Endovascular repair has gained worldwide popularity for the treatment of aortic dissection and aortic aneurysm.The non-tapered stents are selected usually.The aortic diameters vary in different level.High incidence of distal stent-induced complications is closely related to the aortic taper angle.According to several published studies,the aortic taper angle could be evaluated by establishing geometric model.Applications of tapered stents can significantly reducing the incidence of distal stent-induced comnplications.This review summaries the latest researches in the studies of the progress and the application of the aortic taper angle and the tapered stents,providing a reference for endovascular stent-graft selecting in the treatment of aortic dissection and aortic aneurysm.

Objective To study the influence of perdipine on the proliferation and proline-rich tyrosine kinase 2 (PYK_ 2 ) expression in cultured adult rat cardiac fibroblast stimulated by angiotensin Ⅱ, and to explore the mechanism of perdipine on cardiac fibrosis. Methods Adult rat cardiac fibroblasts (CFs) were treated with angiotensin Ⅱ(AngⅡ) to establish fibrosis model. The effects of perdipine on proliferation of CFs were analysed by MTT colorimetric assay, and fibronectin was tested by immunohistochemistry method. PYK_ 2 mRNA and protein level were examined by RT-PCR and Western blot analysis respectively. Results Perdipine inhibited CFs proliferation and fibronectin synthesis stimulated by angiotensin Ⅱ in a dose dependent, and the levels of PYK_2 mRNA and protein were decreased significantly. Conclusion Perdipine can inhibit cardiac fibrosis stimulated by angiotensin Ⅱ by suppressing CFs proliferation and fibronectin synthesis. PYK_2 is involved in the effect of perdipine.

Extracellular matrix protein-1 (ECM-1) is a secretory glycoprotein. Recent studies found that the protein may be related to the digestive tract tumor growth, invasion and metastasis. In this paper,the basic structure and function, as well as the possible mechanism in gastrointestinal cancer have been reviewed.

ObjectiveTo study the expression of vascular endothelial growth factor (VEGF) and aquaporin 1 (AQP1) in the synovium of rheumatoid arthritis (RA) patients,and their correlation with angiogenesis.MethodsThe expression of VEGF and AQP1 in the synovial tissue was detected with immunohistoehemistry in 7 patients with RA,12 patients with osteoarthritis (OA).The expression of VEGF and AQP1 positive cells and vessels was scored,and the correlation of positive cells with vessels was analyzed.Rank-sum test and Spearman's correlation analysis were used for statistical analysis.ResultsThe expression of VEGF positive cells was significantly correlated with vessels in the synovium of RA group(rs=0.971,P＜0.01 ).No significant correlation was found between VEGF positive cells and vessels in synovium of the OA group (rs=0.235,P=0.462).There was no evident difference in the expression of VEGF positive cells between RA and OA group (Z=-0.390,P=0.711 ).The expressions of AQP1 positive cells were significantly correlated with vessels in the synovium of RA group (rs=0.828,P=0.022).No significant correlation was found between AQP1 positive cells and vessels in the synovium of OA group (rs=0.396,P=0.203).There was no notable difference in the expression of AQP1 positive cells between RA and OA group (Z=-0.302,P=0.773).The expressions of VEGF positive cells were significantly correlated with AQP1 positive cells in RA group (rs=0.891,P=0.007).No significant correlation was found between VEGF positive cells and AQP1 positive cells in OA group (rs=0.338,P=0.283).ConclusionThe expressions of VEGF and AQP1 are significantly correlated with angiogenesis in the synovium of RA,and they play an important role in the pathology of RA.Moreover,there may be synergistic effect between VEGF and AQP1 in RA.

Objective:To investigate extraocular muscles(EOM) susceptibility to myasthenia gravis(MG).Methods:Acetylcholine receptor(AChR) ?, ?, ?, ? and ? subunits from human EOM and other different muscle groups from 8 health controls and intercostal muscles from 10 MG patients were studied by RT-PCR System. Serum AChR antibodies from 83 patients with MG were assayed by ELISA.Results:①AChR?, ?, ?, ? and ? subunit mRNA could be amplified from normal human EOM and all muscle groups studied. ②AChR? P3A+/?-actin mRNA was expressed at higher level in general MG than in health controls(P=0.028). ③Ocular and general MG patients had higher AChR antibodies against AChR from adult gastrocnemius muscle than that from fetus(P=0.001,0.016).Conclusion:Susceptibility of EOM to MG is likely associated with muscle AChR subunit mRNA expression and intrinsic susceptivity of EOM.

