A new orally active non-glycosidic, non-adrenergic cardiotonic agent, 2-[(2-me-thoxy-4-methysulfinyl) phenyl]-1 H-imidazo[4, 5-b]-pyridine, AR-L115BS, has been synthesized.The two key intermediates, 2, 3-diaminopyridine and 2-methoxy-4-methylmercap-tobenzoic acid were prepared according to the routes submitted by Fox and Zipp, respectively. The approaches were improved to adapt large scale laboratory preparation. The structure of the end product was proved by elemental analysis,mass spectra, 1H nuclear magnetic resonance spectra and infrared spectra.

Objective To investigate the association of HLA DRB1 alleles with gastric carcinoma and H. pylori infection. Methods HLA DRB1 alleles polymorphism in 63 patients with gastric adenocarcinoma and 136 normal controls were tested with the polymerase chain reaction/sequence specific primer(PCR/SSP) technique. The status of H. pylori infection was determined by histology of gastric biopsy specimens and /or by ELISA. Results Both HLA DRB1 0901 and HLA DRB1 12 were positively associated, and HLA DRB1 15 was negatively associated with gastric adenocarcinoma, but no significant associations were found between patients with and without above HLA DRB1 alleles with regard to patients' age at presentation, sex ratio, tumor site (distal vs proximal), TNM staging, histological grading of tumor or status of H. pylori infection. Conclusions Our results suggest that HLA DRB1 0901, DRB1 12 and DRB1 15 are associated with gastric adenocarcinoma, but are not associated with the clinical features of gastric adenocarcinoma and the status of H. pylori infection.

Objective To study the protective effect of octreotide on myocardial injury after hepatic ischemia-reperfusion in rabbit. Methods Pringle's maneuver rabbit hepatic ischemia-reperfusion model was established. 24 adult New Zealand rabbits were random divided into equal 3 groups: sham operative group ( group A) , ischemia-reperfusion group( group B) and octreotide preconditioning group ( group C ). The levels of CK-MB( MB isoenzyme of creatine kinase) and LDH ( 1actate dehydrogenase), superoxide dismutase (SOD) and malondialdehyde (MDA) of each group were measured at the time before ischemia (T1) , after ischemia for 30 mins ( T2 ) and after reperfusion for 60 mins ( T3 ), 120mins ( T4 ), 240 mins ( T5 ). The SOD and MDA in myocardial tissue of each group were measured after reperfusion for 240 mins. The changes of ultrastructure in the myocardial cell were observed by transmission electron microscopy after reperfusion for 240 mins. Results There was no significant difference in the levels of CK-MB and LDH in serum of each group before ischemia ( P ＞0. 05). The CK-MB and LDH of group B and C were higher than that of group A ( P ＜0.05) after ischemia for30 mins. The CK-MB and LDH of group C were lower than that of group B in this period( P ＜0. 05 ). The highest time point of LDH and CK-MB were after reperfusion for 120 mins and 240 mins. The contents of MDA in group B and group C were higher than that in group A from after ischemia for 30 mins in plasma and after reperfusion for 240 mins in myocardial tissue ( P ＜ 0. 05 ),and it in group C were lower than that in group B( P ＜0.05) .The contents of SOD in group B and group C were lower than that in group A from after ischemia for 30 mins in blood plasma and after reperfusion for 240 mins in myocardial tissue ( P ＜0. 05), and in group C were higher than that in group B( P ＜0. 05).The electromicroscope showed that the pathological change of myocardial ultrastructure of group C was slighter than that of group B. Conclusion Octreotide can stabilize myocardial cell membrane and reduce release of oxygen free radical and significantly relieve the injury of myocardial ultrastructure after hepatic ischemiareperfusion in rabbit. Octreotide preconditioning can relieve myocardial injury after hepatic ischemia-reperfusion in rabbit.

Objective To explore human cytomegalovirus UL97 mutations related to ganciclovir resistance in hematopoietic stem cell transplant (HSCT) recipients.Methods A total of 43 patients,including 24 males and 19 females,with an average age of 21 years old,who had HCMV DNAemia for more than two weeks after HSCT between 2008 and 2010 in Peking University People's Hospital,were included in this prospective study.UL97 GCV resistance mutations were investigated in 49 plasma specimens collected from those patients.GCV resistance mutations such as UL97 M460V/I,H520Q,A591V,A594V,L595S/F,and C603W,were analyzed by modified PCR-RFLP methods.UL97 mutations related to GCV resistance were assayed by the method of PCR-direct sequencing (PCR-DS).An amplified refractory mutation system real-time PCR (ARMS RT-PCR) was developed for the detection of UL97 A594V mutation.Results Eight known UL97 ganciclovir resistance mutations were not detected by PCR-RFLP and PCR-DS.Four new UL97 mutations like UL97 R494P,T502A,N558D,and G561S,were detected by PCR-DS.The ARMS RT-PCR for detecting of UL97 A594V was established successfully.The lower limit of detection of the method was at least 7.5 × 102 copies/ml combined with the use of nucleic acid extraction reagent.UL97 A594V resistance mutation was identified by the method of ARMS RT-PCR in two HSCT recipients.The rate of UL97 A594V mutation was 4.7％ (2/43) in HSCT recipients.Conclusion The ARMS RT-PCR assay represented a sensitive method for the identification of UL97 A594V mutation.

