[Abstract ] Objective Bone marrow mesenchymal stem cells(BMSCs) can be induced to the differentiation into vascular smooth muscle cells in many induction conditions.We sought to explore the possibility of the differentiation of mesenchymal stem cells into vascular smooth muscle cells by continuous cell culture in vitro. Methods Rat BMSCs were isolated from the bilateral tibial and femoral bones by the method of whole bone marrow adherence, followed by ex vivo expansion.BMSCs were identified by flow cytometry and three-lineage differentiation.After continuous five days'cell culture of BMSCs, the specific surface antigens of VSMCs were detec-ted by immunofluorescence, western blot and real-time PCR. Results BMSCs expressed CD29、90, in contrast, they did not express CD45、34、49d.After induction of osteogenesis, adipogenesis and chondrogenesis, alizarin red、oil red and alcian blue staining pro-duced a strong reaction in cells.The expressions ofα-SMA、Calponin1、SM-MHC and SM22 in the cells of experimental group were no-tably increased, which indicated that BMSCs were differentiating towards VSMCs. Conclusion In the absence of exogenous stimula-tion, BMSCs can be successfully induced to differentiate into VSMCs by continuous cell culture.

Objective To investigate the importance of hepatitis B virus ( HBV ) infection in the patho-genesis of cholangiocarcinoma ( CC) and further clarify the correlation between the occurrence of intrahepatic and extrahepatic cholangiocarcinoma .Methods HBV protein and gene of 52 formalin fixed,paraffin embedded tis-sues with CC were detected by immunohistochemistry and nest PCR .Results Hepatitis B virus X gene was de-tectable in 33.3%(7/21)of 21 intrahepatic cholangiocarcinoma cases .Hepatitis B surface antigen(HBsAg)was detectable in 21.7%(5/21)and hepatitis B core antigen(HBcAg)was detectable in 19.0%(4/21)of 21 intrahe-patic cholangiocarcinoma cases .In contrast,no HBsAg,HBcAg and hepatitis B virus X gene were detected in any of the 31 extrahepatic cholangiocarcinoma cases .Conclusion HBV infection is a significant risk factor for intra-hepatic cholangiocarcinoma ,but not for extrahepatic cholangiocarcinoma ,in Northeast of China .The integration of HBV gene may be involved in the carcinogenesis of intrahepatic bile duct epithelial cells .

Objective To investigate the feasibility of induction of experimental chronic pancreatitis rat model with L-arginine.Methods Animals were randomly divided into control group,arginine 12 h group,arginine 24 h group and arginine 7 d group with 10 rats in each group.L-arginine solution was intraperitoneally injected twice with an interval of 1 h.Serum amylase and glucose levels at corresponding time points were detected and histopathological scores of pancreas were evaluated.Collagen in pancreas was stained with Van Gieson method.Results Serum amylase levels were (1 634±890 ) U/L,( 3 872±2 676 ) U/L,( 3 307±2 197)U/L and (1 561±304) U/L in control group,arginine 12 h group,arglnine 24 h group and arginine 7 d group,respectively.The serum amylase level in arginine 7 d group was significantly lower than those in arginine 12 h group and arginine 24 h group (P ＜ 0.05 ).There was no significant difference in serum glucose level among all the groups.Histopathological scores were 0.8±0.4,5.1±2.6,6.5±2.2 and 4.5±1.6,respectively.The histopathological score of arginine 7 d group was significantly lower than those in arginine 24 h group (P ＜ 0.05 ).Obvious collagen could be found in pancreatic parenchyma in arginine 7 d group,while little collagen was found in pancreatic tissue in control,arginine 12 h and arginine 24 h groups.Conclusions Injection of L-arglnine induced fibrosis in pancreatic parenchyma and proliferation of tubular complex 7 days later,and it could be used for chronic pancreatitis model induction.

Objective To observe the preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis (DVT) in patients with cerebral hemorrhage.Methods Eighty patients with cerebral hemorrhage admitted to the Department of Neurosurgery in Huzhou First People's Hospital from November 2014 to January 2016 were enrolled, and they were divided into an observation group and a control group according to the difference in treatment methods, each group 40 cases. Both groups were given routine treatment and nursing care, the patients of observation group were additionally given Taohong Siwu decoction (composition:Radix Angelicae Sinensis (stir-fried with wine) 10 g,Radix Rehmanniae Preparata 10 g,Radix Paeoniae Alba10 g,Ligusticum Chuanxiong Hort 6 g,Semen Persicae 6 g,Carthami Flos 4 g), once a day for consecutive 2 weeks.Results The D-dimer level in the observation group was significantly lower than that in the control group (mg/L: 1.47±0.91 vs. 1.88±0.79,t = 1.991,P = 0.035); the incidence of DVT in the observation group was obviously lower than that in the control group [5.0% (2/40) vs. 20.0% (8/40), χ2 = 4.114,P = 0.043].Conclusion Taohong Siwu decoction can effectively reduce the incidence of DVT in patients with cerebral hemorrhage.

