Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

ObjectiveTo study the types of anatomical variations of hepatic arteries. Methods Hepatic arteries of 64-slice spiral CT scanning data were three-dimensional constructed by using self-designed software. The types of anatomical variations were analyzed and classified with Michels' classification criteria. Results The model presented with realistic profile of hepatic arteries which allowed vivid three-dimensional observation. Of these patients, 40 had normal hepatic arteries (60.61%), 26 had variations (39.39%), and 5 had infrequent aberrant hepatic arteries that was not included in Michels' classification (7.58%). Conclusion Three-dimensional model of hepatic arteries can volumetricly display the anatomical variations of hepatic arteries.

Objective:To evaluate the role of natural killer T cells in renal fibrosis in mice with acute kidney injury (AKI).Methods:Twenty-four clean-grade healthy male C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), AKI group (group A), control plus CD1d antibody group (group C-MA), and AKI plus CD1d antibody group (group A-MA). The model of renal fibrosis in mice with AKI was established by intraperitoneal injection of folic acid 250 mg/kg.In group C, homotypic control antibody 20 mg/kg was injected via the tail vein.In group AKI, homotypic control antibody 20 mg/kg was injected via the tail vein at 24 h before establishing the model. In group C-MA, anti-CD1d monoclonal antibody 20 mg/kg was injected via the tail vein.In group A-MA, anti-CD1d monoclonal antibody 20 mg/kg was injected via the tail vein at 24 h before establishing the model.On the 14th day after folic acid injection, blood samples were taken from eyeballs to determine the concentrations of blood urea nitrogen (BUN) and creatinine (Cr) in serum.Then the mice were sacrificed, and the renal tissues were taken for Sirius red staining and HE staining to determine the area of renal fibrosis, and renal injury was scored.The expression of fibronectin (FN), type I collagen (Col-Ⅰ) and alpha-smooth muscle actin (α-SMA) in renal tissues was detected by immunofluorescence method.The expression of interleukin (IL)-4, IL-13, arginase-1 (Arg-1) and found in inflammatory zone 1 (FIZZ1) mRNA in renal tissues was detected by real-time polymerase chain reaction. Results:Compared with group C, the concentrations of BUN and Cr in serum, renal injury score, and area of renal fibrosis were significantly increased, the expression of FN, Col-Ⅰ and α-SMA and IL-4, IL-13, Arg-1 and FIZZ1 mRNA was up-regulated in A and A-MA groups ( P<0.05), and no significant change was found in the above indexes in group C-MA ( P>0.05). Compared with group A, the concentrations of BUN and Cr in serum, renal injury score, and area of renal fibrosis were significantly decreased, the expression of FN, Col-Ⅰ and α-SMA and IL-4, IL-13, Arg-1 and FIZZ1 mRNA was down-regulated in group A-MA ( P<0.05). Conclusion:Activation of natural killer T cells is involved in the process of renal fibrosis in mice with AKI, and the mechanism may be related to promoting the release of Th2 cytokines and M2 polarization of macrophages.

Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide (H2S) protects against multiple cardiovascular disease states in a similar manner as nitric oxide (NO),and NO/endothelial nitric oxide synthase (eNOS) pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester (L-NAME)-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley (SD) male rats were randomly assigned to 6 groups (n=6):control group,L-NAME group,control + glibenclamide group,control + NaHS group,L-NAME + NaHS group,and L-NAME + NaHS + glibenclamide group.Measurements were made of plasma triglycerides (TG),low-density lipoprotein (LDL),high-density lipoprotein (HDL),total cholesterol (CHO),glutamic-pyruvic transaminase (ALT) levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG ((1.22±0.12) mmol/L in L-NAME group vs.(0.68±0.09) mmol/L in control group; P ＜0.05) and LDL ((0.54±0.04) mmol/L in L-NAME group vs.(0.28±0.02) mmol/L in control group; P ＜0.05) concentration were significantly increased,and the plasma HDL ((0.26±0.02) mmol/L in L-NAME group vs.(0.69±0.07) mmol/L in control group; P ＜0.05) concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels ((1.36±0.09) mmol/g protein in L-NAME group vs.(2.34±0.06) mmol/g protein in control group; P ＜0.05) and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure ((37.25±4.46) mmHg at the fifth week; P ＜0.05),and ameliorate the plasma TG ((0.59±0.06) mmHg),LDL ((0.32±0.04) mmHg),and HDL ((0.46±0.03) mmHg) concentration in L-NAME + NaHS group (all P ＜0.05).H2S therapy can also restore eNOS function and NO bioavailability and attenuate the pathological changes in the liver in L-NAME-induced hypertensive rats.Conclusion H2S protects the L-NAME-induced hypertensive rats against liver injury via NO/eNOS pathway,therefore de.creases the cardiovascular risk.

Objective:To investigate the effect of bel canto breathing training method on the respiratory rehabilitation of patients with chronic obstructive pulmonary disease in stable stage.Methods:Using a quasi-experimental research method, 40 patients with chronic obstructive pulmonary disease in stable stage from September to December 2018 in two wards (the first ward and the second ward) with the same level of diagnosis and treatment of respiratory physicians, nurses' nursing ability and the ward environment of the First Hospital of Lanzhou University were selected. The first ward was used as the experimental group, and the second ward was used as the control group, there were 20 cases in each group. The patients in the experimental group were given bel canto breathing training and conventional breathing training, while the patients in the control group were given conventional breathing training. A WeChat group was established, and training videos were distributed in the WeChat group after discharge to urge patients to perform training. After 3 months of intervention, the quality of life, anxiety, depression, and pulmonary function were evaluated by St George′s Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS), proportion of forced expiratory volume in forced vital capacity in the first second(FEV1/FVC).Results:The SGRQ score, HADS score and FEV1/FVC value in the experimental group before intervention respectively were (41.35 ± 9.94), (16.55 ± 4.29) points and (47.13 ± 8.85)%, at discharge respectively were (28.95 ± 5.66), (11.20 ± 2.75) points and (59.51 ± 10.49)% and after three months of intervention respectively were (21.75 ± 6.31), (7.15 ± 3.51) points and (66.69 ± 7.87)%, while the SGRQ score, HADS score and FEV1/FVC value in the control group before the intervention respectively were (42.10 ± 10.50), (16.60 ± 4.73) points and (46.23 ± 10.14)%, at discharge respectively were (34.90 ± 10.16), (13.35 ± 2.37) points and (52.91 ± 7.86)%, and after three months of intervention (35.80 ± 7.27), (14.20 ± 5.05) points and (52.65 ± 8.60)%. With the increase of the intervention time of bel canto breathing training, the SGRQ score and HADS score decreased ( F=29.65, 17.44, both P<0.05), and the FEV1/FVC value increased ( F=27.38, P<0.05). Within-group comparisons the SGRQ score, HADS score, and FEV1/FVC value in the experimental group at discharge, three months after the intervention versus pre-intervention, and three months after the intervention versus discharge showed statistically significant differences ( t values were -7.73 - 7.38, all P<0.05). SGRQ score, HADS score, and FEV1/FVC value in the control group were only statistically significant at discharge versus pre-intervention ( t=-4.63, -2.79, 5.28, all P<0.05). The SGRQ, HADS score and FEV1/FVC value between the 2 groups were not statistically significant before the intervention, but statistically significant at discharge and three months after the intervention ( t values were -6.53 - 5.39, all P<0.05). Conclusions:Bel canto breathing training can improve the quality of life, reduce anxiety, depression and increase FEV1/FVC in patients with chronic obstructive pulmonary disease in stable stage.

Objective:To probe the diagnostic performance of the combined evaluation of stenosis and plaque characteristics based on coronary computed tomography angiography (CCTA) in identification of myocardial ischemic lesions, using the invasive coronary angiography (ICA)-based fractional flow reserve (FFR) as the gold standard.Methods:From November 2018 to March 2020, the patients with suspected or known coronary artery disease and scheduled for ICA at 5 clinical trials centers were enrolled in this study. All the patients underwent CCTA, ICA and FFR in turn in one week. The luminal stenosis and plaque characteristics were measured and assessed including plaque burden, volume ratios of calcification and non-calcification, lesion length and CT vulnerable features. All culprit vessels were divided into FFR≤0.8 and FFR>0.8 groups, and the parameters of plaque characteristics were compared. The correlation of ischemic lesions with CCTA stenosis and plaque characteristics was analyzed by the logistic regression analysis. The ROC curve was used to evaluate the sensitivity and specificity of CCTA stenosis rate and plaque characteristics, meanwhile the area under curve (AUC) of each parameter was compared by Delong test.Results:Three hundred and sixty-six culprit vessels in 317 patients were analyzed in this study (169 vessels in ischemia group and 197 in nonischemia group). The plaque burden [34.3% (30.3%, 38.8%) vs. 32.4% (28.5%, 37.9%); Z=-2.622, P=0.009], proportion of CT vulnerable features [26.9% (45/169) vs.11.7% (23/197); χ 2=15.311, P<0.001] and lesion length [22.1 (14.4, 35.0) mm vs. 17.6 (11.0, 26.0) mm; Z=-4.388, P<0.001] in FFR≤0.8 group were higher than those in FFR>0.8 group. The results of logistic regression analysis revealed that CCTA stenosis, lesion length, and CT vulnerable features were significant predictors for myocardial ischemia (OR values: 3.794, 2.461, 1.027; P<0.001, P=0.002, P=0.002). The diagnostic performance of CCTA ≥50% stenosis alone in identification of ischemic lesions was low (AUC=0.625). When it combined high-risk plaque characteristics and lesion length, the AUC was improved to 0.714 with a statistical significance. Conclusions:CCTA stenosis, lesion length, and CT vulnerable features are major predictors in identification of myocardial ischemic lesions, and the combination will significantly improve the diagnostic performance of CCTA ≥50% stenosis.

Objective:To investigate the effect of patellar replacement and patellar height on the therapeutic effect of total knee arthroplasty (TKA).Methods:A retrospective analysis was conducted on 429 patients (92 males, 337 females; aged 66.81±7.05 years; left=226, right=203) with severe knee osteoarthritis who underwent TKA in the First Affiliated Hospital of Shandong First Medical University from July 2020 to December 2021, with the body mass index of 27.60±4.22 kg/m 2, Grade-III Kellgren-Lawrence, and Insall-Salvati (IS) ratio >0.8. Afterward, the patients were divided into 4 groups according to whether patellar replacement was performed or not and the preoperative IS ratio (IS of 0.8-1.2 for normal patellar and >1.2 for high patellar): the patellar replacement+normal height patellar group (263 cases), the patellar replacement+high height patellar group (66 cases), the patellar non-replacement+normal height patellar group (68 cases), and the patellar non-replacement+high height patellar group (32 cases). Moreover, postoperative intergroup IS ratio, Knee Society Score (KSS), Hospital for Special Surgery (HSS) knee score, Oxford Knee Score (OKS), knee range of motion, complications, and satisfaction were analyzed. Results:All patients were followed up, and the time was 1.15±0.16 years (range, 1-2 years). Postoperative symptoms such as knee pain, swelling, and limitation of movement were significantly improved compared with the preoperative period. Additionally, KSS pain score, knee range of motion, HSS score and OKS score were significantly different among the four groups ( F=9.49, P<0.001; F=11.09, P<0.001; F=6.74, P<0.001; F=3.24, P=0.022), but the difference in KSS functional scores was not statistically significant ( F=1.84, P=0.140). At the same time, the KSS pain score, HSS score, OKS score, and knee range of motion (41.84±5.25, 80.43±6.99, 14.27±5.39, and 122.33°±4.93°) in the patellar replacement+normal height patella group were all better than those in the patellar non-replacement +normal height patella group (38.31±7.31, 77.00±7.81, 16.05±5.81, 120.99°±4.90°) and patella non-replaced + high height patella group (37.97±7.28, 75.62±11.02, 16.63±6.67, 116.25°±13.08°), with statistically significant differences ( P<0.05). The patella replacement+ high height patella group only had better KSS pain scores than the patella non-replaced+normal height patella group and the patella non-replaced+high height patella group (41.74±6.35, 38.31±7.31, 37.97±7.28), with statistically significant differences ( P<0.05). Moreover, Knee mobility was better in the patellar replacement+high height patella group (121.68°±2.88°) and the patellar non-replacement+normal height patella group (120.99°±4.90°) than in the patellar non-replacement+high height patella group (116.25°±13.08°), and the differences were statistically significant ( P<0.05). There were statistically significant differences in the IS ratio before surgery, 1 day after surgery and 1 year after surgery among the four groups ( P<0.05), and the IS ratio at 1 day after surgery was lower than that before surgery with statistically significant differences ( P<0.05), but there was no statistically significant difference between the IS ratio at 1 year after surgery and that before surgery ( P>0.05).Furthermore, the preoperative differences in the incidence of anterior knee pain, patellar clicking and satisfaction rates in patients with different patellar heights were not statistically significant ( P>0.05). Finally, the patellar replacement group possessed a lower incidence of anterior knee pain (normal height patella: 7.6% vs. 16.2%, χ 2=4.68, P=0.031; high height patella: 9.1% vs. 25.0%, χ 2=4.46, P=0.035) and patellar clicking (normal height patella: 9.1% vs. 17.6%, χ 2=4.05, P=0.044; high patella: 13.6% vs. 31.2%, χ 2=4.28, P=0.039); there was no significant difference in satisfaction rate among the four groups after operation ( P>0.05). Conclusion:Postoperative outcomes were better in patients with patellar replacement during TKA than in patients with no patellar replacement, and knee range of motion was better in patients with normal-height patellas than in patients with high patellas preoperatively, with no effect of TKA on patellar height.

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.

Purpose/Significance To deeply analyze the research progress on the application of medical knowledge graph in the field of stroke,to discuss the problems of the development of stroke knowledge graph in China,and to put forward suggestions for the construc-tion of stroke knowledge graph.Method/Process By reviewing and analyzing the relevant literature,the application of medical knowledge graph in the field of stroke is sorted out and summarized.Result/Conclusion There are still many deficiencies in the development of stroke knowledge graph in China,and in the future,in-depth research can be carried out from four aspects,namely,expanding the ap-plication scope of knowledge graph,promoting the fusion of knowledge graph,developing more efficient algorithms,and upgrading to cog-nitive graph by joint artificial intelligence(AI).

Objective To investigate the feasibility of immature dendritic cells (imDC)phagocytized psoralen ultraviolet A (PUVA)-treated splenic lymphocytes (PUVA-SP DC)in mice inducing B lymphocytes to be regulatory B cells (Breg)with high secretion of interleukin (IL)-10 (IL-10 +Breg). Methods Bone marrow-derived DC of mice was cultured. Spleen lymphocytes of mice were isolated and treated by PUVA,and turned to be PUVA-SP. The bone marrow-derived imDC was co-cultured with PUVA-SP in vitro to obtain PUVA-SP DC. Splenic B lymphocytes of mice were separated by anti-CD19 magnetic beads and co-cultured with different kinds of DC for 48 hours. The levels of interferon (IFN )-γ,transforming growth factor (TGF)-β,IL-12p70,and IL-10 in the culture supernatant of B lymphocytes,imDC,imDC+B lymphocytes, PUVA-SP DC and PUVA-SP DC +B lymphocytes were measured by enzyme-linked immune absorbent assay (ELISA). The accounts of IL-10 +Breg in B lymphocytes,imDC+B lymphocytes,mDC+B lymphocytes and PUVA-SP DC+B lymphocytes were detected by flow cytometry. Results Compared with the other 4 groups, the level of IL-10 in cell culture supernatant of PUVA-SP DC+B lymphocytes was significantly higher (all in P<0.05). Compared with the other groups,the account of IL-10 +Breg in PUVA-SP DC+B lymphocytes was significantly higher. Conclusions PUVA-SP DC can induce splenic B lymphocytes to differentiate into IL-10 +Breg.