AIM: To investigate the effect of L-phenyla lanine on vascular remodeling in hypertensive rats. METHODS: Vascular remodeling was measured by laser scanning conf ocal microscopy (LSCM) in mesenteric resistance arteries isolated from spontaneo usly hypertensive rat (SHR) and normotensive Wistar-Kyoto (WKY) rat. The effect of L-phenylalanine on the hypertensive vascular remodeling was observed. The thi rd most distal first-order branches of mesenteric resistance arteries from SHR a nd WKY were studied. The arteries were fixed under pressure. The segments were s tained with the nuclear dye propidium iodide. The diameter, wall thickness and o rientation angle of smooth muscle cells were measured with LSCM. RESULTS: Compared with WKY, SHR arteries showed: (1) smaller lum en, (2) increased wall thickness, (3) disorganized orientation angle of smooth m uscle cells. L-phenylalanine treatment induced specific changes in the lumen, wa ll thickness and the orientation angle of smooth muscle cells. CONCLUSIONS: Hypertension induces vascular remodeling of the bra nches of mesenteric arteries from SHR. L-phenylalanine inhibits the vascular rem odeling process of hypertension.

Background Receptor for advanced glycation end products (RAGE) play an important role in the process of type 2 diabetes and its microvascular complications.RAGE gene Gly82Ser exists polymorphism,but the correlation of gene polymorphism and diabetic retinopathy (DR) needs further research.Objective This study was to investigate the association of Gly82Ser polymorphism of RAGE gene with DR in Han people of Wuxi area with type 2 diabetic mellitus.Methods One hundred and eighty-five patiens with type 2 diabetes were included in Wuxi district from March 2013 to February 2014.The patients were divided into non DR (NDR) group (93 cases) and DR group (92 cases) according to the DR International Clinical Classification Criteria in 2002,and 120 healthy subjects were included at the same time as the control.All of the subjects received eye examinations,body mass index (BMI) and blood pressure measurement as well as laboratory tests,including blood biochemical indexes,blood lipids and fasting blood glucose levels.The peripheral blood of 3 ml was collected from each subject,and the genotype and allelic frequencies were assayed by PCR-direct sequencing.This study protocol was approved by Ethic Committee of Nanjing Medical University.Written informed consent was obtained from each subject prior to any medical examination.Results The course was significantly longer in the DR group than that in the NDR group (t =2.25,P =0.01).There were two alleles of G and A in the RAGE gene Gly82Ser locus in all the subjects and the distribution of single nucleotide polymorphism was in accordance with Hardy-Weinberg equilibrium (DR group:x2 =0.51,P =0.48;NDR group:x2 =1.38,P =0.24;healthy control group:x2 =0.20,P =0.24).The AA genotype frequency of the subjects in DR group,NDR group and healthy control group were respectively 6.5％,3.2％ and 2.5％,and AA genotype frequency in DR group was higher than that of the NDR group and healthy control group,showing significant intergroup differences (x2 =5.146,P =0.023;x2 =5.039,P =0.037).The distribution of A allele frequency in the DR group was significantly higher than that of NDR group and healthy control group (x2=5.494,P=0.019;x2 =5.235,P =0.023),and the frequencies of G allele and GG genotype in the DR group were lower than those of the NDR and the healthy control group (GG:x2 =4.260,P =0.039;x2 =4.794,P =0.027;G:x2 =5.309,P =0.021;x2 =5.476,P=0.032).No significant differences were seen in the frequencies of genotype and allele of subjects between the NDR group and the healthy control group (AA:x2 =5.346,P=0.127;GG:x2 =6.981,P=0.137;A:x2 =5.618,P =0.082;G:x2 =4.860,P =0.088).Conclusions The Gly82Ser polymorphism of RAGE gene is associated with the pathogenesis of DR in Han population with type 2 diabetes and A allele may be a risk factor of DR.

Objective　To investigate mechanisms of anti-hypertension and anti-cardiovascular remodeling by phenylalanine (phe) in spontaneously hypertensive rats (SHRs). Methods　The comparison of blood pressure (BP) increment with the ages and cardiovascular changes of SHRs was made between the 3% phe-intervented group (SHR-phe) and the control SHRs group. Detection of the structural changes with the VIDAS digital vedio-frequency processing technique and light and electron microscopy were made. The cell growth and proliferation of cultured smooth muscle cells (CSMCs) of the thoracic aortas or myocardial fibroblasts were evaluated by measuring the 3 H-thymidine counts per minute (cpm) incorporated into the new synthesized desoxyribonucleic acid (DNA) and determining the cell number with the crystal violet stain technique. The Ca2+ influx was measured in counts/min of 45　 CaCl2 after incubating it with 5 different concentrations of phenylalanine and the intracellular ［Ca2+］i by Fura-Ⅱ/Am indicator. The total messenger ribonucleic acid (mRNA) of the myocardium was extracted and Northern blot analysis was performed with the probe collagen α2(Ⅰ)cDNA. The tyrosine hydroxylase (TH) activity was measured by high-performance liquid chromatography (HPLC) with electrochemical detector after having reacted with its substrate tyrosine and other reagents. The catecholamine contents in brain homogenat were detected by HPLC method. The comparison of pharmacokinetics of phenylalanine among SHR-phe, SHRs and control Wistar Kyoto (WKY) rats was made after intravenous injection of 3 H-L-phe (1*!ml/kg) by PK-GRAPH Program for kinetic calculation. The 3　H-L-phe uptake by CSMCs after incubating for difinite intervals was also detected and compared. Results　Phenylalanine could prevent the increase of BP with ages and the heart weight (heart/body weight index). The aortic media thickness and the collagen content in the myocardium were decreased significantly in SHR-phe. Whereas the dearranged cardiovascular structure was much improved. The mechanisms might be direct and specific inhibition of the DNA synthesis and proliferation of cardiovascular cells which may be related to the inhibition of collagen α2(Ⅰ)cDNA, c-fos and c-myc expression. Other mechanisms may include decrease of intracellular ［Ca2+］i and an inhibition of central sympathetic activity due to the results of higher TH activity in the caudate nucleus and higher adrenaline content in the posterior hypothalamus. Besides, partial recovery of phenylalanine metabolic aberrants existed in SHRs seems to be another possibility for its effectiveness. Conclusions　Phenylalanine intervention could exert a definite anti-hypertension and anti-cardiovascular remodeling effects on SHRs like seen in human essential hypertension. Its mechanisms might be related to direct inhibition of growth in the cardiovascular cells, decrease of central sympathetic activity, the reverse of the exhibited phenylalanine metabolic aberrants in SHRs, and a decrement of intracellular ［Ca2+］i.

Objective　To clarify whether the disturbances in metabolic kinetics of the essential aminoacid, phenylalanine (phe), are implicated in the genetic pathogenesis of essential hypertension (EH). Methods　1. L-(2, 3D3)-leucine, L-(2, 3D3)-isoleucine, L-15N-lysine, L-(2, 3D3)-valine and L-(2, 3D3)-phe were used for simultaneously studying comparative metabolic kinetics using stable isotope tracer methods with a GC-MS system. Study groups were the offspring with both parents suffering EH (n=10, FH+), 2 or more than 2 parents and grand-parents with EH and stroke (n=12, FS+) and those without genetic predisposition of EH and stroke (n=12, F) groups. 2. By comparing the radioactive counts of ［3H］-phe, and their weight transformation in blood after 1.5?Ci/kg i.v. administration at defined intervals and in tissues obtained after being sacrified among spontaneously hypertensive rats (SHR), 2 kidney-1 clip hypertensive rats (2K1C) and their normotensive controls (WKY). 3. The time transport and concentration transport of ［3H］-L-phe in cpm between the cultured vascular smooth muscle cell of 5th generation in SHR and WKY were compared. Results　A single and unique disturbance of metabolic kinetics in phe were found in FH+, FS+ and SHR. The plasma pool or apparent volume of distribution was enlarged, and the turnover rate constants between plasma and cell tended to show a decrease. The pharmacokinetics of phe in 2K1C was not changed. Only phe content in heart and aorta, the vital organs for predicting BP, were higher in SHR than in WKY tissues studied. Both the time and concentration transport were higher in SHR, e.g., an increment in the net-uptake of L-phe by vascular tissue. Conclusion　A unique aberrant of metabolic kinetics of phe might be implicated in the inherited pathogenesis of EH and stroke both from clinical and animal studies.

