Objective To evaluate serum level of pepsinogenⅠ( PGⅠ) ,PGⅡ, and PGⅠ/PGⅡ-ratio ( PGR ) using latex enhanced turbidimetric immunoassay in patients with different gastric mucosal lesions, and to investigate their changes and clinical significance.Methods Case-control study.Two hundred and seventy-five patients who had enteroscopy and pathological examination from the department of gastroenterology and surgery from Beijing Tongren Hospital between January 2015 and January 2016 were enrolled.Endoscopic and histopathological examination confirmed the normal control group (n=20), chronic non-atrophic gastritis group ( n=68 ) , chronic atrophic gastritis group ( n=76 ) , including antral atrophic gastritis ( n=30 ) , gastric body atrophic gastritis ( n=26 ) , and multifocal atrophic gastritis ( n=20 );intestinal metaplasia group ( n=28 ) , intraepithelial neoplasia group ( n=9 ) , benign gastric ulcer group ( n=46) and intestinal gastric cancer group ( n=28).Latex-enhanced immune turbidity method were used to detect the patients fasting serum PGⅠand PGⅡ.Then the PGR was calculated.The normally distributed data of each group were statistically analyzed by ANOVA, the data between groups were nalyzed using the Mann-Whitney U test and Kruskal-Wallis test.Results Serum PGⅠ[ ( 74.23 ±22.36 ) ] ng/ml and PGR (6.92 ±2.16) in chronic atrophic gastritis group were lower than those in normal controls[PGⅠ(98.94 ± 21.00) ng/ml, PGR 8.13 ±2.47],(FPGⅠ =18.297,PPGⅠ <0.01,FPGR =4.713,PPGR <0.01).The serum PGⅠ[(44.46 ±26.72) ng/ml] and PGR (3.09 ±0.83) in the intestinal type of gastric cancer group were lower than those in the chronic atrophic gastritis group[PGⅠ(74.23 ±22.36)ng/ml, PGR 6.92 ±2.16], (ZPGⅠ =-3.921,PPGⅠ <0.01,ZPGR =-6.662,PPGR <0.01).PGⅠ[(129.95 ±43.39) ng/ml].PGⅡ[(21.09 ±6.78) ng/ml]in the gastric benign ulcer group were higher than those in the normal controls[PGⅠ (98.94 ±21.00) ng/ml, PGⅡ(12.64 ±1.84) ng/ml], FPGⅠ =10.803,PPGⅠ <0.01;FPGⅡ =39.130,PPGⅡ <0.01. PGⅠ[(52.44 ±10.37) ng/ml and PGR (5.47 ±1.59) in the multifocal atrophic gastritis group were lower than those in the antral atrophic gastritis[PGⅠ(94.95 ±14.45)ng/ml, PGR 8.39 ±1.48],ZPGⅠ =-5.941,PPGⅠ <0.01,ZPGR =-4.911,PPGR <0.01.The AUC of PGⅠand PGR for diagnosis of chronic atrophic gastritis were 0.752 and 0.683 respectively.The sequence combined detection sensitivity was 72.37%(55/76), and the specificity was 70.85%(141/199).The AUC of PG I and PGR for diagnosis of intestinal type of gastric cancer were 0.852 and 0.895 respectively.The sequence combined detection sensitivity was 71.42% ( 20/28 ) and the specificity was 81.78% ( 202/247 ) . Conclusion The Latex-enhanced immune turbidity method of combined detection of serum PGⅠ, PGⅡlevels and PGR can be used in the clinic to monitor the status and function of gastric mucosa and are informative for gastric cancer and precancerous lesions of gastric mucosa.

