Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

Objective To analyze and evaluate the characteristics of enzyme kinetics of CTX-M-14 type extended-spectrum β-lactamase(ESBL) with Pro167 residue substitution. Methods By molecular cloning and PCR techniques, CTX-M-14 gene was directionally cloned into plasmid pET28a( + ) from a clinical E. coli isolate and formed an expression vector to transform competent E. coli BL21 (DE3 ). Prol67 residue substitutions of P167G, P167Q, P167S and P167T were introduced to CTX-M-14 by site-directed muta-genesis based on overlap extension PCR with the former recombinant plasmid as PCR template, respectively.The wild-type CTX-M-14, recombinant CTX-M-14 protein and its variants were expressed and purified, then their steady-state kinetic parameters (Kcat, Km and Kcat/Km ) against β-lactam antibiotics were determined.Results The kinetic parameters of wild-type and recombinant CTX-M-14 had no statistically significant differences (P>0.1). The 1/Km, Kcat and Kcat/Km values of P167S variant against ceftazidime were 16-fold, 2.87-fold and 43.6-fold higher than those of recombinant CTX-M-14, respectively, and the Kcat/Km value of P167S variant against penicillin, ampicillin, cefazolin, cefuroxime, ceftriaxone, cefotaxime decreased( < 0.05). Compared with the kinetic parameters of recombinant CTX-M-14, the kinetic parameters of P167T variant against ceftazidime had no significant change, but the Kcat values of P167Q and P167G variants decreased dramatically(P<0.01). Conclusion There was no difference between the enzyme activities of wild-type and recombinant CTX-M-14. P167S variant could not only promote the enzyme affinity of CTX-M-14 to ceftazidime but also improve the conversion rate of enzyme-substrate complex in the ceftazidime hydrolysis. The comparison of the kinetic parameters of CTX-M-14 and its variants with Pro167 residue substitution showed that the increased activity of CTX-M ESBL variants against ceftazidime could not be simply explained with the enlarged cavity in active site that may be caused by the replacement of Pro167 residue by smaller amino acids.

Objective To explore the relationship between blood pressure parameters and cognitive impairment in elderly people.Methods 890 retired workes of Kailuan Coal Mine were surveyed with questionnaires.The cognitive function was evaluated by mini-mental state examination(MMSE).222 cognitive impairment patients were categorized as case group,668 healthy subjects served as control group.Blood pressure and the related indexs were determined.Results The systolic blood pressure(SBP),pulse pressure(PP)and pulse pressure index(PPI)in the case group were higher than control group(all P

The level of serum high-sensitivity C-reactive protein (hsCRP) in the population with new-onset diabetes was detected and its influential factors were analyzed.The concentrations of hsCRP increased with age in the population with new-onset diabetes( Ptrend＜0.01 ).The percentage of subjects with hsCRP levels ＞3 mg/L was 18.8％in men and 26.7％ in women.A logistic regression analysis indicated that age,gender,body mass index,waist circumference,fasting plasma glucose,and triglyceride were the influential factors of hsCRP levels in diabetic population( P＜0.05 or P＜0.01 ).A variety of cardiovascular factors affected hsCRP level and a strong association existed between hsCRP and abdominal obesity.

OBJECTIVETo study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells.

METHODSPig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBα protein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium.

RESULTSPalmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73∓0.61 vs 1.25∓0.90, P<0.05; 5.79∓0.05 vs 4.07∓0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070∓3.907 vs 29.390∓1.072, P<0.05), while IκBα protein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04∓0.22 vs 3.98∓0.18, P<0.05). Palmitate treatment significantly elevated TNF-α (2.52∓0.30 vs 1.38∓0.26, P<0.05) and IL-6 (IL-6: 3.28∓0.32 vs 1.44∓0.28, P<0.05) concentrations in the cell culture medium.

CONCLUSIONPalmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.

Animals ; Blotting, Western ; Endothelial Cells ; drug effects ; metabolism ; I-kappa B Proteins ; metabolism ; Interleukin-6 ; metabolism ; NF-KappaB Inhibitor alpha ; Palmitates ; pharmacology ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Swine ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To investigate the correlation between wholeGorgan MRI score (WORMS)and pain in patients with knee osteoarthritis (OA).Methods 1 1 9 patients with knee OA were enrolled,and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)was used to estimate the pain.Knees of all the subj ects underwent scanning with sagittal,coronal,transverse TSEG T2 WIGFS and sagittal 3DGFLASHGWE sequences at 3.0T MR.The pathological changes of knee cartilage lesions,subarticular bone marrow edema (BME),bone cysts,bone attrition,osteophytes,meniscal inj ury,ligament inj ury,synovial thickening and joint effusion were evaluated according to the WORMS.The correlations between the above pathological changes and the pain were analyzed.Results There were significant and positive correlations between articular cartilage lesions and osteophytes,articular cartilage lesions and BME,BME and cyst,bone attrition and osteophytes,and BME and osteophytes,with the correlation coefficients of 0.6 70,0.5 9 8,0.5 1 8,0.5 1 4 and 0.505 ,respectively (P＜0.05 ).Multiple regression analysis showed that BME,bone attrition,synovial thickening and joint effusion were the main factors affecting the severity of pain after adj usted for age and BMI (P＜0.05).Conclusion The source of OA pain is multifactorial.The severity of BME,bone attrition,synovial thickening and joint effusion are the main factors associated with joint pain.As a nonGinvasive examination method,MR can make a comprehensive evaluation of the pathological changes of knee OA.

