ObjectiveTo analyze the characteristics of left ventricular (LV) twist and discuss the relationship between LV ejection fraction (LVEF) and LV twist in patients with chronic kidney disease (CKD) by two-dimensional speckle tracking imaging (2D-STI).MethodsForty-six patients with CKD and 30 healthy controls were enrolled in this study. After conventional echocardiography, LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method and the LVEF was calculated. And relevant parameters of LV rotation and twist were measured by speckle tracking imaging. Correlation analysis of LVEDV, LVESV and LV peak rotation and twist were analyzed respectively. ResultsCompared with the control group, LV peak twist and the apical rotation were decreased in CKD patients, which was statistically significant (t=0.002 and 0.020, bothP<0.05). The inferior wall and posterior intermediate septum of basal segment were significantly decreased (t=0.044 and 0.041, both P<0.05). Pearson correlation analysis revealed LV apical peak rotation had a relationship with LVEDV and LVESV (r= 0.355 and 0.409, bothP<0.01).Conclusion2D-STI is an practical noninvasive method which can analyze LV twist accurately and recognize LV systolic dysfunction of CKD patients sensitively.

Objective To evaluate global left ventricular(LV) strain of patients with chronic renal failure(CRF) by three-dimensional speckle tracking imaging(3D-STI) and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia (pre-dialysis),and 20 healthy controls.Global peak longitudinal strain (GPSL),global peak area strain(GPSA) and global peak radial strain(GPSR) were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups(F =13.28,4.65,4.68,P ＜ 0.01) as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48(GPSL),4.19(GPSA),4.72(GPSR),P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 (GPSL),P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF(r =-0.679,-0.781,0.719,P ＜0.01).Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS ) combined with detection of immunoglobulin (Ig ) and T‐cell receptor (TCR ) gene rearrangements in primary gastrointestinal lymphoma (PGIL) .Methods From 12nd January ,2012 to 23rd May ,2014 ,the clinical data of 24 patients with suspicious PGIL under endoscopy (regular biopsy negative and without treatment) and underwent further EUS examination was retrospectively analyzed .All patients received EUS‐guided biopsy or EUS‐guided fine needle aspiration (FNA) and the tissue specimens were detected for Ig and TCR gene rearrangements .Considering biopsy result ,surgical pathological diagnosis and follow‐up result as gold standard ,the clinical significance of sensitivity ,specificity ,positive predictive value (PPV) , negative predictive value (NPV ) and accuracy of EUS combined with Ig /TCR gene rearrangements in PGIL were explored .Results Among 24 patients ,19 patients were finally diagnosed as PGIL ,which were all non‐Hodgkin′s lymphoma (NHL ) ;monoclonal gene rearrangement was found in 13 cases of the 19 cases .The left five cases were not lymphoma lesions (three cases of gastritis ,one case of leather stomach and one case of malignant melanoma) with no monoclonal gene rearrangement .In cases diagnosed as PGIL , 14 were B cell NHL ,which included eight cases of muscosa‐associated lymphoid tissue (MALT) lymphoma and six cases of diffuse large B cell lymphoma .Of which ,immunoglobulin heavy chain (IgH)/immunoglobulin kappa (IgK) gene rearrangement was found in 11 cases .A total of five cases were T cell NHL including one case of anaplastic large cell lymphoma , one case of NK /T cell lymphoma and three cases of enteropathy‐associated T‐cell lymphomas . TCR gene rearrangement was found in two cases .Because theoretically ,there was no gene rearrangement in natural killer (NK )/T cell lymphoma ,so NK /T cell lymphoma was excluded from statistical analysis .The sensitivity ,specificity ,PPV ,NPV and accuracy of EUS combined with Ig /TCR gene rearrangements detection in PGIL were 72 .2% ,100 .0% ,100 .0% , 50 .0% and 78 .3% ,respectively .Conclusion The detection of monoclonal gene rearrangement in tissues from EUS‐guided biopsy or EUS‐guided FNA had better diagnostic value in PGIL ,which improved the objectivity and accuracy of lymphoma diagnosis .

