Animals ; Male ; Muscle, Skeletal ; metabolism ; Myogenic Regulatory Factors ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Running

Objective: To study the minor triterpenoid saponins from the roots of Panax notoginseng, which provided basis for the systematic research, quality control and safety evaluation of P. notoginseng. Methods The compounds were isolated and purified by MCI resin, ODS, along with Preparative-HPLC, and the structures were identified by spectroscopic analysis, and comparing with the pubished literature values. Results: Twelve monomeric compounds isolated from the roots of P. notoginseng, were identified as notoginsenoside P1 (1), notoginsenoside T5 (2), ginsenoside Rk3 (3), ginsenoside Rh4 (4), notoginsenoside T3 (5), 20(S)-protopanaxatriol (6), dammar 20 (21),24-diene-3β,6α,12β-triol (7), ginsenoside Rg3 (8), gypenoside XIII (9), ginsenoside Rk1 (10), ginsenoside Rg5 (11), and 20 (S)-ginsenoside Rh2 (12). Conclusion: Compound 1 is a new dammarane-type triterpenoid saponin

Objective To evaluate risk factors of hepatitis B virus (HBV) reactivation after transarterial chemoembolization (TACE) in patients with HBV-related hepatocellular carcinoma (HCC) with undetectable HBV DNA levels.Methods From August 2012 to Sepemter 2015,all patients who underwent TACE for HBV-related HCC with HBV DNA level less than 103 copies/ml in the First Affiliated Hospital of Soochow University were enrolled into the study.These patients were followed-up for at least 6 months after TACE to assess HBV reactivation.Univariate and multivariate logistic regression analyses were done to evaluate the risk factors related to HBV reactivation in these patients.Results With predetermined inclusion and exclusion criteria,99 patients were enrolled into the study.Twenty-four patients (24.2％) developed HBV reactivation after TACE in the followed-up period.The level of transaminase was significantly higher in the HBV reactivation group than the non HBV reactivation group (P ＜ 0.05).HBeAg positivity and tumors more than 3 in number were independent risk factors of HBV reactivation.Conclusion HCC patients with undetectable levels of HBV DNA had a significant risk of HBV reactivation after TACE.

Objective To investigate the role of activated cylic AMP(cAMP) signaling in chemical-induced podocyte injury.Methods Eight-weeks-old male BalB/C mice were randomly divided into three groups:control group,Adriamycin (ADR) group and Forskolin+ADR group.ADR nephropathy models were established by tail intravenous injection,and part of them were injected Forskolin,an agonist of adenylate cyclase,intraperitoneally.Phosphorylation of cAMP response element binding protein (CREB) was detected by laser confocal microscopy,morphology of foot processes were determined with transmission electron microscope,and WT-1 expression in glomeruli were detected by immunohistochemistry.Conditionally immortalized podocytes were treated with puromycin aminonucleoside (PAN),Exchange protein directly activated by cAMP (Epac) agonist 8-pCPT-2-O-Me-cAMP (2Me),protein kinase A (PKA) antagonist H89 and its agonist pCPT-cAMP(pCPT).Western blot was used to detect the expression levels of Epac,caspase3 and cleaved caspase3.PKA activity was assayed using cAMP-dependent protein kinase detection system.Cell viability was determined by a cell count kit and podocyte apoptosis was estimated by TUNEL staining.Mitochondrial membrane potential was evaluated by JC-1 staining.Results (1)Compared with ADR group,the urine albumin decreased significantly (P ＜ 0.05) among Forskolin + ADR group and the WT-1 positive cells per glomerulus increased obviously (P ＜ 0.05).(2)PAN decreased podocyte number in a time-dependent manner (P ＜ 0.05),pre-treatment with pCPT obviously inhibited PAN induced podocyte decrease (P ＜0.05),but H89 prevented the effect of pCPT in a dose-dependent manner (P ＜ 0.05).(3)JC-1 staining showed that the percentage of podocyte with green fluorescence for control,PAN and pCPT+PAN group were (12.67±2.15)％,(31.35±4.60)％ and (16.96 ± 2.51)％ respectively (P ＜ 0.05),and pretreatment with H89 inhibited the effect of pCPT (P ＜ 0.05).(4) PAN promoted podocyte apoptosis and cleaved caspase3 expression (P ＜ 0.05),and pretreatment with pCPT significantly prevented PAN-induced podocyte apoptosis and cleaved caspase3 expression (P ＜ 0.05).Conclusions cAMP signaling activation ameliorated podocyte injury in ADR nice and PAN-induced podocyte apoptosis,and cAMP/ PKA pathway may mediate these processes.

