Objective To investigate the role and mechanism of signal transducer and activator of transcription 4 (STAT4) in homocysteine (Hcy)-induced proliferation,migration and senescence of human aorta smooth muscle cells (VSMCs).Methods After VSMCs were incubated with Hcy (0-0.50 mmol/L) for various time periods,a CCK-8 assay was performed to determine proliferation activity.Modified Boyden chamber system (Transwell apparatus) was used to examine migration ability.A SA-β-gal staining kit was used to determine senescence status.Western blotting was performed to examine the expressions of STAT4 and phosphorylated STAT4 (p-STAT4) proteins,and ELISA was performed to examine MCP-1 expression.Results Hcy (from 0.05 mmol/L) significantly increased the proliferation of VSMCs (P ＜ 0.05).Hcy (from 0.10 mmol/L) significantly increased the migration of VSMCs (P ＜ 0.05).Hcy promoted the senescence of VSMC in a concentration-dependent manner,and significantly increased VSMC senescence when the concentration of Hcy reached 0.10 mmol/L (P ＜ 0.05).Hcy (from 0.10 mmol/L) treatment significantly increased the expression of p-STAT4 (P ＜ 0.05) and MCP-1 (P ＜ 0.05).Conclusions Hcy increases the proliferation,migration and senescence of VSMCs,probably by the activation of STAT4 pathway.

Objective To investigate the missing rate of polypus with colonoscopy and correlation factors for missed diagnosis.Methods Data with colorectal polyps collected a second colonoscopy within 180 days after polyps were detected and removed on the initial colonoscopy in 186 patients between July 2009 and June 2013.The following factors were statistically analyzed,including lesionrelated factors (the lesion size,location,shape,number,and pathology),and non-lesion-related factors (intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).Results Polypus missed diagnosis was found in 57 patients out of 186 recruited subjects (30.64％).A total of 76 polypus were missed out of 343 (22.16％) polypus detected by repeated colonoscopy.Flat small polyps were easily missed diagnosis (P ＜ 0.01).Polyps located at sigmoid,cecum and ascending colon,hepatic flexure,and splenic flexure were easily missed diagnosis (P ＜0.05).The rate of missed diagnosis was significantly increased in the condition of the low intestinal cleanliness,short colonoscopy post-set time,non-intravenous anesthesia,and beginner colonoscopy doctors (P ＜ 0.01).Conclusions A markedly missing rate of polyp existed on colonoscopy,and was closely related to the lesion-related factors (the lesion size,location,shape,number,and pathology) and the non-lesion-related factors (the intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).

Objective To explore the effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.Methods Data with late-onset bleeding after high frequency electric resection of the colon polyps on colonoscopy were collected from 64 elderly patients using antiplatelet drugs from January 2010 to December 2013.Those 64 elderly patiets using antiplatelet drugs were divided into aspirin,clopidogrel,and aspirin + clopidogrel groups.The clinical situation,blood-coagulation time,bleeding-occurrence time,emergency colonoscopy hemostatic rate of demand,and hemostatic time in hospital were analyzed.Results No statistically significant differences were found in the blood-coagulation time,bleeding-occurrence time,and hemostatic time in hospital among aspirin,clopidogrel,and aspirin + clopidogrel groups.However,the clinical situation,and emergency colonoscopy hemostatic rate of demand in aspirin + clopidogrel group were significantly more serious and higher than those of the aspirin or clopidogrel groups (P ＜ 0.01).Conclusions There are more serious clinical situation and higher emergency colonoscopy hemostatic demand in patients with combined use of antiplatelet drugs relative to the use of single antiplatelet drug.The clinicians should pay attention to the combined use of antiplatelet drugs for late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.

Objective To compare the clinical effect of unarmed cardiopulmonary resuscitationand cardiopulmonary resuscitationmachine in the emergency room.Methods One hundred cases patients with cardiopulmonary arrest in Hainan Agricultural Reclamation General Hospital from February 2014 to February 2016 were analyzed.The control group(n=50) were given unarmed cardiopulmonary resuscitation,while thetest group(n=50) were given ardiopulmonary resuscitation machine.Two groups' before and after cardiopulmonary resuscitation of arterial blood gas index(oxygen saturation (SaO2),C02 partial pressure (PaC02),oxygen partial pressure(Pa02)),cardiopulmonary resuscitation effectiveness and the success rate,and complications were compared.Results Before cardiopulmonary resuscitation,there were no significant differences on arterial blood gas index (SaO2,PaCO2,PaO2) between the two groups (t =0.069,0.097,0.121,P ＞ 0.05).After cardiopulmonary resuscitation,the SaO2,PaO2 of the test group were higher than that of the control group ((98.60± 8.51) ％ vs.(86.37 ± 7.84) ％,(13.84 ± 1.40) kPa vs.(8.69± 1.21) kPa),while PaCO2 of test group was lower than the control group ((3.24 ± 0.56) kPa vs.(6.41 ± 0.87) kPa),the differences were significant(t =7.474,21.665,19.679,P ＜ 0.05).The cardiopulmonary resuscitation of effective rate,success rate of test group were higher than the control group (84.00％ (42/50) vs.62.00％ (31/50),26.00％ (13/50)vs.10.00％(5/50),x2=6.139,4.336,P＜0.05).The total complication rate of the test group was lower than the control group(8.00％ (4/50) vs.28.00％ (14/50)),the difference was significant (x2 =6.775,P ＜0.05).Conclusion The clinical effect of cardiopulmonary resuscitation machine is significantly superior to unarmed cardiopulmonary resuscitation,which can effectively improve the patient's arterial blood gas state,improve the efficiency and success rate of cardiopulmonary resuscitation,and reduce the complications.

