Effect of Guipitang on ERK1/2 and p38 MAPK in Rats with Myocardial Ischemia / 中国实验方剂学杂志

ObjectiveTo explore the therapeutic effect and mechanism of Guipitang on rats with myocardial ischemia. MethodFifty SD rats were divided into five groups： a control group， a model group， low and high-dose Guipitang （7.52， 15.04 g·kg-1） groups， and a trimetazidine group （0.002 g·kg-1）. By intragastric administration of vitamin D3 and feeding rats with high-fat forage and injecting isoproterenol， the rat model of myocardial ischemia was established. After drug treatment of 15 d， an electrocardiogram （ECG） was performed to analyze the degree of myocardial injury. A fully automatic biochemical analyzer was used to detect the changes in the serum levels of total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C）. Hematoxylin-eosin （HE） staining and Masson staining were used to observe myocardial histopathological changes. TdT-mediated dUTP nick end labeling （TUNEL） staining was used to detect cardiomyocyte apoptosis. Western blot was adopted to detect the protein levels of extracellular signal-regulated kinase 1/2 （ERK1/2）， phospho-ERK1/2 （p-ERK1/2）， p38 mitogen-activated protein kinase （p38 MAPK）， phospho-p38 MAPK （p-p38 MAPK）， B-cell lymphoma-2 （Bcl-2）-associated X （Bax）， Bcl-2， and cleaved cysteine aspartate proteolytic enzyme （cleaved Caspase-3）. ResultCompared with the control group， the ECG S-T segment decreased in the model group. The serum levels of TC， TG， and LDL-C were increased significantly （P<0.05）. The arrangement of myocardial tissue was disordered， and the proportion of cardiomyocyte apoptosis increased. The protein levels of cleaved Caspase-3， Bax， and p-p38 MAPK in the heart were increased， and the Bcl-2 expression was decreased （P<0.05）. Compared with the model group， the S-T segment downward shift was restored in the low and high-dose Guipitang groups and trimetazidine group， and the levels of TC， TG， and LDL-C were decreased. The protein expression of cleaved Caspase-3 and Bax in the heart dropped， and p-p38 MAPK and p-ERK1/2 protein expressions increased significantly （P<0.05）. The degree of myocardial injury was alleviated， and the proportion of cardiomyocyte apoptosis decreased. Bcl-2 protein expression was increased significantly in the low-dose Guipitang group （P<0.05）. ERK1/2 and p38 MAPK proteins had no significant difference among different groups. ConclusionGuipitang could alleviate myocardial injury and inhibit cardiomyocyte apoptosis in rats by activating the expression of ERK1/2 and p38 MAPK.

The Intrinsic Relation between the Hydrogel Structure and In Vivo Performance of Hyaluronic Acid Dermal Fillers: A Comparative Study of Four Typical Dermal Fillers

BACKGROUND@#Hyaluronic acid dermal fillers are composed of cross-linked viscoelastic particles with high biocompatibility. The performance of the fillers is determined by the viscoelastic properties of particles and the connecting force between particles. However, the relationships among the properties of fillers, the interaction of the gels and the surrounding tissue are not clear enough.METHOD: Four kinds of typical dermal filler were selected in this research to reveal the interaction between the gels and cells. A series of analytical tools was applied to characterize the structure and physicochemical properties of the gel, as well as observing their interaction with the surrounding tissues in vivo and discussing their internal mechanism.RESULT: The large particles internal the gel and the high rheological properties endow the Restylane2 with excellent support. However, these large-size particles have a significant impact on the metabolism of the local tissue surrounding the gel. Juvéderm3 present gel integrity with the high cohesiveness and superior support. The rational matching of large and small particles provides the Juvéderm3 with supporting capacity and excellent biological performance. Ifresh is characterized by small-size particles, moderate cohesiveness, good integrity, lower viscoelasticity and the superior cellular activity located the surrounding tissues. Cryohyaluron has high cohesion and medium particle size and it is prominent in cell behaviors involving localized tissues. Specific macroporous structure in the gel may facilitate the nutrients delivering and removing the waste. @*CONCLUSION@#It’s necessary to make the filler both sufficient support and biocompatibility through the rational matching of particle sizes and rheological properties. Gels with macroporous structured particle showed an advantage in this area by providing a space inside the particle.

