Objective To survey the application of diagnosis and implementation of treatment guidelines of cerebrovascular disease( CAD)combined community acquired pneumonia( CAP)in the community of Shenyang. Methods Randomly chose 7 hospitals in different levels in districts and counties of Shenyang,and made a retrospective survey on the treatments of CAD combined CAP from Oct. 2009 to Jun. 2012 to clear the implementation. Meanwhile,the collected cases were divided into in compliance with guidelines group and non compliance with guidelines group. The information including clinical stable time,length of hospital stay,efficient treatment,empiric therapy and prognosis with the help of guidelines were collected. Results Four hundred and eighty-eight cases were qualified from collected 532 cases,in which,38. 5% initial diagnosis and treatment was accord with the guidelines formulated by the Respiratory Branch of Chinese Medical Association. The efficiency of initial empirical treatment was 84. 5%. The clinical stable time in compliance with guidelines group was (5. 00 ± 0. 27)d,better than that in non compliance with guidelines group((8. 00 ± 0. 45)d;P=0. 021). The length of hospital stay was(11. 00 ± 0. 25)d in compliance with guidelines group,significantly less than that in non compliance with guidelines group(( 14. 00 ± 0. 53 ) d;P =0. 015 ). The effective rate of patients with respiratory failure in compliance with guidelines group was 90. 9%,higher than non compliance with guidelines group(58. 6%),and the difference was significant(P=0. 026),while there were no significant differences in terms of gender,heart and lung diseases. Conclusion There is the smaller patient proportion that diagnosed and cured in accordance with the guidelines formulated by the Respiratory Branch of Chinese Medical Association. It is no distinctive difference for the efficient treatment of guidelines. But selected antibiotic application according to the guidelines can improve the clinical stable time and hospital stay of CAD combined CAP,as well as reduce invalid cases and reduce the mortality rate. The guidelines need to be further extended.

OBJECTIVE To report on concurrent mutations of APC and MLH1 genes identified in a family affected with familial adenomatous polyposis(FAP). METHODS The proband was diagnosed with FAP based on her clinical manifestation, family history and histopathology examination. She developed endometrial epithelial neoplasia(EIN) two years later. With peripheral blood samples collected from her and members of her family, genomic DNA was extracted, and mutations of the APC and MLH1 genes were analyzed by Sanger sequencing. RESULTS Two novel heterozygous mutations were identified respectively in the APC gene(c.637C>T, p.R213X) and the MLH1 gene(c.1153C>T, p.R385C) in the proband. The former has resulted in a truncated protein, while the latter has led to substitution of Arginine by Cystine. CONCLUSION The concurrent mutations of the APC and MLH1 genes probably underline the FAP and Lynch syndrome(LS) in this pedigree. As the first female identified with such mutations, the proband manifested later onset of symptoms with certain degree of variation. For patient with FAP, a detailed family history should be taken.Potential mutation of the APC gene should be screened.Non-intestinal manifestations should be searched. For those who have developed endometrial lesion such as EIN, mutation of the MMR gene (associated with LS) should also be screened.

Objective:To analyze the expression of human leukocyte antigen G (HLA-G) in human T-cell leukemia virus type 1 (HTLV-1)-positive T cells, and to investigate its role in the occurrence and development of HTLV-1 infection.Methods:The expression of HLA-G in HTLV-1-positive T cell lines (MT2 and MT4) was detected by Western blot and real-time PCR. HLA-G gene in MT2 and MT4 cells was knocked down by siRNA, and the effects of HLA-G on the expression of HTLV-1 Tax and P19 at mRNA and protein levels were detected by Western blot and real-time PCR. Moreover, the changes in cytokine expression in MT2 and MT4 cells were monitored at RNA level after HLA-G gene silencing. The proliferation ability of MT2 and MT4 cells was analyzed by CCK8. Signal transducer and activator of transcription 3 (STAT3) pathway-related proteins were detected by Western blot.Results:Compared with HTLV-1-negative T cells (Jurkat and MOLT4), the expression of HLA-G increased significantly in MT2 and MT4 cells. After knocking down the HLA-G gene with siRNA in MT2 and MT4 cells, the expression of HTLV-1 Tax and P19 at mRNA and protein levels was decreased, and the expression of antiviral cytokines IFN-γ and TNF-α was increased. The proliferation of MT2 and MT4 cells and STAT3 phosphorylation in these cells were decreased.Conclusions:HTLV-1 could induce T cells to overexpress the immune tolerance molecule HLA-G. Silencing HLA-G gene in HTLV-1-positive T cells could promote the production of antiviral cytokines and reduce IL-6 expression and STAT3 phosphorylation, thereby effectively inhibiting the replication of HTLV-1.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

For studying the effects of Mycobacterium tuberculosis secretory protein ESAT-6 on the related functions of macrophages, RAW264.7 cells were transfected with pEGFP-C1-ESAT-6 and pEGFP-C1 by liposome respectively. After screening with a high level of G418, the macrophage cell lines that stably expressed EGFP-ESAT-6 fusion protein or EGFP were established. The gene and protein expression levels were further analyzed by RT-PCR, fluorescence microscopy and Western blotting. The results indicated that the EGFP-ESAT6 fusion gene was integrated into the chromosome and the protein could be stably expressed in the selected macrophage cell line. These results gave us a tool for the future study in the mechanisms of ESAT-6 protein in modulating the macrophage cells.
Animals ; Antigens, Bacterial ; biosynthesis ; genetics ; Bacterial Proteins ; biosynthesis ; genetics ; Cell Line ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Macrophages ; cytology ; metabolism ; Mice ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection

Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017. A young child who suffered destructive injury of left forearm, wrist and palm with severed 3rd-5th fingers. Tendon and neurovascular repairs of forearm, wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery. In the Phase II surgery, the abdomina flap division was carried out. The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF) were carried out in Phase III surgery. In Phase IV surgery, fingers functional reconstruction and foot flap thinning were performed. Four years after surgery, the thumb oppositions to middle, ring and little fingers could be completed, with slightly limitations. The appearance and texture of transferred foot flap were good, and the child could walk and run almost normally.

Objective To observe the effect of yin-tonifying and fire-removing prescription on IL-10 and IL-18 in systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency.Methods A total of 86 systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency were enrolled and randomly divided into control group and research group,43 cases in each group.The control group was treated with conventional western medicine,while research group was treated with yin-tonifying and fire-removing prescription on basis of control group.The TCM symptom score,serum IL-10 and IL-18 levels and the incidence rate of adverse reactions were compared between the two groups.The clinical efficacy of the two groups was evaluated.Results Mter treatment,the levels of IL-10 and IL-18 in both group decreased significantly,and the levels in research group were significantly lower than control group (P ＜ 0.05).The total effective rate was 95.35％ in research group,which was significantly higher than 69.77％ in the control group (P ＜ 0.05).The incidence rate of adverse reactions was 6.98％ in the research group,whichwas similar to 9.30％ in the control group (P ＞ 0.05).Conclusion For systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency,yin-tonifying and fire-removing prescription can significantly improve the clinical efficacy,alleviate clinical symptoms,and will not increase the incidence rate of adverse reactions.

Objective:To investigate whether Lycopi Herba can serve as a viable alternative to Alismatis Rhizoma in the treatment of heart failure (HF) through network pharmacology and molecular docking techniques.Methods:TCMSP database was used to filter active components of Lycopi Herba and Alismatis Rhizoma. SwissTargetPrediction database was used to predict potential targets. HF-related targets were collected from databases such as GeneCards, OMIM, and DisGeNET. Venny 2.1.0 was used to draw a Venn diagram illustrating the intersection of targets between Lycopi Herba and Alismatis Rhizoma and HF. A protein-protein interaction (PPI) network was established using the String database, and key targets for the treatment of HF with Lycopi Herba and Alismatis Rhizoma were selected using Cytoscape 3.9.1 software to construct a component-intersection target network. The intersection targets were then analyzed for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways using Metascape. Molecular docking techniques were used to evaluate the affinity between active components and key targets.Results:Lycopi Herba primarily targeted pivotal proteins such as HMGCR and CYP27B1, while Alismatis Rhizoma had a broader target spectrum, including PPARA, JAK2, among others. Shared key targets between the two included HMGCR and ESR1, which were primarily involved in cholesterol synthesis and steroid hormone biosynthesis. Enrichment pathway analysis showed similarities in steroid metabolism between the two; Alismatis Rhizoma, however, was more likely to act through protein phosphorylation regulation and modulating the PI3K-Akt signaling pathway for HF treatment. A unique target for Lycopi Herba in treating HF was CHRM4, indicating its potential for blood pressure regulation and myocardial protection.Conclusions:Both Lycopi Herba and Alismatis Rhizoma exhibit certain commonalities in the treatment of HF, but Alismatis Rhizoma has a wider range of targets and signaling pathways, implying more extensive therapeutic potential. However, considering the nephrotoxicity of Alismatis Rhizoma, Lycopi Herba could be considered as an alternative treatment for HF, especially in patients with renal insufficiency or in the early stages of HF.