Objective To investigate the long-term safety and efficacy of the domestic biodegradable drug-eluting cor?onary stents (BuMA) in treating coronary heart disease (CHD). Methods Patients (n=440) who received BUMA stents were designated as observation group while patients (n=460) received Resolutestents were designated as control group. The base?line clinical characteristics, extend of pathological change shown by Coronary Arteriography (CAG),the procedure of percu?taneous coronary intervention were similar between these two groups. The patients were followed up for a mean of 24 ± 4 months;the primary endpoint was the occurrence of definite or probable stent thrombosis;secondary endpoint was major ad?verse cardiac events (MACEs) including complex end such as recurrent angina, acute non-fatal myocardial infarction, death, target vessel revascularization (TVR); other endpoints include all- cause mortality, cardiac death, myocardial infarc?tion (MI), target lesion revascularization (TLR), non-target vessel revascularization and stroke. Some patients were lost dur?ing follow up, which include 5 in observation group and 26 in control group. Results Patients in observation groups were in?serted with 615 stents while patients in control group were implanted with 614 stents, both groups with average of implanting 1.41 stent/case. There are no statistical significance differences in the primary endpoint [1.4%(6/435) vs 1.8%(8/434), χ2=0.087], secondary endpoint [12.3%(54/435) vs 10.8%(47/434),χ2=0.524] and other endpoints between the two groups. Con?clusion These data suggest that domestic biodegradable drug-eluting coronary stents (BuMA) are with good long-term safe?ty and efficacy.

Objective To establish the ranges of normal reference values of fetal brainstem-vermis angle (BVA)and brainstem-tentorium angle (BTA)in normal fetuses at different gestational weeks,and to evaluate their clinical values in the diagnosis of mega cisterna magna.Methods Totally 320 normal singleton fetuses between 1 8 and 40 weeks of gestation were enrolled in this study.Three-dimensional ultrasound (3DUS)with volume contrast imaging (VCI)was used to measure their BVA and BTA,the correlations of BVA and BTA with gestational age were analyzed.The BVA and BTA of 24 fetuses with mega cisterna magna were also measured and were compared with those of the normal fetuses.Results In these normal fetuses,the BVA and BTA showed no correlations with gestational age (r=-0.05,0.04,both P >0.05);the ranges of normal reference values of BVA and BTA were 2.23°-19.30°and 18.53°-48.13°, respectively.The BVA and BTA of 24 fetuses with mega cisterna magna were 4.23°-17.42°and 20.41°-40.89°,respectively,which were not significantly different from those of normal fetuses (t =-0.55,0.92, both P >0.05).Conclusions 3DUS with VCI is feasible for measuring the BVA and BTA of fetuses,and the measured values can be used as the reference standards for BVA and BTA measurement in China.

Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of rabbits with acute pulmonary thromboembolism (APTE). Methods Thirty-two New Zealand rabbits were randomly divided into normal control group, model group, low molecular weight heparin (LMWH) group and Xuebijing group by random number table, 8 rabbits in each group. APTE model was reproduced by re-infusing autologous blood clots, and nothing was done for the normal control group. After the model was established, intravenous injection of Xuebijing 1 mL/kg from ear marginal vein was given to the rabbits in Xuebijing group, the LMWH 100 U/kg was subcutaneously injected in LMWH group, the same amount of normal saline was given intravenously to model group and normal control group, twice daily for 7 days in all the groups. The changes of plasma D-dimer and endothelin-1 (ET-1) levels were detected by enzyme-linked immunosorbent assay (ELISA) after modeling for 8 hours and 1, 3, 5, 7 days;after 7 days the animals were sacrificed and their lung tissues were removed for the examination of ultrastructural changes under an electron microscope. Results With the prolongation of time, the D-dimer level in the model group was gradually increased, and on the 7th day after modeling, the level was significantly higher than that of the normal control, LMWH and Xuebijing groups (g/L:3.98±1.14 vs. 0.43±0.12, 1.05±0.13, 1.04±0.15, all P<0.05). After modeling for 5 days, the ET-1 level reached its peak in the model group, and it was lowered on the 7th day after modeling, but still significantly higher than that in the normal control, LMWH and Xuebijing groups (g/L:63.8±20.9 vs. 20.0±1.4, 36.5±8.3, 34.2±6.3, all P<0.05). The D-dimer and ET-1 levels in the LMWH and Xuebijing groups were significantly higher than those of the normal control group at each time point, but still obviously lower than those of the model group (all P<0.05), and the differences between the two treatment groups were not statistically significant at each time point (all P>0.05). Electron microscopic examination of lung tissue ultra-structure showed:in the model group, there were the lung tissue basement membrane rupture, the organelle structure in vascular endothelial cells and alveolar epithelial cells typeⅠandⅡnot clear, disappearance of microvilli on cell surface, cytoplasm concentration, nuclear chromatin condensation, a lot of debris due to nuclear lysis, formation of apoptotic bodies after shedding, and mitochondrial structural damage. In LMWH group, the capillary endothelial cell swelling, a lot of necrotized blood cells oozing, blockage of lumen, the cytoplasm of typeⅡalveolar epithelial cell loose, edematous and multiple lamellar bodies vacuolized were seen. In Xuebijing group, capillary endothelial cell swelling, necrotized blood cells blocking the lumen and seeping, the link basically normal, the type Ⅱ alveolar epithelial cell edematous, mitigation of lamellar bodies emptying were found. Conclusions Xuebijing can significantly reduce the plasma D-dimer and ET-1 levels, adjust the balance of coagulation and fibrinolysis, simultaneously decrease the pulmonary vascular permeability obviously in rabbits with APTE, thus it possesses certain protective effect for endothelial function leading to amelioration of lung injury and reduction of lung pathological damage in rabbits with pulmonary embolism.

Objective To research the relationship between the serum level of cystatin C (CysC),N-terminal pro brain natriuretic peptide (NT-proBNP) and the cardiovascular (CV) events in maintenance hemodialysis (MHD) patients,looking for a new and effective biological prediction method for cardiovascular disease (CVD).Methods According to the excluded criteria and included criteria,a total of 126 patients [male 67(53.2％),female 59 (46.8％)] were included in this study,screening out of 452 MHD patients from 3 blood purification centre,no secondary hyperparathyroidism,blood pressure controlled,hemoglobin standard,no lipid abnormalities,and without history of coronary heart disease,heart failure and arrhythmia.Participants adopted 3 dialysis treatment,including hemodialysis,hemoperfusion and hemodiafiltration.Every 3 months before the dialysis,the Cys-C,NT-proBNP,serum phosphorus,serum intact parathyroid hormone (iPTH),hemoglobin and electrocardiogram were detected.The heartbeat ultrasound was examined every 6 months,observed for 24 months and followed up for 3 years,recording the incidence and the inspection results.The correlation and the occurrence of CVD were analyzed by conducting a multiple factor logistic regression analysis.The forecast performance of Cys-C,NT-proBNP was evaluated by using receiver operating characteristic (ROC) curves and area under curves (AUC).Results Eighteen episodes of CV events occurred in 126 patients during the experiment and follow-up,including 8 episodes of heart failure,4 episodes of myocardial infarction,6 episodes of arrhythmia.Detection indexes had no statistically significant correlation (P ＞ 0.05),and the results of ECG and ultrasound heartbeat graph showed that no significant difference in cardiac structure and function before treatment (P ＞ 0.05).After 24 months duration,the research showed that the level of serum calcemia was lower,and the levels of phosphorus and iPTH were higher in hemodialysis group compared with that in the other 2 groups,and the differences had statistical significance (P ＜ 0.05).The median levels of Cys-C and NT-proBNP were 8.59 (9.74,7.10) mg/L and 7 739 (9 887,6 736) ng/L in the patients CV events occurred.Non conditional multivariate logistic regression analysis demonstrated that the increasing interdialytic weight,Cys-C,NT-proBNP,iPTH,dialysis hypotension were the independent risk factors of CV occurrence.AUCs to predict CVD occurrence in MHD patients was 0.64 (95％CI 0.53-0.71,P ＜ 0.05) and 0.79 (95％CI 0.72-0.89,P＜ 0.01) using Cys-C and NT-proBNP respectively.The cut-off values of serum Cys-C and NT-proBNP for CVD occurrence were 8.59 mg/L and 7 739 ng/L,with a sensitivity of 84.3％ and a specificity of 92.7％.Conclusions Cys-C,NT-proBNP can be used to predict the risk of CV events in dialysis patients.

Airway Obstruction ; diagnosis ; therapy ; Child, Preschool ; Humans ; Infant ; Infant, Newborn