In this work, blank polylactic acid (PLA) nanoparticles with unstained surface were prepared by the nano-deposition method. On the basis of the preparation, the effect of surface modification on brain microvascular endothelial cells (BMECs) targeting was examined by in vivo experiments and fluorescence microscopy. The results showed that PLA nanoparticles are less toxic than PACA nanoparticles but their BMECs targeting is similar to PACA nanoparticles. The experiments suggest that drugs can be loaded onto the particles and become more stable through adsorption on the surface of PLA nanoparticles with high surface activity. The surface of PLA nanoparticles was obviously modified and the hydrophilicity was increased as well in the presence of non-ionic surfactants on PLA nanoparticles. As a targeting moiety, polysobate 80 (T-80) can facilitate BMECs targeting of PLA nanoparticles.
Brain/*blood supply ; Brain/drug effects ; Capillaries/cytology ; Capillary Permeability/drug effects ; Drug Delivery Systems ; Endothelium, Vascular/*cytology ; Lactic Acid/*pharmacology ; Mice, Inbred Strains ; Microscopy, Fluorescence ; Nanoparticles ; Polymers/*pharmacology

Objective:To screen the differentially expressed miRNAs in umbilical cord tissue of children with nonsyndromic cleft lip and/or cleft palate( NSCL/P) using miRNA microarray and comprehensive bioinformatics analysis for the prediction of related the bio-logical process and signaling pathways. Methods:Umbilical cord tissues of 4 cases of healthy newborns' and 4 lip or palate tissues of 4 cases with NSCL/P without other disease aged younger than 2 years were collected. The differentially expressed miRNAs were screened by miRNA microarray. Targets of dysrugulated miRNAs were predicted by TARGETSCAN-VERT, MIRDB and RNA22-HSA. All the gene sets were analyzed by gene ontology and pathway enrichment. Results: MiRNA microarray demonstrated that 254 miRNAs were dysregulated(181 miRNAs were up-regulated and 73 downregulated,P <0. 05). The dysregulated miRNAs targets contained 5029 genes. The dysregulated miRNAs targets were enriched in anatomical structure development,cell adhesion,cell proliferation,cell motili-ty and other biological processes. The dysregulated miRNAs targets were enriched in Wnt, mTOR, cGMP-PKG, TGFβ, PI3K-Akt and other signaling pathways. Conclusion:The target genes set of miRNAs are enriched in multiple biological processes and signaling path-ways related to NSCL/P, which indicate that genetic and environmental factors may influence the development process of NSCL/P.

Objective To summarize the image features of primary retrograde type A aortic dissection by CTA examination, aiming to improve the precise diagnosis of this type of specific aortic dissection, and to provide imaging evidence for subsequent therapies.Methods The CTA data of 17 patients with primary retrograde type A aortic dissection treated in Cardiothoracic Surgery Department of Nanjing General Hospital of Nanjing Military Command from January 2010 to December 2014 were retrospectively reviewed.The image features including the dissection type, the location and quantity of intimal tear, the aorta involving area, and the origin of branch vessels were analyzed.Results Nine cases of the total 17 patients had pericardial/pleural effusion.Fourteen patients showed intramural hematoma in ascending aorta, while 3 patients showed active blood flow and thrombosis formation in false lumen of ascending aorta.Five patients showed aortic ulcers and intramural hematoma in descending aorta, and the other 12 patients showed typical dissection image with active blood flow in both true and false lumen,among the 12 patients, there were obvious intimal separations observed in 11 cases, while multiple aortic ulcers in 1 case.Abdominal aorta was involved in l0 cases of the above 11 patients.All of the abdominal branch vessels were originated from true lumen in 2 of the 10 patients,and the other 8 patients showed 1-2 vessels originated from false lumen.Conclusion Primary retrograde type A aortic dissection is relatively rare.However,specific imaging features different from typical aortic dissection can be observed in this type of aortic lesion.Careful viewing of CTA image is extremely necessary for accurate diagnosis.

