ObjectiveTo evaluate the effect of alpha-lipoic acid (ALA) on cardiomyocyte apoptosis following renal ischemia-reperfusion injury(RIRI) in rats.MethodsThirty-six male SD rats weighing 250-280 g were randomly divided into 3 groups ( n =12 each): group sham operation (group S) ; group I/R and group I/R + ALA ( group L).The model of RIRI was produced by occlusion of renal artery and vein for 45 min followed by 24 h reperfusion,in group S the renal pedicles were exposed but not occluded.In group L ALA infusion (30 mg/kg) was given via tail vein at 20 mln before ischemia and at 20 min before reperfusion,while in group I/R the equal volume of solution (35％ polyethylene glycol + 60％ physiological saline + 5％ ethanol) was infused instead of ALA.The animals were saerificed at the end of 24 h of reperfusion,blood samples were taken for detecting concentrations of serum creatinine (Cr) and malondialdehyde (MDA).Then the hearts were immediately removed for determination of SOD activity,MDA content,cardiomyocyte apoptosis (flow cytometry) and Bcl-2/Bax ratio (immunohistology).ResultsSerum Cr concentration,serum and myocardium MDA levels and cardiomyocyte apoptosis were significantly increased after RIRI in groups I/R and L as compared with group S ( P ＜ 0.05).ALA treatment significantly decreased serum Cr concentration,serum and myocardium MDA levels,cardiomyocyte apoptosis and increased SOD activity and Bcl-2/Bax ratio ( P ＜ 0.05).ConclusionALA can attenuate myocardium injury by inhibiting cardiomyocyte apoptosis following RIRI in rats.

Objective:To explore the preoperative diagnostic value of endoscopic ultrasonography (EUS) for intraductal papillary mucinous neoplasms (IPMN).Methods:Data of 62 patients with IPMN confirmed by pathology who underwent EUS before surgery from 2008 to 2018 in Peking Union Medical College Hospital were analyzed. Characteristics that could distinguish low-grade dysplasia (LGD), high-grade dysplasia (HGD) and invasive carcinoma (IC) were explored. A scoring system based on EUS findings was established to determine the preoperative pathology of IPMN by using logistic model.Results:Of the 62 patients, 15 (24.2%) were diagnosed as having LGD, 20 (32.3%) HGD and 27 (43.5%) IC. Univariate analysis showed that the size of mural nodules and width of main pancreatic duct (MPD) were predictive factors for IPMN pathology. The possibility of higher pathological grading would increase 8% for every 1 mm increment in mural nodules. Multivariate analysis showed that only mural nodules≥5 mm ( OR=7.31, 95% CI : 2.49-21.40, P<0.001) was an independent risk factor to distinguish LGD, HGD and IC. Mural nodules≥5 mm, main pancreatic duct (MPD)≥10 mm and mural nodules <5 mm were assigned 2 points, 1 point and 1 point, respectively. The sensitivity, specificity, and area under receiver operator characteristic curve (AUC) of the EUS scoring system to distinguish benign and malignant IPMN were 0.830, 0.867, and 0.867, respectively. Conclusion:Preoperative EUS helps to distinguish LGD, HGD and IC. The size of mural nodules and the width of MPD are vital risk factors to distinguish benign and malignant IPMN.

Objective To evaluate the performance of split-dosed polyethylene(PEG) for colonoscopy preparation.Methods Split-dose means that 1-3 L of PEG is taken in the afternoon or evening before examination and the remains in the next morning.And single-dose refers to all PEG is taken in the evening before ex-amination.A meta-analysis was conducted to compare bowel preparation quality,adenoma detection rate and patients' acceptance between groups.Results Ten randomized controlled trials were included into this study with 3 222 participants(1 481 in split-dose group and 1 741 in single-dose group).Split-dose group had higher rate of satisfactory bowel preparation(OR=3.37,95％CI:2.37-4.79),and so did the subgroup of 2～ 3 L PEG (OR =3.88,95％ CI:2.39-6.29).Split-dose group did not improve adenoma detection rate significantly (OR =0.94,95％ CI:0.71-1.24),but reported less adverse events such as nausea (OR =0.56,95％ CI:0.42-0.74)and vomiting(OR=0.51,95％CI:0.30-0.88).Conclusion Split-dosed PEG provides better colon cleansing with higher patient compliance,but does not improve detection rate of adenoma.

