Angiotensin II (Ang II ) is an effector of rein-angiotensin system. Ang II receptors mediate its biological effects. An analysis of radioactive ligand demostrated that mammalian exists AT1 receptor and AT2 receptor subtype. AT1 receptor exists three isoforms, AT1A, AT1B and AT1c receptor subtype in rat and mouse. The AT3 and the AT4 subtype receptors had been cloned, but their structure and function were unknown. The AT1 receptor belongs to the superfamily of seven trans-membrane domain, G-protein-coupled receptors and was 20%~ 30% homologous to other G-protein-coupled receptors. The AT1 receptor mainly exists in vessel, heart and adrenal glands in adult animals. The AT2 receptor only has 32% amino acid sequences homologous to AT1 receptor and mainly exists in embronic tissue and intersti-tium. Recent studies have shown that the AT1 receptor may mediate most of the biological functionof Ang I . The AT1 receptor mediates promoting the expression of growth-related inducible transcription factors such as c-fos, c-jun and c-myc, and inducing myocardial cell hypertrophy, cardiac fibroblasts proliferation and interstitial collagen deposition. The AT1 receptor antagonist can reverse myocardial hypertrophy and collagen accumulation induced by hypertension, but the AT2 receptor antagonist can't. The biological function of the AT2 receptor is little known. The AT2 receptor may mediate inhibit on of growth factor-induced cell proliferation, oposite AT1 receptor-induced mi-togenic effect and induce apoptosis. The AT1 receptor and AT2 receptor subtype in myocardial tissue may regulate the genesis and development of myocardial remodeling in hypertension togather.

Objective: To evaluate feasibility of using European Nutritional Risk Screening 2002(NRS2002) for nutritional status assessment in primary hospital.Methods: 799 patients were enrolled in this study.697 patients who were according NRS request were assessed using NRS method in hospitalization day.The patient whose NRS scores were higher than 3 were justified under nutritional risk.102 patients who were not according NRS request were assessed by exeamining the serum albumin(ALB) in the next day.The patients whose serum ALB was lower than 35 g/L were justified malnutrition.Results: There were 697 patients could be evaluated by NRS method.Body Mass Index(BMI) was lower than 18.5 in 159(22.8%) cases and NRS scores were ≥3 in 240 cases(34.4 %) among 697 cases.Serum albumin was lower than 35 g/L in 31 (30.4%) cases among 102 cases who could not be evaluated by NRS method because of incapable of standing up(66/102,64.7%) and ascites or hydrothorax(17/102,16.7%) and concomitance of above-mentioned causes(11/102,10.8%) and coma(8/102,7.8%).Conclusion: Assessment of nutritional status of hospitalized patients in primary hospital using NRS2002 method is feasible.The patients who could not be evaluated by NRS 2002 method can be assessed by assaying serum ALB.

Objective To study the skills of laparoscopy for hight difficulty eholecystectomy.Method Forty-eight cases of hight difficulty laparoscopic cholecystectomy from July 2005 to July 2007 were analyzed retrospectively. Result In 48 cases, 5 cases were converted to open surgery, 2 cases suffered in-cision infection, all the patients recovered. Conclusion According to the operating status and experience of the performer, Calot triangle dissection and judge good opportunity to change open surgery are the key faetora to the successful operation for difficult and complex laparoscopie cholecystectomy, which is safe and feasible.

Objective To compare the efficacy of laparoscopic gallbladder bed dissection(LGBD)between retrograde plus anterograde and anterograde only manners.Methods All of 575 cases of laparoscopic cholecystectomy(LC)were randomly divided into two groups(group A and group B).Patients underwent LGBD with retrograde plus anterograde mannerin group A(297 cases)oronly with anterograde manner in group B(278 cases)respectively.The efficacy and safety were compared between two groups.Results The operative time were(10.0±3.7)min and(13.0±3.9)min in group A and group B respectively (P<0.05).There were 33 cases of bleeding volume more than 5 ml in group A with 85 cages in group B (P<0.05).Three cases of gallbladder rupture were found in group A compared with 10 cases in group B (P<0.05).Postoperative fluid collection in gallbladder bed occurred in 5 cases in group A compared with 19 cases in group B(P<0.05).The conversion rate was 3.70%(11/297)and 3.96%(11/278)in group A and group B respectively(P>0.05).One cage of abdominal fluid collection was observed in group A whichwas relieved after conservative therapy.No other complications occurred.Conclusions LGBD applying retrograde plus anterograde manner may shorten the operative time,decrease the bleeding during operation and minimize the postoperative complications.Surgeons might benefit from its advantage of easier manipulation.

Objective To investigate the correlation between knee joint line and anterior knee pain after total knee arthroplasty (TKA).Methods From January 2008 to December 2010,76 patients with osteoarthritis underwent primary TKA in our hospital,including 11 males and 65 females,aged from 47 to 83 years (average,68.88±7.61 years).Fixed-bearing posterior stabilized TKA (PFC) was used in all patients.All patients were followed up every 12 months after TKA.According to the Figgie's method,pre-and post-operative knee joint line was measured,and the changes of pre-and post-operative knee joint line were calculated.If the knee joint line was elevated,it was defined as positive; on the contrary,it was defined as negative.The Feller's patellar score was used to assess pre-and post-operative patellar function.The correlation between joint line level and Feller's patellar score was analyzed 24 months after operation.Results The joint line level ranged from-6.8 to 10.44 mm (average,2.69±3.31 mm).With the rise of the joint line,the patient's patella score decreased.There is a negative correlation between the elevated joint line level and Feller's patellar score (r=-0.763,P=0.000).The Feller's patellar score decreased with the fall of joint line level,and there is a positive correlation between them (r=0.914,P=0.000).The Feller's patellar score was higher in patients whose joint line change was less than 4 mm than that in patients whose joint line change was greater than 4 mm (t=12.648,P=0.000; t=l 1.775,P=0.000).Conclusion The joint line change was correlated to anterior knee pain after TKA with fixedbearing posterior stabilized prosthesis.The joint line change less than 4 mm can result in a better knee joint function.