Oblique intervertebral fusion for treatment of failed internal fixation of thoracolumbar fractures / 中华创伤骨科杂志

Objective:To investigate the clinical efficacy of oblique intervertebral fusion in the treatment of failed internal fixation of thoracolumbar fractures.Methods:A retrospective study was conducted to analyze the clinical data of 14 patients who had undergone revision surgery for failed internal fixation of thoracolumbar fracture at Department of Orthopedics, The First Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. There were 6 men and 8 women with a mean age of 47.5 (42.0, 54.3) years. Fracture segments: T 12 in 2 cases, L 1 in 3 cases, L 2 in 4 cases, L 3 in 3 cases, and L 4 in 2 cases; AO classification: type A in 1 case, type B in 7 cases, and type C in 6 cases. Their prior surgical method was posterior internal fixation with pedicle screws. The revision surgery consisted of subtotal vertebral resection through the oblique lateral approach, bone column reconstruction and lateral screw-rod internal fixation for intervertebral fusion after posterior internal fixation reset. The operation time, intraoperative bleeding, postoperative hospital stay, and incidence of complications were recorded. Compared were visual analogue scale (VAS) and Oswestry disability index (ODI) scores for low back pain at preoperation, 3 days and 3 months postoperation, and the last follow-up, fusion at the last follow-up, and Frankel grading for neurological function at preoperation and postoperation. Results:All the 14 patients underwent surgery successfully and were followed up for 23 (18, 24) months. The operation time was (175.1±28.2) min, the intraoperative bleeding (300.4±122.6) mL, and the postoperative hospital stay 6 (6, 7) d. One case developed postoperative transient hip flexion weakness but was discharged after restoration of normal muscle strength by conservative treatment. Both VAS and ODI scores for low back pain at all postoperative time points were significantly improved compared with the preoperative values ( P<0.05), with a significant trend of 3 days postoperation >3 months postoperation > the last follow-up ( P<0.05). In the 12 patients with preoperative neurological damage, the Frankel grading rose by at least 1 level postoperatively ( Z=-3.110, P=0.002). The last follow-up revealed no loosening or fracture of the internal fixation. Complete bony fusion was visible in all CT sagittal reconstructions. Conclusion:For patients with thoracolumbar fracture undergoing failed internal fixation, oblique intervertebral fusion is an alternative minimally invasive surgical treatment due to its satisfactory overall outcomes.

Effects of growth hormone replacement therapy on glucose and lipid metabolism in patients with hypopituitarism / 中华内分泌代谢杂志

Objective:To investigate the effect of growth hormone replacement therapy(GHRT) on glucose and lipid metabolism in patients with hypopituitarism.Methods:Clinical data of patients with hypopituitarism who received GHRT in Department of Endocrine and Metabolic Diseases, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2016 to February 2020 were retrospectively analyzed. The patients were divided into normal glucose regulation(NGR) group and impaired glucose regulation(IGR) group according to their glucose metabolism status before GHRT. The changes of the characteristics of glucose metabolism before and after GHRT were analyzed.Results:A total of 30 patients aged(23.0±5.2) years were included, 23 patients in NGR group and 7 patients in IGR group. After 12 months of GHRT, there were no significant changes in fasting plasma glucose(FPG), 2-hour postprandial plasma glucose(2hPG), and insulin sensitivity index(ISI) in both groups(all P>0.05), while homeostasis model assessment insulin resistance(HOMA-IR) in IGR group was significantly decreased compared with that before GHRT( P<0.05). None of the patients in NGR group progressed to IGR or diabetes mellitus, and none of the 7 patients in the IGR group progressed to diabetes mellitus, while 4 of them recovered from impaired glucose tolerance(IGT) to NGR. Triglyceride, total cholesterol, and low density lipoprotein-cholesterol levels were all significantly decreased in two groups(all P<0.05). Multivariate linear regression analysis showed that the increase of body mass index was an independent risk factor for the increase of FPG and 2hPG( P<0.05). Conclusion:12-month GHRT significantly improved their blood lipid profiles in patients with hypopituitarism without adversely affecting glucose homeostasis.

Series interpretation to Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020)(Part 1): Genetic causes of acromegaly / 中华内分泌代谢杂志

Acromegaly is a commonly functional pituitary tumor. Standardized managements are crucial for the patients. Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has been updated in 2020 based upon latest advance. This essential introduction about genetic causes would further guide and standardize the management of acromegaly.

