AIM: To investigate the effects of angiotensin Ⅱ (AngⅡ) and valsartan on the expression of AngⅡ type 1 receptor (AT 1), AngⅡ type 2 receptor (AT 2) and endothelial nitric oxide synthase (eNOS) and the synthesis of nitric oxide (NO) in human umbilical vein endothelial cells (HUVECs, ECV304 cells). METHODS: Human umbilical vein endothelial cells (HUVECs) were incubated by Ang Ⅱ or valsartan for various periods. The expression of AT 1/AT 2, eNOS and the production of NO were detected. Potential mechanism of the above effects was explored by using the relevant inhibitors of the signal molecules and antioxidants. RESULTS: Both AngⅡ and valsartan significantly inhibited the mRNA and the protein expression of AT 1 in HUVECs. The combination of the two drugs caused more significantly inhibitory effects. AngⅡ showed a slightly promotive effect at first and a significantly inhibitory effect afterward on the expression of eNOS and synthesis of NO in HUVECs. MAPK inhibitor reversed the promotive effect whereas valsartan and antioxidant vitamine C significantly reversed the inhibitory effect. CONCLUSION: Valsartan can downregulate the expression of AT 1 in HUVECs. Long time action of AngⅡcan significantly inhibit the expression of eNOS and synthesis of NO in endothelial cells, while valsartan can significantly reverse this inhibitory effect.

AIM:To explore the effect of homocysteine (Hcy)-mediated endoplasmic reticulum stress on lipid metabolism in hepatocytes.METHODS: HepG2 cells used in the study were treated with 5 mmol/L Hcy. The concentrations of Hcy, triglycerides (TGE) and cholesterol (CHO) in the cells were measured. In high methionine diet-induced hyperhomocysteinemia C57BL/6 mice, the concentrations of TGE and CHO in hepatocytes were analyzed. The mRNAs and proteins expressions of glucose-regulated protein 78 (GRP-78) and sterol regulatory element binding protein (SREBP-1) were also assessed.RESULTS: The concentrations of Hcy and lipids (TGE, CHO) in HepG2 cells at different time point were elevated after treated with 5 mmol/L Hcy (P0.05,vs 0 week). The mRNAs and proteins expressions of GRP-78 and SREBP-1 in mice at different time point after high methionine diet were higher than that at 0 week (P

Objective To investigate T cell receptor(TCR)variable β(BV)chain usage at the maternal-fetal interface and explore the relationship between the skewed TCR BV usage and unexplained recurrent spontaneous abortion(BSA).Methods Eighteen cases with unexplained RSA,together with matched 41 women with normal pregnancies in first trimester from Renji Hospital,Shanghai Jiao Tong University were studied.A high-resolution spectrum typing analysis of complementarity-determining region 3 (CDR3)was used to detect and compare the degree and frequency of TCR BV family expression in deciduas between RSA patients and normal controls.Results(1)The expression degree of BV19(0.029±0.031 vs.0.013±0.010,P=0.038)in RSA group showed a higher usage,while BV5.2(0.040±0.035 vs.0.067±0.052,P=0.046)showed a significantly lower usage when compared with normal controls.No significant difference in the expression of the other TCR BV families between RSA and controls were observed(P>0.05).(2),TCR BV2,3,6,and 7 were the four most common BV families in deciduas of patients with RSA and normal controls,whose frequencies were all mors than 50%.In RSA group,higher frequencies of BV15 (33.3%vs.7.3%,P=0.018),BV19(38.9%vs.14.6%,P=0.049)and BV20(33.3%vs.7.3%,P=0.018)were observed;meanuhile lower frequencies of BV4(33.3%vs.65.9%,P=0.026)and BV7 (66.7%vs.92.7%.P=0.018)distributions were observed.The other TCR BV families did not display significantly different freqencies of distribution(P>0.05).Conclusions It is suggested that a significant skewed TCR BV family occurs at the maternal-fetal interface in patients who undergo abortion.The specific skewed usages of TCR BV might be associated with the susceptibility to unexplained pregnancy loss.