Objective To investigate the correlation between the stroke-related risk factors and carotid stenosis lesions of ≥40 year′s old Han and minority populations in a community in Beijing as well as the clinical value of carotid ultrasound screening. Methods An investigation of risk factors for stroke and the results of carotid artery ultrasound screening in 510 cases (≥40 years old) Han population and 243 minority population in a community in Minzu University of China in Beijing in April 2014 were analyzed. Results (1)The prevalence of hypertension of the Han population was significantly higher than that of the minority population (53. 5% [n=273] vs. 44. 4% [n=108]; χ2 =5. 43,P=0. 02). (2) The detected rate of carotid intima-media thickness ( IMT ) of the Han population was higher than that of the minority population (77. 5% [n=395] vs. 69. 1% [n=168]; χ2 =6. 03,P=0. 01). There was no significantly difference in the detected rates of carotid plaques and carotid artery stenosis between the two groups (χ2 =0. 56,1. 13 respectively,all P>0. 05). (3) Hypertension and smoking were the independent risk factors for carotid-intima thickening in Han population ( hypertension:OR,1. 851;95% CI 1. 213-2. 825; smoking:OR,2. 311;95% CI 1. 065-5. 016;all P<0. 05). Hyperlipidemia was an independent risk factor for carotid artery intima-media thickening in the minority population (OR,2. 586;95% CI 0. 952-8. 694,P<0. 01). Conclusion To investigate the risk factors for stroke in minority population in China are of particular importance for the prevention of carotid atherosclerotic disease. Carotid ultrasound examination is an important diagnostic technique for early detection of carotid atherosclerotic disease.

Objective To summarize the clinical features of the third portion of duodenum (PATD) for improving the understanding of PATD.Methods Sixteen cases with PATD in Peking Union Medical College Hospital(PUMCH) were retrospectively analyzed.Results The most common symptoms of PATD were upper abdominal pain(12/16),vomiting (9/16) and distention (7/16).On average,the disease had progressed 5.5 months (including 2.5 months of diagnostic workup) before the diagnosis was established.Patients with pathologically poorly differentiated PATD had shorter course of disease (6.5 vs 16.6 months,P =0.56) and lower chance of cancer-directed surgery (1/8 vs 6/8,P =0.04) than those with well differentiated PATD.The diagnostic rate was 11/14 by CT scan while only 2/7 by upper gastrointestinal radiography.Three cases were misdiagnosed as superior mesenteric artery syndrome by barium examination.Conclusions PATD should be considered in patients presenting upper abdominal symptoms with negative gastmendoscopy and barium examination.Overall,CT scan plays a pivotal role in diagnosing PATD.Making a correct diagnosis timely can improve the outcome of PATD patients,particularly,in those with poorly differentiated pathology.

Objective To investigate the protective effect of Gui Zhi Fuling Jiaonang on endurance to ischemia and hypoxia .Methods Mice were randomized into four groups :control group ,positive drug control group ,Gui Zhi Fuling Jiaonang high‐dose group (0 .93 g/kg) ,and Gui Zhi Fuling Jiaonang low‐dose group (0 .465 g/kg) . All mice were treated with corresponding drugs for 7 days .The hypoxia mice model was established through hypoxia in the closed jars , cerebral anoxia by decapitation , poisoning with sodium nitrite and isoprenaline . Then the hypoxia‐ischemia rat model was established by injecting isoproterenol . The anti‐hypoxic effects were observed . Results Compared with control group ,Gui Zhi Fuling Jiaonang high‐dose group (0 .93 g/kg) had a tendency to extend the survival time of mice model established through hypoxia in the closed jars ;Gui Zhi Fuling Jiaonang high‐dose (0 .93 g/kg) and low‐dose (0 .465 g/kg) groups had a tendency to extend the survival time of mice model established through cerebral anoxia by decapitation (P>0 .05) .Compared with that in control group ,the survival time of mice in Gui Zhi Fuling Jiaonang low‐dose group under poisoning with sodium nitrite and Gui Zhi Fuling Jiaonang high‐dose group under poisoning with isoprenaline were significantly prolonged .Besides ,Gui Zhi Fuling Jiaonang relieved myocardial tissue damage caused by ischemia and hypoxia ( P< 0 .05 ) .Conclusion Gui Zhi Fuling Jiaonang has an obviously protective effect on isoprenaline‐induced hypoxia and myocardial ischemia .

Aim To isolate and purify a novel plasminogen activator(PA)from Gloydius brevicaudus venom(GBV)and study characterization and biological activities of GBV-PA.Methods Affinity chromatography in Benzamidine Sepharose 6B(AC)and Lichrospher C-18 4.6/250 reversed phase chromatography(RPC)were used for isolation and purification;SDS-PAGE was used to detect molecular weight(MW);Disc polyacrylamide gel eletrophoresis was used to measure the point of isoelectric(pI);Chromogenic substrate method was used to observe the biological activities.Results A novel GBV-PA which its purification reached the homogeneity level was isolated and purified from GBV by AC and RPC;The MW of the novel GBV-PA was 3.26?104 and the pI was 5.2;The novel GBV-PA activated human plasminogen specifically and the special activity was 2.87 t-PA IU?mg-1;Moreover,our results indicated that this novel GBV-PA was a serine proteinase which had no affinity to fibrin.Conclusion A novel GBV-PA that can be isolated and purificated from GBV by AC and RPC was proved to be a serine protease and has no affinity to fibrin.

Objective To clarify the efficacy and safety of cyclosporine A CsA) as salvage therapy in patients with severe active ulcerative colitis (UC) and refractory to steroids.Methods A total of 24 severe active UC patients refractory to steroids and hospitalized from 2006 to 2012,were retrospectively enrolled.Data including demographic features,clinical manifestations,laboratory tests and medications were collected.Results CsA was effective in 15 (62.5％) patients,who did not receive colectomy during 12-week administration.This regimen was tolerable in most patients.Twelve (50.0％) patients reported 16 adverse events,but only one patient withdrew CsA due to intolerance.The rates of adverse events in initial intravenous CsA including 4 mg · kg-1 · d-1,3 mg · kg-1 · d-1 and 2 mg· kg-1 · d-1 were 2/2,9/17 and 1/5 respectively.Responders had higher white blood cell count compared with non-responders (P =0.045).Conclusions CsA could be an effective alternative regimen to colectomy in severe active UC patients who are refractory to steroids.

Objective To investigate the invasion situation of cardinal ligaments(CL) in stage Ⅰ A2 - ⅡA2 cervical cancer and to find the high risk clinicopathological factors affecting its invasion .Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5 hospitals from January 2004 to De‐cember 2014 .Results (1) Totally 855 cases according with the research condition were included .The CL invasion was found in 20 cases(2 .3% ) .No CL invasion occurred in the stage ⅠA2 ,the CL invasion rate in the stage ⅠB1 was 1 .7% ,in the stage ⅠB2 was 1 .2% ,in the stage ⅡA1 was 5 .7% and in the stage ⅡA2 was 2 .9% .With the increase of FIGO staging ,the CL invasion rate had no significant increase(P=0 .269) .(2) The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2- ⅡA2(P=1 .000) .And the invasion rate of the left CL with different FIGO stages had no statistical difference(P=0 .286) , while the right one had statistical difference(P=0 .005) ,in which the highest was in the stage ⅡA1 (4 .3% ) .(3)The univariate a‐nalysis found that lymph‐vascular invasion ,cervical stroma infiltration depth ,pelvic lymph node metastasis ,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion(P<0 .01);the further multivariate analysis determined that the invasion of uterine body(OR=11 .858) ,pelvic lymph node metastasis(OR=6 .359 ,) ,vaginal fornix infiltration(OR=6 .012 ,) were the risk factors for CL invasion(P<0 .05) .Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low .The invasion of uterine body ,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2- ⅡA2 cervical cancer .

Objective: To observe the activation of microglia and the changing rule of inflammatory cytokine as IL-6, IL-10 and nuclear factor-κB (NF-κB) in experimental rabbits after spinal cord ischemia reperfusion (SCIR) injury in order to provide theoretical basis for post-conditioning time. Methods: Rabbit SCIR injury model was established by thoracic aorta balloon occlusion. 54 New Zealand male adult white rabbits were divided into 9 groups: Sham group (the animals received balloon implantation without occlusion), SCIR-0h group (reperfusion was conducted at 0 hour of spinal cord ischemia), SCIR-1h, -2h, -3h, -8h, -24h,-48h and -72h groups. n=6 in each group. The number of normal and apoptosis neurons, the levels of Iba-1, IL-6, IL-10 and NF-κB in spinal tissue were examined and compared among different groups respectively. Results: The number of normal neuron was decreasing with the extended reperfusion time, TUNEL-positive neuron began to increasing in SCIR-8h group and the peak was reached in SCIR-24h group. The expression of Iba-1 began to elevating in SCIR-2h group and the peak was obtained in SCIR-8h group; NF-κB began to rising in SCIR-3h group and the peak was observed in SCIR-8h group; both IL-6 and IL-10 arrived the peak in SCIR-24h group. The expressions of NF-κB, IL-6 and IL-10 were positively related to Iba-1 level. Conclusion: Microglia activation had dynamic changes in experimental SCIR rabbits and the expression levels of NF-κB, IL-6 and IL-10 were positively to microglia activation; post-conditioning time at front and back to microglia activation may reduce neuron injury.