Objective To explore the effects of corticosteroids on the recurrence of atrial fibrillation (AF) after radio fre-quency catheter ablation (RFCA ) .Methods A total of 50 patients with paroxysmal AF who underwent RFCA and then treated with corticosteroids from January 2011 to April 2014 were enrolled in this study .At the same period ,37 patients with paroxysmal AF who also underwent RFAC but without corticosteroids treatment were selected as control group .The follow-up was carried out by the fixed physician at 1st week ,1st month ,3rd months ,6th months ,12th months after RFCA through a telephone visit or a hos-pital visit ,including the 12-lead electrocardiogram (ECG) and the HOLTER examination ,symptom of heart-throb inquiry and the interpretation of ECG ,AF recurrence were analyzed and compared between hormone treatment group and control group .Results After 1 week treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 54 .1% ,re-spectively ,there was statistic difference(P < 0 .05) ,the recurrence of AF in treatment group was significantly decreased ;after 1 month treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 67 .6% ,respective-ly ,there was no statistic difference(P = 0 .187) ;after 12 months treatment ,the recurrence of AF in treatment group and control group ,was not found statistic significance(P= 0 .711) .Kaplan-Meier survival rate was drew to conduct Log-rank test ,the difference of AF recurrence between the two groups was no statistic significance(P= 0 .711) .Conclusion Transient use of small amounts of corticosteroids after AF ablation may be effective for preventing AF recurrences within 1 week after ablation but it is not effective for preventing AF recurrences at 1st month and 12th months after ablation .

Objective To evaluate the effects of small interfering RNA (siRNA) against peptidylarginine deiminase 4 (PADI4) gene on apoptosis of fibroblast-like synoviocytes (FLS) from synovium of rheumatoid arthritis (RA).Methods The siRNA targeting PADI4 was constructed and transfected into FLS cells in RA via LipofectamineTM 2000.The expression level of PDAI4 mRNA was detected by using real-time quantitative polymerase chain reaction (real-time PCR).The protein expression of PADI4,CyclinB1 and P21 was detected by Western blotting.The apoptosis of FLS cells in RA was examined by flow cytometry.The levels of IL-1β were detected by ELISA.T-test was used for statistical analysis.Results siRNA-PADI4 efficiently down-regulated the PADI4 expression compared with control group,1.00±0.20 vs 0.38±0.20 (t=9.607,P＜0.01),0.39±0.23(t=8.394,P＜0.01).FCM analysis showed that the percentage of apoptosis cells in PADI4 siRNA group in FLS was (5.4±0.6)％ (t=-19.223,P＜0.01) and (6.1±0.6)％ respectively (t=-24.229,P＜0.01),which was significantly higher than that in the control group in FLS (1.6±0.3)％.The expression of CyclinB1 protein was decreased,and P21 increased.The concentrations of IL-1β in culture medium of the transfected group were (26.8±0.7) ng/ml (t=-10.747,P＜0.01) and (27.7±0.7) ng/ml (t=-10.967,P＜0.01),higher than the control group [(23.9±0.7) ng/ml].Conclusion After being transfected with PADI4 siRNA,the apoptosis of FLS cells in RA is increased.Our results have demonstrated the potential role of CyclinB1 and P21 in PADI4 signaling.

ObjectiveTo investigate the effect of macrophages (MCs) on the differentiation of mouse induced pluripotent stem cells (iPSCs) into hepatic progenitor cells (HPCs). MethodsA total of 24 C57BL/6N mice were used to obtain MCs by peritoneal irrigation, and the supernatant was collected to obtain the conditioned medium of MCs (MC-CDM). Activin A, bone morphogenetic protein 4, and fibroblast growth factor were used to induce the differentiation of mouse iPSCs into HPCs. The differentiation of HPCs were randomly divided into control group (normal medium) and experimental group (MC group; use of MC-CDM medium on day 5 of induction). Morphology, immunofluorescence assay, and Western blot were used to compare the morphology of HPCs and the expression of related proteins between the control group and the MC group. The t-test was used for comparison of continuous data between two groups. ResultsHPCs derived from iPSCs were established in vitro, and HPCs had the potential to differentiate into hepatocytes. Immunofluorescence assay showed that compared with the D12 control group, the D12 MC group had a significant increase in the protein expression of the HPC-specific protein CK19 (0.901±0.072 vs 0.686±0.097, t=-3.093, P＜0.05). Western blot showed that compared with the D12 control group, the D12 MC group had a significant increase in the protein expression of the HPC-related protein CK19 (1.922±0.103 vs 1.448±0.012, t =-7.881, P ＜005), as well as a significant increase in the protein expression of the autophagy-related protein LC3 (1.392±0.042 vs 1.101±0048, t =-5.978, P＜005). ConclusionMCs can promote the differentiation of mouse iPSCs into HPCs, possibly by increasing the autophagy level of HPCs.

