B and T lymphocyte attenuator (BTLA) is an immune checkpoint discovered in the early 21st century. BTLA is a typeⅠtransmembrane protein that belongs to Ig super family. The ligand for BTLA is herpesvirus-entry mediator (HVEM), a TNF receptor family protein. BTLA regulates the homeostasis of γδ T cells and innate lymphocytes (ILCs), promotes the survival of effector T cells and helps them differentiate into memory T cells. BTLA also plays an important role in maintaining the homeostasis of dendritic cells (DCs). Studies have shown that BTLA knockout mice have increased susceptibility to autoimmune diseases. Recent studies showed that BTLA also plays a crucial role in allergic diseases (such as allergic conjunctivitis and allergic rhinitis) and autoimmune diseases (such as systemic lupus erythematosus and ankylosing spondylitis). This article makes a systematic review about recent researches of BTLA in immune diseases.

Objective　To investigate the 2-year mortality of early captopril administration in patients with acute myocardial infarction. Methods　Seven thousand and seventy-nine patients with acute myocardial infarction were selected to follow-up from the collaborative hospital which finished more than 20 cases observation in CCS-I study. 76% were male and 24% were female. The mean age were 63.6±10.6 years. The follow-up rate was 88.5%. The mean follow-up period were 23.3±16.9 months. Results　The main baseline characteristics between the captopril group (n=3 554) and placebo group (n=3 525) were similar. During nearly 2-year follow-up, 568 (16.0%) cumulative deaths occurred in captopril group compared with 631 (17.9%) cumulative deaths in placebo group. This 10.6% proportional reduction in deaths was statistically significant (P=0.03). Cardiovascular deaths in captopril group (14.7%) was lower than that in placebo group (16.0%) (P=0.03), especially deaths due to heart failure ( 4.5% vs 6.0%) were more significantly different (P=0.004). Early captopril administration in acute myocardial patients could save 19 patients per 1 000 patients in 2-year follow-up. Early mortality in captopril group (9.0% vs 9.6%) was decreased about 6.3%, but long-term mortality (7.0% vs 8.3%) was decreased by 15.7% (P=0.05), especially deaths from heart failure was more significantly reduced. Conclusion　Early administration of captopril can significantly reduce the cumulative mortality and long-term mortality in patients with acute myocardial infarction.

Objective: To study the relationship between bone morphogenetic proteins(BMPs),BMP receptor type IA (BMPR IA) and the oncogenesis of squamous cell carcinoma in oral epithelia. Methods: Expression of BMP 2/4,BMPR IA was immunohistochemistry analyzed in the specimens obtained from buccal mucosa, including 18 cases of normal mucosa(NB), 24 cases of chronic inflammation(NCI) and 58 cases of oral squamous cell carcinoma(SCC). Result: Weak staining of BMP 2/4 and BMPR IA was observed in normal and chronic inflammation samples,while stroug staining was found in 52 out of 58 cases of oral SCC. No significant difference was found among the heighly,intermediately and poorly differentiated SCC groups.Conclusion: BMP 2/4,BMP IA might be involved in oncogenesis and development of squamous cell carcinoma of oral epithelium.

Objective　In an earlier interim report of the Chinese Cardiac Study (CCS-1) trial, 15 000 patients up to 36 hours after the onset of suspected acute myocardial infarction (AMI) were randomized to receive either oral captopril or matching placebo for one month. Results showed that captopril was associated with a non-significant reduction in 4-week mortality (681 ［9.1%］ captopril-allocated vs 730 ［9.7%］ placebo-allocated deaths; 2P=0.19), but the long-term effects remained uncertain. The present study reports on the long-term effect of early captopril treatment on mortality and other major events in AMI patients of the earlier CCS-1 trial. Methods　Long-term follow-up was carried out in those hospitals which had recruited more than 20 cases in the CCS-1 trial. 8000 patients with MI were thus selected for long-term follow-up. Data on 6749 patients (84.4%) were available. Results　Patient characteristics were comparable between the treatment group (n=3391) and the placebo group (n=3358). Average follow-up time was 23.4±16.9 months; average age was 63.6±10.6 years, and 76.2% were male. At the end of the follow-up time, cardiac function of NYHA Ⅲ-Ⅳ was 9.0% in the treatment group and 9.8% in the placebo group; the reinfarction rate was 5.6% vs. 6.0%; total cardiovascular events were 32.9% vs. 34.3%. Total mortality was 11.9% (n=404) vs 13.8% (n=463), with a 13.8% reduction in the captopril group (P=0.03). Cardiovascular mortality was 10.0% vs. 11.8% (P=0.01), death due to heart failure was 4.1% vs. 5.5% (P=0.01). From the above results, it is estimated that early treatment with captopril can save 19 lives per 1000 patients treated; patients with systolic blood pressure (SBP)≥100 mm Hg at entry would have a long-term mortality 12.4% in the treatment group vs. 13.8% in the placebo group (P=0.04) and patients with a heart rate (HR)≥60/minute at entry would have a long term mortality 12.0% in captopril groups vs. 14.5% in the placebo group (P=0.01). Conclusion　Early treatment with captopril during AMI for 4 weeks can significantly reduce long-term total mortality.

Pulse waves contain rich physiological and pathological information of the human vascular system. The pulse wave diagnosis systems are very helpful for the clinical diagnosis and treatment of cardiovascular diseases. Accurate pulse waveform is necessary to evaluate the performances of the pulse wave equipment. However, it is difficult to obtain accurate pulse waveform due to several kinds of physiological and pathological conditions for testing and maintaining the pulse wave acquisition devices. A pulse wave generator was designed and implemented in the present study for this application. The blood flow in the vessel was simulated by modeling the cardiovascular system with windkessel model. Pulse waves can be generated based on the vascular systems with four kinds of resistance. Some functional models such as setting up noise types and signal noise ratio (SNR) values were also added in the designed generator. With the need of portability, high speed dynamic response, scalability and low power consumption for the system, field programmable gate array (FPGA) was chosen as hardware platform, and almost all the works, such as developing an algorithm for pulse waveform and interfacing with memory and liquid crystal display (LCD), were implemented under the flow of system on a programmable chip (SOPC) development. When users input in the key parameters through LCD and touch screen, the corresponding pulse wave will be displayed on the LCD and the desired pulse waveform can be accessed from the analog output channel as well. The structure of the designed pulse wave generator is simple and it can provide accurate solutions for studying and teaching pulse waves and the detection of the equipments for acquisition and diagnosis of pulse wave.
Algorithms ; Equipment Design ; Heart Rate ; Humans ; Liquid Crystals ; Models, Cardiovascular ; Pulse Wave Analysis ; instrumentation ; Regional Blood Flow

Objective To investigate the effects of icariin (ICA) on partial vasoactive substances in monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) rat model.Methods Sixty male SD rats were randomly divided into five groups:normal control group,model control group,ICA low-,middle-and high-dose (20,40,80 mg · kg-1 · d-1) group,12 rats in each group.Except for normal control group,the rats were injected with MCT (50 mg · kg-1 · d-1) to establish PAH model.After 1 week MCT-injection,ICA was given by intragastric administration for 3 weeks according to different groups.Mean pulmonary artery pressure (mPAP) was recorded through catheter connected with Power Lab system.Except for normal control group,the right ventricular hypertrophy index (RVHI) was calculated using formula:right ventricle weight/the weight of left ventricle with septum× 100％.The morphology of lung artery was assessed by HE staining.Concentration of angiotensin Ⅱ (Ang Ⅱ),endothelin (ET),prostaglandine F2α(PGF2α),thromboxane A2(TXA2) and prostacyclin (PGI2) in serum was measured by ELISA kit assay.The protein levels of angiotensin converting enzyme (ACE),cyclooxygenase-2 (COX-2) and thromboxane A2 synthetase (TXAS) were analyzed by Western blotting,expression of ACE,COX-2 and TXAS mRNA was measured by real time RT-PCR.Results Compared with the normal control group,mPAP [(48.5±5.2) mmHg] and RVHI (33.3±3.8)％in model control group were significantly increased (P ＜ 0.05),the morphology revealed there was obvious artery remodeling at distal artery,the contents of Ang Ⅱ,PGFA2,TXA2 in serum were elevated,and ACE,COX-2 and TXAS gene expression was up-regulated in rats treated with MCT.ICA (40,80 mg · kg-1 · d-1) treatment significantly attenuated mPAP,RVHI and pulmonary artery remodeling (P ＜ 0.05),and decreased the contents of serum Ang Ⅱ,ET,PGF2β,TXA2,and PGI2,and inhibited the gene expression of ACE,COX-2 and TXAS.Conclusion ICA decreases the contents of AngⅡ,ET,PGI2,PGF2α and TXA2 in the serum of MCT-induced PAH rats,which may be one of the mechanisms underlying ICA inhibiting PAH.