Objective To investigate the diagnostic values of model of end-stage with incorporation of serum sodium (MELD-Na) score, chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score and APASL-ACLF research consortium score (AARC-ACLF) for evaluation of prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 72 consecutive patients with HBV-ACLF were included in the study and divided into two groups (group A and group B) according to the prognosis in three-month. Group A were included 29 patients with stable disease or better after medical treatment at least for 3 months, and group B included 43 patients who were dead after treatment or received liver transplantation as failure of medical treatment. When the patients were diagnosed as ACLF or after admission, the data were collected. Results of the laboratory examination were collected when the international normalized ratio (INR) was minimum. Data of total bilirubin (TBIL), prothrombin time (PT), INR, serum creatinine (Cr), serum sodium (Na), albumin (ALB), MELD-Na, CLIF-SOFA and AARC-ACLF scores were calculated respectively. The comparative analysis was performed. Areas under the receiver operating characteristic curve (AUC-ROC) of MELD-Na and CLIF-SOFA scores were used to assess the short-term prognosis in patients with acute-on-chronic liver failure. Results The values of TBIL, INR, MELD-Na, AARC-ACLF and CLIF-SOFA were significantly higher in group B than those in group A (P<0.05). The serum level of Na was significantly lower in group B than that of group A (P<0.05). The area under curve (AUC) values generated by the ROC curves was higher for CLIF-SOFA score (AUC 0.887) than that of MELD-Na score (AUC 0.764) (Z=2.255, P<0.0167). The AUC values generated by the ROC curves showed no significant differences between CLIF-SOFA score and AARC-ACLF score (AUC 0.825) or MELD-Na score and AARC-ACLF score (Z=1.361, 1.127, P>0.0167). The cut-off scores of MELD-Na, CLIF-SOFA and AARC-ACLF were 23.84, 8.50 and 8.50 respectively. Conclusion MELD-Na, CLIF-SOFA and AARC-ACLF scores have appreciable values to evaluate the prognosis in patients with HBV-related ACLF. AARC-ACLF is better than that of MELD-Na and CLIF-SOFA in assessing prognosis of HBV-related ACLF.

Objective To explore the correlation between the enhancement pattern of hepatocellular carcinoma (HCC) on contrast-enhanced ultrasound (CEUS) and its tumor differentiation on histopathology. Methods HCC lesions (n=259) from 224 patients were retrospectively evaluated with CEUS and histopathological examination. CEUS was performed with SonoVue. The characteristics of blood perfusion and parameters of the time-intensity curve (TIC) were analyzed by ACQ soft?ware. Histopathological diagnoses were decided base on Edmonson grading system. Results Pathologic grading of HCC was not related to the arrival time(P>0.05);The washing-out time point and the enhancement time point and peak time point all appeared earlier in poorly differentiated HCC group, than those in moderately differentiated HCC group than those in well differentiated HCC group(P<0.01);The enhancement time point and the expurgation time point are shorter in poorly differ?entiated HCC group than those in moderately differentiated HCC group than those in well differentiated HCC group. All dif?ferences were with statistical significance. The mode of arterial perfusion in early stage was divided into 3 types:spider web type, radiative type and mixed type. The well differentiated HCC group mainly presented as radiative type ( 28/49, 47.14%). But the most of poorly differentiated HCC group mainly present as spider web type(88/127, 69.29%). The mix type was more common in moderately differentiated HCC group(49/83, 59.03%). Conclusion CEUS show different features of TIC pa?rameters and blood perfusion in different pathological stages of HCC lesions so it can serve as a method to assess the biologi?cal behavior of hepatocellular carcinoma.

