The pathogenesis of viral myocarditis is still not completely clear all over the world now.However,the damage to the body caused by the viral myocarditis has been highlighted and its pathogenesis has become a research hot spot.With the development of immunology and molecular biology,the pathogenesis of viral myocarditis has made great breakthrough.Many scholars advocate that the course of viral myocarditis should be divided into three phases:viral replication,immune response and inflammatory dilated cardiomyopathy.This review summarizes the progress of the pathogenesis of viral myocarditis from the above three phases through reviewing previous articles,aiming to provide new evidence and references for clinical diagnosis and therapy of viral myocarditis.

Aim To observe the effects of theaflavin on intracellular calcium concentration(i) level in rat ventricular myocytes and discuss the possible mechanisms.Methods The effects of theaflavin oni were investigated in rat ventricular myocytes.i was detected by laser confocal microscopy and represented by relative fluorescent intensity(FI-FI0)/FI0,%;FI0:control;FI:administration of drugs).Results ① Theaflavin(10,20,40 ?mol?L-1) had no effect on the i of ventricular myocytes in normal Tyrode′s solution.However,it reduced the i of ventricular myocytes in simulated ischemia solution in a concentration-dependent manner.② Pretreatment with Bay k8644(0.5 ?mol?L-1) mostly abolished the effects of theaflavin(20 ?mol?L-1) in simulated ischemia solution.③ Theaflavin(20 ?mol?L-1) markedly inhibited the low concentration of ryanodine-induced i increase in Ca2+-free Tyrode′s solution.④ When the propagating waves of elevated i(Ca2+ waves) were produced by increasing extracellular Ca2+ concentration from 1 mmol?L-1to 10 mmol?L-1,theaflavin(20 ?mol?L-1) could block the propagating waves of elevated i(Ca2+ waves),reduce the frequency and duration of propagating waves,and reduce i as well.Conclusion Theaflavin may reduce the i in isolated rat ventricular myocytes via inhibiting Ca2+ influx by voltage-dependent Ca2+ channel and alleviating Ca2+ release from sarcoplasmic reticulum(SR).

Objective Interleukin-21(IL-21) is likely to contribute to the development of liver fibrosis, but up to now, no study has been reported on the relationship between IL-21 and intrauterine adhesions ( IUA) .This study aimed to establish a rat model of IUA induced by mechanical injury and lipopolysaccharide (LPS) infection (dual injury), determine the expression level of serum IL-21, and confirm the association of serum IL-21 with the formation of IUA. Methods Forty healthy female SD rats were randomly divided into four groups of equal number,control, mechanical injury, LPSinfection, and dual injury.At 7 days after IUA modeling,uterine tissue-swere collected from all the animals for observation of the endometrial glands,detection of the degree of IUA by Masson staining, measure-ment of the serum IL-21 level by radioimmunoassay, and analysis of the correlation between the number of endometrial glands and the de-gree of fibrosis. Results The number of endometrial glandswas significantly smallerin the dual injury group (3.59±1.20) than in the mechanical injury (11.66±2.34) and LPSinfection group(11.59±1.47)(P<0.05), while the proportion of fibrosis area wassignificantly higher in the former group(0.65±0.03) than in the lattertwo(0.30±0.07 and 0.32±0.08)(P<0.05).The level of serum IL-21 was signifi-cantly increased in the dual injury group ([286.21±27.80]pg/mL) as compared with those in the control ( [ 118.65 ±22.55 ] pg/mL ) , mechanical injury([176.20±19.05]pg/mL), and LPS infection group ([187.98±16.51]pg/mL) (P<0.05), with a positive correlation be-tween the IL-21 level and theproportion of fibrosis area ( r=0.271, P<0.05) . Conclusion A rat model ofIUAwas successfully established by mechanical injury and lipopolysaccharide (LPS) infection.The evi-dent increase of serum IL-21 in the IUA model was positively correlated with the percentage of fibrosis area, suggesting that IL-21 may be involved indirectly in the formation of IUA.

