Objective To explore the effects of physiological ischemia training (PIT) on the function of endothelial progenitor cells.Methods Eighteen male New Zealand rabbits (2.5 ± 0.5) kg were divided into 3 groups:a sham operation (SO) group,a myocardial ischemia (MI) group and a MI ± physiological ischemia training (MI ± PIT) group.The PIT was modeled by ischemic isometric contraction of gastrocnemius muscle induced by electric stimulation (40 Hz,1 ms,40％ maximum current strength),and the MI was modeled by implantation of a water balloon to occlude the left ventrical branch of the heart.The experiment was conducted for 4 weeks.Before and after the experiments,the ability of mobilization and adhesion of endothelial progenitor cells were detected,the number and the capillary density were counted.Results Post-experiment,compared with groups SO and MI,PIT group significantly improved the ability of mobilization (151 ± 16 cells/HPF,P ＜ 0.01) and adhesion (17.8 ± 2.8 cells/ HPF,P ＜ 0.05),increased the circulating amount (P ＜ 0.05) and capillary density (824.0 ± 106.6 /mm2,P ＜ 0.05).Pearson analyze showed that there was positive correlation between circulating EPCs and capillary density.Conclusion Physiological ischemia training could improve EPCs mobilization and function,resulted to neovascularization in the ischemic heart tissues.

Objective To study the feature of brain functional in front gyrus,anterior cingulate cortex and hippocampus of patients with generalized anxiety disorder (GAD).Methods 19 patients with GAD and 20 healthy volunteers were scanned on brain using proton magnetic resonance spectroscopic imaging (1H-MRS).The levels of Choline (Cho),Creatine (Cr),N-acetyl-aspartate (NAA) were measured in the frontal gyrus,anterior cingulate cortex and hippocampus of all subjects.The 1H-MRS data were compared between two groups.Results Compared with the healthy matched control,the levels of Cho (7.22 ± 1.99),Cr (5.44 ± 1.68),NAA (12.09 ±2.30)in right frontal gyrus white matter,the levels of Cho(9.89 ±2.40),Cr(8.59 ± 1.71) in right anterior cingulate cortex and the levels of NAA in left anterior cingulate cortex were significantly high (P ＜ 0.05).The ratio of NAA/Cr and Cho/Cr were not difference in two groups.In the hippocampus of the patients,the Cho,Cr,NAA,NAA/Cr and Cho/Cr ratio were not significantly higher or lower than those in control (P ＞ 0.05).Conclusion The brain substance metabolisms of the patients with GAD are abnormal and asymmetrical between left and right brain,especially occurred in right brain.

Objective To evaluate the dual blood supply of lung adenocarcinoma and squamous cell carcinoma using dualinput perfusion CT.Methods A total of 40 patients confirmed with lung cancer pathologically underwent CT perfusion (CTP) scanning.The pulmonary flow (PF),bronchial flow (BF),perfusion index (PI,PI=PF/[PF+BF])and tumor volume,location were measured and recorded by 2 experienced radiologists.The differences in CTP parameters between lung adenocarcinomas and squamous cell carcinomas,the central lung cancers and peripheral lung cancers were analyzed.The correlation between the tumor volume and CTP parameters was analyzed.Interobserver agreements were assessed with intraclass correlation coefficient (ICC).Results The average of PF,BF and PI of all 40 cases was (54.26± 21.07)ml/ (min · 100 ml),(64.41±22.06)ml/(min · 100 ml) and (43.38±16.07)％,respectively.Tumor histology was consistent with adenocarcinomas in 23 cases and squamous cell carcinomas in 17 cases,lung adenocarcinomas showed lower PI than that of squamous cell carcinomas (t=-2.196,P=0.034).There were 17 peripheral lung cancers and 23 central lung cancers,and the PI of the peripheral lung cancers was higher than that of the central lung cancer (t=2.305,P=0.027).No statistically significant differences were found for BF and PF between two types of lung cancers and central lung cancers and the peripheral cancers (all P＞0.05).Tumor volume was negatively associated with PI (r =-0.39,P=0.01).Good agreement was found between the two observers,the ICC for BF,PF and PI was 0.97,0.93 and 0.91,respectively.Conclusion Dual-input CTP technique can be used to evaluate the differences of blood supply between different pathological types and locations of lung cancer,with PI depending both on tumor size and location.

Justified the necessity of remote pathology consultation in China, and described the basic approach of such consultation in terms of the conditions, organizational framework, specialists and consultation process of the hospital. on the basis of benefit in pationts, the consultation helps the development of the pathology department and other specialist departments at the same time, builds initially a pathology quality control system, and accelerates the multi-discipline diagnosis and treatment approach. Expect to encourage contemplation on international remote pathology consultation in an effort to improve such a practice for the benefit of patients.

Objective To investigate the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases (Akt) signal pathway in ulinastatin postconditioning-induced attenuation of apoptosis in myocardial cells in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty NYHA class and ASA physical status Ⅱ or Ⅲ patients of both sexes,aged 21-59 yr,scheduled for cardiac valve replacement with CPB,were randomly divided into 2 groups (n =20 each):normal saline control group (group C) and ulinastatin postconditioning group (group U).In group U,ulinastatin 10 000 U/kg was perfused via the aortic root at 4000-5000 U· kg-1 · min-1 starting from 5 min before aortic unclamping.In group C,the equal volume of normal saline was given instead of ulinastatin.Myocardial specimens were taken from the right auricle at 45 min after aortic unclamping for determination of the expression of Akt,phosphorylated Akt (p-Akt),cytochrome c,caspase-9,Bcl-2 and Bax,and cell apoptosis.Bcl-2/Bax ratio and apoptotic index were calculated.Results The expression of p-Akt and Bcl-2 and Bcl-2/Bax ratio were significantly higher,and the expression of cytochrome c,caspase-9 and Bax and apoptotic index were lower in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin postconditioning attenuates apoptosis in myocardial cells in patients undergoing cardiac valve replacement with CPB through activating PI3K/Akt signal pathway.

Objective To analyze the clinical characters in old patients undergoing coronary artery bypass grafting (CABG). Methods The clinical data of 426 patients undergoing CABG from January 2000 to April 2009 in our hospital were retrospectively analyzed. One hundred eighteen patients were 70-82 years old (older group), 308 patients were 24-69 years old (younger group). The perioperative risk factors, surgical complication and outcomes between the two groups were compared.Results The older group had higher incidences of post-operative complications than younger group.Pre-operative risk factors included the female, chronic obstructive pulmonary disease, peripheral vessel disease, New york heart association(NYHA) class Ⅳ, unstable angina requiring intravenous nitrates until arrival in the anaesthetic room, left ventricular ejection fraction ＜30%. The older group showed higher incidences of postoperative severe complication, operative mortality, and more grafts and longer time in intensive care unit (ICU), and had lower incidents of valve disease and less use of left internal mammary artery [16 patients (13. 6%) vs. 152 patients (49.4%), all P＜0. 05].Conclusions The many CABG risk factors in China are different from those in the western countries.Although the higher incidents of postoperative severe complication and higher operative mortality are found in the older patients, the recovery period after operation isn't obviously prolonged. The operative outcomes are satisfactory.

Objective To evaluate the effect of asymptomatic hyperuricemia on the postoperative functional recovery in osteoarthritis (OA)patients with knee joint replacement.Methods Among the 294 patients who recieved knee joint replacement in our hospital from Feb-ruary 2013 to September 2015,a total of 187 patients were included in this study with 79 cases in the hyperuricemia group and the other 108 cases in the control group.The WOMAC index of the two groups were analyzed before the surgery,2 weeks,3 months,and 6 months after the knee joint replacement surgery.Multivariable linear regression was performed to test the effect of impact factors on the variation of WOMAC index.Results The WOMAC index of the two groups significantly increased 2 weeks after surgery,and the difference was statistically signifi-cant(P <0.05).And the WOMAC index of the control group was higher than that in the hyperuricemia group 2 weeks and 3 months after sur-gery with statistically significant difference(P <0.05).Conclusion The uric acid level before surgery was a influence factor of WOMAC index, and high uric acid level before knee joint replacement has negatively impact for the postoperative functional recovery in the osteoarthritis patients.

Objective To evaluate the role of Fas/FasL signaling pathway in ulinastatin postconditioning-induced attenuation of apoptosis in the myocardial cells of patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty patients of both sexes,aged 21-59 yr,of ASA physical status Ⅱ or Ⅲ (NYHA class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =20 each):control group (group C),and ulinastatin postconditioning group (group U).In group U,ulinastatin 10 000 U/kg was perfused via the aortic root at 4 000-5 000 U·kg-1 ·min-1 starting from 5 min before aortic unclamping.In group C,the equal volume of normal saline was infused instead of ulinastatin.Myocardial specimens were taken from the right auricle at 45 min after aortic unclamping for determination of Fas,Fas ligand (FasL),caspase-8,Bcl-2 and Bax expression and cell apoptosis.The ratio of Bcl-2 expression to/Bax expression (Bcl-2/Bax) and apoptotic index were calculated.Results Fas,FasL,caspase-8 and Bax expression and apoptotic index were significantly lower,and Bcl-2 expression and Bcl-2/Bax were higher in group U than in group C.Conclusion Ulinastatin postconditioning attenuates apoptosis in the myocardial cells through inhibiting Fas/FasL signaling pathway in the patients undergoing cardiac valve replacement with CPB.

Objective To evaluate the effects of ulinastatin on renal ischemia-reperfusion injury in patients undergoing operation on aorta with deep hypothermic circulatory arrest (DHCA ) .Methods Thirty patients ,aged 30-50 yr ,of ASA physical status Ⅲ or Ⅳ (NYHA Ⅱ or Ⅲ) ,scheduled for elective operation on aorta with DHCA ,were randomly divided into 2 groups ( n=15 each) using a random number table :control group (group C ) and ulinastatin group (group U ) .In group U ,ulinastatin 20 000 U/kg was infused via the central vein at 500-1 000 U·kg-1 ·min-1 from the time immediately after tracheal intubation until 10 min before ascending aortic cross-clamping .In group C ,the equal volume of normal saline was infused instead of ulinastatin .At 5 min before the beginning of DHCA (T1 ) and 15 min after the end of DHCA (T2 ) ,blood samples were taken from the extracorporeal circulation for determination of polymorphonuclear leukocyte counts , and plasma levels of intercellular adhesion molecule-1 , tumor necrosis factor-α, iterleukin-6 (IL-6 ) IL-8 , IL-10 , malondialdehyde , myeloperoxidase ,atrial natriuretic peptide ,cystatin C ,and creatinine .Results The polymorphonuclear leukocyte counts and plasma levels of intercellular adhesion molecule-1 , tumor necrosis factor-α, IL-6 , IL-8 , malondialdehyde , myeloperoxidase , cystatin C , and creatinine were significantly lower , and the plasma concentrations of IL-10 and atrial natriuretic peptide were higher in group U than in group C ( P< 0.05 ) . Conclusion Ulinastatin can attenuate renal ischemia-reperfusion injury in patients undergoing operation on aorta with DHCA and inhibition of inflammatory responses is involved in the mechanism .

Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.