Objective To investigate the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in neonates with hypoxic-ischemic encephalopathy (HIE) complicated by myocardial ischemic injury. Methods Forty neonates with HIE ( 16 cases with concurrent myocardial injury and 24 cases without) were enrolled. Twenty healthy neonates were used as control. Plasma NT-proBNP levels were measured using enzyme immunoassay. Cardiac function was measured by echocardiography. Results ( 1 ) The mean plasma NT-proBNP levels in patients with myocardial injury[(350 ± 56) pmol/L]were significantly higher than those in patients without myocardial injury[(135 ± 37 ) pmol/L]and in the control group [(117 ±23) pmol/L](P ＜0. 05). (2) The NT-proBNP levels in mild,moderate and severe HIE neonates were ( 132 ±34) pmol/L, (247 ±43) pmol/L and (343 ±53) pmol/L. Compared with the control group,the NT-proBNP levels in the neonates with moderate and severe HIE significantly increased. There were significant differences in the NT-proBNP levels among the mild, moderate and severe HIE neonates ( P ＜ 0. 05 ).(3) In patients with myocardial injury,the NT-proBNP levels significantly decreased in the convalescent phase [(250±78) pmol/L]compared with those in the acute phase[(350±56) pmol/L](P ＜0.05). (4) The NT-proBNP levels were significantly related with left ventricular ejection fraction. Conclusion Plasma NT-proBNP levels increase in neonates with HIE complicated with myocardial ischemic injury in the acute phase.Detection of NT-proBNP levels maybe useful in the diagnosis of myocardial ischemic injury and severe HIE.

[ ABSTRACT] AIM:To investigate the molecular mechanism and the immunosuppressive phenotype of macropha-ges under long-term exposure to lipopolysaccharide ( LPS) .METHODS:We used Ficoll-Hypaque density gradient centri-fugation combined with MicroBeads Separation Kits to separate peripheral blood mononuclear cells from human blood, and then induced the monocytes into macrophages.We observed the morphology of the macrophages by treating the cells with LPS for 48 h, in comparison with a negative control and IFN-γtreatment.ELISA was used to detect the levels of cytokines, such as IL-10, IL-12, IL-6 and TNF-α, and flow cytometry was used to detect the expression of the surface molecules (HLA-DR, CD14, CCR7, HLA-ABC and CD40).To observe the effect of macrophage on T cell proliferation, co-culture experiment was carried out for 6 d.Real-time PCR was used to validate the expression levels of molecules related to MyD88-independent pathway in Toll-like receptor 4 ( TLR4) signal pathway.RESULTS:The antigen-presenting ability of the macrophages was reduced and the IL-10 expression level was increased after the cells were treated with LPS for 48 h. We observed a poor proliferative capacity of CD8 +T cells after co-culturing of LPS-induced macrophages with CD3+T cells for 6 d.The results of real-time PCR indicated that TRIF, IRF3 and CIITA were down-regulated in LPS-induced macropha-ges.CONCLUSION:We successfully established a macrophage model in vitro and observed that LPS-induced macropha-ges into an immunosuppressive phenotype with poor CD8 +T cell proliferative capacity, in which MyD88-independent TLR4 signaling pathway was impaired.

Objective To evaluate the efficacy of proximal percutaneous pedicle screw fixation combined with distal open osteotomy for sagittal plane imbalance of adult spinal deformity.Methods From January 2011 to June 2015,23 patients with diagnosis of adult spinal deformity were treated with proximal percutaneous pedicle screw fixation combined with distal open osteotomy,there were 8 males and 15 females,aged from 52 to 67 years old (average,62.1 years old).The operation time,blood loss,drainage and perioperative complications were recorded;standing anteroposterior and lateral radiographs of the whole spine were taken and the following parameters were measured:sagittal vertical axis (SVA),lumbar lordosis(LL),pelvic tilt (PT),sacral slope (SS),pelvic incidence/lumbar lordosis mismatch (PI-LL),the above parameters were compared between preoperation and postoperation.Oswestry disability index (ODI) was used to evaluate the clinical efficacy.Results The mean operation time was 253.9±52.1 min,the mean blood loss and drainage was 1 258.5±272.2 ml and 725.1 ± 135.2 ml.No patient got infected,died or had deep vein thrombosis.All patients were followed up for an average of 21.2 months (range,13-52 m).The SVA was restored from 12.6±1.4 cm to 3.5±0.7 cm.In addition,LL,SS,PT,and PL-LL were improved from 13.5°±2.3°,13.9°±2.3°,29.7°±9.6°,29.5°±13.7° to 38.8°±9.6°,25.5°±5.8°,18.9°±8.2°,7.1°±3.6°.The ODI score decreased from 40.3％±12.5％ to 13.6％±2.57％ at the time of the last follow-up compared with preoperation.Conclusion Proximal percutaneous pedicle screw fixation combined with distal open osteotomy for sagittal plane imbalance of adult spinal deformity could restore the sagittal balance and improve the quality of life.