A clinical study of 24-hour pumping of continuous feeding in very low birth weight infants / 中华实用儿科临床杂志

Objective:To investigate the effect of 24-hour continuous feeding by pump on gastrointestinal dysfunction and early growth of very low birth weight infants (VLBWI).Methods:Eighty VLBWI fed by tube in the Neonatal Intensive Care Unit (NICU) of Fuyang Women and Children′s Hospital, Anhui Province from January 2017 to June 2019, were retrospectively analyzed.They were randomly divided into the observation group and the control group according to the simple randomization method, 40 cases in each group.The observation group included 23 males and 17 females, with the gestational age of 28 + 2-33 + 5 weeks, and birth weight of 1.04-1.47 kg.The control group included 21 males and 19 females, with the gestational age of 28 + 1-33 + 5 weeks, and birth weight of 1.05 -1.47 kg.On the basis of giving both groups routine treatment, nursing, and non-nutritional sucking, the control group was treated with intermittent tube feeding and infusion of formula milk, while the observation group was microfed 24 h continuously by pump.The general situation, meconium discharge time, frequency of daily defecation, daily milk volume, gastrointestinal dysfunction, increase of body weight after birth, and neonatal behavioral neurological assessment (NBNA) at 40 weeks of gestational age were compared between the two groups.The increase of body mass after birth and the determination of neonatal behavioral neurological assessment (NBNA) in neonatal behavioral nerve at 40 weeks of gestational age were statistically analyzed by χ2 test and t test. Results:(1)There were no significant differences in sex, gestational age, birth weight, head circumference and body length between the 2 groups (all P>0.05). (2) Compared with the control group, the premature infants in the observation group had increased daily milk volume [(12.95±2.34) g/d vs.(10.08±2.08) g/d], shortened meconium discharge time [(3.90±0.84) d vs.(5.02±0.86) d], and higher frequency of daily defecation[(3.85±1.07) times/d vs.(3.00±0.81) times/d], shortened extubation time[(14.75±3.20) d vs.(16.80±3.08) d], shortened time of weight to loss to minimum[(3.38±0.86) d vs.(4.22±0.89) d], faster growth of the daily average body weight[(15.25±2.29) g/(kg·d) vs.(11.55±1.56) g/(kg·d)], shortened average hospitalization time [(35.58±8.29) d vs.(39.42±8.29) d], and faster increase of the head circumference[(35.23±2.40) cm vs.(33.74±1.63) cm]. The differences were statistically significant ( t=5.805, -5.907, 3.981, -2.918, -2.825, 3.890, -2.060, 3.233, all P<0.05). (3)The incidence of vomiting, abdominal distension, hypoglycemia and hyperbilirubinemia in the observation group was significantly lower than that in the control group ( χ2=5.000, 16.050, 5.165, 14.528, all P<0.05). (4) There was no significant difference in necrotizing enterocolitis (NEC) and dyspnea between the two groups ( χ2=1.438, 10.251, all P>0.05). The total scores of behavioral ability, passive muscle tension, active muscle tension, primitive reflex, general evaluation and NBNA in the observation group were higher than those in the control group, the difference was statistically significant ( t=5.026, 3.207, 3.000, 2.421, 3.150, 6.141, all P<0.05). Conclusions:Twenty-four-hour continuous feeding by pump combined with non-nutritious sucking can significantly reduce the occurrence of gastrointestinal dysfunction in VLBWI, promote the development and maturation of gastrointestinal function, improve the nutritional status, accelerate the physical growth, and thus facilitate the development of behavioral nerve.

A novel tissue engineering complex——BMSCs Sheet-RADA16 scaffold constructed by cell sheet and self-assembled peptides technique / 实用口腔医学杂志

Objective: To construct a novel tissue engineering complex, BMSCs sheet-RADA16 scaffold, by combining cell sheet and self-assembled peptides.. Methods: The self-assembled peptide RADA16 scaffold was wrapped with the BMSCs cell sheet. The morphology of the cells and the complex were observed by SEM and confocal laser microscopy, and the proliferation of cells was assessed by CCK-8. The osteogenic differentiation of BMSCs was examined by detection of related gene expression with RT-PCR. Results: Compared with the BMSCs cell sheet, the numbers of cells on RADA16 scaffold growth rapidly at 3 rd-8 th day, and BMSCs were more on the scaffold than those on the cell sheet (P＜0. 05) . RT-PCR results showed that the expression level of osteogenesis-related genes was higher in the complex (P＜0. 05) . Conclusion: BMSCs Sheet-RADA16 Scaffold may promote proliferation and osteogenic differentiation of BMSCs.