Objective To study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells. Methods Pig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBαprotein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium. Results Palmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73±0.61 vs 1.25±0.90, P<0.05;5.79±0.05 vs 4.07±0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070±3.907 vs 29.390±1.072, P<0.05), while IκBαprotein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04 ± 0.22 vs 3.98 ± 0.18, P<0.05). Palmitate treatment significantly elevated TNF-α(2.52 ± 0.30 vs 1.38 ± 0.26, P<0.05) and IL-6 (IL-6:3.28±0.32 vs 1.44±0.28, P<0.05) concentrations in the cell culture medium. Conclusion Palmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.

Objective To study the effect of palmitate on toll-like receptor 4 (TLR4) expression and signaling in vascular endothelial cells. Methods Pig iliac endothelial cells (PIECs) were incubated with palmitate. TLR4 gene expression levels were measured by quantitative real-time PCR, and TLR4 and IκBαprotein expressions by Western blotting. The expression levels of TLR4 protein on the surface of PIECs were quantified using flow cytometry. ELISA was employed to detect tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations in the cell medium. Results Palmitate treatment significantly increased TLR4 mRNA and protein expression levels in PIECs compared with those in the control cells (4.73±0.61 vs 1.25±0.90, P<0.05;5.79±0.05 vs 4.07±0.31, P<0.05). The expression levels of TLR4 on the cell surface significantly increased (38.070±3.907 vs 29.390±1.072, P<0.05), while IκBαprotein level was significantly lowered in PIECs after palmitate treatment as compared with those in the control cells (2.04 ± 0.22 vs 3.98 ± 0.18, P<0.05). Palmitate treatment significantly elevated TNF-α(2.52 ± 0.30 vs 1.38 ± 0.26, P<0.05) and IL-6 (IL-6:3.28±0.32 vs 1.44±0.28, P<0.05) concentrations in the cell culture medium. Conclusion Palmitate can enhance TLR4 expression and signaling in porcine vascular endothelial cells.

Objective:To observe the healing morphology, macular microstructure and visual function of idiopathic macular hole (IMH) after pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) flap.Methods:Retrospective case study. From 2016 to 2018, 39 eyes of 39 patients with IMH diagnosed in Tianjin Eye Hospital were included in the study. Among them, there were 4 eyes in 4 males and 35 eyes in 35 females, with an average age of 64.56±7.2 years. BCVA, OCT, OCT angiography (OCTA) and MAIA microperimetry examination were performed in all patients. BCVA examination was performed with the international standard visual acuity chart, which was converted to logMAR visual acuity when recording. All patients underwent PPV combined with ILM flap covering and air tamponade. According to the characteristics of OCT images postoperatively, the eyes were divided into U-shaped closed group, V-shaped closed group, irregular closed group and flat closed group, with 26, 5, 7 and 1 eyes respectively. There was a significant difference in the minimum hole diameter ( F=5.118, P=0.005) and macular hole classification ( F=3.608, P=0.024). The shallow capillary layer (SCP) blood flow density in the U-shaped closure group was significantly higher than that in the V-shaped closure group, the irregular closure group and the flat closure group (t=2.079, 2.368; P=0.047, 0.025). At 1, 3, 6 months after the operation, the same equipment and methods were used for relevant examination. The blood flow density of BCVA, SCP, perimeter of foveal avascular zone (PERIM) and mean sensitivity (MS) were compared before and after operation. Independent sample t-test was used for quantitative data comparison between different groups, and χ2 test was used for counting data comparison. Results:Six months after operation, the logMAR of the eyes in the U-shaped closure group was -0.75±0.29 higher than that before operation, and was better than that in the V-shaped closure group, the irregular closure group and the flat closure group ( t=-2.974, -2.518; P=0.006, 0.018). The integrity of external limiting membrane (ELM) and ellipsoid in U-shaped closed group was significantly higher than that in V-shaped closed group, irregular closed group and flat closed group ( χ2=15.229, 10.809; P=0.020, 0.013). The percentage of macular central fovea reflex mass in the U-shaped closed group was significantly lower than that in the V-shaped closed group, irregular closed group and flat closed group ( χ2=20.107, P=0.000). PERIM in U-shaped closure group was smaller than that in V-shaped closure group, irregular closure group and flat closure group, and the difference was statistically significant ( t=-3.391, -2.427; P=0.002, 0.022). The total MS of macular area 10° in the U-shaped closure group was significantly higher than that in the other V-shaped closure group, irregular closure group and flat closure group ( t=2.939, 2.811; P=0.001, 0.001). Conclusion:After IMH operation, the U-shaped closure showed better BCVA and macular light sensitivity, the proportion of ELM and ellipsoid to restore structural integrity are higher, PERIM is smaller, and there are fewer macular fovea strong reflex masses.