Objective To evaluate the significance of ST/TP relative value in electrocardiogram in diagnosis of hypocalcemia.Methods ST/TP relative value in electrocardiogram in 61 children with hypocalcemia and 31 normal children were detected by NIHOH KOHDEN CardiofaxQ ECG-9130P electrocardiogram machine designed by Japanese futian company.Calcium ion was checked out by clinic electrolyte equipment.Results There was significant difference of ST/TP relative value between patients with hypocalcemia and normal children(P

Objective To evaluate protein kinase Cθ(PKCθ)for the differential diagnosis of gastrointestinal stromal tumors(GIST).Methods The expression pattern of PKC θ was detected by immunohistochemistry in 121 GISTs,paired 51 distant normal tissues and 70 non-GIST sarcomas.Results Immunoreactivity for PKC θ was detected in 111 of 121 GIST cases,all eight CDll7-negative GISTs were PKC θ positive.PKC θ was negative in all distant normal tissue samples and 26 smooth muscle tumors.The positive expression rate of gastrointestinal mesenchemal tumors other than GIST was 18.2％.The expression rate of PKC θ did not vary with of tumor location,cell morphology and risk grades.Conclusions PKC θ could be a potential diagnotic marker in GIST patients,especially in those with negative CD117.

Objective:To evaluate the effectiveness and safety of endovascular treatment in solving symptomatic cerebral artery tandem lesions.Methods:From June 201 2 to February 201 4,1 2 cases (24 lesions)with symptomatic cerebral artery tandem lesions were accepted for the endovascular treatment. The distributions of the tandem lesions were as follows:the common carotid artery and internal carotid ar-tery (1 case),the internal carotid artery and the proximal of the carotid cavernous sinus segment (3 ca-ses),the internal carotid artery and the distal of the carotid cavernous sinus segment (4 cases),the in-tracranial segment of internal carotid artery and middle cerebral artery M1 segment (2 cases),the first segment of vertebral artery and intracranial segment of vertebral artery (2 cases).All of these cases were treated from distal lesions to proximal lesions except for tandem lesions in the internal carotid artery and the distal of the carotid cavernous sinus segment in order to obtain better support.Tandem lesions were treated in the same operation with local anesthesia or general anesthesia.The procedures of the 1 2 cases retrospectively were analyzed and the peri-operation complications and responsibility region recurrent is-chemic stroke incidents observed.Results:All tandem lesions were solved successfully all at once.There were no peri-operation complications or recurrent ischemic stroke incidents.There were no recurrent is-chemic stroke incidents or stent restenosis cases in the follow-up.Conclusion:It is safe and effective for selective endovascular treatment in solving symptomatic cerebral artery tandem lesions at the same time, but we should take careful preoperative evaluation and improve the operation plan.

BACKGROUNDOxidative Stress and p38 mitogen-activated protein kinase (p38MAPK) play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.

METHODSRat mesangial cells were cultured and randomly assigned to control group, high glucose group and pioglitazone group. After 48-hour exposure, the supernatants and cells were collected. The protein levels of p22(phox), p47(phox), phosphorylated p38MAPK, total p38MAPK were measured by Western blotting. The gene expressions of p22(phox), p47(phox) were detected by RT-PCR. The levels of intracellular reactive oxygen species (ROS) were determined by flow cytometry. The levels of superoxide dismutase (SOD) and maleic dialdehyde (MDA) in the supernatant were determined respectively.

RESULTSCompared with the control group, the expression levels of p22(phox), p47(phox), phospho-p38 and ROS significantly increased, activity of SOD decreased in high glucose group, while the level of MDA greatly increased (P < 0.01). Pioglitazone significantly suppressed p22(phox), p47(phox) expressions and oxidative stress induced by high glucose. The expressions of p22(phox), p47(phox), phospho-p38MAPK and ROS generation were markedly reduced after pioglitazone treatment (P < 0.05). The activity of SOD in the the supernatant increased (P < 0.05), while the level of MDA decreased greatly by pioglitazone (P < 0.05). The level of oxidative stress was associated with the phosphorylation level of p38MAPK (P < 0.01).

