Objective To investigate the early diagnostic value of high‐sensitivity C‐reactive protein(hs‐CRP) ,D‐dimer and cTnI in ACS .Methods All the 83 blood samples of patients with chest pain in the emergency department of our hospital were enrolled in the study ,and 30 healthy people were recruited as the control group .According to the final clinical diagnosis ,29 patients were grouped into non‐ischemic chest pain(NICP) group and 54 patients were grouped into ACS group .Venous blood samples were col‐lected and the concentrations of serum hs‐CRP ,cTnI ,plasma D‐dimer were measured .The diagnostic value of the 3 indicators and their combined test for ACS was evaluated by using the receiver operating characteristic(ROC) curve and Youden index .Results The levels of hs‐CRP ,cTnI and D‐dimer in ACS group were significantly higher than those of the control group and the NICP group (P<0 .05) .The levels of hs‐CRP and D‐dimer in ACS group were significantly higher than those of the NICP group(P<0 .05) . ROC showed that the area under urve of hs‐CRP ,D‐dimer and cTnI were 0 .564 ,0 .631 and 0 .639 respectively .The sensitivity ,spe‐cificity and accuracy of the combined detection of hs‐CRP ,cTnI and D‐dimer were 88 .1% ,58 .7% ,53 .2% respectively . Conclusion To some extent ,the levels of hs‐CRP ,cTnI and D‐dimer all could be used as indicators in the diagnosis of ACS .But combined detection of hs‐CRP ,cTnI and D‐dimer could improve the sensitivity and specificity ,and had value to guide clinical diagno‐sis of ACS in the early stage .

Objective To observe the long-term effect of suramin on the inhibition of proliferation of human retinal pigment epithelial (RPE) cells in vitro. Methods RPE cells grown in 9 pieces of 96-well plate (12 wells each plate) were divided into experimental and control group, with 6 wells in each group. The concentration of 0.1 ml RPE cells in each well is 5?104 cells/ml. After the change of the medium, RPE cells were treated with suramin (250 ?g/ml) in experimental group while treated with nothing in the control group. The medium of the 2 groups were changed to the normal medium after 4 days. At the 1~st , 2~nd , and 4~th day after the addition of suramin and at the 1~st , 2~nd , 3~rd , 5~th , 6~th , 7~th , 9~th , 11~th and 13~th day after removing suramin, 1 plate was randomly selected to stop culturing, and the proliferation of RPE cells were detected by methyl thiazolyl tetrazolium (MTT) assay. Results Under reversed microscope, RPE cells in control group were fused completely at the 7~th day after inoculation. The extracellular space of RPE cells in experimental groups was larger than that in the control group, and remained unfused at the 13~th day after inoculation. The inhibitory rate of proliferation of RPE cells at the first day after treated with suramin was 14.85% and increased to the highest 25.79% at the 4~th day. The first day after the suramin-containing media was removed, the inhibitory rate decreased to 12.35%, and then raised gradually to over 20% at the 3~rd to 5~th day. Finally, the rate drop to 14.71%. Conclusion Suramin has the long-term effect on the inhibition of RPE cells induced by serum, especially the inhibitive effect after the remove of suramin, which indicates the specific double-peak inhibition during the whole process.

Background:Prognosis of early colorectal carcinoma( ECC)is well because of low rate of lymph-node metastasis ( LNM). How to improve the detection rate and select appropriate therapy for ECC has been an eager task in clinical practice. Aims:To analyze the pathological features of ECC treated by endoscopic resection(ER)or surgery,and evaluate the therapeutic efficacy of ER. Methods:Pathological data of 503 ECC lesions treated by ER or surgery were retrospectively analyzed. Risk factors of infiltration depth,LNM of ECC were analyzed,and therapeutic efficacy of ER was evaluated. Results:The overall detection rate of ECC was 10. 7%. The incidence of LNM was 1. 2%(6/503);the LNM incidence of mucosal high-grade neoplasia was 0%( 0/247 ),while was 2. 3%( 6/256 ) in submucosal carcinoma. The LNM incidence of submucosal superficial carcinoma treated by ER was 0%( 0/31 ). Tumor location, size,histological type and LNM had significant impacts on infiltration depth(P<0. 05). The rates of en bloc,complete and curative resection by ER were 96. 0%,94. 2% and 82. 1%,respectively. Infiltration depth was the risk factor of piecemeal,incomplete and noncurative resection of ER(P<0. 05). Conclusions:The incidence of LNM in ECC is extremely low. Accurate evaluation of character and infiltration depth of lesion before operation is helpful for selecting appropriate therapy. It should be cautious to choose ER for lesions infiltrated into submucosa,thereby to improve the therapeutic efficacy of ER.

