Objective To investigate the feasibility of using superparamagnetic iron oxide(SPIO)as MRI contrast agent to assess rat nonalcoholic steatohepatitis Kupffer cells(KC)function.Methods Twenty male SD rats were randomly divided into A and B groups,group A(n=10)was the experimental group fed high fat diet,group B(n=10)was the control group fed normal diet After 8 weeks,plain MR and SPIO enhanced MR were performed in all the rats.Blood lipids were measured,and HE and Perl's blue staining in all livers specimen was done.The related results of the staining were analyzed with t test Results Group A TC and TG levels[(6.58±1.25)and(1.53±0.23)mmol/L respectively]were significantly higher than group B[(1.64±0.22)and(0.55±0.14)mmol/L respectively](t=11.716 and 11.588,P＜0.01).Group A and B groups hepatic signal intensity decreased in all sequences after SPIO enhanced,but in group A the level of decline[(34.78±4.51)% and(60.38±3.49)% respectively]was less than group B[(64.96±2.42)% and(81.08±1.66)% respectively]on PDWI and T_1WI,and statistically significant differences(t=-18.451 and-16.240,P＜0.01)were found.In group A the ratio of signal intensity of liver to spleen(1.002±0.141,5.000±0.516,20.004±1.490 and 2.601±0.077 respectively)was more than group B(0.400±0.102,1.500±0.115,0.503±0.105 and-0.300±0.058)before and after contrast enhancement on PDWI,T_2WI,T_2~* WI andT_1WI(t=10.745,19.800,39.168 and 92.785,P＜0.01).Typical histological hepatic lesions of NASH were observed in group A,Perl's staining-positive particles in group A(2.33±0.50)were fewer than in group B(4)(t=-10.000,P＜0.01).Conclusion The high-fat diet induced model of SD rats was close to the human NASH and was easy to establish.Clinical application of SPIO enhanced MR successfully assessed the phagocytic activity of KC in the study,and it suggested that the pathogenesis of NASH was related to the decreased phagocytic activity of KC.

ObjectiveTo retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a point just cephalad to the posteroseptal commissure.The suture was tied with positioning a 27-29 mm valve siser across the tricuspid valve.At last, a 3-5 mm width felt strip was prepared and was sutured to the plicated posterior annulus region with interrupted mattress sutures of 2 to 3 2-0 prolene.A favorable result was considered when TR was not marked by saline injection.Echocardiography was routinely examined one week postoperatively and patients were followed up 6 month after discharge.ResultsThere is no death in all patients.The CVP diminished significantly from 16mmHg preoperatively to 8mmHg postoperatively (P = 0.0021).The systomic pulmonary pressure diminished from 59 mmHg preoperatively to 41 mmHg postoperatively (P = 0.038).Echo one week postoperative showed no tricuspid regurgitation in 56 patients and mild in 18 patients, while 2 had moderate tricuspid regurgitation.The diameter of right atrium diminished significantly postoperatively, too.The ejection fraction was improved even though there was not significant difference as compared with preoperative data.The cardiac function of all patients improved and the signs of right heart failure were alleviated or disappeared.Follow up 1 to 36 months showed no change of the regurgitation except for one become moderate from mild when discharged.No hepatic congestion or edema was observed in all patients.ConclusionThese new modifications make the technique more selective in the remodeling of the tricuspid annulus.It could achieve better coaptation of the anterior leaflet with the others, successful annular reduction, better maintenance of the contractile property of the tricuspid ring, better distribution of pursing force in the more dilated region.It could prevent the tear of the endocardium in the posteroseptal region in the long period of time postoperatively.

