Objective To investigate the protective role of senegenin(SEN)in the mouse ischemia-reperfusion injury and its mechanism.Methods Mice were divided at random into control group(the ligature was placed but not ligated for 225 min),is-chemia-reperfusion model group(the anterior descending coronary artery remained ligated for 45 min and then reperfused for 180 min)and SEN treatment group(30 mg/kg SEN was used 10 min before reperfusion).The myocardial infarct size was meas-ured by using Evans blue-TTC staining.Fluorescence assay was employed to detect the activity of Caspase-1 2 and Caspase-3 to assess the myocardial apoptosis.Western blot was used to detect the expression of two endoplasmic reticulum stress (ERS) markers,GRP78 and CHOP,in infarcted myocardia.Results Compared with the control group,the myocardial infarct size was significantly increased,the activities of Caspase-12 and Caspase-3 were increased by 4.71 fold and 3.37 fold,respectively,and the expression levels of ERS markers GRP78 and CHOP were conspicuously elevated in the ischemia-reperfusion model group.Pretreatment with SEN(30 mg/kg)could significantly reduce the myocardial infarct size,the activities of Caspase-12 and Caspase-3 and the expression levels of GRP78 and CHOP when compared with those in the ischemia-reperfusion model group and there was significant difference between the two groups(P<0.05 or P<0.01).Conclusion SEN can protect against the myocardial ischemia-reperfusion inj ury by ameliorating ERS-mediated myocardial apoptosis in mice.

AIM:To observe the expression of TLR2 and TLR4 on mast cells (MCs) in the periapical tissues from different types of human chronic periapical diseases , and to analyze the role of TLR 2 and TLR4 on tryptase-positive MCs in the immunopathogenesis of human chronic periapical diseases .METHODS: A total of 60 donors, including healthy control group , periapical granuloma group and periapical cyst group , were enrolled in the study .The periapical tis-sue specimens were fixed in 10%buffered formalin and stained with hematoxylin and eosin for histopathology , or stained with double-immunofluorescence for identification of TLR 2-tryptase and TLR4-tryptase double-positive MCs in the periapical tissues.RESULTS:Compared with the healthy control , the densities of TLR2-tryptase and TLR4-tryptase double-positive MCs in periapical tissues were significantly increased in human chronic periapical diseases (P<0.01).The densities of TLR2-tryptase and TLR4-tryptase double-positive MCs in periapical cyst group were significantly higher than those in peria-pical granuloma group (P<0.01).CONCLUSION:TLR2 and TLR4 were expressed on the MCs in the periapical tissues of human chronic periapical diseases .TLR2-tryptase and TLR4-tryptase double-positive MCs may participate in the patho-genesis of chronic periapical diseases .

OBJECTIVE:To study the mechanism and location of absorption of DZ18.METHODS:In this study,improved intestinal absorption experiments(in vivo,in vitro)were used to study the absorption of DZ18in rats.RESULTS:It was found that there was no significant difference in absorptive rate in rats between without and with bile duct ligation.The cumulative percentages of absorption were59.2%and58.8%.CONCLUSION:There are no significant differences among the absorptive rates at different parts of small intestine in rats,which shows that there is no specificity of intestinal segments in absorption.

