Objective To investigate the role of exosomal microRNA(miR)-191 derived from NaAsO2-transformed cells in proliferation of human liver L-02 cells.Methods The normal wild-type L-02 cells (recipient L-02 cells)were treated with media or exosome derived from 2 μmol/L NaAsO2-transformed L-02 cells.Anti-miR-191 and anti-miR-NC were transfected into NaAsO2-transformed L-02 (T-L-02) cells by lipofectamineTM 2000,respectively,while untreated group was set as control.The expression of miR-191 was detected by qRT-PCR.Cell proliferation was evaluated by CCK-8 assay.Results The proliferation [(207 ± 24)％ vs (105 ± 21)％,t =5.462,P ＜ 0.01] and the expression of miR-191 [(206 ± 25)％ vs (105 ± 20)％,t =4.116,P ＜ 0.05] of recipient L-02 cells were significantly increased in the transformed L-02 cells media (T-CM) treated group compared with in the normal L-02 cells media (CM) group.Several concentrations of exosomes derived from CM did not change the proliferation and miR-191 expression of recipient L-02 cells (F =2.213,2.213,all P ＞ 0.05).Several concentrations of exosomes derived from T-CM increased the proliferation and miR-191 expression of recipient L-02 cells in a dose-response manner (F =10.910,4.553,P ＜ 0.01 or ＜ 0.05).The proliferation [(160 ± 32)％ vs (102 ± 8)％,(203 ± 7)％ vs (111 ± 5)％,t =2.999,18.750,P ＜ 0.05 or ＜ 0.01] of recipient L-02 cells treated with 20 or 50 mg/L exosomes derived from T-CM was higher than that treated with the same concentration of exosomes derived from CM.The expression of miR-191 [(166 ± 13)％ vs (113 ±9)％,(211 ± 55)％ vs (102 ± 8)％,(206 ± 31)％ vs (105 ± 6)％,t =5.611,3.357,5.509,P ＜ 0.05 or ＜ 0.01] of recipient L-02 cells treated with 10,20 or 50 mg/L exosomes derived from T-CM was higher than that treated with the same concentration of exosomes derived from CM.The miR-191 levels of T-L-02 cells [(39 ± 10)％ vs (100 ± 0)％ or (106 ±17)％,all P ＜ 0.01] or exosomes [(30 ± 19)％ vs (100 ± 0)％ or (104 ± 17)％,all P ＜ 0.01] in the anti-miR-191 treated group were significantly lower than that in the untreated group or anti-miR-NC treated group.The exosomes derived from untreated group promoted the proliferation [(395 ± 31)％ vs (100 ± 0)％,t =16.290,P ＜ 0.01] and miR-191 expression [(208 ± 47)％ vs (100 ± 0)％,t =4.015,P ＜ 0.05] of recipient L-02 cells.The proliferation [(157 ± 19)％ vs (395 ± 31)％ or (411 ± 55)％,P ＜ 0.05] and miR-191 expression of [(103 ± 44)％ vs (208 ± 47)％ or (197 ± 37)％,P＜ 0.05 or ＜ 0.01] of recipient L-02 cells treated with exosomes derived from anti-miR-191 treated group were lower than those treated with exosomes derived from untreated group or anti-miR-NC treated group.Conclusion The exosomal miR-191 secreted by NaAsO2-transformed L-02 cells promotes proliferation of normal human L-02 cells.

Objective To compare the clinical characteristics and the outcomes of severe hyperlipidemic pancreatitis (SHLP) and severe acute gallstone pancreatitis (SAGP).Methods The clinical data of 22 patients with SHLP and 91 patients with SAGP admitted from January 2009 to December 2015 were retrospectively reviewed.The clinical manifestations,laboratory tests,organ dysfunction,medical treatment,complications and outcomes in 30 d after admission were analyzed and compared between two groups of patients.Results There were 16 males and 6 females with a mean age of (60.5 ± 9.1) years in SHLP group;while 32 males and 59 females with a mean age of (54.3 ± 5.4) years in SAGP group.The blood and urine amylase levels in SHLP group were significantly lower than those in SAGP group [(715 ±99) U/L vs.(1 551 ± 107) U/L,t =4.65,P =0.00;(382 ±56) U/L vs.(773 ± 66) U/L,t =4.52,P =0.00,respectively].The incidence of circulation insufficiency,respiratory insufficiency,renal dysfunction,and long-term puhnonary infection in SHAP patients was significantly higher than that in SAGP patients [36 ％ (8/22) vs.14 ％ (13/91),x2 =5.22,P =0.01;41％ (9/22) vs.7 ％ (6/91),x2 =9.46,P =0.01;23％(51/22) vs.5％ (5/91),x2 =4.20,P=0.03;55％(12/22) vs.32％ (29/91),x2 =7.02,P =0.01].Two cases died in the SHLP group and 9 cases died in SAGP group due to critical infection,cardiac events and bleeding.Conclusion Compared to SAGP patients,the blood and urine amylase levels are usually not remarkably high in SHLP patients,and the prevention and management of multi-organ failure and lung infection are more important for SHLP patients.

Objective To explore the clinical characteristics and prognostic factors of breast carcinosarcoma.Methods Clinical data of 37 breast carcinosarcoma patients treated at Tianjin Cancer Hospital from 1974 to 2014 was analyzed retrospectively.Kaplan-Meier unvariate analysis was used to calculate the survival rate and compare the survival rates.Multivariate factors for survival were analyzed by COX proportional hazards regression model.Results 37 cases of breast carcinosarcoma were all female.The median age was 55 years.Among them 31 cases complained for painless mass,six cases had breast mass with skin ulceration.21 cases were three-negative breast cancer.Ten cases had axillary lymph node metastasis,ten cases had distant metastasis.The 5-year survival rate was 62.3％.Unvariate analysis showed that axillary lymphnodes metastasis (P =0.045) and therapeutic schedule (P =0.016) significantly influenced the oulcome of the patients.COX multivariate analysis validated that the therapy modality was an independent prognostic factor for breast carcinosarcoma(P =0.041).Conclusions Breast carcinosarcoma is rare and has a poor prognosis.ER,PR and HER-2 expressions in most cases are negative.If there is axillary lymph node metastasis,the prognosis is poor.A reasonable and comprehensive treatment can improve the prognosis.

Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction,in the same period of coronary artery bypass grafting (CABG).Methods From January 2012 to January 2015,76 patients with myocardial infarction were selected.Patients were divided into transplantation group (n =46) and control group (n =30) on the basis of whether being treated by autologous peripheral blood stem cell transplantation.After myocardial infarction patients were taken to the hospital with the therapy of conventional drug,5 days before CABG,transplantation group was given the autologous peripheral blood stem cell mobilization and expansion,24 hours before CABG,taking autologous peripheral blood stem cell collection.76 patients took CABG with non-cardiopulmonary by pass,transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial,while the control group was not given the injection of autologous peripheral blood stem cell.The LV morphology,wall motion score index (WMSI) and index of cardiac function before and after the operation in both groups were evaluated by echocardiography.Results Six months after CABG,there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index,Left ventricular ejection fraction was increased.The indexes of cardiac function in the transplantation group were better than the control group.Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function,and has obvious recent clinical curative effect in the same period of CABG.

Objective To investigate the role of transcriptional-coactivator with PDZ-binding motif( TAZ) in genistein-induced osteoblastogenic differentiation of mouse bone marrow-derived mesenchymal stem cells ( BMSCs) .Methods Mouse BMSCs were cultured in phenol red-freeα-MEM containing osteogenic supplements for inducing osteogenic differentiation.BMSCs were transfected with siRNA-TAZ and treated with genistein.The temporal sequence of osteoblastic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition.The mRNA expression of bone sialoprotein ( BSP) and osteocalcin ( OC) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The binding interaction between TAZ and cbfa1 was identified by co-immunoprecipitation.Results TAZ expression was detected during the induction of osteogenic differentiation, the ALP activity and calcium deposition were significantly decreased in BMSCs which were transfected with siRNA-TAZ.Genistein(0.01-1 μmol/L) exhibited a dose-dependent effect on TAZ expression in mouse BMSCs cultures.Treatment with genistein ( 1 μmol/L ) resulted in increased ALP avtivity and calcium deposition of BMSC cultures as function of time.Genistein(1μmol/L) also promoted the nuclear localization of TAZ and augmented the interaction between TAZ and cbfa1, and by which upregulated cbfa1-mediated gene expression such as BSP and OC.However, the ALP avtivity and calcium deposition, as well as the expression of BSP and OC were not promoted by genistein in BMSCs transfected with siRNA-TAZ.Conclusion These data suggest that the TAZ plays an important role in genistein-induced osteoblastic differentiation of mouse BMSCs cultures.

