Objective To observe the change of Wnt-β-catenin signaling's location and expression in kidney repair after acute kidney injury induced by ischemla reperfusion (I/R).Methods Ischemia reperfusion injury in BAT-gal reportor mice was made and blood sample was taken from tails on the 1th day after injury. Mice were sacrified on the 2th or 7th day and kidneys and blood were collected. Renal pathological change was observed by PAS stain. The changes of location and expression of Wnt-β-catenin signaling were detected by immunofluorescence costainning X-gal-LTL, X-gal-NKCC2, X-gal-DBA respectively. The protein expressions of the Wnt4 and co-receptor Lrp6 were assessed by Western blotting. Results PAS-stained kidney sections showed desquamative or flattened epithelia, necrotic debris on day 2 and regenerating tubules on day 7. An injury-induced enhancement of the Wnt pathway response (X-gal staining) in kidney cortex and out-medulla. Immunolabelling of kidney sections from injured BAT-gal mice revealed that X-gal staining was detected in kidney epithelial cells (double-labelled with LTL or NKCC2). Western blotting showed the Wnt4 protein was up-regulated and phospho-Lrp6, indicative of active canonical Wnt signaling, was noted in kidney cortex from day 2 after I/R, but in control kidney cortex pLrp6 was not detected. Conclusion Wnt-β-catenin signaling is activited after acute kidney I/R injury and is required for tubular epithelial repair and regeneration following kidney I/R injury.

Objective To explore the expression of RET in cervical squamous carcinoma tissues and evaluate its relationship with cervical squamous carcinoma clinical pathological indexes and its prognostic value. Methods The expression and distribution of RET in normal cervical tissues ,CINⅠ,CINⅡ& CINⅢ and cervical squamous carcinomas tissues were detected by immunohistochemistry in wax blocks. Clinical data and follow-up data are integrated to analyze its relationship with clinical pathological factors and prognosis value. Results The positive rate of RET protein in cervical squamous carcinomas tissues is higher than in other tissues.The positive rate was related to FIGO stage and lymph node metastasis(P<0.05),and not related with the age of patients or the degree of tumor differentiation(P>0.05). The result of survival analysis with Kaplan-Meier method showed poorer disease-free survival time in the patients with high expression of RET (P < 0.05). Prognostic analysis of patients with cervical cancer through COX proportional hazard regression model suggested that RET expression was an independent prognostic factor. Conclusions RET has been involved in the progression ,FIGO stage and metastasis of cervical squamous cell carcinomas.

Objective To construct vectors expressing small interfering RNA targeting the Toll like receptor-4 (TLR4) gene and obtain TLR4 knock downed vascular smooth muscle cells (SMC). Methods Three small hairpin RNA (shRNA) targeting the TLR4 gene were designed, synthesized and cloned into the pSilence 2.1-U6 neo vector. Positive clones were verified with double enzyme digestion and sequencing. Then the recombinants were transfected to SMC by the cationic lipid method respectively.SMC were stably transfected with an expression plasmid and screened by G418. TLR4 mRNA and protein expression were detected by RT-PCR and Western blot methods. Results The pSilence2.1-siTLR4 ex-pression vectors were successfully constructed and a TLR4 knock-downed SMC cell line was established. RT-PCR and Western blot analysis confirmed that the expression of TLR4 was significantly down-regulated in the infected SMC cell line, and pSilence2.1-siTLR4-1was the most efficacious recombinant vector.Conclusion Recombinant vectors carrying shRNA targeting the TLR4 gene were successfully constructed and the TLR4 expression in vascular SMCs was inhibited.

