Objective To compare the diagnostic value of renal ultrasound scan (RUS) and 99Tcmdimercaptosuccinic acid (DMSA) renal scintigraphy in children with acute pyelonephritis (APN). Methods In all, 165 children with initial clinical diagnosis of APN, aged from 1.5 months to 11 yrs ( median 20 months), were included in the study, all of which were examined with RUS and DMSA renal scientigraphy. The diagnosis with DMSA renal scientigraphy results was taken as the standard reference to evaluate the diagnostic sensitivity and specificity of RUS. Results Of 99 out of all 330 kidneys that were found abnormal on DMSA renal scientigraphy, 31 were abnormal on RUS. Of the rest normal kidneys on DMSA scans renal scientigraphy, 4 were abnormal on RUS. Thus diagnostic sensitivity of RUS for APN was 31.3%(31/99) and specificity was 98.3% (227/231). Conclusions Although RUS provides with high diagnostic specificity for children with APN, its low sensitivity may underestimate the clinical evaluation of APN.More often than not, 99Tcm-DMSA renal scientigraphy is a clinical necesscity for the definite RUS diagnosis.

Objective To investigate the effects of simvastatin(Sim) and losartan(Los) on cardiac fibrosis and myocardial expression of MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA in pressure overloaded rat hearts. Methods The pressure overload model was induced by descending aortic constriction (DAC) in rats. SD rats were randomized into 6 groups (n=20 each) : normol control group, control sham group, DAC group, Los group (DAC+Los, 5 mg/kg), Sire group ( DAC + Sire, 2 mg/kg), Los + Sire group (DAC+Los+Sire, Los 5 mg/kg, Sire 2 mg/kg). Water, Los or Sire drug was administrated by garage daily beginning from day 5 after operation for 30 days. Collagen was measured on Masson stained myocardial sections, and the level of MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA in left ventricle were detected by RT-PCR. Results Collagen volume fraction (CVF) in DAC group was significantly higher than the normal control and sham groups (P<0.01) which could be significantly reduced by Los and Sire (P<0.05), especially in DAC + Los + Sire group (P<0.01). The levels of myocardial MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA were also significantly higher in DAC group than in normal control and sham groups (P<0.01). Treatment Sim and Los alone and especially in combination significantly decreased the TIMP-1 mRNA, TIMP-2 mRNA expressions (P<0.01) while MMP-2 mRNA, MMP-9 mRNA levels remained unchanged (P>0.05). Conclusion Upregulation of myocardial MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA expressions might contribute to myocardial fibrosis in this model, Sire and Los significantly inhibited myocardial fibrosis possibly by downregulating myocardial TIMP-1 mRNA, TIMP-2 mRNA expressions in this model.

Objective To explore the relationship between serum YKL-40 levels and endothelial function in patients with essential hypertension (EH).Method Sixty EH patients [34 male,aged between 43-76 years,mean(59 ±7)years]and 30 healthy subjects [17 male,mean age (57 ±5) years] were enrolled in this study.Serum YKL-40 levels were measured by enzyme immunoassay (ELISA).Endothelial function [endothelin-1 (ET-1),nitric oxide (NO),flow-mediated dilatation (FMD)] was also measured.EH patients were further divided to no metabolic syndrome and metabolic syndrome group.Results Serum uric acid,ET-1,hs-CRP were significantly higher while serum NO,FMD and NMD were significantly lower in EH group than in control group (all P ＜ 0.05).YKL-40 was significantly higher in EH group than in the control group [51.7 (35.6-341.9) μg/L vs.33.2 (23.3-167.3) μg/L,P ＜ 0.05] and significantly higher in EH patients with metabolic syndrome than in EH patients without metabolic syndrome(152.3 μg/L vs.94.2 μg/L,P ＜0.05).In this cohort,serum YKL-40 level was positively correlated with SBP,DBP,BMI,TG and hsCRP(r =0.360,0.303,0.281,0.216,0.530,all P ＜ 0.05) but not correlated with FMD,ET-1 and NO (all P ＞ 0.05).Conclusions Serum YKL-40 levels are increased compared to normal controls and positively correlated with blood pressure level but not with endothelial function parameters in hypertensive patients.Serum YKL-40 level might thus be used as a biomarker reflecting inflammation status other than endothelium function in hypertensive patients.

MicroRNAs (micro-ribonucleic acid,miRNAs) are small non-coding RNA molecules,which play an important role in regulating gene transcription.Recent research has found that miRNAs can be used as a new biomarker because of being involved in the progresses of cardiomyocyte development,proliferation and apoptosis.They play an important role in the early diagnosis,prognosis and treatment of acute myocardial infarction.However,there are still many problems and challenges in detection technology,mechanism research and clinical trials of miRNAs.

Objective To explore a method for isolation and culture Dispase Ⅱ and Trypsin-EDTA.Cells were seeded onto mitomycin C-treated of rat buccal mucosa stem cells and to identify the stem cells.Methods Epithelial cell mass were obtained by digesting rat buccal mucosa with 3T3 Swiss albino layer and cultured in DMEM for 24 hours,followed bv K-SFM culturing.Some cells were induced to osteocytes and adipocytes and underwent ALP testing after 72 hours.Five days later,the primary cells were digested with trypsin and inoculated onto collagen Ⅳ-coated flasks and cultured at room temperature for 20 minutes.The adherent cells continued to be cultured with epithelial stem cell medium,then examined for identifying the clones,osteocytes,adipocytes,cytokeratin and ALP staining.Results 83.96 percent of the primary epithelial cell mass were in G0/G1 phase by flow cytometry test. The clones were seen after 72 hours on 3T3 Swiss albino layer,and the osteocytes and adipocytes were positive.Cells were adhered quickly to collagen Ⅳ,in a shape of round or orbicular-ovate with strong refraction.The induced-osteocyte and adipocyte,cytokeratin and ALP were all positive.Conclusions The stem cell-like epithelial cells could be obtain using the 3T3 Swiss albino layer method.Sieved by collagen Ⅳ and cultured in epithelial stem cell medium could make the epithelial stem cells depurate and proliferate qnickly.

Objective To investigate the expression changes of myeloid-related protein-8 (MRP-8) and myeloid-related protein-14 (MRP-14) in children with Kawasaki disease (KD) and to obtain laboratory diagnostic serum markers and new targets for its drug therapy.Methods A total of 46 patients with KD(KD group) were enrolled from Jul.2009 to Dec.2010 and divided into the coronary artery dilatation(CAD) group(n =15) and the normal coronary artery group(n =31) ;Meanwhile,25 febrile patients with acute respiratory tract infection but without disease in the circulatory,blood,immune systems formed the non-KD febrile group.Twenty healthy children from the out-patient department formed the healthy control group.Peripheral venous blood was collected in the acute and subacute stage of KD.Levels of MRP-8/MRP-14 were detected with enzyme-linked immunosorbnent assay (ELISA).Gene expressions of MRP-8,MRP-14 in leukocytes were analyzed by semi-quantitative reverse transcription-polymerase chain reaction(RTPCR).Results The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in the leukocytes in the out-patient acute and subacute stage of KD were significantly higher than those in the non-KD febrile group and the healthy control group(all P ＜ 0.05) ;There was no significant difference between non-KD febrile group and healthy control group (P ＞ 0.05).The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in leukocyte in actue stage of KD were significantly higher than those in subacute stage(all P ＜ 0.001).The serum levels of MRP-8/MRP-14 as well as mRNA expressions of MRP-8 and MRP-14 in the acute and the subacute stage of CAD group were significantly higher than those in the normal coronary artery group(P ＜ 0.05).Conclusions MRP-8/MRP-14 may probably play a role in the pathogenesis of KD and can be used as a diagnostic indicator for KD;MRP-8/MRP-14 may be involved in the formation of coronary artery lesion and can be used as an effective predictor for the coronary artery lesion.

Objective To explore the ability and mechanism of insulin-like growth factor l (IGF-1) induced bone mesenchymal stem cells ( BMSCs) differentiation into cardiomyocyte-like cells ( CLCs).Methods BMSCs were isolated and purified in vitro.BMSCs were treated with control medium and 15 ng/ml IGF-I for 3,7, 14 and 21 d, respectively. The expression of Troponin-T ( TNT), Troponin-I (TNI) and pIGF-1R were c~etected by immunocytochemistry and Westem blot.In another experimental setting,BMSCs were treated with control medium and 15 ng/ml IGF-l,ICF-1 antaS;onist I-Ome AG538 (300 nmol/L) and 300 nmol/L I-Ome AG538 + 15 ng/ml IGF-1 for 3 t0 48 h,respectively.Phosphorylation status of ERKl/2 and AKT,the two downstream mediators of mitogen-activated protein kinase ( MAPK) kinase and phosphatidylinositol 3-kinase ( PBK) pathways,were detected by immunocytochemistry and Yvestem blot.Results After 3 t0 21 d exposrue to IGF-1, the expression of pIGF1R,TNT and TNI were significandy higher in 'IGF-1 group than those in control group,pIGF-IR peaked 14 d (all P ＜0.05).After 3 and 6 h treatment,the ratio of pAKT/AKT(0.17 ± 0.03)and pERK1/2/ERK1/2(0.06 ± 0.03)were significantly downregulated in I-Ome AG538 group compared to control group (1.00 ±0.05) (all P ＜ 0.05).The ratio of pAKT/AKT(1.00 ± 0.07) and pERK1/2/ERK1/2 (1.00 ± 0.09) were significantly upregulated in IGF-1 group compared to control group (0.72 ± 0.05) (all P ＜ 0.05),but the ratio of pAKT/AKT(0.31 ± 0.10)and pERK1/2/ERK1/2 (0.39 ±0.04) were significantly downregulated in I-Ome AG538 group compared to control group (0.63 ± 0.05) (all P ＜ 0.05),the value of gray scale of TNT (195.06 ± 5.98) and TNI (198.32 ± 3.46) in I-Ome AG538 + IGF-1 group were significantly upregnlated than that in IGF-1 group for TNT (188.70 ± 5.35) and TNI (176.10 ± 4.96) (all P ＜ 0.05).Conclusions IGF-1 could induce BMSCs differentiation into CLCs in vitro by activating MAPK and PI3K signaling pathways.

Objective To observe the exercise single photon emission computed tomograpby (SPECT)myocardial perfusion imaging of patients with myocardial bridge and assess the association between myocardial ischemia and extent of myocardial systolic compression.Methods Seventeen patients with myocardial bridge diagnosed by coronary angiogram were included and underwent exercise SPECT myocardial perfusion imaging.Results Abnormal SPECT perfusion imaging was evidenced in 12 out of 17 patients with myocardial bridge(2 out of 6 patients with systolic compression induced stenosis＜50%,3 out of 4 patients with systolic compression induced stenosis between 50%-75%and 7 out of 7 patients with the systolic compression induced stenosis between 75%-100%).Conclusion Exercise stress SPECT myocardial perfusion imaging could detect myocardial ischemia in patients with myocardial bridge and abnormal perfusion is positively related to the extent of systolic compression induced stenosis.

Objective To summarize our experience with intraoperative neural electrophysiological monitoring during spinal cord surgery. Methods The clinical data of 11 patients undergoing spinal cord surgery with intraoperative neural electrophysioiogical monitoring were retrospectively reviewed, and the monitoring was performed by recording the motor-evoked potential (MEP), somatosensory evoked potential (SEP), and evoked electromyography (EMG). Results Subtotal resection of the intramedullary cystic lesion was performed in 1 case and partial resection of the intramedullary tumor in another. In 9 cases of tethered spinal cord syndrome, obvious improvement was obtained in 8 cases, and the other 1 case showed no obvious changes in the symptoms after the operation. In all the 11 cases, the spinal cord remained intact and its function was totally preserved without damage of the eonus medullaris or the cauda equine. Conclusion Combined monitoring of MEP, SEP, and evoked EMG during spinal cord surgery is useful for protecting the spinal cord and the nerves roots, and may enhance the detection of the tethered tissue and ensure better safety of operations.

Objective To analyze the feasibility of local LINGO-1 polyclonal antibody administration for treatment of spinal cord injury in adult rats. Methods Twenty-four adult female SD rats were randomized into sham-operated group, rabbit IgG group and LINGO-1 antibody group. In the latter two groups, partial transaction of the T9 segment of the spinal cord was performed to completely sever the dorsal eorticospinal tract, followed immediately by administration of rabbit IgG and anti-LINGO polyclonal antibody via a mini-osmotic pump, respectively. At 3 and 28 days after the operation, the T8～10 segments of the spinal cord were harvested to prepare cryosections, and immunofluorescence staining was used to analyze the penetration of LINGO-1 polyclonal antibody into the spinal cord tissue and its specific binding to LINGO-1 molecules. Results In LINGO-1 antibody group, the presence of rabbit antibodies was detected at the injured sites of the spinal cord at 3 and 28 days after the operation. The mean immunofluorescence density was significantly lower in L1NGO-1 antibody group than in rabbit IgG group at 3 days after the operation (P<0.05). In rabbit IgG group, the mean immunofluorescence density for LINGO-1 in the crysections pre-treated with LINGO-1 polyclonal antibody was significantly lower than that in sections pre-treated with rabbit IgG(P<0.05). Conclusion Locally administered LINGO-1 polyclonal antibody can penetrate into the injured sites in the spinal cord in a wide time window and recognizes LINGO-1 molecule specifically, suggesting the feasibility of passive immunotherapy for spinal cord injury.