Objective To explore the efficacy of different bulbourethral sling procedures in the treatment of male acquired urinary incontinence.Methods A retrospective study of 105 patients with acquired urinary incontinence was performed.The patients underwent 3 different bulbourethral sling procedures under urodynamic monitoring between October 2000 and June 2013.Mean age was 54 years (range 15-81).Urinary incontinence was secondary to post-prostatectomy in 70 patients and posterior urethroplasty in 35.Preoperatively,10 patients were completely urinary incontinence and 95 patients were stress urinary incontinence.Mean duration of urinary incontinence was 3 years (1-12).The surgical techniques were composite device suspension in 54 patients,pedicled rectus abdominalis muscle and fascial flaps suspension in 10 and transobturator sling in 41.Results The patients were followed up for 3-128 months (mean 54 months).The urethral catheter was left in situ for 5-7 days in 103 patients.Of the 103 patients,5 patients were difficulty in voiding but corrected by indwelling of urethral tube for another 1 week in 4 patients and transurethral bladder neck resecting in 1.In the remainder 2 patients,the maximum urethral pressure was 110 and 158 cm H2O (1 cm H2O=0.098 kPa) at the end of surgery and both patients were able to void on day 14 and 21 respectively and achieved complete continence.In this study,complete continence was achieved with good voiding in 74 patients (70.5％),completed control of urination rate was 81,4％ (57/70) in group of prostate and 48.6％ (17/35) in group of posterior urethroplasty.Twenty-six patients were improved and 5 patients were failed.Conclusion Bulbourethral sling procedure under urodynamic monitoring is an effective option in the treatment of male acquired urinary incontinence,especially for patients of incontinence of post-prostatectomy.

Objective To investigate the optimal monochromatic parameters of CT angiography (CTA) on small feeding arteries of abdominal tumors using single source dual-energy CT with gemstone spectral imaging (GSI) technique.Methods The clinical and medical imaging data of 32 patients with abdominal malignant tumor were analyzed retrospectively during January to April 2012.Three phase-enhanced CT scans (Discovery CT750 HD,GE Heahhcare,Milwaukee,USA) of the abdomen were recorded using the GSI technique on 32 patients.The minor feeding arteries of tumor with diameter between 1.5 mm to 3.0 mm were reconstructed by 140 kVp mixed energy,66 keV,and optimal monochromatic mode respectively.After CT scanning,the original data were processed with layer and interval of 0.625 mm,the 140 kVp mixed energy images and 70 keV monochromatic images were obtained with standard algorithm.The original images were conveyed to AW4.5 work-station to process furthermore,then the data of the optimal monochromatic group and 66 keV group were reconstructed.Comparative parameters include contrast-to-noise ratio (CNR),signal-to-noise ratio (SNR) and subjective scores of the small feeding arteries CTA quality.Subjective scores were evaluated by two radiologists according to the sharpness and resolution of the small feeding arteries.One-way ANOVA was used to for statistical analysis.Results CNR of the optimal monochromatic group,the 66 keY group,and the 140 kVp mixed energy group were 21.70 ±9.74,16.63 ±7.60,and 9.85± 6.76,respectively.SNR were 35.05 ± 17.75,26.77 ± 11.51,and 16.32 ± 9.5,respectively.Subjective scores were 4.58 ± 0.40,3.55 ± 0.57,and 2.75 ± 0.46,respectively.CNR,SNR and subjective scores had significant difference among groups (F =17.11,15.73 and 116.01,P ＜ 0.01).The optimal monochromatic group was superior to the 66 keV group and the 140 kVp mixed energy group.Conclusion The optimal monochromatic mode can improve CTA quality of small feeding arteries of abdomen malignant tumors with GSI technique using single source dual-energy CT.