In order to optimize the ~(18)O labeling method, two key aspects, peptide dispersion and trypsin deac tivation were discussed o The addition of Rapigest SF in H_2~('8)O and microwave heating enhanced labeling efficiency of α-casein digested peptides(~(18)O/~(16)O) ratio >99%).Chemical modification with tris(2-carboxyeth yl) phosphine (TCEP) and iodoacetamide (IAA) resulted in trypsin deactivated completely.No significant back-exchange from ~(18)O to ~(16)O was observed after labeling in 6 days.The experiment result with peptide mixture from showed that the improved method could be effectively used to label protein and peptide.

Objective To investigate the effect of injection of air into the epidural space on the subarachnoid puncture during the combined spinal-epidural anesthesia (CSEA) .Methods Two hundred and ten ASA Ⅰ or Ⅱ parturients who were at full term with a singleton fetus, aged 20-42 yr, weighing 57-82 kg (height 152-170cm) , undergoing cesarean section under CSEA, were randomly divided into 3 groups ( n = 70 each) : hanging drop technique group (group Ⅰ ) and injection of small volume of air group (group Ⅱ ) and injection of large volume of air group ( group Ⅲ ) . The epidural space was indentified using hanging drop technique in group Ⅰ and using loss of resistance to air technique in Ⅱ and Ⅲ groups. Injection of air was stopped as soon as the clear loss of resistance identified the epidural space in group Ⅱ , whereas all 4 ml of air was injected in group Ⅲ . After the epidural space was confirmed at L3,4 interspace, a 25-gauge spinal needle protruding 14 mm beyond the 18-gauge epidural needle was introduced through the epidural needle. Subarachnoid placement was confirmed by backflow of cerebrospinal fluid (CSF) . If no backflow of CSF was observed, the spinal needle was withdrawn and an epidural catheter was inserted through the epidural needle to perform epidural anesthesia. Successful subarachnoid puncture, failures to observe backflow of CSF and adverse reactions were recorded. Results The three groups were comparable with respect to age, height, body weight and gestation weeks. The success rate of subarachnoid puncture was 91% ,93% and 79% in Ⅰ ,Ⅱ and Ⅲ groups respectively, and it was significantly higher in Ⅰ and Ⅱ groups than in group Ⅲ ( P < 0.05) . There was no significant difference in the success rate of subarachnoid puncture between Ⅰand Ⅱ groups ( P > 0.05) . Bilateral segmental analgesia presented in all cases who received only epidural anesthesia after no backflow of CSF was observed, and the expected analgesia also presented in all cases in whom back flow of CSF was observed. No adverse reactions occurred. Conclusion Injection of air into the epidural space is related to the success of subarachnoid puncture during CSEA and injection of a large volume of air lowers the success rate.

ObjectiveTo investigate the effect of varied hyperglycemia and durations on preventing peripheral neuropathy (PN) with methylcobal in diabetic rats.Methods80 Sprague Dawley rats were selected and randomly chosen 16 as normal control (NC) group, others 64 animals as diabetic model induced by alloxan. The model rats were evenly divided into relatively good control (GC) group and relatively poor control (PC) group based on levels of hyperglycemia regulated with exogenous insulin. 16 rats of each GC/PC group were intramuscularly injected with methylcobal (500 μg/kg). The sensory nerve conduction velocity (SNCV), motor nerve conduction velocity (MNCV) and evoked potential amplitute (EPA) of sciatic nerve of rats were detected by evoked electromyogram respectively at 2nd, 8th and 12th week after onset of diabetes. Fructosamine in serum was also detected.ResultsThe rats injected with methylcobal had a significantly delayed reduction of SNCV, MNCV and EP in GC group (fructosamine,1.0 mmol/L) than that in PC group (fructosamine, 1.2 mmol/L) ( P<0.05～0.01). Up to 8th week after onset of diabetes, there was no obvious difference in physioelectroparameters between the GC group and NC group. At 12th week after onset of diabetes, physioelectroparameters in the PC group fell to the level of non-methylcobal injected group. No effect of methylcobal on blood glucose revealed in any groups ( P>0.05).ConclusionMethylcobal has a beneficial effect on delaying the onset of diabetic PN, and is of high efficacy with a good control of diabetic state, especially at early stage.