Background Extracellular matrix (ECM) fibrosis leads to corneal scaring during the process of cornea wound healing.Transforming growth factor-β1 (TGF-β1) is known to mediate overproduce of ECM components.Our previous study developed a three-dimensional model for corneal stromal cells culture in vitro.Objective The hypothesis of this study was to apply TGF-β1 in the three-dimensional culture system to establish a corneal stroma ECM fibrosis model.Methods Fresh bovine corneas were extracted for the culture of bovine keratocytes in constructed three-dimension culture system.The Pellets were cultured in the DMEM/F12+ 10％ fetal bovine serum (FBS) medium with 0.5 ng/ml or 1.0 ng/ml TGF-β1 or without TGF-β1,respectively.Calcein AM/(propidium iodide) PI staining was employed to assay the cell viability 2 weeks after culture.The expressions of α-smooth muscle actin (α-SMA),type Ⅰ collagen (Col Ⅰ) and Col Ⅲ mRNA and protein in the cells were detected by real-time PCR and Western blot respectively 48 hours,1 week and 2 weeks after cultured.The results were statistically analyzed.Results Cultured for 48 hours in the Pellet system,corneal stromal cells clustered and was identified alive by Calcein-AM/PI staining in 2 weeks.The relative expression levels of α-SMA,Col Ⅰ and Col m mRNA were elevated in both the 0.5 ng/ml and 1.0 ng/ml TGF-β1 supplement groups in comparison with the only DMEM/F12+10％ FBS group,with marked difference among the three groups (Fgroup =696.745,P＜0.001;Fgroup =35.166,P＜0.001;Fgroup =33.677,P＜0.001),and the expression levels increased with the lapse of culture time (Ftime =5.863,P＜0.05;Ftime =298.614,P＜0.001;Ftime =607.472,P＜0.001).The synthetic rate of Col Ⅲ mRNA was obviously faster than that of Col Ⅰ mRNA.Western blot showed that only a trace of α-SMA,Col Ⅰ and Col Ⅲ were detected 48 hours and 1 week after culture.The expression levels of α-SMA,Col Ⅰ and Col Ⅲ in Pellet system in 0.5 ng/ml TGF-β1 medium were 0.395±0.208,1.060±0.175 and 0.629±0.382,and in 1.0 ng/ml TGF-β1 medium were 0.758±0.228,1.201 ±0.187 and 0.753±0.468,respectively 2 weeks after culture,significant differences were shown among the three groups (α-SMA:F=10.691,P＜0.05;Col Ⅰ:F=14.094,P＜0.05;Col Ⅲ:F=10.995,P＜0.05).Conclusions Addition of TGF-β1 and serum enhance the assembly and fibrosis of ECM,showing the higher expressions of specific fibrotic markers in bovine keratocytes Pellet.This culture systerm can be used as a candidate three-dimensional model for corneal stroma ECM fibrosis.

Objective:To evaluate the optimized efficacy of erector spinae plane block (ESPB) with high volume of ropivacaine combined with general anesthesia for patients undergoing thoracoscopic pulmonary surgery.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, scheduled for elective thoracoscopic pulmonary surgery, were divided into 2 groups ( n=30 each) using a random number table method: ESPB with high volume (40 ml) of 0.4% ropivacaine combined with general anesthesia group (E40 group) and ESPB with conventional volume (20 ml) of 0.4% ropivacaine combined with general anesthesia group (E20 group). Ultrasound-guided ESPB was performed on the operated side before general anesthesia induction in both groups.In E40 group, 0.4% ropivacaine 40 ml was injected.In E20 group, 0.4% ropivacaine 20 ml was injected.Total intravenous anesthesia was applied in both groups.Sufentanil was used for patient-controlled intravenous anesthesia (PCIA) after the end of operation.The PCIA pump was set up with a 2 ml bolus dose (0.04 μg/kg), a 10 min lockout interval and background infusion at a rate of 0.05 μg·kg -1·h -1.The analgesia lasted for 48 h after operation, and the numeric rating scale (NRS) score was maintained ≤ 3.When NRS score ≥ 4, morphine 5 mg was intravenously injected for rescue analgesia.The onset time of block, intraoperative consumption of propofol and remifentanil, time to first pressing the analgesia pump, the first requirement for morphine and the ratio of patients using morphine within 48 h after surgery were recorded.The cumulative consumption of requirement for opioids (effective pressing dose of analgesic pump+ consumption of requirement for morphine) within 12, 24, 36 and 48 h after surgery and satisfaction with analgesia were recorded.The extubation time, length of ICU stay, the first postoperative off-bed time, the chest tube removal time and duration of stay in hospital were recorded.The incidence of intraoperative adverse events (hypertension and hypotension) and postoperative adverse events (dizziness, nausea and vomiting) were recorded. Results:Compared with E20 group, the onset time of block was significantly shortened, the cumulative consumption of requirement for opioids within 24, 36 and 48 h after surgery was decreased, the ratio of paitents using morphine within 48 h after surgery was decreased, time to first pressing the analgesia pump and the first requirement for morphine were prolonged, satisfaction with analgesia score was increased, and the first postoperative off-bed time and the chest tube removal time were shortened in group E40 ( P<0.05). There was no significant difference in the incidence of adverse events between the 2 groups ( P>0.05). Conclusion:Compared with ESPB with the conventional volume of ropivacaine combined with general anesthesia, ESPB with the high volume of ropivacaine combined with general anesthesia can reduce the postoperative consumption of opioids, and prolong the duration of effective analgesia, which are helpful for postoperative rapid recovery without increasing the development of adverse events in patients undergoing thoracoscopic pulmonary surgery.

