

Influence of orthokeratology lens on vision, intraocular pressure and biometric measurement parameters of adolescent myopia / 重庆医学

Objective To evaluate the influence of orthokeratology lenses on vision,intraocular pressure and biometric measurement parameters in adolescent myopia.Methods A total of 72 adolescent myopia patients (136 eyes) with orthokeratology lens,aged 8-16 years old,in Hebei Provincial Eye Hospital from Junuary 2013 to December 2015 were randomly selected.The vision,intraocular pressure,axial length,corneal topography,corneal thickness and anterior chamber depth were observed before wearing glasses,at 1 week,1,3,6 months after wearing glasses.Results After orthokeratology wearing,the uncorrected visual acuity was obviously improved (P＜0.05),the average refraction diopter was declined (P＞0.05) and the non-contact intraocular pressure was decreased (P＜0.05).The axial length after orthokeratology wearing had little change (P＞0.05).The curvature of the patient's cornea at one week after wearing glasses was deceased (P＜0.05) and the posterior corneal curvature tended towards stability.The corneal thickness at 1 week after wearing glasses had no obvious change compared with before wearing glasses(P＞0.05),which at 1 month after wearing glasses was decreased(P＜0.05) and which at 3,6 months after wearing glasses trended to be stabilized.The anterior chamber depth after wearing glasses had no obvious change.Conclusion Orthkeratology lens can decrease the myopia degree,increases the uncorrected visual acuity and has obvious effect for controlling adolescent myopia.The intraocular pressure and biometric measurement parameters have corresponding change after wearing orthkeratology lens.

Effect of asiaticoside on endothelial-to-mesenchymal transition in hypoxia pulmonary hypertension / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of asiaticoside (AS) on endothelial-to-mesenchymal transition (EndoMT) in hypoxia pulmonary hypertension (HPH). METHODS Male Sprague-Dawley (SD) rats were divided into normoxia control group, hypoxia model group, and AS 25 and 50 mg · kg-1 group. Hypoxia model group and AS group were subjected to intermittent hypoxia exposure. Control group and model group received 1-1.5 mL saline daily, and AS groups were ig administrated with AS 25 and 50 mg·kg-1 for 4 weeks. Human pulmonary artery endothelial cells (HPAECs) were divided into normoxia control group and hypoxia AS groups. Hypoxia groups were cultured with AS 0, 25, 50, 100 and 200 mg·L-1 for 72 h under hypoxic (5%O2, 5%CO2) conditions. Anti-proliferation effect of AS was investigated by CCK-8 assay. Then, HPAECs were divided into normoxia control group, normoxia AS 100 mg · L-1 group, hypoxia model group, and hypoxia AS 100 mg · L-1 group. After five days of culture, migration ability of cells was detected by Transwell test. Expression of CD31 andα-SMA was detected by immunofluorescence and Western blotting in both in vivo and in vitro experiments. RESULTS In both in vivo and in vitro experiments, compared with normoxia control group, expression of CD31 was reduced (P<0.01) andα-smooth muscle actin (α-SMA) was increased (P<0.01) in hypoxia model group in both immunofluorescent analysis and Western blotting. Compared with hypoxia model group, expression of CD31 was increased andα-SMA was decreased (P<0.05, P<0.01) in AS treatment groups. Compared with normoxia control group, proliferation and migration ability of HPAEC were elevated in hypoxia model group (P<0.05). Compared with hypoxia group, AS 100 mg · L-1 depressed proliferation and migration of HPAEC under hypoxia exposure up to 72 h (P<0.05). CONCLUSION EndoMT might be involved in HPH and could be partly inhibited by AS.

Comparative study of optical properties and visual quality of two diffractive multifocal intraocular lens / 眼科新进展

Objective To compare the optical properties and visual quality between Tecnis ZMB00 and AcrySof ReSTOR SN6AD1 multifocal intraocular lens (MIOL) in patients undergoing cataract surgery.Methods A total of 120 patients (130 eyes) who umderwent elective cataract surgery in our hospital from March 2012 to July 2015 were selected prospectively.All patients were treated with diffractive MIOL,and divided into group A (Tecnis ZMB00 group) and group B (AcrySof ReSTOR SN6AD1 group).The uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA),uncorrected medium distance visual acuity (UCIVA),best corrected distance visual acuity (BCDVA) and best corrected near visual acuity (BCNVA) were measured before and after surgery.The defocusing curve was drawn for analysis of the contrast sensitivity,and the postoperative visual function and survival quality questionnaire (VF-14) was used to evaluate the postoperative visual quality.Results At 1 week,1 month and 3 months after surgery,recovery of UCNVA,UCIVA and BCNVA in group A was better than that in group B (all P ＜ 0.05).At 1 week and 3 months after surgery,the recovery of UCDVA in group A was better than that in group B (all P ＜ 0.05).At 3 months after surgery,the spherical equivalent was lower in group A than group B (P ＜ 0.05).The contrast sensitivities under scotopia,photopic glare and scotopic glare of different frequencies in group A were higher than those in group B (all P＜0.05).The VF-14 score in group A at 3 months after surgery was lower than that in group B (P＜0.05).In group A,0.0 D and-2.5 D formed 2 peaks,and from-2.0 D to-2.5 D formed the platform stage,while in group B,only 0.0 D and-3.0 D formed 2 peaks.Conclusion The implantation of Tecnis ZMB00 MIOL after cataract surgery can improve the uncorrected visual acuity of treated eye,contrast sensitivities,postoperative visual function and quality of life of patients.

Real-time three-dimensional transesophageal echocardiography in evaluation of Carpentier's classification of mitral regurgitation / 中国医学影像技术

Objective To evaluate the feasibility of real-time threedimensional transesophageal echocardiography (RT3D TEE) in Carpentier's classification of patients with mitral regurgitation (MR).Methods Totally 124 patients with MR were divided into type Ⅰ—Ⅲ type according to Carpentier's classification,and the cases and methods of operation were followed up.Results In all of the 124 patients,9 cases were Carpentier's type Ⅰ,including 8 cases of atrial fibrillation,1 case of mitral valve cleft;102 patients were type Ⅱ,including pure mitral valve prolapse in 16 cases,mitral valve prolapse with chordae rupture in 80 cases,infective endocarditis in 6 cases;13 cases were type Ⅲ,including Ⅲa type rheumatic heart disease in 8 cases,Ⅲ b type of left ventricular systolic dysfunction in 5 cases.Totally 101 cases underwent MR surgery,including mitral valve plasty in 83 cases and valve replacement in 18 cases.Conclusion RT3D TEE is feasible and accurate in defining different types of MR,and it is useful to make management decisions and select the appropriate surgical strategy.

Effects of MDR1 C3435T Polymorphism on the Dose of Analgesia Agents after Joint Replacement / 中国药房

OBJECTIVE:To investigate the effects of multidrug resistance gene 1(MDR1)C3435T polymorphism on the dose of analgesia agents(dezocine combined with sufentanil)after joint replacement. METHODS:300 patients receiving joint replace-ment were selected from Tianjin People's Hospital and Tianjin Port Hospital during Jan. 2014-Feb. 2016. They were given dezocine and sufentanil for postoperative analgesia. PCR-RFLP was used to determine MDR1 C3435T polymorphism;VAS scores,Ramesy scores,the dose of dezocine+sufentanil and the occurrence of ADR were compared among different genotypes. RESULTS:Among 300 patients,there were 100(33.3%),102(34.0%)and 98(32.7%)cases of MDR1 C3435T CC,CT and TT genotype,respec-tively,the frequencies of which were all in line with Hardy-Weinberg balance (P>0.05). There was no statistical significance in VAS scores and Ramesy scores among different genotypes 0,24,48 h after surgery(P>0.05). No excessive sedation was found. The dose of dezocine+sufentanil in CT and TT genotype were all significantly lower than CC genotype 0-24 h,>24-48 h after sur-gery,with statistical significance(P0.05). The incidence of postoperative nausea and vomiting (PONV),ADR in TT genotype were significantly lower than CC and CT genotypes,with statistical significance (P0.05). CON-CLUSIONS:With similar sedation and analgesic effect,MDR1 mutant type have lower resistance to dezocine+sufentanil,and smaller drug dose is need,the incidence of ADR is lower. MDR1 genotype can be regarded as an important indicator of clinical in-dividualized treatment.