Objective To explore the clinical efficacy and safety of modified Ponticelli regimen in treating patients with idiopathic membranous nephropathy (IMN).Methods A retrospective analysis was performed in 90 patients with IMN (type Ⅰ / Ⅱ,79/11 respectively) diagnosed by clinical data and renal biopsy.The patients were divided into modified Ponticelli group (n =23),steroid plus cyclophosphamide (CTX) (CTX group,n =39) and steroid plus cyclosporine A(CsA) (CsA group,n =28) according to the treatment.Liver function,renal function,serum lipid,proteinuria were recorded before and after treatment.Efficacy and adverse reactions were evaluated in three groups.Results (1) In all three groups,the quantity of proteinuria after treatment for 3 months [(3.33 ± 1.53) g/d,(4.70 ± 2.97) g/d,(3.92 ± 2.57) g/d],6 months [(1.60 ± 1.10) g/d,(2.34 ± 1.61) g/d,(2.25 ± 1.78) g/d] was significantly decreased compared with baseline level[(7.26 ± 2.06) g/d,(7.50 ± 2.55) g/d,(7.54 ± 2.70) g/d;P ＜ 0.05].Serum albumin levels at 3 months [(31.42 ± 3.86) g/d,(30.59 ± 5.79) g/d,(30.90 ± 7.87) g/d],6 months [(36.25 ± 4.20) g/d,(34.70 ± 6.70) g/d,(35.36 ± 8.29) g/d] were significantly increased compared with baseline levels [(24.13 ± 2.61) g/d,(23.98 ± 3.79) g/d,(22.94 ± 4.57) g/d;P ＜ 0.05],whereas serum creatinine at 3 and 6 months had no significant changes (P ＞ 0.05).(2) After treatment for 3 months,partial remission rates in modified Ponticelli group,CTX group and CsA group were 39.1％,35.9％,35.7％ respectively and complete remission rates were 8.7％,5.1％,10.7％,which were not statistically significant in all three groups (P ＞ 0.05).At 6 months,partial remission rates in three groups were 56.5％,41.0％,42.9％ respectively and complete remission rates were 21.7％,20.5％,28.6％,which did not suggested significant difference in all three groups either (P ＞ 0.05).(3) In modified Ponticelli group,steroid diabetes,impaired liver dysfunction,infections and gastrointestinal adverse events occurred in 1,1,2 and 2 patients,respectively.In CTX group,steroid diabetes,infections and gastrointestinal adverse events occurred in 5,8 and 2 patients,respectively.In CsA group,steroid diabetes and infections occurred in 1 and 3 patients,respectively.Conclusion Modified Ponticelli regimen to treat patients with IMN has a trend of better outcome than classic CTX regimen.The efficacy is not inferior to CsA regimen with fewer side effects.

Nasopharyngeal carcinoma (NPC) is a polygenetic inheritance tumor. It has very high incidence in southern China and among immigrants and their offspring from south Chinese, and has done a great harm to the health of south Chinese. As a malignant tumor with obvious tendency of familial aggregation and regional difference, it is suggested that the etiology and pathogenesis of NPC are relevant to the coeffects of genetic and environmental factors. It is the main point to focus on the elucidating of the pathogenesis of PNC as a polygenetic inheritance tumor, primarily establishing of the concept of susceptibility gene groups in NPC and the carcinogenesis model of the multi-step Domino effect involved in the molecular mechanisms of NPC dominated by susceptibility gene groups in order to lay out a substantial foundation for finding the high-risk susceptibility factors of NPC, screening the high-risk population of NPC and exploring the targetic and individual measures in diagnosis and treatment of NPC.

Objective To investigate clinical significance of intermittent sinusoidal feial heart rate at third trimester.Methods From Jan 2002 to Dec 2010,48 pregnant women at 33 to 41 gestational weeks undergoing electronic fetal heart rate(FHR)monitoring presented with intermittent sinusoidal FHR in Department of Obstetrics and Gynecology,Second School of Clinical Medicine,Jinan University were enrolled in this retrospective study.Twenty-one cases were categorized into continuous group(i.e.with sinusoidal feature and a constant duration≥10 minutes).while the other 27 cases were categorized iuto intermittent group(i.e.with a duration＜10 minutes).In the mean time.76 normal cases were chosen randomly matched as control group.Blood gas and hemoglobin were measured in umbilical artery after fetal head delivery.General neurological system examination were performed in those fetus in hospitalization.The outcome of those fetuses was compared.Results (1)Neonatal complications:the rate of asphyxia,meconium-stained amniotic fluid and fetal anemia were 63%(17/27),33%(9/27)and 63%(17/27)in group of intermittent sinusoidal FHR,which were significantly higher than 1%(1/76),4%(3/76),3%(2/76)in control group(P＜0.05).When compared with 67%(14/21),52%(11/21),76%(16/21)in group of continuous sinusoidal,the statistical difierence were not observed(P＞0.05).(2)Blood gas in neonate:the rates of pH less than 7 were 18%(5/27)in intermittent group,52%(11/21)in continuous group and 0 in control group,which all reached statistical difference among those three groups(P＜0.05).(3)Brain damage and death:the rates of brain damage and death were 48%(13/27)and 11%(3/27)in intermittent group,81%(17/21)and 43%(9/21)in continuous group,and 0 in control group,which all showed significant difference between them(P＜0.05).Conclusion Intermittent and continuous sinusoidal FHR are typical graphics of severe fetal anemia at third trimester.Intermittent sinusoidal FHR is indicative of serious fetal hypoxia.

BACKGROUND:Molars are characterized by multi-root, multi-root canal, multi-directional, different geometric shape and distribution. Single-root canal teeth post-core theory was used to guide molar repair in the clinic. It is easy to cause root canal perforation or vertical fracture due to excessive post preparation. Therefore, it is necessary to make further study and investigation in the design of fiber post-resin core for repairing molars. OBJECTIVE: To evaluate the clinical therapeutic effects of fiber post-resin core with different numbers of posts in the repair of molar residual roots and crowns. METHODS: A total of 54 human molar residual roots and crowns with sound root canal filing in 48 patients were selected and restored with fiber post of different numbers and resin core as wel as complete coronal restoration. There were 17 cases (20 samples) restored with single fiber post core, 16 cases (18 samples) restored with double fiber post cores, and 15 cases (16 samples) restored with three fiber post cores. They were folowed up for 24 months and the repair results were compared. RESULTS AND CONCLUSION:After 24 months of folow-up, the success rates were 85%, 94% and 94% in the single fiber post, double fiber post and three fiber post groups, respectively, and no significant difference was detected among the three groups. Five failures were observed among 54 teeth: three cases of fiber post shedding in the single fiber post group, one case of fiber post shedding in the double fiber post group, and one case of fiberpost shedding in the three fiber post group, and no root fracture occurred. Three kinds of fiber post-resin cores for repairing molar residual roots and crowns can get a better short-term clinical result. The repair effects were not different because of the different numbers of fiber posts.

Objective: To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM. Methods: T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis. Results: The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM. Conclusions The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.

Objective To observation the changes of left atrium and pulmonary veins(PV)in patients with atrial fibrillation(AF) by transthoracic two-and three-dimensional echocardiography. Methods Transthoracic echocardiography were applied in 126 patients,which were divided into sinus rhythm(SR) group(64 cases)and AF group(62 cases),AF group were further divided into two subgroups:the paroxysmal AF and non-paroxysmal AF group.Left atrial area(LAA),left atrial volume(LAV),left atrial diameter(LAD)were measured by 2-dimensional echocardiography imaging.PV diameters were measured by three-dimensional echocardiography. Results Compared with SR group,PV diameters were significantly increased in AF group(P＜0.05).In patients with AF,PV diameters in non-paroxysmal AF group were larger than paroxysmal AF group.The four PV diameters in SR,paroxysmal AF and non-paroxysmal AF group did not show statisticant difference(P＞0.05).Compared with SR group,LAD,LAA,LAV were increased in AF group.LAD,LAA,LAV were larger in non-paroxysmal AF group than SR group and paroxysmal AF group(P＜0.05).Conclusions Left atrium and PV dilate significantly in patients with AF,transthoracic echocardiography could be a non-invasive method to observe left atrium and PV.

Objective:To investigate the relationship between VitD 3 concentration and glucose and insulin levels of OGTT in patients with CKD 3-5 stages.Methods: We included the patients with CKD 3 and 4 and 5 stages who fulfill the including standard.All patients were recorded the concentrations of [1,25 (OH):D3]concentration of glucose and insulin at fasting ,postprandial 1 h,2 h during OGTT and concentration of glycosylated hemoglobin level ,C peptide concentration.We performed the correlation analysis about [1,25 (OH):D3],glucose and insulin.Results: We totally included 91 patients with 3-5 stages CKD into our study.The D3 concentration of stage 3 were 160.9-261.3 mmol/L[(218.38±8.67)mmol/L] of stage 3,75.2-166.3 mmol/L[(117.01±4.72) mmol/L] of stage 4 and 11.8-96.5 mmol/L[(41.91±12.83)mmol/L] of stage 5 (P<0.05).The average concentrations of serum glucose at fasting,1 h after the meal and 2 h after the meal was(4.74±0.21)mmol/L,(8.31±0.43)mmol/L and(7.36±0.32)mmol/L in 3 stage and (4.92±0.25) mmol/L,(9.14±0.15) mmol/L and (9.14±0.39)mmol/L at 4 stage and (4.81±0.13)mmol/L, (10.72±0.41)mmol/L and (10.72±0.49)mmol/L at 5 stage (P<0.05).The average concentrations of insulin during OGTT at fasting,1 h after the meal and 2 h after the meal was (6.58±0.32) μU/L,(57.78±5.63)U/L and (42.77±8.45)U/L in 3 stage (6.03±0.53)U/L,(55.69±7.35)U/L and (62.52±5.39)U/L in 4 stage and (6.12±0.65)U/L,(62.82±9.73)U/L and (77.34± 8.62)U/L in 5 stage (P<0.05).Correlation analysis shows that the concentration of 1,25 (OH):D3 of different stages of patients with CKD and vitamin D 3 concentration and glucose tolerance test was found to be inversely associated with the insulin levels ( P<0.05 ) . Conclusion:There are obvious differences of concentration of vitamin D 3 between patients with 3-5 stages of chronic kidney disease (CKD).There also showed a negative correlation relationships between glucose and insulin levels ,and vitamin D3 concentration and glucose and insulin levels at OGTT of patients with 3-5 stages CKD.