Incidence of cognitive impairment and risk factors associated with prognosis in maintenance hemodialysis patients / 中华肾脏病杂志

Objective@#To investigate the incidence and prognosis of cognitive impairment and to find out the risk factors associated with the outcome for better understanding and preventing cognitive impairment in maintenance hemodialysis (MHD) patients.@*Methods@#The patients who met the criteria as below: MHD patients (≥3 months) in Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2000 to July 2014, ≥18 years old were enrolled and could carry on the montreal cognitive assessment (MoCA) of voluntary cooperation. According to the score of MoCA, all enrolled patients were divided into two groups: cognitive impairment (MoCA<26) group and non-cognitive impairment (MoCA≥26) group. The follow-up period was 3 years. There were 130 males, and the incidence, demography data, medical history, hemodialysis data, laboratory examination and prognosis of cognitive impairment in hemodialysis patients were prospectively compared and analyzed. Logistic regression analysis was used to investigate the risk factors of cognitive impairment. Kaplan-Meier survival curve and Cox regression model were used for prognostic analysis.@*Results@#A total of 219 MHD patients were enrolled. The incidence of cognitive impairment in MHD patients was 51.6%. There were 130 males, and the ratio of male to female was 1.46∶1. Age was (60.07±12.44) years old and dialysis vintage was (100.79±70.23) months. Compared with non-cognitive impairment group (n=106), patients in cognitive impairment group (n=113) were older, and had higher proportion of education status<12 years, history of diabetes and anuria (all P<0.05); however, the post-dialysis systolic pressure, pre-dialysis diastolic pressure, post-dialysis diastolic pressure, platelet and spKt/V were lower (all P<0.05). Multivariate logistic regression analysis showed that education status<12 years (OR=3.428, 95%CI 1.919-6.125, P<0.001), post-dialysis diastolic pressure<73 mmHg (OR=2.234, 95%CI 1.253-3.984, P=0.006) and spKt/V<1.72(OR=1.982, 95%CI 1.102-3.564, P=0.022) were the independent risk factors for cognitive impairment in MHD patients. The Kaplan-Meier survival curve analysis showed that the survival rate of patients with cognitive impairment was lower than that of non-cognitive impairment group in MHD patients during 3 years follow-up (χ2=3.977, P=0.046). Multivariate Cox regression analysis showed that cognitive impairment was an independent risk factor for death in MHD patients (RR=2.661, 95%CI 0.967-7.321, P=0.058).@*Conclusions@#Cognitive impairment is one of the common complications and an independent risk factor for death in MHD patients. The mortality is high in patients who suffer cognitive impairment. Education status<12 years, post-dialysis diastolic pressure<73 mmHg and spKt/V<1.72 are the independent risk factors for cognitive impairment in MHD patients.

Incidence of cognitive impairment and risk factors associated with prognosis in maintenance hemodialysis patients / 中华肾脏病杂志

Objective To investigate the incidence and prognosis of cognitive impairment and to find out the risk factors associated with the outcome for better understanding and preventing cognitive impairment in maintenance hemodialysis (MHD) patients. Methods The patients who met the criteria as below: MHD patients (≥3 months) in Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2000 to July 2014, ≥18 years old were enrolled and could carry on the montreal cognitive assessment (MoCA) of voluntary cooperation. According to the score of MoCA, all enrolled patients were divided into two groups: cognitive impairment (MoCA<26) group and non-cognitive impairment (MoCA≥26) group. The follow-up period was 3 years. There were 130 males, and the incidence, demography data, medical history, hemodialysis data, laboratory examination and prognosis of cognitive impairment in hemodialysis patients were prospectively compared and analyzed. Logistic regression analysis was used to investigate the risk factors of cognitive impairment. Kaplan-Meier survival curve and Cox regression model were used for prognostic analysis. Results A total of 219 MHD patients were enrolled. The incidence of cognitive impairment in MHD patients was 51.6％. There were 130 males, and the ratio of male to female was 1.46:1. Age was (60.07 ± 12.44) years old and dialysis vintage was (100.79 ± 70.23) months. Compared with non-cognitive impairment group (n=106), patients in cognitive impairment group (n=113) were older, and had higher proportion of education status<12 years, history of diabetes and anuria (all P<0.05); however, the post-dialysis systolic pressure, pre-dialysis diastolic pressure, post-dialysis diastolic pressure, platelet and spKt/V were lower (all P<0.05). Multivariate logistic regression analysis showed that education status<12 years (OR=3.428, 95％CI 1.919-6.125, P<0.001), post-dialysis diastolic pressure<73 mmHg (OR=2.234, 95％CI 1.253-3.984, P=0.006) and spKt/V<1.72(OR=1.982, 95％CI 1.102-3.564, P=0.022) were the independent risk factors for cognitive impairment in MHD patients. The Kaplan-Meier survival curve analysis showed that the survival rate of patients with cognitive impairment was lower than that of non-cognitive impairment group in MHD patients during 3 years follow-up (χ2=3.977, P=0.046). Multivariate Cox regression analysis showed that cognitive impairment was an independent risk factor for death in MHD patients (RR=2.661, 95％CI 0.967-7.321, P=0.058). Conclusions Cognitive impairment is one of the common complications and an independent risk factor for death in MHD patients. The mortality is high in patients who suffer cognitive impairment. Education status<12 years, post-dialysis diastolic pressure<73 mmHg and spKt/V<1.72 are the independent risk factors for cognitive impairment in MHD patients.