To study the inhibitory effect of RNA interference (RNAi) on MMP-9 gene expression in THP-1 cell line.To investigate the application of RNAi on the therapy of leukemia.Methods:Small interfering RNA ( siRNA) for MMP-9 gene was designed and transfected into THP-1 cells.MMP-9 mRNA expression was assessed by RT-PCR, and MMP-9 protein expression was tested by Western blot.MTT and trypan blue staining were used to observe the effect on the proliferation of THP-1 cells after RNAi.The changes in cell morphology were observed under the microscope.Results:The expressions of MMP-9 mRNA and protein were inhibited in THP-1 MMP-9 siRNA-transfected cells ,significantly lower than those of control cells.The results of MTT and trypan blue staining in-dicated that the proliferation ability of THP-1 cells obviously decreased after siRNA-transfected 48h and 72h.The growth of cells was in-hibited and the cells survival rate was significantly lower than that of control group ( P<0.05 ).The cells of control groups grew semi-quote wall under inverted microscope.The outline of cells was clear and the shape was uniform.The cells grew vigorously.While the growth of cells in siRNA group was inhibited.The morphology of siRNA group cells changed obviously by the Wright staining.Most cells expressed changes of apoptosis.Conclusion: siRNA for MMP-9 gene can not only reduce the expressions of MMP-9 mRNA and protein,but also inhibit the proliferation and induce apoptosis of THP-1 cells.

Objective To study the CT perfusion imaging features of pancreas under liver cirrhosis.Methods 191 cases including 48 normal controls(group A)and 143 patients with liver cirrhosis(group B)were randomly collected according to the inclusion and exclusion criteria.The scope of pancreatic perfusion imaging scan was determined based on conventional plain CT scan of middle and upper abdomen.All patients were injected with contrast agent at the antecubital vein tunnel group and then with normal saline at the same rate.The original perfusion images were transmitted to the workstation and were analyzed by the pancreatic perfusion software package,and the perfusion parameters were recorded for statistical analysis.Results (1)There were statistical differences in pancreatic perfusion parameter values,namely blood flow(BF),blood volume(BV)and mean transit time(MTT),between group A and group B(P<0.05).BF and BV of group B were lower than those of group A but MTT was higher than that of group A,and there was no statistical difference in permeability surface(PS)(P>0.05).(2)For group B,each pancreas part(head,body and tail)had no statistical difference in perfusion parameter values,namely BF,BV,PS and MTT(P>0.05).(3)For group B which was divided into three groups according to Child-Pugh,there were statistical differences in parameter values BF and BV(P<0.05)among the three groups and no statistical differences in BF and BV among any two of the groups(P<0.05);there were no statistical differences in PS and MTT among the three groups.(4)In group B,there was a statistical difference in BF between the subgroup with collateral circulation and the one without collateral circulation(P<0.05),the subgroup with collateral circulation showed lower BF than that of the subgroup without collateral circulation and there were no statistical differences in BV,PS and MTT(P>0.05).Conclusion Liver cirrhosis can result in microcirculation disturbance of pancreas,the change in microcirculation varies depending on the degree of liver cirrhosis, and CT perfusion imaging is helpful to the evaluation of pancreatic microcirculation in the state of liver cirrhosis.

