BACKGROUND:Extracel ular vesicles (EVs) are a kind of subcel ular component produced by paracine mechanism including exosomes, microparticles and microvesicles, which have become hotspots in recent years. OBJECTIVE:To review the research status and progress of EVs, especial y in the studies about definition, secreting mechanism, isolation and identification, biological characteristics and functions in diseases as wel as in biomedical research. METHODS:The first author retrieved PubMed and CNKI databases for relative articles published from July 2006 to August 2016. The keywords were“extracel ular vesicles, exosome, microvesicle, microparticle”in English and Chinese, respectively.RESULTS AND CONCLUSION:A total of 44 eligible literatures are enrol ed. Almost al cel s can secrete EVs, which contain a variety of metrocyte-derived bioactive molecules, such as lipids, proteins, mRNAs, microRNA, lncRNA, cicrRNA, and non-coding RNA. These bioactive molecules are encapsulated in EVs or binding with the membrane. EVs are described to be involved in inflammation, immunity, signal transduction, cel survival and apoptosis, angiogenesis, thrombogenesis, and autophagy, which are of great significance to the maintenance of homeostasis and disease progression. Special EVs may be used as new biomarkers for the diagnosis and prognosis of many diseases and serve as novel tools in the fields of antitumor therapy, regenerative medicine, immunoregulation and vaccination and drug delivery. But the molecular mechanisms regulating the secretion of EVs and the specific pathways activated upon EVs interaction with the target cel are not ful y understood. Based on miRNA, lncRNA and circRNA are attracting researchers’ attention.

Objectives: To study the executive function (EF) profiles in children with ADHD. Methods: 1.We used some neuropsychological tests,including Stroop test, visual and auditory Go/No-Go tasks, digits reciting inverse, delayed spacial position memory span test, tower of London (TOL), tail making test (TMT),to evaluate the capacity of response inhibition, phonological working memory, visual-spacial working memory, planning and set-shifting of subjects. Results: 1.The ADHD children spent more time to accomplish color naming when the word color was inconsistent with the word meaning than normal control (NC) in Stroop test(p﹤0.05). 2.The ADHD children made more errors than NC in both visual and auditory Go/No-Go test(p﹤0.01). 3.The scores of digits reciting inverse was lower in ADHD than NC(p﹤0.01). 4.The representation of ADHD was poorer than NC in delayed spacial position memory span test(p﹤0.01). 5. In TOL test, the ADHD children spent more time in all of two-move, four-move and five-move tasks than NC, and broke rules more frequently than NC(p﹤0.05). 6.In TMT, the ADHD children spent more time and made more errors on part B than NC(p﹤0.05), and there was no significant difference on part A (p﹥0.05). Conclusions: The obvious impaired executive functions are found in children with ADHD, involving poor response inhibition,impaired working memory, dysfunction of planning and set-shifting.

Objective To explore the clinical curative effect of recombinant human endostatin injection combined with chemotherapy in the treatment of patients with advanced gastric cancer and malignant ascites,and its influence on the quality of life.Methods 62 patients with advanced gastric cancer from July 2012 to July 2015,were randomly divided into observation group (31 cases)and control group (31 cases).The control group was treated with FOLFOX6 chemotherapy,the observation group was given recombinant human endostatin injection on the basis of the treatment of the control group.The two groups were treated for 3 weeks.The curative effect,QOL score,Karnofsky score,the change of serum CEA and CA19 -9 levels and drug adverse reaction incidence before and after treatment were compared in the two groups.Results The RR of the observation group was higher than that of the control group (54.84 vs 29.03%,χ2 =4.239 3,P <0.05).The QOL score and Karnofsky score in the two groups were increased after treatment (P <0.05).The QOL score and Karnofsky score after treatment in the observation group were higher than the control group(t =6.512 7,5.669 0,all P <0.05).The serum CEA and CA19 -9 levels of the two groups decreased significantly after treatment (P <0.05).The serum CEA and CA19 -9 levels of the observation group were lower than the control group after treatment (t =5.276 0,6.310 8,all P <0.05).The leukopenia,thrombocytopenia, peripheral neurotoxicity,decreased hemoglobin,diarrhea,nausea and vomiting adverse reaction rate of the two groups had no significant differences (P >0.05).Conclusion The clinical efficacy of recombinant human endostatin injec-tion combined with malignant ascites in the treatment of patients with advanced gastric carcinoma is significant,and can significantly improve the quality of life of patients,has the important research value.

Objective Investigate the clinicopathological characteristics of h?rthle cell tumors of the thyroid. Methods Sixteen cases of HCT were studied by the clinicopathological study and immunohistochemical and review of the literature. Results There were 13 cases of h?rthle cell adenomas, 5 h?rthle cell follicular carcinomas. Immunostains showed that almost all benign and malignant HCT expressed TG, vimentin, S-100 protein. Conclusions HCT is a potential malignant tumor with a defined pathologic feature. It should be follow up for a longer time to their biological behaviors. To distinguish between the benign and the malignant depends on traditional encapsulation, and whether there is a blood vessel invasion or metastasis.

Objective To explore and evaluate the hemostatic effects of hemocoagulase in elderly surgery bleeding. Methods 150 cases (60~75 years old)admitted to Affiliated Hospital of Chuanbei Medical College for abdominal operation from June 2011 to June 2012 were used as subject. They were divided radomly into hemocoagulase group (50 cases),reptilase group (50 cases)and physiological saline solution group (50 cases). The hemostatic time,hemorrhagic volume,hemorrhagic volume per square unit,and body coagulation parameters in three groups were observed and compared. Results The hemorrhagic volume in hemocoagulase group was (9.2 ±2.7 )g,average hemostatic time was (124.5 ±45.7 )s,and hemorrhagic volume per square unit was (0.3 ±0.1 )g,which were similar with reptilase group,but significantly different with those in physiological saline solution group (P<0.05 ). In hemocoagulase and reptilase groups,the hemorrhagic and hemoagglution time decreased in 30 minutes and 1 day after operation, the differences were statistically significant when compared with physiological saline solution group (P <0.05 ).Conclusion Hemocoagulase has better hemostatic effect on hemorrhagic capillary in elderly surgery.

Objective To compare the effect of low concentration versus ultra-low concentration of ropivacaine in combination with sufentanil delivered via programmed intermittent epidural bolus (PIEB) with patient-controlled epidural analgesia (PCEA) during labour on obstetric and anesthetic outcomes.Methods Seventy-six ASA Ⅰ or Ⅱ nulliparous parturients who were at full term with a singleton fetus in vertex presentation were randomized to receive 0.1 ％ ropivacaine with 0.5 μg/mL sufentanil (Group L,38 cases) or 0.06％ ropivacaine with 0.5 μg/mL sufentanil (Group UL,38 cases).Another matched 76 cases of primiparas without labor analgesia (Group C) served as controls.For primiparas received analgesia,an epidural catheter was inserted when the cervical dilatation was up to 2-3 cm.The analgesia level was controlled below T8,and VAS score was controlled below 4.Thirty minutes after analgesia started,Group L and UL received PIEB with PCEA regimen including basal infusion of 8 mL/h of ropivacaine with sufentanil,patient-controlled bolus 6 mL and lockout interval 10 minutes.The duration of labor,delivery mode,Apgar score,VAS score and anesthetic drug consumption of each group were recorded.Results The second stage of labor were not statistically different between Group UL and C.The second stage of Group L was longer than that of Group C (P＜0.05).Furthermore,with similar performance in pain score and satisfactory level at each time point,Group UL consumed much less ropivacaine than Group L (P＜0.05).The cesarean section rate,instrumental delivery rate and the Apgar score were not significantly different among the 3 groups.Conclusions While using PIEB with PCEA,0.06％ ropivacaine was capable of providing satisfactory analgesia effects for primipara and has less effects on the obstetric outcome.Therefore,it could be recommended for labour analgesia.

Objective To prospectively evaluate the correlation between a single breath-hold three-dimensional (3 D) and several breath-hold two-dimensional (2D) delayed enhancement MR imaging sequences in the assessment of myocardial infarction size and the differences on image quality. Methods Fifteen patients with myocardial infarction underwent MR scan by using a single breath-hold 3D inversion-recovery fast low-angle shot (FLASH) sequence and several breath-hold 2D turbo-FLASH as the reference standard. Paired-samples t test was used to compare the ratio of the infarction areas in two sequences. Two-way ANOVA was used to assess the contrast-to-noise ratio (CNR) on 3D,2D magnitude-reconstructed and 2D phase-sensitive (PS) images. P value less than 0.05 was considered to indicate a significant difference. Meanwhile subjective visual evaluation was also performed to compare the image quality. Results The infarction ratio determined by 3D MR imaging 31.28% was no significant difference with that of 2D MR imaging 30.91% and had a good correlation (t = -0.505,P =0.621,r =0.990). The CNR was significantly higher in 3D and 2D magnitude-reconstructed groups than in 2D-PS group (3D and 2D magnitude-reconstructed images, 2D P5 image, 43.43±20.67 and 34.10±14.29, 7.59±2.59, respectively) (F = 24.376, P < 0.01). However, the contrast between normal and infracted myocardium was the highest in 2D-PS group with subjective visual evaluation (scores of 3D, 2D magnitude-reconstructed and 2D-PS images, 2.33, 2.13 and 2.73, respectively). On the other hand, the background noise on 2D-PS images was the highest in 3 groups (scores of 3 D, 2 D magnitude-reconstructed and 2 D-PS images, 2.67, 2.53 and 1.20, respectively). Conclusion The myocardial infarction ratio obtained with 3D MR imaging sequence is accurate, and the image quality is good.