Co-expression of p53 and EGFR in colorectal cancer detected by quantum dots fluorescence probe / 国际检验医学杂志

Objective Simultaneous detection of two tumor markers p53 and EGFR in colorectal cancer samples.Methods Co-expression of p53 and EGFR in colorectal cancer detected by QDs fluorescence probe. TNM staging,grade and other factors were analyzed.Results The strong positive rate of p53 in colorectal cancer was 48.6%.It was significantly correlated with the N staging(P<0.05),the positive rate of EGFR and p53 in colorectal carcinoma was 67.1%.It was significantly correlated with the N staging(P<0.05),and was independent of other factors(P>0.05).Conclusion The method of QDs is helpful to quantitative analy-sis of co expression of p53 and EGFR in colorectal cancer,and it can provide the basis for clinical prognosis of colorectal cancer.

Clinical analysis of bilateral macronodular adrenal hyperplasia / 中华内分泌代谢杂志

Objective To investigate the clinical characteristics in patients with bilateral macronodular adrenal hyperplasia ( BMAH). Methods We enrolled 357 patients with adrenal tumors including 42 BMAH, 167 cortisol-producing adrenal adenoma (CPA), and 148 non-functional adenomas (NFA). The clinical manifestations, hormonal explorations and complications were compared among groups. Results (1) Age at diagnosis of BMAH group was significantly higher than that of CPA group [(53.7±8.3 vs 41.1±13.1)years], female proportion of BMAH group was lower that that of CPA group(54.8%vs 88.0%, P＜0.01). Both were similar to NFA group. (2) Compared to NFA group, metabolic abnormalities were severer in BMAH and CPA groups. Prevalence of hypertension, diabetes mellitus, and hypokalemia were the highest in BMAH group. ( 3) BMAH patients had lower midnight serum cortisol, 24 hour urine free cortisol, and adrenocorticotrophic hormone levels than CPA patients (P＝0.008, 0.010, and P＝0.001, respectively). The suppression rate of serum cortisol after low-dose dexamethasone suppression test was significantly higher in BMAH group ( P＝ 0. 005). Conclusion BMAH patients were at higher age at diagnosis. Although hypercortisolism in BMAH patients is relatively slight, metabolic abnormalities are more severe. Besides functional diagnosis, physicians should pay more attention to the assessment of complications related to hypercortisolism.