Aim To investigate the interaction between regulatory proteins related to the activation of eNOS and CYP4A/20-HETE.Methods The endothelia of pulmonary artery of new born bovine were cultured and divided into four groups: controlling group: ethanol solvent as vehicle (the volume is the same with 1?10~ -6 mol?L~ -1 20-HETE) was added to culture dish and incubated for 10 min; 20-HETE 5 min treatment group:1?10~ -6 mol?L~ -1 20-HETE was added to culture dish and incubated for 5 min; 20-HETE 10 min treatment group:1?10~ -6 mol?L~ -1 20-HETE was added to culture dish and incubated for 10 min; VEGF 10 min treatment group: 1?10~ -8 mol?L~ -1 VEGF was added to culture dish and incubated for 10 min. CYP4A,eNOS and proteins related to the activation of eNOS were measured by Immunoprecipitating and immunobloting.Results Expressions of eNOS and phospho-eNOS(Ser1177)in PAECs were upregulated after the cells were treated with 20-HETE, and similar phenomena were observed when 20-HETE was replaced by VEGF; 20-HETE increased the binding of Hsp、Akt and eNOS.Conclusions ①20-HETE phosphorylates eNOS at Ser1177 site which activates the eNOS to catalyze L-aginine to produce nitric oxide.②eNOS binds with Hsp90 and Akt in endothelial cell of pulmonary artery and 20-HETE increase the binding. ③eNOS binds with CYP4A in endothelial cell of pulmonary artery.

Objective To observe the ultrastructural characteristics of human retinal progenitor cells cultured in vitro. Methods Six 5-month-old human fetuses(12 eyes)without eye diseases were selected. Retinal progenitor cells from the retina of one eye of each fetus were cultured in vitro,and observed by transmission electronic microscopy(TEM); while those from the other eye were directly observed by TEM. Results Abundant heterochromatin were found in the karyon of 5-month embryonic retinal neuroepithelial cells,and the figure of the karyons was irregular.A few scattered initial cells were seen in retinal neuroepithelial layer with large karyon,smooth surface,abundant euchromatin,and distinct nucleolus.The human retinal progenitor cells cultured in vitro had the same ultrastructural characteristics as the initial cells:with huge karyon which almost occupied the whole cell,little cytoplasm,distint nucleolus,abundant euchromatin,and little heterochromatin.The cells clung to each other in the neural globoid cell mass.The size of the outer cells was large,and karyokinesis could be found. Conclusion The cultured human retinal progenitor cells are provided with the same ultrastructure characteristics as the initial cells.

Objective:To screen the plasma microRNAs( miRNAs) of differential expression in a high fat diet-induced insulin resistance in mouse models;further investigations on the mice with insulin resistance treated by TLR4 inhibitors TAK-242,and to study the changes of plasma miRNAs expression profile and the relationship among TLR4, miRNAs and high fat diet-induced insulin resistance. Methods:The plasma samples were from 3 mouse groups of previous study,namely,the control group with general basic diet ( low fat diet,LFD) ,TLR4 inhibitors TAK-242 treatment group with a high fat diet ( HFD-T) and the high fat diet control group( HFD-C) . The differential expressed miRNAs was screened by expression profiling of plasma miRNAs, which was detected using mouse miRNA microarray. The quantitative Real-Time PCR ( qRT-PCR ) was used to verify the results of microarray. The target genes of differential expressed miRNAs were predicted in TLR4 signaling pathway using bioinformatics methods,and the GO and KEGG database molecular annotation system were used to investigate the main effects of the miRNAs targeted genes on the biological functions or signal pathway. Results:The screening results of miRNA microarray chip showed that,comparing miRNAs expression between HFD group and LFD control group,185 miRNAs were significant in the high fat diet group,including 6 up-regulated and 179 down-regulated miRANs. A significant difference of miRANs was also found between HFD-T group and LFD control group,the total number of differential expression miRNAs was 171,and all of them were down-regulated. Comparing miRNAs expression between HFD-C group and HFD-T group,13
miRNAs were significant in HFD-T group,all of them were down-regulated. Bioinformatics analysis results showed that a total of 10 in-teraction proteins with TLR4 were predicted;the difference of mmu-miR-3095-3p,mmu-miR-5113,mmu-miR-709 and mmu-miR-335-3p expression levels was more than 1 000 times between HFD-C group and HFD-T group,and their target genes can be found in TLR4-in-teraction protein or Toll like receptor signaling pathway;GO and KEGG analysis showed 74% of these target genes belonged to the biological processes genes, and the transcription factors accounted for 82%. The expression of mmu-miR-3095-3p, mmu-miR-5113, mmu-miR-709 and mmu-miR-335-3p detected by qRT-PCR exhibited the similar patterns of down regulation to those shown in microarray results. Conclusion:When insulin resistance occurs,there is a change in plasma miRNAs expression profile,this change is associated with TLR4 and its signaling pathways. The finding enrichs the possible mechanisms of insulin resistance and provides a basis for finding miRNAs diagnostic markers for early diagnosis of insulin resistance.