Longitudinal Strain of Primary Mitral Regurgitation Predicts Postoperative Worsening of Left Ventricular Systolic Function / 中国医科大学学报

Objective To analyze subclinical changes of left ventricular deformation by using two-dimensional (2-D) speckle tracking imaging (STI) in primary mitral regurgitation (MR) and to identify sensitive parameters of left ventricular deformation that reflect reduction of left ventricu-lar function after mitral valve repair.Methods We evaluated patients with primary MR who underwent mitral valve repair between May 2013 and June 2015.According to the reduction in ejection fraction (EF),the MR patients were divided into MR1 (EF reduction of ≤10％) and MR2 groups (EF reduction of ＞10％).The parameters of left ventricular deformation were measured by using 2-D STI.Results Compared with the MR1 group,the MR2 group had increased global longitudinal strain (GLS;P ＜ 0.05).A positive correlation was found between postoperative EF reduction and left ventricular intemal dimension at end-diastole,left ventricular internal dimension at end-systole,end-diastohc volume,left ventricular mass index,regurgitant volume,and GLS (P ＜ 0.05).GLS showed a diagnostic value in predicting EF reductions of ＞ 10％.Conclusion STI is useful for evaluating the postoperative reduction of left ventricular function in primary MR patients and thus is helpful for optimizing surgical timing.

Association between Toll-Like Receptor 9-1237T/C Polymorphism and the Susceptibility of Inflammatory Bowel Diseases: A Meta-Analysis

PURPOSE: The -1237T/C polymorphism of the Toll-like receptor 9 (TLR9) gene has been implicated in the susceptibility of inflammatory bowel diseases (IBDs), but the results remain conflicting. We further investigated this association via meta-analysis. MATERIALS AND METHODS: Multiple electronic databases were extensively searched until February, 2015. The strength of association was evaluated by calculating the pooled odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 2987 cases and 2388 controls from eight studies were analyzed. Overall, association was found between TLR9 -1237T/C polymorphism and the risk of IBDs when all the studies were pooled (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.13, 95% CI: 1.00-1.27, p=0.05). Stratification by ethnicity indicated an association between TLR9 -1237T/C polymorphism and IBDs risk in Caucasians (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.12, 95% CI: 1.00-1.27, p=0.05). When stratified by disease type, significant correlation were only found in the Crohn's disease subgroup (recessive model, OR: 1.69, 95% CI: 1.05-2.73, p=0.03; homozygote model, OR: 1.74, 95% CI: 1.07-2.82, p=0.02; allele model, OR: 1.15, 95% CI: 1.01-1.32, p=0.04). CONCLUSION: The present study suggested that the TLR9 -1237T/C polymorphism might act as a risk factor in the development of IBDs, particularly in Caucasians.

Expressions and Significance of CXC Chemokine Receptor Type 2 and Interleukin-8 in Patients with Inflammatory Bowel Disease / 胃肠病学