Objective To identify potential linkage of cholesterol efflux with the expressions of ATP-binding cassette receptor A1(ABCA1),ABCG1 and scavenger receptor B1(SR-B1) in monocytes derived macrophages of patients with type 2 diabetes mellitus.Methods and Results Blood was collected from subjects with or without type 2 diabetes mellitus.Peripheral blood monocytes were differentiated for 72 hours into macrophages,and cholesterol efflux assays,Real-time quantitative PCR and western blot were performed.Macrophages from patients with type 2 diabetes mellitus showed a reduction in cholesterol efflux.The mRNA and protein expressions of ABCG1 in macrophages from patients with type 2 diabetes mellitus were significantly reduced.In contrast,the expression of ABCA1 and SR-B1 was not significantly different in both control subjects and diabetic patients.In addition,cellular cholesterol efflux from macrophages to autologous serum and pool serum was significantly correlated with the expression of ABCG1.Conclusion ABCG1 expression and cholesterol efflux are reduced in patients with type 2 diabetes mellitus.This impaired cholesterol efflux significantly correlates with decreased expression of ABCG1.

Objective To evaluate the feasibility, safety, and outcome of hepatectomy by hand-assisted laparoscopic surgery (Lapdisc system) in patients with hepatic hemangioma. Methods Eight patients with hepatic hemangioma underwent hand-assisted laparoscopic hepatectomy. Procedures included introduction of Lapdisc system, isolation of the liver from the ligments, occlusion of the hepatic porta, dissection of the hepatic parenchyma by harmonic scaple and removal of the samples. ResultsIn all patients, the hand-assisted laparoscopic hepatectomy were successfully performed. The operation time was(196.3?81.2)min. Blood loss was (307.5?224.7)ml, and postoperative hospital stay was (7.9?2.9)d. There was no significant postoperative complication such as bile leakage, bleeding or infection. ConclusionsLapdisc system could be safely used for hepatectomy in cases of hepatic hemangioma.

Objective To identify potential linkage of cholesterol efflux with the expressions of ATP-binding cas-sette receptor A1 (ABCA1), ABCG1 and scavenger receptor B1 (SR-B1) in monocytes derived macrophages of patients with type 2 diabetes mellitus. Methods and Results Blood was collected from subjects with or without type 2 diabetes mellitus. Peripheral blood monocytes were differentiated for 72 hours into macrophages, and cholesterol efflux assays, Real-time quantitative PCR and western blot were performed. Macrophages from patients with type 2 diabetes mellitus showed a reduction in cholesterol efllux. The mRNA and protein expressions of ABCG1 in macrophages from patients with type 2 diabetes mellitus were significantly reduced. In contrast, the expression of ABCA1 and SR-B1 was not significantly different in both control subjects and diabetic patients. In addition, cellular cholesterol efflux from macrophages to autologous serum and pool serum was significantly correlated with the expression of ABCG1. Conclusion ABCG1 expression and cholesterol efflux are reduced in patients with type 2 diabetes mellitus. This impaired cholesterol efflux significantly correlates with decreased expression of ABCG1.

Objective To investigate the effects of dopaminergic medication on decision-making un-der ambiguity in patients with early Parkinson's disease( PD) . Methods Using Iowa Gambling Task ( IGT) for 24 early non-medication idiopathic PD patients( Hoehn and Yahr Scale≤Ⅱlevel) ,24 early idiopathic PD patients with regular dopaminergic medication and also for 24 healthy controls( HC) whose age,gender,and education match to PD patients to test their ability of decision-making under ambiguity. Results The results showed non-medication PD group showed impairments on digtal span and verbal fluency and decision-making task. There was significant difference in IGT task scores among the three groups(F=6.024, P=0.004) . The total net scores of advantageous choices in IGT were significantly lower in non-medication PD group( (-4.50 ±22.19) scores) than medication PD group((8.83±23.24)scores) and healthy group((15.92±15.77) scores) . The difference of net scores in block1 to block5 between non-medication PD group and medication PD group was gradually increased,and the difference of net scores in block5 was significant(P<0.05) . There was no significant difference in total net scores and net scores in block1 to block5 between medication PD group and healthy group(P>0.05) . As the game processing,medication PD group gradually shifted their se-lections toward the advantageous choices. But non-medication group did not exhibit this shift pattern and the performance was much poorer. Meanwhile, the study also indicated the total net scores of advantageous choices for non-medication PD group was positive correlation to the MoCA scores ( r=0.614, P=0.001). Conclusion The present study has shown that non-medication PD group has impairment in decision-making under ambiguity risk condition and prefer to choose risky options. when exogenous complement dopaminergic medication,the risk decision-making ability of medication PD group has been improved.