Objective To evaluate the diagnostic value of gastrin?17( G?17) and pepsinogen( PG) for gastric cancer. Methods A multicenter cross?sectional study of patients with continuous stomach discomfort from four centers including Changhai Hospital Affiliated to Second Military Medical University, the First Hospital Affiliated to Anhui Medical University, Qinghai Provincial People′s Hospital and the First Hospital Affiliated to Zhejiang University of Chinese Medicine from May 2014 to September 2015 was conducted. Before gastroscopy, fasting serum gatrin?17 and pepsinogen were analyzed by enzyme?linked immunosorbent assay(ELISA). The efficacy of G?17 and PG were evaluated according to endoscopic and pathological results. Results Based on the results of the pathological diagnosis, 1 122 cases were enrolled and divided into chronic atrophic gastritis group ( 548 cases ) , chronic non?atrophic gastritis group ( 370 cases), and gastric cancer group(204 cases). Serum G?17 and PGⅡ levels significantly increased(P<0?05) and PGR significantly decreased( P<0?05) in gastric cancer group compared with other groups. There was no significant difference in PGⅠlevel among three groups. The cut?off value of G?17 to diagnose gastric cancer was 7 pmol/L. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of G?17 for gastric cancer were 59?31%, 70?59%, 68?54%, 30?95% and 88?65% respectively. The cut?off value of PG Ⅰ/PG Ⅱ( PGR ) to diagnose gastric cancer was 7. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PGR for gastric cancer were 41?18%, 83?01%, 75?40%, 35?00% and 86?39% respectively. The cut?off value of PGⅡto diagnose gastric cancer was 10 μg/L. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PGⅡfor gastric cancer were 73?53%, 53?05%, 56?77%, 25?82% and 90?02% respectively. If G?17>7 pmol/L and PGR<7 was regarded as the cut?off value of diagnosis of gastric cancer, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 25?00%, 91?29%, 79?23%, 38?93%and 84?56%respectively. If G?17>7 pmol/L and PGⅡ>10μg/L was regarded as the cut?off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 48?04%, 79?74%, 73?98%, 34?51% and 87?35% respectively. If PGR<7 and PGⅡ>10 μg/L was regarded as the cut?off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 33?82%, 84?86%, 75?58%, 33?17% and 85?23% respectively. Based on logistic regression analysis of the independent variables of high serum G?17 value(>7 pmol/L), low serum PGR value(<7) and high serum PGⅡvalue(>10 μg/L), their OR value were 2?592, 2?237 and 1?864 respectively, and high serum G?17 value showed the highest risk of gastric cancer. Conclusion High serum G?17 and PGⅡ, low PGR are indicators of gastric cancer. Combination of G?17 and PGR has the best diagnostic value for gastric cacer. Gastric cancer can be screened in large scale by combining G?17 and PGR in order to improve the early diagnostic rate of gastric cancer and reduce the mortality of gastric cancer in our country.

