Objective To investigate the value of creatine kinase and computed tomography(CT)angiography to evaluate short-term prognosis of patients with superior mesenteric artery embolism(SMAE).Methods The retrospective cross-sectional study was adopted.The clinical data of 26 patients with SMAE who were admitted to the first Affiliated Hospital of Wenzhou Medical University between January 2008 and October 2015 were collected.The patients received serologic examination and CT angiography firstly,and then medicinal conservative method and surgical method were respectively conducted according to the results of above examinations.Observation indices:(1)clinical features,(2)serum indicators results,(3)CT angiography results:①location(main stem and non-main stem)of SMAE and development of distal branches of superior mesenteric artery(SMA),②indirect signs,such as bowel wall thickening,bowel dilatation combined with effusion and air accumulation and pneumatosis intestinalis,(4)therapy and prognosis.Measurement data with normal distribution were presented as-x±s,comparisons among groups were analyzed by one-way ANOVA.Measurement data with skewed distribution were presented as M(range)and analyzed by the Kruskal-Wallis rank sum test,and pairwise comparison was done using the Nemenyi test.Results(1)Clinical features:of 26 patients with SMAE,6 patients had intestinal ischemia,8 patients had partial intestinal necrosis and 12 patients had long segmental intestinal necrosis(postoperative short bowel syndrome in 5 patients and total small intestinal necrosis and partial colonic necrosis in 7 patients).Duration of symptoms before diagnosis was(1.7±0.8)days in 6 patients with intestinal ischemia and(2.1±1.1)days in 8 patients with partial intestinal necrosis and(1.5±0.7)days in 12 patients with long segmental intestinal necrosis,with no statistically significant difference(F=1.27,P＞0.05).(2)Serum indicators results:levels of serum creatine kinase in patients with intestinal ischemia,partial intestinal necrosis and long segmental intestinal necrosis were 68 U/L(range,50-86 U/L),98 U/L(range,54-244 U/L)and 300 U/L(range,40-873 U/L),respectively,with a statistically significant difference among patients(H=7.32,P＜0.05)and between patients with intestinal ischemia and with long segmental intestinal necrosis(H=7.21,P＜0.05),and with no statistically significant difference between patients with partial intestinal necrosis and with intestinal ischemia or long segmental intestinal necrosis(H=1.53,2.07,P＞0.05).(3)CT angiography results:①developments of SMAE(main stem and non-main stem)and distal branches of SMA:main stem embolism of SMA in 13 patients demonstrated hypodense shadow,with non-contrast of distal branches of artery,including 1 with intestinal ischemia,1 with partial intestinal necrosis and 11 with long segmental intestinal necrosis.Main stem embolism of SMA in 8 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 3 with intestinal ischemia,4 with partial intestinal necrosis and 1 with long segmental intestinal necrosis.Main stem embolism of SMA in 2 patients demonstrated hypodense shadow,with non-contrast of distal branches of SMA,showing partial intestinal necrosis.Non-main stem embolism of SMA in 3 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 2 with intestinal ischemia and 1 with partial intestinal necrosis.②Indirect signs:5 patients had bowel wall thickening,including 3 with intestinal ischemia and 2 with long segmental intestinal necrosis.Seventeen patients had bowel dilatation combined with effusion and air accumulation,with gas fluid level in local intestinal canal,including 2 with intestinal ischemia,5 with partial intestinal necrosis and 10 with long segmental intestinal necrosis.Two patients had pneumatosis intestinalis,with bubble shadow of bowel wall,showing long segmental intestinal necrosis.(4)Therapy and prognosis:of 6 patients with intestinal ischemia,1 underwent embolectomy of SMA and 5 underwent low-molecular-weight heparin anticoagulation and vasodilator alprostadil therapy.Eight patients with partial intestinal necrosis received resection of necrotic intestine.Of 12 patients with long segmental intestinal necrosis,5 with postoperative short bowel syndrome received resection of necrotic intestine combined with postoperative parenteral hyperalimentation.The above-mentioned patients were improved and discharged from hospital after symptomatic treatment and surgery.Twelve patients with long segmental intestinal necrosis,7 with total small bowel necrosis and partial colonic necrosis underwent only exploratory laparotomy and then were dead in a short time.Conclusion Elevated creatine kinase and main stem embolism of SMA combined with non-contrast of distal branches using CT angiography maybe predict poor short-term prognosis of patients with SMAE.

Objective To investigate the expression and significance of estrogen receptor alpha in renal tissue of immunoglobulin A (IgA) nephropathy.Methods Fifty renal tissue samples including forty five cases of IgA nephropathy and five cases of normal expression were collected.The expression of estrogen receptor αt (ERα) was detected by immunohistochemistry method,and its relationship with clinical parameters and the degree of glomerular damage were analyzed.Results ERα was located in the glomerular and renal tubules.With the severity of the lesion,the expression of ERα in renal tissue of IgA nephropathy decreased gradually (P =0.001) and its expression was associated with estimated glomerular filtration rate (eGFR),serum creatinine (Scr),and pathologic grade of IgA nephropathy (r =0.876,-0.818,and -0.736,P ＜ 0.05),The expression of ERα was significantly decreased in hypertensive patients with IgA nephropathy,and the difference was statistically significant compared with that in non-hypertensive group (P =0.011).Conclusions The expression of ERα in renal tissue of IgA nephropathy was significantly decreased and there was a correlation between the degree of renal tissue damage,suggesting that ERα might play a role in the development of renal disease.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective: To study the relationship between the inhibitory effects of Tongxie Yaofang, a compound traditional Chinese herbal medicine, on the contraction of the colonic smooth muscle isolated from rats and calcium mobilization. Methods: By measuring the tension of the isolated colonic smooth muscle strips, the inhibitory effects of Tongxie Yaofang on the contraction induced by acetylcholine (ACh), KCl and exhausting Ca(2+) of internal calcium store were assessed respectively. Results: Tongxie Yaofang could concentration-dependently inhibit the contraction of isolated rat colonic smooth muscle strips induced by KCl and exhausting the Ca(2+) of internal calcium store. Tongxie Yaofang could also inhibit the tension of the second contractile phase induced by ACh (P<0.01, vs control), but had no influence on the first contractile phase. Conclusion: Tongxie Yaofang can inhibit the contraction of isolated rat colonic smooth muscle strips mainly by preventing the influx of extracellular Ca(2+), which may be associated with blocking voltage-dependent channel, store-operated channel and receptor-operated channel, but not by preventing the release of internal Ca(2+) from calcium store.

An analytical procedure for the determination of water-and methanol-extractable pentachlorophenol ( PCP) in soils using vortex assisted liquid-liquid extraction ( VALLE ) and gas chromatography ( GC ) was developed. Significant extraction parameters, such as liquid-liquid ratio and vortex speed were optimized. The recovery of PCP was the highest ( 97. 4%) at the vortex rotation speed of 2000 r/min, with good reproducbility and a small relative sdandard deviation ( RSD, 0. 5%), with regard to the volume ratio of derivatization solution to n-hexane, the recovery of PCP was 103% with an RSD of 0. 7% at 10:4. The linearity of the calibration ranged from 1. 25 μg/L to 4000 μg/L, with a correlation coefficient ( R2 ) of 0. 9999. The detection limit of the PCP in water was below 0. 2 μg/L. Compared with traditional liquid-liquid extraction ( LLE) and solid phase extraction ( SPE) , the VALLE method was more simple and more economic in terms of chemical consumption, also with a recovery of 96. 8% and a RSD of 3. 7%. Four different soils were used to check the reliability of this method. The soils were respectively extracted with water once and methanol three times. The total recoveries were 89. 5%-98. 9% and 88. 7%-98. 4% at the PCP spiking level of 1 and 10 mg/kg, respectively. It is concluded that the VALLE method satisfied the extraction and determination of water and methanol extractable PCP in soils with varying PCP polluting rates.

Objective To study the treatment effect of multilevel atherosclerotic occlusive disease of lower extremity. Methods From July 2004 to January 2008,intraoperative iliac balloon angioplasty and stenting combined with blood vassel prosthesis or autogenous reversed great saphenous vein bypass were performed on 32 patients suffering from lower extremity multilevel atheresclerotic occlusive disease. Results Surgical procedures were technically successful in all patients. The effect was good,intermittent claudication disappear, and rest pain improved. Preoperative vs postoperative ABI was 0.28±0.14 vs 0.65±0.18 (P<0.05 ).Thirty patients were followed up,the mean following period was 18 months (range of 3-36 months).Conclusions Simultaneous intravaseular interventional therapy combined with vascular bypass are effective in the treatment for patients with severe and multilevel atheroselerotie occlusive disease of lower extremity, the operation is less traumatic and the procedures are easy to do.The result is satisfactory.

Objective To investigate the nutritional risk,undemutrition,and nutrition support in inpatients with early and middle stage gastrointestinal cancer undergoing radical surgery in a tertiary hospital in Weifang,Shandong Province.Methods A total of 8390 inpatients who were treated in the departments of oncological surgery,enterohepatic surgery,and general surgery in our hospital were consecutively recorded from December 2010 to August 2011 and from November 2011 to October 2012.After 153 patients were excluded for hospital length of stay less than 24 hours,age less than 18 years old or more than 90 years old,obnubilation,and/or refusal to participate in the research,8237 patients were sampled.After patients who did not meet the scheduled diagnosis were excluded,300 pathology-confirmed patients with early or middle stage gastrointestinal cancer were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was performed within the first 48 hours after admission and nutrition support was evaluated until the discharge.Results A total of 300 early and middle stage gastrointestinal cancer patients (141 cases of gastric cancer and 159 cases of colorectal carcinoma) who underwent radical surgery met the inclusion criteria.Among them 185 (61.7％) were at nutritional risk.The undernutrition rate was 12.3％ (37/300) if evaluated from the score of nutritional defect part of NRS 2002,and 10.0％ (20/300) if based on body mass index ＜18.5 kg/m2.Totally 165 patients (89.2％) at nutritional risk and 99 patients (86.1％) without nutritional risk received nutrition support.The average ratio of parenteral nutrition to enteral nutrition was 82:1.The intake of calories was (78.1±24.8) k1/(kg,d) [(18.6±5.9)kcal/(kg·d)] and that of nitrogen was (0.10±0.06) g/(kg · d),yielding a ratio of calories vs.nitrogen of (244 ± 164)∶1.Conclusions Inpatients with early and middle stage gastrointestinal cancer tend to have high nutritional risk.The undernutrition rate is 10％-12.3％ in this population.Meanwhile,the application of nutrition support should be further standardized,particularly for patients without nutritional risk.

Exosomes are small vesicles with a diameter of about 40-160 nm actively secreted by cells. They participate in a variety of pathophysiological processes and are closely related to the occurrence and development of diseases. As a newly carrier of intercellular communication and circulating biomarkers of disease diagnosis and prognosis, exosomes have attracted great attention for their potential clinical applications. However, many aspects such as exosome biogenesis, targeted transport, and mechanism of action are still unclear. This paper focuses on the exosome biogenesis, summarizes the exosome biogenesis pathways, and describes relevant molecular modulation mechanisms of importance. And this review provides a theoretical basis for disease treatment based on regulating exosome production.

BACKGROUND: Preliminary study has prepared the three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold successfully.OBJECTIVE: To explore the mechanical properties, physical characteristics, chemical composition and antibiotic sustained-release ability of three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold loaded with levofloxacin. METHODS: Levofloxacin/chitosan (3:1) microspheres were constructed by emulsion settlement filter method. 5, 7.5 and 10 g of microspheres were added into 2％ of silk fibroin/chitosan/nano-hydroxyapatite mixed solution through freeze drying and chemical cross-linking to obtain the scaffolds loaded with antibiotics. The scaffolds loaded with antibiotics underwent scanning electron microscope observation, and chemical composition analysis. The sustained release, mechanical properties, porosity, water absorption expansion rate and hot water soluble loss rate were detected. RESULTS AND CONCLUSION: (1) Scanning electron microscope observed that there were drug microspheres at the inner wall of the scaffold, and the voidage was decreased with mass of microspheres increasing. (2) Energy spectrum analysis showed that the three kinds of scaffolds were rich in calcium and phosphonium ions. (3) The three kinds of scaffolds showed the same releasing trend, which presented with sudden-release effect at the former 3 days (release> 50％) , and then tended to be stable. The release rate was the slowest in the scaffold loaded with 10 g of microscopes, and the rapidest in the scaffold loaded with 5 g of microscopes. (4) With the mass of microspheres increasing, there was an increase in the compressive and tension abilities and hot water soluble loss rate, and a decrease in the porosity, mean pore size and water absorption expansion rate. (5) These results indicate that the three-dimensional tissue-engineered scaffold loaded with levofloxacin is constructed successfully by freeze drying and chemical cross-linking method, which holds good sustained-release effect and compressive ability, water absorption expansion rate and hot water soluble loss rate.

Objective: To compare the setup accuracy between Catalyst HD and skin markers in stereotactic body radiotherapy (SBRT) of lung cancer. Methods: A total of 24 cases treated with SBRT were selected and all patients were fixed with vacuum pad in the supine position. Patients in group A were positioned by Catalyst HD and those in group B were positioned by shin markers. All patients were matched with the CT images after CBCT scan by rigid registration and the setup errors in six directions (x-, y-, z-axis, Rtn, Pitch and Roll) were obtained. Results: The mean±SD in group A and B in the six directions were as follows: (0.13±0.12) cm, (0.25± 0.19) cm; (0.26±0.15) cm, (0.13±0.11) cm; (0.23±0.19) cm, (0.35±0.29) cm; (0.43°±0.40°), (0.80°±0.69°); (0.48°±0.47°), (0.79°±0.64°); (0.62°±0.60°) and (0.88°±0.70°), respectively. Except the x-axis data in group B, all the data in the six directions were not normally distributed. The obtained data significantly differed between two groups (all P<0.05). The out-of-tolerance errors (>0.5 cm/2°) also significantly differed between two groups (P<0.05). Conclusions The setup errors of Catalyst HD are less than those of the skin markers (except the y-axis). The setup accuracy of Catalyst HD is superior to that of traditional skin markers, which is worthy of application in clinical practice.