It is discovered that dilated cardiomyopathy (DCM) is not only affected by environmental factors, but also has a significant genetic basis. Phospholamban ( PLN ), one of these related genes, is a prominent regulator of myocardial contractility, It is an important regulatory factor for heart muscle contraction. It can regulate the activity of sarcoplasmic reticulum Ca2+ ATPase ( SERCA2a), and inhibit SERCA2a activity through restricting the Ca2+ flow in myocardial cells. The activity of SERCA2a can be improved by lowering the expression of PLNmRNA, and the affinity of SERCA2a is strengthened, so that the heart's activity is improved.

The diameters and projection area of the articular surfaces, contributed to the formation of the sacroiliac joint, were determined on 50 sets of pelvic bones with image analysing apparatus.By drawing a line connecting the most anterior point of the prominence to the deepest point of the posterior incisure, the articular surface may be divided into a superior and an inferior portions. The inferior portion was larger than the superior portion. Each portion of the articular surface on the ilium is slightly larger than that on the sacrum.In order to explore the relationship between the form of the articular surface and its function in transmitting the gravity of the human body, the stress of the neighbouring area near the anterior margin of the articular surface was determined. Moreover, the bony architecture on the cross section passing through the articular surface was observed. It suggests that the strain in the neighbouring area was in linear equation with the gravity loaded on the spinal column. The strongest stress was determined at the anterior margin of the anterior prominence and the thickness of the cortex lying on the relevant bones appears most obvious at the same sites. These results further improve that the bony architecture was consistent with the strain in bearing the body weight. Besides, the form of the articular surface was also adapted to its function.

In present study, animal model of cardiac hypertrophy induced by abdominal aortic stenosis was utilized, and the lysosomes were investigated by electron microscopy and ultrastructural cytochemistry. The results showed that while cardiac hypertrophy developed, lysosomes participate in apparent remolding of cardiac muscle cells; in the late stage of cardiac hypertrophy, a great deal of autophagocytoses were viewed in some muscle cells which may result in irreversible cell damage.

Objective To assess the therapeutic efficacy of colonic tumor with targeted microbubbles encapsulated VEGFR2 monoantibody (mAb) combined with ultrasonic abrupted destroy.Methods Seventeen Balb/C nude mice with subcutaneous colonic carcinoma xenografts were divided into three groups:group A (5 mice) underwent contrast-enhanced ultrasonography (CEUS) examination and sham ultrasonic abrupted destroy;group B (6 mice) underwent lipid-microbubbles administration combined with ultrasonic irradiation;group C (6 mice) underwent VEGFR2 monoantibody-loaded microbubbles injection combined with ultrasonic irradiation.Red fluorescent protein(RFP) was labeled to all the nude mice model.Both CEUS and flurography were performed before and one week after abrupted destroy.The size,fluroscent area and fluroscent intensity(FI) and vessel density (VD) of each tumor were measured and compared.Results The parameters of length,fluroseent area,FI and VD of each tumor before abrupted destroy were no significant difference among three groups ( P ＞0.05).Parameters of post-sham ultrasonic abrupted destroy in group A were higher than those before sham ultrasonic abrupted destroy ( P ＜0.05).FI and VD in group B were significantly lower than those after abrupted destroy( P ＜0.05).There were no difference of length,fluroscent area of tumor in group B between pre- and post- ultrasonic abrupted destroy (P ＞0.05).Length,fluroscent area,FI and VD of each tumor in groups C were decreased significantly compared with post ultrasonic abrupted destroy ( P ＜0.01 ).There were significant difference of length,fluroscent area,FI and VD of each tumor among groups after ultrasonic abrupted destroy( P ＜0.05).Conclusions VEGFR2 mAb-loaded lipid microbubble combined with ultrasonic abrupted destroy can improve the therapeutic efficacy of colonic tumor.

ObjectiveTo introduce clinical experience of the modified lateral crural reverse island skin flap with two sets of blood supply system for aged ankle & foot soft tissue defect.MethodsOn the anatomy base that cutaneous artery branches of lateral crural reverse island skin flap and perforating branches of sural neurocutaneous vascular flap were originated from peroneal artery, we designed the modified lateral crural reverse island skin flap located in posterolateral cruris treated for aged ankle & foot soft tissue defect. The modified flap had two sets of blood supply system which were from lateral crural flap and sural neurocutaneous flap.ResultsAll 11 flaps survived. The skin grafting of donor sites healed well. Followed up 3-9 months, six cases were satisfactory. Five cases with extensor defect were regained by tendon transplantation after 3 months of the operations.Conclusion The modified lateral crural reverse island skin flap with two sets of blood supply system is a good method for aged ankle & foot soft tissue defect.