Objective To observe the expression levels of Mig in the patients with chronic hepatitis B .Methods The study pop‐ulation consisted of 88 chronic hepatitis B patients and 53 healthy controls .The ELISA ,RT‐PCR and Western‐blotting were used for analysing the expression levels of Mig in serum ,peripheral blood mononuclear cells and liver tissue of the patients with chronic hepatitis B ,while the immunohistochemistry was applied for analysing the distribution of Mig in liver tissue .Results The expres‐sion of Mig in serum ,peripheral blood mononuclear cells and liver tissue of the chronic hepatitis B patients with HBeAg negative were (247 .03 ± 63 .14)pg/mL ,(0 .95 ± 0 .21) ,(0 .79 ± 0 .23) ,and that in the chronic hepatitis B patients with HBeAg positive were (243 .05 ± 53 .00)pg/mL ,(0 .98 ± 0 .35) ,(0 .74 ± 0 .18) ,which were both significantly higher than those in healthy controls ,the difference was statistically significant(P<0 .05) .Conclusion Increased levels of Mig in the patients with chronic hepatitis B may be related to immune state of patients .

Objective To examine the effects of high-density lipoprotein(HDL) and lipoprotein-deficient serum(LPDS) isolated from patients with type 2 diabetes mellitus on cholesterol efflux through human skin fibroblast(HSF) and human hepatoma cell line(HepG2).Methods and Results Blood was collected from 13 patients with type 2 diabetes mellitus and 17 healthy volunteers,HDL and LPDS were isolated.Cholesterol efflux assays,RT-PCR and Western blot were performed with HSF and HepG2 cells.The HepG2 cells showed a high expression of scavenger receptor B1(SR-B1) and lack of functional ATP-binding cassette receptor A1(ABCA1) and ATP-binding cassette receptor G1(ABCG1) while HSF cells express SR-B1 at very low level and have a high expression of ABCA1 pretreated with 22-OH cholesterol.The cholesterol efflux from HepG2 cells to HDL isolated from patients with diabetes decreased significantly as compared to controls.However,cholesterol efflux from HSF cells to LPDS was not different between groups.Conclusion The function of HDL involving cholesterol efflux in type 2 diabetes mellitus was impaired while cholesterol efflux induced by LPDS from HSF cells was maintained,suggesting that HDL plays a critical role in mediation of intracellular cholesterol accumulation and progression of atherosclerosis inpatients with type 2 diabetes.

Objective To investigate the clinical data of a patient with IgG4-related disease involving the trachea and paratracheal soft tissue and review the literature so as to improve the understanding level of the disorder.Methods To analyze the clinical manifestation,laboratory examination,imaging,histopathology,treatment and prognosis of a patient with IgG4-related disease trachea and paratracheal soft tissue involved,who was admitted to the Department of Respiratory and Critical Care Medicine at Beijing Chaoyang Hospital.The relevant literatures were reviewed.Results A 18-year-old female was admitted with chief complaint of cough,dyspnea,and neck mass.Neck CT suggested that tracheal stenosis was caused by surrounded soft tissue.Paratracheal mass biopsy showed dense collagen fibers with infiltration of many lymphocytes and plasma cells.Immunohistochemical stain found that IgG4-positive plasma cells were ＞ 50/high power field (HPF) and a ratio of IgG4/IgG positive cells was over 40％.The level of serum IgG4 was significantly increased (2 930 mg/L).She was diagnosed as IgG4-related disease.The patient was treated with 80 mg intravenous methylprednisolone per day for three days,then prednisone 40 mg daily oral.Her dyspnea was significantly relieved.One month later,CT scan showed that the cervical tracheal stenosis was significantly improved.We identified 20 cases of IgG4-related disease involving the trachea and paratracheal soft tissue from databases,in which only 1 case was similar as this patient.The other 19 cases were of extratracheal involvement.Elevated serum IgG4 was detected in 11/12 patients.Most patients were treated with glucocorticoid,some combined with immunosuppressive agents and rituximab.The clinical outcome was good.Conclusion IgG4-related disease involving the trachea and paratracheal soft tissue is a rare condition.Serum IgG4 level and histopathology should be considered for diagnosis.Glucocorticoid is effective.