Objective To investigate the value of plasma miR-22 in diagnosis of idiopathic pulmonary arterial hypertension ( IPAH ),and its role of regulation mechanisms in the pathogenesis of the disease.Methods Circulating miR-22 levels of IPAH patients and healthy controls were evaluated by RTPCR.The silico analysis of targets for miR-22 was taken, and followed by eGFP reporter assay for verification of predicted target gene Myc binding protein (MYCBP). Results Compared with healthy controls,the expression of plasma miR-22 in IPAH patients was significantly decreased (P ＜ 0.01 ).The area under curve (AUC) of ROC curve was 0.744.MYCBP was a real target of miR-22 confirmed by silico analysis and eGFP reporter assay. Conclusions The expression of plasma miR-22 was significantly decreased in IPAH patients,and it could serve as a potential biomarker for diagnosis.The miR-22 might be involved in the pathogenesis of the disease through promoting its target gene MYCBP to activate the c-Myc pathway.

AIM: To observe the clinical efficacy and safety of vincamine sustained release capsules on non- arteritic anterior ischemic optic neuropathy ( NAION) . · METHODS: Patients who were diagnosed with monocular onset NAION in acute stage from January to September 2015 were divided into two groups. Routine treatment such as steroid pulse therapy and neurotrophic treatment were given to all the patients. Vincamine was added to the treatment group patients with 30mg twice a day for 3mo. The best corrected visual acuity ( BCVA), mean deviation ( MD) of visual field, retinal nerve fiber layer ( RNFL ) , ganglion cell complex ( GCC ) , pattern visual evoked potential ( PVEP ) and OCT results were analyzed before and after the treatment. ·RESULTS:Totally 42 eyes of 42 patients were enrolled in our study. There were 27 patients in the treatment group, aged from 33 to 79 years old, the average value was 55. 55± 11. 83 years old. The control group has 15 patients, aged from 40 to 70 years old, the average value was 55. 71 ± 10. 06 years old. There were no statistical differences between the two groups in the baseline. After 3mo of the treatment, MD value of the two groups were lower compared with the baseline, the difference was statistically significant in the treatment and control group respectively (t= 2. 342, 2. 692; P = 0. 027, 0. 041). The difference of PVEP amplitude and potential of the two groups before and after the treatment were not statistically significant. The thickness of retinal nerve fiber layer and the ganglion cell complex were all lower than the baseline, and the difference was statistically significant (P<0. 001). The treatment of the two groups were both effective, the treatment group has better treatment effect than the control group. Adverse events related to the treatment of vincamine had not been found. ·CONCLUSION:Vincamine is helpful in the treatment of non-arteritic anterior ischemic optic neuropathy.

OBJECTIVE: To investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (HCN4) and connexin43 (Cx43) in the sinoatrial node of electric shock death. METHODS: As experimental group, 34 cases of electric shock death who had definite current mark evidence were selected from pathology department of Xuzhou Medical College from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. The expressions of HCN4 and Cx43 in the sinoatrial node were observed by immunohistochemical technology. RESULTS: HCN4 positive cells expressed in the cell membrane and cytoplasm of the sinoatrial node. Cx43 positive cells expressed in the cell membrane and cytoplasm of T cells and myocardial cells. The expression of HCN4 was significantly higher than that of the control group (P < 0.05) and the expression of Cx43 was significantly lower than that of the control group (P < 0.05). CONCLUSION The changes of HCN4 and Cx43 expressions in the sinoatrial node illustrate electric shock death might be related to the abnormalities of cardiac electrophysiology and conduction.
Connexin 43/metabolism* ; Cyclic Nucleotide-Gated Cation Channels ; Heart Rate ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/metabolism* ; Immunohistochemistry/methods* ; Myocardium/metabolism* ; Myocytes, Cardiac ; Sinoatrial Node/physiopathology*