Eestablishing a scientific supervision system is essential to achieve a better environment for teaching and learning and improve teaching quality in medical college.We took undergraduate education evaluation as an important supervising subject and made a scientific evaluation program for teaching,learning,and testing,based on specific features of medical college.The practice of the program proves to be successful.We present the main contents in this article.

Objective To investigate the impact on registration accuracy with the different registration ranges of CBCT images and CT images.Methods CBCT and CT scans were performed on the of 5 patients.The registration ranges of five patients' images of abdomen,head and chest performed CBCT and CT scanning were processed with four modes.Mode 1:the registration range of CT images was larger than the registration range of CBCT images,mode 2:the registration range of CT images and CBCT images were equally,mode 3:taking a 5 cm translation of CT images range from mode 2,mode 4:The CBCT range and CT range reduced 2 cm both sides simultaneously from mode 2.Using the registration program from Insight Segmentation and Registration Toolkit (ITK) to the four modes,the Mean Square Difference (MSD) metric values of four modes after registration were compared and the relationship between mode 2 and another three modes was analyzed by paired t test.Results For the MSD metric values,mode 3 was maximum,mode 2 and 4 were minimum,and mode 1 was centered.The difference between the mode 2 and mode 4 was not statistically significant(P ＞ 0.05).The difference between the mode 2 and mode 1 was statistically significant(t =-4.586,-4.164,-5.618,P ＜ 0.05).The difference between the mode 2 and mode 3 was statistically significant(t =-6.423,-8.109,-19.601,P＜0.05).Conclusion The registration ranges of CBCT and CT images has a certain extent of influence on the accuracy of image registration.The closer the registration range of CBCT and CT is,the higher the registration accuracy is.

A 71-year-old man was admitted to hospital due to chest tightness and shortness of breath for more than half a year. Echocardiography suggested severe mitral regurgitation and tricuspid regurgitation. The patient underwent repair of atrial septal defect under cardiopulmonary bypass in 1983 and right kidney transplantation in 2010 due to renal failure. Mitral and tricuspid biovalve replacement was performed on the patient in 2019. No obvious infection and acute renal insufficiency occurred after the operation, and no abnormality was found in the artificial mitral valve and tricuspid valve on echocardiography. The patient was discharged successfully. There are few reports of cardiopulmonary bypass for renal transplant patients, especially for the second time. This case and perioperative management can provide reference for other surgeons.

Objective To evaluate the efficacy and safety of rabbit VX2 liver tumor model by percutaneous intratumoral injection with 188Re labeled stannic sulfur colloid.Methods The VX2 liver tumor model was established in 45 rabbits,which were randomly assigned to 3 groups (n =15) according to material used in intratumoral injections,as follows:0.1 ml normal saline (Group A,control group),absolute ethanol 1ml (Group B),37MBq (1mCi) 188Re labeled stannic sulfur colloid 0.1 ml (Group C).Five rabbits from each group were killed at intervals of 1,4 and 7d after injection and the volume of tumors were measured.Meanwhile,the histopathological changes and extent of cell apoptosis were evaluated.ALT and urea levels before the operation and at intervals of 1,4,7d post injection were also detected.Results In the first day after the injection,there was no significant statistical heterogeneity of the tumor volumes between each group.At 4th day post injection,tumor volumes of group A [(1 873.1 ± 77.3) mm3] showed significant statistical heterogeneity with group B [(905.7 ± 113.3) mm3] and C [(860.2 ± 59.6) mm3] (P ＜0.01),while there were no obvious statistical significance between group B and group C (P =0.421).At 7th day post injection,there were marked statistical significance of tumor volumes between A,B and C groups[respectively,(4093.1 ± 126.5)mm3,[(2569.5 ±64.6)mm3 and (2 169.6 ± 141.9)mm3](P＜0.01).At any time after injection,the apoptosis index (AI) of peritumoral tissue in group B and C was higher than control group with statistical significance (P ＜ 0.001).At 4th day post injection,AI of group C remained higher than group B (P ＜ 0.05).At 7th day,AI of group C progressively decreased,and there were no statistical difference between group B and group C (P ＞ 0.05).Conclusion Percutaneous intratumoral injection of 188Re labeled stannic sulfur colloid is a safety and effective approach to the treatment of VX2 liver tumor in rabbits.

