Objective To study the influence of perdipine on the proliferation and proline-rich tyrosine kinase 2 (PYK_ 2 ) expression in cultured adult rat cardiac fibroblast stimulated by angiotensin Ⅱ, and to explore the mechanism of perdipine on cardiac fibrosis. Methods Adult rat cardiac fibroblasts (CFs) were treated with angiotensin Ⅱ(AngⅡ) to establish fibrosis model. The effects of perdipine on proliferation of CFs were analysed by MTT colorimetric assay, and fibronectin was tested by immunohistochemistry method. PYK_ 2 mRNA and protein level were examined by RT-PCR and Western blot analysis respectively. Results Perdipine inhibited CFs proliferation and fibronectin synthesis stimulated by angiotensin Ⅱ in a dose dependent, and the levels of PYK_2 mRNA and protein were decreased significantly. Conclusion Perdipine can inhibit cardiac fibrosis stimulated by angiotensin Ⅱ by suppressing CFs proliferation and fibronectin synthesis. PYK_2 is involved in the effect of perdipine.

Extracellular matrix protein-1 (ECM-1) is a secretory glycoprotein. Recent studies found that the protein may be related to the digestive tract tumor growth, invasion and metastasis. In this paper,the basic structure and function, as well as the possible mechanism in gastrointestinal cancer have been reviewed.

Endovascular repair has gained worldwide popularity for the treatment of aortic dissection and aortic aneurysm.The non-tapered stents are selected usually.The aortic diameters vary in different level.High incidence of distal stent-induced complications is closely related to the aortic taper angle.According to several published studies,the aortic taper angle could be evaluated by establishing geometric model.Applications of tapered stents can significantly reducing the incidence of distal stent-induced comnplications.This review summaries the latest researches in the studies of the progress and the application of the aortic taper angle and the tapered stents,providing a reference for endovascular stent-graft selecting in the treatment of aortic dissection and aortic aneurysm.

Objective To explore the correlation between the enhancement pattern of hepatocellular carcinoma (HCC) on contrast-enhanced ultrasound (CEUS) and its tumor differentiation on histopathology. Methods HCC lesions (n=259) from 224 patients were retrospectively evaluated with CEUS and histopathological examination. CEUS was performed with SonoVue. The characteristics of blood perfusion and parameters of the time-intensity curve (TIC) were analyzed by ACQ soft?ware. Histopathological diagnoses were decided base on Edmonson grading system. Results Pathologic grading of HCC was not related to the arrival time(P>0.05);The washing-out time point and the enhancement time point and peak time point all appeared earlier in poorly differentiated HCC group, than those in moderately differentiated HCC group than those in well differentiated HCC group(P<0.01);The enhancement time point and the expurgation time point are shorter in poorly differ?entiated HCC group than those in moderately differentiated HCC group than those in well differentiated HCC group. All dif?ferences were with statistical significance. The mode of arterial perfusion in early stage was divided into 3 types:spider web type, radiative type and mixed type. The well differentiated HCC group mainly presented as radiative type ( 28/49, 47.14%). But the most of poorly differentiated HCC group mainly present as spider web type(88/127, 69.29%). The mix type was more common in moderately differentiated HCC group(49/83, 59.03%). Conclusion CEUS show different features of TIC pa?rameters and blood perfusion in different pathological stages of HCC lesions so it can serve as a method to assess the biologi?cal behavior of hepatocellular carcinoma.

Objective:To investigate extraocular muscles(EOM) susceptibility to myasthenia gravis(MG).Methods:Acetylcholine receptor(AChR) ?, ?, ?, ? and ? subunits from human EOM and other different muscle groups from 8 health controls and intercostal muscles from 10 MG patients were studied by RT-PCR System. Serum AChR antibodies from 83 patients with MG were assayed by ELISA.Results:①AChR?, ?, ?, ? and ? subunit mRNA could be amplified from normal human EOM and all muscle groups studied. ②AChR? P3A+/?-actin mRNA was expressed at higher level in general MG than in health controls(P=0.028). ③Ocular and general MG patients had higher AChR antibodies against AChR from adult gastrocnemius muscle than that from fetus(P=0.001,0.016).Conclusion:Susceptibility of EOM to MG is likely associated with muscle AChR subunit mRNA expression and intrinsic susceptivity of EOM.

ObjectiveTo study the expression of vascular endothelial growth factor (VEGF) and aquaporin 1 (AQP1) in the synovium of rheumatoid arthritis (RA) patients,and their correlation with angiogenesis.MethodsThe expression of VEGF and AQP1 in the synovial tissue was detected with immunohistoehemistry in 7 patients with RA,12 patients with osteoarthritis (OA).The expression of VEGF and AQP1 positive cells and vessels was scored,and the correlation of positive cells with vessels was analyzed.Rank-sum test and Spearman's correlation analysis were used for statistical analysis.ResultsThe expression of VEGF positive cells was significantly correlated with vessels in the synovium of RA group(rs=0.971,P＜0.01 ).No significant correlation was found between VEGF positive cells and vessels in synovium of the OA group (rs=0.235,P=0.462).There was no evident difference in the expression of VEGF positive cells between RA and OA group (Z=-0.390,P=0.711 ).The expressions of AQP1 positive cells were significantly correlated with vessels in the synovium of RA group (rs=0.828,P=0.022).No significant correlation was found between AQP1 positive cells and vessels in the synovium of OA group (rs=0.396,P=0.203).There was no notable difference in the expression of AQP1 positive cells between RA and OA group (Z=-0.302,P=0.773).The expressions of VEGF positive cells were significantly correlated with AQP1 positive cells in RA group (rs=0.891,P=0.007).No significant correlation was found between VEGF positive cells and AQP1 positive cells in OA group (rs=0.338,P=0.283).ConclusionThe expressions of VEGF and AQP1 are significantly correlated with angiogenesis in the synovium of RA,and they play an important role in the pathology of RA.Moreover,there may be synergistic effect between VEGF and AQP1 in RA.

Objective To investigate the effect of injection of air into the epidural space on the subarachnoid puncture during the combined spinal-epidural anesthesia (CSEA) .Methods Two hundred and ten ASA Ⅰ or Ⅱ parturients who were at full term with a singleton fetus, aged 20-42 yr, weighing 57-82 kg (height 152-170cm) , undergoing cesarean section under CSEA, were randomly divided into 3 groups ( n = 70 each) : hanging drop technique group (group Ⅰ ) and injection of small volume of air group (group Ⅱ ) and injection of large volume of air group ( group Ⅲ ) . The epidural space was indentified using hanging drop technique in group Ⅰ and using loss of resistance to air technique in Ⅱ and Ⅲ groups. Injection of air was stopped as soon as the clear loss of resistance identified the epidural space in group Ⅱ , whereas all 4 ml of air was injected in group Ⅲ . After the epidural space was confirmed at L3,4 interspace, a 25-gauge spinal needle protruding 14 mm beyond the 18-gauge epidural needle was introduced through the epidural needle. Subarachnoid placement was confirmed by backflow of cerebrospinal fluid (CSF) . If no backflow of CSF was observed, the spinal needle was withdrawn and an epidural catheter was inserted through the epidural needle to perform epidural anesthesia. Successful subarachnoid puncture, failures to observe backflow of CSF and adverse reactions were recorded. Results The three groups were comparable with respect to age, height, body weight and gestation weeks. The success rate of subarachnoid puncture was 91% ,93% and 79% in Ⅰ ,Ⅱ and Ⅲ groups respectively, and it was significantly higher in Ⅰ and Ⅱ groups than in group Ⅲ ( P < 0.05) . There was no significant difference in the success rate of subarachnoid puncture between Ⅰand Ⅱ groups ( P > 0.05) . Bilateral segmental analgesia presented in all cases who received only epidural anesthesia after no backflow of CSF was observed, and the expected analgesia also presented in all cases in whom back flow of CSF was observed. No adverse reactions occurred. Conclusion Injection of air into the epidural space is related to the success of subarachnoid puncture during CSEA and injection of a large volume of air lowers the success rate.

In order to optimize the ~(18)O labeling method, two key aspects, peptide dispersion and trypsin deac tivation were discussed o The addition of Rapigest SF in H_2~('8)O and microwave heating enhanced labeling efficiency of α-casein digested peptides(~(18)O/~(16)O) ratio >99%).Chemical modification with tris(2-carboxyeth yl) phosphine (TCEP) and iodoacetamide (IAA) resulted in trypsin deactivated completely.No significant back-exchange from ~(18)O to ~(16)O was observed after labeling in 6 days.The experiment result with peptide mixture from showed that the improved method could be effectively used to label protein and peptide.

Objective:To systematically evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in acute kidney injury (AKI).Methods:All studies about the predictive effect of NLR on AKI were searched in the National Medical Library of the United States PubMed Database, the Embase database in the Netherlands, the Chinese Biology Medicine disc (CBMdisc) and the Chinese Evidence Based Medicine Cochrane Centre Database (CEBM/CCD). The data updated by October 2020, and regardless of language, region or whether blind method was used. Two authors independently extracted data and evaluated the quality of the studies. Data extracted from the studies were analyzed with RevMan 5.3 to assess the predictive value of NLR on AKI. A subgroup Meta-analysis was conducted to assess the predictive value of NLR on AKI according to different countries, different disease types (cardiovascular surgery, infectious diseases, other diseases including burns, cirrhosis, and emergency), and different sample sizes (≤ 300 cases and > 300 cases). The publication bias of included studies about the predictive effect of NLR on AKI were assessed by funnel plots.Results:A total of 11 studies were included in this Meta-analysis, including 4 997 patients, 1 308 patients in AKI group, and 3 689 patients in non-AKI group. The Meta-analysis results showed that: increased NLR had predictive value for the occurrence of AKI [mean difference ( MD) = 2.73, 95% confidence interval (95% CI) was 1.78-3.68, P < 0.000 01]. Subgroup analysis showed that increased NLR had predictive value for the occurrence of AKI in patients from Southeast Asia ( MD = 4.04, 95% CI was 1.09-6.99, P = 0.007) and Eurasia ( MD = 2.51, 95% CI was 1.12-3.90, P = 0.000 4). Increased NLR had predictive value for the occurrence of AKI in patients undergoing cardiovascular surgery ( MD = 0.77, 95% CI was 0.34-1.20, P = 0.000 4), infectious diseases ( MD = 4.74, 95% CI was 1.51-7.96, P = 0.004) and other diseases ( MD = 8.53, 95% CI was 6.26-10.80, P<0.000 01). Increased NLR had predictive value for the occurrence of AKI in studies with a sample size of ≤ 300 cases ( MD = 6.02, 95% CI was 4.90-7.14, P <0.000 01) and > 300 cases ( MD = 1.32, 95% CI was 0.61-2.03, P = 0.000 3). There was no significant publication bias in the included studies assessed by funnel plots. Conclusion:NLR is an important predictive tool for AKI.

OBJECTIVE To study the clinical features and therapeutic efficacy of middle ear adhesion.METHODS The clinical data of 40 cases of middle ear adhesion collected during 5 years from 2002 to 2007 were studied retrospectively. RESULTS Part or all of the tympanic membrane of the patients did not move under Siegle otoscopy. The lesions of middle ear adhesion were extensive and invaded all middle ear structures including round and oval windows.The lesions were severe, especially in narrow anatomical spaces such as mesotympanum,hypotympanum and interossicular spaces.Pure tone audiometry showed that average air-bone gap (A-B gap) were (35.34?6.99) dB preoperatively.The average A-B gap were (18.47?5.76) dB 6 months after operation.Follow-up observations and postoperative CT scan showed that tympanic membranes and middle ear cavity recovered well.CONCLUSION There are various degrees of tympanic fibrous adhesion and atelectatic tympanum in middle ear adhesion,especially in mesotympanum, hypotympanum and interossicular spaces.The middle ear adhesion can be treated with operation.The key points for a successful operation include preserving normal tympanum mucosa,opening eustachian tubes, making a bigger middle ear cavity,and performing tympanoplasty with perichondrium-cartilage plates.