AIM　To discuss the intraspecific relationship in Magnolia officinalis and the genuineness of Cortex Magnoliae officinalis, and to find some DNA characters of certified “Houpo”. METHODS　Thirty-three samples from eleven locations, which can represent most of the distribution of M.officinalis, were selected. The total DNA was extracted. Severty-four random primers were tried to get good amplification. RESULTS One hundred and sixteen bands amplified from seventeen primers, were clustered by NTSYS-pc software. Three branches were obtained. Some distinctive primers and bands, which represent certified species or fine breed, were obtained also. CONCLUSION　1) M.officinalis should be divided into three geographic clans instead of two subspecies or varieties, they are, a) typical officinalis, b) typical biloba and c) Middle type. This conclusion agrees with the leaf form and other characters. 2) The genetic difference between “Chuanpo” and “Wenpo” is evident and the difference is in correspondence with the quantities of their chemical constituents. So, the genetic difference is the main reason of the genuineness of Cortex Magnoliae officinalis. 3) These results may be used to establish DNA database for identification of Cortex Magnoliae officinalis.

Objective To evaluate the synchrony of heart after catheter-based renal denervation by two dimensional speckle tracking imaging.Methods Each renal sympathetic nerve of 20 dogs were ablated,and the index of heart and blood pressure were detected 6 weeks later.Standard 2D images were acquired in the 2-,3-and 4-apical views.The times from QRS onset to peak-systolic strain rate and to peak-diastolic strain rate were measured for the longitudinal 16-segments in Qlab software,and the standard deviation were calculated.The time to peak longitudinal strain rate and time to peak contraction strain rate of left atrium were measured for each segment contained septal,latera,anterior and posterior in the level of the basal segments,middle sections and apical in Qlab software,and the standard deviation were calculated.Parameters were compared among the before and after of the ablation.Results The systolic pressure and diastolic pressure had no changes after the ablation of renal sympathetic nerve (P ＞ 0.05).The R-R showed a increasing trend,but no significant differences(P ＞0.05).The peak time of LV systolic and diastolic strain rate had a extended trendency too,but no differences(P ＞0.05),and standard deviations of the peak times had no significant differences(P ＞0.05).The peak time of LA longitudinal strain rate and contraction strain rate had a extended trendency,but no obvious change (P ＞0.05),and the standard deviations of the peak times had no significant differences (P ＞0.05).The size of the heart cavity had no differences(P ＞0.05).Conclusions The systolic pressure and diastolic pressure have no changes after the ablation of renal sympathetic nerve,and the synchrony parameters of LV and LA have no significant differences,demonstrate that the synchrony of heart is not affected by the renal sympathetic denervation.

Objective To evaluate the security of catheter-based renal denervation by two dimensional speckle tracking imaging.Methods 20 dogs was ablated,whose indicies of heart and blood pressure were detected 6 weeks later.Standard 2D images were acquired in the 2-,3-and 4-apical views as well as the parasternal short-axis views at the level of the mitral valve and papillary muscles.The time to peak-systolic strain of each segment in the level of the mitral valve and papillary muscles,the standard deviation of the time to peak-systolic strain,the peak strain of the longitudinal 12-segment were recorded.Parameters were compared among the before and after ablation.Results Compared with before ablation of renal sympathetic nerve,the systolic pressure and diastolic pressure didn't reduced significantly after the ablation of renal sympathetic nerve (P ＞ 0.05),while there were no significant difference in the peak strain of the longitudinal 12-segment,the dyssychrony parameters and the size of the heart cavity before and after ablation(P ＞0.05).Conclusions The pressure had no change after the ablation of renal sympathetic nerve while without harmful effect on the the size of the heart cavity,the function of the myocardial contraction and the dyssychrony parameters.The ablation of renal sympathetic nerve can' t lower the normal blood pressure and be safe for heart at the same time.

