Objective To investigate the effects of postconditioning with α7 nicotinic acetylcholine receptor (α7nAChR) agonist and ischemia on myocardial ischemia-reperfusion (IR) injury in rats. Methods Fifty adult male SD rats weighing 290-320 g were randomly divided into 5 groups ( n = 10 each): Ⅰ sham operation group, Ⅱ IR group, Ⅲ ischemic postconditioning group, Ⅳ α7nAChR agonist postconditioning group and Ⅴpostconditioning with α7nAChR agonist and ischemia group. Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 1 80 min of reperfusion. In group] the anterior descending branch was only exposed but not ligated. In group Ⅲ the hearts were subjected to 3 episodes of 10 second ischemia at 10 second intervals at the end of 30 min ischemia before 180 min reperfusion, Intraperitoneal PNU282987 2.4 mg/kg was injected at the end of 30 min ischemia before 180 min reperfusion in group Ⅳ and Ⅴ .Blood samples were taken from right internal jugular vein at 180 min of reperfusion. Then the rats were killed and hearts removed to determine the concentrations of serum cardiac troponin-I (cTnI), TNF-α and high-mobility group box 1 (HMGB1) by ELISA. The infarction size was measured by Evans blue and triphenyltetrazolium chloride staining. Results The infarction size was significantly larger in the other groups and concentrations of serum cTrI, TNF-α and HMGB1 were significantly higher in group Ⅱ than in group Ⅰ ( P ＜ 0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGBI were significantly lower in group Ⅲ, Ⅴ than in group Ⅱ (P ＜ 0.05). The infarction size was significantly smaller in group Ⅴ and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅳ and Ⅴ than in group Ⅲ (P ＜0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅴ than in group Ⅳ ( P ＜ 0.05 ). Conclusion Postconditioning with α7nAChR agonist and ischemia can reduce myocardial I/R injury and the efficacy is better than that of α7nAChR agonist postconditioning or ischemic postconditioning alone.

Objective To observe the clinical efficacy of long-snake moxibustion in treating asthma due to deficiency of lung and spleen. Method Seventy patients were randomized into a treatment group and a control group. The treatment group was intervened by using long-snake moxibustion, while the control group was by regular acupuncture treatment. The therapeutic efficacy was evaluated after 1-month treatment. Result In the treatment group, 22 subjects showed marked efficacy, 27 showed effective, 6 failed, and the total effective rate was 89.1%; in the control group, 18 subjects showed marked efficacy, 25 showed effective, 12 failed, and the total effective rate was 78.2%. The therapeutic efficacy of the treatment group was significantly higher than that of the acupuncture group(P＜0.05). Conclusion Long-snake moxibustion can produce a higher therapeutic efficacy than regular acupuncture in treating asthma due to deficiency of lung and spleen.

Objective:To construct pGEX-3X/hTSHa Escherichia coli(E.coli)expression system and prepare purified recombinant GST-recombinant human thyroid stimulating hormone(rhTSH)α protein.Methods:The complete coding sequence of hTSHα was obtained by RT-PCR with total RNA extracted from fresh chorial tissue as the template,and thereafter cloned into expression vector pGEX-3X by EcoRl and BamHI digestion.The recombinant plasmid was transformed into E.coli Mach1-T1 and then induced expression by WrG.The GST-rhTSHα fusion protein was identified by SDS-PAGE and its antigenicity was verified by a modified competitive ELISA.Results:A specific protein band of 36 ku,in accordance with predicted molecular weight,could be visualized in SDS-PAGE.As the result of ELISA,the recombinant GST-hTSHα protein can inhibit the intact TSH molecular binding with anti-TSHα antibody in a dose dependent manner.Conclusion:The cDNA of hTSHα was cloned and the recombinant expression vector pGEX-3X/hTSHα was constructed successfully.The recombinant GST-rhTSHα protein could be highly expressed in E.coli Machl-T1 and was approved of possessing antigenicity.

Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine,China) from July 2004 to June 2016.Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.Results· Of the 84 patients who were treated with ICE regimen,37 (44.0％) patients had responses,including 26 (31.0％) achieving complete remission.The median number of cycles per patient was 3 (range 1-6 cycles).The 1-year and 2-year OS rates were 49.5％ and 30.0％,respectively.The median OS time was 12.2 months.On univariate analysis,patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes.While improved outcome was found in patients in complete remission after chemotherapy (P=0.000).The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor,and remission after chemotherapy was an independent prognostic factor for prolonging survival.Conclusion· The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.

Objective:To construct suitable vectors for the secretory expression of hirudin in Pichia pastoris.Methods:The α-facor-hirudin gene was amplified from pPIC9-hirudin by PCR and sub-cloned into PA0815.The multi-copy recombinant plasmid pA0815-(α-Hirudin)n was constructed.The recombinant was transformed into P.pastoris strain GS115 for induction expression and then the activity of secreted products was identified.Results:A new multi-copy vector pA0815-(αHirudin)n was successfully constructed and was capable of secreting recombinant hirudin efficiently,which was confirmed respectively by PCR and SDS-PAGE.The products possessed the activity of thrombin inhibitor.Conclusion:This result offers efficient P.pastoris stains for mass production of biological active hirudin.