Objective To compare the dosimetric difference of RapidArc and fixed gantry IMRT for liver carcinoma.Methods The CT data of 10 liver cancer patients were used to design 3 groups of treatment plan:IMRT plan,single arc RapidArc plan(RA1) ,and dual arc RapidArc plan(RA2).The planning target volume (PTV) dosimetric distrubition,the organs at risk (OAR) dose,the normal tissue dose,mornitor units(MU) and treatment time were compared.Results The maximum dose of PTV in RA1 and RA2 plans were lower than that of IMRT(Z = -2.090,-2.666,P ＜ 0.05).RapidArc groups had an improved 90% prescription dose conformity index than IMRT(Z = -2.805,-2.809 ,P ＜ 0.05).For organs at risk,RapidArc group plan had a significantly lower dose in V40 of stomach and small bowel than I MRT plan,but higher in mean dose of left kidney (Z = -1.988,-2.191,P ＜ 0.05).The values of V5,V10 and V15 of healthy tissue in RapidArc plan groups were higher than those in IMRT plan,while the values of V20 ,V25 and V30 of healthy tissue in RapidArc plan groups were lower than those in IMRT plan.The number of computed MU/fraction of Rapid Arc plan was 40% or 46% of IMRT plan and the treatment time was 30% and 40% of IMRT.Conclusion RapidArc showed improvements in conformity index and healthy tissue sparing with uncompromised target coverage.RapidArc could lead to the less MU and shorter delivery time compared to IMRT.

Objective To investigate the correlation between functional lung dose-volume histogram (f-DVH) parameters and radiation-induced lung toxicity (RILT) in patients of locally advanced non-small cell lung cancer (NSCLC) treated with late-course accelerated hyperfractionated radiotherapy and chemotherapy,and to identify the excellent predictors of f-DVH and their reference thresholds.Methods A total of 51 patients of NSCLC at stage Ⅲ underwent PET/CT/SPECT coregistered image guided radiotherapy.Philips Pinnacle3 planning system was used for delineation of the target volume and organs at risk so as to establish the three dimensional conformal radiotherapy or intensity-modulated radiotherapy treatment plans.The version 3.0 of the NCI Common Terminology Criteria for Adverse Events was used to evaluate the grade of RILT,and analyze the correlation of the DVH parameters of the total lung (TL),ipsilateral lung (IL),and functional lung (FL) and RILT,and to identify the excellent predictors.The median follow-up was 15 months.Results During the follow-up,10 cases of RILT (19.6%) ≥grade 2 were observed.Single factor analysis showed that the V5-V40 of TL,V5-V/20 of IL,and V5-V50 of FL were all related to the occurrence of RILT,and multiple factor analysis showed that TL-V15 and FL-V20remained associated with RILT (P = 0.005 and P = 0.016).According to ROC analysis,the V10 (45.38%) of FL was the most sensitive predictor with a sensitivity rate of 90.0% and 1/25 (27.78%) of FL was the most specific predictor with a specificity rate of 90.24%.The sensitivity,specificity and accuracy of V20 of FL were 70.00%,73.17%,and 74.90%,respectively.Conclusions The occurrence of RILT is closely associated with multiple f-DVH parameters of FL,and f-DVH has good sensitivity and specificity for prediction.

ObjectiveTo evaluate the effectiveness and safety of high frequency electronic associating stents insertion and subsequent radiotherapy guided by fiberoptic bronchoscope in treating tracheobronchial stenosis caused by lung and esophagus carcinoma.MethodsFifty-two patients which were ascertained with serious stenosis in trachea or bronchi by fiberoptic bronchoscope were subjected to the study.Fiberoptic bronchoscope was used to investigate the location,extent,blood supply and the degree of tracheobronchial stenosis before the study.After the focus in the airways was cleared up with high frequency electronic,electrocoagulation and snare under the guide of the euthyphoria of fiberoptic bronchoscope,Ni-Ti memory alloy stents were placed into the stenosis airways.The 52 patients were divided into two groups with 26 cases each:the stent group and the stent associating radiotherapy group(radiotherapy group).The later group accepted subsequent radiotherapy after the therapy.The following indexes of the two groups were investigated:short-time clinical effect,dyspnea index class,rate and average time of airway restenosis,life span and survival rate.ResultsAfter therapy,the 52 patients had obvious improvements in dyspnea and the diameter of the stenosis airways.The short-time total effective rate was 100.0％ (52/52),but there was not significant difference between the two groups(P＞ 0.05 ).After therapy,there was significant difference in two groups in dyspnea index class(P ＜ 0.01 ).Although there was not significant difference in the rate of airway restenosis between the two groups(P＞0.05),the average time of airway restenosis in the radiotherapy group was obviously longer than that in the stent group(P＜ 0.01 ).The survival rate of the radiotherapy group in the 6th and 9th month after therapy was higher than that in the stent group (P ＜ 0.05),but there was no significantdifferenee in the 3rd and 12th month (P ＞0.05).ConclusionHigh frequency electronic associating stents insertion and subsequent radiotherapy guided by fiberoptic bronchoscope is an effective and safe treatment for the patients suffering tracheobronchial stenosis caused by lung and esophagus carcinoma.