Objective To investigate the expression difference of microRNA -21 (miRNA-21) in patients with chronic cardiac function and analyze its clinical significance. Methods Patients with chronic heart failure (trial group,150 cases) and the subjects without chronic heart failure (control group,45 cases) were enrolled. Patients with chronic heart failure were divided into three subgroups according to NYHA: group A (heart function classⅡ,49 cases),group B (classⅢ, 51 cases) and group C (class Ⅳ, 50 cases). miRNA-21 levels were detected by qRT-PCR method. The levels of B type natriuretic peptide urea (BNP),left ventricular end diastole diameter (LVEDD) and left ventricular ejection fraction (LVEF) were determined. Results miRNA-21 expression in patients with heart failure were higher than that of control group (P < 0.01),and miRNA-21 expression in group C was higher than that of group A.Correlation analysis showed that there was a positive correlation between expression of BNP (r = 0.763,P < 0.01), LVEDD (r = 0.691,P<0.01), and the level of miRNA-21 in patients with chronic heart failure.And a negative correlation between LVEF value and the level of miRNA-21 (r = -0.918,P < 0.01). Conclusion miRNA-21 might be a potential marker for diagnosis of heart failure and could be a basis for reference about prognosis evaluation.

Objective To summarize clinical experience of application of muliplefoliated flap combined with tendon graft from dorsal foot for repairing soft tissue defects of multi-fingers. Methods Based on the results of microdissection researches, muliplefoliated flap including medial foot flap, the first metatarsal dorsal flap, lateral foot flap, extensor pollicis brevis of toe and extensor proprius of the fifth toe pedicled by anterior tibial vessels and dorsal pedis vessels as trunk, anterior medial malleolus vessels, the first metatarsal vessels and anterior lateral malleolus vessels as branches respective was designed for repairing soft tissue and tendon defects of multi-fingers. Results In all 12 cases, total survival of flap was 11 cases , 1 case had partial necrosis of distal flap and it was healed by dress changing. Conclusion Transplantation of muliplefoliated flap combined with tendon graft from dorsal foot is a good method to repair soft tissue and tendon defects of multi-fingers.

Objective: To explore effects of allogeneic hematopoietic stem cell transplantation (HSCT) in combination with infusion of endothelial progenitor cells (EPC) on bone marrow inflammatory injury. Methods: 6-8 weeks BALB/c (H-2K^d) mice after lethal dose of irradiation (TBI) were subjected to allogeneic bone marrow transplantation (BMT group) or co-transplantation of EPC (EPC group) . Samples of bone marrow cells of mice in each group on days 7,14,21,28 after transplantation were obtained to detect EPC cultural and cell chimeric rates by flow cytometer. Mice were sacrificed on days 7, 14, 21 and 28 post HSCT to analyze bone marrow pathology by H&E staining, the infiltration of macrophages and neutrophils by Western blot, validation expression levels of inflammatory complexes nlrp1、nlrp6 and its downstream molecules casepase-1 by Q-PCR and Western blot. Results: Cell chimeric rate on day 7 after transplantation in EPC group[ (91.65±2.77) %] was significantly higher than in BMT group[ (83.69±1.26) %]. Alleviated osteomyelitis injury and inflammatory cell infiltration in EPC group were observed when compared with BMT mice. Also significant reductions of the levels of nlrp1、nlrp6、casepase-1 transcription complexes in EPC mice were noted when compared with BMT ones. Conclusion Co-transplantation of HSC and EPC could alleviate inflammatory cell infiltration and activation of the complex to promote the repair of bone marrow.

Objective: To explore the function of NLRP1 in noninfectious pulmonary injury (nonIPI) after allogeneic stem cell transplantation (allo-HSCT) . Methods: In this study, we established the model of allo-HSCT with C57BL/6 and NLRP^-/- mouse as recipients. Chimera rate was measured by flow cytometry. The HE staining was used to observe the pathology changes in the lungs. NLRP1 and relevant inflammatory proteins were measured by Western Blot. Results: On the day 14 after allo-HSCT, the chimera rate was more than 96%, HSCs of donors had been successfully transplanted into recipients. HE staining showed that nonIPI occurred after allo-HSCT. The degrees of injuries reached the peak on day 21. In addition, the expressions of MPO, NLRP1, p20, Mature-IL-1β and Mature-IL-18 had same tends with the degrees of nonIPI. When we knocked out NLRP1 gene of recipients, the degrees of nonIPI reduced and the expressions of MPO, p20, Mature-IL-1β and Mature-IL-18 were less than in non-knockout group. Conclusion allo-HSCT could cause nonIPI and high expressions of MPO, p20, IL-1β, IL-18, NLRP1. Knocking out NLRP1 gene could alleviate the degrees of nonIPI and reduce the expressions of relevant inflammatory proteins, indicating that NLRP1 might be one of factors contributed to nonIPI after allo-HSCT.

Objective: To analyze the efficacy of recombinant activated factor Ⅶ a (rF Ⅶ a) on hematonosis with moderate or severe bleeding signs. Methods: Of total 16 cases with rF Ⅶ a treatment from May 2013 to May 2016, 8 cases received allogeneic hematopoietic stem cells transplantation (allo-HSCT) and the other were non-transplantation patients. In two groups, there was no significant difference on rF Ⅶ a usage and dosage. 15 patients with acute graft-versus-host disease (aGVHD) after allo-HSCT were control group (without rF Ⅶ a) . Results: ①The total response rate was 75.0% (6/8) in non-transplantation group and 37.5% (3/8) in transplantation group, respectively. Median interval for hemorrhage stop was 38.5 hours in non-transplantation group and 63.0 hours in transplantation group. The median overall survival (OS) was 201.0 and 29.0 days for non-transplantation group and transplantation group, respectively, and the OS rate was 50.0% (4/8) and 25.0% (2/8) , respectively. The bleeding-related mortality rate was 50.0% (2/4) and 83.3% (5/6) , respectively. ②Of the 16 cases, 9 showed response to rF Ⅶ a treatment and the other 7 cases’bleeding signs did not alleviate. The median OS was 268.0 in 9 cases with response and 24.0 days in 7 cases without response, respectively. ③In patients with intestinal aGVHD complicated with intestinal hemorrhage, the median OS of observation group (n=6) and control group (n=15) were 25.5 days and 20.0 days, respectively. Conclusion Patients with hematological diseases, especially patients after allo-HSCT, had high bleeding-related mortality, and rFⅦa therapy had a obvious hemostatic efficacy. The survival rate of patients with response was higher than that of cases without response. The causes of poor hemostasis efficacy of rF Ⅶ a therapy were associated with unsatisfactory control of complications in patients with intestinal bleeding after allo-HSCT.

Objective:To develop an HPLC method for the determination of vonoprazan pyroglutamate and vonoprazan fumarate. Methods:The column of Intertsil ODS-3 (150 mm×4.6 mm,5 μm) was used. The mobile phase was composed of methanol and a mixture of 0.15% phosphoric acid(ajust pH of 3 with 0.15% triethylamine solution). Gradient elution was adopted and the flow rate was set at 1.0 ml·min-1. The detection wavelength was 230 nm and the column temperature was 30℃. The sample size was 10 μl. Results: The standard curve of vonoprazan pyroglutamate showed a good linearity over the range of 2.060-131.800 μg·ml-1with a correlation coefficient of 0.999 7. The average spiked recovery of vonoprazan pyroglutamate was 99.40% (RSD=0.63%, n=9). The content of three batches of TAK-438 P was 98.7%,99.0% and 98.4%(n=3),respectively. The standard curve of vonoprazan fumarate showed a good linearity over the range of 1.844-118.000 μg·ml-1with a correlation coefficient of 0.999 9. The average spiked recovery of TAK-438 F was 100.67%(RSD =0.52%, n =9). The content of three batches of vonoprazan fumarate was 98.5%,98.2% and 98.9%(n=3),respectively. Conclusion:A reliable and sensitive HPLC method for the quantification of vono-prazan pyroglutamate is established and validated,which provides the basis for the content determination.