Objective To investigate the effects of lipopolysaccharide(LPS) on the expression of hypoxia inducible factor-1?(HIF-1?) and its target gene glucose transpoter-1(GLUT-1)in human monocyte lines THP-1. Methods THP-1 cells were stimulated with 1 ?g/mL LPS for 0,2,4,6 or 8 h.The expression of HIF-1? protein of THP-1 cells was detected by Western blotting,and RT-PCR was employed to detect the expression of HIF-1? mRNA and GLUT-1 mRNA.THP-1 cells were exposed to different concentrations of LPS(0,0.01,0.1 and 1 ?g/mL) for 6 h,and the expression of HIF-1? protein of THP-1 cells was detected by Western blotting. Results The expression of HIF-1? protein of THP-1 cells began to increase 2 h after being treated with 1?g/mL LPS,significantly increased after exposure for 4 h(P

Objective To determine the perinatal outcomes and its risk factors of fetuses prenatally diagnosed with the double bubble sign on ultrasound scanning.Methods The clinical data of 57 cases of fetal double bubble sign which was prenatally diagnosed by ultrasound in Xin Hua Hospital from January 1,2000 to December 31,2013 were retrospectively analyzed.The neonates survived not less than 42 days were as surviving group,and who survived lower than 42 days were as dead group.The t test,x2 test and Logistic regression were used for statistical analysis of the data.Results Of 57 fetuses with the double bubble sign,the incidence of polyhydramnios,intrauterine fetal death and associated anomalies was 88％ (50/57),4％ (2/57) and 23％ (13/57),respectively.Induced labor to terminate the pregnancy was occurred in eight cases,the other 49 cases had live births but ten neonates abandoned therapy.Thirty-nine live babies accepted surgical treatment with one dead,and the other 38 neonates survived not less than 42 days.The overall 42-day survival rate was 67％ (38/57) and the surgical survival rate was 97％ (38/39).Compared with surviving neonates,the neonates who died had lower gestational age [(35.8±3.0) vs (38.1 ± 1.9) weeks,t=2.859,P＜0.01] and birth weight [(2 229±567) vs (2 830±558) g,t=3.136,P＜0.01],and a higher incidence of prenatally diagnosed structural anomalies [3/11 vs 3％ (1/38),P＜0.05] and karyotype anomalies detected after birth [3/11 vs 3％ (1/38),P＜0.05].Logistic regression analysis showed that the fetuses with the double bubble sign and fetal growth restriction had a higher risk of complications (OR=9.893,95％CI:1.758 55.661,P=0.009).Conclusions Fetuses with double bubble sign have adverse outcome if they complicating preterm delivery,low birth weight,prenatally diagnosed structural anomalies and karyotype anomalies.

Objective To discuss prenatal ultrasound features and fetal outcomes of meconium peritonitis.Methods This is a retrospective study of all cases of fetal meconium peritonitis (n=26) registered in the Department of Obstetrics,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 1,2004 to December 31,2014.Prenatal ultrasound features,surgical findings and fetal outcomes were discussed.Variance analysis,Chi-square test or Fisher's exact test were applied for statistics.Results Among the 26 cases,25(96.2％) were diagnosed prenatally,24 (92.3％) underwent neonatal surgery,and 24 (92.3％) survived.Prenatal ultrasound findings included bowel dilatation (88.5％,23/26),intra-abdominal calcification (42.3％,11/26),fetal ascites (30.8％,8/26),intra-abdominal pseudocysts (15.4％,4/26) and polyhydramnios(50.0％,13/26).Surgical findings confirmed the diagnosis of meconium peritonitis was due to jejunal atresia[16.7％(4/24)],ileal atresia[75％(18/24)],and atresia of jejunal and ileal junction [8.3％(2/24)],respectively.However,no statistical significance was shown in the incidence of bowel dilatation,intra-abdominal calcification,fetal ascites,pseudocysts and polyhydramnios among the three groups of different etiology (all P＞0.05).Conclusions The prenatal ultrasound features of meconium peritonitis may vary a lot.But bowel dilatation combined with intra-abdominal calcification,fetal ascites or pseudocysts prompts the diagnosis of meconium peritonitis.Early surgical intervention in neonatal period could reduce the neonatal mortality remarkably,thus comprehensive and standardized perinatal management are necessary to improve fetal outcomes.

Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) with different imaging changes in children.Methods Hospitalized patients with MPP during September 2012 to August 2013 in Beijing New Century Children's Hospital were retrospectively reviewed.The data including clinical features,laboratory tests,treatment and prognosis were collected.The patients were divided into 3 groups according to the radiological findings,including interstitial infiltration (group 1),intralobular infiltration (group 2) and segmental or larger infiltration (group 3).The clinical data were compared among the 3 groups.Results The percentages of patients in the 3 groups were 18.8％ (36/191 cases) in group 1,39.8％ (76/19 cases) in group 2 and 41.4％ (79/191 cases) in group 3,respectively.In 144 cases of MPP patients older than 3 years old,48.6％ (70/144 cases) were segmental or larger infiltration.The incidence of higher fever,hypoxemia and elevated C-reaction protein and lactate dehydrogenase in group 3 [50.6％ (40/79 cases),87.3％ (69/79 cases),78.5％ (62/79 cases),29.1％ (23/79 cases)] were higher than those in group 1 [5.6％ (2/36 cases),61.1％ (22/36 cases),19.4％ (7/36 cases),0] and group 2 [10.5％ (8/76 cases),67.1％ (51/76 cases),14.5％ (11/76 cases),3.9％ (3/76 cases)],and the differences were significant(all P ＜ 0.01).Patients in group 3 had higher risk of cardiac and/or liver impairment,refractory MPP,and treated by glucocorticoids and bronchoalveolar lavage [41.8 ％ (33/79 cases),29.1％ (23/79 cases),94.9 ％ (75/79 cases),50.6％ (40/79 cases)].The hospital stay was (9.48 ±3.26) d in group 1,(9.24 ±2.97) d in group 2,and (12.09 ±3.01) d in group 3,respectively,and the difference was significant among 3 groups (F =19.348,P =0.005),the hospital stay in group 3 was longer than that in the other 2 groups (t =4.210,5.931,all P =0.000),while there was no difference between group 1 and group 2 (P ＞ 0.05).Patients in group 1 with wheeze were more co-mmon,and were treated by Azithromycin earlier than that in group 3 [(5.08 ± 3.43) d vs.(4.16 ± 2.20) d],the difference was significant(t =2.498,P =0.014),while the incidence of hypoxemia was common than that in group 2 (x2 =3.176,P =0.012).Conclusions MPP patients with segmental or larger infiltration are older than patients in the other groups,and present with severe complications,higher inflammatory factors,longer hospital stay,and higher risk for refractory MPP.Glucocorticoids and bronchoalveolar lavage are usually used in these patients.Patients with interstitial infiltration are prone to manifest with wheeze and hypoxemia,and its diagnosis and treatment by Azithromycin are usually delayed.Therefore,pediatrician should pay more attention to MPP patients with different imaging changes,in order to diagnose and treat the patients timely.

Objective To explore the prenatal diagnosis and factors influencing prognosis of congenital diaphragmatic hernia (CDH).Methods Fifty seven cases of CDH prenatally diagnosed by ultrasound in the Department of Obstetrics,Xinhua Hospital from January 1,2006 to March 31,2013 were retrospectively reviewed.Prognosis and risk factors were analyzed by ultrasound characteristics and newborn status.Statistical analysis was performed using t test,x2 test and Logistic regression.Results Forty-five (79％)of all cases were left-side CDH and the rest 12 (21％)were right-side.Fourteen fetuses were aborted.Thirty three were delivered and treated surgically,twenty-three infants survived after surgery and ten died,with an overall survival rate of 40％ (23/57).The other ten cases were delivered,but died of no treated surgically.The birth weight of the surviving neonates was heavier than that of those who died [(3 173 ±348) vs (2 846±568)g,t=2.238,P=0.033].The gcstational age at diagnosis of the aborted fetuses was younger than that of the surviving neonates [(24.0 ± 4.1) vs (30.0± 6.0) weeks,t=3.181,P=0.003].Twenty-one (91％,21/23) of the surviving neonates had a lung-to-head ratio (LHR) ≥ 1.4.A linear trend test showed a negative correlation between LHR and adverse outcome (x2=9.223,P=0.002) with a correlation coefficient-0.730 (P=0.000).LHR＜1.4 (OR=35.867,95％CI:1.861-691.341,P=0.018) and polyhydramnios (OR=9.285,95％CI:1.102-78.212,P=0.040) were risk factors for neonatal death.Right-side CDH (OR=0.158,95％CI:0.009-2.824,P=0.210),liver herniation into the thorax (OR=1.730,95％CI:0.144 20.707,P=0.665) and birth weight (OR=l.002,95％CI:0.999-1.005,P=0.135) were not risk factors.Conclusions The survival rate of CDH is still low.Gestational age on diagnosis,presence of polyhydramnios and LHR＜ 1.4 predict an adverse outcome.

Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .

Objective To evaluate the diagnostic value of dobutamine?stressed cardiac morphing ( CM) MPI ( CMMPI) for coronary artery disease ( CAD) in middle?aged patients. Methods A total of 97 middle?aged patients (52 males, 45 females, age 40-65 (52.98±7.74) years) from March 2011 to Febru?ary 2015 with chest distress, cardiopalmus and chest pain symptoms ( suspected CAD) were retrospectively studied. Informed consents were signed by patients before examination. All patients underwent one?day dobu?tamine?stressed/rest CMMPI and CAG within one month. The diagnostic value of CMMPI was assessed and compared with CAG. Results CMMPI revealed 42 abnormal cases and 9 normal cases in 51 cases with cor?onary artery stenosis by CAG. CMMPI found 11 abnormal cases and 35 normal cases in 46 cases with normal coronary artery by CAG. In comparison with CAG, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CMMPI were 82.35%(42/51), 76.09%(35/46), 79.38%(77/97), 79.25%(42/53)and 79.55%(35/44) respectively. The side effect was slight and transient with an inci?dence of 82.47%(80/97). Conclusion The dobutamine?stressed CMMPI has an important value for the diagnosis of CAD and the assessment of myocardial damage in middle?aged patients.

Objective To explore the underlying molecular mechanisms of estrogen induced apoptosis of synthetic vascular smooth muscle cells (VSMCs). Methods Cultured VSMCs on passage 3 were divided into three groups: 17?-estradiol (E-2) group, p38 inhibitor group (SB+E-2) and control group. With treatment for 72 hours,the apoptosis of cells was quantified by measuring the intracellular nucleosomes with ELISA; expressions of total p38, phospho-p38 and myocyte enhancer factor-2 (MEF2) were analyzed by Western blotting, with a confirmative immunohistochemical staining for MEF2. Results Compared with that of control cells, the rate of apoptosis in VSMCs grown in E-2 was significantly increased, with up-regulations of total p38, phospho-p38 and MEF2. These effects of E-2 were blocked in SB+E-2 group in which the rate of cell apoptosis and expression of p38 had no obvious change compared with that of control group, while the expression of p-p38 and MEF2 was decreased. Immunohistochemical staining showed that MEF2 was mainly located in cellular nucleus, and its expression was increased in E-2 group but decreased in SB+E-2 group. Conclusion Estrogen may induce apoptosis of synthetic VSMCs through p38 pathway-dependent up-regulation of MEF2.

Objective To analyze the image characteristics of chest schwannoma in coincidence 18FFDG SPECT studies,and to evaluate its prospective diagnostic function on chest schwannoma.Methods Four cases confirmed as schwannoma by surgery and pathology were enrolled in this retrospective study.Enhanced CT and coincidence 18F-FDG SPECT studies were performed before surgery.Imaging characteristics for the diagnosis of chest schwannoma were summarized.Results Tumors were totally removed by surgery.The histological diagnosis of schwannoma was confirmed by pathological,HE and immunohistological staining examination (positivity for the S-100 protein and vimentin),including 1 case of malignant schwannoma and 3 cases of benign.Four cases all showed high uptake of 18F-FDG.The uptake in malignant schwannoma was much higher than that in benign schwannoma.Benign schwannomas were noninvasive masses and mainly showed compression symptoms,with obvious lobulation and distinct borders.Malignant schwannoma was invasive masses.Conclusions 18 F-FDG coincidence SPECT is of limited value as a prospective diagnostic imaging technique for the identification of benign schwannoma from malignant schwannoma.But it could play an important role in the staging,restaging,and post-therapy follow-up of schwannoma.

OBJECTIVEWith functional magnetic resonance imaging (fMRI), cerebral function imaging of acupuncture and sham acupuncture at Taichong (LR 3) in patients with essential hypertension (EH) was observed to analyze central mechanism of Taichong (LR 3) to treat EH.

METHODSEighteen EH patients were divided into a twisting acupuncture group (10 cases) and a sham acupuncture group (8 cases), which were treated with twisting manipulation and sham acu- puncture at right Taichong (LR 3), respectively. The treatments were both given with 30-second manipulation and 30- second interval for totally 5 min. During the acupuncture, fMRI was adopted to scan the cerebral function imaging of EH patients on resting state, and the acquired data were analyzed with SPM2 module in Matlab software.

RESULTSAcupunc- ture at Taichong (LR 3) in EH patients mainly increased opposite-side oxygen consumption, which generally activated left anterior cingulated gyrus (BA 32), left inferior parietal lobule (BA 40), left inferior temporal gyrus (BA 19), left middle temporal gyrus (BA 37) and right anterior central gyrus (BA 6). The activated areas were related to motor, vision and cognition of emotion. Stimulation region of sham acupuncture mainly included right anterior cingulated gyrus (BA 24), left inferior parietal lobule (BA 40) and left inferior frontal gyrus (BA 7).

CONCLUSIONThe central mechanism of Tai- chong (LR 3) on antihypertensive effect and symptom improvement is not in thalamus and medulla that are traditionally believed to control blood pressure. Taichong (LR 3) could activate anterior cingulated gyrus to regulate parasympathetic nerve and lower blood pressure, and through anterior cingulated gyrus, the connection with the surrounding areas is strengthened to improve the cognitive impairment caused by long-term hypertension.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain ; diagnostic imaging ; Cognition ; Essential Hypertension ; Female ; Humans ; Hypertension ; diagnostic imaging ; psychology ; therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography