Objective:To investigate the cognitive characteristics,dangerous factors and the syndromes in mild cognitive impairment(MCI).Methods: Memory and cognitive function were assessed with Mini-Mental State Examination(MMSE).The MCI cases and normal controls were assessed by the Delayed Paragraph Story Recall Examination(DPR).A syndrome scale was used to diagnose the syndromes of subjects.The diagnosis of MCI,AD was made according to Petersen’s criteria,NINCDS-ADRDA,respectively.Results: MMSE scores of MCI cases were higher than that of normal controls,a signifi cantly difference was found.Average education level of normal controls was higher than that of MCI cases,but average contractive pressure was lower.Defi ciency of kidney,defi ciency of qi and phlegm syndromes were popular in both MCI cases aormal controls,and MCI cases had increased percentage of combined syndromes.Conclusion:The cognition function of MCI cases was decreased.Cognitive impairment was related to hypertensive disease and low education.As the development of cognitive impairment,complex Chinese medical syndromes appeared.

Objective To assess the value of multi-slice spiral CT angiography (MSCTA) in diagnosis of posterior nutcracker syndrome (NCS). Methods MSCTA of 15 patients clinically diagnosed as posterior NCS (patient group) and 50 subjects with normal renal vessels (control group) were retrospectively analyzed. The anatomy, course and relationship to the adjacent structure of left renal vein (LRV) and its branches were observed. The anteroposterior diameter (d1) and cross areas (s1) of the angle of control group and posterior abdominal artery (AA), the anteroposterior diameter (d2) and cross areas (s2) at the largest lumen near the renal hilar were measured and the ratio of s2/s1 and d2/ d1 were calculated.Results All LRVs posterior AA of patient group were compressed and narrowing with dilating apparently near the renal hilar. The difference of d2 was not significant (P＞0.05), but of other values were significant (P＜0.05).Conclusion MSCTA can show anatomy and three-dimentional trend clearly of LRV for posterior NCS, and evaluate the extent of narrow and dilating lumen accurately with cross areas measuring.

Objective To explore the effects of piperine on cell proliferation and migration in angiotensin Ⅱ (Ang Ⅱ)-treated rat airway smooth muscle cells (ASMCs).Methods The primary ASMCs of rats were cultured by improved tissue-piece digestion inoculation and trypsin digestion.MTT assay was used to detect the effects of Ang Ⅱ and Ang Ⅱ receptor antagonist losartan on cell proliferation activity.After treatment with Ang Ⅱ and piperine, the cell proliferation activity, the cell cycle distribution and the cell migration were detected by MTT, flow cytometry and Transwell assay respectively.ERK1/2 inhibitor PD98059 and losartan were then applied to determine the expression of cyclin D1, MMP-9, p-ERK1/2, ERK1/2, and β-actin proteins by Western blot assay.Results After 24 h culture, Ang Ⅱ treatment promoted the cell proliferative activity in rat ASMCs (P<0.05), and the promotive effect of 10-7 mol/L Ang Ⅱ was the most significant.Additionally, losartan blocked the Ang Ⅱ-induced cell proliferative activity in rat ASMCs (P<0.05).10-7 mol/L Ang Ⅱ treatment resulted in the elevated cell proliferative activity, higher S phase fraction, increased migrated cell number, and enhanced expression of cyclin D1, MMP-9and p-ERK1/2 proteins (P<0.05);these effects were dose-dependently reversed by piperine.Both PD98059 and losartan blocked Ang Ⅱ-induced expression of p-ERK1/2, cyclin D1 and MMP-9 proteins in rat ASMCs.Conclusions Piperine may inhibit Ang Ⅱ-induced cell proliferation and cell migration via ERK1/2 signaling pathway in rat ASMCs.

Objective To investigate the clinical implication of Neoral C 2 in evaluating drug hepatic toxicity following renal transplantation in hepatitis patients. Methods 162 cases receving renal transplantation were divided into two groups: positive group with positive hepatitis B and(or) C viral antigens or de finite hepatitis history before renal transplantation ( n =51) and the remaining 111 cases served as normal control group. One week posttransplantation, the blood concentrations of cyclosporins at 0 (C 0) and 2 (C 2) h after administration were determined. Results In the positive group, C 2, not C 0 one week postoperation was higher than normal control group ( P

Objective:To investigate the effect of 3 HLA matching measures on preventing hyperacute rejection(HAR). Methods:Among 1 152 cases,550 cases received anti donor lymphocytotoxic crossmatch(LXM),335 cases received LXM and HLA serological test,267 cases of the latter again received panel reaction antibody(PRA)test, the change of the HAR rate with different HLA matching measures were analyzed. Results:If LXM value ≤10% or HLA matched loci ≥3,the rate of HAR was unrelated to LXM value or HLA matched loci. HAR rate decreased significantly in patients with LXM and HLA serological test, and decreased more markedly in those with additional PRA test compared with those only with LXM test. Conclusion:HLA test and PRA are necessary and effective to avoid HAR.

Objective To explore the effect of transplantation of mesenchymal stem cells (MSCs) transfected with the human receptor activity modifying protein 1 (hRAMP1) gene on proliferation and apoptosis of vascular smooth muscle cells (VSMCs) after carotid balloon angioplasty was performed in rabbits with carotid atherosclerosis.Methods Density gradient centrifugation and adherent culture were carried out to obtain MSCs,which were then transinfected with an adenovirus vector carrying the hRAMP1 gene or an empty adenovirus vector.A rabbit model of atherosclerotic stenosis and balloon angioplasty was successfully established.Results were randomly divided into three groups:the hRAMP1-MSCs group,theadipose-derived MSCs (Ad-MSCs) group and the control group.MSCs were transinfected with Ad-EGFP-hRAMP1,Ad-EGFP or PBS by transplantation into the injured carotid arteries.Homing and differentiation were assessed with MSCs harvested at 7 d.With MSCs collected at 28 d,Western blotting was used to measure the expression of the hRAMP1 target gene in the carotid artery; the neointima and media area in the injured carotid arteries were estimated; carotid artery morphology was examined with H&E staining; and the proliferation and apoptosis of VSMCs were determined by immunohistochemistry and TUNEL.Results The expression of CD31 and EGFP was found in proliferating neointima lesions at 7d in the hRAMP1-MSCs group and the Ad-MSCs group.At 28d of MSC transplantation,the level of RAMP1 significantly increased in the hRAMP1-MSCs group,compared with the Ad-MSCs and control groups [(63.0±4.9) vs.(28.3±2.5) and (27.2±7.2),all P＜0.05],but there was no differencein the RAMP1 level between the Ad MSCs group and the control group (P＞0.05).Positive expression of the α-smooth muscle antibody (α-SMA) was found in all three groups at 28 d of MSC transplantation.The thickness of the hyperplastic neointima significantly decreased in the hRAMP1-MSCs group,compared with the other two groups (P＜0.05),and was lower in the Ad-MSCs group than in the control group (P＜0.05).The expression of proliferating cell nuclear antigen (PCNA) was lower in the hRAMP1-MSCs group than in the Ad-MSCs and control groups at 28d of MSC transplantation (P ＜0.05),while the PCNA level was lower in the Ad-MSCs group than in the control group (P＜ 0.05).The VSMC apoptosis rate significantly increased in the hRAMP1-MSCs group,compared with the Ad MSCs and control groups (P＜0.05),and was the lowest in the control group (P＜0.05).Conclusions Gene-modified stem cell therapy can effectively inhibit vascular intimal hyperplasia,thereby reducing restenosis after angioplasty.