Objective To explore the relationship between the severity of experimental acute pancreatitis (AP) and the expression of Myc interacting zinc finger protein 1 (MIZ1) in rat, to evaluate the value of MIZ1 for severity assessment .Methods Acute necrotizing pancreatitis ( ANP) model was induced by retrograde injection of sodium taurocholate into the pancreatic duct , and normal saline was used in control group.The rats were sacrificed at 6, 24, 48 h, and the blood and pancreas tissue was collected , and serum amylase level , C reactive protein ( CRP ) , TNF-α, IL-6 and MIZ1 were determined by ELISA .Pancreatic tissue was routinely examined by pathologist , and the MIZ1 protein expression in pancreatic tissue was measured by immunohistochemistry and Western blot .Results The serum amylase levels of control group and ANP group at 6, 24, 48 h were (449 ±40), (578 ±25), (1 021 ±205), (971 ±143)U/L, and the levels of CRP were (123 ±23), (169 ±25), (226 ±34), (229 ±24)mg/L;and the levels of IL-6 were (20.16 ± 4.11), (38.60 ±12.05), (52.33 ±6.77), (44.83 ±4.30)ng/L;and the levels of TNF-αwere (55.33 ±3.32), (82.8 ±5.26), (120.66 ±16.00), (108.33 ±12.17)ng/L;and the levels of MIZ1 were (5.51 ± 0.34), (3.44 ±0.56), (2.11 ±0.11), (2.41 ±0.43) ng/L.The pathologic scores of pancreas were (1.83 ±0.75), (6.00 ±1.67), (8.16 ±2.70), (9.33 ±1.50), and the expressions of MIZ1 in pancreatic tissue were 0.81 ±0.05, 0.53 ±0.07, 0.31 ±0.06, 0.21 ±0.08.Except for amylase level of ANP 6h group, other parameters of ANP group were significantly different with those of control group , and the parameters of ANP 24, 48 h group were significantly different with that of ANP 6 h group ( P<0.01), but there was no significantly different between ANP 24 and 48 h group.MIZ1 expression was negatively correlated with serum amylase level , CRP, TNF-α, IL-6 and pathologic scores of pancreas , and the difference was statistically signific ant (P<0.01).Conclusions The decreasing expression of MIZ1 is closely correlated with the severity of AP , and may be a potential marker for prognosis evaluation .

The HPLC-UV-Fluorescence technique and HPLC-UV-MS technique were used to determine fluorescence molecule in gastric juice of patients with malignant gastric cancer,which is identified as tryptophan. Lidocaine was detected in gastric juice of patients who were examined by gastric endoscopy. A method was developed to determine concentration of tryptophan and lidocaine in gastric juice using HPLC-UV technique,in which Kromasil C_(18) column(150 mm×4.6 mm,5μm) and methanol(containing 0.1% trifluoroacetic acid (TFA))-water(containing 0. 1% TFA) as gradient mobile phase were used. The linear relationships were obtained between the concentration of tryptophan in the range of 0.5 - 200 mg/L and its peak area at 278 run with correlation coefficient of 0.9994,and between the concentration of lidocaine in the range of 20 -5000 mg/L and its peak area at 254 nm with correlation coefficient of 0.9992. The limit of detection is 0.15 mg/L for tryptophan and 5 mg/L for lidocaine. The recovery is 70. 8% - 110. 4% for tryptophan and 87. 1% -116.2% for lidocaine. 38 gastric juice samples of patients with malignant gastric disease and 48 gastric juice samples of patients with benign gastric disease were tested and the concentration of tryptophan in those two groups of gastric juice samples was apparently different.