Objective To analyze a potential outbreak mechanism 0f Pseudomonas eruginosa by investigating the homology of pan-drug resistance isolates(PDR)isolated in four hospitals of Guangzhou from March 2005 to March 2007.Methods The pulse-field gel lectrophoresis(PFGE)was used to detectl34 strains of pan-drug resistant Pseudomonas eruginosa in four hospitals,and determined whether they were derived from the same clone.Results 1 34 strains were classified into 56 types based on PFGE pattern. Type A Was the commonest clone among four hospitals,45 strains belonged to type A,mainly spreaded in hospital A. The rest strains were identified:7 for type B,6 for type C,6 for type D,which were isolated from hospital B to hospital D,respectively.There were 40 strains classified for individual types.General comparison showed there Was no a large clone existing in all four hospitals,though type Q clone appeared in hospital B and hospital D.One strain from hospital B and one strain from hospital C had 80%homology with type A from hospital A.The environment survey showed there was no clonal strain of type A found in hospital A,although various samples from respiratory therapy equipment,bronchoscopes and medical erosols were collected and cultivated for three times during the period.However,six patients arrying type A Pseudomonas aeruginosa had been admitted to the same ICU of hospital A for many times.Analysis of antimicrobial resistance of the common clone from four hospitals revealed that 42 of 43 type A of Pseudomonas aernginosa produced IMP-9 metallo β-lactamase.The strains of type B,type C and type D didn't produced metallo B. 1actamase.Conclusions The various degree of clonal spread of pan-drug resistance Pseudomonas aeruginosa had occurred in four hospitals individually in two years.There Was also clonal spread among some hospitals. It is important to monitor the patients colonized with epidemic clones to prevent clonal spread.

Objectives: To evaluate the predictor and risk factor of left ventricular (LV) free wall reverse remodeling in patients with obstructive hypertrophic cardiomyopathy (HCM) after modiifed Morrow procedure by three-layer speckle tracking of echocardiography.
Methods: Our investigation included 2 groups: HCM group, n=60 patients who had successful modified Morrow procedure in our hospital from 2014-06 to 2014-12, there were 41 (68.3%) male with the average age of (39.1 ± 15.2) years. Control group, n=40 healthy subjects. Three-layer speckle tracking echocardiography was conducted to analyze pre-and post-operative LV free wall three-layer myocardium (endocardial, mid, and epicardial layers) changes at longitudinal strain (LS) and circumferential strain (CS). Clinical and echocardiography information were collected at pre-and (6-24) months post-operation. The impact factors for LV free wall reverse remodeling was identiifed by liner regression analysis and the segment’s thickness≥15mm was deifned as the hypertrophic LV free segment.
Results: In HCM group, compared with pre-operative condition, the post-operative thickness of LV free wall including anterior, anterolateral and inferolateral were reduced;while both post-operative LS and CS elevated (-13.8 ± 4.8)%vs (-17.0 ± 5.2)%and (-23.7 ± 3.8)%vs (-25.4 ± 3.7)%, P<0.05. LV mass index by echocardiography was larger than LV mass index by surgical resection (13.5 ± 30.9) g/m2 vs (3.4 ± 2.0) g/m2, P<0.05. Liner regression analysis indicated that the number of pre-operative hypertrophic segments (r=-0.680, P<0.001) and age (r=0.638, P<0.001) were the independent impact factors for post-operative LS;△left ventricular outlfow tract (LVOT) gradient (r=0.386, P=0.005) was the independent impact factor for post-operative CS.
Conclusion:①After modiifed Morrow procedure, LVOT obstruction disappeared which leaded LV free wall reverse remodeling in HCM patients, ②three-layer myocardium of LV free wall all had reverse remodeling, ③better improved LVOT gradient were with less number of hypertrophic segments;the elder patients usually had the better post-operative reverse remodeling.

Objective To summarize the diagnosis and treatment of one case of combined heart liver transplantation. Methods On November 24, 2011, one case of combined heart-liver transplantation was performed on a patient with Ebstein's anomaly and tricuspid valve replacement after 5 years,complicated with congestive cirrhosis,liver failure dccompensation,preoperative heart failure Ⅲ degree and B grade of liver function Child-Pugh score. The operation was done with the graded cardiopulmonary bypass assisted mode:first creating the vena cava-aortic bypass to complete heart transplantation, second creating the femoral vein-ascending aorta bypass to complete liver transplantation,and third stopping and neutralizing.The aortic cross-clamping time was 54 min and the an hepatic phase was 38 min.The total time of three times of cardiopulmonary bypass was 199 min and the total time-consuming of operation was 517 min. The patient was given basiliximab +methylprednisolone for immune induction therapy, and tacrolimus + mycophenolate mofetil +prednisone solution for anti-rejection. After operation, liver protecting treatment, anti-infection therapy and nutrition support therapy were given.Results The recipient died of multiple organ failure after 78 days.The mechanical ventilation treatment duration for this recipient was 78 days and ECMO adjuvant therapy for postoperative hypoxemia time lasted 63 days.Conclusion The combined heart liver transplantation is an effective measures for treatment of heart and liver failure.

