Objective:To investigate the correlation between body composition and cardiovascular disease (CVD) in patients with chronic kidney disease (CKD).Methods:CKD patients who were hospitalized in the Department of Nephrology of Chongqing General Hospital from January 2017 to December 2019 and had complete clinical biochemical data were divided into CKD patients with CVD and CKD patients without CVD according to their medical history and corresponding auxiliary examinations. Clinical data were collected and anthropometric measurements were conducted. Skeletal muscle index (SMI), appendage lean mass/height 2, total body fat (TBF), visceral adipose tissue (VAT), bone mineral capacity, bone mineral density and et al, were measured by dual-energy X-ray absorptiometry. T test, U test and Chi-square test were used for statistical analysis. Logistic regression was used to analyze the relationship between body composition and CVD. Results:A total of 604 CKD patients were included in this study, including 560 patients (92.7%) with CKD stage 3, 44 patients (7.3%) with CKD stage 4, and 180 CKD patients with CVD (29.8%), 424 CKD patients without CVD (70.2%). Compared with CKD patients without CVD, the proportion of men, the proportion of hypertension, the proportion of diabetes, age, duration of CKD, systolic blood pressure, blood uric acid, waist to hip ratio and waist circumference were higher (all P<0.05), while low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and estimated glomerular filtration rate (eGFR) were lower in CKD patients with CVD (all P<0.05). In terms of body composition, SMI ( t=-11.964, P<0.001) and body mass index ( t=-4.462, P<0.001) in CKD patients with CVD were significantly lower than those in CKD patients without CVD, but VAT ( t=3.089, P=0.002) and TBF ( t=5.177, P<0.001) in CKD patients with CVD were significantly higher. After adjusting for confounders such as age, CKD duration, hypertension history, diabetes history, LDL-C, body mass index, eGFR, TBF, etc. by multivariate logistic regression analysis, the risk of CKD patients suffering from CVD increased significantly with the decrease of SMI [with SMI high tertile (36.37%-50.80%) as reference, SMI middle tertile (28.23%-36.31%): OR=1.49, 95% CI 1.24-1.71, P=0.003; SMI low tertile (15.28%-28.19%): OR=2.17, 95% CI 1.79-2.62, P<0.001], and VAT was not found to be associated with the risk of CVD in CKD patients ( P>0.05). Conclusion:Reduction of SMI is independently associated with CVD in CKD patients.

ObjectiveTo investigate the protective effect of erythropoietin (EPO) on human renal tubular epithelial-mesenchymal transition (EMT) induced by high glucose. MethodsCultured HK-2 cells were divided into 5 groups: normal control group, osmolarity control group, high glucose group, high glucose with EPO (5 U/ml)group and high glucose with EPO (10 U/ml)group. The mRNA expression of α-SMA, TGF-β1, Smad2, ILK of cells were measured by RT-PCR. The levels of intracellular α-SMA and TGF-β1 protein were measured by immunocytochemistry. ResultsCompared with the control groups, mRNA expression of α-SMA, TGF-β1, Smad2, ILK and protein expression of α-SMA and TGF-β1 were increased after high glucose treatment (P<0.01). Compared with the high glucose group, EPO 5 U/ml or EPO 10 U/ml remarkably down-regulated the expression of α-SMA, TGF-β1, Smad2 and ILK (P<0.01). ConclusionEPO can inhibit the progression of EMT and the up-regulation of TGF-β1, Smad2 and ILK induced by high glucose.

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

The incidence of thyroid nodule is on the rise year by year. The traditional treatment methods include surgical operation, thyroxine treatment and radioiodine treatment. In recent years, radiofrequency ablation has been widely used in thyroid diseases because of its advantages of simple operation, minimally invasive and beauty. This paper summarizes the application progress of radiofrequency ablation.

Objective To investigate the distribution of LAP+CD4+T cells in gastric carcinoma microenvironment and the correlation of LAP + CD4 + T cells with the progression of gastric tumor. Methods Forty gastric tumor patients and 20 healthy donors were enrolled in this study. The percentage of LAP+CD4+T cells in the peripheral blood and tumor tissue was detected by flow cytometry. The correlation of LAP+CD4+T cells with the progression of gastric tumor was analyzed. Results The percentage of LAP+CD4+T cells in the peripheral blood of gastric tumor patients was higher than that of health donors:(10.9±3.3)%vs. (4.3 ± 1.2)%;the percentage of LAP+CD4+T cells from tumor tissue was higher than that from non-tumor tissue:(13.5 ± 5.3)%vs. (4.7 ± 1.4)%. The percentage of LAP+CD4+T cells in peripheral blood from metastasis patients was higher than that from non-metastasis patients and health donors: (10.1 ± 6.4)% vs. (4.5 ± 1.3)% and (4.3 ± 1.2)%. Conclusions LAP+ CD4+ T cells accumulates in gastric carcinoma microenvironment and the percentage of LAP+CD4+T cells increases along with the progression of gastric tumor.