Objective: To explore the effect of Wamingfen on eosinophil apoptosis and oxygen free radicals and to study the influence of hydrocortisone on airway inflammation in asthma guinea pigs. Methods: Guinea pig models of asthma were induced by egg albumin. The effect of Wamingfen on plasma malonyl dialdehyde (MDA), blood glutathione peroxidase (GSH-Px),erythrocytic superoxide dismutase (SOD) activity , serum hydrocortisone level and the percentage of EOS apoptosis in bronchial-alveolar lavage fluid (BALF) were observed. Results: Wamingfen can apparently increase the content of GSH-Px ,SOD and serum hydrocortisone, promote the apoptosis of EOS and reduce the amount of MDA. Conclusion: Wamingfen can effectively increase serum hydrocortisone content, remove the oxygen free radical, promote eosinophil apoptosis and reduce the hyper-reactivity in the inflammatory airway.

Objective To study the genotypic and biological characteristics of catheter-related MRSE isolates and to further provide information for the diagnosis and prevention of catheter-related bloodstream infection. Methods Thirty strains of catheter-related MRSE isolates were collected from venosus blood and whole blood of 30 inpatients including 20 males and 10 females from Beijing Tongren Hospital, Capital Medical University from January 2006 to December 2009. The genetic features of these strains were determined by MLST. PCR was used to detect the icoA gene (encoding the polysaccharide intercellular adhesion associated with pathogenicity), and the antimicrobial susceptibility test was detected by disc diffusion test. Results A total of 15 STs were obtained from 30 strains ST259, ST20, ST2 and ST235 were common clones obtained from 17 strains. Four novel STs were found and uploaded to the MLST database (http://www. mlst. net), including ST259 (6 strains), ST260 (1 strain), ST261 (1 strain) and ST262 (1 strain). The ST259 was the dominant clone of catheter-related MRSE isolates in this hospital, and 3 strains carrying icaA gene were detected in this study. Conclusion Some ST259 isolates express high pathogenesis among the four novel STs, which may make them as the pandemic strains in nosocomial infection, and this would increase the difficulty of the prevention and control of nosocomial infection.

Objective To study on virulence characteristics and multilocus sequence type of Vibrio parahaemolyticus isolated from clinic in Beijing Tongren hospital.Methods Total 152 strains of Vibrio parahaemolyticus isolates were collected from diarrheal patients of outpatients in Beijing Tongren Hospital,Capital Medical University from 2009 to 2011.PCR was used to detect hemolysin gene thermo stable direct themolysin gene (tdh),TDH-related hemolysin gene (trh),type Ⅲ secretion system 2 (T3SS2α,T3SS2β)and systematic functional gene (toxRS/new,orf8) for pandemic 03∶ K6 clone and its derivatives.The genetic features of these strains were determined by multilocus sequence typing (MLST).Results 96％ (146/152) VP harbored tdh gene,2％ (3/152) VP harbored trh gene and 100％ (152/152) VP harbored T3SS2 gene.In this study there were 107 pandemic strains (both tdh and toxRS/new positive and trh negative),38 pathogenic strains (tdh positive and/or trh positive) and 6 nonpathogenic strains (both tdh and trh negative).All nonpathogenic strains harbored systematic functional gene (toxRS/new,orf8).Only one pathogenic strains harbored orf8 gene.One clone harbored all virulence gene.In this study there were 16 sequence types,and ST3 is the pandemic sequence type,including 113 strains,and four new sequence types were found.Conclusions In this study more than 90％ Vibrio haemolyticus harbored tdh gene and ST3 was the pandemic sequence type in Beijing.One can get bacterial pathogenic charateristic and population genetics information by virulence gene testing and MLST.

