AIM: To examine the changes in immune cells which might be involved in systemic immune dysfunction after severe burns, we detected the sequence of expressed sequence tag in lymphocytes and monocytes of F344 rats post-burn. METHODS: Two pairs of primers were designed depending on the sequence of AI764697.1. SMART RACE technology was employed for amplification of whole sequence. Furthermore, the amplified sequence was testified by Northern blot. RESULTS: A 592bp sequence, which was testified by Northern blot, was suceessfally obtained in our experiments. This product was accepted by GenBank and its accession number is AF244895. CONCLUSION: A cDNA whole sequence in immune cells of F344 rats after severe burns was amplified successfully. More research work should be done to identify the resource, location in genome and function of this product.

Objective To systematically assess the efficacy of the low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right frontal cortex for depression. Methods Clinical randomized controlled trials (RCT) studies about low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) for depression were collected from database such as PubMed, SCI, CBM, CNKI, and VIP. The meta-analysis using the software of RevMan 5.2 was conducted to com?pare the response rate of low-frequency rTMS to the right DLPFC with sham stimulation and high-frequency rTMS to the left DLPFC, respectively. Results Nine RCT studies with 156 patients in low-frequency rTMS group and 162 patients in sham stimulation group were included. Meta-analysis showed that low-frequency rTMS to the right DLPFC significantly improved response rate compared with sham stimulation(RR=2.15,95%CI:1.57~2.95,P<0.01). Eleven RCT studies with 178 patients in low-frequency rTMS group and 200 patients in high-frequency group were included. There was no significant difference in response rate between the two groups(RR=0.80,95%CI:0.63~1.02,P=0.07). Conclusion The efficacy of low-frequency rTMS to the right frontal cortex for depression is significant but the efficacy is not superior in comparison with the high-frequency rTMS to left DLPFC.

Exosomes contain many components including variety kinds of lipids,proteins,microRNAs (miRNAs) and so on.They can transport their loaded substances to the recipient cells and play a role of biology.Exosomal miRNAs play important roles in the occurrence and development of tumors,and they are closely related to the tumor growth,metastasis,drug resistance and immune regulation.Exosomes and exosomal miRNAs can be served as reference indexes for tumor metastasis and prognosis,which provide new targets for tumor therapy.

The purpose of education is to cultivate talents who can master the ability of self-learning lifelong. With the rapid development of multimedia technology, the knowledge carrier represented by micro curriculum plays a very important role in improving students' self-learning ability. In traditional Chinese medicine college, due to the short of time, weak learning foundation, the ability of self-learning is hard to improve in the modern medical courses such as biochemistry. This is not conducive to the cultivation of modern talents of Chinese medicine. In this paper, we chose the biochemistry teaching in TCM college as an example, and discuss how we can make the application of micro courses reasonably in the teaching process. This study was regarded as a starting to improve the students' self-learning ability effectively.

Objective To analyze the reasons and treatment methods of high transprothetic pressure gradient after aortic valve replacement. Methods The clinical data of 45 patients with high transprothetic pressure gradient after aortic valve replacement were retrospectively analyzed. The patients were followed up for average 24.6 (12 - 40) months. The postoperative effective orifice area (EOA) of artificial valve was measured by transthoracic color Doppler ultrasound. Compared with published referred EOA of different artificial valve, there were 2 kinds results:measured EOA=referred EOA and measured EOA0.85 cm2/m2 and EOAI<0.85 cm2/m2. The reasons of high transprothetic pressure gradient were analyzed according to the above different standard. Results In the 45 patients with high transprothetic pressure gradient after aortic valve replacement, prosthesis-patient mismatch (PPM) was in 33 cases, and prosthetic dysfunction was in 10 cases, among whom 5 cases were because of thrombus (3 cases improved after increasing the dosage of warfarin, 2 cases underwent re-aortic valve replacement), 3 cases were because of severe bioprosthetic calcification (underwent re-aortic valve replacement), and 2 cases were because of prosthetic ring pannus and influenced movement of the leaflets (underwent re-aortic valve replacement). High flow in the left ventricular outflow tract occurred in 2 cases. The patients had no obvious discomfort, and did not receive special treatment. Four cases died, among whom 2 cases were because of severe PPM, and the other 2 cases were because of noncardiac. Conclusions Many reasons can result to the high transprothetic pressure gradient, and the PMM is the most common reason. Choosing the right treatment plan can improve the survival rate of patients.