The clinical analysis of severe adrenal Cushing′s syndrome / 中华内分泌代谢杂志

Objective To investigate the methods and efficacy of treatment on severe adrenal Cushing′s syndrome. Methods The clinical data of 22 cases with severe adrenal Cushing′s syndrome ( severe group) , and 136 cases with mild or moderate adrenal Cushing′s syndrome ( non-severe group) were reviewed. The clinical features were analyzed by comparing the differences between these two groups when patients were admitted to hospital. We discussed the clinical managements of patients with severe adrenal Cushing′s syndrome by comparing the differences with non-severe group after preoperative preparation, and with themselves before and after preoperative preparation. The effects of surgery were evaluated by comparing the differences between pre-operation and post-operation on patients with severe adrenal Cushing′s syndrome. Results At admission, serum/urine cortisol, disease course, and blood pressure were significantly higher in the severe group than those in non-severe group ( P＜0.05 or P＜0.01) , serum potassium and ACTH level were decreased significantly in the severe group than those innon-severegroup[(3.01±0.75vs3.62±0.48)mmol/L,P＜0.01;(6.47±2.91vs8.21±3.22)pg/ml,P＜0.01] . However, no significant difference was observed in diastolic blood pressure, serum potassium, and fasting plasma glucose between these two groups after preoperative preparation (all P＞0.05). And then, we performed adrenalectomy. The symptoms of 22 cases with severe adrenal Cushing′s syndrome were obviously alleviated after 3 months. During follow-up, 5 cases of primary bilateral macronodular adrenal hyperplasia ( BMAH) and 1 case of primary pigmented nodular adrenocortical disease ( PPNAD ) were treated with contralateral adrenalectomy. Conclusion Sufficient preoperative preparation is essential for patients with severe adrenal Cushing′s syndrome because of its high level serum cortisol with severe complications. If preparation fails before surgery, cortisol-lowering medication or emergency unilateral adrenalectomy is necessary. Severe patients with BMAH and PPNAD were firstly performed unilateral adrenalectomy and followed-up closely, and then, contralateral adrenalectomy is needed when the recurrence of hypercortisolism recognized.

Efficacy and safety of spironolactone in mono-therapy versus low dose spironolactone in combined-therapy for the treatment of idiopathic hyperaldosteronism / 中华内分泌代谢杂志

Objective The aim of this study was to compare the efficacy and safety of spironolactone in mono-therapy versus low dose spironolactone in combined-therapy for the treatment of idiopathic hyperaldosteronism (IHA). Methods This was a prospective and randomized study. After 2 weeks wash out period, 48 patients confirmed IHA were assigned to either spironolactone mono-therapy or low dose spironolactone combined-therapy groups. All patients underwent adrenal venous sampling and showed no lateralization. The primary outcome was the percentage of patients with blood pressure<140/90 mmHg(1 mmHg＝0.133 kPa) at 16 weeks. The other observatory parameters were: the occurrence of gynecomastia, renal insufficiency, and hyperkalemia. Results At the end of 16 weeks, the patients′blood pressure were normalized in 17 out of 24 patients(70.8%) in mono-therapy group and in 23 out of 24 patients ( 95. 8%) in combined-therapy group ( P<0. 05). There was no hyperkalemia in both groups. 2 patients and 5 patients in mono-therapy group were observed renal insufficiency and gynecomastia respectively, while no patients in combined-therapy group presented with those side effects. Conclusion Low dose spironolactone combined-therapy group is more effective to control blood pressure and hypokalemia without increase the occurrence of renal insufficiency or gynecomastia.

Influence of trimetazidine on cardiac function, plasma levels of BNP and Hcy in patients with congestive heart failure / 心血管康复医学杂志

Objective: To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide (BNP) and homocysteine (Hcy) in patients with congestive heart failure (CHF) and its therapeutic effect.Methods: A total of 120 patients diagnosed as CHF in our department were selected.According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment group, 20mg/time, twice/d), both groups were treated for six months.Left ventricular relaxation time (LVRT), E peak decrease time (EDT), early diastolic peak velocity/late diastolic peak velocity (E/A), left atrial diameter (LAD), levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, BNP and Hcy were measured and compared between two groups before and after treatment.Results: After six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group (93.3% vs.80.0%, P=0.032);compared with routine treatment group after treatment, there were significant reductions in LVRT [(92.1±4.6)ms vs.(74.5±2.7)ms], EDT [(165.3±5.1)ms vs.(139.2±3.9)ms] and LAD [(41.1±2.6)mm vs.(33.1±1.8)mm], and significant rise in E/A [(0.89±0.21) vs.(1.16±0.51)] (P<0.01 all);and significant reductions in serum levels of IL-6 [(16.3±2.8) ng/ml vs.(11.3±1.3) ng/ml], TNF-α [(3.17±0.99) ng/ml vs.(2.01±1.12) ng/ml], BNP [(311.4±27.9)pg/ml vs.(278.2±31.3) pg/ml] and Hcy [(15.6±4.2) pg/ml vs.(11.3±2.7) pg/ml] in trimetazidine group, P<0.01 all.Conclusion: Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.

Hormonal and radiographic features of primary empty sella / 中华内分泌代谢杂志

Clinical data of 116 cases diagnosed as primary empty sella (PES) from 2012 to 2016 in the Department of Endocrine and Metabolic Diseases, Ruijin Hospital were analyzed in this study. Insulin-induced hypoglycemia test and magnetic resonance imaging (MRI) were applied to explore the predictive factors of hypopituitarism in patients with PES. The results showed that 43 (37. 07%) patients with PES were with hypopituitarism. Pituitary height<2. 35 mm and pituitary sagittal area<23. 5 mm2indicated a high risk of hypopituitarism in patients with PES.

Effects of low-dose of TGF-β1 on maintaining bovine corneal stromal cell growth and retarding extra cellular matrix fibrosis in a three-dimensional culture model / 中华实验眼科杂志

Background Transforming growth factor-β1(TGF-β1) plays an important role in corneal woundhealing.The effects of TGF-β1 on the synthesis of extra cellular matrix (ECM) vary upon different concentrations.Previous studies focused on the effects of high concentration of TGF-β1 on keratocytes under the two-dimensional culture condition,and the effect of low concentration of TGF-β1 on the synthesis of ECM in keratocytes remains unclear.Objective This study was to investigate the growth of Pellet,a three-dimensional model of corneal stroma cells in vitro,and its ECM synthesis under a low concentration of TGF-β1.Methods Bovine corneal stromal cells were isolated from fresh bovine eyeballs by two-step digestion by collagenase and cultured using DMEM/F12 medium with 10％ fetal bovine serum (FBS).Pellets derived fresh bovine keratocytes with culture medium containing 0.25 ng/ml TGF-β1 +5％ FBS and 0.50 ng/ml TGF-β1 +5％ FBS were established,respectively.The morphology of Pellets was observed under the natural light at 48 hours,1 week,2 weeks and 3 weeks after culture.In 3 weeks after culture,the cell structures was observed by hematoxylin-eosin staining,and Calcein-AM/propidium (Calcein-AM/PI) staining was used to assay the cell viability.Real-time flurorescence quantitative PCR and immunofluorescence technology were applied to analyze the expressions of α-smooth muscle actin (α-SMA),fibronectin (FN),type Ⅰ collagen (Col Ⅰ) and type Ⅲ collagen (Col Ⅲ) mRNA and proteins.RT-PCR was employed to detect the expressions of lumican (LUM) mRNA and keratocan (KERA) mRNA in the cells.Results Cells in Pellet clustered throughout the culture duration.Hematoxylin-eosin staining showed the mass red-dyed collagen fibers in both 0.25 ng/ml TGF-β1 +5％ FBS group and 0.50 ng/ml TGF-β1 +5％ FBS group,and most cells possessed complete structures.The death rate of the cells was (33.60±1.65)％ in the 0.25 ng/ml TGF-β1 +5％ FBS group and (30.90±0.78) ％ in the 0.50 ng/ml TGF-β1 +5％ FBS group,showing an insignificant difference between them (t =0.144,P=0.887).The expressions of α-SMA,FN and Col Ⅲ proteins in 0.25 ng/ml TGF-β1 +5％ FBS group were lower than those in the 0.50 ng/ml TGF-β1 + 5 ％ FBS group (tα-SMA =4.622,P =0.010;tFN =2.973,P =0.040;tCol Ⅲ =7.845,P＜0.001),but the expression of Col Ⅰ in 0.25 ng/ml TGF-β1 +5％ FBS group was higher than that in 0.50 ng/ml TGF-β1+5％ FBS group (tColⅠ =4.022,P=0.016).The ratio of Col Ⅲ/Col Ⅰ in 0.25 ng/ml TGF-β1+5％ FBS group was lower than that in the 0.50 ng/ml TGF-β1 +5％ FBS group in both mRNA and protein level (tmRNA =-3.039,P =0.038;tprotein =3.215,P =0.032).The expression of LUM mRNA and KERA mRNA were detected in Pellet at different time points.The expression of LUM mRNA in 0.25 ng/ml TGF-β1 +5％ FBS group increased over time.While in 0.50 ng/ml TGF-β1 +5％ FBS group,the expression of LUM mRNA peaked at 1 week but declined at 2 weeks.The expression of KERA mRNA in two groups were all peaked at 1 week but declined at 2 weeks.Conclusions Low-dose TGF-β1 in Pellet can maintain the normal growth of keratocytes and synthesize ECM.The expression of ECM tends to the normal condition after reducing the concentration of TGF-β1,implying a scarless expression.

