BACKGROUND: Calcitonin gene-related peptide(CGRP) can relieve myocardial ischemia-reperfusion injury. Because adrenomedulin(Adm) and CGRP share certain structural homology, it is assumed that Adm might have protective effect on myocardium.OBJECTIVE: To investigate Adm' s inhibitory effect on vascular cell adhesion molecule-1 (VCAM-1) expression in ischemia-reperfusion rats and its protective effect on myocardial ischemia.DESIGN: A randomized paired design using ischemia-reperfusion model of SD rats.MATERIALS: The experiment was conducted in the Experimental Animal Center of Xianning Medical College from December 2003 to May 2004. Twenty-four healthy male SD rats were selected.METHODS: The hearts of the rats were removed to make into ischemia-reperfusion model and then randomized to control group, Adm1-50(1× 10-9) mol/L group, Adm1-50(1 × 10-8) mol/L group and Adm1-50(1 × 10-7) mol/L group. After the hearts underwent ischemia for 60 minutes, the hearts in control group were reperfused with oxygenation Kerbs-Henseleit bicarbonate(KHB) for 60 minutes while those in the other three groups had reperfusion with oxygenation KHB and Adm1-50( 1 × 10-9),(1 × 10-8), and(1 × 10-7) mol/L, respectively, for 15 minutes and KHB perfusion for another 45 minutes. The liquid flowing from the coronary artery was collected, and the content of creatine kinase isoenzyme was detected. Myocardium in the left ventricle was collected for RNA extraction, and the expression of VCAM-1m RNA was determined with reverse transcription-polymerase chain reaction method.MAIN OUTCOME MEASURES: The expression of myocardial VCAM-1mRNA in control group and groups of different concentrations of Adm1-50.RESULTS: After electrophoresis, each group was found to have an obvious amplified band at 194bp, which was GADPH mRNA amplified segment, and the expression of GADPH mRNA in each group was the same. VCAM-1 mRNA amplified segment with strong brightness and clear border was found at 334bp in control group and Adml-50 (1 × 10-9) mol/L group. The brightness of VCAM-1 mRNA amplified band decreased significantly in Adm1-50(1 × 10-8) mol/L group whereas slight brightness and obscure amplified band was found in Adm1-50(1 × 10-7) mol/L group. The gray value of amplified VCAM-1mRNA and GAPDH mRNA in Adm1-50(1 × 10-8)group and(1 × 10-7) mol/L group was 0.6 ±0.31 and 0.5 ±0.36, respectively, which was obviously lower than that in control group( 1.2 ± 0. 52) ( P＜ 0. 05).CONCLUSION: Adm1-50 may inhibit the expression of myocardial VCAM-1mRNA in myocardial ischemia-reperfusion in a dose-dependent manner.

AIM: To investigate the protective effect of ischemic-preconditioning under the mild hypothermia against small intestine ischemia-reperfusion injury in rats and its mechanism. METHODS: Thirty-two rats were randomized into 4 groups (8 rats in each group): sham operated group (Sham), ischemia-reperfusion (I/R) group, ischemic-preconditioning (IP) group, mild hypothermia ischemic-preconditioning (MHIP) group. The wet/dry ratio, Ca 2+ -Mg 2+ -ATPase activity in intestine tissue, the malondialdehyde (MDA) content, activities of lactate dehydrogenase (LDH), superoxide dismutase (SOD) and total antioxdase (TAX) in blood were determined. Ultrastructure, Bcl-2 and Bax expression in intestinal mucosa tissue were also observed. RESULTS: After I/R, the intestinal tissue wet/dry ratio, the content of MDA, LDH activity, the optic density of Bcl-2 and Bax proteins were significantly higher in I/R group than those in sham group (P

AIM and METHODS: To study the protective effects of liposomes containing L-Arg,Se and taurine on intestinal ischemia-reperfusion injury in rats. Wistar rats were divided randomly into sham operated group,ischemia-reperfusion(I/R) group,pretreatment with liposomes group and treatment with liposomes at reperfusion group. In the experiments, superior mesenteric artery was clipped for 60 min, and then unclipped. 2 hours of reperfusion later, MDA content, T-SOD and Ca 2+ -Mg 2+ -ATPase activities in intestinal tissues were detected respectively, ultrastructure and bcl-2 expression in intestinal mucosa tissue were observed. RESULTS: MDA content in liposomes-treated group was less than I/R group ( P 0.05). CONCLUSION: Liposomes containing L-arginine, Se and taurine can protect intestine against ischemia-reperfusion injury in rats,which may be related to inhibiting lipid peroxidation, stabilizing internal circumstances and inducing bcl-2 protein expression.

