Objective To study the changes and clinical significance of serum matrix metalloproteinase-9(MMP-9) ,tissue inhibi-tor of metalloproteinase-1(TIMP-1) and vascular endothelial growth factor (VEGF) in infants with early wheezing .Methods Ser-um levels of MMP-9 ,TIMP-1 and VEGF in 116 infants with early wheezing(wheeling group)and 36 healthy infant (control group) were detected by using ELISA .Results Serum levels of MMP-9 ,TIMP-1 and VEGF in wheeling group were significantly higher than those in control group(P<0 .05);In wheeling group ,there was a linear relationship between the level of MMP-9 and VEGF ;the ratio of MMP-9/TIMP-1 was significantly lower in wheeling groups than in control group(P<0 .05) .Conclusion The infants with early wheezing have the dangerous of airway remodeling .Detection of serum levels of MMP-9 ,TIMP-1 and VEGF is of a cer-tain significance for intervention therapy to wheezing infants as early as possible .

Objective:To investigate effects of over-expression and suppression of HMGB1 on proliferation and invasion of endometrial carcinoma HEC-1A cell and underlying mechanisms.Methods:Over-expression or silence of HMGB 1 in HEC-1A cell lines were established by lentiviral vector containing HMGB 1 recombinant plasmid or by HMGB 1 shRNA,respectively.Cell counting kit-8,Transwell,and wound healing assay were used to analyze proliferation,invasion,and migration of HEC-1A cells,respectively.Western blot and reverse transcription-PCR (RT-PCR) were used to detect the expression of NF-κB,VEGF,and matrix metalloproteinase 2 (MMP2) in the cells.Results:Over-expression of HMGB1 promoted the proliferation,invasion,and migration of HEC1A cell,and up-regulated NF-κB,VEGF,and MMP2 expressions,while suppression of HMGB1 inhibited the proliferation,invasion,and migration of HEC-1A cells and down-regulated NF-κB,VEGF,and MMP2 expressions.Conclusion:HMGB1 plays an important role in proliferation,invasion,and migration of HEC1A cell via NF-κB/VEGF/MMP2 pathway.HMGB 1 might be a potential target for endometrial carcinoma therapy.

Objective To optimize the formulation of metoprolol succinate ( MS) controlled release pellets by central composite design-response surface methodology .Methods MS sustained-release pellets were prepared using sugar pellet cores as starter beads , ethyl cellulose as coating materials and MS itself as a pore former .The formulation of MS sustained-release pellets was optimized by a central composite design with two factors at five levels .These two factors ( two independ-ent variables) were the pore former level and coating level , and the evaluated indexes ( namely dependent variables ) included the in vitro cumulative release percentages of MS at 1, 4, 8, 12 and 16 h, respectively.Results and Conclusion The results of mathematical equation fitting suggested that the second-order quadratic model was the optimal fitting equa-tion.According to the response surfaces , the optimum values at the pore former level and coating level weve ranged from 16%to 18%and 20% to 25%, respectively .The in vitro cumulative release percentage of MS from the pellets at 1 h reached 9.15%,which consequently eliminated the lag phase in the initial release period and exhibited a good sustained-release effect.Central composite design-response surface methodology can be applied to optimizing the coating formulation for MS sustained release pellets .

Objectives To explore the clinical symptoms, therapy and prognosis of tachycardia-induced cardiomyopathy (TIC) in children. Methods Clinical data of 22 children with TIC from July 2007 to July 2012 were retrospectively analyzed. Results TIC was mostly seen in male infants and 81.82%of TIC was caused by atrial arrhythmias. The clinical symptom relieved after arrhythmia and ventricular rates were under control with average effective treatment time of (14.00 ± 8.20) days. Ten patients had tachycardia recurrence, 7 of them had atrial arrhythmia and their clinical symptoms were improved after treatment;while 3 of them showed longer time of therapy with average treatment time of (19.50±8.40) days (P<0.05). Five children underwent radiofrequency ablation before school age and got good therapeutic effect. The post-treatment echocardiographic parameters showed cardiac function of TIC children was significantly improved after treatment, including left ventricular end-diastolic diameter index, left ventricular end-systolic diameter index, left ventricular ejection fraction and shortening score (all P<0.05). Conclusions Childhood TIC is a reversible myocardial dysfunction and its prognosis is good. TIC can be induced by various types of tachyarrhythmias and normally by atrial arrhythmia. The preferred treatment of TIC is administration of antiarrhythmic drugs but radiofrequency ablation is needed to ventricular arrhythmias induced TIC.

Objective To investigate the efficacy and tolerability of estradiol (E2) gel with postoperative patients of moderately severe ovarian endometriosis cyst,who suffer from the side effect of GnRH agonist.Methods Sixty samples were selected with stage Ⅲ ～ Ⅳ ovarian endometriosis after conservative operation by the same operator at the Department of Gynecology,Xiangya Hospital,Central South University,between February 2013 and August 2014.All of the patients after surgeries were randomly divided into three groups:control group (n =20) with only goserelin injection after conservative surgery,treatment group A (n =20) who received estradiol gel,and treatment group B (n =20) who received tibolone as an add-back therapy.The serum E2,follicle stimulating hormone (FSH),luteinizing hormone (LH),hypoestrogenic symptoms,the incidence of uterine bleeding,and the recurrence after conservative operation were compared among three groups.Results Three months later aster treatment with goserelin,the serum level of E2 of three groups showed statistically significant difference (P ＜ 0.05).Serum E2 level of treatment group A was not significantly higher than treatment group B (P ＞ 0.05).The kupperman sore,the incidence of hot flashes sweating,tiring,and agrypnia of treatment groups A and B were significantly lower than the control group (P ＜ 0.05).The incidence of uterine bleeding and recurrence dont differ sharply among three groups (P ＞ 0.05).Conclusions GnRHa combined with estradiol gel can improve symptoms of postoperative patients,reduce side effects effectively,and avoid increase of the risk of vagina bleeding and relapse.

Objective To observe the anatomical symmetry of the structures and istribution of the Glissonean pedicle of the intrahepatic Glisson system ,integrating with embryology and comparative anatomy .Methods Morphology of the Glissonean pedicle of liver was examined through peeling and dissecting 20 adult corpses without liver pathological changes.The relevant data were collected and analyzed statistically .Meanwhile, we tried to elucidate elaborating the symmetry theory of liver anatomy through the dissection anatomy ,embryonic anatomy and comparative anatomy .Results The angle between main stem of Glisson system/left branch of Glisson system(GM/GL) was (76.7 ±17.36)°.The angle between GM/GR was (81.4 ±13.8)°.The length of the the Glisson pedicle of left hepatic was (3.1 ±0.76) cm.The length of the the Glisson pedicle of middle hepatic was ( 2.61 ±0.72 ) cm.The length of the the Glisson pedicle of right hepatic was (1.5 ±0.50)cm.The shapes of the Glissonean pedicle stem of the left hepatic presenting arch , the number of radial level 3 branches were between 2-8.The shapes of the Glissonean pedicle stem of the middle hepatic continuing the main of Glissonean pedicle , the number of radial level 3 branches were between 2-6.The shapes of 30%of the Glissonean pedicle of the right hepatic presenting Y and V , 70% of the Glissonean pedicle of the right hepatic presenting C , the number of radial level 3 branches were between 3-8.Conclusion In the light of morphology ,embryology and comparative anatomy, it is reasonable to divide the liver into left ,middle,right lobe by Glissonean pedicle of radial level 2 branches and the liver is an axiality and symmetry organ .

Objective To explore the expression characteristic of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 in colorectal cancer , evaluate the clinical significance of candidate miRNAs in CRC diagnosis.Methods Case-control study was used.The expression levels of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 from 50 CRC patients and 27 normal controls were detected by real-time PCR, the levels of miRNAs expression in serum of 8 CRC patients 1 day before and 7 days after radical surgery were analyzed.The sensitivity and specificity of serum miRNAs expression for the diagnosis of colorectal cancer were evaluated using the receiver operating characteristic ( ROC) curve.Results The expression level of mir-16, miR-21, mir-92a in serum of patients with CRC were (75.55 ±37.73), (35.96 ±23.81), (24.79 ±8.97) fmol/ml, significantly higher than that of the healthy control group (32.73 ±18.94), (24.36 ±13.27), (16.36 ±5.58) fmol/ml (tmir-16 =2.77, tmir-21 =2.34, tmir-92a =3.85,P <0.05).However, the expression levels of mir-29a and mir-143 showed no significant difference between two groups (tmir-29a=-0.17, tmir-143 =1.59,P>0.05).In addition, serum miR-16 and miR-92a levels of CRC patients 7 days after tumor resection were (36.02 ±19.95), (14.82 ±7.78) fmol/ml, significantly lower than that before operation (62.18 ±34.17), (24.06 ±12.99) fmol/ml (tmir-16 =3.59, tmir-92a =2.60,P<0.05).Area under the ROC curve ( AUC) of combined detection of mir-16, miR-21and mir-92a was 0.877, the sensitivity and specificity were 88% and 85%, respectively, which was higher than any of 3 miRNAs alone and the conventional tumor marker CEA.Conclusion Combination of mir-16, mir-21 and mir-92a in the diagnosis of CRC shows a better sensitivity and specificity , which would be expected as new tumor biomarkers for noninvasive diagnosis and monitoring progression of colorectal cancer.

Objective To evaluate the diagnostic value of invasive cardiac catheterization for restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP).Methods Twenty-seven children with CP or RCM hospitalized in Department of Cardiology,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiaotong University from February 2002 to December 2015,were selected,including 10 patients who had been surgically documented CP and 17 patients with RCM who underwent cardiac catheterization.Intracardiac pressure waveforms were recorded and all the measurement indexes of pressure of all the patients were analyzed.The changes of cardiac pressure under deep breathing in 9 patients with local anesthesia was recorded.Results There were significant differences in pulmonary artery pressure,difference between left ventricular end-diastolic pressure (LVEDP) and right ventricular end-diastolic pressure (RVEDP),and the ratio of RVEDP/right ventricular systolic pressure between group RCM and group CP [(50.2 ± 12.0) mmHg(1 mmHg =0.133 kPa) vs.(38.1 ±6.8) mmHg,(7.8±5.5) mmHgvs.(1.8 ±4.7) mmHg,0.27 ±0.10vs.0.45 ± 0.20,respectively;t =2.912,2.787,2.418,all P ＜ 0.05].However,there was overlapping for these criteria,and the predictive sensitivity of any of the criteria was less than 66.7％.In patients with CP,reciprocal changes in the filling between right ventricle and left ventricle occurred during respiration.In patients with RCM,the right ventricle and left ventricle pressures moved concordantly with respiration.The systolic area index was greater in group CP than that in group RCM (1.20 ± 0.03 vs.0.70 ± 0.14),and the difference was significant (t =6.152,P ＜ 0.01).The systolic area index had a sensitivity of 100.0％ and a predictive accuracy of 100.0％ for the identification of patients with surgically proven CP.Conclusions Measurements in catheterization,especially the ratio of right ventricular to left ventricular systolic area during inspiration and expiration is a reliable catheterization criterion for differentiating CP from RCM.

Objective To investigate the expression and clinical significance of DJ-1 protein in the endometrial carcinoma and delineate its functional roles in endometrial carcinoma progression.Methods Expression of DJ-1 was examined with immunohistochemical staining of 69 paraffin-embedded endometrial carcinoma samples who underwent surgery at Hunan province Tumor Hospital.Kaplan-Meier analysis was performed to describe the survival curve.Univariate and multivariate analyses were performed with COX proportional hazard model.Results (1) The expression of DJ-1 protein in endometrial carcinoma was significantly higher than that in normal endometrial tissues (P ＜ 0.05).(2) There was positive correlation between the high expression of DJ-1 protein in endometrial carcinoma samples and the pathological grade,the International Federation of Gynecology and Obstetrics (FIGO) stage,depth of myometrial invasion,or lymph node metastasis (P ＜ 0.05).(3) Kaplan-Meier analysis indicated that the cumulative 5-year survival rate in the low-DJ-1 expression group was 80.8％,whereas it was only 51.2％ in the high-DJ-1 expression group (P ＜ O.05).COX analysis indicated that the expression of DJ-1 was not the endometrial carcinoma independent prognostic factors for overall survival time (P ＞ 0.05).Conclusions The high expression of DJ-1 protein in endometrial carcinoma samples demonstrated a significantly positive correlation with the pathological grade,FIGO stage,depth of myometrial invasion,and lymph node metastasis.However,DJ-1 is not enough to be independent prognostic factor for overall survival time.

Objective Patients with single-ventricle physiology pose a wide variety of therapeutic challenges.Pulmonary artery or anastomosis stenosis in single-ventricle physiology will have only subtle hemodynamic derangements due to the lack of the pumping chamber to force blood across the stenosis.This study aimed to evaluate the feasibility and usefulness of the stent implantation for treatment of branch pulmonary artery and anastomosis stenosis in children with univentricular hearts.Methods Retrospective analysis of 8 implanted stents between March 2014 and January 2015 in Shanghai Children's Medical Center.Transthoracic echocardiography,chest roentgenography and electrocardiography were carried out as follow-up studies at the second day after operation and 1,3,6,12 months after the procedure.Results In all of eight patients (6 males and 2 females),5 cases were post-Glenn operation and 3 cases were post-Fontan operation.The median age was 6.6 years (range 4.0-8.5 years).The median weight was 19.5 kg(range 13.8-25.6 kg).9 stents were implanted successfully in all patient,6 in left pulmonary arteries,2 in right pulmonary arteries and 1 in anastomosis.All stents were placed in the target lesion without any complication.The diameter of the narrowed segment improved from (3.63 ± 2.06) mm to (7.89 ± 1.62) mm (P ＜ 0.01).During follow-up no other complication occurred except thrombus in one patient because of discontinuation anticoagulation.Conclusion Branch pulmonary arterial stenosis in single-ventricle patients may often be underestimated due to the low pressure venous system and/or the development of venovenous collaterals bypassing and decompressing the pulmonary circuit.In these patients,even mild stenosis should be treated aggressively,especially in the presence of pleural effusions,pericardial effusions,protein-losing enteropathy and low-output states.Stent implantation is an effective method of treating branch pulmonary artery stenosis.