Aim This study is designed to analyze the influence of L-arginine (L-Arg) on expression level of angiotensin Ⅱ receptors (ATR) and the mitogen-activated protein kinase (MAPK) in cultured cardiomyocytes, with the intention to clarify the mechanisms relative to L-Arg's inhibitory effects on formation of cardiac hypertrophy. Methods Five groups of cardiomyocytes were established: control group, Angiotensin Ⅱ (ATⅡ) group, ATⅡ + Saralasin group, ATⅡ + L-Arg group, ATⅡ + L-Arg+L-NAME (N-nitro-L-arginine methyl ester) group. After 48 hours in supplemented culture, synthetic velocity of protein, NO production, expression level of ATR and p38 MAPK in cardiomyocytes were detected through the [3H]-leucine incorporation method, colorimetry, RT-PCR and western blotting, respectively. Results L-Arg could decrease the expression level of ATR1 and phosphorylated p38 MAPK, enhance NO production and reduce the synthetic velocity of protein in cultured cardiomyocytes stimulated by ATⅡ. Both ATⅡ and L-Arg had no influence on the expression level of angiotensin receptor type 2(ATR 2). Correlation analysis revealed that the relationship of negative correlation was significant between NO production and each of following factors: ATR1 expression level and phosphorylated p38MAPK expression level; As indicated by multiple stepwise regression analysis, not ATR2 expression level, but ATR1 expression level acted as the regression predictor of expression level of phosphorylated p38MAPK. Conclusion By enhancing myocardial NO production, L-Arg-NO pathway inhibits the p38MAPK activation mediated by ATR1, leading to inhibition of the hypertrophic response of cardiomyocytes. ATR2 seems to be independent from the activation process of p38 MAPK.

Objective To investigate the effect of hypobaric hypoxia postconditioning( HHP) on neurological func-tion prognosis in traumatic brain injury( TBI) rats. Methods 48 adult male Wistar rats were randomly divided into sham group(n=12),fpi group(n=18) and HHP group(n=18). The rat model of TBI was made by the method of fluid percussion injury( FPI) and rats in HHP group were submitted to HHP(360 Torr,2 h,3 trails spaced at 24 h) starting 3 h after FPI. The learning and memory abilitiy,motor coordination,anxiety and depression-like behaviors and surviving neurons of ipsilateral hippocampus were evaluated by Morris water maze( MWM) ,rotatord test,open-field test and hippocampus nissl stain respectly. Results Morris water maze:compared with sham and HHP group, learning and memory abilitiy of rats in fpi group were significantly decreased(F=4. 257 6,P<0. 05),whereas no difference was observed between sham and HHP group(P>0. 05);Rotatord test:compared with sham group,motor coordination of rats in HHP group were significantly decreased ( F=4. 335 , P<0. 05 ) , whereas no difference was observed between sham and fpi group ( P >0. 05 );Open-field test:compared with sham group, rats of fpi group showed significant anxiety and depression-like behavioral changes, whereas no difference was observed between sham and HHP group;Nissl stain:No difference of surviving neurons of ipsilateral hippocampus CA1 and CA3 re-gion was observed among three gourps at 3 d after FPI(P>0. 05). There were significantly fewer surviving neurons of ipsilateral hippocampus CA1 and CA3 region in fpi group than sham and HHP group at 24 d after FPI ( F =46. 758,5. 486,P<0. 05). Conclusion TBI induces learning and memory impairment,anxiety and depression-like behaviors and neurons death in hippocampus. HHP was first discovered having double effects on neurological func-tion prognosis in TBI rats. On the one hand,HHP can remove the impairment of learning and memory,anxiety and depression-like behaviors and neurons death in hippocampus;on the other hand,HHP impairs motor coordination at the same time.

Objective To study the clinical value of vascular ultrasound examination in detection of carotid artery disease. Methods 53 cases of ischemic cerebrovascular disease who served as experimental group,tested 387 vessels; and used the same period 55 cases of healthy persons as control group, tested 394 blood vessels. Comparison of two blood flow parameters between groups with differences in plaque detection. Results The results of vascular ultrasound examination could detect the visual display and quantitative carotid artery lesions in the experimental group a significant thickening of carotid artery IMT,carotid artery plaque prevalence was significantly higher than control group (P ＜0.01). Conclusion Vascular ultrasound examination was an effective screening method to detect ischemic cerebrovascular disease.

0.05). Conclusion Keloid mainly contains collagens of types Ⅰand Ⅲ, which is different in arrangement and content of collagens from that in scar. Compared with immunohistochemical technique, sirus red staining and polarization microscopy is a ideal method in analysis of the collagen formation and its content in human keloid.

Objective To investigate the CT manifestations in mesenteric injury.Methods CT imaging data were analyzed retrospectively in 28 patients with mesenteric injury caused by abdominal trauma,of which 26 patients were confirmed by surgery and 2 patients received conservative treatment.Results CT showed simple mesenteric injury in 5 cases,and multiple organ injury in other 23 cases.Only 18 cases were dignosed by preoperative abdominal CT,and the rate of missed diagnosis was 36%.Conclusion Multi-slice CT is an important evaluation method for the detection of acute mesenteric injury.