Objective To introduce the clinical types of perforator branches of anterosuperior malleolus flap and explore its application.Methods Anterosuperior malleolus flap coupling with dorsal pedal flap was used for repairing the soft tissue defect of hands in 18 patients,in which anterosuperior malleolus flap-dorsal pedal single flap in 12 cases,anterosuperior malleolus flap-dorsal pedal bilobate flap in 4 cases,anterosuperior malleolus flap-dorsal pedal trilobate flap in 2 cases;Anterosuperior malleolus retrograde island (bone) flap was used in recovering pedal soft tissue in 22 patients,the flap pedicled from stem of anterior tibial artery in 16 cases,dorsal pedal flap-anterosuperior malleolus flap in 2 cases,the flap from perforate vessels without injuring the anterior main tibial artery in 2 cases,the bone flap combined with the distal of tibia in 2 cases.Results In the 18 cases of hands,17 cases survived,and 1 case of flap mild necrosis at the distal site took a second-phase skin-grafting to repair.Twenty cases of anterosuperior malleolus retrograde island (bone) flap survived,and the other 2 cases needed secondary skin-grafting to repair the necrosis edge of flaps because of venous limited.After a follow-up from 3 to 6 months,30 cases showed the satisfied postoperative outlook,with the good healing of the donor sites.Typing the 40 cases according to the location of perforator branches of the anterosuperior malleolus flap,20 cases locate in the medial of anterior tibial muscle,16 cases locate between the anterior tibial muscle and extensor hallucis longus,4 cases locate between extensor hallucis longus and extensor digitorum longus.Conclusion Knowing the clinical types of the perforator branches of anterosuperior malleolus flap is not only helpful for the accurate processes of operations、preventing cutaneous branches,but also improving the success rate of surgery.

The blood reserve bank for preparedness against war,as a store of blood products and a base of blood supply,bears the responsibility of wartime emergency blood supply.Site selection is the basis of the construction of the blood reserve bank and directly related with its capacity of blood supply in both peace and wartime.The decision-making process concerning site selection is complicated and multi-aimed with various factors mutually related and conditioned.This paper proposes some basic principles of selecting the site of the blood reserve bank for preparedness against war,which are hoped to be beneficial for the demonstration of its site selection.

Objective To analyze hemolysin and virulence -related genes in incomplete hemolytic Staphylococcus aureus.Methods Fifty strains of incomplete hemolytic Staphylococcus aureus were isolated from patients admitted in the Second Affiliated Hospital of Soochow University during 2013 and 2014, and the isolates with complete hemolytic phenotype were also collected at the same period as the control strains . All the strains were inoculated and subcultured on four kinds of sheep blood agar plates supplied by different manufacturers to compare their hemolytic phenotype .The relative mRNA expressions of hemolysin genes (hla, hlb, hlc, hld) in standard strain, complete and incomplete hemolytic phenotype strains were detected by real-time quantitative polymerase chain reaction (RT-qPCR), and valued by 2 -△△Ct method.t test was used to compare mRNA expressions of hemolysin genes .Western blot was performed to analyze the expression of α-hemolysin.Antibiotic susceptibility test of incomplete hemolytic strains was performed using broth microdilution method.Resistant gene mecA and virulence genes pvl, tst were detected by PCR.Results The steady and hereditary incomplete hemolysis was observed in 50 strains of incomplete hemolytic Staphylococcus aureus on the sheep blood agar plates from different suppliers .Taking mRNA expression of hla, hlb, hlc, hld in standard strain as 1, the relative mRNA expressions of hemolysin genes in incomplete hemolytic strains were 0.02, 7.51, 0.06 and 0.12 respectively, there were statistical differences between standard strain and incomplete hemolytic strains (t =8.46, -56.40, 8.12 and 7.61, all P <0.05).And the expression of α-hemolysin was decreased in incomplete hemolytic strains .All the strains were identified as methicillin resistant Staphylococcus aureus (MRSA).Three strains exhibited different minimum inhibitory concentrations of teicoplanin and linezolid after subcultured , but the differences had no impact on the final results of antibiotic susceptibility test .mecA, pvl and tst genes were positive in incomplete hemolytic strains . Conclusion Staphylococcus aureus with incomplete hemolytic phenotype is methicillin resistant with higher expression of β-hemolysin and lower expressions of α-hemolysin, γ-hemolysin and δ-hemolysin.It carries plv and tst virulence genes and is of high virulence .

Essential of rheumatoid arthritis (RA) is destruction of invasive pannus formation in cartilage, bone and surrounding tissues Chronic inflammation of synovial membrane. Vascular endothelial growth Factor (VEGF) increases vascular permeability and induces angiogenesis. It plays a very important role in the process of joint erosion and destruction of RA. It not only promotes the formation of RA synovial pannus formation, but also acts as a direct proinflammatory factor in the pathogenesis of RA.

Objective To evaluate the effect of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)on the detection of carbapenemase producing enterobacteriaceae. Methods A total of 21 carbapenem non-susceptible enterobacteriaceaeclinical strains were collectedfrom the Second Affiliated Hospital of Soochow University during January to May, 2018, including 11 strains of Klebsiella pneumonia, 3 strains of Klebsiella oxytoca, 3 strains of Enterobacter cloacae, and 4 strains of Escherichia coli. All the isolates were incubated with 0.5g/L meropenem solution for 2 hours. The supernatant was centrifuged and collected for MALDI-TOF MS detection. The characteristic peaks were captured to determin whether the strain was producing carbapenemase or not. And then, the results were compared with PCR results by Kappastatistical analysis. Results The PCR results showed that all the strains were positive for carbapenmase genes, among them 15 isolates were encoding KPC genes, 6 isolates encoding GES genes, 2 isolates encoding NDM genes, 1 isolate encoding VIM genes, 4 isolates encoding GIM and 1 isolate encoding SIM. And the strains could carry one or more carbapem-resistant determinants. MALDI-TOF MS showed that meropenem were hydrolyzed by 21 isolates and a characteristic drug hydrolysis peak appeared at 199 m/z, as a result of carbapenemase produced by enterobacteriaceae. The assay of MALDI-TOF MS was highly consistentwith PCR results. Conclusions The investigation showed that MALDI-TOF MS can directly detect the carbapenemase by capture the characteristic drug hydrolysis peak.