Objective To identify the morphological parameters that are related to intracranial aneurysms (IAs) rupture using a case-control model. Methods A total of 107 patients with multiple IAs and aneurysmal subarachnoid hemorrhage between August 2011 and February 2017 were enrolled in this study. Characteristics of IAs location, shape, neck width, perpendicular height, depth, maximum size, flow angle, parent vessel diameter (PVD), aspect ratio (AR) and size ratio (SR) were evaluated using CT angiography. Multiple logistic regression analysis was used to identify the independent risk factors associated with IAs rupture. Receiver operating characteristic curve analysis was performed on the final model, and the optimal thresholds were obtained. Results IAs located in the internal carotid artery (ICA) was associated with a negative risk of rupture, whereas AR, SR1 (height/PVD) and SR2 (depth/PVD) were associated with increased risk of rupture. When SR was calculated differently, the odds ratio values of these factors were also different. The receiver operating characteristic curve showed that AR, SR1 and SR2 had cut-off values of 1.01, 1.48 and 1.40, respectively. SR3 (maximum size/PVD) was not associated with IAs rupture. Conclusions IAs located in the ICA are associated with a negative risk of rupture, while high AR (>1.01), SR1 (>1.48) or SR2 (>1.40) are risk factors for multiple IAs rupture.

Objective To explore the role of miR-20a on pulmonary surfactant synthesis of alveolar epithelial cells A549 and its potential mechanism.Methods Lentivirus miR-20a overexpression vector(miR-20a group) or lentivirus no-load vector(no-load group) was transfected into A549 cells,and the expression of green fluorescent protein(GFP) was observed to determinate the transfection effficiency;cell proliferation was detected by using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT);the bioinformatics software and database were applied to predict and analyze the target genes of miR-20a about lung development;expressions of miR-20a,pulmonary surfactant-associated protein A(SP-A),pulmonary surfactant-associated protein B(SP-B),pulmonary surfactant-associated protein C(SP-C) and pulmonary surfactant-associated protein D(SP-D) mRNA were detected by using quantitative real-time PCR(qPCR);the expressions of SP-A protein,SP-B protein,SP-C protein,SP-D protein and protein signal transducers and activators of transcription 3 (STAT3) were detected by using Western blot.Results Observation of GFP expression under a fluorescent microscope indicated similar transfection efficiency,and real time-PCR showed that the expression of miR-20a increased after being transfected with lentivirus miR-20a overexpression vector(3.85 ± 0.18)compared with the normal group (0.99 ± 0.04)and the no-load group (1.21 ± 0.12),and the differences were significant(t =10.85,9.64,all P ＜0.001).As a result,lentivirus miR-20a overexpression vector was constructed successfully.Online software predicted that STAT3 gene was likely to be the target gene of miR-20a.Compared with the normal group (24 h,48 h,72 h:0.23 ± 0.01,0.39 ± 0.01,0.56 ± 0.03) and the no-load group (24 h,48 h,72 h:0.25 ± 0.01,0.44 ± 0.05,0.59 ± 0.01),miR-20a did not change the cell proliferation at different time points(24 h,48 h,72 h:0.26 ± 0.01,0.41 ± 0.02,0.58 ± 0.02) (all P ＞ 0.05).Compared with the normal group (1.00 ± 0.05,1.24 ± 0.20,1.31 ± 0.09,0.89 ± 0.12) and the no-load group (0.76 ± 0.10,1.31 ± 0.13,1.50 ± 0.11,1.01 ± 0.11),miR-20a up-regulated the mRNA expressions of SP-A,SP-B,SP-C and SP-D (2.05 ± 0.17,2.14 ± 0.10,2.84 ± 0.09,1.66 ± 0.08),and the differences were significant (all P ＜ 0.05).Compared with the normal group (0.46 ± 0.01,0.27 ± 0.03,0.69 ± 0.01,0.43 ± 0.01) and no-load group (0.43 ± 0.01,0.21 ± 0.01,0.79 ± 0.02,0.44 ± 0.02),miR-20a also increased the protein expressions of SP-A,SP-B,SP-C and SP-D (0.55 ±0.01,0.47 ±0.05,0.96 ±0.02,0.59 ±0.03),the diffe-rences were statistically significant (all P ＜0.05).The expression of STAT3 in miR-20a group(0.37 ±0.05) was significantly lower than that in the normal group(0.60 ±0.04) and the no-load group (0.68 ±0.06),and the differences were statstically significant (all P ＜ 0.05) in A549.Conclusions STAT3 is a downstream target gene of miR-20a.miR-20a can promote pulmonary surfactant synthesis of alveolar epithelial cells A549 by inhibiting STAT3.