Objective This study assesses a feasible and safe volume threshold for chest tube removal following a VATS lobectomy.Methods The study included 168 consecutive patients who underwent VATS lobectomy or bilobectomy with two insicion between August 2012 and February 2014.Eligible patients were randomized into 3 groups:Group A (chest tube removal at the drainage volume of 150 ml/d or less.n =49) ; Group B (chest tube was removed when the drainage volume was less than 300 ml/d.n =50) ; Group C(chest tube removal when the drainage was less than 450 ml/d.n =51).And there were 18 patients who were excluded.All patients got the same postoperative care with a clinical pathway,and all patients were followedup 7 days after discharge from hospital.The time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic,incidence of complications and thoracocentesis were measured.Results There were no statistically significant differences among 3 groups with general information and incidence of complication (P ＞ 0.05).And there were statistically significant differences between Group A and Group B with the time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic(P ＜ 0.05).But there were no statistically significant differences between Group A and Group B with incidence of thoracocentesis(P ＞0.05).Analysis of data showed no statistically significant differences between Group B and Group C with postoperative hospital stay,postoperative VAS values and dosage of analgesic (P ＞ 0.05),but there were statistically significant differences for incidence of thoracocentesis (P ＜ 0.05).Conclusion A 300 ml/d volume threshold for chest tube removoal after VATS lobectomy is feasible and safe,and it can bring more advantages than the 150 ml/d volume threshold.On the other hand,a 450 ml/d volume threshold for chest tube removoal after VATS lobectomy may increase the risk of thoracocentesis.

Objective To analyze the clinical characteristics and treatment strategy of ankle supination fracture in children.Methods From January 2012 through July 2014,89 children were treated at our department for ankle fracture caused by supination sprain according to their medical history,physical examination,X-ray films and CT three-dimensional reconstruction of the ankle.Appropriate protocols were applied on the basis of Lauge-Hansen classification,type and displacement of their fractures.Of them,52 belonged to the supination-adduction type (the extramalleolus fracture was of Odgen type Ⅶ in 51 children whose epiphyseal plate of distal fibula had not been closed),35 to the supination-extorsion type (32 cases had tri-plane fracture and 3 Tillaux fracture),and the remaining 2 did not fit the Lauge-Hansen classification.Surgical treatment was applied in 32 cases and conservative treatment in 57 ones.Results All the children received outpatient follow-up from 12 to 24 months(mean,18 months).No bone nonunion,osteoarthritis,or fracture malunion was found.The American Orthopaedic Foot & Ankle Society scores averaged 92 points (range,from 88 to 100 points) at the last follow-ups.Conclusions In children whose epiphyseal plate is nearly closed,supination-adduction sprain likely causes an extramalleolus fracture of Salter-Harris type Ⅰ or type Ⅱ,but in children whose epiphyseal plate is unclosed,an epiphyseal fracture of Odgen type Ⅶ is inclined to happen.A Tillaux fracture or tri-plane fracture at the level of distal tibiofibular syndesmosis results often from supination-extorsion sprain in children.For fractures involving epiphysis or epiphyseal plate,anatomical reduction and proper fixation are critical to functional recovery and reducing complications.