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.

Objective:To investigate the safety and efficacy of transcatheter genicular artery embolization (GAE) for moderate to severe knee osteoarthritis (KOA).Methods:This prospective study included 13 patients (17 knees) with KOA who were treated with GAE from October 2020 to March 2021. The Kellgren-Lawrence (K-L) grade was 2-3 for 11 knees, and 4 for 6 knees. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) assessments were performed for all the subjects before operation. The success rate, clinical efficacy and complications were recorded after operation. Clinical outcomes were evaluated at 1 day, 1week and 1, 3, 6 months after the operation.Results:The success rate of GAE in 17 cases was 100%, and the success rate of target artery superselection was 98.4%(63/64). The baseline WOMAC pain score was 11(10, 13) and total score was 44(38, 58) for 17 knees. Post-operation follow-up WOMAC pain score were 4(3, 7), 2(1, 5), 2(1, 6) and 4(2, 6) at 1 day, 1 week, 1 month, and 3 months. Post-operation follow-up WOMAC total score were 22 (15, 34),20 (12, 24),17 (12, 26) and 20 (12, 31) at 1 day, 1 week, 1 month, and 3 months. There were 16 knees with 6 month follow-up assessment, with the WOMAC pain score of 2.5(2, 5), and the total score of 15(12, 26). Significant difference was found in the WOMAC pain score between baseline and the 1 day, 1 week, 1, 3 and 6 months follow up ( Z=-3.631, -3.623, -3.622, -3.622, -3.532, all P<0.001); also, the total score was statistically significant different between the baseline and the 1 day, 1 week, 1, 3 and 6 months follow up ( Z=-3.639, -3.634, -3.646, -3.527, -3.532, all P<0.001). At 3 months follow-up, there was 1 knee recognized clinical failure. Post-operative adverse reaction in this group included skin ecchymosis in femoral artery puncture area ( n=3), knee joint stiffness and pain within 1 week ( n=4),and clanging joints during postoperative activities ( n=6). Conclusion:GAE is a feasible and safe procedure with obvious short-term curative effect, which can alleviate pain symptoms and improve restricted movement in patients with KOA.

Objective To investigate the relationship between serum survivin,adenosine triphosphate bind-ing cassette transporter Al(ABCA1)and poor coronary collateral circulation(CCC)in patients with single coronary artery occlusion in acute myocardial infarction(AMI).Methods A total of 155 patients with single coronary artery occlusion in AMI admitted to Handan Fist Hospital from May 2021 to May 2023 were selected as the study objects,and were divided into poor CCC group(n=80)and good CCC group(n=75)according to their CCC status.Serum survivin and ABCA1 levels were compared between the two groups,univariate and multivariate Logistic regression models were used to analyze the influencing factors of poor CCC,and the effi-cacy of serum survivin and ABCA1 in predicting poor CCC was analyzed by receiver operating characteristic curve.Results Compared with good CCC group,serum survivin and ABCA1 in poor CCC group were signifi-cantly decreased,and the difference was statistically significant(P＜0.05).Compared with good CCC group,Gensini score,creatinine kinase isoenzyme-MB(CK-MB),Killip heart function grade≥Ⅱ and history of hy-pertension in poor CCC group were significantly increased,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression model showed that high Gensini score,high CK-MB,Killip heart function grade≥Ⅱ and history of hypertension were risk factors for poor CCC(P＜0.05),while high sur-vivin and high ABCA1 were protective factors(P＜0.05).The area under the curve,sensitivity and specificity of the two indexes combined to predict poor CCC were 0.949,90.70％and 92.52％,which were significantly better than the single detection.Conclusion Serum survivin and ABCA1 are closely relate to poor CCC in pa-tients with single coronary artery occlusion in AMI,the lower the serum levels of survivin and ABCA1,the greater the risk of poor CCC,the combine detection of the two has a high predictive value for poor CCC in pa-tients with single coronary artery occlusion in AMI.