Construction and preliminary functional study of heterologous expression system of TRPV1 channel / 中国药理学通报

Aim The TRPV1 plasmid was transiently transfected into human embryonic kidney HEK 293T cells to establish the heterologous expression system of TRPV1-channel. Methods The transfection efficiency was confirmed under fluorescence mi-croscope and the TRPV1 protein expression was identified by u-sing Western blot, and the functional characteristics of the chan-nel were studied by using the method of confocal microscopy. Results The transfection rate could reach 40% ~50%; the transfected cells were found to have a clear band at the corre-sponding position that TRPV1 should be, which indicated that TRPV1 channel protein was expressed in the transfected cells. The confocal microscopy imaging result showed that the trans-fected HEK 293T cells were activated by TRPV1 channel ago-nist. Conclusion Transient transfection of HEK 293T cells with TRPV1 channel is successfully constructed and the heterol-ogous TRPV1 channel is verified to have normal calcium-media-ting function.

Evaluation of regulational function of ingredients from hot herbs on TRPV1 channel based on 7900 PCR instrument / 中国药理学通报

Aim To further study the molecular mecha-nism of the herbs with hot nature on the regulational action on TRPV1 channel based on the 7900 Real-time PCR instrument. Methods 7900 PCR instrument was applied to detect the intracellular flurescence of TRPV1 channel in the dorsal root ganglions ( DRG ) neurons and the effect on the TRPV1 ’ s thermo-sensational functions of the selected 11 ingredients from hot herbs was explored. Results TRPV1 channels could be ac-tivated by gradually elevated temperature; the activa-tion process could be blocked by the TRPV1 specific blocking agent capsaizepine. Most of the ingredients from hot-nature herbs had the potential to up-regualate TRPV1 channel function. Conclusions The estab-lished TRPV1 channel detection system based on PCR instrument is suitable for the analysis of regulational functions of drugs on the heat-activated TRPV1 chan-nel;the functions of hot herbs may be related to the up-regualtional effects of its active ingredients on the TRPV1 channel which will further up-regulate energy metabolism.

Clinical efficacy and complications of transoral endoscopic peroral endoscopic myotomy for achalasia / 中国内镜杂志

Objective To explore the clinical efficacy and complications of transoral endoscopic peroral endo﹣scopic myotomy (POEM) for achalasia (AC). Methods 38 patients with AC received POEM treatment from January 2013 to January 2013 in our digestive endoscopy center. Procedure-related complications and gastroesophageal re﹣flux were observed, and ECKARDT score and the lower esophageal sphincter pressure changes were analysed. Results All patients underwent POEM successfully. No serious POEM-related complications were observed, bleed﹣ing, gas related complications were treated successfully by conservative treatment. Postoperative follow-up time was 10.4 months (range 9 to 12 months), the symptoms of all the patients were alleviated, ECKARDT score average from preoperative 8.7 points dropped to postoperative 1.2 points (P<0.01), esophageal sphincter pressure decreased sig﹣nificantly, mean pressure dropped from preoperative (33.40 ± 11.80) mmHg to postoperative (13.50 ± 4.30) mmHg (P< 0.01) and gas related complications occurred in 6 cases (15.78 %), esophageal reflux occurred rate total was 23.68%(9/38). Conclusion POEM is safe and effective for the treatment of AC, and has better long-term effect.

Diagnosis and treatment of Cushing's syndrome caused by bilateral solitary adrenal neoplasma / 中华内分泌代谢杂志

_ Objective_ To evaluate the efficacy of unilateral subtotal adrenalectomy in the treatment of bilateral adrenal solitary neoplasma causing Cushing's syndrome and to elaborate the therapeutic principle. Methods From 2007 to 2013, a total of ten patients were diagnosed with Cushing's syndrome caused by bilateral solitary adrenal neoplasma. We compared patients'clinical symptoms, hormone profiles, biochemical and metabolic parameters, and imaging data before and after the surgery. Five of them chose the optimal neoplasma based on the lateralization ratio of adrenal venous sampling result and the other 5 patients chose the optimal neoplasma based on the diameter of the mass reflected by the computed tomography result and were then operated. Results After the unilateral subtotal adrenalectomy,the24-hour urinary free cortisol decreased significantly(P<0.05)and the midnight serum cortisol level also significantly reduced(P<0. 01). Plasma adrenocorticotropic hormone level increased significantly(P<0. 01). Nine patients of them did not need contralateral adrenalectomy and one patient received contralateral adrelectomy because of the remnant of Cushingnoid symptoms. Conclusion Unilateral subtotal adrenalectomy is an effective and safe way to treat Cushing's syndrome caused by bilateral solitary neoplasma.