Objective To investigate the regulation of protein kinase C(PKC) to the expression of β-1,4-galactusyhransferase- Ⅰ ( β-1,4-GalT- Ⅰ ) and the influence on cytoskeleton and adherence ability of human umbilical vein endothelial cells(HUVECs) when stimulated by lipopolysaccharide (LPS). Methods Cultured HUVECs were pretreated by various PKC inhibitors or phorbol 12-myristate 13-acctate( PMA), an excitomotor of PKC respectively for 30 min, then stimulated by LPS for 4 h. β-1,4-GalT-Ⅰ expression were detected by RT-PCR and Western blot, expression of β-1,4-galactosylated carbohydrate chains and cytoskeleton were assayed by immumofluorescence, and adherence ability of HUVECs was observed by endothelialmonocyte cell adherence test. Results Up-regulated expression of β-1,4-GalT- Ⅰ and β-1,4-galactosylated carbohydrate chains in HUVECs stimulated by LPS were suppressed by PKC inhibitors and increased by PMA. F-actin and β-1,4-GalT- Ⅰ were partly co-localized in HUVECs. PKC inhibitor inhibited the effect of LPS on the distribution of F-actin and β-1,4-GalT- Ⅰ. Adherence ability of HUVECs enhanced by LPS was significantly suppressed by PKC inhibitor. Conclusion PKC signal transduction pathway may participate in regulating β-1,4-GalT-Ⅰ expression in endothelial cells stimulated by LPS. Furthermore, polytypes of PKC may participate in this regulating process; PKC might regulate cytoskeleton reorganization and adherence ability of EC through β-1,4-GalT-Ⅰ during inflammation.

Objective To explore the efficacy of acupuncture in the treatment of nonalcoholic fatty liver disease by using magnetic resonance iterative decomposition of water and fat with echo asymmetry and least-squares estimation-quantitative FAT/R2 * imaging (IDEAL-IQ) technique.Methods Totally 36 patients with nonalcoholic fatty liver were divided into acupuncture group (25 cases) and control group (11cases).The patients were performed liver magnetic resonance IDEAL-IQ and the liver fatty component value (F value) was measured before and after the treatment,at the same time clinical indicators of liver function and blood lipid were measured.The Spearman correlation analysis was used to compare the consistency of F value and blood lipid in all patients.The t test was used to compare the differences of liver F values,liver function,blood lipids and other clinical indicators of two groups before and after the treatment.Results There were significantly positive correlation between the fat component and triglyceride (TG),total cholesterol (TC) level (r =0.836,0.852,P ＜ 0.05),and significant negative correlation between the fat component and high density lipoprotein (HDL) level in the fatty liver group (r =-0.735,P ＜0.05),The liver F values,alanine aminotransferase (ALT) and aspartate aminotransferase (AST) contents and TG,HDL,low density lipoprotein (LDL) and TC contents of the acupuncture group after treatment were statistically significant (P ＜ 0.05).Comparison of each index in the acupuncture group after treatment with the control group,the differences were statistically significant (P ＜ 0.05).Conclusions Acupuncture is an effective approach to treat nonalcoholic fatty liver disease,as it can improve liver function and down-regulate lipid level.Magnetic resonance IDEAL-IQ technique can quantitatively detect its therapeutic efficacy.

Human tissue kallikrein-binding protein (Kallistatin, KAL), a secretory protein that participates in the regulation of multiple signaling pathways by binding to the extracellular receptor, however, at present has not been reported about the intracellular activity, and whether it has the similar biological activity with extracellular activity. Here we constructed no signal peptide KAL (NSK) into the adeno-associated virus vector to explore the intracellular activity of KAL. Both the endothelial cell and lung cancer cells could express KAL, but not secreted after rAAV2-NSK transfection. The proliferation and migration of human umbilical vein endothelial cells (HUVECs) were inhibited, but the apoptosis rate was not affected. The proliferation rates, mobility and tubule formation of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited to different extents. This cellular study not only confirmed the intracellular activity, but also suggested it may serve as a kind of "balance factor" in multi-targeted controlling, which may provide a new train of thoughts to explain the regulatory contradiction in PI3K-Akt signaling pathways by KAL.

Objective To investigate the effect of Santong electroacupuncture (EA) on mRNA and protein expression of p75 neurotroph-in receptor (p75NTR) in rats with spinal cord injury (SCI). Methods A total of 72 female Sprague-Dawley rats were randomly assigned to sham operation group (group A, n=8) and model group (n=64). In the model group, Allen's method was used to make SCI rats model, in which 48 survived model rats were further subdivided into model control group (group B, n=12), EA group (group C, n=12), inhibitor Nogo extra cellular peptide residues 1-40 (NEP1-40) group (group D, n=12) and EA+inhibitor NEP1-40 group (group E, n=12) according to de-sign proposal. The treatment groups were electroacupunctured on Dazhui (GV14) and Yaoyangguan (GV3), bilateral Ciliao (BL32) and Zu-sanli (ST36) with loose-tight wave, for 20 minutes every day. After 7 and 14 days of treatment, injured spinal cord tissue was extracted for detecting. The mRNA and protein expression of p75NTR was detected by real-time fluorescent quantitative PCR, in situ hybridization and Western blotting respectively. The hind limb motor function was assessed with Basso-Beattie-Bresnahan (BBB) score. Results The BBB score increased in the treatment groups compared with group B, and was higher in group E than in groups C and D (P<0.05), as well as on the 14th day than on the 7th day in all the treatment groups (t>2.623, P<0.05). The mRNA and protein expression of p75NTR in spinal cord tissues decreased in the treatment groups compared with group B (P<0.05), and no significant difference was found among the treatment groups (P>0.05). Conclusion Santong elerctroacupuncture treatment could improve the hind limb motor function, which may associate with inhibition of the mRNA and protein expression of p75NTR in rats after SCI.

Objective To analyze the short-term complications and long-term outcomes of spleenpreserving distal pancreatectomy (SPDP) in pediatric pancreatic tumors.Methods A retrospective analysis was conducted on 43 patients with tumors of the body and tail of the pancreas in Beijing Children's Hospital from Jan 2007 to Jan 2018.Results There were 17 boys (39.53％) and26girls (60.47％),with a median age of 123 (80,141) months.The median maximum diameter of primary tumor was 7.60 cm.Diagnoses included solid pseudopapillary tumor (n =28),pancreatoblastoma (n =10),neuroendocrine tumor (n =4),and pancreatic cyst (n =1).Two cases (4.65％) received tumor enucleation,4 cases (9.30％) did distal pancreatectomy plus splenectomy,and 37 cases (86.05％) did SPDP.16 cases (37.21％) had short-term complications,including pancreatic fistula (n =13),delayed gastric emptying (n =3),abdominal infection (n =7) and postoperative bleeding (n =2).After a median follow-up of 46 (23,71) months,38 cases (88.37％) were disease-free;two cases (4.65％) with tumor recurrence;one case of pancreatoblastoma died of tumor recurrence.Two cases lost to follow-up.Three patients had long-term complications,including chronic fatty diarrhea (n =2) and hypoglycemia (n =1).Three patients underwent second operation for recurrent tumor (one pancreatoblastoma and two solid pseudopapillary tumor).Conclusions SPDP is safe and effective in the treatment of tumors of the body and tail of the pancreas in children.

Objective To investigate the risk factors for postoperative gastrointestinal bleeding (GIB) in patients with type A aortic dissection, and further discuss its prevention and treatment. Methods The clinical data of patients with type A aortic dissection admitted to the Department of Cardiovascular Surgery of the First Affiliated Hospital of Naval Medical University from 2017 to 2021 were retrospectively analyzed. Patients were divided into a GIB group and a non-GIB group based on the presence of GIB after surgery. The variables with statistical differences between two groups in univariate analysis were included into a multivariate logistic regression model to analyze the risk factors for postoperative GIB in patients with type A aortic dissection. Results There were 18 patients in the GIB group including 12 males and 6 females, aged 60.11±10.63 years, while 511 patients in the non-GIB group including 384 males and 127 females, aged 49.81±12.88 years. In the univariate analysis, there were statistical differences in age, preoperative percutaneous arterial oxygen saturation (SpO2)<95%, intraoperative circulatory arrest time, postoperative low cardiac output syndrome, ventilator withdrawal time>72 hours, postoperative FiO2≥50%, continuous renal replacement therapy (CRRT) rate, extracorporeal membrane oxygenation (ECMO) rate, infection rate, length of hospital stay and ICU stay, and in-hospital mortality (all P<0.05). In the multivariate logistic regression analysis, preoperative SpO2<95% (OR=10.845, 95%CI 2.038-57.703), ventilator withdrawal time>72 hours (OR=0.004, 95%CI 0.001-0.016), CRRT (OR=6.822, 95%CI 1.778-26.171) were risk factors for postoperative GIB in patients (P≤0.005). In the intra-group analysis of GIB, non-occlusive mesenteric ischemia (NOMI) accounted for 38.9% (7/18) and was the main disease type for postoperative GIB in patients with type A aortic dissection. Conclusion In addition to patients with entrapment involving the superior mesenteric artery who are prone to postoperative GIB, preoperative SpO2<95%, ventilator withdrawal time>72 hours, and CRRT are independent risk factors for postoperative GIB in patients with type A aortic dissection. NOMI is a major disease category for GIB, and timely diagnosis and aggressive treatment are effective ways to reduce mortality. Awareness of its risk factors and treatment are also ways to reduce its incidence.

Kallistatin, which protects organs and cells against inflammation, fibrosis and oxidative stress, is mainly synthesized and secreted in liver. However, its relationship to human liver disease remains unclear. The purpose of this study was to explore the relationship between serum kallistatin and clinical evidence of both cirrhosis and hepatocellular carcinoma (HCC), and to determine if serum kallistatin levels could be used as a diagnostic indicator of hepatic health status, especially human liver cirrhosis (LC). Our cohort consisted of 115 patients with clinically proven liver fibrosis (LF), LC, or HCC by liver biopsies, and 31 healthy controls (CON). Serum kallistatin levels were quantified by ELISA. Results of the present study demonstrated that irrespective of the underlying etiology, serum kallistatin levels were significantly lower in the LF/LC group when compared with the CON group. A decrease in serum kallistatin levels appeared to reflect the extent of cirrhosis, with the lowest levels associated with higher grades of cirrhosis. Patients with LC had a noticeable correlation between serum kallistatin levels and other serum biochemical indicators. The area under the curve (AUC) for LC, viral liver cirrhosis (VLC) and alcoholic liver cirrhosis (ALC) was 0.845, 0.757 and 0.931, respectively. In conclusion, our findings demonstrated that kallistatin, a plasma protein produced by the liver, can be a useful and reliable diagnostic indicator of hepatic health status, especially for LC.

Bone homeostasis is a relative balance between bone formation and resorption. Signal transducer and activator of transcription 3 (STAT3), which is closely related to bone homeostasis, takes part in multiple intracellular and extracellular signal pathways. STAT3 participates in the process of osteoblast differentiation regulated by several factors. It can also maintain bone homeostasis by regulating the recruitment, differentiation and activation of osteoclasts. In addition, STAT3 is involved in the interaction between osteoblasts and osteoclasts. Patients with STAT3 mutations can have several inherited bone metabolism diseases. Furthermore, STAT3 plays a critical role in load-driven bone remodeling. Mechanical stimulation promotes osteoblast differentiation and bone formation through activating or enhancing STAT3 expression during bone remodeling process. This review summarizes the participation of STAT3 in maintaining bone homeostasis together with its possible mechanisms and discusses the connection between STAT3 and mechanical stimulation in bone remodeling, so as to provide a potential pharmacological target for the treatment of bone diseases.