AIM:Toinvestigatetheeffectsofcalcitoningene-relatedpeptide(CGRP)onmyocardinexpres-sion and phenotypic switch in vascular smooth muscle cells ( VSMCs) .METHODS:VSMCs were obtained by aortic tissue adherent culture and treated with angiotensin Ⅱ( AngⅡ) , AngⅡ+CGRP or AngⅡ+CGRP +CGRP8-37 .The protein expression of myocardin and the phenotypic proteins of the VSMCs was detected by Western blot .RESULTS:The expres-sion of myocardin in cultured VSMCs showed downregulation along with time expansion .The protein level of myocardin was higher at 48 h and 72 h than that at baseline in the cultured VSMCs (P<0.05).However, the myocardin was lower at 48 h and 72 h than that at baseline after treatment with CGRP in cultured VSMCs (P<0.05).Furthermore, at 48 h in cul-tured VSMCs, the myocardin decreased along with α-smooth muscle actin (α-SMA) (P<0.05), and osteopontin (OPN) increased (P<0.05) in AngⅡ group compared with control group .After treatment with CGRP, the levels of myocardin andα-SMA become higher ( P <0.05 ) but OPN was lower ( P <0.05 ) in CGRP group than those in AngⅡ group. CGRP8-37 abrogated CGRP-induced increase in myocardin and α-SMA and decrease in OPN in CGRP 8-37 group compared with CGRP group .CONCLUSION: CGRP may regulate the phenotypic switch of the VSMCs and maintain the cells in contractile phenotype through the upregulation of myocardin protein , which may be accomplished by the combination of CGRP and its receptor .

Objective To observe the effect of adenovirus- receptor activity modifying protein-1 (RAMP1) on nuclear factor(NF κB) and myocardial fibrosis in heart of rabbit with myocardial infarction. Methods Myocardial infarction (MI) models were developed in 54 rabbits and they were randomly divided into RAMP1 group,EGFP group and control group according to whether pAd2-EGFP-RAMP1,pAd2-EGFP or PBS was injected into infarction region and its border.At 7 d,14 d and 28 d after injection,Left ventricular function indices such as LVEF,LVSd,LVDd and LVFS were estimated by echocardiogram,the expression of NF-κB in myocardium was detected by Western blot,the plasma level of TNF-α was measured by ELISA,and fibrosis and collagen content was measured by Masson stain. Results At 7 d after adenovirus injection,the expression of RAMP1was significantly increased in RAMP1 group (67.33 ± 3.97)％ as compared to EGFP group(20.59 ±3.26) ％ and PBS group ( 23.80 ± 5.08) ％ ( P ＜ 0.05 ).The expression of NF κB was decreased in RAMP1 group ( 26.54 ± 5.13 ) ％ versus EGFP group (62.60 ± 6.18) ％ and PBS group (62.95 ±5.17)％ (P＜0.05).The plasma level of TNF-α was lower in RAMP1 group than in EGFP group and in PBS group at different time[7 d:( 136.74 ± 5.42) μg/L vs.( 196.97 ± 14.17) μg/L,(203.67 ±13.90)μg/L; 14 d:( 154.51 ± 13.61 )]μg/L vs.( 112.22±6.74 )μg/L,(160.46± 14.27)μg/L ;28 d;(51.10± 5.62)μg/L vs.( 95.55 ± 9.94 )μg/L,( 98.96 ± 12.68) μg/L,all P＜ 0.05].The collagen content was reduced in RAMP1 group as compared with EGFP group and PBS group at 14 d and 28 d [14 d:(7.10±0.98)％ vs.(19.52±2.32)％,(17.91±0.96)％ ;28 d:(17.04±2.44)vs,(34.10±5.59) ％,(33.98±4.33)％,all P＜0.01].At 28 d after infarction,the infarct size was decreased in RAMP1 group (26.54 ± 5.13) ％ compared with EGFP group (32.20 ± 3.73) ％ and control group (35.58±2.65) ％ (P＜0.01),and better heart function appeared in RAMP1 group. Conclusions The high-expression of RAMP1 could decrease the collagen deposition and fibrosis in the border of infarction and improve heart function through lower expression of NF-κB and decreasing the plasma level of TNF-α.

Objective To explore the clinical efficacy of the gap above the splenic pedicle in laparoscopic splenectomy (LS).Methods The retrospective cohort study was conducted.The clinical data of 189 patients who underwent LS in the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between August 2012 and March 2015 were collected.Among 189 patients receiving splenic pedicle division,42 without the application of the gap above the splenic pedicle were allocated into the group A and 147 with the application of the gap above the splenic pedicle were allocated into the group B.Observation indicators included:(1) operation situations:combined operation,operation time (excluding combined operation time),volume of intraoperative blood loss (excluding blood volume of spleen),cases with conversion to open surgery;(2) postoperative situations:time to initial anal exsufflation,time for fluid diet intake,occurrence of postoperative complications and duration of hospital stay;(3) follow-up.Patients were followed up by telephone interview and outpatient examination up to August 2016.Follow-up included routine blood test,coagulation function,liver function,with or without long-term complications.Measurement data with normal distribution were represented as x±s and comparison between groups was analyzed using the t test.Comparisons of count data were analyzed by the chi-square test.Results (1) Operation situations:of 189 patients undergoing LS,136 combined with laparoscopic pericardial devascularization,13 combined with laparoscopic cholecys-tectomy,9 combined with laparoscopic radio frequency ablation (RFA) of liver tumors and 26 combined with pathological examination using laparoscopic liver tissues sampling.Operation time,volume of intraoperative blood loss and cases with conversion to open surgery were (118±31) minutes,(80±38) mL,2 in the group A and (70± 22) minutes,(50± 28) mL,1 in the group B,respectively,with statistically significant differences between the 2 groups (t =12.579,-8.516,x2=4.912,P＜0.05).(2) Postoperative situations:time to initial anal exsufflation,time for fluid diet intake,number of patients with postoperative complications and duration of hospital stay were (22± 10)hours,(3.1 ± 1.3) days,8,(9±3)days in the group A and (23±11)hours,(3.8±1.8)days,13,(8±3)days in the group B,respectively.Pancreatic fistula,intra-abdominal hemorrhage,asymptomatic portal vein thrombosis,pulmonary infection and intraperitoneal infection were respectively detected in 2,2,2,1,1 patients in the group A and 1,2,5,2,3 patients in the group B.There was no significant difference in time to initial anal exsufflation,time for fluid diet intake and duration of hospital stay between the 2 groups (t =1.102,0.745,0.583,P＞0.05),and a statistically significant difference in number of patients with postoperative complications between the 2 groups (x2 =7.259,P＜ 0.05).There were statistically significant differences in cases with pancreatic fistula and intra abdominal hemorrhage (x2=16.021,5.812,P＜0.05) and no significant difference in cases with asymptomatic portal vein thrombosis,pulmonary infection and intraperitoneal infection (x2 =1.391,0.396,0.865,P＞0.05).Patients with postoperative complications were cured by symptomatic treatment.(3) Follow-up:156 of 189 patients (33 in the group A and 123 in the group B) were followed up for 1-18 months,with an average time of 12 months.During the follow-up,13 patients had recurrent hematemesis and melena,including 3 in the group A and 10 in the group B.Eight patients stopped bleeding after conservative treatment,3 stopped bleeding after proxial gastrectomy and 2 died of excessive bleeding and organ failure.Conclusion Splenic pedicle division using Endo-GIA through the gap above the splenic pedicle in LS can reduce operation time,volume of intraoperative blood loss,rate of conversion to open surgery and postoperative complications.

Objective To investigate the clinical value of amplitude integrated electroencephalogram on early diagnosis and prognosis evaluation of brain injury caused by neonatal asphyxia.Methods A total of 34 full-term asphyxiated neonates(asphyxia group)hospitalized in NICU of our hospital from January 2015 to September 2015 were selected;meanwhile,34 full-term healthy infants(control group)of the same term were selected.All cases were monitored for the activities of aEEG background,sleep-awakening cycle(SWC)and epileptic activity(SA)within 6 hours after birth.Meanwhile,the relationships between various indexes and asphyxia degree and brain injury were analyzed.Results The electroencephalogram of the asphyxia group was 52.9％and the rate of SWC was 58.8％,which were lower than those of the control group,and the difference had statistic significance(P<0.05).Meanwhile,neonates with epileptic activity in asphyxia group accounted for 11.8％,which was higher than that of control group significantly(P<0.05).Conclusion The AEEG changes of neonates at early period after birth are closely related to perinatal asphyxia and brain injury after asphyxia.The application of amplitude integrated electroencephalogram has an important significance on early diagnosis of neonatal asphyxia.