Objective To retrospectively evaluate the diagnosis and treatment of Mirizzi syndrome (MS).
Methods Patients who received elective or emergency cholecystectomies in our center during 23 years were retrospectively evaluated. The data reviewed included demography, clinical presentations, diagnostic methods, surgical procedures, postoperative complications, and follow-up.
Results There were 27 patients diagnosed with MS among 8697 cholecystectomies performed during that period. The preoperative diagnostic modalities included ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography. The incidence of MS Type I (12/27, 44.4%) had the dominance in the four types, the incidence of MS Type II and III were 33.3% (9/27) and 22.2% (6/27), and there were no MS Type IV patients. Laparoscopic cholecystectomy was performed in 15 (55.6%) patients, but only 3 (11.1%) patients with MS Type I had a successful surgery, and the other 12 were converted to open cholecystectomy. The remaining 12 patients directly underwent open cholecystectomy. The surgical procedures except laparoscopic cholecystectomy included simply open cholecystectomy (including laparoscopic cholecystectomy converted to open cholecystectomy) (6/27, 22.2%), open cholecystectomy, T-tube placement with choledochotomy (9/27, 33.3%), open cholecystectomy, closure of the fistula with gallbladder cuff, T-tube placement (3/27, 11.1%), and open cholecystectomy with excision of the external bile ducts, and Roux-en-Y hepatico-jejunostomy (6/27, 22.2%). Of them, 88.9% (24/27) patients recovered uneventfully and were discharged in good condition without any operation related mortality.
Conclusions Endoscopic retrograde cholangiopancreatography is a good method with diagnostic and therapeutic purposes. Total or partial cholecystectomy is generally adequate for MS Type I. For MS Type II-IV, paritial cholecystectomy, choledochoplasty, or if impossible, Roux-en-Y hepatico-jejunostomy may be performed. Laparoscopic cholecystectomy may be successful in selected preoperatively diagnosed MS Type I patients, and open cholecystectomy is the standard therapeutic method.

OBJECTIVETo study the chemical constituents of radix and rhizome of Ligularia sagitta.

METHODIsolation and purification were carried out on the column chromatography of silica gel and sephadex LH -20. The structures were identified by spectral analysis.

RESULTSeven terpenoid compounds were isolated from the radix and rhizome of L. sagitta. Five of them are sesquiterpenoids, the structures were determined as 7alpha-hydroxy-9(10) -ene-1, 8-dioxo-6, 7-dihydrofuranoeremophilane (1), 1p, 10P3-epoxy-6beta, 8 beta-dihydroxy-eremophil7 (11) -en-12, 8alpha-olide (2) , 1-oxo-9-desoxycacalol (3), benzofuranoeremophil-l-ene (4) and bakkenolide (5); other two compounds belong to triterpenoid. 3p, 16P3-dihydroxy-12-oleanen-28-al (6) and lupeol (7).

CONCLUSIONCompoundsl-3 and 6 were: isolated from L. sagitta for the first time, and compounds 3 and 6 were obtained from Ligularia for the first time.

4-Butyrolactone ; analogs & derivatives ; chemistry ; isolation & purification ; Asteraceae ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Sesquiterpenes ; chemistry ; isolation & purification ; Terpenes ; chemistry ; isolation & purification

OBJECTIVETo evaluate the treatment of recurrent acute cholangitis with hepatolithiasis.

METHODSWe retrospectively analyzed the clinical data of patients with recurrent acute cholangitis who were treated in Peking Union Medical College Hospitals emergency department from January 1998 to December 2008.

RESULTSTotally 408 patients underwent surgery, of which 167 patients received emergency operations and 241 underwent selective operations after medication and interventional treatment. The incidence of complications was 6.4% among those who received emergency operations and 3.2% among selective operations. The 30-day mortality rate of selective operations was zero.

CONCLUSIONAlong with the progress of percutaneous cholangiographic drainage and endoscopic retrograde cholangiopancreatography, selective operations have been increasingly applied for acute cholangitis with notably low complications and postoperative death.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cholangitis ; etiology ; surgery ; Cholelithiasis ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Background Little information is available regarding the effect of angiotensin Ⅱ (Ang Ⅱ) on the bumetanide-sensitive sodium-potassium-2 chloride cotransporter (NKCC2), the thiazide-sensitive sodium-chloride cotransporter (NCC), and the Cl- channel (CLC)-K2 at both mRNA and protein expression level in Ang Ⅱ-induced hypertensive rats. This study was conducted to investigate the influence of Ang Ⅱ with chronic subpressor infusion on nephron-specific gene expression of NKCC2, NCC and CLC-K2. Results Ang Ⅱ significantly increased blood pressure and up-regulated NKCC2 mRNA and protein expression in the kidney. Expression of CLC-K2 mRNA in the kidney increased 1.6 fold (P<0.05).There were no changes in NCC mRNA or protein expression in AngII-treated rats versus control. Conclusions Chronic subpressor Ang Ⅱ infusion can significantly alter NKCC2 and CLC-K2 mRNA expression in the kidney, and protein abundance of NKCC2 in kidney is positively regulated by Ang Ⅱ. These effects may contribute to enhanced renal Na+ and Cl- reabsorption in response to Ang Ⅱ.

Objective To explore a method for isolation and culture Dispase Ⅱ and Trypsin-EDTA.Cells were seeded onto mitomycin C-treated of rat buccal mucosa stem cells and to identify the stem cells.Methods Epithelial cell mass were obtained by digesting rat buccal mucosa with 3T3 Swiss albino layer and cultured in DMEM for 24 hours,followed bv K-SFM culturing.Some cells were induced to osteocytes and adipocytes and underwent ALP testing after 72 hours.Five days later,the primary cells were digested with trypsin and inoculated onto collagen Ⅳ-coated flasks and cultured at room temperature for 20 minutes.The adherent cells continued to be cultured with epithelial stem cell medium,then examined for identifying the clones,osteocytes,adipocytes,cytokeratin and ALP staining.Results 83.96 percent of the primary epithelial cell mass were in G0/G1 phase by flow cytometry test. The clones were seen after 72 hours on 3T3 Swiss albino layer,and the osteocytes and adipocytes were positive.Cells were adhered quickly to collagen Ⅳ,in a shape of round or orbicular-ovate with strong refraction.The induced-osteocyte and adipocyte,cytokeratin and ALP were all positive.Conclusions The stem cell-like epithelial cells could be obtain using the 3T3 Swiss albino layer method.Sieved by collagen Ⅳ and cultured in epithelial stem cell medium could make the epithelial stem cells depurate and proliferate qnickly.

OBJECTIVETo retrospectively evaluate the diagnosis and treatment of Mirizzi syndrome (MS).

METHODSPatients who received elective or emergency cholecystectomies in our center during 23 years were retrospectively evaluated. The data reviewed included demography, clinical presentations, diagnostic methods, surgical procedures, postoperative complications, and follow-up.

RESULTSThere were 27 patients diagnosed with MS among 8697 cholecystectomies performed during that period. The preoperative diagnostic modalities included ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography. The incidence of MS Type I (12/27, 44.4%) had the dominance in the four types, the incidence of MS Type II and III were 33.3% (9/27) and 22.2% (6/27), and there were no MS Type IV patients. Laparoscopic cholecystectomy was performed in 15 (55.6%) patients, but only 3 (11.1%) patients with MS Type I had a successful surgery, and the other 12 were converted to open cholecystectomy. The remaining 12 patients directly underwent open cholecystectomy. The surgical procedures except laparoscopic cholecystectomy included simply open cholecystectomy (including laparoscopic cholecystectomy converted to open cholecystectomy) (6/27, 22.2%), open cholecystectomy, T-tube placement with choledochotomy (9/27, 33.3%), open cholecystectomy, closure of the fistula with gallbladder cuff, T-tube placement (3/27, 11.1%), and open cholecystectomy with excision of the external bile ducts, and Roux-en-Y hepatico-jejunostomy (6/27, 22.2%). Of them, 88.9% (24/27) patients recovered uneventfully and were discharged in good condition without any operation related mortality.

CONCLUSIONSEndoscopic retrograde cholangiopancreatography is a good method with diagnostic and therapeutic purposes. Total or partial cholecystectomy is generally adequate for MS Type I. For MS Type II-IV, paritial cholecystectomy, choledochoplasty, or if impossible, Roux-en-Y hepatico-jejunostomy may be performed. Laparoscopic cholecystectomy may be successful in selected preoperatively diagnosed MS Type I patients, and open cholecystectomy is the standard therapeutic method.

Adult ; Aged ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Male ; Middle Aged ; Mirizzi Syndrome ; diagnosis ; pathology ; physiopathology ; surgery ; Retrospective Studies

OBJECTIVETo summarize the clinical features and outcomes of unsupected gallbladder carcinoma ( UGC) detected during or after laparoscopic cholecystectomy.

METHODSMedical records of 8005 patients, who underwent laparoscopic cholecystectomy in Peking Union Medical College Hospital between June 1993 and June 2011, were reviewed. Patients that pathologically diagnosed as UGC were retrospectively studied in terms of clinical features, preoperative and postoperative diagnosis, surviving period, and complications.

RESULTSIn the 8005 patients who received laparoscopic cholecystectomy, 36 (0.45%) were diagnosed as UGC during (25 patients) or after (11 patients) laparoscopic cholecystectomy. The gallbladder cancer was staged as T1 in 16 patients, T2 in 11 patients, and T3 in 9 patients. The 1-, 3-, and 5-year survival rates of all the patients were 88.9% (32/36), 63.9% (23/36), and 58.3% (21/36). The 5-year survival rates in T1 stage, T2 stage, and T3 stage patients were 100%, 75.0%, and 0.0%, respectively.

CONCLUSIONSThe survival rate of UGC is associated with tumor stage, not with operation approaches. Laparoscopic cholecystectomy is appropriate for T1 patients.

Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies