Objective: To investigate the effects of 1,25(OH)_(2)D_(3) on renal interstitial fibrosis in rats.Methods: Male SD rats(7 weeks old) were divided into 4 groups at random: ①the treatment group(6 rats): Unilateral ureteric obstruction(UUO)+1,25(OH)_(2)D_(3) 3 ng/100 g body wt/day intraperitoneally(I.P),②the control group(6 rats): UUO + ethanol by I.P,③UUO group(6 rats),④sham operated group(6 rats).Kidneys were harvested at day 7 after UUO.Fibrosis was assessed by measuring tissue hydroxyproline content.Tissue NF-?B expression was determined by RT-PCR. Results: UUO for 7 days significantly activated NF-?B,induced interstitial fibrosis in obstructed kidneys in the control group and UUO group compared with sham operated group rats.Conversely daily administration of(1,25(OH)_(2)D_(3)) significantly inhibited NF-?B expression,inflammatory cell infiltration and decreased interstitial fibrosis in obstructed kidneys in the treatment group. Conclusion: 1,25(OH)_(2)D_(3) had beneficial effects on interstitial fibrosis in SD rats with UUO,and this effect may be associated with 1,25(OH)_(2)D_(3) inhibits NF-?B expression and inflammatory cell infiltration.

Aim To investigate the role of endothe-lium in the enhancement of phenylephrine-mediated vasoconstriction by bupivacaine in the isolated rat aor-ta.Methods The isolated rat aortic rings were pre-pared, and the vascular endothelium was removed chemically or physically .Phenylephrine-mediated vas-oconstriction was recorded .Results A pretreatment with bupivacaine at 30 μmol · L-1 for 20 min signifi-cantly increased the Emax value of vasoconstrictive re-sponses to phenylephrine from 2.22 ±0.07 g of sol-vent-controlled group to 2.50 ±0.05 g ( P<0.01 ) in the isolated endothelium-intact rat aorta.However, the Emax value was not significantly changed by a pretreat-ment with bupivacaine at 30 μmol · L-1 for 5 , 10 or 15 min ( P>0.05 ) .A pretreatment with bupivacaine at 30 μmol · L-1 for 20 min slightly but significantly inhibited the vasoconstrictive responses to low concen-tration of phenylephrine in the isolated endothelium-de-nuded rat aorta (P<0.05).In the isolated endotheli-um-intact rat aorta under a combined treatment with in-dometacin, ChTX, apamin and L-NAME, the vasodi-lator responses to acetylcholine were completely sup-pressed , and a pretreatment with bupivacaine at 30μmol· L-1 for 20 min did not significantly affect the vasoconstrictive responses to phenylephrine ( P >0.05 ) .Conclusion Bupivacaine enhances α1-adre-noceptor-mediated vasoconstriction by inhibiting vascu-lar endothelium in the isolated endothelium-intact rat aorta, Which potentiates indirectly the vasoconstrictive responses to phenylephrine .

Aim To investigate the selective inhibition of ethanol on muscarinic receptor-or 5-HT receptor-me-diated contractile responses in the circular smooth mus-cle strips isolated from the different regions of rat stom-ach. Methods Circular muscle strips isolated from the rat gastric fundus, body, cardia and pylorus were prepared, and the contractile responses to carbachol ( CCh ) or 5-HT were recorded. Results Ethanol (0. 000 05~0. 000 5, V/V) did not affect the contrac-tile response to CCh in circular muscle strips from the rat gastric fundus and cardia, and that to 5-HT in the strips from rat gastric fundus and body ( P >0. 05 ) . However, ethanol(0. 000 1 and 0. 000 5) significantly inhibited the Emax value of the contraction by CCh from (12. 18 ± 0. 33) g of control level to (10. 88 ± 0. 41) g and -lgEC50 value from ( 6. 33 ± 0. 05 ) of control level to (6. 12 ± 0. 06)(P <0. 05) in the strips from rat gastric body. Ethanol(0. 000 1 and 0. 000 5) also significantly inhibited the Emax value of the contraction by CCh from (2. 87 ± 0. 15) g of control level to (2. 2 ± 0. 13) g and -lgEC50 value from (6. 49 ± 0. 10) of control level to (6. 05 ± 0. 09)(P<0. 01) in the strips from rat gastric pylorus. Moreover, ethanol ( 0. 000 1 and 0. 000 5) significantly inhibited the Emax value of the contraction by 5-HT from (2. 93 ± 0. 35) g of con-trol level to ( 2. 1 ± 0. 30 ) g ( P<0. 05 ) , but did not affect the -lgEC50 value in the strips from rat gastric cardia. Conclusions Ethanol inhibits the contractile responses to 5-HT only in the circular muscle strips of rat gastric cardia, and it inhibits the contractile respon-ses to CCh more strongly in the circular muscle strips of gastric pylorus than gastric body. In those gastric circular muscle strips, ethanol decreases both the ac-tivity and affinity of CCh to muscarinic receptors, but decreases only the activity of 5-HT to its receptors.

Objective To observe the effects of enhanced exercise and combined vitamin D and calcium supplementation on muscular strength and fracture occurrence in postmenopausal women with a high risk of osteoporosis.Methods Totally 614 postmenopausal women at high risk factors of osteoporosis were enrolled in Dongcheng district of Beijing and randomized into four groups:group A(control group,n=173),group B(regular Tai Chi exercise,n=171),group C(calcium 600 mg/d+VitD800 U/d,n=139),and group D[calcium 600 mg/d+25 hydroxyl vitamin D(25OHD) 0.25 μg/d,n=131].Muscular strength was measured at baseline and one and two years after intervention.Bone turnover markers were measured at baseline and during the two-year follow-up.Falls and fractures were recorded.Results The incidence of 25OHD<50 nmol/L was approximately 92.6%.During the follow-up,the left grip strength decreased significantly two years after intervention(t=-3.252,P=0.001)in group A.Right grip strength decreased significantly in group B(t=2.460,P=0.015)while left grip strength improved significantly in group C(t=-2.051,P=0.043)one year after intervention.In group D,muscular strength in both 12-month and 24-month did not change compared with baseline(both P>0.05).Furthermore,serum procollagen type I N-terminal propeptide elevated significantly in group A(t=-2.962,P=0.004),group B(t=-2.888,P=0.005),and group C(t=-2.441,P=0.016),whereas β-C-terminal telopeptide of type I collagen decreased significantly in group B(t=2.285,P=0.024)and group D(t=2.596,P=0.011)two years after intervention.Conclusion Enhanced exercise and combined calcium vitamin D supplementation may help sustain muscle strength in postmenopausal women,while calcium and vitamin D supplementation may improve muscular strength within a short period of time.

Objective: To evaluate the sensitivity and specificity of immunohistochemistry (IHC) in the classification of cardiac amyloidosis on endomyocardial biopsy (EMB) and heart allograft. Methods: Twenty cardiac tissues from 19 patients at Fuwai Hospital from January, 1990 to April, 2017 with histopathologic features of amyloidosis and Congo red staining positivity were included. IHC was performed with monoclonal antibodies against AA amyloid and polyclonal antibodies against transthyretin (ATTR), λ-light chain (AL-λ), κ-light chain (AL-κ), ApoAⅠ, ApoAⅡ, ApoA Ⅳ and β₂-microglobin. The extent of interstitial staining was evaluated by light microscopy, and three patterns were recognized; these included diffuse pericellular pattern, discrete pericellular pattern, and nodular pattern. Two patterns of vascular deposition were also noted, including arterial pattern and venous pattern. Endocardial involvement was also assessed and recorded. Results: Nineteen cases were divided into three groups according to the pattern of proteins expression in specimens. The first group (5 cases) only showed single protein expression on EMB. The second group (6 cases) showed more than one protein expression, but one of them was intensely stained or any staining of any protein together with ApoA Ⅳ co-staining. The third group (8 cases) also showed more than one protein expression and all of them had intense staining. Amyloid deposits were successfully subtyped as AL-λ, ATTR, AL-κ and ApoAⅠby IHC in the former two groups with the sensitivity of 11/19. In the third group, amyloid deposits could not be subtyped by immunohistochemistry due to their poor specificity. The pericellular pattern tended to favor AL over ATTR amyloidosis and vascular deposition tended to favor ATTR. Conclusions Amyloid deposits can be reliably subtyped in diagnostic cardiac specimens using IHC. The co-deposition of chaperon proteins, the distribution of amyloid proteins and clinical features are also auxiliary to subtype cardiac amyloidosis.