Objective To study the effects of dihydroartemisinin and quinine on plasmodium falciparum gametocytes at early stage. Methods Eleven patients with falciparum malaria who had plasmodium falciparum gametocytes at early stage(PFGe) in bone marrow but no matured plasmodium falciparum gametocytes(PFGm) in bone marrow and peripheral blood were allocated to two groups.Group A(n=6) were administered orally with dihydroartemisinin at a total dosage of 480mg for 7 days and Group B(n=5) with quinine sulfate at a total dosage of 10?500 mg for 7 days.The number of gametocytes in bone marrow and peripheral blood was examined at regular time. Results PFGe in bone marrow disappeared in Group A on 10 th day after the first administration while existed in all the cases of Group B on 10 th day and still in 2 cases on 14 th day.The clearance time for peripheral PFGe was 4.8?0.9 days in Group A and 22.0?5.8 days in Group B. Conclusion Dihydroartemisinin can clear PFGe but quinine shows no this action.

A study was carried out in south of Vietnam 15 Patients with Plasmodium falciparum gametocytes and asexual parasites were distributed into groups A, B and C. Artesunate was given orally at a total dose of 600 mg for 5 days in group A, 200 mg for 2 days in group B and intravenously at a total dose of 360 mg for 5 days in group C respectively. Gametocytes count was done before medication and daily after medication. Meanwhile, Anopheles dirus as a vector was employed to study the infectivity of gametocyte, The result showed that the mean gametocyte clearance time in three groups were respectively 15.4?5.0, 20.6?4.8 and 20.3?4.0 days. The mosquitoes were not infected from the blood in 2, 5 and 5 of 5 patients respectively on days 7, 14 and 21 in group A; 1 and 5 of 5 patients on day 14 and 21 in group B; 2 of 5 patients and 3 of 3 patients on days 14 and 21 in group C. It indicates that artesunate has remarkable effect on Plasmodium falciparum gametocytemia and its infectivity to mosquitoes.

OBJECTIVETo study the chemical constituents of Incarvillea younghusbandii.

METHODThe chemical constituents were isolated by various column chromatographic methods and structurally identified by NMR and MS evidence.

RESULTFifteen compounds were obtained and identified as isobergapten (1), sphondin (2), imperatorin (3), xanthotoxin (4), phellopterin (5), heraclenol (6), rivulobirin A (7), methyl oleanolate (8), methyl caffeate (9), grevillic acid (10), boschniakinic acid (11), tert-O-beta-D-glucopyranosyl-(R)-heraclenol (12), 5-methoxy-8-O-beta-D-glucopyranosyloxypsoralen (13), 1'-O-beta-D-glucopyranosyl-3-hydroxynodakenetin (14) and phenylethyl-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside (15).

CONCLUSIONAll of these compounds were isolated from this plant for the first time and most of them are furocoumarins.

Benzopyrans ; chemistry ; Bignoniaceae ; chemistry ; Caffeic Acids ; chemistry ; Coumarins ; chemistry ; Furans ; chemistry ; Furocoumarins ; chemistry ; Magnetic Resonance Spectroscopy ; Methoxsalen ; analogs & derivatives ; chemistry ; Molecular Structure