Objective:To prepare cisplatin-loaded anti-progastrin-releasing peptide (ProGRP) monoclonal antibody targeted nanobubbles, and to explore the proliferation inhibition effect and anti-cancer molecular mechanism of them on small cell lung cancer (SCLC).Methods:The cisplatin targeted nanobubbles were prepared by thin film hydrating method, and the physicochemical property were explored. The subcutaneous xenograft tumor models of SCLC in 10 nude mice were established, and the ultrasound molecular targeting development effect of cisplatin targeted nanobubbles was analyzed by using blank nanobubbles as control. Another 24 tumor-bearing nude mouse models were established and randomly divided into four groups: blank nanobubbles group, cisplatin group, cisplatin nanobubbles group, cisplatin targeted nanobubbles group. The tumor inhibition rate was calculated. The effect on SCLC proliferation was detected by CCK8 method. RT-PCR and Western blotting methods were used to detect SCLC proliferation related genes the P53, Rb, c-myc protein and mRNA expression level of change, the molecular regulatory mechanism was analyzed.Results:The cisplatin targeted nanobubbles were successfully prepared. The particle size was (467.3±42.3)nm, the structure was stable. The cisplatin targeted nanobubbles had a good effect of ultrasonic molecular development in SCLC xenograft.Compared with the control group, the proliferation of SCLC cells was significantly inhibited by cisplatin targeted nanobubbles. The RT-PCR and Western blotting analysis showed that compared with the control group, the mRNA and protein levels of the proliferation-related gene P53 and Rb in the cisplatin targeted nanovesicles group were significantly up-regulated, and the mRNA and protein levels of c-myc were significantly down-regulated (all P<0.05). Conclusions:The cisplatin targeted nanobubbles can inhibit the proliferation of SCLC, and may be used as a new potential targeted drug for the treatment of SCLC.

Chimeric antigen receptor T-cell strategy targeting CD19 (CART19) has prominent anti-tumor effect for relapsed/refractory B-cell lymphomas. CART19-associated complications have been gradually recognized, however, late-onset complications have not been extensively studied. Herein, for the first time we report a diffuse large B-cell lymphoma patient with terminal ileum involvement obtained rapid remission and developed spontaneous terminal ileal perforation 38 days following CART19 infusion. The late-onset perforation reminds us that, for the safety of CART treatment, more cautions are warranted for the management of delayed GI complications.
B-Lymphocytes* ; Humans ; Ileum ; Lymphoma, B-Cell* ; Receptors, Antigen* ; T-Lymphocytes*

ObjectiveTo study the correlation between Vimentin and hepatocellular carcinoma （HCC） and the mechanism of Jianpi Yiqi prescription against HCC through Vimentin. MethodCorrelation between Vimentin and HCC was analyzed based on the cancer genome atlas（TCGA）， clinical proteomic tumor analysis consortium（CPTAC）， STRING， and Cytoscape. SD rats were randomized into normal group （normal saline， ig， once/day， 4 weeks）， model group （normal saline， ig， once/day， 4 weeks）， low-dose， medium-dose， and high-dose （5.25， 10.5， 21 g·kg^-1， ig， once/day， 4 weeks） JianpiYiqi prescription groups， signal transducer and activator of transcription 3 （STAT3） inhibition group （C188-9， 4.5 mg·kg^-1， ip， once/day， 4 weeks）， and glycoprotein 130 （gp130） inhibition group （SC144， 4.5 mg·kg^-1， ip， once/day， 4 weeks）， 10 rats in each group. Diethylnitrosamine （DEN， 70 mg·kg^-1 body weight， ip） was injected in rats except the normal group to induce HCC. After the modeling， administration began. After last administration， Real-time polymerase chain reaction（Real-time PCR） was performed to determine Vimentin mRNA level in rat liver tissue. Caspase-3 activity in liver tissue was detected by colorimetry， and expression of Rho kinase （ROCK）1， ROCK2， aurora kinase B （AURKB）， Zinc-finger protein 148 （ZNF148）/zinc-binding protein-89 （ZBP-89）， STAT3， p-STAT3， total Vimentin， and phosphorylated （p）-Vimentin in liver tissue and Vimentin in liver tissue nucleus detected by Western blot. Serum Vimentin concentration was measured by enzyme-linked immunosorbent assay （ELISA）. ResultVimentin mRNA level was high in tissues from HCC patients with different cancer stages （stage Ⅰ-Ⅳ）， different pathological grades （G₁-G₃）， no regional lymph node metastasis （N0）， and different subtypes （P<0.01）. Vimentin mRNA expression was higher in tissues from patients with lymph node metastasis than in patients without lymph node metastasis and normal samples. Vimentin protein level was decreased in HCC tissues （P<0.01）. Vimentin gene has 4 mutations which can induce change in the primary structure of Vimentin protein and patients with Vimentin gene mutation had short disease free survival time （P<0.01）. The mRNA expression of Vimentin was negatively associated with HCC cell purity （P<0.01） but was positively associated with the infiltration levels of cancer-associated fibroblasts， M2 macrophages， myeloid dendritic cell and other immune cells in tumor microenvironment （P<0.01）. Association analysis results showed that the expression of Vimentin was correlated with the STAT3 expression in HCC tissues （P<0.01）. As for the animal experiment， Vimentin mRNA level and protein levels of total Vimentin and p-Vimentin in liver tssue， Vimentin protein level in liver tissue nucleus， Vimentin in rat serum， ROCK2， AURKB， STAT3 and p-STAT3 in liver tissues were up-regulated （P<0.01） and protein level of negative regulator ZBP-89 was reduced in the model group （P<0.01） compared with those in the normal group. Activity of Caspase-3 in liver tissue increased and the ROCK1 protein level was increased in the model group compared with those in the normal group. STAT3 inhibitor， gp130 inhibitor， and medium-dose and high-dose Jianpi Yiqi prescription all can reduce the secretory Vimentin protein in serum， protein levels of total Vimentin and p-Vimentin in liver tissues， and Vimentin in liver tissue nucleus， and the protein levels of STAT3/Vimentin signaling pathway-related molecules， such as STAT3， p-STAT3， ROCK2， and AURKB and up-regulate the protein level of negative regulator ZBP-89 and activity of Caspase-3 （P<0.05， P<0.01）. Effect of medium-dose or high-dose Jianpi Yiqi prescription on Vimentin mRNA expression， STAT3 protein expression， ZBP-89 protein expression， ROCK2 protein expression， AURKB protein expression and Caspase-3 activity was not significantly different from that of STAT3 inhibitor. ConclusionVimentin， an important inflammatory molecule， is closely related to the occurrence and development of HCC and its expression， subcellular location and function may be affected by cancer-associated fibroblasts， M2 macrophages， myeloid dendritic cell， and IL-6/STAT3 signaling pathway， particularly by STAT3 molecule. Jianpi Yiqi prescription may exert therapeutic effect on HCC via regulating Vimentin through the STAT3/Vimentin signaling pathway.

Objective:To explore the genetic causes of cerebellar hypoplasia (CH) diagnosed by prenatal ultrasound.Methods:This retrospective study involved 32 fetuses with CH diagnosed by prenatal ultrasound in Wuxi Maternal and Child Health Hospital from January 2014 to December 2022. Prenatal ultrasound findings and genetic testing results for amniotic fluid were collected and analyzed. The correlation between fetal CH and genetic abnormality was analyzed. A descriptive statistical method was used for data analysis.Results:(1) General data: The 32 mothers were (28.0±4.9) years old, ranging from 18 to 37 years old; the gestational age at amniocentesis was (24.2±4.0) weeks, ranging from 18 +3 weeks to 37 +2 weeks. Apart from one case lost to follow-up, the other 31 cases terminated the pregnancies, including 30 terminated before 28 weeks of gestation and one at 33 weeks of gestation due to unmarried status. (2) Ultrasonic features: Among the 32 cases, 30(93.8%) were complicated by intracranial or extracranial abnormalities including cardiac abnormalities (15 cases), dilated lateral ventricles (ten cases), and abnormalities in limbs (eight cases) and face (nine cases). Two CH cases (6.2%) were isolated. (3) Genetic testing: Among the 32 cases, 13 cases (40.6%) had normal results of amniotic fluid karyotype analysis and single nucleotide polymorphism (SNP) array. Among the 19 cases with abnormal amniotic fluid test results (59.4%), 16 cases have abnormal results in amniotic fluid karyotype analysis and SNP array detection [nine cases were numerical abnormalities, including five cases of trisomy-18, three of trisomy-21, and one of trisomy-13; seven cases were chromosomal structural abnormalities, including four cases of terminal deletion of chromosome 5 (Cri-du-Chat syndrome) and three cases of reciprocal translocation of chromosomes]. There was no abnormality in karyotype analysis of amniotic fluid in three cases. Still, their SNP array test results showed copy number variations (CNV) [one of 6q terminal deletion, one of 6q terminal deletion with 5p15.33 duplication, and one of 6q terminal deletion with 15q26.3 duplication; all variations were of unknown significance]. (4) Of the 19 cases with abnormal SNP array results, 17 were accompanied by abnormal intracranial/extracranial ultrasound findings. Among them, ten cases showed cardiac malformation, seven showed lateral ventricular widening, and seven showed limb abnormality. Conclusions:Numerical abnormalities, CDCS, and 6q terminal deletion are the most common genetic causes of CH diagnosed by prenatal ultrasound. Chromosome microarray analysis should be recommended for fetuses with ultrasound-diagnosed CH to evaluate fetal prognosis accurately.