OBJECTIVE To make a research on the diagnostic value of Magnetic resonance image for preoperative localization of the parathyroid glands in secondary hyperparathyroidism patients.METHODS This retrospective study was on 51 patients with secondary hyperparathyroidism who underwent parathyroid gland resection and autoplastic transplantation and were examined with Magnetic resonance imaging 99mTC-MIBI nuclide imaging and Color doppler ultrasound in our hospital from 2010 to 2016.Compare to the gold standard of pathological diagnosis after operation,the sensitivity of various imaging examination on identifying the parathyroid glands were calculated.RESULTS The number of parathyroid glands diagnosed by pathology was 197,including 180 conventional parathyroid glands and 17 eetopic parathyroid glands.The sensitivity of MRI,99mTC-MIBI nuclide imaging and Color doppler ultrasound on identifying the conventional parathyroid glands was 76.67％,51.11％ and 44.44％ respectively,and the sensitivity on identifying the ectopic parathyroid was 29.41％,0 and 0 respectively.Sensitivity of the Magnetic resonance on identifying the conventional parathyroid and the ectopic parathyroid imagin were better than 99mTC-MIBI nuclide imaging and color doppler(P＜0.05).CONCLUSION Magnetic resonance imaging is an effective auxiliary examination on preoperative localization of the parathyroid glands in secondary hyperparathyroidism patients and can be the first choice of the image examination.

BACKGROUND:With the continuous progress of science and technology,the introduction of new technologies and methods will bring more possibilities and new breakthroughs for the application of shape memory alloys in the fields of assistive and rehabilitation. OBJECTIVE:To review the application status of shape memory alloys in assistive and rehabilitation equipment,discuss their main methods,techniques and results,summarize and put forward suggestions,hoping that shape memory alloys can be continuously optimized and bring more new changes for the development of assistive and rehabilitation equipment. METHODS:WanFang,PubMed,and Web of Science databases were searched by computer."Shape memory alloys,application progress,orthodontics,orthopedic,prosthesis,rehabilitation,properties,implantation,mechanical properties,nickel-titanium memory alloys,actuation"were used as Chinese search terms."Shape memory alloys,application,orthodontics,orthopedic,prosthetics,rehabilitation,properties,implant,drive,progress,prostheses"were used as English search terms.Finally,91 articles were included for review. RESULTS AND CONCLUSION:(1)Shape memory alloy has the characteristics of corrosion resistance,wear resistance,biocompatibility,fatigue resistance,kink resistance and other properties.Compared with other traditional materials(stainless steel,titanium alloy,cobalt-chromium alloy,etc.),shape memory alloy has lower elastic modulus and no biological toxicity,which is suitable for long-term implantation as an implant prosthesis.Due to its shape memory effect and excellent mechanical properties,it is mainly used as a driving element or as a bridge connecting the device and the human body in artificial limbs,orthoses and rehabilitation equipment.(2)The use of shape memory alloy drive elements can reduce the weight of the device,eliminate noise,easy to operate,easy to carry,better assist joint movement;compared with the use of pneumatic,hydraulic,and electrical drive methods of the device,it has obvious advantages.(3)In addition,shape memory alloy can produce permanent and stable stress during deformation.Compared with stainless steel,titanium alloy and aluminum alloy,shape memory alloy has a higher material recovery rate and does not need to be replaced and adjusted frequently,so it is more practical in the correction of deformity.(4)At present,shape memory alloy is most commonly used in orthosis,and the best clinical application effect is in stapes prosthesis.However,due to the limitations of technology and cost,shape memory alloys are rarely used in artificial limbs and rehabilitation equipment,and there is a lack of large sample size studies on the application effect.(5)Although shape memory alloys have been developed in the field of auxiliary and rehabilitation,there are still many problems:it is difficult to accurately control the shape memory alloys;the cooling speed of shape memory alloy is slow;the deformation speed of shape memory alloy cannot be controlled;there is a lack of comparative research and expert consensus on shape memory alloys with different properties;shape memory alloys are costly and expensive.(6)In the future,attention should be paid to the development of new shape memory alloys,increase comparative research,and use new technologies and methods(such as 4D printing)to solve the existing problems,so as to develop high-performance assistive devices and rehabilitation equipment.

