Hydrogen sulfide is found to be the third gasotransmitter.It exerts extensive biological effects in nerve system,cardiovascular system,gastrointestinal system,and so on.In cardiovascular system,it exerts the function of vasorelaxation,inhibition of vascular smooth mu-scle cells and cardioprotection.It is also concerted with many cardiovascular diseases such as pulmonary hypertension,hypertension,coronary heart disease,atherosclerosis.This review discusses the latest research progress in the significance of hydrogen sulfide in cardiovascular diseases.

Objective:To examinethe absolute numbers of cluster of differentiation (CD4) + T cell subsets in peripheral blood of patients with rheumatism and further to develop a new immunomodulatory therapies which aimed to restore their imbalanced CD4 + T lymphocyte subpopulation. Methods:A total of 6 395 rheumatic patients [4 430 females, 1 965 males, mean age (49±15) years] and 206 healthy controls (HCs) were enrolled in this retrospective cross-sectional study, which included rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), Psoriatic arthritis (PsA), systemic sclerosis (SSc), primary Sj?gren′s syndrome (pSS), Be?het's disease (BD), dermatomyositis/polymyositis (DM/PM), gout and vasculitis. Some patients received treatment combined with immunoregulatory drugs (IMiDs) such as low-dose interleukin (IL)-2, rapamycin, metformin, retinoic acid and coenzyme Q10. The absolute numbers of T helper cell (Th)1, Th2, Th17 and regulatory T cell (Treg) in peripheral blood (PB) of these individuals were measured by Flow Cytometery (FCM). Independent sample t test and paired sample t test were used to compare the levels of CD4 + T cell subsets in PB of patients and HCs, before and after treatment respectively, and P<0.05 was considered statistically significant. Results:Compared with HCs, the mean absolute number of Treg was significantly decreased [(31±15) cell/μl vs (27±17) cell/μl, t=3.407, P<0.01] and the ratio of Th17/Treg was increased in all patients [(0.3±0.2) vs ( 0.4±0.7), t=-9.508, P<0.01]. There was a significant increase in the number of Th17 in patients with AS [(10±8) cell/μl, t=-5.403, P<0.01], PsA[ (11±11) cell/μl, t=-3.829, P<0.01], SSc [(7±6) cell/μl, t=3.114, P<0.01], BD [(11±9) cell/μl), t=-4.774, P<0.01] and gout [(11±9) cell/μl, t= -4.604, P<0.01) , and we observed lower level of Treg in patients with RA[(28±15) cell/μl, t=3.032, P<0.01], SLE [(21±21) cell/μl, t=6.836, P<0.01], AS [(28±15) cell/μl, t=2.216, P<0.05], SSc [(27±16) cell/μl, t=3.698, P<0.05], BD [(27±17) cell/μl, t=2.502, P<0.05], DM/PM [(27±22) cell/μl, t=2.974, P<0.01) and gout [(28±15) cell/μl, t=2.079, P<0.05). After IMiDs combination treatment, the levels of CD4 + T subsets were increased. Interestingly, the expansion of Treg was much more dramatical than those of other effector T cells, resulting in a decrease in ratios of Th17/Treg, especially in SLE [(0.6±1.0) vs (0.5±0.4), t=3.157 , P<0.01]. Conclusion:Impaired balance of pro- and anti-inflammatory immune cells, especially insufficiency of Treg, might be a cornerstone of the pathogenesis of rheumatism. The new immunomodulatory therapies could relatively specifically promote Treg proliferation and restored patients' autoimmune tolerance, which isexpected to provide a new strategy for the treatment of rheumatism.

BACKGROUND:Tissue-engineered bone can be obtained by the combination of chondrocytes and polyglycolic acid scaffold. OBJECTIVE:To investigate the effect of alogeneic chondrocytes/polyglycolic acid scaffold compound in the repair of thyroid cartilage defects in rabbits. METHODS: Twenty New Zealand adult rabbits were randomly divided into experimental group with implantation of alogeneic chondrocytes/polyglycolic acid scaffold compound and control group with implantation of polyglycolic acid scaffold. Gross and histological observations were done at 4 and 8 weeks after implantation. RESULTS AND CONCLUSION: (1) Gross observation results: 4 weeks after surgery, cartilage defects in the experimental group were repaired certainly, and no necrosis appeared in the repair area; in the control group, the defects were filed with muscle and connective tissues. At 8 weeks after implantation, cartilage defects in the experimental group were further repaired, with unclear repair boundaries, and in the control group, cartilage defects were no repaired and showed a notable boundary with the surrounding normal cartilage tissues. (2) Immunohistochemical staining results: the expression of type II colagen in the experimental group was higher than that in the control group (P < 0.05) at 4 and 8 weeks after implantation. These findings indicate that the alogeneic chondrocytes/polyglycolic acid scaffold compound can promote the repair of thyroid cartilage defects in rabbits.

OBJECTIVETo observe the effects of electroacupuncture (EA) at "Dazhui" (GV 14) on Wnt-β-catenin signal pathway in annulus fibrosus cells in intervertebral disc in rats with cervical spondylosis.

METHODSForty SD rats were randomized into a control group, a model group, an EA group and a medication group, 10 rats in each one. Rats in the control group were treated with sham operation, only incision on local skin; rats in the remaining groups were made into cervical spondylosis models. After model establishment, rats in the control group and model group received fixed treatment under identical condition; rats in the EA group were treated with EA at "Dazhui" (GV 14), 30 min per treatment; rats in the medication group were treated with intragastric administration of meloxicam tablets. Treatments were both given once a day, and 14 days were taken as one session; there was an interval of 2 days between two sessions, and totally two sessions were given. After the treatments, immunohistochemistry was applied to measure the expression of Wnt, glycogen synthase kinase-3β (GSK-3β) and Axin in annulus fibrosus cells; western blot was used to test the expression of P-β-catenin.

RESULTSIn the control group, there were more positive cells of Wnt, GSK-3β and Axin, which were intensively distributed, deeply colored, and strongly positive; In the model group, there were less positive cells of Wnt, GSK-3β and Axin, which were sparsely distributed and weakly positive. The expression of Wnt, GSK-3β, Axin and P-β-catenin in the model group was less than that in the control group (all P < 0.05); expression of Wnt, GSK-3β, Axin and P-β-catenin in the EA group and medication group was higher than that in the model group (all P < 0.05); expression of Wnt, GSK-3β, Axin and P-β-catenin was not significantly different between EA group and medication group (all P > 0.05).

CONCLUSIONEA could delay the degeneration of intervertebral disc, which may be related to EA inhibiting signal pathway of Wnt-β-catenin.

Acupuncture Points ; Animals ; Electroacupuncture ; Female ; Fibrosis ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Humans ; Intervertebral Disc ; metabolism ; pathology ; Male ; Rats ; Spondylosis ; genetics ; metabolism ; pathology ; therapy ; Wnt Signaling Pathway ; beta Catenin ; genetics ; metabolism

Objective To characterize the spectrum of adult choledochal cyst and to determine suitable surgical procedures for this disorder.Methods The medical records of 169 patients who were treated for choledochal cyst from July 1977 to October 2008 in our Department were retrospectively reviewed.The cysts were classified using Todani's classification as type Ⅰ in 110 patients (65.1％),type Ⅱ in one patient (0.6％),and type Ⅳ in 56 patients (33.1％).The choledochal cysts in two patients could not be classified because of the lack of clinical data.163 patients received surgical treatment,which included cystectomy (n=119),cystenterosotmy (n=33),T-tube drainage following bile duct exploration (n=5),surgical exploration/biopsy (n =5),and endoscopic sphincterotomy (n =1).Results There was an increase in the number of patients in the 1980s which became stable at round 30 patients per every four years since the late 1990s.The proportion of patients presenting with a history of biliary surgery decreased and accounted for about 25％ of patients in the past decades.The rate of cyst malignancy dropped from 16.5％ in 1977=1995 to 9.7％ in 1996=2008.Of the 163 patients who received surgical treatment,long-term complications included anastomotic strictures and intrahepatic bile ductal stones presenting with repeated cholangitis.Conclusions The incidence of adult congenital choledochal cysts had become stable following years of rapid increase.The rate of cancer progression had gradually decreased.The use of different surgical treatments based on the condition of the proximal bile duct helped to prevent postoperative stenosis of biliary anastomosis.

BACKGROUND:Heart valve surgery combined with coronary artery bypass grafting has been gradual y used for treatment of coronary heart disease combined with cardiac valve disease.
OBJECTIVE:To retrospectively summarize the experience of combined coronary artery bypass grafting and valvular procedure.
METHODS:Total y 51 patients who underwent combined heart valve surgery and coronary artery bypass grafting were retrospectively analyzed, including 10 cases with aortic valve replacement, 14 cases with mitral valve replacement, eight cases with mitral valve replacement combined with tricuspid annuloplasty, four cases with aortic valve and mitral valve replacement, three cases with aortic valve and mitral valve replacement combined with tricuspid annuloplasty, seven cases with mitral valvuloplasty, and five cases with mitral valvuloplasty combined with tricuspid annuloplasty.
RESULTS AND CONCLUSION:Biovalve replacement was performed in nine patients, mechanical valves replacement in 31 cases, mitral valvuloplasty in 11 cases and tricuspid annuloplasty in 16 cases. There were total y 109 bypass graft vessels, and the average number of coronary artery bypass grafts was (1.92±0.73) branches. Four cases died within 30 days postoperatively, and 47 patients were successful y discharged from the hospital. Forty-five of 47 discharging patients were fol owed for 3-48 months. One case died of cerebral infarction within 6 months postoperatively, and another case died of cardiac dysfunction over 1 year after operation. The heart function of 45 survival patients was significantly improved. The comprehensive analysis showed that improving the heart function preoperatively, strengthening myocardial protection, shortening operation and myocardial ischemia time, and complete revascularization are the key factors for successful operation.

In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.

BACKGROUND:Drug therapy can partly reduce and delay the progress of Alzheimer’s disease, but only 30%with the single drug treatment obtain clinical cure. OBJECTIVE:To study the therapeutic effect of bone marrow mesenchymal stem cel s transplantation for rats with Alzheimer’s disease. METHODS:Amyloidβ-protein was injected into the hippocampus of Sprague-Dawley rats to construct the model of Alzheimer’s disease. And bone marrow stromal stem cel s were transplanted into the hippocampus of the rat models. RESULTS AND CONCLUSION:At 2 weeks after modeling, compared with the control group, the escape latency in the model and experimental groups was significantly longer (P<0.05), which indicating that Alzheimer’s disease models were successful y established. At 4 weeks after cel transplantation, compared with the model group, the average escape latency in the experimental group was significantly decreased, but retention time on the platform quadrant was significantly prolonged (P<0.05). Besides, at 4 weeks after cel transplantation, expression of choline acetyltransferase in the experimental group was significantly higher than that in the model group (P<0.05). In conclusion, bone marrow mesenchymal stem cel s cannot only differentiate and survive in the hippocampus of rats with Alzheimer’s disease, but also improve the learning and memory ability.

Disability Evaluation ; Femur/diagnostic imaging* ; Humans ; Lower Extremity

Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.