Objective To evaluate the effect of propofol on interleukin-1β (IL-1β)-induced increase in monolayer permeability of human umbilical vein endothelial cells (HUVECs).Methods Primary HUVECs were cultured and purified by immuno-magnetic separation.The expression of VE-cadherin in endothelial cells was determined by immunofluorescence.The HUVEC monolayer permeability was detected by the Transwell system.The cells were seeded on the upper chamber (2 × 105 cells/well) and cultured for 3 days after confluence.The cells were treated in two ways.The cells were randomly divided into 6 groups (n =36 each) and 5 of the 6 groups treated with 1,2,5,10 and 20 ng/ml IL-1β for 24 h except for control group.The cells were also randomly divided into 5 groups (n =30 each) and 4 of the 5 groups were pretreated with 0,10,50 and 100 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h except for control group.The cells were radomly divided into 3 groups (n =18 each) and 2 of the 3 groups were pretreated with 50 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h or 30 min.The expression of occludin protien,p38 mitogen activiated protienkinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) was determined by Western blot.Results Compared with control group,5,10 and 20 ng/ml IL-1β significantly increased HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.05 or 0.01).10,50 and 100 μmol/L propofol inhibited IL-1 β-induced increase in the permeability of HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.01).IL-1β could down-regulate HUVEC occludin protein expression,and activate p38MAPK signaling pathway,and propofol inhibited IL-1β-induced down-regulation of HUVEC occludin protein expression and activation of p38 MAPK signaling pathway (P ＜ 0.01).Conclusion Propofol can alleviate IL-1β-induced increase in the permeability of HUVEC monolayer via inhibiting activation of p38 MAPK signaling pathway.

Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome. Methods Forty-seven patients (33 males and 14 females, mean age 85.9+4.6 years,ranging from 80 to 99 years) with chronic heart failure (NYHA Ⅱ-Ⅳ) and low triiodothyronine (T3) state were randomly allocated to the treatment group or control group. The treatment group patients received oral administration of levothyroxine sodium (Euthyrox) 25-50mg/d in addition to conventional therapy of heart failure, whereas patients in control group were given conventional therapy only. Serum level of total T3 (TT3), free T3 (FT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were determined. For both groups, left ventricular ejection fraction (LVEF) and stroke volume (SV) were assessed by two-dimensional echocardiography before and at 8 weeks after treatment. The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups. Results The reduced serum T3 level in the treatment group was corrected after thyroid hormone therapy,and these patients had a significant improvement in cardiac function after treatment. By contrast, in the control group only changes of serum TT3 and TT4 levels and SV and LVEF after treatment were statistically significant. The heart rate-adjusted mean SV and LVEF in both groups were also increased, which was significantly greater in the treatment group than in the control group. Conclusion In the elderly patients with heart failure and sick euthyroid syndrome, addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T3 state and cardiac function independent of changes of heart rate.

Objective To evaluate the efficacy and safety of clip traction in endoscopic submucosal dissection (ESD) for heterotopic pancreas in stomach.Methods Data of 62 patients with pathologically confirmed heterotopic pancreas treated by ESD between May 2013 and February 2016 were retrospectively studied in Department of Gastroenterology of Xinqiao Hospital,whose lesions were single and origins were submucosal.Thirty-six cases underwent ESD with clip traction (clip group,n=36),and 26 cases underwent ESD without clip traction (non-clip group,n =26).The procedure time,visualization of the submucosal during dissection,complications and the result of follow-up were evaluated between the two groups.Results ESD was successful in all cases.The procedure time was significantly shorter in the clip group than in the non-clip group (19.35±10.34 min VS 27.02± 14.27 min,t'=2.333,P=0.023),and good visualization was obtained by applying clip traction.The rate of bleeding in the clip group was 55.6％ (20/36),and that in the non-clip group was 61.5％ (16/26).There was no significant difference between the two groups(x2 =0.222,P =0.638).Moreover,perforation did not occur in the clip group,but occurred in one patient in the non-clip group (3.8％,1/26).There was no significant difference between the two groups (P =0.419).All patients were followed up,there was no recurrence.Conclusion ESD is effective and safe for heterotopic pancreas in stomach.Clip traction can shorten the operation time and reduce complications of ESD.