Background:CXC chemokine receptor type 2(CXCR2)is a member of G protein coupled receptor superfamily,and is mainly involved in the growth of tumor,angiogenesis and the pathogenesis of inflammatory diseases. Studies showed that CXCR2 was associated with the pathogenesis of inflammatory bowel disease(IBD),but the exact role has not yet been clarified. It was found that the interaction of interleukin-8(IL-8)with CXCR1 and CXCR2 played an important role in the pathogenesis of IBD. Aims:To investigate the expressions and significance of CXCR2 and IL-8 in patients with IBD. Methods:A total of 121 IBD patients in active stage from October 2013 to December 2014 at Zhongnan Hospital of Wuhan University were enrolled and assigned into Crohn’s disease(CD)group and ulcerative colitis(UC)group. Seventy healthy subjects were served as controls(HC). Expressions of IL-8 mRNA and CXCR2 mRNA in peripheral blood and intestinal mucosal tissue were determined by real-time PCR;expression of CXCR2 protein in intestinal mucosal tissue was determined by Western blotting. Results:In peripheral blood,expression of IL-8 mRNA in UC group was significantly higher than that in HC group(P = 0. 017),while expressions of CXCR2 mRNA in CD,UC and HC groups were not significantly different (P = 0. 285). In intestinal mucosal tissue,expressions of IL-8 mRNA in CD,UC and HC groups showed no significant difference(P = 0. 206),while expressions of CXCR2 mRNA in CD and UC groups were significantly higher than that in HC group(P = 0. 002;P < 0. 001),and expression of CXCR2 mRNA in UC group was significantly higher than that in CD group(P = 0. 005);expressions of CXCR2 protein in UC and CD groups were higher than that in HC group(P = 0. 049 P =0. 080). Conclusions:Expressions of CXCR2 mRNA and protein in intestinal mucosal tissue of patients with IBD, especially UC are significantly increased. Down regulation of CXCR2 expression in intestinal mucosa may provide a new target for treatment of UC. IL-8 is significantly highly expressed in peripheral blood of patients with UC,which suggests that IL-8 might be related mainly with UC.

Asiaticoside attenuates bleomycin-induced interstitial pulmonary fibrosis / 中国药理学与毒理学杂志

OBJECTIVE To study the therapeutic effect and the underlying mechanism of asiatico?side on bleomycin-induced rat interstitial pulmonary fibrosis(IPF). METHODS Male Sprague-Dawley (SD)rats were divided into normal control group,bleomycin 5 mg·kg-1 model group and asiaticoside 50 mg · kg-1 group. The model and asiaticoside group were administrated with bleomycin 5 mg · kg-1 to induce IPF,while the asiaticoside group was administrated with asiaticoside 50 mg·kg-1 by gastric perfusion. Hematein eosin(HE)and Masson staining were carried out to analyze the histopathological changes in the lung. Lung homogenates were used to examine hydroxyproline(HYP) content,and serum samples were used to measure the concentration of interferon-γ(IFN-γ),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α). In addition,immunohistochemical methods were used to locate lung transforming growth factor-β1(TGF-β1)and adenosine 2A receptor(A2AR)expression,and Western blotting was used to examine the expression levels of TGF-β1 and A2AR. RESULTS On the 7th,14th and 28th days,the scores of pulmonary inflammation were higher in model group than in control group (P<0.01),and the asiaticoside group showed mitigated alveolitis(P<0.01,P<0.05) compared with model group. Compared with control group,the scores of pulmonary fibrosis in model group were elevated(P<0.01),and the asiaticoside group showed reduced pulmonary fibrosis(P<0.05). On the 14th and 28th days,HYP content in the model group〔1.85±0.10,(2.48±0.18)mg·g-1〕was higher than in the control group〔0.79 ± 0.07,(0.84 ± 0.08)mg · g-1〕(P<0.01),but HYP content in the asiaticoside group〔1.32±0.131,(1.71±0.13)mg·g-1〕was lower than in the model group(P<0.05). IL-4 and TNF-αin the asiaticoside group were lower than in model group(P<0.05),but were higher in the model group than in the control group(P<0.01,P<0.05). The expression level of TGF-β1 protein in the asiaticoside group was lower than in the model group(P<0.05),but was higher in the model group than in the control group(P<0.05). The expression level of A2AR protein in the asiaticoside group was higher than in the model group(P<0.05),but was lower in the model group than in the control group(P<0.05). CONCLUSION Asiaticoside can mitigate bleomycin-induced IPF by inhibiting the expression of IL-4, TNF-αand TGF-β1,and raising the level of A2AR.