Objective To study the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions (SPL) rapid on-site evaluation (ROSE).Methods From February 2011 to October 2014,225 patients with SPL who underwent EUS-FNA and obtained the cytological diagnosis were enrolled.The lesions were finally diagnosed according to pathological results,imaging and follow-up data,and then the sensitivity,specificity,and accuracy of EUS-FNA in the diagnosis of SPL were calculated based on the new papanicolaou society of cytopathology terminology.Logistic stepwise regression analysis was performed to analyze the risk factors.Results Among 225 patients with SPL,96 cases (42.7％)had uncertain cytological diagnosis,17.3％ (39/225) could not be diagnosed,8.0％ (18/225) were atypical lesions,and 17.3％ (39/225) were suspicious malignant carcinomas.Among 129 cases (57.3％)with certain cytological diagnosis,15.1％ (34/225) were benign lesions,14.7％ (33/225) were tumors (benign or others) and 27.6％ (62/225) were malignant tumors.When atypical lesions were added into non-tumor lesions or tumor lesions,the sensitivity,specificity and accuracy of diagnosis were 87.3 ％,91.7％,88.2％,and 94.7％,72.2％,90.3％,respectively.Serum CA125≥14 kU/L (odds ratio (OR) =7.13,95％ confidence interval (CI) 2.02 to 25.22,P=0.002) and history of biliary disease (OR=3.85,95％CI 1.22 to 12.51,P=0.022) were two independent risk factors of pancreatic tumors.Conclusions Despite of a high percentage of uncertain cytological diagnosis,EUS-FNA still has high diagnostic value in SPL when combined with the new papanicolaou society of cytopathology terminology.Furthermore,serum CA125≥14 kU/L and history of biliary disease may help to diagnose pancreatic tumors.

OBJECTIVE: In this paper, the key points of quality control and safety evaluation of human assisted reproductive medium were summarized to provide reference for the establishment of relevant standards and quality control in the future. METHODS: Through literature research, the key factors of quality control and risk control of human assisted reproductive medium were summarized, and the problems in clinical transformation were discussed. RESULTS: It is very important for the development of human assisted reproduction technology to study the active ingredients and their harmful degradation products and drugs in the culture medium of assisted reproduction. CONCLUSIONS At present, the biggest challenge is to effectively control the quality of the culture medium for human assisted reproduction, establish corresponding inspection methods and quality standards for the key components, ensure the safety and effectiveness during the product shelf life, and thus improve the success rate of human assisted reproduction technology.
Humans ; Quality Control ; Reproduction ; Reproductive Techniques, Assisted

Objective:Assisted traction technology is effective in increasing the rate of super minimally invasive surgery (SMIS) in patients with early gastric cancer (EGC), and shortening the operator′s learning curve. We adopt the variable angle traction technique of tissue clamp dental floss as a traction technique in this research.Methods:Patients with early gastric cancer who were treated with SMIS - non full layer resection of EGC were enrolled in the First Medical Center of Chinese PLA General Hospital from January 2022 to June 2023. This research was carried out by experts at the same level. It was divided into two groups: traction and non-traction. Submucosal detachment time (SDT), submucosal detachment rate (SDS), lamina propria exposure, muscularis propria defect (MPD), bleeding during operation, block resection, surgical resection, hand operation expenses, and surgical instruments were recorded.Results:Nine patients adopted variable angle traction, and 9 patients did not. The overall resection rate and curative resection rate of both groups were 100%. The mean SDT time was 28.00 (21.00, 34.00) min in traction group and 56.00 (40.00, 85.00) min in non traction group. And it had statistical significance ( P = 0.005). The SDS was (0.58 ± 0.21) cm 2/min in traction group and (0.23 ± 0.10) cm 2/min in non-traction group. And it had statistical significance ( P<0.05). Exposure of intrinsic muscle layer (IML): 8 cases in the traction group and 6 cases in the non-traction group. Intraoperative IML injury: in the traction group, 8 cases were MPD-0 and 1 case was MPD-Ft; in the non-traction group, 4 cases were MPD-0, 1 case was MPD-Pt, and 4 cases were MPD-Ft. There was no statistical difference between the two groups in terms of intraoperative bleeding, hospitalization expenses, surgical expenses, and the total hospitalization time. There were no serious adverse reactions or outcomes. Conclusions:The variable angle traction method accelerates SDT and SDS for SMIS-non full layer resection of EGC. It has the advantages of the sufficient separation of IML and mucosal layer, the deeper dissection depth, the low injury of IML, low intraoperative bleeding, and no additional medical costs. Therefore, this method can become an auxiliary treatment technology for SMIS.