BACKGROUND AND OBJECTIVES: Previous studies have shown that integrins alpha5beta1 (ITGA5B1) gene-modified rat bone marrow mesenchymal stem cells (rBMSCs) could prevent cell anoikis and increase the nitric oxide (NO) production. Here we examined the capability of rBMSCs/ITGA5B1 on the phenotype modulation of Human Pulmonary Artery Smooth Muscle Cell (HPASMC) in vitro. METHODS AND RESULTS: The synthetic (dedifferentiated) phenotype of HPASMC was induced by monocrotaline (MCT, 1μM) for 24 h and then co-cultured with rBMSCs/ITGA5B1 in a transwell culture system. The activation of NO/cGMP (nitric oxide/Guanosine-3′, 5′-cyclic monophosphate) signaling was investigated in HPASMC. The changes of pro-inflammatory factors, oxidative stress, vasodilator, vasoconstrictor, contractile and synthetic genes, and the morphological changes of HPASMC were investigated. The results of this study showed that the NO/cGMP signal, endothelial nitric oxide synthase (eNOS) expression, the expression of the vasoprotective genes heme oxygenase-1 (HMOX1) and prostaglandin-endoperoxide synthase 2 (PTGS2) were increased, but the expression of transforming growth factor-β1 (TGF-β1), CCAAT/enhancer-binding proteins delta (Cebpd), Krüppel-like factor 4 (KLF4), and activating transcription factor 4 (ATF4) were reduced in MCT treated HPASMC co-cultured with rBMSCs/ITGA5B1. The synthetic smooth muscle cells (SMCs) phenotype markers thrombospondin-1, epiregulin and the vasoconstrictor endothelin (ET)-1, thromboxane A2 receptor (TbxA2R) were down-regulated, whereas the contractile SMCs phenotype marker transgelin expression was up-regulated by rBMSCs/ITGA5B1. Furthermore, rBMSCs/ITGA5B1 promoted the morphological restoration from synthetic (dedifferentiation) to contractile (differentiation) phenotype in MCT treated HPASMC. CONCLUSIONS: rBMSCs/ITGA5B1 could inhibit inflammation and oxidative stress related genes to promote the HPASMC cell differentiation by activation NO/cGMP signal.
Activating Transcription Factor 4 ; Animals ; Anoikis ; Bone Marrow ; Cell Differentiation ; Endothelins ; Epiregulin ; Genes, Synthetic ; Heme Oxygenase-1 ; Humans ; In Vitro Techniques ; Inflammation ; Integrins ; Mesenchymal Stromal Cells ; Monocrotaline ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Nitric Oxide Synthase Type III ; Nitric Oxide ; Oxidative Stress ; Phenotype ; Prostaglandin-Endoperoxide Synthases ; Pulmonary Artery ; Rats ; Receptors, Thromboxane A2, Prostaglandin H2

Objective To study the effect of puncture length per cubic centimeter of prostate biopsy on the detection rate of prostate cancer. Methods The clinical data of 254 prostate cancer patients who had underwent the first prostate biopsy by transrectal ultrasound guidance from September 2013 to November 2017 were retrospectively analyzed. The patients were divided into prostate cancer group and non prostate cancer group according to biopsy pathologic results. The total prostate specific antigen (TPSA), prostate volume, puncture length per needle, puncture length per cubic centimeter of prostate, volume of per needle and percentage of the sampled prostate volume were compared between 2 groups, and the relationship between puncture length per cubic centimeter of prostate and prostate cancer detection rate were analyzed. Results Among the 254 patients, the prostate cancer was in 67 cases (prostate cancer group), and the benign lesion was in 187 cases (non prostate cancer group). The prostate cancer detection rate was 26.4% (67/254). There were no statistical differences in age, puncture length per needle and volume of per needle between 2 groups (P＞0.05). The TPSA, puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume in prostate cancer group were significantly higher than those in non prostate cancer group: (13.8 ± 6.8)×103 ng/L vs. (8.5 ± 3.9)×103 ng/L, (3.42 ± 0.12) mm/cm3 vs. (2.83 ± 0.18) mm/cm3 and (2.75 ± 0.31)% vs. (2.24 ± 0.25)%, the prostate volume was significantly lower than that in non prostate cancer group: (45.8 ± 15.5) cm3vs. (56.3 ± 13.8) cm3, and there were statistical differences (P＜0.05). Receiver operating characteristic curve analysis showed that area under the curve was 0.628, 95% CI 0.561 to 0.695. The cutoff value of puncture length per cubic centimeter of prostate was 3.40 mm/cm3, with the sensitivity of 59.8% and the specificity of 64.8% . Conclusions The puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume are important morphometric parameters in the determination of prostate cancer. The detection rate of prostate cancer is the highest , when puncture length per cubic centimeter of prostate is≥3.40 mm/cm3.