Objective To investigate the risk factors of perioperative complications of laparoscopic radical distal gastrectomy and influence of body shape on the short-term therapeutic effects.Methods The retrospective case-control study was conducted.The clinicopathological data of 506 patients (328 males and 178 females,average age 60 years with the range of 24-85 years) who underwent laparoscopic radical distal gastrectomy+D2 lymph nodes dissection in the 8 clinical centers between March 2016 and November 2018 were collected,including 143 in the First Affiliated Hospital of Xiamen University,66 in the Affiliated Hospital of Qinghai University,66 in the Second Affiliated Hospital of Wenzhou Medical University,64 in the Zhongshan Hospital of Xiamen University,54 in the Affiliated Hangzhou First people's Hospital of Zhejiang University School of Medicine,48 in the Zhangzhou Affiliated Hospital of Fujian Medical University,35 in the Affiliated Quanzhou First Hospital of Fujian Medical University,30 in the Second Affiliated Hospital of Xiamen Medical College.The maximum thickness of subcutaneous fat at the level of umbilicus (USCF),the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UAPD),the maximum horizontal distance between the anterior abdominal skin and the back skin at the level of the umbilicus (UTD),the maximum verticaldistance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (XAPD),the maximum horizontal distance between the.anterior abdominal skin and the back skin at the level of the xiphoid bone (XTD),the distance between the anterior abdominal skin and the root of celiac artery (CAD) and the maximum horizontal distance at a right angle to CAD (CATD) were measured using preoperative imaging examinations.Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up situations;(3) risk factors analysis of perioperative complications;(4) influence of body shape related indexes on intraoperative situations and postoperative recovery:① Pearson univariate correlation analysis,② liner regression model analysis.Followup using outpatient examination and telephone interview was performed to detect the postoperative survival and tumor recurrence or metastasis up to December 2018.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of ordinal data were analyzed by Mann-Whitney U nonparametric test.Risk factors of perioperative complications of laparoscopic distal gastrectomy were analyzed by Logistic regression model.Influence of body shape related indexes on intraoperative situations and postoperative recovery was analyzed by Pearson univariate correlation analysis and liner regression model.Results (1) Intraoperative and postoperative situations:all the 506 patients underwent successful laparoscopic distal gastrectomy,including 103 with Billroth Ⅰ anastomosis,140 with Billroth Ⅱ anastomosis,201 with Billroth Ⅱ + Braun anastomosis,62 with Roux-en-Y anastomosis.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake and duration of postoperative hospital stay were (233±44)minutes,(102±86)mL,34±13,(3.6±1.5)days,(5.8±3.3)days,(8.3±3.8)days,(12.2±5.7)days respectively in the 506 patients.Of 506 patients,196 were defined as pathological stage Ⅰ,122 were defined as pathological stage Ⅱ and 188 were defined as pathological stage Ⅲ postoperatively.Of 506 patients,93 had 106 times of perioperative complications,including 33 times of pulmonary and upper respiratory infection,12 times of incisional infection,11 times of anastomotic leakage,11 times of abdominal infection,8 times of intestinal obstruction,8 times of gastroplegia,6 times of abdominal hemorrhage,5 times of bacteremia,3 times of anastomotic hemorrhage,3 times of lymph fluid leakage,2 times of pancreatic leakage,1 time of urinary infection,1 time of anatomotic stenosis,1 time of deep venous thrombosis and 1 time of pulmonary embolism;the same patient can merge multiple complications.Eleven patients were in the Clavien-Dindo classification ≥ Ⅲ.(2) Follow-up situations:465 of 506 patients were followed up for 1-32 months with a median time of 12 months.During the follow-up,451 had postoperative survival and 38 had tumor recurrence or metastasis.(3) Risk factors analysis of perioperative complications.① Results of univariate analysis showed that age,body mass index (BMI),preoperative hemoglobin,preoperative serum albumin and XAPD were related factors affecting perioperative complications of laparoscopic distal gastrectomy (x2 =10.289,7.427,5.269,5.481,4.285,P＜ 0.05).② Results of multivariate analysis showed that age,BMI,preoperative serum albumin were independent related factors affecting perioperative complications of laparoscopic distal gastrectomy (odds ratio =1.033,1.118,0.937,95％ interval confidence:1.011-1.057,1.025-1.219,0.887-0.990,P＜0.05).(4) Influence of body shape related indexes on intraoperative situations and postoperative recovery.① Results of Pearson univariate correlation analysis showed correlations between UAPD,XAPD,CAD,CATD and volume of intraoperative blood loss (r=0.107,0.169,0.179,0.106,P＜0.05),between UAPD,XAPD,CAD and the number of lymph nodes dissected (r=-0.137,-0.143,-0.173,P＜0.05),between USCF,XAPD and time to postoperative anal exsufflation (r =0.122,0.109,P＜0.05),between USCF,XAPD,CAD and time for initial fluid diet intake (r=0.132,0.108,0.132,P＜0.05),between USCF,XAPD and duration of postoperative hospital stay (r=0.116,0.100,P＜0.05).② Results of liner regression model analysis showed a positive correlation between CAD and volume of intraoperative blood loss (r =6.776),a negative correlation between CAD and the number of lymph nodes dissected (r =-0.841),with statistically significant differences (t =2.410,-1.992,P＜ 0.05);a positive correlation between USCF and time to postoperative anal exsufflation (r=0.170),between USCF and time for initial fluid diet intake (r=0.365),between USCF and duration of postoperative hospital stay (r=0.636) respectively,with statisticallysignificant differences (t =2.188,1.981,2.107,P＜ 0.05).Conclusions Abdominal shape can influence intraoperative situations and postoperative recovery of laparoscopic distal gastrectomy,but cannot increase risks ofperioperative complications.Age,BMI and preoperative serum albumin are independent related factors affecting perioperative complications of laparoscopic distal gastrectomy.