Objective To evaluate the efficacy and safety of oxygen inhalation combined with oral administration of soy isoflavones on people who migrated from plains to high altitude area suffering from polycythemia. Methods Eighty young men, who migrated to the area of altitude of 3500~5300m for more than ten months, and their hemoglobin (HGB) level was verified in the range of 190g/L≤HGB <210g/L, which was confirmed by blood routine examination for three times, were randomly divided into 2 groups: oxygen group (n=37) and oxygen plus soy isoflavones group (n=37). For the former, the subjects were given low flow oxygen inhalation (1-2L/min) for 1.5 hours, 2-4 times per day; for the latter, the subjects were given low flow oxygen therapy (same as the former) combined with oral administration of 40mg soy isoflavones per day. After 12 weeks, all the subjects were rechecked with blood routine examination and the clinical symptoms of chronic mountain sickness (CMS) score, to evaluate the improvement in red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), and the clinical symptoms. Results After 12 weeks of follow-up, the value of HGB in oxygen plus soy isoflavones group was lowered by 8.76 ± 5.15g/L, while in oxygen group it was lowered by 4.16 ± 5.33g/L, and the magnitude of lowering was significantly different between the two groups (P<0.05). The degree of improvement of clinical symptoms after the intervention was observed in the two groups, and it was found that obvious improvement was observed in the oxygen plus soy isoflavones group (P<0.05), but no obvious improvement was observed in oxygen group (P>0.05). Multiple linear regression analysis revealed that the affecting factors of HGB that the change in HGB values was significantly associated with test grouping. In addition, there were no obvious side effects and changes in BP, ECG, chest X-ray, liver and kidney functions before and after soy isoflavones intake. Conclusion In high-altitude area, oxygen and oral administration of soy isoflavones are safe and more effective measure in the early prevention of high altitude polycythemia.

OBJECTIVETo explore the impact of kruppel like factor 15 (KLF15) on cardiac fibroblasts on angiogenesis in a pressure overload rat model.

METHODSPressure overload was induced in female rats by aortic constriction for 3 and 6 weeks. After 6 weeks aortic banding, rats underwent aortic debanding for 3 or 6 weeks. Sham rats were observed for 3 and 6 weeks (n = 10 each). Cardiac function, myocardial pathological changes, interstitial angiogenesis and KLF15 expression during rat myocardial overloading-unloading process were determined. Cardiac fibroblasts and vascular endothelial cells were cultured in vitro in the absence or presence of KLF15-shRNA recombinant adenovirus and the regulation effect of KLF15 on vascular endothelial cells and angiogenesis was observed on a three-dimensional angiogenesis in vitro model.

RESULTSThe ascending aorta diameter, ejection fraction, fractional shortening, left ventricular systolic pressure and the KLF15 protein expression level were significantly lower but the left ventricular end-diastolic pressure was significantly higher in pressure overloaded rats than in Sham rats (all P < 0.01) after 6 weeks. At the same time, increased myocardial hypertrophy and fibrosis as well as reduced angiogenesis density were observed in pressure overloaded rats. These changes were significantly attenuated post aortic debanding. In vitro, KLF15-shRNA recombinant adenovirus transfection into cardiac fibroblasts significantly downregulated the protein expression of KLF15 compared with the control group (4 922 ± 430 vs. 7 034 ± 178, P < 0.01). The formation of tubular structure of vascular endothelial cells was shorter after KLF15-shRNA recombinant adenovirus transfection and the structure was incomplete when compared with the control group.

CONCLUSIONOur results suggest that upregulation of KLF15 expression in myocardial fibroblasts might promote vascular generation, alleviate the myocardial interstitial fibrosis and improve cardiac function in this pressure overload rat model.

Animals ; Aorta ; Aortic Valve Stenosis ; Down-Regulation ; Female ; Fibrosis ; Heart ; Kruppel-Like Transcription Factors ; metabolism ; Myocardium ; Neovascularization, Physiologic ; Rats ; Vascular Remodeling

OBJECTIVETo investigate the change and correlation of carbon monoxide/heme oxygenase and nitrogen monoxide/nitric oxide synthase system in atherosclerosis and the influence of the two systems on atherosclerotic progress.