Objective To evaluate and compare the effectivity and safety of mini-percutaneous nephrolithotomy (mPNL) and flexible ureteroscopic lithotripsy (FURL) for diameter 10 to 20 mm renal stone in obese patients. Methods This was a multicenter prospective study. One hundred and ten obese patients (body mass index≥28.0 kg/m2) with diameter 10 to 20 mm kidney stone from January 2015 to May 2017 were selected. The patients were divided into mPNL group (58 cases) and FURL group (52 cases) according to the patients′ will. The operation time, hospitalization time, complication, one-stage stone removal rate and ultimate stone removal rate were compared between 2 groups. Results The operation time, hospitalization time and incidence of complication in FURL group were significantly lower than those in mPNL group: (66.7 ± 21.9) min vs. (85.7 ± 33.4) min, (72.5 ± 23.7) h vs. (120.8 ± 33.5) h and 9.6% (5/52) vs. 31.0% (18/58), and there were statistical differences (P＜0.05). There were no statistical differences in the one-stage stone removal rate and ultimate stone removal rate between 2 groups (P＞0.05). In aspect of postoperative bleeding, hemoglobin decreased after operation (15.8 ± 9.7) g/L in mPNL group; no hemorrhage occurred in FURL group, and no significant changes in hemoglobin were observed before and after operation. Conclusions Both mPNL and FURL achieve satisfactory stone-free rates in obese patients with diameter 10 to 20 mm renal stone. Compared with mPNL, FURL has shorter operation time and lower incidence of complication.

Objective To evaluate the consistency among the results of preoperative midstream urine culture (PMUC), renal pelvis urine culture (RPUC) and renal stone (RSC) culture in patients undergoing percutaneous nephrolithotomy (PNL) and their relationship with postoperative infection. Methods This was a multicenter prospective study. From September 2014 to November 2017, 115 patients undergoing standard channel PNL or microchannel PNL in the First Affiliated Hospital of Soochow University and Yancheng Hospital of Traditional Chinese Medicine were selected. The PMUC, RPUC and RSC were detected. Samples for RPUC and RSC were obtained during PNL. The clinical data, stone configuration, stone burden and results of cultures were recorded. Results In the 115 patients, PMUC positive was in 4 cases (3.5%), RPUC positive was in 17 cases (14.8%), and RSC positive was in 16 cases (13.9% ); both RPUC and RSC positive were in 7 cases (6.1% ), among whom consistent pathogenic bacterium was in 6 cases, and inconsistent pathogenic bacterium was in 1 case; all the 3 cultures were positive in 1 case, but the types of pathogenic bacterium of PMUC were totally different with RPUC and RSC. At least one positive of the 3 cultures was in 29 cases (25.2% ). The types of pathogenic bacterium of PMUC were multidrug susceptible Escherichia coli and Staphylococcus aureus , and the types of pathogenic bacterium of RPUC and RSC were multidrug resistant pathogens and/or fungus. The consistency of pathogenic bacterium between PMUC and RPUC, RSC was very low; while the consistency of pathogenic bacterium between RPUC and RSC was very high (6/7). Postoperative infection occurred in 8 of 115 patients (7.0% , 5 cases of infective fever and 3 cases of urinary sepsis). In the 8 patients, PMUC was negative, PRUC positive in 4 cases, RSC positive in 7 cases, and both PRUC and RSC positive were in 3 cases. Conclusions PMUC can not accurately reflect the true situation of upper urinary tract renal calculi and pyelo-urine pathogenic bacterium. In patients with PNL postoperative infectious complications, the result of PMUC is often negative, but the results of RPUC and RSC are mostly positive. RPUC and RSC are helpful to detecting pathogenic bacterium in time, guiding the application of sensitive antibiotics, preventing and treating PNL postoperative infection.

Sepsis is one of the critical illnesses caused by burns, trauma, shock, infection, and so on. In patients with sepsis, vascular permeability is prone to develop through various pathophysiological mechanisms and thus could result in accumulation of tissue fluid, insufficient intravascular fluid, and finally cause septic shock and multiple organ dysfunction syndrome. Recent studies have shown that various factors and mediators involved in the regulation of vascular permeability in sepsis are expected to become targets for clinical treatment of sepsis. In this paper, we have reviewed the research advances on some molecules which are significantly associated with vascular permeability in sepsis, such as vascular endothelial growth factor, angiopoietin, sphingosine-1-phosphate, heparin-binding protein, and Slit2.