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To compare the effects of ischemic preconditioning versus ischemic postconditioning on myocardial ischemia-reperfusion (I/R)-induced inflammatory response in rats. Methods Forty male SD rats weighing 290-320 g were randomly divided into 4 groups ( n = 10 each): Ⅰ group sham operatin (group S); Ⅱ group I/R; Ⅲ group ischemic preconditioning (group IPC) and Ⅳ group ischemic postconditioning (group IPOC).Myocardial I/R was induced by 30 min ligation of left anterior descending branch (LAD) of coronary artery followed by reperfusion. In group IPC myocardial I/R was preceded by 3 cycles of ischemia followed by reperfusion (each lasting 5 min) while in group IPOC 3 cycles of I/R (each lasting 10 s) was started at the end of 30 min myocardial ischemia. MAP, HR and RPP ( MAP × HR) were recorded before (baseline) and at 1 and 20 min of ischemia and 60, 120 and 180 min of reperfusion. Venous blood samples were collected at 30 and 180 min of reperfusion for determination of serum concentrations of TNF-α, IL-6, high-mobility group box 1 (HMGB1) and cTnI. The animals were sacrificed at 180 min of reperfusion and the myocardial infarct size was measured. Results Myocardial I/R significantly decreased MAP and RPP and increased myocarcial infarct size, serum concentrations of TNF-α, IL-6,HMGB1 and cTnI in group I/R as compmed with group S. Ischemic pre- and postconditioning significantly increased MAP and reduced myocardial infarct size and I/R-induced increase in serum TNF-α, HMGB1 and cTnI concentrations in group Ⅲ and Ⅳ as compared with group Ⅱ (I/R). The myocardial infarct size was significantly larger and the serum concentrations of TNF-α, IL-6 and HMGB1 were significantly higher in ischemic postconditioning group than in the preconditioning group. Conclusion Ischemic preconditioning is more effective in attenuating the myocardial I/R-induced inflammatory response than the ischemic postconditioning.

Objective To evaluate the preventive efficacy of oral small-dose thyroid hormone tablet premedication for a short time on euthyroid sick syndrome (ESS) in children undergoing open heart surgery under cardiopulmonary bypass (CPB) .Methods Forty ASA Ⅰ or Ⅱ children aged 3-12 yr, weighing 10-30 kg, scheduled for elective congenital heart disease surgery under CPB, were randomly allocated into 2 groups ( n = 20 each):placebo group (group P) and thyroid hormone tablet group (group T). Group T received oral thyroid hormone tablets 0.4 mg/kg every day for 4 consecutive days before surgery, while group C were given placebo. CPB was routinely established, and mild hypothermia, moderate hemodilution and high flow perfusion were adopted. Blood samples were taken from radial veins before administration (baseline) and on 1st, 2nd and 4th day after surgery to detect the serum concentrations of triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH).SP, DP and HR were recorded before administration, immediately after surgery, and on 1st and 2nd day after surgery. The endotracheal extubation time, length of ICU stay, application of positive inotropic agents and occurrence of ESS were recorded. Results No significant difference was found in hemodynamic parameters, endotracheal extubation time and length of ICU stay between the two groups ( P ＞ 0.05). As compared with the baseline values,the serum T3 levels on 1st, 2nd and 4th day after surgery, and the serum TSH levels on 1 st day after surgery were significantly decreased in the two groups, and the serum T4 levels were significantly decreased on 1 st day after surgery in group P ( P ＜ 0.05). The serum levels of T3 and T4 were significantly higher, the severity of postoperative ESS and the number of positive inotropic agent administration were significantly lower in group T than in group P (P ＜ 0.05 ). Conclusion Although oral small-dose thyroid hormone tablet premedication for 4 days (0.4 mg/kg per day) can reduce the severity of postoperative ESS, but it can not prevent the occurrence of ESS in children undergoing open heart surgery under CPB.

Objective:To explore the effect of clinical conventional fractionated dose radiation on the expression levels of immunogenic cell death (ICD) related proteins in patients with nasopharyngeal carcinoma (NPC).Methods:A total of 38 newly-treated NPC patients admitted to the Affiliated Cancer Hospital of Guizhou Medical University from November 2020 to December 2021 were enrolled, all of whom received induction chemotherapy and concurrent chemoradiotherapy, and another 20 healthy volunteers were selected as controls for a prospective study. The contents of ICD related proteins, namely calreticulin (CRT), high mobility group box 1 protein (HMGB-1) and heat shock protein 70 (HSP70) and the proportion of dendritic cell (DC) in the peripheral blood of patients were detected before treatment, after induction chemotherapy and after concurrent chemoradiotherapy, respectively. The correlation between the above indicators, general clinical data and short-term efficacy was analyzed by statistical methods such as t-test and analysis of variance (ANOVA). Results:The levels of HSP70 and HMGB-1 in peripheral blood of NPC patients before treatment were higher than those of healthy controls (both P<0.05). After concurrent chemoradiotherapy, the content of CRT was significantly higher than that before treatment ( P<0.05), whereas the difference before and after induction chemotherapy and the difference before and after concurrent chemoradiotherapy were not significantly correlated with the short-term efficacy of NPC patients. HSP70 level was significantly decreased after concurrent chemoradiotherapy ( P<0.001). There were no significant differences in the content of HMGB-1 after induction chemotherapy and concurrent chemoradiotherapy (both P>0.05). Conclusion:NPC patients receiving TPF regimen (docetaxel+cisplatin+fluorouracil) for induction chemotherapy and sequential cisplatin concurrent chemotherapy may induce ICD in NPC cells, and CRT has potential value in reflecting the clinical efficacy of NPC.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.