ObjectiveTo evaluate whether the human patient simulator-based training would improve the leadership and management skills in critical care unit physicians.MethodsThe 40 physicians was completed 1/2 day of training on the human patient simulator. Each subject participated in four scenarios in the rescue team and two experts scored emergency care skills and teamwork leadership/interpersonal skills. A multiple choice question examination and training effectiveness questionnaire were completed before and after training.ResultsThe training effectiveness had more advantages than traditional teaching.Improvement was seen in participants' scores in leadership skills ( 34.8％ ),interpersonal ability ( 36.5％ ) and self-confidence ( 29.9％ ).ConclusionHuman patient simulator training may be useful for leadership,teamwork,and self-confidence skills in critical care unit physicians.

Objective The aim of this study was to explore the effect of low density lipoprotein ( LDL) on the proliferation and differentiation of MC3T3-E1 osteoblasts, as well as the expression of low density lipoprotein receptor-related protein 5(LRP5) and dickkopf-1(DKK1) mRNA of MC3T3-E1 osteoblasts. The possible mechanisms of the treatment of atorvastatin on LDL expression in MC3T3-E1 osteoblasts were also investigated. Methods Proliferation, osteocalcin expression, LRP5, and expression of DKK1 mRNA of MC3T3-E1 with interaction of LDL at 0. 05, 0. 10, 0. 20 mg/ml levels after 24 h, 48 h, 72 h were detected by CCK8, ELISA, and fluorescence quantitative PCR. Furthermore, proliferation, osteocalcin expression, LRP5 and DKK1 mRNA of MC3T3-E1 after the treatment of atorvastatin of 10-6 mol/L and 10-5 mol/L were also be studied, respectively. Results The effect of LDL on proliferation, expression of osteocalcin and expression of LRP5 and DKK1 mRNA in MC3T3-E1 osteoblasts was the most obvious under LDL with 0. 20 mg/ml level. Under that level, atorvastatin (10-6 mol/L or 10-5 mol/L) was able to make the proliferation of MC3T3-E1 osteoblasts in 48 h and 72 h be decreased, while significantly caused upregulation of osteocalcin, LRP5 mRNA expression; and down regulated DKK1 mRNA expression ( all P<0. 05). Conclusions Atorvastatin can reduce the inhibitory effect of LDL on the proliferation and differentiation of osteoblasts. The mechanisms of atorvastatin on osteoblasts are possibly related to the osteoblast proliferation and expression of LRP5 mRNA and DKK1 mRNA of osteoblasts of wnt signal pathway.

Objective To explore the detailed underlying molecular and signaling mechanisms in the effects of icariin on bone formation by an in vitro cell model. Methods The proliferation of MC3T3-E1 osteoblast-like cells was evaluated by MTT, and gene expression of cell cycle related proteins in MC3T3-E1 cells after icariin treatment was detected by real-time PCR. The phosphorylation of MAPK signals, including ERK, P38, and JNK was determined by Western blot, and then the inhibitors of MAPK signals were used to treat cells with icariin alone or together to determine the role of MAPKs in the process of icariin treatment on MC3T3-E1 cell proliferation. Alkaline phosphatase and Alizarin red staining were used to detect the formation of mineralization nodules, and gene expressions of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in osteoblasts after being treated by icariin were evaluated by real-time PCR. ICI182780, and nilutamide was used to decide the participation of estrogen and androgen receptor signals in the process of icariin treatment on the differentiation and mineralization of MC3T3-E1 cells. Results Treatment with icariin promoted MC3T3-E1 cell growth in a time- and dose-dependent manner. This treatment also revealed that icariin increased the expression of mRNAs encoding both cyclin E and PCNA, positive regulators of cell growth, but decreased levels of mRNAs encoding Cdkn2b, a negative regulator of cell cycle progression. When MC3T3-E1 cells were cultured in a differentiated condition, icariin enhanced mineralized nodule formation and increased the expression of mRNAs encoding alkaline phosphatase, type Ⅰ collagen, and osteocalcin. Treatment with icariin significantly induced phosphorylation of both ERK and JNK and this phosphorylated effect occurred very rapidly within 5 minutes and reached peak at 15 minutes. Furthermore, the stimulated effects of icariin on proliferation and gene expression of cyclin E, PCNA, and Cdkn2b in MC3T3-E1 cells were dramatically attenuated by treatment with both U0126 and SP600125, inhibitors of MAPKs. Interestingly, such stimulating effects of icariin were at least partly reduced by treatment with ICI182780, an inhibitor of estrogen receptor. Icariin induced mineralized nodule formation and gene expression of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in MC3T3-E1 cells were also partly reduced when the cells were treated with ICI182780. Conclusions Our findings indicate that the anabolic effect of icariin on bone formation is, at least partly, mediated through the MAPK signaling pathway in order to modulate osteoblast proliferation and differentiation.

Objective To compare the clinical value of three-dimensional dynamic contrast enhanced magnetic resonance angiography (3D DCE MRA) and digital subtraction angiography (DSA) in diagnosing inferior vena cava diseases in suspected case of Budd-Chiari syndrome (BCS).Methods Radiological findings of 91 suspected BCS cases obtained from 3D DCE MRA and DSA in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.DSA test was considered as golden standard,which assess the capacity of 3D DCE MRA in diagnosing inferior vena cava diseases,including sensitivity,specificity and accuracy.Kappa test was utilized to compare the coincidence ratio of 3D DCE MRA and DSA in diagnosing inferior vena cava diseases.Results Among 91 suspected BCS cases with 3D DCE MRA,a total of 17 cases without inferior vena cava diseases were misdiagnosed as inferior vena cava stenosis,two patients with inferior vena caval obstruction was misdiagnosed as falsely negative.Seventy-two patients with 3D DCE MRA were confirmed via DSA in diagnosing inferior vena cava diseases,sensitivity was up to 97.7％ (58/60),false positivity 54.8％ (17/31),specificity 45.2％ (14/31),respectively.Fair coincidence ratio of 3D DCE MRA and DSA in diagnosing inferior vena cava diseases (Kappa =0.474,P ＜ 0.05).Conclusions There could be clinical value of 3D DCE MRA for its high sensitivity and low specificity in diagnosing inferior vena cava diseases,and favorable coincidence ratio was discovered between 3D DCE MRA and DSA.Comprehensive consideration is needed for suspected cases of inferior vena cava stenosis detected by 3D DCE MRA,and further analysis may figure out potential causes of misdiagnosis and decline false positive events.

BACKGROUND: Early enteral nutrition (EEN) following liver transplantation can benefit to recover and guarantee the normal gastrointestinal tract function,which plays an important role on post-operational immunosuppressive therapy.OBJECTIVE: To conduct EEN on the patients undergoing liver transplantation,and observe the post-operation recovery of intestinal function.DESIGN: Case analysis.SETTING: The 81 Hospital of Chinese PLA.PARTICIPANTS: From April 2003 to June 2006,86 patients undergoing liver transplantation in Liver Transplantation Center at the 81 Hospital of Chinese PLA were enrolled,including 57 males and 29 females.They aged 21-68 years,with a mean of 48 years.Among them,there were 37 cases of primary hepatic carcinoma and 49 cases of posthepatitic cirrhosis; 8 cases graded in Child A (all hepatic carcinoma),34 cases in Child B,and 44 cases in Child C.And 5 cases were complicated with serious hepatitis liver function failure and hepatic coma.Informed consents were obtained from all the patients and relatives.Transplantation operation was approved by the hospital ethical committee.METHODS: Surgical approach was orthotopic liver transplantation through caval vein in 80 cases,typical orthotopie liver wansplantation without veno-venous bypass in 4 cases,and piggyback orthotopic liver transplantation in 2 cases.The average warm ischemia time was (4.8±2.4) minutes,and average cold ischemia time was (8.6±3.2) hours.Anhepatic phase was (84±28)minutes.Post-operational trigeminy immunity and anti-rejection therapy consisted of tacrolimus (Fujisawa product) +mycophenolate mofetil (Roche product) + prednisone (Pred).According to the presence of nasogastric feeding tube,the patients were divided into control group (n=49) and EEN group (n =37).There were no significant differences in the sex,age and general data of patients between the two groups.Control group adopted EEN mainly,while EEN group was fed with EEN via a nose-intestine nutritional tube,and they received short-peptide enteral nutrition (Pepti-2000) at 24 hours post-operation at the initial dose of 63-126 g/d,which was gradually increased to 372 g/d.Liquid diet was allowable by 3-5 days.MAIN OUTCOME MEASURES: ①Clinical recovery and complications of patients.②Liver function recovery indices such as total serum protein,albumin and prealbumin,as well as C reactive protein at days 1,3,5 post-operation.③Level of serum immune globulin at day 7 post-operation.RESULTS: Totally 86 patients were involved in the result analysis.①Clinical recovery and complications: In EEN group,abdominal distension occurred in 10 cases,diarrhea in 5 cases,and blocking or slippage of feeding tube in 3 cases; No emesia,back flow or aspirated pneumonia was found; In control group,2 cases appeared bile leakage,which was not detected in the EEN group.②Indices of liver function recovery: Compared with control group,the prealbumin level was significantly rised and C reactive protein was significantly decreased in the EEN group at days 3 and 5 (P ＜ 0.05).③Levels of serum immune globulin: Blood IgA and IgM of EEN group were significantly higher than those of control group at day 7 (P ＜ 0.05).CONCLUSION: EEN in post-operation patients can reduce stress,promote synthesize metabolism,improve the recovery of liver cells,and decrease the infection rate.