Objective To investigate the mechanism of naringin(NAR)on retinal microvascular endothelial cells(HRMECs)injury based on adenosine-monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)pathway.Methods HRMECs were randomly di-vided into control group,high glucose(HG)group,HG+NAR group(3 mg/L NAR),HG+activa-tor(AICAR)group(1 mmol/L AICAR),and HG+NAR+AICAR group(3 mg/L NAR+1 mmol/L AICAR);the control group was treated with 5 mmol/L D-glucose added to the culture medium,while the other groups were treated with 30 mmol/L D-glucose added to the culture medium.CCK-8 and Tr-answell were used to detect cell proliferation and migration respectively;enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of interleukin(IL)-1 β,IL-6 and tumor necrosis factor-α(TNF-α)in the supernatant;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of autophagy factors LC3 mRNA and p62 mRNA;Western blot was applied to detect the AMPK/mTOR pathway and expression levels of auto-phagy-related proteins.Results Compared with the control group,the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression increased in the HG group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG group,the cell viability,the num-ber of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression decreased in the HG+NAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression increased,but the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,p-AMPK/AMPK and LC3 Ⅱ/LC3 Ⅰ expression increased in the HG+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG+NAR group,the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA ex-pression increased in the HG+NAR+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG+AICAR group,the cell via-bility,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression significantly decreased in the HG+NAR+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression increased(P＜0.05).Conclusion NAR can alleviate HG induced injury to HRMECs,and its mechanism may be related to the inhibition of AMPK/mTOR pathway mediated autophagy.

Objective To investigate the mechanism of naringin(NAR)on retinal microvascular endothelial cells(HRMECs)injury based on adenosine-monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)pathway.Methods HRMECs were randomly di-vided into control group,high glucose(HG)group,HG+NAR group(3 mg/L NAR),HG+activa-tor(AICAR)group(1 mmol/L AICAR),and HG+NAR+AICAR group(3 mg/L NAR+1 mmol/L AICAR);the control group was treated with 5 mmol/L D-glucose added to the culture medium,while the other groups were treated with 30 mmol/L D-glucose added to the culture medium.CCK-8 and Tr-answell were used to detect cell proliferation and migration respectively;enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of interleukin(IL)-1 β,IL-6 and tumor necrosis factor-α(TNF-α)in the supernatant;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of autophagy factors LC3 mRNA and p62 mRNA;Western blot was applied to detect the AMPK/mTOR pathway and expression levels of auto-phagy-related proteins.Results Compared with the control group,the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression increased in the HG group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG group,the cell viability,the num-ber of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression decreased in the HG+NAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression increased,but the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,p-AMPK/AMPK and LC3 Ⅱ/LC3 Ⅰ expression increased in the HG+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG+NAR group,the cell viability,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3 Ⅱ/LC3 Ⅰ as well as LC3 mRNA ex-pression increased in the HG+NAR+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression decreased(P＜0.05);compared with the HG+AICAR group,the cell via-bility,the number of migrating cells,levels of IL-1,IL-6 and TNF-α,and p-AMPK/AMPK,LC3Ⅱ/LC3 Ⅰ as well as LC3 mRNA expression significantly decreased in the HG+NAR+AICAR group,while the p-mTOR/mTOR,p62 protein and p62 mRNA expression increased(P＜0.05).Conclusion NAR can alleviate HG induced injury to HRMECs,and its mechanism may be related to the inhibition of AMPK/mTOR pathway mediated autophagy.

OBJECTIVETo explore permeability of artificial blood-brain barrier (aBBB) by oxygen-glucose deprivation combined (OGD)-induced using tetramethylpyrazine combined with puerarin in vitro.

METHODRats were divided into normal control group, model group, tetramethylpyrazine group, puerarin group, tetramethylpyrazine-puerarin group and nimodipine group. Culture rat brain microvascular endothelial cells and astrocytes in vitro and build the OGD-induced aBBB damage model. Evaluate aBBB damage characteristics by TEER, gamma-GT, AKP and LDH. Determine contents of tetramethylpyrazine, puerarin, nimodipine and calculate drug permeating concentration of OGD-induced aBBB model by HPLC.