AIM:To explore the improving effect of osteocalcin on obesity-related insulin resistance and in-flammation in the adipose tissue of obese mice .METHODS:The C57BL/6 mice were fed with high-fat diet for 12 weeks to obtain obese mice.Osteocalcin (30 ng/kg or 3 ng/kg) and saline solution (control) were intraperitoneally injected for other 4 weeks.The fat mass, body weight, serum triglycerides and serum free fatty acid were analyzed .Intraperitoneal glu-cose tolerance test and insulin tolerance test were carried out .Macrophage infiltration degree in the adipose tissue was ob-served by immunohistochemical staining .The mRNA expression of monocyte chemotactic protein-1 ( MCP-1 ) and CD68 was detected by real-time fluorescence quantitative PCR .RESULTS:Osteocalcin (30 ng/kg or 3 ng/kg) treatment for 4 weeks significantly reduced the body weight , fat mass and insulin level , and improved abnormal glucose tolerance and insu-lin resistance in the obese mice .Moreover, the macrophage infiltration decreased , and the mRNA expression of MCP-1 and CD68 was down-regulated in the adipose tissue of obese mice treated with osteocalcin at 30 ng/kg.CONCLUSION:Os-teocalcin at 30 ng/kg significantly reduces body weight and fat mass , and attenuates the severity of insulin resistance through down-regulating the mRNA expression of MCP-1 and CD68 and inbihiting macrophage infiltration in the adipose tis-sue of obese mice induced by high-fat diet.

Objective To investigate the correlation of CT image features of mesenteric fibromatosis and its pathological characteristics.Methods Data of 12 mesenteric fibromatosis proved histopathologically in PLA General Hospital and Jiangsu Taizhou People's Hospital from March 2006 to March 2015 were retrospectively reviewed.Results There were 5 males and 7 females with ages ranging from 13 to 67.On the CT image,the masses varied from 3.9 cm to 33.0 cm in diameter.8 of them were round or oval well-circumscribed masses,and 4 were irregular with blurry border.10 of 12 cases were totally similar density,which was ranged from 27 HU to 39 HU.Contrast enhanced CT scan showed moderate enhancing masses in l0 of 12 cases.Macroscopic examination of these specimens revealed that the sections of 11 were solid,firm,grey and yellowish,and 1 was solid-cystic.On the histopathology,the masses consisted of homogeneous spindle shaped fibroblasts,myofibroblasts and collagen.Tumor cells were embedded in a collagen network interrupted by fibrotic sections.Immunohistochemical analysis revealed that the tumor cells expressed Vimentin,H-caldesmon and β-catenin.Conclusions Mesenteric fibromatosis is a rare disease with characteristic CT images,which were based on their pathological characteristics.CT images form the basis of preoperative diagnosis of this disease.

OBJECTIVETo discuss the applicatioen of flap for the urethroplasty in the distal penile segment in the staged correction of severe hypospadias.

METHODSFrom Oct. 2004 to Aug. 2014, 25 cases with severe hypospadias were treated by staged urethroplasty for urethra reconstruction. The urethral meatus were located at peroscrotum in 4 patinets, at scrotum in 8 patients and at perineum in 13 cases. At the first stage, the urethral plate was divided and chordee was corrected. Then tubularized transverse island flap was used to prefabricate partial distal urethra. The defective urethra was repaired by using the Thiersch-Duplay principle at the second stage.

RESULTSAll patients completed both stages of the operation. The follow-up duration was 6-72 months (average, 24 months). In the first-stage, the modified tabularized transverse preputial island flap was performed on 10 patients, whereas the modified preputial double-faced island flap was performed on the other 15 patients. All of the prefabricated partial distal urethras had no evidence of stenosis or scarring. The result of the second-stage procedure was a complete penis with integrated urethral. All patients were satisfied with cosmetic and functional results. Neither stricture nor diverticula was observed. A good urinary stream during the urination was achieved in 19(19/ 25, 76%) patients. Five cases (5/25, 25%) developed urethrocutaneous fistula and one cases developed meatal stenosis (1/25, 4%) after the second stage repair.

CONCLUSIONSStaged urethroplasty using flap is a good choice for severe hypospadias. The successful rate is relatively high with good cosmetic and functional results.

Cicatrix ; Follow-Up Studies ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Perineum ; Reconstructive Surgical Procedures ; methods ; Scrotum ; Surgical Flaps ; Time Factors ; Urethra ; abnormalities ; surgery ; Wound Healing

Objective To summarize the clinical features and treatment of male urethral duplication.Methods The clinical data of 2 cases treated in June 2011 and April 2014 were analyzed retrospectively.The first case was a 5-year-old boy presented with passages of urine from two orifices in the penis.The second case was a 15-year-old boy presented with dorsal chordee and a sinus on the dorsum of the penis.The patient had a small amount of watery discharge occasionally dripping out of the opening for 10 years.The 2 patients underwent retrograde urethrography, which revealed a complete duplicated urethra with the channel arising from the proximal prostatic urethra ( class ⅡA2 according to the classification of Effman) .The 2 patients underwent excision of the accessory urethra under general anesthesia.Results The pathology reports of the 2 cases were hyperplasia of squamous epithelium and urothelial mucosa.Pathological diagnosis was urethral duplication.The first case was followed up for 1 year with a satisfactory functional and cosmetic outcome.The second case was followed up for 6 months and no watery discharge noticed from the residual dorsal chordee.Conclusions Urethral duplication is a rare congenital anomality affecting mainly boys.Clinical presentation varies depending on the different anatomical patterns of the urethral anatomy. Surgical management must be evaluated for each different anatomical variation.