Objective To explore the value and methods of echocardiographic application in percutaneous left atrial appendage(LAA) closure for stroke prevention in patients with nonvalvular atrial fibrillation.Methods 6 male patients with nonvalvular atrial fibrillation were enrolled for percutaneous LAA closure,the mean age was (68.7 ± 5.6) years old,the mean CHADS2 (congestive heart failure,hypertension,age≥75 years,diabetes mellitus,and prior stroke or transient ischemic attacks) score was 3.2 ± 1.0.Rheumatic valvular diseases were excluded by transthoracic eehocardiography(TTE) before closure procedure.Transesophageal echocardiography(TEE) was performed to guide the punctures of the atrial septum and then monitored the operation all through the closure procedure.Diameter of LAA orifice was measure by TEE to help choosing the closure device.Immediate results of closure and complications were inspected by TEE simultaneously.24 hours,7 days,3 months,6 months and 1 year follow-up were performed using TTE.Results All the 6 patients underwent LAA closure successfully.3 LAmbre(Lifetech Scientific,Shenzhen) devices and 3 Watchman(Boston Scientific,Natick,Massachusetts) devices were implanted respectively in the 6 patients.Mean diameter of the LAA orifice was (22.4 ± 3.3)mm,and mean size of the closure devices was (28.0 ± 2.9) mm.2 mm in width residual flow at the inferior edge of closure device existed in 1 ease.No complication was observed.Post-procedure 24 hours and 7 days post-procedure followup showed optimal results in all cases.Conclusions Implantation of both LAA closure devices can be performed with high success rates in patients with nonvalvula ratrial fibrillation,with high risk for stroke,and who either had contraindication or were not willing to accept oral antieoagulation.Echocardiography plays a core role all through the closure procedure and can make it safer and more efficient.

Objective To explore the expression of sterol regulatory element binding protein 1C (SREBP-1C) and glucose-regulated protein 94(GRP-94)in hyperhomocysteinmia and to evaluate the effects of endoplasmic reticulum stress proteins on hepatocytes lipids metabolism. Methods After hyperhomocysteinmia C57BL/6 mice model being induced by high methionine diet, TGE and CHO of Hepatocytes were determined, and the expression of SREBP-1C and GRP-94 was assessed by RT-PCR and Western blot. All data were compared to those in control group′s. Results The level of plasmic homocysteine(Hcy) and hepatocytes TGE or CHO of high methionine diet mice at different time point significantly ascended(P

Objective To validate the clinical effect of evidence-based nursing on early rehablilitation of patients with acute myocardial infarction undergoing PTCA and intracoronary stenting. Methods 47 patients with acute myocardial infarction undergoing PTCA and intracoronary stenting were divided into the nursing group(24 cases)and the control group(23 cases).The nursing group received nursing with evidence-based nursing pattern while the control adopted routine nursing method. The nursing effect in the two groups was compared in the following aspects such as the incidence rate of adverse effect,average hospitalization days, athletic ability and psychological status. Results The incidenece rate of adverse effect Was lower(P＜0.05)and the average hospitalization days were shorter(P＜0.01)than those of the control group with addition of cardiovascular complications(P＞0.05).The athletic ability and psychological status were also superior to those of the control group(P＜0.05).Conclusion Application of evidence-based nursing could hasten the rehabilitative process of patients undergoing PTCA and intracoronary stenting.

Objective:To compare the applicability and consistency of NRS2002,SGA and MNA in general surgery hospitalized patients and analyze the effect in clinical outcomes of NRS resuits with respect to each tool.Method:The 150 patients hospitalized in our hospital were chosen as object of study,to screen and evaluate nutritional risk of patients by NRS 2002,SGA and MNA,respectively,on the second hospital day,then to compare the consistency of NRS results with respect to the four tools on clinical outcomes.Results:The applicabilities of hospital NRS2002,SGA and MNA were alternatively 97.25,97.25％ and 98.35％.The evaluation of patients' NRS corresponding to different four tools was consistent.The effects of screening results of MNA,NRS2002 and SGA on clinical outcomes were most closely related.Conclusion:The three nutritional evaluation tools can be applied to the screening of malnutrition in General Surgery.The effects of screening results of NRS2002 and SGA on clinical outcomes were most closely related.