Objective To investigate the effect of aloe-emodin on Akt/mTOR,apoptosis and migration of autophagy-related pathway in colorectal cancer LOVO cells. Methods The LOVO cells were divided into control group(normal culture),low dose group(LOVO cells+10 μmol/L aloe-emodin culture 30 min), medium dose group (LOVO cells + 30 μmol/L aloe-emodin culture 30 min) and high dose group (LOVO cells + 50 μmol/L aloe veratin culture 30 min). The cell proliferation rate was measured by CCk-8 method at 24,48 and 72 h respectively. The apoptotic rate of each group was detected by flow cytometry. The migration ability of each group was detected by Transwell chamber. Western blot was used to detect the expression of IC3-Ⅰ,IC3-Ⅱ,Beclin-1,mTOR,p-mTOR,Akt and p-Akt.Results Compared with that of the control group,the cell rate,migration ability and apoptosis rate of the low dose group was not significantly changed(P>0.05).The cell rate and migration ability of the medium and high dose groups was significantly decreased and the apoptosis rate was significantly increased:0.43 ± 0.03,0.59 ± 0.04 vs.0.16 ± 0.00;0.57 ± 0.07,1.06 ± 0.17 vs.0.34 ± 0.02;0.37 ± 0.02, 0.49 ± 0.01 vs.0.13 ± 0.00,P<0.05,there was dose dependent(P<0.05).Compared with those of the control group,the expressions of IC3-Ⅰ,IC3-Ⅱ,Beclin-1,mTOR,p-mTOR,Akt and p-Akt in the low dose group showed no significant change(P>0.05),those were decreased in middle and high dose groups which showed significant differences:0.85 ± 0.08,0.37 ± 0.02 vs.2.08 ± 0.07;1.42 ± 0.09,1.19 ± 0.02 vs.1.97 ± 0.11;0.97 ± 0.00,0.84 ± 0.06 vs.1.19 ± 0.02;0.43 ± 0.02,0.31 ± 0.01 vs.0.98 ± 0.08,P<0.05, there were dose dependent (P < 0.05). Conclusions Aloe-emodin can promote autophagy, apoptosis there inhibit the growth,migration of colorectal cancer LOVO cells by reducing the expression of Akt/mTOR signaling pathway and reducing its phosphorylation level.

Objective:To explore the application effect of flipped classroom teaching method in musculoskeletal ultrasound teaching for standardized residency training of ultrasound department.Methods:In the study, 30 residents in ultrasound department of The Second Affiliated Hospital of Chongqing Medical University were collected and divided into control group ( n=15) and experimental group ( n=15). The control group was taught by traditional teaching method and the flipped teaching method was adopted in the experimental group. All residents were trained for 3 months. At the end of the training, theoretical test and operating skill test as well as the questionnaire survey were performed to evaluate the effects of these 2 teaching methods. SPSS 17.0 was used for t test and chi-square test. Results:The experimental group were superior to the control group in the aspects of the theoretical test scores, operating skill test scores, improving learning efficiency, building clinical thinking patterns, improving self-study ability, and there were significant differences. The satisfaction degree of teaching methods in the experiment group was higher than that in the control group, with significant differences ( P<0.001). Conclusion:Flipped classroom teaching method can improve the teaching outcomes and quality to ensure smooth completion of the teaching objectives.

To investigate the modulation effects of breathing movement on cardiovascular system and to study the physiological coupling relationship between respiration and cardiovascular system, we designed a comprehensive testing system for cardiorespiratory interaction research. This system, comprising three parts, i. e. physiological signal conditioning unit, data acquisition and USB medical isolation unit, and a PC based program, can acquire multiple physiological data such as respiratory flow, rib cage and abdomen movement, electrocardiograph, artery pulse wave, cardiac sounds, skin temperature, and electromyography simultaneously under certain experimental protocols. Furthermore this system can be used in research on short-term cardiovascular variability by paced breathing. Preliminary experiments showed that this system could accurately record rib cage and abdomen movement under very low breathing rate, using respiratory inductive plethysmography to acquire respiration signal in direct-current coupling mode. After calibration, this system can be used to estimate ventilation non-intrusively and correctly. The PC based program can generate audio and visual biofeedback signal, and guide the volunteers to perform a slow and regular breathing. An experiment on healthy volunteers showed that this system was able to guide the volunteers to do slow breathing effectively and simultaneously record multiple physiological data during the experiments. Signal processing techniques were used for off-line data analysis, such as non-invasive ventilation calibration, QRS complex wave detection, and respiratory sinus arrhythmia and pulse wave transit time calculation. The experiment result showed that the modulation effect on RR interval, respiratory sinus arrhythmia (RSA), pulse wave transit time (PWTT) by respiration would get stronger with the going of the slow and regular breathing.
Algorithms ; Artifacts ; Autonomic Nervous System ; physiopathology ; Diagnosis, Computer-Assisted ; methods ; Electrocardiography ; Equipment Design ; Heart ; physiology ; Humans ; Lung ; physiology ; Monitoring, Physiologic ; instrumentation ; methods ; Respiration ; Respiratory Mechanics ; physiology

Objective To construct oligomeric hyaluronic acid(5 KDa)-modified ellagic acid-loaded liposomes(EA-HA-L)to improve the aqueous solubility,in vitro transdermal effect and whitening activity of ellagic acid.Methods Oligomeric hyaluronic acid-modified cholesterol(HA-Chol)was prepared by esterification reaction and structurally characterized by FTIR and 1H NMR;Oligomeric hyaluronic acid-modified ellagic acid-loaded liposomes were prepared by film dispersion-ultrasound method,and the prescribing process was optimized by Box-Behnken design-response surface method,and the particle sizes,the polydispersity index(PDI),zeta potential and encapsulation rate of liposomes under the optimal prescribing process were determined;the difference in solubility between EA-HA-L and free EA was evaluated;in vitro transdermal effect of liposomes were investigated using rat abdominal skin;inhibitory effect on tyrosinase and intracellular tyrosinase in mouse melanoma cells(B16-F10)was surveyed via dopa oxidation method.Results HA-Chol was synthesized and characterized;the optimized prescription process was mass ratio of 10:1 for soy phospholipids to HA-Chol,lipid-drug ratio of 40:1,hydration temperature of 30℃,hydration time of 60 min,ultrasound intensity of 35％,ultrasound time of 21 min,and the particle size of EA-HA-L produced under the optimized prescription process was(140.30±1.30)nm,PDI was(0.29±0.01),the encapsulation rate of ellagic acid was 91.16％±3.06％,and the zeta potential was(-5.67±0.09)mV;after EA was encapsulated by liposomes,the solubility of EA in water increased by about 40-fold;the cumulative transdermal amount of EA-HA-L was 46.98±2.17 μg·cm-2 in 24 h,and the intradermal retention was 66.15±0.61 μg·cm-2,which was 1.72 times higher than that of free EA(P<0.0001)and 1.23 times higher than plain liposome(EA-L)(P<0.01);and the tyrosinase inhibitory activity of EA-HA-L was higher than that of both free EA and EA-L in the EA concentration range of 50-400 μg·mL-1.Conclusion Oligomeric hyaluronic acid-modified ellagic acid-loaded liposomes with small particle size and high encapsulation rate were successfully prepared.EA-HA-L significantly improved the water solubility of EA and possessed better transdermal effect and stronger whitening activity than free EA and EA-L.

Objective:To explore the agonistic CD40 antibody(CD40ScFv and CD40mAb)-mediated suppression of mouse breast cancer cell growth and change in tumor tissue Th1/Th2 balance,as well as the mechanism underlying its antitumor effect.Methods:The re-combinant plasmid containing the CD40ScFv gene fragment was transformed into the Rosetta strain of Escherichia coli to express and purify the recombinant functional CD40ScFv protein.The 4T1 mouse breast cancer cells were cultured in vitro.Balb/C tumor model mice were divided into CD40ScFv,CD40mAb agonist,and saline(NS group)groups,which were administered CD40ScFv,CD40mAb ago-nist,and saline,respectively,to observe the change in tumor volume.The tumor tissues were removed and enzyme-linked immunosor-bent assay(ELISA)was used to determine IL-12 concentration in the tumor tissue supernatants.The tumor infiltrating lymphocytes (TILs)were extracted by enzymatic digestion.The proportion of Th1 and Th2 cells in TILs was determined by flow cytometry.Results:The CD40ScFv protein was successfully identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blot.The molecular size and concentration of the purified protein were 27kDa and 1.12 mg/mL,respectively.The tumor sizes of the CD40ScFv and CD40mAb groups were(3.044±0.239)cm3and(2.749±0.261)cm3,respectively,which were significantly smaller(P<0.05)than that of the NS group(3.933±0.326)cm3.The tumor IL-12 concentration(determined by ELISA)in the CD40ScFv group(396.27±48.13)pg/mL and the CD40mAb agonist group(457.63±58.37)pg/mL were significantly higher(P<0.05)than that of the NS group(79.51±14.97) pg/mL.The results of flow cytometry showed that the excited Th1/Th2 cell ratios were 6.32±0.87 and 5.54±0.71 for the CD40ScFv and CD40mAb groups,respectively,which were significantly higher(P<0.05)than that of the NS group(1.79±0.38).Conclusions:The agonis-tic CD40 antibody inhibited tumor growth by regulating the Th1/Th2 ratio and IL-12 secretion via promotion of DC activation,which is one of the important mechanisms affecting Th1/Th2 balance in the tumor microenvironment