Objective:To investigate the MRI features of progressive multifocal leukoencephalopathy (PML) in acquired immunodeficiency syndrome (AIDS) patients, and to provide evidence for clinical diagnosis, evaluation and staging.Methods:Form Janurary 2016 to April 2018, 11 AIDS patients with clinical diagnosis of PML were enrolled at Zhongnan Hospital of Wuhan University. A total of 25 MRI examination data of 11 patients (5 patients underwent multiple examinations) were reviewed. The distribution, morphology and signal characteristics of the lesions were analyzed, and the changes of the lesions between multiple MRI examinations were compared. The lesions of all 25 MR images were staged according to MR features.Results:Typical image findings of PML included confluent, bilateral but asymmetric distributed, supratentorial white matter abnormal signal lesions. The parietal lobe was most commonly involved, followed by the frontal lobe. The lesions often showed hypointensity on T 1 and hyperintensity on T 2 weighted images. No obvious mass effect or enhancement was found. In advanced stage, multifocal white matter lesions were enlarged in size and more confluent, displaying large patchy abnormal signal intensity, with gradually involving the deep white matter, and occasionally combing with gray matter and cerebellar lesions. The disease showed heterogenous signal intensity due to necrosis in the lesion. The newly appeared lesions showed obvious diffusion restriction, demonstrating high signal intensity on diffusion weighted imaing with low apparent diffusion coefficient value. The main finding of the later stage was necrosis, with focal asymmetric brain atrophy was observed. Conclusions:PML in AIDS patients has characteristic MRI findings, and MRI features varies in different stages. MRI can be helpful in clinical diagnosis, evaluation and staging of PML.

Objective To summarize the computed tomographic (CT) manifestations of pulmonary aspergillosis after organ transplantation and compare different signs between pulmonary aspergillosis and bacterial pneumonia.Methods CT images of pulmonary aspergillosis (n =62) and bacterial pneumonia (n =68) in post-transplantation patients were reviewed.The signs were categorized with consolidation,mass,large nodule (≥1crn),small nodule and bud-in-tree pattern.Some detailed useful differentiating signs such as halo sign,air bronchogram sign,reversed halo sign,hypodensity sign and cavitation were also analyzed.Results CT patterns of pulmonary aspergillosis included consolidation,mass,large nodule,small nodule and bud-in-tree pattern.The most common was large nodule (75.8％),followed by consolidation (48.4％)and mass (29.0％).And small nodule (16.1 ％) and bud-in-tree (12.9％) patterns were concurrent.For consolidation pattern,the proportion of bacterial pneumonia (69.1％) was the larger;For mass pattern,the proportion of pulmonary aspergillosis (29.0％) was the larger.For large nodule pattern,there was no difference.The detail sign of large nodule in two groups had no difference In detailed signs of consolidation pattern,air bronchogram sign was more often seen in bacterial pneumonia while cavitation was more frequently found in pulmonary aspergillosis.In detailed signs of mass pattern,pulmonary aspergillosis often has single lesion (66.7％),cavitation (83.3％)and air crescent sign (77.8％) is more common.The proportion of halo sign was 30.7％.Conclusions CT manifestations of pulmonary aspergillosis are diverse after organ transplantation.There is some difference and yet overlap with bacterial pneumonia.