Objective: To explore the mechanisms of acupuncture in improving osteoporosis. Methods: In this study, the expression of OPG and BMP-2 proteins of femur in SAMP6 control group, SAMP6 acupuncture group, SAMP6 sham-acupuncture group and SAMR1 control group were determined by Western Blot technique. Results: Compared with SAMR1 control group, the expression of OPG and BMP-2 proteins of the femur in SAMP6 control mice decreased obviously. Acupuncture could stimulate the expression of OPG and BMP-2 and no differences were detected between the SAMR1 control group and SAMP6 acupuncture group. Conclusion: Osteoporosis observed in SAMP6 was correlated with low expression of OPG and BMP-2. After acupuncture treatment, both of them showed increased expression, it suggested that the curative effects of acupuncture on osteoporosis were partly due to stimulating skeleton formation, inducing the production of some local factors of bone metabolism and decreasing the bone turnover rate.

There are several special advantages of the application of standardized patients ( SPs) in the assessments of clinical skills examination of medical practitioners .However , this application in China is restricted by some limit factors, such as the shortage of SP trainers and SPs , the huge funds needed and the imbalance of regional develop-ment.The suggestion to overcome those limitation and to promote SPs be applied to the clinical skills examination of medical practitioners are as follow: the preparatory of regional university union of SPs , the introduction of social capital to participate in and the adoption of the mode of scale operation .

Objective To establish a stable HCV full-length genome replication cell model which is labeled with reporter gene and easyly to quantify intracellular HCV proteins and RNA level. Methodsneo gene was inserted into Luc-JC1 to make Luc-JC construct. Luc-JC RNA was obtained by in vitro transcription and then delivered into Huh7 cells by transfection. G418-resistant clones of Huh7 cells were obtained by selection. Clones of HCV full-length genome replication cell were confirmed by luciferase activity assay, Western blot and cleaveage of eYFP-MAVS by HCV NS3/4A protease. Then, HCV replication cell colonies were treated by different dose IFN-α in order to observe the change of luciferase activity, HCV protein and RNA level. Results At 3-4 weeks post-transfection, visible colonies were selected and stained by crystal violet. Luciferase activity and HCV NS3, NS5A protein were detected by luciferase activity assay and Western blot, respectively. Subcellular localization of eYFP-MAVS transferred from mitochondria to cytoplasms by cleavage of NS3/4A protease in cell colonies. Luciferase activity, HCV protein and RNA diminished obviously after IFN-α treatment. Conclusion A stable HCV full-length genome replication cell model labeled by reporter gene was successfully established and reporter activity can be used to indicate level of HCV proteins and RNA in cells. This cell model is a useful tool for the study on HCV pathogenesis and the screening of antiviral drugs.

OBJECTIVE To master the pathogenic conditions,clinical characteristic,and diagnostic clues about AIDS combinated with penicilliosis marneffei and malignant lymphoma.METHODS The clinical data about AIDS combinated with penicilliosis marneffei and malignant lymphoma were summarized in order to learn by experience.RESULTS The clinical symptoms of AIDS combinated with penicilliosis marneffei and malignant lymphoma could be unique,but most were various,the primary symptoms were always fever and enlargement of liver and spleen.CONCLUSIONS AIDS combinated with penicilliosis marneffei is common to be seen,but with penicilliosis marneffei and malignant lymphoma are rarely seen in the clinics,which should be taken high attention.

Objective:To investigate the effects of establishment of a trauma center on the therapeutic efficacy for patients with severe multiple injuries.Methods:A retrospective study was conducted in the patients who had been treated at The Second Affiliated Hospital, University of South China for severe multiple injuries from October 2015 to September 2019. They were assigned into 2 groups. The study group included 102 patients who had been treated after establishment of our trauma center (from October 2017 to September 2019) while the control group 126 patients who had been treated before establishment of our trauma center (from October 2015 to September 2017). The 2 groups were compared in terms of time for emergency treatment (from admission to emergency surgery or ICU), ICU stay, hospital stay, total medical costs and mortality.Results:There was a significant difference between the 2 groups in time for emergency treatment [51 (47, 57) min for the study group versus 97 (87, 107) min for the control group] ( P<0.05). There were no significant differences between the 2 groups in ICU stay [4 (1.8, 9.3) d versus 4 (2.0, 10.0) d], hospital stay [25.5 (15.8, 39.0) d versus 21.5 (12.8, 41.5) d], or total medical costs [￥41,259.0 yuan (￥26,950 yuan, ￥81,599 yuan)] ( P>0.05). There was a significant difference between the 2 groups in mortality [12.7% (13/102) for the study group versus 24.6% (31/126) for the control group] ( P<0.05). Conclusion:Establishment of a trauma center can effectively shorten time for emergency treatment, improve treatment efficacy and reduce mortality for patients with severe multiple injuries.