Objective:To explore the deficits of facial expression recognition,theory of mind and empathy in patients with schizophrenia and to examine the association of facial expression recognition with theory of mind and empathy.Methods:Totally 47 patients with schizophrenia who met the diagnostic criteria of the Diagnostic and Sta-tistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 35 normal participants were selected.The Facial E-motion Identification Test(FEIT),Yoni task,and the Questionnaire of Cognitive and Affective Empathy(QCAE)were used to measure expression recognition,theory of mind,and empathy.The main indicators were task accuracy and questionnaire scores.Results:Compared to normal controls,patient group showed significantly poorer perform-ance on facial expression recognition accuracy and the Yoni task,and lower scores on cognitive empathy and pe-ripheral responsivity subscale of the QCAE(Ps＜0.05).Regression analyses showed that performance on cognitive theory of mind(β=0.33,P＜0.01)and affective theory of mind(β=0.33,P＜0.01)of the Yoni task were posi-tively associated with accuracy in recognizing happy expressions.Cognitive empathy scores of the QCAE were neg-atively associated with accuracy in recognizing neutral expressions(β=-0.23,P＜0.05).Patients had lower af-fective theory of mind accuracy(β=-0.23,P＜0.05)and QCAE cognitive empathy scores(β=-0.34,P＜0.01).Conclusion:Patients with schizophrenia have deficits in expression recognition,theory of mind,and empa-thy,and that their abnormal expression recognition may be associated with deficits in theory of mind and empathy.

This study was aimed to discover core agent for the treatment of ulcerative colitis and explore the medication rules . A total of 525 ulcerative colitis medical records in the Jiangsu Province Hospital of TCM were selected from 2009 to 2013 . The records were input into the structured information acquisition system of clinical diagnosis and treatment . The complex network analysis was used to analyze core drugs of prescription and drug compatibility after data mining and rule processing . The results showed that the core drugs are Diyu , Huanglian, Muxiang, Baishao, Xianhecao, Danggui, Chaobaizhu, Huangqin, Zicao, Yiyiren, Fuling, Shanyao. It was concluded that data mining can be an objective method in the analysis of core drugs and compatibility in the treatment of ulcerative colitis. It can also be used to guide the clinical prescription medication.

Objective:To observe the effects of miR-146a on human retinal endothelial cell (HREC) under high glucose condition.Methods:Total of 57 cases diagnosed as diabetic mellitus and 40 cases with diabetic retinopathy (DR) in Wuxi People's Hospital Affiliated to Nanjing Medical University from October to December 2013.Forty-one healthy volunteers were enrolled and served as control group.The clinical data and venous blood samples of subjects were collected.HRECs were cultured in normal glucose (5.5 mmol/L) or high glucose medium (30 mmol/L). Real-time PCR was used to detect the expression of miR-146a.The cultured HRECs were transfected with miR-146a mimic, mimic negative control, inhibitor and inhibitor negative control by lipofectamine2000, respectively.The expression of miR-146a and intercellular cell adhesion molecule-1 (ICAM-1) mRNA was examined by real-time PCR and the expression of nuclear factor-кB (NF-кB) p65 and NF-кB p65 Ser536 was detected by Western blot assay. Results:The relative expression of miR-146a mRNA in the diabetic mellitus group and DR group was 0.36±0.08 and 0.27±0.08, respectively, which were significantly lower than 1.00±0.16 in the control group (both at P<0.01). The expression of miR-146a mRNA was 0.37±0.11 in the high glucose group, which was lower than 1.00±0.18 in the normal control group ( t=5.57, P<0.01). The relative expression of miR-146a mRNA in the miR-146a mimic group was 2 540.00±105.00, which was significantly higher than 61.00±17.90 in the miR-146a mimic control group; The relative expression of miR-146a mRNA in the miR-146a inhibitor group was 0.04±0.01, which was significantly lower than 0.88±0.04 in the miR-146a inhibitor control group ( t=23.23, 17.12; both at P<0.01). The relative expression of ICAM-1 mRNA in the miR-146a mimic group was 0.35±0.12, which was significantly lower than 1.00±0.13 in the miR-146a mimic control group; The relative expression of ICAM-1 mRNA in the miR-146a inhibitor group was 2.74±0.48, which was significantly higher than 1.00±0.16 in the miR-146a inhibitor control group ( t=3.58, 3.37; both at P<0.05). The relative expression of NF-кB p65 Ser536 in the miR-146a mimic group was 0.43±0.03, which was significantly lower than 1.07±0.09 in the miR-146a mimic control group ( t=6.74, P<0.01). The relative expression of NF-кB p65 Ser536 in the miR-146a inhibitor group was 2.08±0.12, which was significantly higher than 1.00±0.01 in the miR-146a inhibitor control group ( t=8.76; P<0.01). Conclusions:miR-146a can reduce inflammation of HREC in high glucose condition through inhibiting ICAM-1 expression and NF-кB phosphorylation.

Objective:To investigate the epidemiological characteristics of lower extremity deep vein thrombosis (DVT) in patients with femoral fracture.Methods:Retrospectively analyzed were the data of 2,571 patients with femoral fracture who had been treated at the Third Hospital of Hebei Medical University from January 2019 to December 2019. There were 1,079 males and 1,492 females, aged from 14 to 96 years (average, 67.1 years). There were 1,158 femoral neck fractures, 951 femoral intertrochanteric fractures, 309 femoral shaft fractures, and 153 femoral condylar fractures. 2,414 patients were treated surgically while 157 patients non-surgically. Color Doppler ultrasonography of both lower extremities was performed to determine the occurrence of DVT before operation and every week after operation for patients undergoing surgical treatment, and within 48 hours after admission and every week during hospitalization for those undergoing non-surgical treatment. The incidence and location of DVT were recorded for different femoral fractures.Results:The incidence of DVT in this cohort was 35.5%(913/2,517), that of proximal DVT 5.3%(135/2,571), and that of distal DVT 30.3% (778/2,571). In patients with femoral neck fracture, femoral intertrochanteric fracture, femoral shaft fracture and femoral condylar fracture, the incidence of DVT was respectively 28.8% (334/1,158), 44.7% (425/951), 30.7% (95/309) and 38.6% (59/153), the incidence of proximal DVT was respectively 2.7% (31/1,158), 5.6%(53/951), 9.7% (30/309) and 13.7% (21/153), and the incidence of distal DVT was respectively 26.2% (303/1,158), 39.1% (372/951), 21.0% (65/309) and 24.8%(38/153). The incidence of DVT in the femoral vein and above, popliteal vein, tibiofibular vein and intermuscular vein in this cohort was respectively 2.3%(60/2,571), 2.9%(75/2,571), 6.4%(165/2,571) and 23.8%(613/2,571).Conclusions:The incidence of DVT may be high in patients with femoral fracture, and the proximal DVT with a high risk of pulmonary embolism may occur more in patients with femoral condylar fracture.

OBJECTIVETo analyze the clinical feature and constituent ratio of adult hip fractures in Southwest China.

METHODSThe data of adult inpatients and outpatients with hip fractures treated between January 2010 and December 2011 in 11 hospitals of the Southwest China were collected and analyzed. The data includes gender, age, age distribution and fracture pattern according to AO classification.

RESULTSThere were a total of 2,833 adult hip fractures, including 1,340 (47.30%) males and 1,493 (52.70%) females, with a male-to-female incidence ratio of 1: 1.11 and a mean age of (66±18) years. The highest frequency of hip fractures was seen in the 71 to 85 years age group (42.18%, 1,195/2,833). There were 844 fractures (29.79%) in the young and middle-aged group (16-<60 years) and 1 898 fractures (70.21%) in the geriatric group (≥60 years). Men had a higher rate than women (men: 577 fractures, 68.4%) in the young and middle-aged group, while women had a higher rate than men (women: 1,226 fractures, 61.64%) in the geriatric group, with a significant difference in the sex distribution between the two groups (χ2=214.001, P<0.01). The proportion of intertrochanteric fracture (type 31-A), femoral neck (type 31-B) and femoral head fracture (type 31-C) was 46.59%, 49.74% and 3.67% respectively. The highest frequency of the sub-type in each fracture type was type 31-A2, type 31-B2 and type 31-C2.

CONCLUSIONSWomen have a higher rate than men in Southwest China. Geriatric patients are more than the young and middle-aged patients. The femoral neck fractures, intertrochanteric fractures and femoral head fractures are in descending orders according to the proportion of the three different hip fractures.

Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Femoral Fractures ; Femoral Neck Fractures ; Femur ; Femur Head ; Femur Neck ; Hip Fractures ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged