Objective:To investigate the expression of serum galectin-3 (Gal-3), cystatin-C (Cys-C) and endothelin-1 (ET-1) in elderly patients with hypertension and analyze their correlation with left ventricular hypertrophy(LVH).Methods:A total of over 65 years old 110 patients with essential hypertension in Tieling Central Hospital from July 2018 to May 2019 were selected as hypertension group, according to the LVH, patients with essential hypertension were divided into (non LVH group, 66 patients) and LVH group (44 patients). At the same time, a total of 110 healthy people in the same period were selected as control group. The expressions of serum Gal-3, Cys-C and ET-1 in each group were compared, and the correlation between left ventricular mass index (LVMI) and Gal-3, Cys-C in patients with essential hypertension were analyzed.Results:The levels of Gal-3, Cys-C and ET-3 in the hypertension group were higher than those in the control group: (132.28 ± 38.18) μg/L vs. (110.60 ± 17.51) μg/L, (1.19 ± 0.12) mg/L vs. (0.81 ± 0.06) mg/L, (21.28 ± 0.72) ng/L vs. (16.50 ± 0.68) ng/L, and the differences were statistically significant ( P<0.05). The levels of Gal-3, Cys-C and ET-1 in the LVH group were significantly higher than those in the non LVH group: (159.75 ± 36.37) μg/L vs. (113.96 ± 26.79) μg/L, (1.24 ±) mg/L vs.(1.16 ± 0.08) mg/L, (21.84 ± 0.71) ng/L vs.(20.90 ± 0.41) ng/L, and the differences were statistically significant ( P<0.05). Pearson correlation analysis showed that LVMI was positively correlated with Gal-3( r=0.650, P<0.01), Cys-C( r=0.659, P<0.01) and ET-1( r=0.858, P<0.01). The receiver operating characteristic(ROC) curve showed that the area under the curve (AUC) of Gal-3 in diagnosing hypertensive LVH was 0.821, 95% CI 0.743-0.899, the cutoff value was 148.55 μg/L, and the sensitivity and specificity were 59.10% and 89.40%. The AUC of Cys-C in diagnosing hypertensive LVH was 0.672, 95% CI 0.558-0.786, the cutoff value was 1.320 mg/L, and the sensitivity and specificity were 43.20% and 98.50%. The AUC of ET-1 in diagnosing hypertensive LVH was 0.876, 95% CI 0.811-0.941, the cutoff value was 22.275 ng/L, and the sensitivity and specificity were 65.90% and 95.50%. The AUC of combined detection was 0.948, 95% CI 0.855-0.976, and the sensitivity and specificity were 84.10%, 98.50%. Conclusions:The serum levels of Gal-3, Cys-C and ET-1 in elderly patients with hypertension are significantly increased, and there are a good correlation between them and LVH, and combined detection can be used as a sensitive index for the diagnosis of hypertensive LVH.

Biomedical Research ; trends ; Female ; Humans ; Hydatidiform Mole ; diagnosis ; genetics ; Pregnancy ; Uterine Neoplasms ; diagnosis

Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N2-N3 nasopharyngeal carcinoma (NPC).Methods The clinical data of 915 patients with T1-4N2-3M0 NPC from 2007 to 2010 were retrospectively analyzed.A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT =0 group,concurrent chemoradiotherapy group) for age,N stage,pathological subtype,and NACT regimen.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),recurrence-free survival (RFS),and distant metastasis-free survival (DMFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox proportional hazards model was used for multivariate prognostic analysis.Results For the NACT≥ 3,NACT =2,and NACT =0 groups,the 5-year OS rates were 89.4％,81.6％,and 73.7％,respectively (P=O.000),the 5-year DFS rates were 83.2％,69.8％,and 64.2％,respectively (P=O.000),the 5-year RFS rates were 86.0％,76.0％,and 69.3％,respectively (P=0.001),and the 5-year DMFS rates were 86.6％,76.0％,and 68.3％,respectively (P=0.000).Three to four cycles of NACT was an independent protective factor for OS,DFS,RFS,and DMFS in patients with N2-N3 NPC.Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N2-N3 NPC.

Cytochrome P 4501 A 1, Cytochrome P 4501 B 1,Vascular endothelial growth factorand carbonic anhydrase Ⅸ belong to the downstream genes of aryl hydrocarbon receptor (AhR)and hypoxia inducible factor 1(HIF-1)signaling pathways. The abnormal expression of those genes were regarded to associated with the occurrence,development and angiogenesis of lung cancer. In this paper, the relationship between CYP1 A 1,CYP1 B 1,VEGF,CAⅨgenes and lung cancer was summarized, which aims to provide new ideas for lung cancer research.

Objective Through studying the effect of Tangnaikang (TNK) on the expression of Smad 2, 3, 7 mRNA of human renal tubular epithelial cells HK-2 induced by transforming growth factor-β1 (TGF-β1), to explore the mechanism of TNK on prevention and treatment of renal fibrosis. Methods The HK-2 cells were cultured by DMEM/F12 (1∶1) with 10% fetal bovine serum and divided into control group, TGF-β1 group (TGF-β1 10 ng/mL), blank serum control group (TGF-β1 10 ng/mL + 10% animal serum), TNK drug-containing serum therapy groups (TGF-β1 10 ng/mL + 5% TNK or + 10% TNK or + 20% TNK). After 24 h, the expression of Smad 2, 3, 7 mRNA were tested by fluorescence quantitatiye PCR assay. Results After the HK-2 cells were induced by TGF-β1, the expression of Smad 2, 3 mRNA were increased and the expression of Smad 7 mRNA was decreased compared with the control group (P<0.05). The expression of Smad 2, 3 mRNA were decreased and the expression of Smad 7 mRNA was increased in TNK drug-containing serum therapy groups compared with TGF-β1 group (P<0.05), but blank serum control group had no such effect. Conclution TNK could prevent the development of renal fibrosis to some extent through regulating the expression of Smads signaling pathway.

ObjectiveTo study the expressions of Ki-67 and p53 in the surface cells and polygonal cells in pulmonary sclerosing hemangioma(PSH)and investigate the relation of cell proliferation index and biological behaviour of the tumor.MethodsDouble-staining immunohistochemistry was used to detect the expressions of Ki-67 and CK8/18 protein. Double immunofluorescence staining was used to detect the expressions of p53 and AE1/AE3 protein. ResultsThe positive signal of AE1/AE3 and CK8/18 were localized in cytomembrane of surface cells. The positive signal of Ki-67 and p53 were localized in cell nucleus of the two kinds of cells.The positive rate of Ki-67 was under 1％ in surface cells and 1％-10 ％ in polygonal cells. p53 protein was mainly expressed in polygonal cells (6/9, 33.3 ％) and only exsited in seldom surface cells.ConclusionThere are differences on cellular morphous and immunophenotype between the surface cells and polygonal cells.The proliferation index and gene mutation are all predominant in polygonal cells than in surface cells. The biological behaviour of PSH maybe mainly be decided by the polygonal cells.

Objective To discuss the efficacy and safety of transversus abdominis plane block (TAPB) combined with rectus sheath block (RSB) for peritoneal dialysis catheter placement.Methods Thirty patients,ASA Ⅰ or Ⅱ,body mass index (BMI) 18-30 kg/m2,were scheduled for elective peritoneal dialysis catheter placement.They were randomly divided into three groups:local anesthesia group (group L),ultrasound-guided TAPB group (group T),ultrasound-guided TAPB combined with RSB group (group TR).Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before (T0) and after (T1) anaesthesia,the beginning of operation (T2) and abdomen-closing (T3),6 h (T4),12 h (T5),24 h (T6) after surgery.The consumption of local anesthetic during the surgery,dezocine after the surgery,the score of visual analogue scale (VAS) during rest and movement at T2-T6 and the adverse reactions were recorded.Results At T3,MAP and HR in group L and group T were higher than those in group TR (P ＜ 0.05).At T4 and T5,MAP and HR in group L were higher than those in group T and group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine in group L and group T were more than that in group TR (P ＜ 0.05);the consumption of local anesthetic ropivacaine and dezocine in group L were more than that in group T (P ＜ 0.05).The VAS score was significantly lower in group T and group TR at T3,T4,T5 compared with that in group L (P ＜ 0.05).There were no adverse reactions.Conclusion Ultrasound-guided TAPB combined with RSB is safe and efficacious in patients undergoing peritoneal dialysis catheter placement.

Objective As the first robotic da Vinci S surgical system(Intuitive Surgical,Inc,CA) in China,atrial septal de- fect repair(ASD) were performed in 15 patients using the robotic da Vinci S surgical system.Prespectively,we evaluated safety and efficacy in performing both simple and complex ASD repairs.Methods Eligible patients had ASD with mild to moderate pulmonary hypertension.Operative techniques included peripheral cardiopulmanary perfusion,a 2 cm working port only in the forth intercostal space,transthoracic aortic occlusion,and antegrade blood cardioplegia.Transesophageal echocardiograms(TEE) were done intraoper- atively with three-dimensienal reconstructions.Successful repairs were defined.Results Enhanced three-dimensional visualization of ASD allowed safe,dexterous intracardiac tissue manipulation.All patients had successful repairs including direct suturing in 10 cases, as well as pericardial patching in 5 cases.There were no operative deaths,strokes,or device-related complications.One patient was reexplored for bleeding.There were no incisional conversions.The mean cardiopulmonary bypass times and aortic crossclamp times were (109.5?12.6) minutes and (41.2?11.7) minutes.Both robotic repair and total operating times decreased significantly re- spectively.Total ICU length of stay for patients was 1 to 2 days.Conclusion This study shows that the da Vinci S surgical system (intuitive Surgical,lnc) has no limitations in performing ASD repairs.Articulated wrist-like instruments and three-dimensional visual- ization enabled precise tissue telemanipulation.

With the reform of medical education ("5+3"), the clinical mentors usually need to guide three kinds of students who are at different stages of medical education at the same time. And we summed up the core concept of clinical thinking and problems in its training, such as the imperfect teaching mode, insufficient teacher teaching awareness, students' difficulties in adapting to role changes, thinking patterns, and relying on auxiliary examinations, etc. For the training targets of three kinds of students are different, we explored and constructed a "multi-level integrated" training mode and the evaluation system of clinical thinking from the building of professional thinking, lectures, heuristic rounds, multi-aspect thinking mode extension, group learning and case discussions. So far, they have made effective achievements among a small part of students, which are hopefully useful for clinical training.

OBJECTIVETo investigate the clinical utility of short tandem repeats(STR) genotyping technique for diagnosis of partial hydatidiform moles (PHM).

METHODSTen cases with the original diagnosis of PHM and six cases diagnosed as "favour PHM" or "abnormal villous, PHM not excluded" were selected for the study. The clinical information and follow-up data were reviewed. Histopathologic features were evaluated along with p57 immunohistochemistry. After DNA extraction from each sample, genotyping was performed by AmpFlSTR(®) Identifiler™ PCR kit to amplify 15 STR polymorphism loci plus the amelogenin gender-determining in a single robust PCR.

RESULTSThe age of patients ranged from 18 to 49 years (mean=29 years, median=29 years). Two villous populations (7/16), irregular villous contour (13/16), at least moderate trophoblastic hyperplasia (2/16), cistern formation (8/16), syncytiotrophoblastic knuckles (14/16), trophoblastic pseudoinclusions (6/16) and nucleated fetal red blood cells (8/16) were presented in these cases. Of the cases in the study, STR genotyping identified 4 monospermic complete hydatidiform moles (MCM), 3 dispermic partial hydatidiform moles (DPM) and 9 hydropic abortions (HA). The misdiagnosis rate was 13/16 only relied on morphology evaluation. Immunostaining of p57 showed 3/4 of MCM were focally positive (<5%-20%+), 1/4 of MCM were diffusely positive (70%+), 3/3 of DPM were diffusely positive (≥50%+), 7/9 of HA were diffusely positive (≥50%+), and 2/9 of HA were focally positive (10%+).

CONCLUSIONSCombination of histomorphologic evaluation and p57 immunostaining is insufficient for a definitive diagnosis of PHM. STR genotyping offers an accurate diagnosis of PHM.

Abortion, Spontaneous ; Adolescent ; Adult ; Cyclin-Dependent Kinase Inhibitor p57 ; metabolism ; Female ; Genotype ; Genotyping Techniques ; Humans ; Hydatidiform Mole ; diagnosis ; genetics ; Immunohistochemistry ; Microsatellite Repeats ; Middle Aged ; Polymerase Chain Reaction ; Pregnancy ; Trophoblasts ; pathology ; Uterine Neoplasms ; diagnosis ; genetics ; Young Adult