Objective To investigate the effect of cyaniding?3?glucoside (Cy3G) on glucose and lipid metabolism in the APPswe/PS1ΔE9 mouse model of Alzheimer’s disease (AD). Methods Seven?month?old APPswe/PS1ΔE9(PAP) mice were randomly divided into model group (PAP), Cy3G treatment group (PAPCy, 5 mg/kg/d) and negative?control group (nPAP). In addition, age?matched and normal wild?type of C57BL/6J mice were selected and divided into vehicle group (WT), Cy3G intervention group (WTCy, 5 mg/kg/d). Each group containing 12 mice, with equal number of male and female mice. After 8?week Cy3G supplementation, microPET/CT was used to measure cerebral glucose metabolism rate of mice in each group. Biochemical methods were used to detect the liver / kidney function as well as indicators associated with lipid metabolism. After weighting brain tissue, the brain coefficient was tested and pathological examination was used to observe tissues changes. Transmission electron microscope was used to observe neuropathological amyloid plaques deposition. Western?blot was used to determine protein levels of AKT and JNK. Results Compared with the WT group, PAP mice had low levels of 18 F?FDG uptake rates, especially in the regions of the frontal lobe and hippocampus accompanied by the decreased brain coefficient and amyloid plaques deposition in hippocampus. And levels of aspartate transaminase ( AST) and lactic dehydrogenase ( LDH) were also increased in PAP mice, but lipid metabolism index was relatively normal. In addition, the expression of JNK was decreased and AKT was increased in mice of PAP. However, in the PAPCy group, 18 F?FDG uptake rates were obviously increased in the regions of the frontal lobe and hippocampus compared with those in the PAP mice. And the reduction of brain atrophy and amyloid plaques deposition, normal lipid metabolism and no obvious liver/kidney toxicity were also observed. Cy3G also could reverse the changes of JNK and AKT protein. Conclusions Cy3G can improve glucose metabolism disorders instead of lipid metabolism, inhibit the senile plaques deposition in hippocampus and regulate insulin resistance and inflammatory reaction associated with JNK/AKT pathway. Thus, Cy3G has a good safety profile and may be used as an ideal alternative to traditional disease?modifying treatments against AD.

Objective To analyze the outcome of intra-artery chemotherapy for T1G3 bladder cancer , and its effectiveness and safety. Methods From June 2003 to May 2014, 39 patients with T1G3 bladder cancer chose intra-artery chemotherapy (Gemcitabine plus cis-platin), and close follow-up was required after 2 cycles of chemotherapy. During the follow-up, transurethral resection of bladder tumor was performed for non-muscle invasive bladder cancer, and cystectomy was performed for muscle invasive tumor. Results Of all patients, 32 were male and 7 were female. The median age was 56 years old (range: 32-82 years), and median follow-up time was 56 months (range: 12-136 months). Nineteen patients were primary bladder cancer, and 20 were recurrent tumor. During the follow-up, 17 patients developed recurrent tumors, including 8 progressed tumors and 3 died from tumor. Two-year and 5-year progressed-free survival were 88% and 74%, and 2-year and 5-year cancer-specific survival were 97% and 89%, respectively. During 5 years′ follow-up, 81% survivor preserved intact bladder, and only 1 patient cancelled chemotherapy for adverse effect. Conclusions Intra-artery chemotherapy (GC regimen) is a choice for T1G3bladder cancer, preventing from disease progression with good tolerance.

