The adiponeetin mRNA expression and secretion of human omental and subcutaneous preadipocytes were increaed by renin-angiotensin system (RAS) bloekers. Compared with thiazolidinedione, RAS blockers have stronger effects on human omental preadipoeytes in adiponeetin mRNA expression and secretion,suggesting a potential benefit of RAS blockers on metabolic syndrome with characteristic intra-abdominal obesity.

Objective To identify gene mutations in two families with epidermolytic hyperkeratosis (EHK).Methods Clinical data were collected from two families with EHK.Peripheral blood was isolated from the probands and unaffected family members in the families as well as from 50 healthy controls.PCR was performed to amplify the encoding exons and flanking intron regions of KRT1 and KRT10 genes followed by direct DNA sequencing.Results Two mutations in the KRT10 gene,including a heterozygous acceptor splice site mutation in intron 4 (c.1030-2 A＞G) and a heterozygous missense mutation c.467 G＞A,were identified in the probands of both families,but absent in the unaffected family members or healthy controls.ConclusionThe splice site mutation c.1030-2 A＞G and missense mutation c.467 G＞A might be responsible for the phenotype of EHK in the two families.

Objective To discuss the nursing management method in the cardiovascular intensive care unit. Methods The management evaluation standard was set up and the comprehensive evaluation of quality (CEQ) was introduced according to factors influencing nursing quality. Results The nursing quality control data and complications after operation before and after the application of CEQ were statistically different. Conclusions Nursing management should innovate unceasingly and comprehensive quality evaluation is one of the effective nursing management method.

Objective To evaluate the efficacy of Arndt endobronchial blocker (AEB) for airway management during one-lung ventilation (OLV) in pediatric patients.Methods Thirty pediatric patients,aged 4 months-12 yr,weighing 5.6-26.0 kg,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,scheduled for elective thoracotomy under OLV requiring the use of single lumen tracheal tube assisted by AEB,were enrolled in this study.OLV was performed with the AEB placed outside the single lumen tracheal tube in pediatric patients below 2 years old and with AEB inserted through the single lumen tracheal tube in pediatric patients ≥ 2 years old.The rate of successful establishment of artificial airway at first attempt,time of establishing artificial airway,time of pulmonary collapse,AEB malpositions and airway pressure before and after OLV were recorded,and the efficacy of lung collapse was evaluated.Results The rate of successful tracheal intubation of extraluminal and endoluminal AEB placement at first attempt was 100％ in 30 pediatric patients,and no high airway pressure was found after OLV.The efficacy of lung collapse was poor in one patient and good in one patient,and intraoperative AEB malpositions were found in two patients among the pediatric patients used extraluminal AEB placement.The efficacy of lung collapse was good in one patient,intraoperative AEB malposition was found in one patient,and SpO2 was decreased after OLV in one patient among the pediatric patients used endoluminal AEB placement.Conclusion Reasonably selecting the method of placing AEB followed by enhancing intraoperative airway management can be safely and effectively applied for OLV in pediatric patients.

Objective To analyze the changes of serum markers of liver function and liver fibrosis in patients with fatty liver,and to explore the relationship between them,so as to provide scientific basis for the prevention and treatment of fatty liver into hepatic fibrosis. Methods From January 1st,2015 to December 31st, 2015,one thousand three hundred and forty-six healthy cases were selected,and 361 cases of fatty liver were diagnosed by ultrasound. Liver function index of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was detected by automatic biochemical analyzer. Hyaluronic acid (HA),laminin (LN),serum type Ⅲprocollagen peptide ( PC Ⅲ) and type Ⅳ collagen ( C-Ⅳ) were detected by enzyme-linked immunosorbent assay. The correlation between liver function and serum liver fibrosis indexes was analyzed by Pearson parameter analysis. Results The liver function index ALT,AST((69. 04±18. 72) U/L,(59. 78±15. 65)U/L) in fatty liver group were higher than those in the non-fatty liver group((25. 71±10. 25) U/L,(23. 68±8. 23) U/L),the differences were statistically significant ( t＝279. 283,388. 461,P＜0. 05) . Four serum fibrosis index HA,LN, PCⅢ,C-Ⅳ in the fatty liver group were (112. 64±21. 63) μg/L,(125. 85±27. 52) μg/L,(127. 28±29. 37) μg/L,(79. 38±18. 52) μg/L,respectively,which were higher than those in the non-fatty liver group ( (53. 98 ±16. 84) μg/L,(86. 31±20. 46) μg/L,(53. 31±18. 23) μg/L,(57. 26±15. 86 ) μg/L),the differences were statistically significant ( t＝727. 724,170. 432,941. 357,71. 169,P＜0. 001) . The correlation analysis of liver function and serum liver fibrosis indexes showed that ALT and AST were positively correlated with the fibrosis indexes HA,LN,PCⅢ( correlation coefficient r＝0. 230,0. 119,0. 370;0. 363,0. 361,0. 509,P＜0. 001),and which had no significant correlation with C-Ⅳ(P＞0. 05). Conclusion Liver function and serum liver fibrosis index can be used as the important basis for monitoring and diagnosis on the progression of fatty liver disease.

