Transforming growth factor-? (TGF-?) is a multifunctional peptide growth factor with a wide range of effects. TGF-? signals are conveyed through cell-surface serine/threonine kinase receptors to the downstream cytoplasmic mediators, known as Smads proteins. Receptor-regulated Smads become phosphorylated by activated type Ⅰ receptors and form heteromeric complexes with a common Smad-Smad4, which translocates into the nucleus to regulate gene transcription. Inhibitory Smads inhibit the activation of receptor-regulated Smads. There are positive, negative and feedback regulations in the Smads mediated TGF-? signaling pathway.

Objective To introduce a new surgical method of reconstructing A ch illes tendon by transfer of the soleus tendon flap. Methods The method was desig ned on the basis of the anatomical characteristics of the superficial muscles as sociated with Achilles tendon. It was applied to treat 12 patients with Achilles tendon defects. These patients were followed up for 0.5 to 6 years (average 39 months). Results The curative effect of the method were assessed according to Ar ner-Lindholms evaluation criteria. 9 cases were rated as excellent, 2 fine an d 1 poor, with the total excellent and fine rate being 92%. Conclusions ①Misdi agnosis and improper initial treatment are the major causes of Achilles tendon d efects. ②Systematic training after operation is very important for good curativ e effects. ③The method mentioned above brings about less trauma, less negative effects on blood supply to Achilles tendon, and good healing after operation.

Objective To investigate whether intensive atorvastatin treatment in patients after percutaneous coro-nary intervention ( PCI) could decrease the effect of contrast medium on kidney function and the incidence of con-trast-induced acute kidney injury( CI-AKI) . Methods A total of 128 patients with PCI were randomly divided into two groups:the enhanced treatment group (n=64) and the control group(n=64). The enhanced treatment group received 80 mg atorvastatin at 12~24 h before PCI and 24,48 h after PCI. The control group was given 20 mg ator-vastatin respectively before and after PCI. The primary end point was the incidence of CI-AKI. Serum creatinine (Scr), cystatin C, glomerular filtration rate(eGFR), urinary albumin and urinary β-2 microglobulin levels were observed at 24 h before PCI and 24, 48, 72 h after PCI. Results In the enhanced treatment group 3. 1 % (n=2) of patients developed CI-AKI versus 4. 7 % (n=3) in the control group, without statistical difference (P=1.00). There was no significant difference between two groups in postoperative Scr, cystatin C, eGFR, urinary al-bumin, urinary β-2 microglobulin and creatine kinase(CK). Three days after the operation, alanine aminotrans-ferase ( ALT) elevated in two groups, and aspartate aminotransferase ( AST) increased in the enhanced treatment group (P<0. 05), but they were all in the normal range. Conclusion There has been no significant difference in decreasing the incidence of CI-AKI and the damage of contrast medium on renal function between the enhanced treatment group and the control group before PCI.

Objective:To establish the quality standard for Chidan Ganxian granules. Methods:TLC was used to identify Paeoni-ae Radix Rubra, Rhizoma Polygoni Cuspidati, Radix Salviae Miltiorrhizae, Herba Saururi and Radix et Rhizoma Rhei in Chidan Ganx-ian granules, and the content of paeoniflorin was determined by HPLC. The stationary phase was an Apollo C18 column ( 150 mm × 4. 6 mm, 5 μm), the mobile phase was acetonitrile-water(12. 5∶87. 5), the flow rate was 1. 0 ml·min-1, the detection wavelength was at 230 nm, and the temperature was 30℃. Results:The characteristic spots of the granules were the same as those of the standard samples without any interference from the negative control. Paeoniflorin had a good linear relationship within the range of 0. 120-1. 436 μg(r=0. 999 4), and the average recovery was 99. 8% with RSD of 1. 80%(n=6). Conclusion:The method is simple, ac-curate, reliable and reproducible, which can be used in the quality control of Chidan Ganxian granules.

BACKGROUND: Studies have shown that basic fibroblast growth factor has effects on stimulating vessel regeneration and collateral reconstruction. However, administration was performed mostly by peripheral vein, left atrium or percutaneous coronary intervention, and it is difficult to achieve an effective therapeutic concentration in the local myocardium. OBJECTIVE: Based on the property of poly(D, I-lactic-coglycolic acid) (PLGA), to investigate outcomes of inducing neovascularization in the myocardium in combination of basic fibroblast growth factor (bFGF) by ensuring target release of protein growth factor in local tissue. METHODS: PLGA and bFGF were dissolved in dichloromethane. This liquid mixture was rolled into the form of a hollow tube (3.0 mm outer diameter, 2.8 mm inner diameter, 0.1 mm thick, 10 mm length) for further use. The middle third of the left anterior descending coronary artery of mini-swines was ligated, and the local myocardium became dark purple. After the successful establishment by abnormal regional wall motion in the cardiac apex at anterior wall using ultrasound, the mini-swines were assigned to channels and bare scaffolds (BS) group and channels and bFGF-incorporating scaffolds (FS) group. The scaffold was implanted in the myocardium using self-made hollow bit. At 6 weeks, the number of proliferative cells was quantified by immunohistochemical staining. New vessels were quantified utilizing Image-Pro Plus software package in both groups. Quantitative analysis of changes in mass defect percentage was performed by Emory Cardiac Toolbox software combined with single-photon-emission computed tomography. RESULTS AND CONCLUSION: At 6 weeks, number of proliferative cells and the density of new vessels were significantly increased in the FS group compared with BS group(P<0.001). Single-photon-emission computed tomography illustrates that MDP was significantly lower in the FS group compared with the BS group (P < 0.001). Results have suggested that PLGA scaffolds that incorporate bFGF were able to induce angiogenesis and enhance blood-flow perfusion.

Objective To study the relationship of expression of metastasis suppressor gene nin23-H1 protein in gastric carcinoma tissue and tumor infiltration and metastasis.Methods The expression of metastasis suppressor gene nm23-H1 protein in 50 gastric carcinoma tissues was detected by SP immunohistocbemistry tech-nology.Results Correlations were presented among expression of nm23-H1 protein, infiltrate grade of gastric carcinoma, lymph node metastasis and TNM stage.Conclusions Expression of nm23-H1 may suppress infiltra-tion and metastasis of gastric carcinoma, Low expression of nm23-H1 protein may be of great reference value in judgement of tumor progression, metastasis and reeidivation.

Objective To Study the expression and clinical meaning of nm23-H1,c-Met and survivin protein in gastric carcinoma tissue.Methods Expression of nm23-H1,c-Met and survivin protein in 50 paraffin block samples of gastric carcinoma were detected by S-P immunohistochemistry technology.The relationship of expression to tumor differentiation degree,infiltration depth,lymph node metastasis,TNM stage,tumor metastasis and reeidivation were analyzed.Results The positive expression rates of nm23-H1,c-Met and survivin protein were 46%,72% and 80%,low nm23-H1 protein expression and high c-Met protein expression correlated tightly with TNM stage and lymph node metastasis of gastric carcinoma,high survivin protein expression correlated tightly with differentiation degree,TNM stage and lymph node metastasis of gastric carcinoma,there was a inverse correlation between nm23-H1 protein expression and survivin,but a direct correlation between c-Met and survivin.Conclusions Low nm23-H1 protein expression and high c-Met and survivin expression has important guidance significance of making a early diagnosis and judging prognosis.Selective gene therapy guided by these may be helpful.

Objective To explore the relationship between WT1 and prognosis of patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), and to evaluate the possibility of WT1 as a potential marker for monitoring the minimal residual disease (MRD). Methods Bone marrow mononuclear cells from 58 patients with primary AML, 32 patients with primary ALL, 40 patients with AML-complete remission (CR), 28 patients with ALL-CR and 31 patients with trilineage hyperplasia (control group) were collected. Real-time fluorescent quantitative PCR method was used to detect the expression of WT1 in all patients. The expression threshold of WT1 in each group was established. WT1 copy number/ABL copy number ratio×100%denotes the relative expression level of WT1 gene. Results Median relative expression level of WT1 in the control patients was much lower than that in primary AML patients [0.026%(0-0.240%) vs. 20.880 % (3.550 %-48.500 %), Z=-7.74, P<0.000 1]. Relative expression level of WT1 between AML-CR patients [0.102%(0-5.380%)] and primary AML patients had significant difference (Z=-8.34, P<0.000 1). Moreover, the relative expression level rate of the first course in AML patients with higher WT1 expression level (>20.880 %) was 60.7 % (17/28), while the CR rate was 76.7 % (23/30) in those with lower WT1 expression. WT1 expression was increased dramatically in recurrent AML patients. Relative expression level of WT1 was significantly higher in primary ALL patients [0.350 % (0.021 %-10.780 %)] compared with that in the control group Z=-2.58, P<0.05. There was no significant difference in relative expression level of WT1 between ALL and ALL-CR patients [0.038 % (0-2.800 %), P=0.065]. Conclusion WT1 expression level in AML patients is relatively high, which could be used as an effective index of prognosis evaluation and MRD monitoring for AML patients, but not for ALL patients.

Objective:To discuss the dosimetric contribution of the ovoid in the cervical cancer brachytherapy through the intracavity combined with interstitial(IC/IS)technique.Methods:The data on 20 patients with FIGO(2009)stageⅡ A, Ⅱ B or Ⅲ Bcervical cancer treated with radical radiotherapy in China-Japan Union Hospital of Jilin University during 2015-2017 was collected. External irradiation treatment was 45 Gy/1.8 Gy× 25 fractions. Brachytherapy was MRI-guided IC/IS brachytherapy with a prescription of 28 Gy/7 Gy× 4 fractions. All of 20 patients developed two kinds of plans, the ovoid group and the non-ovoid group. The original MRI-guided brachytherapy treatment plan was set(80 fractions)to the ovoid group. As contrast model that removed the ovoid and consisted of tandem combined with needles set to the non-ovoid group was built, and the same physicist designed the plan to make the dose of D90% for high-risk clinical target volume(HR-CTV)similar to the ovoid group. The dosimetric differences of the D90% and D98% for HR-CTV, D90% and D98% for intermediate-risk clinical target volume(IR-CTV)and D2 cm 3 for the bladder, rectum, sigmoid colon and small intestines between two groups of plans were analyze by paired t-test. Results:Compared with the ovoid group, the non-ovoid group showed no significant difference on HR-CTV D90%( P>0.05), but the HR-CTV D98%(6.99±0.60 vs. 6.78±0.76), IR-CTV D90%(4.71±0.58 vs. 4.26±0.57) and D98%(3.77±0.58 vs. 3.26±0.59) of the non-ovoid group decreased significantly( t=3.906, 9.860, 8.636, P<0.05). The sigmoid colon showed no significant difference( P>0.05), while the bladder (5.29±0.67 vs. 4.92±0.74), rectum (3.72±0.69 vs. 3.35±0.92) and small intestines (3.05±1.37 vs. 2.98±1.34) D2 cm 3of the non-ovoid group decreased significantly( t=8.758, 7.543, 8.059, P<0.05). Conclusions:Ovoid is very important for IC/IS technique in cervical cancer brachytherapy. Reasonable optimization of the dose weight ratio of the ovoid and the needle can bring better clinical benefits.

Objective To find out the clinical characteristics and prognostic risk factors of malignant hypertension (MHT) with pre existed chronic glomerulonephritis.Method The clinical and renal pathological data of 38 chronic glomerulonephritis patients with MHT hospitalized in our department from 1990 to 2002,and the associated factors for renal prognosis were analyzed. Results All the patients suffered from chronic glomerulonephritis.The ratio of male to female was 3 75∶1.The average age was (29 5?7 74)years old. The rates of recognition, therapy and control of hypertension before MHT onset were 75 7%, 13 5%and 5 4%respectively. IgA nephropathy was the most common pathological type.Of 38 cases,3 maintained normal renal function, 6 presented acute renal failure,13 presented chronic renal failure, and 16 had acute attack based on chronic renal failure. Twenty four patients were followed up for 1～6 months after antihypertensive therapy and renal function of 10(41 7%) was improved. 1 year renal survival rate of 20 patients was 55%. The analysis of risk factors showed that those patients who were possessed of positive hypertension family history(P=0 03), high SBP/DBP levels(P=0 023,0 047), and high scores of chronic index of renal pathology(P=0 032) had worse prognosis. The level of highest serum creatinine and the scores of chronic index of renal pathology were associated with 1 year renal survival(P=0 031,0 037).Conclusions MHT occuring in young patients with chronic glomerulonephritis is not rare, which becomes an important reason inducing rapidly decrease of renal function, especially in patients with IgA nephropathy. Actively antihypertensive therapy is helpful for renal function recovery. The low rates of recognition, therapy and control of pre existed renal hypertension may play key roles in the development of MHT. It is important to recognize and treat the hypertension at early stage of renal disease to improve the renal survival.