Atrial fibrillation (AF) is the most common clinical arrhythmia.Atrial electrical remodeling and structural remodeling are the important mechanisms for AF.The intracellular Ca2+ handling abnormalities play an important role in the induction of triggered ectopic activity and in the activation of Ca2+-related cell signaling which mediates fibrillatory remodeling.In addition,the importance of microRNAs,which are a new class of small noncoding sequences that regulate gene expression,has been found in both electrical and structural remodeling.The new discovery of AF mechanisms are helpful to exploring the effective treatment for AF,showing good prospects for the use of translational perspectives.

Objective To investigate the application of whole-body diffusion-weighted imaging (WB-DWI),and to detect bone metastasis in malignant tumor patients.Methods A total of 118 malignant tumor patients prospectively underwent WB-DWI,standard MRI/CT in suspicious bone metastases parts within one week after inspection.Final diagnosis of the bone metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.The differential diagnosis value of apparent diffusion coefficient (ADC) in benign and malignant bone metastases was compared with the variance analysis.Results Area under ROC curve value of WB-DWI with standard MRI/CT (0.999) was larger than that of WB-DWI (0.944) and standard MRI/CT (0.983),and the specificity,accuracy and positive predictive value were also the highest(100.0 ％,97.4 ％,100.0 ％).The ADC values of malignant bone metastases were significantly lower than those of benign lesions[(0.71±0.15)×10-3 mmTs vs (1.50±0.23)×10-3 mm2/s] with a statistically significant difference(F =261.587,P ＜ 0.001).Conclusion WB-DWI is the beneficial supplements of standard MRI/CT.Which can be used for assessment and differential diagnosis of bone metastases in malignant tumor patients combined with ADC value.

Objective To prospectively and directly compare the capability of whole-body DWI,MRI and/or CT (MRI-CT),and whole-body DWI with MRI-CT for assessment of lymphatic metastases in non-small cell lung cancer (NSCLC) patients.Methods The institutional review board approved this study; informed consent was obtained from patients.A total of 56 NSCLC patients underwent whole-body DWI and thoracic CT scan prospectively.Conventional MRI was performed in suspicious lymphatic metastases parts within one week after inspection.Final diagnosis of the lymphatic metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.Two chest radiologists independently assessed all examination results and used a five-point visual scoring system to evaluate the probability of metastases.Final diagnosis based on each of the methods was made by consensus of two readers.Receiver operating characteristic (ROC) analysis was used to compare the capability for lymphatic metastases assessment among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT.The detection abilities of lymph nodes with different size were compared with x2 test.Value of apparent diffusion coefficient (ADC) in the differential diagnosis of benign and malignant lymph nodes was compared with the variance analysis.Results (1) Lymph nodes metastases were divided into 3 groups according to the length diameter (＜ 2,2-3,＞ 3 cm).A statistically significant difference (x2 =13.819,P ＜ 0.01) was found in detection of lymph nodes (＜ 2 cm) among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT(within the 123 lymph nodes,109,98 and 117 were detected respectively),whole-body DWI with MRI-CT was superior to conventional MRI-CT(x2 =13.324,P＜0.01).There were no statistically significant difference between the other 2 groups (in the length diameter 2-3 cm group,43,40 and 45 of all 46 lymph nodes were detected respectively by whole-body DWI,MRI-CT and whole-body DWI with MRI-CT,x2 =3.816,P ＞ 0.05,while in the length diameter ＞ 3 cm group,all of the 27 lymph nodes were detected by each of them.(2) Conventional MRI-CT was superior to whole-body DWI in the diagnosis of lymph node metastasis in NSCLC.The area under ROC curve value of whole-body DWI with MRI-CT(Az =0.978),the sensitivity,specificity,accuracy (97.4％ 、88.9％ 、86.3％ respectively) were significantly higher than conventional MRI-CT or whole-body DWI.(3)The ADC value of malignant lymph nodes were significantly lower than those of benign [(0.79 ± 0.15) × 10-3 mm2/s vs (1.59--0.15) × 10-3 mm2/s,F =332.813,P ＜ 0.01].The sensitivity,specificity,accuracy were 100％ with the cut-off value of 1.06 × 10-3mm2/s.Conclusions Whole-body DWI is the beneficial supplements of MRI-CT and can be used as a earlier clinical technique in patients with suspected NSCLC lymph node metastasis.Combined with ADC value,it can be used for assessment and differential diagnosis of lymphatic metastases in NSCLC patients.

Serum Ca, P, AKP, plasma iPTH, cAMP, urinary Hyp and BMC were measured in 31 cases of Graves' disease. The results showed that about 66.67% of the patients (including 21 controlled and 10 uncontrolled cases) had a decreased BMC, while serum Ca, P, plasma iPTH, cAMP were within the normal range. The data also showed that about 54.6% of the patients had increased serum AKP, but it would not exceed 25 U if no hepatic disease existed. There were positive correlations between serum T, and urinary Hyp, and between urinary Hyp and serum AKP, but a negative correlation between urinary Hyp and BMC. It was suggested that serum AKP and urinary Hyp could be considered as the indices of negative balance of bone metabolism in Graves' disease, and probably it was induced by excessive thyroid hormone directly.

Objective To observe the effects of Changrui Enemas on IL-1β and NF-κB in the rat model of radiation-induced proctitis, and to explore the mechanism of its repairing mucous membrane and diminishing inflammation. Methods Radiation was given on the pelvis of rats through linear accelerator to establish the model of proctitis. 70 rats were divided into seven groups randomly. Small dose (0.4 g/ml), middle dose(0.8 g/ml) and large dose(1.6 g/ml) of Changrui Enemas by retention enema were given for 7 days, with the admixture liquids of Gentamyein and Dexamethasone, Xilei Powder was used as controls. Changes of IL-1β and NF-κB expression were investigated by semi-quantitative RT-PCR and IHC respectively. Results The expression of IL-1β and NF-κB were determined in the groups accepted radiation, but there had been a dramatic decline in the treatment groups(P<0.05). The high dose treatment group was superior to the low dose one on the whole. Conclusion Changrui Enemas can down-regulate the expression of inflammatory factor IL-1β and NF-κB on radiation induced proctitis rats, and reduce the inflammatory reaction, protect the rectal mucosa, accelerate healing up of the ulcer and relief the symptoms.

AIM: To study the effects of vitamins on vascular activity elements in rabbits with atherosclerosis risk factors to determine whether vitamins have a role in preventing atherosclerosis. METHODS: 26 male Chinese rabbits were randomly divided into 3 groups. The first group was fed with normal feed as control group (n=6) .The other two groups were fed with normal feed plus cholesterol, lard and methionine as model group (n=10) and vitamin treatment group (n=10) respectively. In addition, the vitamin group was given multi-vitamin daily by gastrogavage. The experiment lasted for 8 wk. The vascular activity elements of the three groups were detected by radioimmunoassay and nitrate reductase respectively ,and the aorta pathological sample was prepared. RESULTS: In model group, the levels of plasma endothelin and thromboxane B 2/6-keto-prostaglandin F l? were significantly increased compared with control group, but serum nitric oxide showed no obvious changes between both groups. In vitamin group, the levels of plasma endothelin and thromboxane B 2 were significantly decreased, and the levels of 6-keto-prostaglandin F1? and nitric oxide were significantly increased compared with model group. In model group, there were significant pathological lesions, but the lesion was decreased by vitamin treatment. CONCLUTION: The vitamins supplement can alleviate or block the impairment of vascular endothelia caused by atherosclerosis risk factors, and help adjust the equilibrium of vascular activity elements. Therefore vitamins may play a positive role in preventing atherosclerosis.

Objective To investigate the significance of T-bet and GATA-3 in the pathogenesis of pityriasis rosea.Methods SYBR Green Ⅰ real-time fluorescence quantitative PCR was performed to detect the expressions of T-bet and GATA-3 mRNA in peripheral blood mononuclear cells (PBMCs) from 17 patients with pityriasis rosea and 20 normal human controls.Results The average delta Ct value of T-bet mRNA and GATA-3 mRNA was 3.33 ± 0.94 and 5.22 ± 0.69 respectively in the patients,4.31 ± 1.11 and 4.36 ± 1.02respectively in the controls.There was a higher expression of T-bet mRNA but a lower expression of GATA-3 mRNA in the patients compared with the controls (both P ＜ 0.05).Conclusions Patients with pityriasis rosea show an increased ratio of T-bet to GATA3 expression and predominant expression of Th1-type cytokines.Abnormal cellular immunity may play an important role in the pathogenesis of pityriasis rosea.

Objective To investigate the auditory features in patients with severe obstructive sleep apnea hy-popnea syndrome(OSAHS) and the effects of continuous positive airway pressure (CPAP) on auditory functions . Methods Pure tone audiometry thresholds ,auditory brainstem responses (ABR) and distortion product otoacoustic emissions(DPOAE) were performed in three groups with 12 observed objects in each group ,which were the OS-AHS group(before and after treatment of CPAP) ,the simple snoring group and the normal control group .Results In the OSAHS group ,the high frequency auditory thresholds(at 8000 Hz) were greatly higher and the amplitudes of DPOAE reduced ;the detection rates of DPOAE were obviously declined .The peak latencies of Ⅰ ,Ⅲ and Ⅴ , and interpeak latencies of Ⅲ - Ⅴ andⅠ - Ⅴ were longer than those of in the other two groups .The differences were statistically significant(P<0 .05) .The differences of the interpeak latencies of Ⅰ - Ⅲ ,common pure tone au-ditory thresholds (125～4000 Hz) and the thresholds of Ⅴ -wave reaction in the OSAHS group did not change sig-nificantly compared with the other two groups(P>0 .05) .The amplitudes and the detection rates of DPOAEs (0 .5～8 kHz) increased after treatment with CPAP .The differences were statistically significant except the amplitudes of 500 ,750 and 1500 Hz (P<0 .05) .Pure tone audiometry and ABRs did not changed significantly after treatment with CPAP (P> 0 .05) .Conclusion The auditory functions of patients diagnosed with severe OSAHS were im-paired .Treatments with CPAP can partly improve the patients' auditory functions .

Objective To establish and evaluate chemotherapeutic phlebitis model rats induced by vinorelbine via the dorsalis pedis vein.Methods Rats were divided randomly into control and 4 different concentration of vinorelbine-induced model groups.Control rats were injected with 0.1 mL normal saline via the dorsalis pedis vein of the hind limb,while other rats were injected with different concentrations of vinorelbine(2,3,4,5 mg/mL),as above.General observations were performed and the hind limb volume was measured daily for 7 consecutive days to calculate the swelling rate.The rats were then killed and histological changes in the dorsalis pedis vein were observed by hematoxylin and eosin staining.Microstructural changes on the surface of the vascular endometrium were observed by scanning electron microscopy.Results Injection of 2,3,4,5 mg/mL vinorelbine via the dorsalis pedis vein significantly induced hind limb swelling in a concentration-dependent manner,peaking on day 3 in each group.The phlebitis rates on day 7 were 50%in the 2 mg/mL group and 83.3%in the 3 mg/mL group.Phlebitis was also induced in the 4 mg/mL and 5 mg/mL groups,including grade Ⅲ in 66.6%and grade Ⅳ in 83.3%.Histopathology showed inflammatory cell infiltration,wall thickening,lumen stenosis,and thrombosis in the tissues surrounding the veins.Scanning electron microscopy showed destruction of tight junctions of venous endothelial cells,and a rough surface of the vascular lining,resultsing in blood cell adhesion.Conclusions Injection of 0.1 mL of 3～5 mg/mL vinorelbine via the dorsalis pedis vein could induce red,swollen,and cord-like veins,as well as infiltration of inflammatory cells around the vein,thickened vein walls,lumen stenosis,and thrombosis.In addition,the surface of the venous intima was rough and adhered to numerous blood cells.All these features are consistent with those of clinical chemotherapeutic phlebitis in terms of the symptoms and pathological structure.

Objective: To investigate the diagnosis and treatment for oral mucositis induced by low-dose methotrexate and to provide a reference for clinicians Methods : A case of severe chemotherapy-induced oral mucositis caused by short-term use of low-dose methotrexate (the maximum cumulative dose within 1 week) was reported and reviewed in combination with the literature. Results: The patient was treated with low-dose methotrexate (2.5 mg orally every other day at weeks 1, 2, and 4; the third week, 2.5 mg each time for 3 consecutive days for twice, with a maximum cumulativedose of 15 mg within a week). After irregular medication for approximately three weeks, the patient gradually developed severe erosion of the lips, pain, difficulty eating, and skin erosion on both legs. Methotrexate was stopped after admission, and local symptomatic treatments such as Kangfuxin solution were given. Recombinant human granulocyte colony-stimulating factor was used systemically when combined with neutropenia. After treatment, the chemotherapy-induced oral mucositis and skin lesions were improved. A literature review shows that chemotherapy-induced oral mucositis is a toxic reaction to high-dose methotrexate, while cases of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate are rare. Studies have found that the more risk factors patients have, such as poor local oral conditions and systemic diseases such as liver and kidney dysfunction and diabetes, the higher the risk of chemotherapy-induced oral mucositis. Clinicians should cooperate with dentists to address oral diseases as much as possible before using chemotherapy drugs. In addition, when ordering patients to take methotrexate, we should pay attention to the patient's general condition and susceptibility factors, standardize the frequency and dose of administration, adopt personalized treatment plans, and give patients detailed medication education to prevent the occurrence of adverse consequences caused by medication errors. If methotrexate poisoning occurs, the drug should be stopped in time, detoxification and active symptomatic and supportive treatment should be given. Basic oral care, cryotherapy, laser therapy, nutritional support and analgesic drugs are common treatments for chemotherapy-induced oral mucositis. Systemic administration of granulocyte colony-stimulating factor may be considered when accompanied by neutropenia. Conclusion It is necessary to be alert to the occurrence of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate in clinical practice.