Background:Protein inhibitor of activated STAT 1( PIAS1 )is an important regulator for inflammatory signaling network,which is low expressed in gastric cancer and associated with development of cancer,but its mechanism has not been elucidated. Aims:To investigate the effect of PIAS1 on epithelial-mesenchymal transition( EMT)of gastric cancer under inflammatory microenvironment. Methods:Recombinant adenovirus Ad5/F35-PIAS1 and Ad5/F35-null were constructed and transfected into gastric cancer cell line SGC-7901,mRNA and protein expressions of PIAS1 were detected by RT-PCR and Western blotting,respectively. SGC-7901 cells were divided into IL-6 treatment group,Ad5/F35-PIAS1﹢IL-6 treatment group and Ad5/F35-null﹢IL-6 treatment group. Cell proliferation was measured by MTT method,migration and invasion capacities were assessed by wound healing test and Transwell chamber invasion assay. Protein expressions of E-cadherin,Snail,Twist,Vimentin and P-p38MAPK were assessed by Western blotting. Results:The transfection of Ad5/F35-PIAS1 significantly increased the expressions of PIAS1 mRNA and protein in SGC-7901 cells. Compared with IL-6 treatment group and Ad5/F35-null﹢IL-6 treatment group,capacities of cell proliferation,migration and invasion were significantly decreased(P ﹤0. 01);protein expressions of Snail,Twist,Vimentin and P-p38MAPK were significantly decreased while expression of E-cadherin protein was significantly increased in Ad5/F35-PIAS1 ﹢IL-6 treatment group ( P﹤0. 01). No significant differences in above-mentioned indices were found between IL-6 treatment group and Ad5/F35-null﹢IL-6 treatment group(P﹥0. 05). Conclusions:PIAS1 could inhibit EMT of gastric cancer cells under inflammatory microenvironment,and may play an important role in inhibition of tumor invasion and metastasis.

Objective To screen gastric infiltrating carcinoma from gastric high grade intraepithelial neoplasia (HGIEN) checked again by regular gastroscopy and confocal laser endomicroscopy(CLE).Methods From January 2005 to December 2010,82 patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN were collected at Department of Gastroenterology,Ruijin Hospital,Jiaotong University.61 male patients and 21 female patients were collected,of which 38 patients underwent common gastroendoscopy and the other 44 patients were underwent CLE besides common gastroendoscopy.The pathological diagnosis of endoscopic biopsy tissues were compared,and patients with indications were referred to surgery and pathological examination again.Results A total of 82 patients were confirmed by repeated examination,and there were 8 cases of inflammation or benign ulcers (24.4％),12 cases of low grade intraepithelial neoplasia (14.6％),10 cases of HGIEN (12.2％),52 cases of infiltrating carcinoma (63.4％).36 cases of differentiated carcinoma and 16 cases of undifferentiated carcinoma.Of the 21 infiltrating carcinoma cases diagnosed by CLE,17 cases (81.0％) were consistent with the pathological diagnosis.The consistent parameter value of κ between CLE diagnosis and pathological diagnosis was 0.7250.Conclusion It is necessary to make differential diagnosis of infiltrating cancer in patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN.

Objective To investigate the accuracy and the consistency with pathological diagnosis of confocal laser endomicroscopy (CLE) in real-time diagnosis of gastric malignancy and precancerous diseases.MethodsFrom January 2010 to March 2011, the out-patients and hospitalized patients of suspected gastric malignancy or precancerous diseases in Shanghai Ruijin Hospital were screened and undergone confocal laser endomicroscopy.Fluorescein sodium was used as fluorescent agent in the examination.A four-tiered diagnostic system was applied in the real time diagnosis with CLE images, and targeted biopsy was performed accordingly. Surgery was performed in CLE diagnosed or highly malignancy suspected patients.The diagnosis of common endoscopy, CLE and pathology was reviewed.ResultsA total of 160 patients were enrolled in this study, of those one patient withdrew because of fluorescin allergy and the rest 159 patients completed the CLE examination.A total of 194 lesions were inspected, among them, 130 cases each with one lesion, 23 cases each with two lesions and 6 cases each with three lesions.Overall accuracy rate of CLE was 93.3％ (181/194).And the sensitivity and specificity of CLE in gastric malignancy diagnosis was 93.6 ％ and 99.3 ％ respectively.Ideal correlation was identified between confocal laser endomicroscopy and final pathology results (Kappa=0.876).The incidence of marked fluorescin-related adverse events was only 0.6％ (1/160). ConclusionsCLE is consistent with histopathology and is helpful to make accurate diagnosis of gastric malignancy and precancerous diseases.It is important in early diagnosis of gastric malignancy and helps to avoid misdiagnosis and missed diagnosis.