Objective:To analyze the frequency and alteration of circulating dendritic cells (DCs) and subtypes in patients with ST‐elevated acute myocardial infarction(AMI) .Methods:A total of 17 patients with ST‐elevated AMI(AMI group) and 14 pa‐tients with stable angina pectoris(SAP) as SAP group and 15 people with normal coronary angiogram with matched age and gender(control group) were enrolled .The absolute number and percentage in peripheral blood mononuclear cells of circulating DCs ,myeloid dendritic cell(mDC) and plasmacytoid dendritic cell(pDC) in the three groups were detected using the 3‐colure staining flow cytometry .The levels of interleukin‐6(IL‐6) and tumor necrosis factor‐α(TNF‐α) were detected with enzyme‐linked immunosorbent assay .In the AMI group ,these indexes were measured on the 7th day after the attack .Results:The per‐centage of circulating DCs in peripheral blood mononuclear cells and the absolute number of DCs ,the percentage of circulating mDC and pDC in peripheral blood mononuclear cells and the absolute numbers of mDC and pDC and mDC/pDC ratio in the AM I group on the day of attack(<24 h) were significantly lower than those in the control group and the SAP group(P<0 .01 or 0 .05) .In the AMI group ,on the 7th day after the attack , the percentages of DCs ,mDC and pDC in peripheral blood mononuclear cells and the absolute numbers of DCs ,mDC and pDC and mDC/pDC ratio were higher than those on the day of attack (P<0 .01 or 0 .05) .The level of IL‐6 and TNF‐αin the AMI group on the day of attack were significantly higher than those in the control group and SAP group(P<0 .05) ,and the level of IL‐6 decreased on the 7th day after the attack in the AMI group (P<0 .05) .But there was no significant difference in the percentage of DCs ,mDC and pDC in peripheral blood mononu‐clear cells and the absolute numbers and mDC/pDC ratio between the control group and the SAP group(P>0 .05) .Conclu‐sions:Circulating mDC and pDC are significantly reduced in patients on the day of attack of AM I ,and it can increase to nearly normal on the 7th day after attack .It indicates that the possibility of DCs recruits into coronary plaques and improve the forma‐tion of unstable plaque .

Objective To observe the effects of electroacupuncture on the motor function and mitochondrial dynamics of skeletal muscle of SAMP8 mice;To explore the mechanism of electroacupuncture in improving the motor dysfunction of Alzheimer disease(AD)from the perspective of mitochondrial dynamics.Methods Totally 18 SAMP8 mice were divided into model group and electroacupuncture group,with 9 mice in each group,and the SAMR1 mice with the same age were set as control group."Baihui","Dazhui"and"Shenshu"were selected in the electroacupuncture group,and electroacupuncture was performed daily for 20 min,8 d as a course of treatment.Each course of treatment was separated by 2 d,for a total of 3 courses of treatment.The model group and the control group were not intervened.The motor function of mice was tested by grip strength test,suspension test,hind limb extension test and Morris water maze experiment.The morphology and structure of gastrocnemius were observed by HE staining,ATP content in gastrocnemius was determined by colorimetry,the mRNA expression of optic atrophy 1(OPA1),mitofusin 2(MFN2)and dynamin-related protein 1(DRP1)in gastrocnemius were detected by real-time quantitative PCR,the expressions of OPA1,MFN2 and DRP1 in gastrocnemius were detected by Western blot.Results Compared with the control group,the grip strength,the score in suspension test,and the average speed and maximum speed of Morris water maze experiment of mice in model group significantly decreased(P<0.01);the arrangement of fibers in the gastrocnemius muscle tissue was disordered,the gaps become wider,and the distribution of nuclei was uneven;the ATP content in the gastrocnemius muscle tissue was significantly decreased(P<0.01),the mRNA and protein expressions of OPA1 and MFN2 were significantly decreased(P<0.01),and the expression of DRP1 mRNA and protein significantly increased(P<0.01).Compared with the model group,the grip strength,the score in suspension test,and the average speed and maximum speed of Morris water maze experiment in electroacupuncture group significantly increased(P<0.01);the arrangement of gastrocnemius muscle tissue was relatively neat,the gaps become narrower,and the distribution of nuclei was more uniform;the ATP content in gastrocnemius muscle tissue significantly increased(P<0.01),while the mRNA and protein expressions of OPA1 and MFN2 significantly increased(P<0.05,P<0.01),the expression of DRP1 mRNA and protein significantly decreased(P<0.01).Conclusion Electroacupuncture can improve the skeletal muscle morphological structure and motor dysfunction of SAMP8 mice,and the mechanism may be related to the correction of skeletal muscle mitochondrial dynamic imbalance and the increase of skeletal muscle ATP content.