METHODSThe rabbits received 1% cholesterol diet (chol group, n = 8), or 1% cholesterol diet plus L-arginine (L-arg group, n = 8) or L-NAME (L-NAME group, n = 8) by drinking water, or 1% cholesterol diet plus heme-L-lysinate (Heme group, n = 8) or ZnPP-IX (ZnPP group, n = 8) by injection in abdominal cavity for 10 weeks.

RESULTSCompared with those in control group, aortic NO production and expression of NOS decreased markedly; while CO production (P < 0.01) and HO-1 activity increased obviously in chol group. The aortic plaques area was (40.2 +/- 8.9)% in chol group. Compared with those in chol group, aortic areas [(26.6 +/- 9.2)%] reduced distinctly in heme group, aortic CO production and NOS activity increased obviously (P < 0.01) in L-arg group. However, compared with those in control group, HO-1 expression and CO production decreased markedly (P < 0.01) in heme group, while they were not different from those in chol group. Compared with those in chol group, aortic cNOS activity and NO production increased obviously and aortic plaques area [(28.1 +/- 7.7)%] greatly reduced (P < 0.01) in L-arg group. However, HO-1 expression and CO production of L-arg group decreased distinctly compared with those of control group, but they were similar to those of chol group. The aortic c-myc and c-fos expressions in both heme group and L-arg group reduced markedly compared with those in chol group, while they were similar to those in ZnPP and L-NAME group.

CONCLUSIONThe reciprocal relationship between heme oxygenase/carbon monoxide and nitric oxide synthase/nitrogen monoxide system in atherosclerosis may play the inhibitory role against atherosclerotic lesion.

Animals ; Atherosclerosis ; metabolism ; pathology ; physiopathology ; Carbon Monoxide ; metabolism ; Heme Oxygenase-1 ; metabolism ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Rabbits

BACKGROUNDTo determine the inhibitory effect of antisense peptide nucleic acids (PNA) of telomerase on the growth of lung cancer cell lines.

METHODSThe synthesized modified antisense PNAs of telomerase were transfected into the lung cancer cell lines A549 and NCI-H446 respectively by lipofectamine transfection. Telomerase activity was detected by RT-PCR-ELLISA, and the cell counts were determined by MTT.

RESULTSSeventy two hours after transfection with antisense PNAs of telomerase, telomerase activity (A450 value) of A549 and NCI-H446 were down regulated from 0.582 ±0.039, 0.571±0.043 to 0.294±0.048 ( P < 0.01), 0.276±0.051 ( P < 0.01) respectively, and alive cell counts (A580 value) of them from 0.485± 0.009 , 0.513±0.015 to 0.191±0.027 ( P < 0.01), 0.138±0.046 ( P < 0.01) respectively. The growth of two lung cancer cell lines were significantly inhibited.

CONCLUSIONSAntisense PNA of telomerase might inhibit not only the telomerase activity, but also the growth of lung cancer cell lines in vitro.

Objective　To study the indication, contraindication and short-term clinical effects of stereotactic radiotherapy (X-knife) in lung cancer. Methods　A total of 56 cases (Treatment group) of lung cancer were treated with X-knife composing of the modern 3-D treatment planning system and the stereotactic body frame, and SL-75 accelerator. And another 53 cases only treated with routine external radiation served as the control. In treatment group, 42 cases received 50 Gy radiation, at 2 Gy per day, 5 d per week in the upper mediastinum, hilus of lung, below the primary focus first and then underwent X-knife for the primary focuses, and other 14 recurrent and metastatic cases received irradiation of 8-12 Gy per day, 5 d by X-knife alone. Results　The actually reexamination rate for 1, 3, 6, and 12 months after X-knife treatment in 78 focuses from 56 cases was 79.5% (62/78), 89.8% (70/78), 87.2% (68/78) and 78.2% (61/78) respectively. The focuses reappeared in 3 months after the treatment and the growth rates of focus in 3, 6, and 12 month after the treatment were 2.6% (2/78), 5.1% and 9% (7/78) respectively. There were 2 focuses received a second treatment with X-knife because no change after the first one. Both the 1-and 2-year survival rates of 36 cases of the primary lung cancer in the treatment group were higher than that of control group (89.1%, 53.9% and 77.4%, 39.6%). Conclusion　The stereotactic radiotherapy is of applicable and prospective in the treatment of lung cancer. The indications include: ①As a boost dose in case when primary focus is less than 5 cm after the first external radiotherapy may reduce the exposure of lung tissue to x-ray and the occurrence of radiation pneumonia; ②Treatment for the recurrence after radiotherapy and operation; ③Radical treatment for the metastatic focus less than 5 cm. Attention must be paid to when multiple treatment is carried on the volume of the focus, the Karnofsky scores and the general condition when stereotactic radiotherapy combined with X-knife for lung cancer.

Objective: To investigate the influencing factors for postoperative urinary retention in patients with spinal surgery. Methods: The clinical data of patients with spinal surgery were collected and divided into two groups according to the occurrence of urinary retention (urinary retention group and non occurring urinary retention group). The factors that may affect postoperative urinary retention were compared and multiple factor Logistic regression was used. Results: Among the 292 patients, 56 cases had postoperative urinary retention and the morbidity was 19.18%. Single factor analysis indicated that Univariate analysis showed that there was a statistically significant difference in anesthetic mode, time of indwelling catheter, time of lying in bed, clamping catheter and timing of removal of urinary catheter (χ²=5.035-22.747, P<0.05 or <0.01). Multivariate Logistic regression analysis showed that the risk factors for urinary retention were time of catheter more than 3 days and bed time is no less than 5 days, and the protective factors were clamping the catheter indwelling training, having a sense of urine and bladder filling. Conclusions During the period of indwelling catheter can be closed catheter training, grasp the time of indwelling catheter 1-2 d best catheter time. Urinary catheter should be removed when urine is filled and bladder is filled. At the same time, under the premise of ensuring safety, the patient's bed time should be shortened as far as 5 days, and the rate of urinary retention can be reduced.

OBJECTIVEThis study aimed to construct the expression of bone morphogenetic protein-4 (BMP4) lentiviral vector gene and explore its influence on the biological activity of mouse induced pluripotent stem (iPS) cells.

METHODSiPS cell lines stably overexpressing BMP4 were constructed by lentivirus transfection (BMP4-overexpressing group). Cells without transfection served as the blank group, and cells with only vector transfection served as the empty-vector group. Cell proliferation was detected by CCK8, and the expression levels of ameloblastin (AMBN), cytokeratin (CK) 14, dentin sialophospho-protein (DSPP), bone sialoprotein (BSP), and Runx2 mRNA were detected by quantitative polymerase chain reaction. Alkaline phosphatase (ALP) activity was used to detect the degree of cell differentiation.

RESULTSCompared with blank and empty-vector groups, proliferation activity and ALP activity of BMP4-overexpressing group obvious increased (P<0.05), BMP4, AMBN, CK14, DSPP, BSP, Runx2 mRNA expression also increased (P<0.05).

CONCLUSIONSBMP4 can significantly promote the odontogenic differentiation of iPS.

BACKGROUNDRecrossing the compromised side branch (SB) with a balloon is sometimes technically challenging. The aim of this study was to evaluate whether in-stent anchoring (ISA) is safe and effective to facilitate SB balloon delivery for final kissing.

METHODSOne hundred and fifty-nine consecutive patients were included (166 bifurcation lesions) in this prospective, single-center registry. ISA was used as a bailout method after unsuccessful SB crossing using conventional techniques, including low-profile balloons. Technique success was defined as SB balloon delivery and final kissing.

RESULTSKissing-balloon delivery was successfully performed with conventional strategies in 149 of 166 lesions (89.8%). In the remaining 17 lesions (10.2%), recrossing of the main vessel stent strut was not successful; therefore, ISA was attempted. The balloon successfully crossed the stent struts, and final kissing was achieved in 15 of 17 lesions (88.2%). Total final kissing was achieved in 164 of 166 lesions (98.8%), with success rates of 100% in the single-stent group and 97.6% in the two-stent group. Two cases without balloon delivery had complex bifurcation lesions with severe calcification. There was no vessel dissection in the anchoring zone.

CONCLUSIONSISA is safe and effective for recrossing stent struts when conventional low-profile balloons have failed. However, large-scale trials are warranted for further evaluation.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; methods ; Coronary Artery Disease ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries ; Treatment Outcome