Objective To investigate the analgesic effects of parecoxib sodium combined with patient controlled epidural analgesia (PCEA) after orthopedic subarachnoid block anesthesia surgery.Methods Two hundred patients undergone orthopedic subarachnoid block anesthesia surgery were randomly and equally divided into two groups:Group P (treated intravenously with 40 mg parecoxib sodium combined with PCEA at the end of operation) and Group C ( treated intravenously with 0.5 g tramadol combined with PCEA at the end of operation).The visual analog scale (VAS) was performed at 6,12,24,48 and 72 hours postoperatively in two groups.Meanwhile,the press frequency of analgesic pump,effective frequency,side effects and satisfaction degree were recorded. Results The VAS sore of Group P was lower than that of Group C at 6,12,24,48 and 72 hours postoperatively ( P ＜ 0.05 ).Group P showed a less number in aspects of the press frequency of analgesic pump,effective frequency,and side effects at 12 and 24 hours,but a higher satisfactory degree,compared with Group C (P ＜0.05). Conclusion Combined use of parecoxib sodium and PCEA can exert a better analgesic effect and have a low incidence rate of side effects following orthopedic subarachnoid block anesthesia.

Objective To explore the expression of cytokine and Toll- like receptors(TLRs) in children′s bacterial infection and its clinical significance. Methods Sixty children patients with systemic inflammatory response syndrome(SIRS)were enrolled in this study from December 2014 to June 2016.They were infected by Gram-positive bacteria(G+), Gram-negative bacteria(G+), and regarded as G+group (30 cases) and G- group (30 cases). In addition, 20 healthy subjects were selected as control group.The levels of tumor necrosis factor(TNF)-α, interferon(IFN)-γ, interleukin(IL)-2, IL-4, IL-6, IL-10 and TLR2, TLR4 in peripheral blood were compared.Results The levels of TNF-α,IFN-γ,IL-2, IL-6 and IL-10 in G+group and G-group were significantly higher than those in the control group, and the levels of IFN-γ,IL-6,IL-10 in G+group were significantly lower than those in G+group(P<0.05). The level of TLR2 in G+group was significantly higher than that in G+group and control group(P<0.05).The level of TLR4 in G+group was significantly higher than that in G+group and control group(P<0.05). After treatment, the levels of TNF-α, IFN-γ, IL-2,IL-4, IL-6,IL-10,TLR2 and TLR4 in SIRS were significantly lower than those before treatment: (5.42 ± 1.34) ng/L vs. (9.13 ± 2.91) ng/L, (3.91 ± 1.26)ng/L vs.(6.69 ± 2.13)ng/L,(2.42 ± 0.34)ng/L vs.(3.28 ± 0.62)ng/L,(3.57 ± 0.69)ng/L vs.(4.55 ±1.17) ng/L, (18.82 ± 3.32) ng/L vs. (253.32 ± 38.21) ng/L, (14.32 ± 2.57) ng/L vs. (45.27 ± 8.24) ng/L, 0.366 ± 0.015 vs.1.084 ± 0.053, 0.424 ± 0.029 vs.0.824 ± 0.068,P<0.01.Conclusions Cytokine spectroscopy and TLRs is involved in the process of bacterial infection. Combined detection has great significance in the diagnosis of bacterial infection and identification of infection in children and can provide reference for clinic.

Objective To explore the relationship between mitochondrial DNA gene,GJB2 gene mutations and the susceptibility to noise-induced hearing loss in the army,and to provide scientific evidence for gene screening of susceptible individuals and relevant molecular epidemiology.Methods 182 blood samples were collected from 349 soldiers,consisting of susceptible and tolerance groups exposed to military noise in Beijing.Genomic DNA was isolated,and the targeted fragments of mitochondrial DNA and coding region of GJB2 gene were amplified by polymerase chain reaction(PCR).The PCR products were analyzed by direct sequencing.Results The results revealed that there were 98 mtDNA variants(41 reside in 12SrRNA) and 12 GJB2 gene variants;among them,mtDNA T1095C and G7642A coexisted in 4 susceptible individuals,but these mutations were not found in the tolerance group.In addition,3 tolerant individuals carried 961delT+insC while no one was found in the susceptible group.Conclusion The 12SrRNA is an area evidenced by high variant and mutation rate.The coexistence of mtDNA T1095C and G7642A in the susceptible group exposed to the similar noise suggests that these mutations are pathogenic mutations associated with NIHL.Three tolerant individuals with the history of long-term noise exposure carry 961delT+insC,suggesting that 961delT+insC might be a conditional pathogenic mutation,but not correlate with NIHL.