CONCLUSIONPioglitazone can inhibit oxidative stress through suppressing NADPH oxidase expression and p38MAPK phosphorylation.

Animals ; Blotting, Western ; Glucose ; pharmacology ; Mesangial Cells ; drug effects ; enzymology ; NADPH Oxidases ; genetics ; metabolism ; Rats ; Reactive Oxygen Species ; metabolism ; Thiazolidinediones ; pharmacology ; p38 Mitogen-Activated Protein Kinases ; genetics ; metabolism

Animals ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Disease Models, Animal ; Humans ; Mice ; Rats

Objective:To analyze correlation factors of hemodynamic damage after carotid artery stenting.Methods:In this study, 66 cases (71 lesions) who undertook carotid artery stenting were col-lected and the correlation factors of hemodynamic damage were analyzed .Results:Hemodynamic damage emerged in 23 cases (32.4%), of which, 11.3%developed hypotension.The distance between bifurca-tion and lesions (P=0.002 0), plaque distribution (P=0.000 2), plaque character (P=0.001 9), post-dilation ( P =0.002 6 ) were associated with hemodynamic damage by single factor analysis . However, only eccentric plaque (P=0.015 3) and calcified plaque (P=0.009 7) were associated with hemodynamic damage by multiple factors analysis .All the patients could reach stable circulation by drugs during operation , and no cerebral ischemic events ( transient ischemic attack or stroke ) and cardiovascu-lar ischemic events happened .Conclusion: The distance between bifurcation and lesions , eccentric plaques, calcified plaques are correlation factors of hemodynamic damage .

With deeper understanding of gastrointestinal stromal tumor(GIST), more and more patients are diagnosed as GIST. Although the prognosis of early GIST is satisfactory after complete surgical resection, there are still many problems in the treatment of advanced GIST. Variety of treatment options has been used in the treatment of GIST, such as surgery, targeted drug therapy, and surgery plus imatinib therapy. However, post-operative recurrence, imatinib-resistance, multi-targeted drug resistance are still challenges. Many clinical evidences show that a reasonable management strategy can improve the prognosis of patients with advanced GIST. All the doctors should have a clear mind to carry out appropriate interventions. Advanced GIST should not be simply considered to be either medical or surgical disease, but rather must be systematically managed by multidisciplinary team approach combining surgical oncology, medical oncology, pathology, and interventional medicine. This review will advocate suitable treatment strategies based on the most recent progresses in systemic treatment for advanced GIST and our clinical experience to achieve early detection, early prevention, proper management, and therefore improve the survival of these patients.
Gastrointestinal Stromal Tumors ; diagnosis ; drug therapy ; pathology ; surgery ; Humans ; Neoplasm Metastasis

Objective:To anslysis the hemodynamic states of vertebrobasilar dolichoectasia based on computational fluid dynamics technique.Methods:The original DICOM format image data from a patient with vertebrobasilar dolichoectasia (VBD), were imported by the Mimics software directly,and the 3D Objects were constructed.The simulation of model was made with Ansys software, the hemodynamic pa-rameters such as streamlines, wall shear stress( WSS) and wall pressure were described.Results:There was stable laminar flow in proximal basilar artery and was no blood flow mixed by bilateral vertebral arter-y.However, Spiral flows were appeared in distal tortuous basilar artery.The low WSS regions in the ver-tebra-basilar junction section and inferior segment of basilar artery were coincide with the high wall pres-sure regions.It could be speculated the initial growth regions might be located in the vertebra-basilar junction section and inferior segment of basilar artery.Local regions with low WSS and high wall pressure might be associated with the occurrence and development of VBD.Conclusion: CFD numerical simula-tion maybe can provide a theoretical basis for the role of hemodynamic factors in occurrence and develop-ment of VBD.

Abstract: Objective　To investigate the molecular characteristic and evolutionary trends of full-genome sequences of coxsackievirus A2 (CV-A2) and A5 (CV-A5) in Changsha City. Methods　The CV-A2 and CV-A5 strains were isolated and detected from patients with hand, foot and mouth disease (HFMD) cases. The full-genome sequences of CV-A2 and CV-A5 strains were obtained using NGS sequencing. Homology and phylogenetic tree analysis were performed, and the recombination regions of the strains were examined by SimPlot software. Results　The full-genome sequences of CV-A2 and CV-A5 strains were obtained from routine surveillance cases of HFMD in Changsha in 2019. The CV-A2 strain was named S281/Changsha/CHN/2019 with the full-genome sequence of 7 422 bp long; the CV-A5 strain was named S272/Changsha/CHN/2019 with the full-genome sequence of 7 425 bp long. Homology analysis of the isolates by comparison with the nucleic acid sequences of CV-A2 and other CV-A2 strains in China showed that the non-structural protein region shared lower similarity than that of structural protein region. The CV-A2 showed 79.20% similarity with Fleetwood strain (NC038306), showed the highest similarity 95.60% with MN419014 strain from Hubei Province. The non-structural protein 3C and 3D region shared the lowest similarity with MN419014, 90.51 and 92.06%, respectively. Phylogenetic tree analysis showed that 3C and 3D regions were located in the CV-A4 branch. Amino acid mutation sites were found in non-structural protein region, and the amino acid sequence in structural protein region was conserved. SimPlot analysis showed that genetic recombination was found in the 3C and 3D region of CV-A2 strains. The full-genome sequence of CV-A5 showed 80.7% similarity with the Swartz (AY421763) and 97.43% similarity with the strain (MH111030) from Australian. Homology analysis showed that the non-structural protein region shared lower similarity than that of structural protein region, based on full-genome of CV-A5. Phylogenetic tree analysis showed that CV-A5 and MH111030 were in the same branch, indicating that CV-A5 strain not from local. The amino acid sequence of CV-A5 strain was conserved. Conclusions　The CV-A2 strain in Changsha City shared genome sequence information with CV-A4, and the CV-A5 strain was imported from abroad. Our findings are expected to understand the molecular and recombination characteristics of CV-A2 and CV-A5, provided the data of evolution and genetic features of the coxsackievirus, and interrupt disease transmission in a timely and effective manner.

Aim To observe the effects of metformin (MET) on the silencing regulatory protein 1 (SIRT1) mRNA and protein expression in renal tissues of type 2 diabetic mellitus (T2DM) rats, and explore its reno-protective mechanisms. Methods Thirty model T2DM rats were randomly divided to glibenclamide in-tervention group (GLY group, 5 mg·kg-1·d-1), metformin intervention group (MET group,300 mg· kg-1· d-1) and diabetic control group (T2DM group),and 10 rats with normal glucose tolerance were used as normal control(NC group). After 8 weeks, HbA1c,blood glucose (BG), urea nitrogen (BUN), urinary albumin, creatinine and glomerular basement membrane thickness (GBMT) were detected. The ex-pression of SIRT1 protein in renal tissues was detected by immunohistochemistry, the expression of SIRT1 mRNA in renal tissues was detected by real-time PCR, and urinary SIRT1 protein was detected by ELISA. Results At the end of 8 weeks, the levels of BG,HbA1c,urinary albumin/urinary creatinine(UACR), urinary SIRT1/urinary creatinine (USIR) and GBMT in MET and GLY groups were significantly lower than those in T2DM group (P<0.05). There was no sig-nificant difference in BG, HbA1c and GBMT between MET group and GLY group (P>0.05). The expres-sions of SIRT1 mRNA and protein in MET group were significantly lower than those in NC group (P <0.05), but higher than those in T2DM group (P <0.05). The UACR, expression of SIRT1of renal tis-sues in MET group was higher than that in GLY group (P<0.05),but urinary SIRT1 protein was lower than that in GLY group (P <0.05). Conclusion Met-formin can increase the expressions of SIRT1 in renal tissues of T2DM rats,which may be related to its renal protection.