Objective To investigate the correlation between Young′s elastic modulus (EI) using shear wave elastography (SWE) and liver pathology .Methods Liver biopsy was performed on 231 patients with chronic hepatitis B (CHB) under supersonic guidance ,and SWE with EI of liver was obtained concurrently .The correlation between measured liver stiffness and pathology was analyzed by using the liver pathology as golden standards .One‐way analysis of variance and Spearman rank correlation analysis were performed for the comparison between groups and correlation between two variables , respectively .Receiver operating characteristic (ROC) curve was used to explore the predictive value of shear modulus for the liver inflammation grades and fibrosis stages .Results The EI medians of different liver inflammation grades were 6 .78 kPa (G1) ,7 .30 kPa (G2) ,9 .93 kPa (G3) and 14 .93 kPa (G4) , respectively ,which were statistically different (H=55 .19 ,P<0 .01) .And EI medians of various fibrosis stages were 6 .62 kPa (S0 -S1) ,7 .15 kPa (S2) ,9 .78 kPa (S3) and 14 .62 kPa (S4) ,respectively , which were also significantly different (H=62 .14 ,P<0 .01) .EI was positively correlated with both liver inflammation grades (r=0 .454 6 ,P<0 .01) and liver fibrosis stages (r=0 .505 6 ,P<0 .01) .The areas under the ROC for G≥2 ,G≥3 and G=4 were 0 .68 (95% CI:0 .61 -0 .75) ,0 .77 (95% CI:0 .70 -0 .84) and 0 .85 (95% CI:0 .77-0 .92) ,respectively .The areas under the ROC for S≥2 ,S≥3 and S=4 w ere 0 .73 (95% C I:0 .66 -0 .79 ) ,0 .78 (95% C I:0 .72 -0 .85 ) and 0 .83 (95% C I:0 .75 -0 .91 ) , respectively .Conclusion The EI measured by SWE is correlated with liver pathology of CHB patients , which may be used to dynamically monitor the progress of liver fibrosis .

Background: Chronic atrophic gastritis (CAG) is a precancerous lesion of gastric cancer.The diagnostic value of serum gastrin-17 (G-17) level for CAG differs substantioulsy, and Helicobacter pylori (Hp) infection may play an important role.Aims: To explore the effect of Hp infection on serum G-17 level, and the diagnostic value of serum G-17 level for CAG under different Hp infection status.Methods: A total of 204 patients with chronic non-atrophic gastritis and 81 patients with CAG from May 2014 to May 2015 at the three different hospitals were enrolled.Gastroscopy was performed, fasting serum G-17 level, postprandial serum G-17 level and Hp-IgG antibody were determined by ELISA.Results: Fasting serum G-17 level was significantly increased in Hp positive group than in Hp negative group (P=0.001), and postprandial serum G-17 level was significantly decreased in CAG group than in non-atrophy group (P=0.002).AUC of fasting serum G-17 level for diagnosing Hp positive and negative CAG were 0.634 (95% CI: 0.537-0.732) and 0.576 (95% CI: 0.478-0.675), respectively, the accuracy were 62.6% and 54.9%, respectively.AUC of postprandial serum G-17 level for diagnosing Hp positive and negative CAG were 0.675 (95% CI: 0.581-0.769) and 0.595 (95% CI: 0.495-0.694), respectively, the accuracy were 61.8% and 53.1%, respectively.Conclusions: Hp infection has impact on serum G-17 level, as a result, the diagnostic value of G-17 level for CAG is different for patients with and without Hp infection.Diagnostic values of fast and postprandial serum G-17 for Hp positive CAG are higher than Hp negative CAG.

Early-onset facioscapulohumeral muscular dystrophy is a rare clinical syndrome characterized by severe muscle weakness started in early childhood,with extramuscular manifestations such as retinal vascular tortuosity,sensorineural hearing loss and epilepsy.Herein we report a case with early-onset facioscapulohumeral muscular dystrophy and Coats syndrome.Early diagnosis of Coats syndrome is critical for the prognosis.

Objective To investigate the correlation between the vitreomacular adhesion (VMA) and exudative age-related macular degeneration (AMD).Methods A literature research was performed in PubMed,EMbase,Cochrane Library,CNKI and Wanfang database from January 2000 to December 2016.Case-control studies on the relationship between VMA or posterior vitreous detachment and exudative AMD were included in this analysis.Literature screening and data extraction were performed according to inclusion and exclusion criteria.The qualities of the literatures were evaluated according to the Newcastle-Ottawa Scale (NOS).Seven literatures were selected into meta-analysis.The NOS score was 9 points in 1 article,8 scores in 4 articles,7 points in 2 articles.A total of 947 eyes with exudative AMD,638 eyes with dry AMD,and 618 eyes with controls were included.The correlation between exudative AMD and VMA were analyzed using the software Review manager 5.3.Results The prevalence of VMA in exudative AMD eyes was higher than that in controls [odds ratio (OR)=2.14,95％ confidence interval (CI)=1.19-3.84,P=0.010] and dry AMD eyes (OR=2.24,95％CI=1.24-4.03,P=0.007).There was no difference in PVD prevalence among exudative AMD eyes,dry AMD eyes (OR=0.44,95％CI=0.16-1.20,P=0.110) and controls (OR=0.70,95％CI=0.41-1.18,P=0.180).Conclusion There is correlation between VMA and exudative AMD.