Objective　To study the ultrastructural changes of 8 human fetus hearts of different months Method　by TEM and SEM chemical digestion. Results　The shape and ultrastructure of myocytes became complicated gradually with development. Conclusion　All the changes are related to function of blood supply of human fetal heart.

Objective To investigate the effect of hirudo micropowder on inflammatory factors in rats with cerebral ischemia-reperfusion injury.Methods Rats were randomly divided into sham-operation group,model group,coarse powder hirudo group,high-,middle-and low-dose micropowder hirudo groups.The corresponding drugs were given to the rats for 10 days by intragastric administration.Then middle cerebral artery occlusion(MCAO) model was made by suture method.The changes of inflammatory factors were observed.Results The level of intercellular adhesion molecule 1(ICAM-1) in high-dose micropowder hirudo group was lower than that in coarse powder hirudo group,and the level of platelet-derived growth factor(PDGF) in middle-and high-dose micropowder hirudo groups was also lower than that in coarse powder hirudo group obviously(P

Non-alcoholic fatty liver disease(NAFLD)is a common liver disease in Western populations.Non-alcoholic steatohepatitis(NASH)is a more debilitating form of NAFLD characterized by hepatocellular injury and inflammation,which significantly increase the risk of end-stage liver and cardiovascular diseases.Unfortunately,there are no available drug therapies for NASH.Bile acids are physiological detergent molecules that are synthesized from cholesterol exclusively in the hepatocytes.Bile acids circulate between the liver and intestine,where they are required for cholesterol solubilization in the bile and dietary fat emulsification in the gut.Bile acids also act as signaling molecules that regulate metabolic homeostasis and inflammatory processes.Many of these effects are mediated by the bile acid-activated nuclear receptor farnesoid X receptor(FXR)and the G protein-coupled receptor TGR5.Nutrient signaling regulates hepatic bile acid synthesis and circulating plasma bile acid concentrations,which in turn control metabolic homeostasis.The FXR agonist obeticholic acid has had beneficial effects on NASH in recent clinical trials.Preclinical studies have suggested that the TGR5 agonist and the FXR/TGR5 dual agonist are also potential therapies for metabolic liver diseases.Extensive studies in the past few decades have significantly improved our understanding of the metabolic regulatory function of bile acids,which has provided the molecular basis for developing promising bile acid-based therapeutic agents for NASH treatment.

Many clinical trials have shown that androgen deprivation therapy (ADT) combined with novel hormonal therapy or chemotherapy can improve the overall outcome of metastatic hormone-sensitive prostate cancer (mHSPC) patients. In this article, we report a patient with mHSPC diagnosed as stage T 3bN 0M 1b, who had a significant PSA decrease after receiving ADT combined with abiraterone acetate and underwent corticosteroid switch due to adverse events. This case suggest that ADT combined with abiraterone acetate could improve the overall survival of mHSPC patients, but clinicians should make individualized treatment plan based on patients special condition.

Objective The present study was designed to investigate the protection of Astragaloside Ⅳ(AS-Ⅳ)and Tanshinone Ⅱa(Tan Ⅱa)on human umbilical vein endothelial cells(HUVECs)after oxygen-glucose deprivation(OGD)injury and underlying mechanism.Methods HUVECs were cultured in vitro to establish the OGD injury model.The cells were divided into control group,model group,AS-Ⅳ group,Tan ⅡA group,and AS-Ⅳ+Tan ⅡA treatment group.The protective effect of AS-Ⅳ and Tan ⅡA combination on HUVECs after oxygen-glucose deprivation injury was observed,and the proliferation,migration,and tube formation of endothelial cells were analyzed.Apoptosis of HUVECs was determined using an AnnexinV-FITC apoptosis detection kit.The protein expressions of VE-cadherin,TGF-β1,VEGFA and Enos were detected by Western blotting.The expression of the proteins CD31 and Enos were detected by immunofluorescence.The concentration of nitric oxide(NO)in cell culture supernatants was also measured by ELISA.Results Compared with the control group,oxygen-glucose deprivation induced HUVECs dysfunction and apoptosis,and decreased the protein expression levels of VE-cadherin,TGF-β1,VEGFA,CD31,Enos as well as NO content(P<0.01).Compared with the model group,treatment group improved proliferation,migration and tube formation abilities of HUVECs,inhibited apoptosis,and increased the protein expression levels of VE-cadherin,TGF-β1,VEGFA,CD31,Enos as well as NO content(P<0.05).Conclusion AS-Ⅳ and Tan ⅡA can alleviate OGD-induced damage and may promote angiogenesis of HUVECs via upregulating the expression of Enos and enhancing the release of NO.