Objective To investigate the pathological changes and related factors leading to failure of bioprosthetic valves.Methods The surgical explanted bioprosthetic valves in Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from January 2006 to December 2014 were retrospectively reviewed.Calcification,cusp tears,pannus and infectious endocarditis of bioprosthetic valves were evaluated by gross examination,X ray photography and histopathological analysis.Meanwhile,the age and the site at implantation,and the tissue type of bioprosthetic valves,the implantation duration were obtained by chart review and used to be analyzed with the modes of valve failure.U test,x2 test and Fisher exact test were used to analyze the data.Results Total 48 bioprostbetic valves were collected from 40 cases with 26 females.Their age at the time of implantation was 12 to 71 years (median 58 years).The tissue types of bioprosthesis included 24 bovine pericardial valves and 24 porcine aortic valves respectively.The implantation sites included mitral in 29 valves,aortic in 14 valves and tricuspid in 5 valves.The implantation duration ranged from 5 days to 27 years (mean (111 ± 77) months).The study showed that the commonest mode of valve failure was structural valve deterioration (32 valves,66.7％).The fewer modes of valve failure were infectious endocarditis (9 valves,18.7％) and non-structural valve deterioration (7 valves,14.6％).No thrombosis was found in this series.The degree of calcification was correlated positively with implantation duration (r =0.52,P =0.000).The implantation duration of bovine pericardial valves was longer than that of porcine aortic valves ((146 ± 74) months vs.(77 ± 68) months,Z =-3.24,P =0.001).Porcine aortic valves had a higher incidence of cusp tears than bovine pericardial valves (66.7％ vs.16.7％,x2 =12.34,P =0.000) despite they had a relatively lower incidence of calcification (41.7％ vs.75.0％,x2 =5.37,P =0.019).For the age at the time of implantation,the patients ≤ 60 years old had more calcification of bioprosthetic valves compared with those ＞ 60 years old (45.1％ vs.2/17,x2 =5.51,P =0.019) whereas the patients ≤60 years old had fewer cusp tears (12.9％ vs.58.8％,P =0.002).Infectious endocarditis was found more frequently in the valves failure within 5 years than those failure after 5 years (6/14 vs.8.8％,P =0.006).Conclusions Structural valve deterioration is the principle cause of bioprosthetic valve failure while infectious endocarditis mainly involves the valves failure in early and middle terms after surgery.The mode of valve failure in the patients ≤60 years old is different from that in the patients ＞ 60 years old at the time of implantation.More calcification would occur in bioprosthetic valve in the younger patients.

Objective To investigate the pathological changes and related factors leading to failure of bioprosthetic valves.Methods The surgical explanted bioprosthetic valves in Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from January 2006 to December 2014 were retrospectively reviewed.Calcification,cusp tears,pannus and infectious endocarditis of bioprosthetic valves were evaluated by gross examination,X ray photography and histopathological analysis.Meanwhile,the age and the site at implantation,and the tissue type of bioprosthetic valves,the implantation duration were obtained by chart review and used to be analyzed with the modes of valve failure.U test,x2 test and Fisher exact test were used to analyze the data.Results Total 48 bioprostbetic valves were collected from 40 cases with 26 females.Their age at the time of implantation was 12 to 71 years (median 58 years).The tissue types of bioprosthesis included 24 bovine pericardial valves and 24 porcine aortic valves respectively.The implantation sites included mitral in 29 valves,aortic in 14 valves and tricuspid in 5 valves.The implantation duration ranged from 5 days to 27 years (mean (111 ± 77) months).The study showed that the commonest mode of valve failure was structural valve deterioration (32 valves,66.7％).The fewer modes of valve failure were infectious endocarditis (9 valves,18.7％) and non-structural valve deterioration (7 valves,14.6％).No thrombosis was found in this series.The degree of calcification was correlated positively with implantation duration (r =0.52,P =0.000).The implantation duration of bovine pericardial valves was longer than that of porcine aortic valves ((146 ± 74) months vs.(77 ± 68) months,Z =-3.24,P =0.001).Porcine aortic valves had a higher incidence of cusp tears than bovine pericardial valves (66.7％ vs.16.7％,x2 =12.34,P =0.000) despite they had a relatively lower incidence of calcification (41.7％ vs.75.0％,x2 =5.37,P =0.019).For the age at the time of implantation,the patients ≤ 60 years old had more calcification of bioprosthetic valves compared with those ＞ 60 years old (45.1％ vs.2/17,x2 =5.51,P =0.019) whereas the patients ≤60 years old had fewer cusp tears (12.9％ vs.58.8％,P =0.002).Infectious endocarditis was found more frequently in the valves failure within 5 years than those failure after 5 years (6/14 vs.8.8％,P =0.006).Conclusions Structural valve deterioration is the principle cause of bioprosthetic valve failure while infectious endocarditis mainly involves the valves failure in early and middle terms after surgery.The mode of valve failure in the patients ≤60 years old is different from that in the patients ＞ 60 years old at the time of implantation.More calcification would occur in bioprosthetic valve in the younger patients.

Objective:To explore the risk factors of acute kidney injury(AKI)after liver transplantation(LT), examine its prognostic impact and construct a clinical prediction model.Methods:Clinical data are retrospectively reviewed for 220 LT recipients.They are divided into two groups of AKI(93 cases)and non-AKI(127 cases)according to the occurrence of AKI post-LT.Clinical data of two groups are compared.The variables with statistically significant inter-group differences in univariate analysis are included for multivariate analysis for obtaining the independent risk factors for AKI post-LT.Then the independent risk factors are employed for fitting a prediction model and a visual nomogram is constructed.At the same time, discrimination and calibration of the prediction model are evaluated.Extubation time, length of intensive care unit(ICU)stay, continuous renal replacement therapy(CRRT)rate, length of hospital stay, in-hospital mortality, estimated glomerular filtration rate(eGFR)at discharge, incidence of chronic renal failure(CRF)and readmission times are compared between two groups.Survival analysis is also performed between AKI and non-AKI groups and AKI 0/1 and AKI 2/3 stages.Results:The incidence of AKI post-LT is 42.3%.Age( OR=1.036, 95% CI: 1.001~1.073), preoperative serum creatinine level( OR=1.030, 95% CI: 1.011~1.049), platelet count( OR=0.992, 95% CI: 0.985~0.999), Child-Pugh class C( OR=2.678, 95% CI: 1.031~6.952), postoperative abdominal infection( OR=2.271, 95% CI: 1.120~4.603)and abdominal hemorrhage( OR=3.869, 95% CI: 1.016~14.72)are independent risk factors for AKI post-LT.The AUC/C-index of nomogram prediction model is 0.789 with a Brier score of 0.183, showing decent discrimination and calibration.According to the nomogram score, the recipients with a risk of AKI>50% are included into high-risk group while those with a risk of AKI<50% into low-risk group.Postoperative survival of low-risk group is better than that of high-risk group( P<0.001).Compared with non-AKI group, AKI group had a later extubation time( P=0.003), a longer length of ICU stay( P<0.001)and hospital stay( P=0.001), a higher rate of CRRT usage( P<0.001)and in-hospital mortality( P<0.001), a lower eGFR at discharge( P<0.001)and a higher incidence of CRF( P<0.001).Postoperative survival of non-AKI group was better than that of AKI group( P=0.048).Postoperative survival of patients with AKI 0/1 is better than that of those with AKI 2/3( P=0.002). Conclusions:Advanced age, high preoperative serum creatinine, low preoperative platelet, poor preoperative liver function, postoperative abdominal infection and abdominal hemorrhage may elevate the risks of AKI post-LT.And the nomogram prediction model based upon the above risk factors has a high value of clinical application.