Objective:To construct a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy and to conduct internal and external validation and evaluation of clinical benefit.Methods:A total of 1 071 patients with enterostomy treated in Zhongshan Hospital Affiliated to Fudan University from October 2013 to December 2020 were selected as the research objects by the convenient sampling method. Patients from October 2013 to December 2019 were selected as the modeling group ( n=943) . The data of patients were obtained by questionnaire and other methods. The clinical prediction model of early postoperative parastomal hernia in patients with enterostomy was constructed based on Cox regression analysis and the model was internally verified by Bootstrap method. Patients from January to December 2020 were selected as the validation group ( n=128) for external validation of the model. C-statistic, area under receiver operating characteristic curve and calibration map were used to evaluate the discrimination and calibration of the model. Decision curve analysis was used to draw decision curve analysis chart to evaluate the clinical benefit of the prediction model. Results:Age, history of alcohol consumption, postoperative body mass index, diabetes mellitus, respiratory diseases, history of abdominal surgery, stoma route, stoma nature and C-reactive protein were independent influencing factors for early postoperative parastomal hernia in patients with enterostomy ( P<0.05) . The C- index value of early postoperative nomogram was 0.710 (95% CI: 0.660-0.750) . Conclusions:The clinical prediction model of early parastomal hernia in patients with enterostomy has good predictive performance, which can help clinical medical staff to screen out high-risk groups in time and guide medical staff to focus on prevention.

Objective:To construct a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy and to conduct internal and external validation and evaluation of clinical benefit.Methods:A total of 1 071 patients with enterostomy treated in Zhongshan Hospital Affiliated to Fudan University from October 2013 to December 2020 were selected as the research objects by the convenient sampling method. Patients from October 2013 to December 2019 were selected as the modeling group ( n=943) . The data of patients were obtained by questionnaire and other methods. The clinical prediction model of early postoperative parastomal hernia in patients with enterostomy was constructed based on Cox regression analysis and the model was internally verified by Bootstrap method. Patients from January to December 2020 were selected as the validation group ( n=128) for external validation of the model. C-statistic, area under receiver operating characteristic curve and calibration map were used to evaluate the discrimination and calibration of the model. Decision curve analysis was used to draw decision curve analysis chart to evaluate the clinical benefit of the prediction model. Results:Age, history of alcohol consumption, postoperative body mass index, diabetes mellitus, respiratory diseases, history of abdominal surgery, stoma route, stoma nature and C-reactive protein were independent influencing factors for early postoperative parastomal hernia in patients with enterostomy ( P<0.05) . The C- index value of early postoperative nomogram was 0.710 (95% CI: 0.660-0.750) . Conclusions:The clinical prediction model of early parastomal hernia in patients with enterostomy has good predictive performance, which can help clinical medical staff to screen out high-risk groups in time and guide medical staff to focus on prevention.

Objective To determine whether local gradient fluid shear stress(FSS)causes a specific distribution of intracellular calcium ion concentration,which ultimately determines the direction of cell migration.Methods Numerical simulations were performed using COMSOL software.The method of staining intracellular calcium ion for RAW264.7 osteoclast precursors was established.After applying gradient FSS on the cells,the distribution and dynamic changes of intracellular calcium ion concentration and cell migration parameters were analyzed.Results Osteoclast precursors tended to migrate towards regions with lower FSS,and oscillatory flow regulated the distribution of intracellular calcium ions along the direction of cell migration.After blocking phospholipase C(PLC),mechanosensitive cation-selective channels(MSCC),endoplasmic reticulum(ER),and removing extracellular calcium,the migration speed of cells towards the low FSS direction was significantly reduced,but the migration speed along the liquid flow direction was significantly enhanced.Meanwhile,the calcium ion distribution along the liquid flow direction was significantly increased.Conclusions Osteoclast precursors can sense the FSS gradient,resulting in a specific distribution of intracellular calcium ions along the direction of migration.This ultimately leads to the migration of osteoclast precursors towards regions with lower FSS.This study provides important basic data for ultimately elucidating the cellular and molecular mechanisms of bone tissue remodeling under dynamic external forces.

With continuous advancements in medical technology, the tools and techniques for intravenous therapy and infusion are also evolving and innovating. This paper summarizes and analyzes the current application status of intravenous therapy infusion tools and techniques, thus providing deep reflections and suggestions to serve as a beneficial reference and guide for the development of these tools and techniques in China.