Objective:To explore the risk factors of Pneumocystis carinii pneumonia (PCP) after orthotopic liver transplantation (OLT), and optimize the treatment strategy. Methods:From May 2015 to March 2019, patients undergoing OLT and suffering from postoperative PCP were selected into PCP group ( n=8). Using the propensity score matching method, controls without postoperative PCP were selected from concurrent OLT patients at a ratio of 1: 4 ( n=32). Clinical data were collected and counted for analyzing the risk factors of PCP post-OLT. Results:During this period, 385 cases of OLT were performed. The incidence of PCP was 2.1% (8/385). PCP group were all males with an average age of (52.63±12.99)(27-69) years. PCP has an average onset time of (19.88±13.22)(9-50) weeks post-OLT. There were benign liver disease ( n=2) and malignant liver tumor ( n=6). All operative approaches were modified camel OLT. Univariate analysis revealed significant differences in rejection, peripheral blood lymphocyte count and percentage of peripheral blood lymphocyte after OLT ( P<0.05) and no significant differences existed in other factors ( P>0.05). Logistic regression analysis indicated that a lower count of peripheral blood lymphocyte post-OLT was an independent risk factor for postoperative PCP. Conclusions:A lower count of peripheral blood lymphocyte post-OLT elevates the risk of PCP. For high-risk patients, prophylaxis with TMP-SMX (trimethoprim-sulfamethoxazole) may effectively lower the incidence of PCP post-OLT.

Objective:To determine the prevalence situation of adult female acne (AFA) patients and to explore the risk factors related to AFA.Methods:From September 2019 to June 2020, 290 female acne patients aged from 25 to 48 (29.57±4.50) years were surveyed with a questionnaire of risk factors and the prevalence situation of acne in the acne clinic of the Department of Dermatology, Wuxi No.2 Hospital Affiliated with Nanjing Medical University.Results:AFA occured more frequently in the jaw (95.17%), cheek (93.79%) and forehead (89.66%). Recurrent acne (38.62%) and comedonal acne (50.34%) more commonly occured. Cosmetics, endocrine, diet, genetics and other factors aggravated AFA. Age ( H=7.286, P>0.05; F=0.122, P>0.05), gonadal hormone concentrations ( Z=-0.365, P>0.05; χ 2=0.276, P>0.05), menstrual cycle ( Z=-0.274, P>0.05; χ 2=0.217, P>0.05), genetics ( Z=-1.244, P>0.05; χ 2=1.771, P>0.05) made no difference to acne grading and types. Excessive use of cosmetics could lead to increased comedo (χ 2=7.097, P<0.05). Cosmetics had no difference to acne grading ( Z=-0.065, P>0.05). Gonadal hormone concentrations were uncorrelated with menstrual cycle (χ 2=1.397, P>0.05). Conclusions:The pathogenesis of AFA is related to a variety of factors, which affect the skin barrier function and require comprehensive treatment.