Inflammatory myofibroblastic tumor (IMT)is a potentially or low-grade malignant mesenchymal neoplasm, which is rare in clinic. Renomedullary interstitial cell tumor(RICT) is a clinically rare benign renal tumor. The combination of these two diseases in one patient has not been reported. A 25-year-old female patient was admitted to the hospital due to left back pain for 12 days and hematuria for 1 week. MRI of kidneys showed a mass in the left renal pelvis, which was considered as renal pelvic carcinoma. Urine cytopathological examination was negative. Robot-assisted laparoscopic radical left nephroureterectomy was performed. There was no tumor recurrence or metastasis during the follow-up for more than 6 months after operation.

Objective:To investigate the experience and results of the modified lateral prostate capsule sparing robot-assisted radical cystectomy-orthotopic ileal neobladder (LPCS-RARC-OIN).Methods:From December 2018 to November 2020, 19 patients received LPCS-RARC-OIN by a single surgeon in Sun Yat-sen Memorial Hospital, Sun Yat-sen University. LPCS-RARC-OIN was performed on male patients with high-risk non-muscle-invasive bladder cancer or muscle-invasive bladder cancer cT 2N 0M 0 without tumour in the bladder neck or urethra, and prostate cancer was ruled out by MRI and serum PSA<2.5ng/ml. The average age was 57.6 years, the average IIEF-5 score was 20.4. Separating the prostatic adenoma and the lateral prostate capsule from the base to the apex of the prostate, and retaining the lateral prostate surgical capsule or lateral prostate capsule about 1-2mm thickness. Patients were followed up and urinary function, sexual function and oncological outcomes were recorded. Results:All 19 operations were finished successfully. The average operation time was 279.9 (225-345) min and average estimated blood loss was 88.9 (30-200) ml. The average postoperative hospital stays was 15.8 (9 -23) days. The average lymph node yields was 23.3 (11-42). All surgical margins were negative and no incidental prostate cancer was found. 2 weeks, 1 month, 3 months and 6 months after catheter removal, the daytime and nighttime continence were 42.1% (8/19)and 36.8% (7/19), 63.2% (12/19)and 63.2% (12/19), 78.9% (15/19) and 73.7% (14/19), 94.7% (18/19) and 89.5% (17/19), respectively. 3 months and 6 months after operation, the average IIEF-5 score was 7.2 and 10.1 points respectively. The average follow-up was 10.6 months (5.4-26.1 months)and no recurrence or distant metastasis was found in this study.Conclusions:LPCS-RARC-OIN could improve the urinary and sexual function in selected patients. However, the long-term follow up is needed for functional and oncological outcomes.

ObjectiveTo explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines. MethodA total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups. On the basis of conventional western medicine treatment for hypertension， the control group （47 patients） was treated with Shugan Jieyu capsules for 8 weeks， while the treatment group （51 patients） with Gouteng prescription for 8 weeks. The two groups were compared in terms of the blood pressure level， 24-hour blood pressure variability， Hamilton anxiety scale （HAMA） score， Pittsburgh sleep quality index （PSQI） score， quality of life （SF-36 scale） score， traditional Chinese medicine （TCM） syndrome score and efficacy， incidence of adverse reactions， and the levels of interleukin （IL）-1β， IL-6， IL-10， and IL-4 in the serum of peripheral blood. ResultThe final trial was completed with 95 patients， including 46 in the control group and 49 in the observation group. The treatment in both groups lowered the blood pressure and blood pressure variability （P<0.05， P<0.01）. The observation group outperformed the control group in recovering the systolic blood pressure （SBP）， 24-hour mean systolic blood pressure （24 h SBP）， 24-hour systolic blood pressure variability （24 h SBPV）， and 24-hour diastolic blood pressure variability （24 h DBPV） （P<0.05）. After treatment， the HAMA and PSQI scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower HAMA and PSQI scores than the control group （P<0.05）. Compared with those before treatment， the SF-36 scores in both groups increased （P<0.05， P<0.01）. After treatment， the observation group had higher scores of physiological function （PF）， bodily pain （BP）， social function （SF）， role-emotional （RE）， and mental health （MH） indicators than the control group （P<0.05）. After treatment， the TCM syndrome scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower score than the control group （P<0.05）. The total response rate regarding TCM syndrome in the observation group was 85.71% （42/49）， which was higher than that （63.04%， 29/46） in the control group （χ²=6.621， P<0.05）. The treatment in both groups lowered the levels of pro-inflammatory cytokines （IL-1β， IL-6） and elevated the levels of anti-inflammatory cytokines （IL-10， IL-4） （P<0.05， P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.05）. There were no adverse events during the research process. ConclusionGouteng prescription can recover the blood pressure level， reduce blood pressure variability， suppress anxiety state， improve sleep and quality of life， decrease TCM syndrome score， increase total response rate， lower serum IL-1β and IL-6 levels， and elevate serum IL-10 and IL-4 levels in the patients with primary hypertension complicated with anxiety disorder due to yang hyperactivity and heat toxin. It may exert the effects by regulating the balance of pro-inflammatory and anti-inflammatory cytokines.