Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area.Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected.According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP).Chi square test and multiple Logistic regression analysis were used for data analysis.Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively;those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively;those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively;those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively;those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively;those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively;those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively;and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively.The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98;39.6%,21/53 vs 9.2%, 9/98), and the differences were statistically significant (x2=31.069, 18.246 and 20.019, all P<0.01).Biliary disease was the independent etiology of NSAP in Tibetan (odd ratios (OR)=20.668, 95% confidence interval (CI) 5.072 to 59.427, P<0.01), but alcohol (OR=16.007, 95%CI 3.700 to 45.654) and hyperlipidemia disease (OR=11.590, 95%CI 2.581 to 33.859) were the independent etiologies of SAP (both P<0.01).There was no statistically significant difference in etiology of SAP between Tibetan and Han (P>0.05).Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area.

Human stomach cancer cell line BGC-823 was treated by Tween 80 in combination with hyperthermia 39℃ to 43℃ for 20 to 100 minutes, respectively. The cell ultrastructure and succinate dehydrogenase (SDH) activity were studied at 0 hr, 48hr and 96hr after treatment respectively. Normal human fibroblast was used as control. The main changes of BGC-823 cells induced by hyperthermia were: dilation of endoplasmic reticulum, swelling of mitochondria, increase of fat droplets and decrease in SDH activity. After treatment at 43℃, the mitochondria showed vesicles or myelin figures and the polyribosomes tended to disaggregate. In nuclei, heterochromatin increased and the nucleolus become a dense homogeneous spot or annular ring. A few cells got necrosis. Effects of Tween 80 on BGC-823 cells were similar to that of hyperthermia. When Tween 80 combined with heating, marked synergic action was observed and the damage of membrane structure appeared earlier and more seriously. The effects of 41℃ combined with Tween 80 for 100 minutes were similar to that of 43℃ for 100 minutes alone. The critical temperature of hyperthermia for BGC-823 cells decreased to 41℃. The responses of the human fetal lung fibroblasts were slight and reversible. The results mentioned above suggested that the Tveen 80 enhanced the damage effect of hyperthermia on the tumor cells by decreasing the phase transition temperature of the tumor cells.

[ ABSTRACT] AIM:To investigate the inhibitory effect of ginsenoside Re on intimal hyperplasia induced by bal-loon-injury and to explore the role of NF-κB p65 signaling pathway in the process.METHODS:SD rats (n=40) were di-vided into 5 groups randomly: sham operation group, model group, low-dose ginsenoside Re group, middle-dose ginsen-oside Re group and high-dose ginsenoside Re group.The carotid artery intima injury model was established by 2F balloon catheters in all groups except the sham operation group.The day after modeling, the animals in model group and sham op-eration group were administered intragastrically with distilled water, and the rats in low-dose, middle-dose and high-dose ginsenoside Re groups were given ginsenoside Re at doses of 12.5 mg/kg, 25mg/kg and 50 mg/kg, respectively.After 14 continuous days, the morphological changes of the injured arteries were observed by HE staining and the lumen area, intima area and media area as well as the ratio of intimal area/media area were determined.The expression of tumor necrosis fac-tor-α( TNF-α) and interleukin-1β( IL-1β) were detected by real-time PCR.The proliferating cell nuclear antigen ( PC-NA) and nuclear factor-kappa B ( NF-κB) p65 were examined by immunohistochemistry.RESULTS:Compared with sham operation group, the vessel cavity was narrowed (P<0.01), the mRNA levels of TNF-αand IL-1β, and the protein ex-pression of PCNA and NF-κB p65 were increased in model group (P<0.05).Compared with model group, the vascular intimal hyperplasia was alleviated obviously (P<0.05), and the mRNA levels of TNF-αand IL-1β, and protein expres-
sion of PCNA and NF-κB p65 were decreased in medium and high-dose ginsenoside Re groups (P<0.05).CONCLU-SION:Ginsenoside Re inhibits the vascular neointimal hyperplasia induced by balloon-injury in rats, and the molecular mechanism may be related to the inhibition of NF-κB p65 signaling pathway.

Aim To explore the effect of Osthole (Ost)on the right ventricle remodeling in monocrot-alinetreated rats and the possible mechanism.Meth-ods ♂ SD rats were randomly divided into normal control group,model group,low dose of Ost treatment group (10 mg·kg -1 )and high dose of Ost treatment group (20 mg·kg -1 ).All rats were given a single dose of MCT 50 mg·kg -1 subcutaneously to establish the right ventricle remodeling except normal control group.Then the rats in Ost treatment group were ga-vaged once daily.After 28 days of administration,the right ventricle(RV)and left ventricle plus septum(LV+SEP)were weighed separately.RV hypertrophy in-dex (RVHI)were measured by the relative weight rati-o of RV to LV +SEP.The morphological changes of right ventricle were executed by HE staining.The pro-tein expression of PPARαand PPARγwere detected by Western blot.Results Compared with the control group,RVHI was increased obviously (P <0.05 ), myocardial hypertrophy and structure disorders were observed in model group.The protein expression of PPARαand PPARγwere down-regulated significantly in model group (P <0.05).Compared with the model group,the value of RVHI (P <0.05),myocardial hy-pertrophy,structure disorders were improved signifi-cantly in Ost treatment group.The protein expression of PPARαand PPARγwere up-regulated in Ost treat-ment group (P <0.05).Conclusion Ost can attenu-ate the right ventricle remodeling induced by MCT in rats,which may be related to up-regulating the expres-sion of PPARαand PPARγ.

Objective To study the expression and clinical significance of EphB4 in breast infiltrating ductal carcinoma.MethodsSP immunohistochemical technique was used to examine the expression of EphB4 in 65 cases of breast infiltrating ductal cancer and 12 matched adjacent tissue samples.ResultsThe level of EphB4 in breast infiltrating ductal cancer was significantly higher than that of adjacent normal tissues(P0.05).ConclusionEphB4 plays a crucial role in the occurrence and development of breast cancer.

Aim To investigate the effect of Icariin ( Ica) on remodeling of left ventricular in SHR and ex-plore the mechanism. Methods Twenty-one male SHR aged 14 weekswere randomly divided into model group(n=7), low-dose of Ica-treated group(20 mg· kg-1 . bid, n =7 ) , high-dose of Ica-treated group ( 40 mg·kg-1. bid,n=7), and WKY as control group(n=7 ) . Low- and high-dose of Ica-treated groups were given Ica from the age of 14 weeks to 26 weeks. The other rats in the model group and control group were given the same amount of double distilled water. Then, the content of hydroxyproline ( Hyp) was measured by ELISA. The morphological changes of the left ventricu-lar were observed by Masson staining. The mRNA and the protein expression of PPARα and PPARγ were ex-amined by real time RT-PCR and Western blot tech-nique respectively. Results Compared with the nor-mal control group, interstitium fibrosis and myofibrilla were lined up in disorder; the content of Hyp was in-creased and the mRNA and protein expression of PPARα and PPARγ were down-regulated in model group(P<0. 01). Compared with the model group,the myocardial cells were arranged less disorderly and the myocardial fibrosis was reduced; the content of Hyp was decreased in low-and high-dose of Ica-treated groups(P<0. 01 or P<0. 05);the mRNA and protein expression of PPARα and PPARγwere up-regulated in low- and high-dose of Ica-treated groups ( P <0. 01 or P<0. 05 ) . Conclusion Ica may attenuate left ven-tricular remodeling in SHR by up-regulating PPARαand PPARγ.

BACKGROUND:Kyphotic deformity in ankylosing spondylitis is the flexion deformity of spine sagittal plane in the late lesion. Spinal osteotomy is the only treatment method in patients with severe wheel-like kyphosis. For thoracic and thoracolumbar ankylosing spondylitis patients with lumbar severe wheel-like kyphosis, osteotomy at a single site cannot obtain safe and effective orthopedic effect. OBJECTIVE:To observe the orthopedic effect of total spine osteotomy combined with V-shaped osteotomy for correction of severe wheel-like kyphosis deformity due to ankylosing spondylitis, and to analyze stress distribution. METHODS:From May 2003 to October 2012, total spine osteotomy combined with V-shaped osteotomy and pedicle screw fixation were adopted for repair of concurrent thoracic, thoracolumbar and lumbar severe wheel-like kyphosis deformity due to ankylosing spondylitis in 36 male cases in the Sixth Affiliated Hospital of Xinjiang Medical University. Spinal convex angle, chin-brow vertical angle and C 7 plumb line were measured to evaluate orthopedic effect. RESULTS AND CONCLUSION:The whole spine convex Cobb angle was corrected from preoperatively (89.6±9.8)° to (32.2±6.7)° at 1 week after treatment, showing significant difference (P<0.05), with an average correction rate of 64%. The chin-brow vertical angle was 9.6° averagely after correction (P<0.05), with an average correction rate of 76%. The C 7 plumb line was 4.4 cm averagely after correction (P<0.05), with an average correction rate of 81%. After fol ow-up of 24-48 months, no significant difference in above indexes was detected during final fol ow-up and 1 week postoperatively (P>0.05). Radiographs demonstrated that fixation position was good in al patients. These results confirmed that in patient with severe wheel-like kyphosis deformity due to ankylosing spondylitis, the application of total spine osteotomy combined with V-shaped osteotomy is a safe and effective method, can better correct the spinal sagittal curvature and reduce the risk of sagittal angle, result in the stress distribution in many segments and the shortening of the spine and epidural buckling in relatively long segment, can avoid nerve damage induced by spinal cord shortening and epidural excessive buckling within short segment.

Objective To investigate cervical spinal upper motor neuron (UMN) dysfunction in patients with frail arm syndrome (FAS) by physical examination,triple stimulation technique (TST) and pectoralis tendon reflex tests.Methods Sixty-seven FAS patients,coming from Peking University Third Hospital from June 2013 to June 2016,underwent physical examination and routine electrophysiological tests.The pyramid signs,the results of pectoralis tendon reflex and TST were collected to estimate the function of cervical spinal UMN.Results On the time of diagnosis,weakness of bilateral proximal upper limbs was found in 61 patients,while weakness of unilateral proximal upper limb was found in six patients.There were 25 patients with tendon hyperreflexia,20 patients with tendon hyporeflexia and 22 patients with tendon areflexia.All the patients were pectoral muscle tendon hyperreflexia except one.UMN score of cervical region was 2.0 ± 0.5.Lower motor neuron score of cervical region was 2.0 ± O.2.The amplitude ratio of TSTtest/TSTcontrol was 78.31％ ± 6.52％.The latency and amplitude of quantitative detection of pectoralis tendon reflex was (7.80 ± 1.22) ms and (1.23 ± 0.14) mV,respectively.In the follow-up study,the tendon reflexes and the UMN score declined,the amplitude ratio of TSTtest/TSTcontrol decreased,while the lower motor neuron score increased and the latency of quantitative detection of pectoralis tendon reflex remained almost unchanged.Conclusion The results showed that there was cervical spinal UMN dysfunction in patients with FAS,and the pyramid signs were often concealed by muscle atrophy with progression of the disease.

OBJECTIVE:To observe the effect of pathological lesion of renal tissue in rats with spontaneous hypertension (SHR),and study its mechanisms based on nuclear factorκB(NF-κB)signaling pathway. METHODS:21 SHR were randomly di-vided into model group and ICA low-dose,high-dose groups(20,40 mg/kg,denoted by ICA-L,ICA-H groups);other 7 homolo-gous Kyoto rats (WKY) were regarded as control group. All rats were intragastrically administrated,twice a day,for 11 weeks, rats in control group and model group received equal volume of double distilled water,ig. Pathological changes in renal tissue in each group were observed;Western blot method was used to detect protein expressions of p-NF-κB-p65,IκB and TNF-α in renal tissue. RESULTS:Compared with control group,model group showed disorder renal structure,narrow and irregular glomerular cysts;the protein expression of IκB was significantly down-regulated,protein expressions of p-NF-κB-p65 and TNF-α were signifi-cantly up-regulated(P<0.01). Compared with model group,the above-mentioned changes of rats showed improvement in ICA-L, ICA-H groups;the protein expression of IκB was significantly up-regulated in ICA-L,ICA-H groups (P<0.05 or P<0.01);the protein expressions of p-NF-κB-p65 and TNF-α were significantly down-regulated(P<0.01)in ICA-H groups;p-NF-κB-p65 pro-tein expression was significantly down-regulated in ICA-L group(P<0.05);while there was no significant difference in TNF-αpro-tein expression in ICA-L group(P>0.05). CONCLUSIONS:ICA plays a role in improving renal pathological lesion in SHR,and the mechanism may be related to inhibiting NF-κB signaling pathway.

Objective To investigate the association of serum C peptide concentration with the severity and the outcome of diabetic foot ulcer (DFU). Methods The clinical data of 257 inpatients with DFU were collected, including fasting and postprandial 2h C peptide levels and C peptide area under curve (AUCCP ). The patients were followed up on the outcomes of ulcers and death. The associations of serum C peptide concentration with the Wagner degree, infection severity, and healing rate were analyzed. Results The medians of fasting and 2h postprandial serum C peptide as well as AUCCP were 1. 37(0. 02 ~ 9. 00) nmol/ L, 3. 22(0. 02 ~ 29. 61) nmol/ L, and 511. 65 (3. 60 ~ 2 691. 30)nmol·min-1 ·L-1 respectively, which were lower than general levels. The time of follow-up in our study was 2. 8 (1. 0 ~ 5. 1) years. By the end of study, the wound of 75. 88% patients was healed, 3. 5%undergone major amputation, and 23. 74% died. After adjusting for relative factors, there were no significant associations of serum fasting and postprandial C peptide levels and AUCCP with Wagner degree and infection severity (P>0. 05). Cox regression analysis showed that the fasting plasma C peptide and hemoglobin were the independent protective factors for the healing of ulcers; old age, male, higher infection degree, and diabetes family history were their independent risk factors ( all P < 0. 05). Conclusions The lower plasma fasting C peptide concentration in patients with DFU is not correlated with Wagner degree and infection severity, but closely related with healing rate.