Objective To evaluate the changes of the waveform of the photopic negative response in flash-electroretinogram, visual acuity and central retinal thickness in the treatment of intravitreal injections of bevacizumub. Design Retrospective self-comparative case series. Partidpants 8 subjects (9 eyes) with exudative age-related macular degeneration and 3 subjects (3eyes) with proliferative diabetic retinopathy. Method Evaluation protocol included examinations of the Early Treatment Diabetic Retinopathy study visual acu-ity, visual field, intraocular pressure, fundus fluorescein angiography, optical coherence tomography and flash-electroretinogram. Intravit-real injections of bevacizumab, 1.25 mg (0.05ml), were given under an operating microscope and aseptic conditions. All the subjects were followed-up one month later. Main outcome Measure The amplitudes of PhNR, visual acuity and central retinal thickness. Re-sult At 1 months, the mean amplitudes of PhNR and mean visual acuity in all cases had no obvious change (n=12, P>0.05).The central retinal thickness reduced obviously (n=12, P<0.05), but it was neither significantly correlated with PhNR (r=0.294, P=0.145) nor with visual acuity(r=-0.358, P=0.073). Conclusion The single intravitreal injection of bevacizumab is showed promising in absorption of in-traretinal edema and subretinal fluid in patients with exudative age-related macular degeneration and proliferative diabetic retinopathy, but the changes of visual function (including PhNR) might need further investigation. (Ophthalmol CHN, 2009, 18: 243-246)

Aim To investigate the effect of oxymatrine on lipid metabolism regulated genes in liver in fat-in-duced insulin resistance in ApoE -/- mice.Methods Seventeen C57BL/6J male mice were selected in normal control group.Sixty-eight ApoE -/- mice with high fat diet for 1 6 weeks,were randomly divided into model group,oxymatrine low,middle and high dose groups.Then they were gavaged for 8 weeks.Body weight and general biochemical indicators were deter-mined in mice.The mRNA and protein expression lev-els of LPL,FAT/CD36,CPT1 ,UCP2,SREBP-1 c,FAS and ACC were examined by real-time PCR and West-ern blot in the liver.Results Compared with model group,oxymatrine reduced body weight(BW),fasting
blood glucose (FBG),cholesterol (TC ),triglyceride (TG),free fatty acids(FFA),fasting plasma insulin (FINS)and insulin resistance index(HOMA-IR)(P <0.05),while improved glucose infusion rate (GIR). Oxymatrine down-regulated the mRNA and protein ex-pression of LPL,FAT/CD36,UCP2,SREBP-1 c,FAS and ACC(P <0.05),and up-regulated the mRNA and protein expression of CPT1 in varying degrees (P <0.05).Conclusion Oxymatrine can regulate the ex-pression of lipid metabolism regulated genes in liver and improve insulin resistance in ApoE -/- mice in-duced by high fat diet.

Objective To assess the evidence-based support of short-term efficacy of sleeve gastrectomy and Roux-en-Y gastric bypass in obesity with metabolic syndrome by laparoscopy.Methods Electronic literature search was performed on PubMed,EMBASE,Cochrane Library,CNKI database for the efficacy of sleeve gostrectomy and Roux-en-Y gastric bypass in the treatment of obese patients with metabolic syndrome from Jan.2011 to Jun.2016.The inclusion and exclusion criteria were selected for quality evaluation,data extraction.Review Manager 5.3 software was used to conduct the statistical analysis.Results Thirteen articles were included in the Meta-analysis,including 5 randomized controlled trails,eight case-control studies with 18,850 cases,including 2,559 cases in the sleeve gastrectomy group and 16,291 cases in the Roux-en-Y gastric bypass group.The results of the Meta-analysis showed that there was no significant difference in the remission rate of type 2 diabetes rnellietus between sleeve gastrectomy and Roux-en-Y gastric bypass group (78.7％ vs 83.0％;RR =0.94,95％ CI:0.81 ～ 1.09,P ＞0.05),the reduction of body mass index was significantly higher in Roux-en-Y gastric bypass group than sleeve gastrectomy group from the short-term follow-up (MD =-2.03,95％ CI:-3.25 ～ 0.81,P ＜ 0.05).Both two surgeries can reduce the incidence of high blood lipids and hypertension,but there was no significant difference between them as well as type 2 diabetes mellitus remission.Conclusion Both sleeve gastrectomy and Roux-en-Y gastric bypass are effective in treating obesity complicated with metabolic syndrome,and can reduce the incidence of type 2 diabetes mellitus,hypertension and hyperlipidemia and reduce the body weight.Roux-en-Y gastric bypass is superior to sleeve gastrectomy in the treatment of obesity.