RESULTCompared with the model, the level of TEER was lower than the control group with significant difference (P < 0.01). The levels of gamma-GT, AKP in tetramethylpyrazine group, tetramethylpyrazine-puerarin group and nimodipine group were higher than the model group, the differences were significant (P < 0.01). Compared with tetramethylpyrazine group or puerarin group, the level of AKP of tetramethylpyrazine-puerarin group increased significantly (P < 0.01). The differences of levels of TEER, gamma-GT, AKP and LDH between tetramethylpyrazine-puerarin group and nimodipinthe group were significant (P < 0.05). Tetramethylpyrazine-puerarin group has a synergistic effect of increasing TEER, gamma-GT, AKP and reducing LDH. The permeating rate in tetramethylpyrazine-puerarin group was higher than tetramethylpyrazine group and puerarin group.

CONCLUSIONTetramethylpyrazine-puerarin can permeate aBBB more easily and protect aBBB. The cause may relate to reducing the permeability of the OGD-induced aBBB.

Animals ; Blood-Brain Barrier ; drug effects ; Drug Combinations ; Glucose ; physiology ; Isoflavones ; administration & dosage ; pharmacology ; Male ; Oxygen ; physiology ; Permeability ; Pyrazines ; administration & dosage ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the safety and efficacy of Yinhua Pinggan granule of Qingjie Xuantou lung defense prescription in the treatment of patients with upper respiratory tract infection accompanied by traditional Chinese medicine (TCM) syndrome of pathogen stagnated in lung-defense phase and to explore the best effective dose.Methods A randomized double blinded, positive drug parallel controlled and multicentric clinical trial was conducted, 270 patients with upper respiratory infection were collected from the First Affiliated Hospital of Zhejiang Chinese Medical University, Affiliated Hospital of Jiangxi Medical University, the Second Affiliated Hospital of Tianjin University of TCM, Tongde Hospital of Zhejiang Province, and Fujian Province Institute of TCM, after screening only 242 cases were consistent with the criteria of enrollment into the Per-Protocol Set (PPS) population, and they were divided into three groups: high dose observation group (82 cases), low dose observation group (79 cases) and control group (81 cases). The high and low dose observation groups were treated with Yinhua Pinggan granule (5 g per bag), high dose means once 1 bag orally taken 3 times a day, low dose indicates once 1 bag taken twice a day; the control group was treated with Yinqiao Jiedu granule (5 g per bag) once 1 bag, 3 times a day; the curative effects of the above groups were all evaluated after consecutive oral administration of the drug respectively for 1 therapeutic course (3 days). The main efficacy evaluation indexes included the TCM syndrome total score and the total score of main symptoms of upper respiratory tract infection; the secondary efficacy evaluation indexes included the situations of patients with different scores of main symptoms of fever and chills, and of disappearance of TCM symptoms; the clinical comprehensive therapeutic effect and the changes of proportion of neutrophils were observed and the safety of drugs was evaluated.Results In PPS population, after treatment the TCM syndrome total score and the total score of main symptoms in the control group and the high and low dose observation groups were all significantly lower than those before treatment, on the 3rd day statistical significant differences were shown (4.4±3.9 vs. 15.5±4.6, 3.7±3.2 vs. 15.0±4.3, 3.0±2.7 vs. 15.2±3.9, 2.8±2.6 vs. 9.7±2.7, 2.3±2.1 vs. 9.5±2.5, 2.0±1.9 vs. 9.6±2.4, respectively, all P < 0.01). After treatment for 1 day, the numbers of patients with 6 score in the control group and the high and low dose observation groups were reduced significantly compared with those before treatment in main symptoms of fever with chills (7 vs. 32 cases, 6 vs. 31 cases, 4 vs. 28 cases, respectively); 3 days after treatment, compared with those before treatment, the numbers of patients with main symptoms of fever with chills score being 0 were significantly increased in the above three groups (65, 73, 77 cases vs. 0 cases, respectively), the numbers of patients with the score being 3 were significantly decreased (16 vs. 47 cases, 5 vs. 46 cases, 5 vs. 52 cases, respectively); the control and high dose observation group had no patients with the score being 6, there was only 1 case with the score being 6 in the low dose observation group. The results showed that the treatments of high and low dose observation groups and the control group all could alleviate the clinical symptoms, and the changes of numbers of patients with the scoresbeing 0 and 3 in high and low dose groups were more significant than those in the control group (respectively 73, 77 vs. 65 cases, 5, 5 vs. 16 cases, allP < 0.05), showing that the antipyretic effect of Yinhua Pinggan granule was superior to that of the Yinqiao Jiedu granule. The disappearance rates of fever with chills symptoms in high and low dose observation groups were significantly higher than that in the control group [respectively 93.9% (77/82), 92.4% (73/79) vs. 80.2% (65/81), allP < 0.05]. The TCM syndrome cure and obvious effect rate and effective rate in high and low dose observation groups were higher than those in the control group [respectively 87.80% (72/82), 79.75% (63/79) vs. 74.07% (60/81) and 98.78% (81/82), 96.20% (76/79) vs. 96.30% (78/81)]; the cure and marked effective rate and effective rate of controlling symptoms of upper respiratory tract infection in high and low dose observation groups were higher than those in the control group [respectively 78.05% (64/82), 74.68% (59/79) vs. 65.43% (78/81) and 98.78% (81/82), 96.20% (76/79) vs. 96.30% (78/81)], comparisons of efficacy among the three groups possessed clinical practical significance, but the differences were not statistically significant (allP > 0.05). The percentages of neutrophils in high and low dose observation groups and control group were significantly lower than those before treatment (respectively 0.61±0.08 vs. 0.63±0.08, 0.62±0.08 vs. 0.64±0.08, 0.61±0.09 vs. 0.64±0.09, allP < 0.05). Yinhua Pinggan granule was safe in the prescribed course of treatment and range of therapeutic dose.Conclusions Yinhua Pinggan granule is a safe and effective drug in the treatment of patients with upper respiratory tract infection accompanied by syndrome of pathogen stagnated in lung-defense phase.

