Objective The aim of this article is to study the clinical features, image, electroencephalogram and gene mutation of mitochondrial encephalomyopathy with MELAS and to improve understanding of the disease. Methods Clinical data was collected from 12 MELAS cases. Their clinical symptoms, head imageological result,electroencephalo-gram and gene mutation were analyzed. Results The average onset age was 28 years old. The main manifestations of 12 patients were epilepsy(66.7%), stroke-like episodes(50.0%), mental behavious disorder and decrease of perceive (41.7%),diabetes or abnormal glucose tolerance(41.7%), hearing impairment(41.7%). The imaging results showed long T1, long T2 and high signals on DWI. The nidus involved occipital lobe, temporal lobe, parietal lobe most. Five of six cases undergoing MRS imaging had large lactate peak at 1.33 ppm. There were 9 cases carrying mtDNA A3243G muta-tion. Conclusion The clinical presentation of MELAS is highly variable without any obvious specificity on MRI and EEG. Large lactate peak on MRS may indicate the disease. Most patients carry A3243G mutation.

In the heart, stimulation of beta-adrenergic receptors (betaAR) serves as the most powerful means to increase cardiac contractility and relaxation in response to stress or a "fight-or-flight" situation. However, sustained beta-adrenergic stimulation promotes pathological cardiac remodeling such as myocyte hypertrophy, apoptosis and necrosis, thus contributing to the pathogenesis of chronic heart failure. Over the past decade, compelling evidence has demonstrated that coexisting cardiac betaAR subtypes, mainly beta(1)AR and beta (2)AR, activate markedly different signaling cascades. As a result, acute beta(1)AR stimulation activates the G(s) -adenylyl cyclase-cAMP-PKA signaling that can broadcast throughout the cell, whereas beta(2)AR-evoked cAMP signaling is spatially and functionally compartmentalized, due to concurrent G(i) activation. Chronic stimulation of beta(1)AR and beta(2)AR elicits opposing effects on the fate of cardiomyocytes: beta(1)AR induces hypertrophy and apoptosis; but beta(2)AR promotes cell survival. The cardiac protective effect of beta(2)AR is mediated by a signaling pathway sequentially involving G(i), G(betagamma), PI3K and Akt. Unexpectedly, beta(1)AR-induced myocyte hypertrophy and apoptosis are independent of the classic cAMP/PKA pathway, but require activation of Ca(2+)/calmodulin-dependent kinase II (CaMK II). The outcomes of cardiac-specific transgenic overexpression of either beta AR subtype in mice have reinforced the fundamentally different functional roles of these betaAR subtypes in governing cardiac remodeling and performance. These new insights regarding betaAR subtype stimulation not only provide clues as to cellular and molecular mechanisms underlying the beneficial effects of beta AR blockers in patients with chronic heart failure, but also delineate rationale for combining selective beta(1)AR blockade with moderate beta(2)AR activation as a potential novel therapy for the treatment of chronic heart failure.
Adenylyl Cyclases ; metabolism ; Animals ; Cyclic AMP-Dependent Protein Kinases ; metabolism ; GTP-Binding Proteins ; metabolism ; Heart ; physiology ; Heart Failure ; physiopathology ; Humans ; Myocardium ; metabolism ; Receptors, Adrenergic, beta ; classification ; physiology ; Receptors, Adrenergic, beta-1 ; physiology ; Receptors, Adrenergic, beta-2 ; physiology ; Signal Transduction

By reverse transcription-polymerase chain reaction (RT-PCR), an open reading frame of pathogenesis-related protein 1 (PR1) was isolated from Panax notoginseng and named as PnPR1. Molecular and bioinformatic analyses of PnPR1 revealed that an open reading frame of 501 bp was predicted to encode a 166-amino acid protein with a deduced molecular mass of 18.1 kD. Homology analysis showed that the deduced amino acid sequence of PR1 protein of Panax notoginseng had a high similarity with other higher plants had the same conservative structure domain of cysteine-rich secretory protein (CAP). The recombinant expressed plasmid pET28a(+)-PnPR1 was expressed in Escherichia coli BL21. The expression conditions were optimized by induction at different times, different temperatures, different IPTG concentrations and different giving times. The optimum expression condition was 0.4 mmol.L-1 IPTG at 28 degrees C for 20 h. The successful expression of PnPR1 provides some basis for protein purification and preparation of the monoclonal antibody.
Amino Acid Sequence ; Cloning, Molecular ; Escherichia coli ; metabolism ; Molecular Weight ; Open Reading Frames ; genetics ; Panax notoginseng ; chemistry ; Phylogeny ; Plant Proteins ; genetics ; metabolism ; Plants, Medicinal ; chemistry ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Alignment

Objective To survey the prevalence of tendency on tendency of personality disorder among college students.Methods By means of stratified cluster sampling,498 students from 6 colleges in Shijiazhuang city and 204 students from 3 colleges in Beijing were studied through 'personality diagnostic questionnaire- revised UPDI'.Results The incidence rates on dependent personality (2.81%),histrionic personality (2.41% ) and borderline personality (2.21% ) were higher than obsessive- compulsive personality (0.40%) and schizoid personality (0.60%).The prevalence of personality disorder tendency was related to sex,major and years in college,blood type as well as their origins(from urban or rural).The overall incidence of personality disorder was 28.31% while the incidence rates of personality deviation and serious personality disorder tendency were 17.07% and 11.24% respectively.The incidence in males was higher than that in females.There appeared differences in dissociative personality,avoidant personality,paranoid personality,obsessive-compulsive personality,histrionic personality and narcissistic personality on people with different blood types.The scores of the city students were higher than that of the students from the rural areas regarding paranoid personality,dependent personality and narcissistic personality.Differences were also noticed between freshmen and students from other levels in the incidence rates on the tendency of avoidant personality disorder.Conclusion There were different incidence rates on the tendency of personality disorder among college students that related to sex,level in college and the origins where they were from(urban or rural).

Objective To evaluate the clinical feasibility of localization CT enhanced image replacing plain CT scan image for target delineation and dose calculation.Methods Forty cases of NPC were collected and divided into two groups with different concentrations of contrast agents.The contours of planning target volume (PTV) and organs at risk (OARs) of each case were delineated in the plain scan image,and the contours of PTV and OARs were copied to the enhanced image.Two plans based on the plain scan image and the enhanced image were designed in the planning system of Eclipse.The dose distribution and OARs and MU were compared between the groups.Results No statistical differences were found in the dosimetry of PTV,OARs and MU (P＞0.05).Conclusion The image intensifier has little effect on the dose calculation of Eclipse for NPC.In the radiotherapy for NPC,the localization CT enhanced image can be used to replace the plain CT scan image for target delineation and dose calculation.

Objective To explore the protective effects and its mecha-nism of stachydrine on focal cerebral ischemia reperfusion injury in mice . Methods The focal cerebral ischemia reperfusion injury model in mice was established by thread method.KM mice were randomly divided into 6 groups(n＝16):sham operation group , model group, control group, ex-perimental-L, experimental -M, experimental -H groups, mice in each group were given related drugs via intragastric administration before the operation, once a day, lasting for 7 d.Reperime 22 h, the levels of Caspase-3, B-cell lymphoma-2 (Bcl-2), B-lymphoma-2 gene-related X protein (Bax) and adenosine triphosphate (ATP) enzyme activity in each group was detected by enzyme linked immunosorbent assay .Results The relative expression of Bax in model group,control group, experimental -L, experimental -M, experimental -H groups were (4.00 ±0.51 ), (2.84 ±0.48),(2.87 ±0.41),(2.92 ±0.46),(3.12 ±0.59)ng· mL-1,respectively; the relative expression of Caspase-3 in the 5 groups were(13.43 ±0.87),(9.95 ±1.57),(10.02 ±1.55),(10.58 ±1.48),(10.79 ±1.69) pmol· L-1,respectively; the relative expression of Bcl -2 in the 5 groups were (11.94 ±1.40 ),(16.14 ±1.33 ), (15.89 ±1.45),(15.31 ±1.20),(14.78 ±1.17)ng· mL-1,respectively;compared with the model group, the rela-tive expressions of Bax and Caspase -3 in control group, three doses experimental groups markedly reduced while the relative expression of Bcl-2 in the 4 groups markedly increased significantly (all P<0.01).The Na +-K+-ATP en-zyme activity in the model group ,control group, experimental -L, experimental -M, experimental -H groups were (2.82 ±0.56),(4.84 ±1.61),(4.81 ±1.48),(4.50 ±1.22),(4.13 ±1.17)μmolPi· mg -1· h -1,respectively;and Mg2+-ATP enzyme activity in the 5 groups were (2.55 ±0.56), ( 5.25 ±1.86 ), ( 5.15 ±2.37 ), (4.62 ±1.89 ) ,(4.13 ±1.54 ) μmolPi· mg-1· h-1, respectively; comparison between 4 drugs groups and model group,the differences of the factors were significant ( P<0.05 or P<0.01 ) .Conclusion Stachydrine can markedly reduce the lesion of focal cerebral ischemia reperfusion model in mice , and its mechanism may be related to improve energy metabolism disorder , inhibit neuronal apoptosis and improve the microcirculation of the brain .

Objective: To Evaluation the effect of PD-1 inhibitor Nivolumab on the proliferation and cytotoxicity of anti-CD19 chimeric antigen receptor T cells (CD19-CAR-T) in vitro. Methods: Five patients with high PD-1 expression in peripheral blood and five healthy volunteers were selected. These peripheral blood mononuclear cells were used as the source of T cells to prepare CD19-CAR-T cells. Different doses (72, 36, 18 μg/ml) of Nivolumab was added on day 8 to the culture medium. Patient T cells incubated with 72 μg/ml Nivolumab and CD19-CAR-T cells of healthy volunteers were used as controls. CCK-8, lactate dehydrogenase (LDH) cytotoxicity assay and ELASA were used to detect the proliferation capacity, the specific cytotoxicity and the inflammatory factor secretion. Results: ①T cells from patients with high expression of PD-1 as the source of CD19-CAR-T cells did not affect transfection rate compared with that of healthy volunteers [(32.80±7.22)% vs (35.10±5.84)%, t=-0.554, P=0.593]. ②Incubation of CD19-CAR-T cells with 72 μg/ml Nivolumab did not affect CD19-CAR-T cell proliferation, but its cytotoxicity was significantly higher than that of CD19-CAR-T cells alone or patients' T cells +72 μg/ml Nivolumab (all P<0.001), there was no significant difference in the killing activity between the 72 μg/ml and 36 μg/ml Nivolumab treated CD19-CAR-T cells on Pfeiffer cells (P=0.281, 0.267, respectively), and they were all higher than those of 18 μg/ml Nivolumab treated CD19-CAR-T cells (all P<0.001). ③Different doses of PD-1 inhibitor Nivolumab combined with CD19-CAR-T cells does not affect the secretion of IFN-γ and IFN-α (all P>0.05). Conclusion: Combination of 36 μg/ml PD-1 inhibitor and CD19-CAR-T cells could reduce the drug toxicity and enhance the cytotoxicity.
Antigens, CD19 ; Cell Proliferation ; Humans ; Leukocytes, Mononuclear ; Nivolumab/pharmacology* ; Programmed Cell Death 1 Receptor ; Receptors, Antigen, T-Cell ; Receptors, Chimeric Antigen ; T-Lymphocytes

OBJECTIVETo investigate the effects of root canal preparation treated by endodontists of different levels in different difficulty associated with the root canal anatomy factors.

METHODSTotally 422 teeth with 901 root canals were randomly selected from the Conservative Dentistry Department, West China Stomatology Hospital, and these teeth were respectively treated by junior specialist postgraduates, senior specialist postgraduates and endodontic specialists. Grading criteria of root canal risk factor and root canal therapy difficulty assessment were found based on 6 items: Tooth type, working length, root curvature, calcification, number of canals, and the previous endodontic treatment. The effects of root canal preparation with different difficulty in different groups were analyzed with RxC Chi-square test.

RESULTSSuccess rates of root canal preparation in junior group and senior group during three difficulty groups were statistically different (P < 0.05), and the root canal therapy difficulty group I > group II > group III. The operator factors in root canal therapy difficulty group I and group II were not significantly different P > 0.05). But in root canal therapy difficulty group III, the endodontic specialist group have highest success rate in root canal preparation.

CONCLUSIONThe cases of root canal treatment should be treated by endodontist of corresponding level according to the difficulty. In difficult cases, endodontic specialist can provide better root canal preparation result.

China ; Humans ; Root Canal Preparation ; Root Canal Therapy ; Tooth Root

OBJECTIVETo explore the clinical application of sural neurovascular pedicle fasciocutaneous reversed island flap to repair soft-tissue defection of the ankle and foot.

METHODSFrom Sep. 1994 to Oct. 2004,29 patients with soft-tissue defects in the ankle and foot were repaired by use of sural neurovascular fasciocutaneous reversed island flap, including 15 cases of traumatic defects, 11 cases of burns and 3 cases of chronic ulcer. The flap area ranged from 5 cm x 7 cm to 12 cm x 20 cm, and the length of pedicle from 5 cm to 12 cm.

RESULTSThe flaps survived totally in 27 cases, the distal necrosed partially and secondary free-skin grafting were further conducted in 2 cases. Twenty-one cases were followed-up for 3 to 60 months,the circulation, color and texture of the flaps were excellent and 2-point discrimination was 10 - 15 mm. The appearance and function of ankle joints were good.

CONCLUSIONThis flap has sufficient blood supply and a high survival rate; It is convenient in design, dissection and without sacrifice of major arteries. So, it is an effective method for the reconstruction of soft-tissue defects in ankle and foot.

Adolescent ; Adult ; Ankle Injuries ; surgery ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Sural Nerve ; blood supply ; Surgical Flaps ; blood supply ; Young Adult