ObjectiveTo observe the effects of Hirudo， Notoginseng Radix et Rhizoma， and drug pair on renal pathological morphology and protein phosphatase 2A （PP2A）/adenylate activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signal pathway in rats with chronic renal failure （CRF）. MethodThe 55 male SD rats were randomly divided into a normal group （n=11） and a modeling group （n=44）. The normal group was fed conventionally， and the modeling group was given 0.25 g·kg^-1·d^-1 adenine by gavage for 28 days to replicate the CRF model. After successful modeling， rats were randomly divided into model group， Hirudo group （3 g·kg^-1·d^-1）， Notoginseng Radix et Rhizoma group （3 g·kg^-1·d^-1）， and Hirudo + Notoginseng Radix et Rhizoma group （3 g·kg^-1·d^-1）， with 9 rats in each group. The normal group and model group were given a constant volume of normal saline by intragastric administration for 30 days. At the end of the experiment， the levels of serum creatinine （SCr） and urea nitrogen （BUN） in all groups were measured. The renal pathological morphology changes were observed by hematoxylin-eosin （HE） staining， Masson staining， and electron microscopy. The mRNA expressions of PP2A， AMPK， and mTOR were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The protein expression levels of PP2A， AMPK， phosphorylation（p）-AMPK， mTOR， and p-mTOR in renal tissue were detected by Western blot. ResultCompared with the normal group， the renal pathological structure changes were obvious， and the levels of SCr and BUN were significantly increased. The mRNA expression of PP2A， protein expression of PP2A， and p-mTOR/mTOR expression were significantly increased， and the p-AMPK/AMPK was significantly decreased in the model group （P<0.05）. Compared with the model group， the renal pathological morphology changes were significantly improved， and the levels of SCr and BUN were significantly decreased. The mRNA expression of PP2A， protein expression of PP2A， and p-mTOR/mTOR expression in the renal tissue were significantly decreased， and the p-AMPK/AMPK was significantly increased （P<0.05） in all groups after drug intervention. In addition， the effect in the Hirudo+Notoginseng Radix et Rhizoma group was better. The mRNA expression levels of AMPK and mTOR in the renal tissue were not significantly different among the normal group， model group， and other groups. ConclusionThe efficacy of Hirudo and Notoginseng Radix et Rhizoma pairs in improving renal fibrosis in rats with CRF is significantly better than that of the single drug， and its improvement on renal fibrosis in rats with CRF may be related to the regulation of PP2A/AMPK/mTOR signaling pathway.

OBJECTIVE To establish the quality standard of Onosma echioides . METHODS Sixteen batches of O. echioides from different sources were collected to observe their appearance ，microscopic powder identification ，and TLC identification ；the impurity，moisture，total ash and acid -insoluble ash of the medicinal materials were examined . The total pigment content of hydroxynaphthoquinone in O. echioides was determined by UV -visible spectrophotometry ；the contents of alkannin and β，β′- dimethylacrylalkannin in O. echioides were determined by HPLC . RESULTS Medicinal material and powder of O. echioides were purplish red ；non-glandular single cells ，embolized cells ，parenchyma cells ，reticulate ducts could be seen microscopically . TLC results showed that the color and change of the spots in the chromatogram of test sample were consistent with that of the control . The contents of moisture ，total ash and acid insoluble ashshall not exceed 13.0%，18.0%，6.0%. The total pigment content of hydroxynaphthoquinone should not be less than 0.80%. The content of alkannin was recommended to be no less than 0.06 mg/g. The content of β，β′-dimethylacrylalkannin was recommended to be no less than 0.60 mg/g. CONCLUSIONS The established standard can provide reference for the scientific evaluation of the quality of the medicinal materials of O. echioides.