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.

Objective To investigate the evaluation index of melasma staging by clinical manifestations and non-invasive skin detection technology.Methods A total of 195 patients with a clinical diagnosis of melasma were enrolled from the First Affiliated Hospital of Kunming Medical University.The skin with lesion enlarged,color darker,erythema,red occured after scratching or lesion faded after compressing with glass belonged to the active stage;on the contrary,it was in the stable stage.Reflectance confocal microscopy (RCM),dermoscopy,Mexameter 18 and LAB were used to observe skin lesions of different stage of melasma.Results There were 115 patients (59.0 ％) in the active stage of melasma and 80 patients (41.0 ％) in the stable stage.DMA score in active stage 35.08± 10.59 were significantly higher than that of the stable stage 15.06-4-9.20 (P＜0.05).There were statistically significant difference in the quantity of inflammatory cell and blood vessels between two stages of melasma (P＜0.05).Erythema index (EI) in active stage of melasma 376.35±61.39 were high-er than that of the stable stage 320.364± 62.40 (P＜0.05).A-value in active stage of melasma 13.28± 1.75 were higher than that of the stable stage 12.34± 1.78 (P＜0.05).However,there were no siginificant differences in the quantity of melenin,melanin index (MI),L-value and B-value.Conclusions Melasma could be divided into active stage or stable stage,respectively,according to its clinical manifestations.DMA score,quantity of inflammatory cells and blood vessels,EI and A-value could be used as the reference index of melasma staging.

Objective To discuss the proper operation time of patients with encapsulated empyema secondary to tubercu-lous pleurisy by review the clinical characteristics and duration of these patients.Methods From December 1995 to May 2017, 235 patients with encapsulated empyema and pleural decortication were operated.The course of disease and preopera-tional data were collected.Patients were divided into three groups according to the duration of disease(group A with 113 cases,≤12 months; group B with 53 cases, 12 -24 months; group C with 69 cases, >24 months).Propensity score matching (PSM) was used to decrease the baseline difference among three groups.Preoperational features, such as operation time, bleeding, complications were compared between groups.Results PSM were conducted between group A and group B (45 paired patients), group B and group C(29 paired patients), respectively.The length of operation, amount of bleeding and blood transfusion in group B were significantly higher than those in group A and group C .The days with tube and hospitalization in group B were significantly longer than group A, but they were insignificantly different compared with group C(P>0.05). Postoperative complications were similar between the three groups(P>0.05).Conclusion Encapsulated empyema in early stage(within 1 year of onset) or after the maturation of the fibrous plate(over 2 years) is less difficult for surgical intervention, and try to avoid surgical treatment at high risk(1 to 2 years).

Objective:To analyze the optical coherence tomography (OCT) imaging characteristics in patients with Coats disease and their value in predicting macular fibrosis.Methods:A nested case-control study was performed.A total of 43 patients (43 eyes) diagnosed with Coats disease through color fundus photography, ocular B-scan ultrasonography, fundus fluorescein angiography, and spectral-domain OCT examination were enrolled from January 2008 to October 2021 at the Xijing Hospital.Among them, there were 40 males and 3 females, aged from 2 to 60 years old, with a median age of 13 years.Macular fibrosis was used as an indicator of poor prognosis, and patients were divided into two groups based on whether macular fibrosis occurred at the end of follow-up.The differences in OCT characteristics between two groups were compared and logistic regression analysis was used to identify the risk factors for macular fibrosis.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Xijing Hospital of Fourth Military Medical University (No.KY20202009-C-1).Results:The OCT clinical features of 43 cases of Coats disease included intraretinal hard exudates in 43 eyes (100%), subretinal fluid in 21 eyes (48.8%), macular cysts in 17 eyes (27.9%), subretinal exudates in 9 eyes (20.9%), anterior retinal hyperreflective dots in 7 eyes (16.3%), epiretinal membrane in 21 eyes (48.8%), and intraretinal fluid in 22 eyes (51.2%).In color fundus photos of 41 eyes, 38 eyes (93.0%) had hard exudates distributed in the posterior pole and 27 eyes (65.9%) had the mid-peripheral region.OCT examination showed that hard exudates were distributed in the inner nuclear layer in 35 eyes (81.4%) and the outer nuclear layer in 33 eyes (76.7%).Among 21 eyes with exudative retinal detachment detected by OCT, 9 eyes (42.9%) were detected by fundus photography and 18 eyes (85.7%) were detected by B-scan ultrasonography.The proportions of eyes with subretinal fluid and subretinal exudates were higher in the macular fibrosis group than in the non-macular fibrosis group, and the differences were statistically significant ( χ2=20.755, P<0.001; χ2=6.133, P=0.013).Logistic regression analysis showed that the presence of subretinal fluid was a risk factor for macular fibrosis (odds ratio=48.345, 95% confidence interval: 4.272-547.066, P=0.002). Conclusions:OCT examination can detect subretinal fluid, subretinal exudates, macular cysts, macular exudates, and hyperreflective spots in the retina of patients with Coats disease.Subretinal fluid is a risk factor for macular fibrosis.

ObjectiveTo investigate the effect and mechanism of osthole on the proliferation and apoptosis in human intrahepatic cholangiocarcinoma HuCCT1 cells. MethodThe effect of 10， 20， 40， 80， and 120 μmol·L^-1 osthole on the proliferation of HuCCT1 cells was detected by the cell counting kit-8 （CCK-8）. A blank group， and low-， medium-， and high-dose osthole groups （16， 32， and 64 μmol·L^-1） were set up. The effect of osthole on cell clone formation rate was detected by colony formation assay. The effect of osthole on cell cycle and apoptosis was detected by flow cytometry. The effect of osthole on cell apoptotic morphology was detected by Hoechst 33342 fluorescent staining. The effect of osthole on cell cycle protein cyclin B₁， proliferating cell nuclear antigen （PCNA）， cysteine-aspartic acid protease （Caspase）-9， Caspase-3， cleaved Caspase-9， cleaved Caspase-3， cleaved poly（ADP-ribose） polymerase （cleaved PARP）， B-cell lymphoma-2 （Bcl-2）， phosphorylated protein kinase B （p-Akt）， phosphorylated mammalian target of rapamycin （p-mTOR）， and phosphorylated ribosomal protein S6 （p-RPS6） was detected by Western blot. ResultThe cell viability in the osthole group（40，80，120 μmol·L^-1） decreased （P<0.05，P<0.01）， with the half maximal inhibitory concentration （IC₅₀） of 63.8 μmol·L^-1 as compared with that in the blank group. Compared with the blank group， the osthole groups（32，64 μmol·L^-1）showed reduced clone formation rate （P<0.01）， increased number of cells in the G₂ phase （P<0.05，P<0.01）， decreased number of cells， increased pyknosis and fragmentation， increased apoptosis rate （P<0.05，P<0.01）， down-regulated expression of cyclin B₁， PCNA， Bcl-2， Caspase-3， Caspase-9， p-Akt， p-mTOR， and p-RPS6 （P<0.05，P<0.01）， and up-regulated expression of cleaved Caspase-3， cleaved Caspase-9， and cleaved PARP （P<0.05，P<0.01）. ConclusionOsthole can inhibit the proliferation and promote the apoptosis of HuCCT1 cells， and its mechanism may be related to the Akt/mTOR signaling pathway.