Background::The study aimed to describe the aortic valve morphology in Chinese patients underwent transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis (AS), and the impact of sizing strategies and related procedural outcomes.Methods::Patients with severe AS who underwent TAVR were consecutively enrolled from 2012 to 2019. The anatomy and morphology of the aortic root were assessed. "Downsize" strategy was preformed when patients had complex morphology. The clinical outcomes of patients who performed downsize strategy were compared with those received annular sizing strategy. The primary outcome was device success rate, and secondary outcomes included Valve Academic Research Consortium-3 clinical outcomes variables based on 1-year follow-up.Results::A total of 293 patients were enrolled. Among them, 95 patients (32.4%) had bicuspid aortic valve. The calcium volume (Hounsfield Unit-850) of aortic root was 449.90 (243.15-782.15) mm 3. Calcium is distributed mostly on the leaflet level. Downsize strategy was performed in 204 patients (69.6%). Compared with the patients who performed annular sizing strategy, those received downsize strategy achieved a similar device success rate (82.0% [73] vs. 83.3% [170], P= 0.79). Aortic valve gradients (downsize strategy group vs. annular sizing group, 11.28 mmHg vs. 11.88 mmHg, P = 0.64) and percentages of patients with moderate or severe paravalvular regurgitation 2.0% (4/204) vs. 4.5% (4/89), P = 0.21) were similar in the two groups at 30 days after TAVR. These echocardiographic results were sustainable for one year. Conclusions::Chinese TAVR patients have more prevalent bicuspid morphology and large calcium volume of aortic root. Calcium is distributed mostly on the leaflet level. Compare with annular sizing strategy, downsize strategy provided a non-inferior device success rate and transcatheter heart valve hemodynamic performance in self-expanding TAVR procedure.

Adenocarcinoma of esophagogastric junction (AEG) refers to the tumor invading the esophagogastric junction and Siewert type is the most practical classification at present.There are many surgical controversies about AEG,mainly focusing on Siewert Ⅱ type.In this paper,definition and classification of AEG,epidemiological characteristics,pathological TNM staging,rules of lymph node metastasis and dissection,esophageal resection margin,gastric resection scope,surgical approach and other issues are investigated combined with recent highquality evidence.