Objective:To access the genetic defects and clinical characteristics of patients with KCNV2-associated cone dystrophy. Methods:Three pedigrees with KCNV2-associated cone dystrophy were recruited in Peking Union Medical College Hospital from August 2017 to December 2019.Peripheral blood from each patient and their parents was collected, and genomic DNA was extracted.Targeted exome capture plus next-generation sequencing (NGS) was used to detect the candidate variants.Suspected causative variants were validated by Sanger sequencing and segregation analysis.Comprehensive ocular examinations were performed, including vision acuity, colour vision, fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), visual field and electroretinogram (ERG). This study was approved by the Institutional Review Board of Peking Union Medical College Hospital and adhered to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination. Results:Three probands from three unrelated Chinese families were confirmed carrying biallelic KCNV2 disease-causing variants.Two patients harbored compound heterozygous variants and one patient with history of consanguinity was identified carrying homozygous variant.Five novel variants in the KCNV2 gene were identified, including p. T121M, p.R244C, p.C199Y, p.M250R and p. L171Pfs*201.All patients enrolled in this study were male with age of 25, 16 and 2 years old, respectively.Three affected individuals complained of vision loss and photophobia and two patients demonstrated reduced color perception and nystagmus.Macular discoloration (bull's eye maculopathy or gold foil macular reflex) was observed in fundus photographs.Macular hypofluorescence was illustrated in FAF imaging, which accompanying a broad hyperfluorescent ring surrounding the central atrophy or not.Macular thinning with loss of the inner segment ellipsoid zone was noted in OCT images, and the disruption was more profound in older patients.Central scotoma with or without peripheral visual field defects was observed in perimetry.Severe cone function loss and variable scotopic rod impairment were demonstrated in ERG, whereas a broad a-wave trough response to scotopic bright flash stimulation was noted. Conclusions:Patients with KCNV2-associated cone dystrophy show a characteristic ERG manifestation.ERG results and KCNV2 variants in Chinese patients differ from those in foreigners.

Objective To provide detailed clinical and molecular genetic findings and describe the characteristics of natural history in Chinese choroideremia (CHM) patients.Methods The patients with CHM who met the inclusion criteria of at least two visits over a minimum period of 5 years were recruited on a voluntary basis at the Ophthalmic Genetics Clinic in Peking Union Medical College Hospital from April 2009 to August 2017.Molecular genetic analysis results,best-corrected visual acuity (BCVA),color fundus photograph,optical coherence tomography (OCT),visual field (VF),full-field electroretinography (fERG) were obtained.This study protocol was approved by the Institutional Review Board of Peking Union Medical College Hospital (S-K125).Written informed consent was obtained from each participant.Results Ten Chinese Han patients from seven CHM families were included.The mutations were confirmed by molecular genetic analysis,and two novel mutations were found.The median age of 10 patients at first visit was 44 years (range 8-52 years).The mean first-last visit period was 6.08 years (range 5.03-7.24 years).The mean BCVA at first visit in logMAR equivalents was 0.56 (range 0.0-2.0) or approximately 0.28 decimal acuity.The correlation between BCVA at first visit and age showed that relative good vision remained until 35 years old and BCVA subsequently reduced rapidly.OCT showed a thickening of the central retinal thickness at early stage,followed by a thinning over decades.Outer retinal tabulation (ORT) was shown in some patients.There was a strong negative correlation (r=-0.861,P＜0.001) between residual VF and age.Five patients did not need to record fERG because of serious fundus lesions.Two patients exhibited decreased amplitudes for both rod and cone-driven responses,and three patients exhibited no fERG amplitudes.Conclusions The progression of CHM may be severer and faster in Chinese patients than that in Western patients.ORT is an important manifestation of OCT in CHM patients.VF and fERG are applicable to evaluate the condition of very-early phase of CHM.

Objective To analyze the clinical features of cancer-associated retinopathy (CAR).Methods The clinical data of 10 patients who diagnosed as CAR during 5 years were retrospectively analyzed.All patients underwent detailed ocular examinations,including electroretinogram (ERG),optical coherence tomography (OCT),visual field (VF) and autofluorescence(AF).Results The primary malignancy was lung carcinoma in 3 patients,thymoma in 3 patients,thyroid carcinoma in 1 patients,maxillary sinus tumor in 1 patients,nasopharyngeal carcinoma in 1 patients and rectal cancer in 1 patients.All patients complained progressive visual reducing.Three patients manifested night blindness.The best corrected visual acuity (BCVA)＜0.1 was in three eyes,≤0.1-＜0.5 in seven eyes,and ≥0.5 in ten eyes.Patients showed normal fundi or mild abnormality.OCT images showed disorganization and/or loss of the ellipsoid zone in the macular area in 4 patients,and other six patients had only central foveal ellipsoid zone preserved.Eight patients had moderately or severely reduced ffERG,and 2 patients demonstrated electro-negative ERG.Five patients revealed peripheral visual defect.AF images were from normal to low or high AF patches in the posterior pole and mid-peripheral retina.Conclusions The clinical manifestations of CAR are varied as common characteristics of progressive visual decrease with or without night blindness,visual field defect and abnormal ffERG recording.