Objective:To investigate the effect of survivin-siRNA plasmid on survivin expression in human lung cancer cell line A549, and to observe its effect on the apoptosis, proliferation, and chemosensitivity of A549 cells. Methods: pSilencer-survivin-siRNA (survivin-siRNA) plasmid was constructed using pSilencer-U6 plasmid and was transfected into A549 cells. Expression of survivin mRNA and protein was examined by RT-PCR and Western blotting analysis, respec-tively. Apoptosis and proliferation of A549 cells were examined by DAPI staining and MTT, respectively. Results: Sur-vivin-siRNA plasmid was successfully constructed, and it significantly inhibited survivin mRNA and protein expression in A549 cells. Survivin-siRNA transfection induced apoptosis, inhibited proliferation and increased chemosensitivity of A549 cells to cisplatin. Conclusion: pSilencer-survivin-siRNA can silence survivin expression in A549 cells and subsequently inhibit proliferation, promote apoptosis, and enhance chemosensitivity of A549 cells to cisplatin. Survivin may serve as a potential target for gene therapy of lung cancer.

Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.

Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.

Objective To investigate the distribution of the prevalence of albuminuria in elderly population of a community in Tianjin and analyze the situation of their early renal injury and its clinical and environmental risk factors.Methods The morning spot urine sample and the clinical data from 2 050 old population (aged ≥ 60 years)who took part in healthy examination were collected.The concentration of urine albumin and creatinine were tested,and the albumin/creatinine ratio(ACR)was calculated.We analyzed the prevalence of albuminuria,and used logistic regression to analyze the odd ratio(OR) of risk factors.Results In the 2 050 participants,the prevalence was 1162 cases (56.69％) for hypertension,264 cases (12.86％) for diabetes and 568 cases (27.71％) for albuminuria.The prevalence of ACR ＞ 30 mg/g was lower in men than in women (21.61％ vs.32.55％,P＜0.001).The OR for increased ACR was 1.45 in 70-79y subjects as compared with 60-69y subjects,and the OR was 1.89 in ＞80y old people.The OR of increased ACR was 2.03 in ＞80y old people after adjusting gender.Body mass index and waist circumference were not the risk factors of increased ACR after adjusting confounding factors.There was an association between the prevalence of albuminuria and triglycerides(OR=1.19),hypertension(OR=1.68),diabetes(OR=1.95).ACR value was increased along with increased number of cigarettes,however,there was also no association between smoking and albuminuria(P＞ 0.05).Physical activity could reduce the risk of albuminuria,the OR of ACR＞30 mg/g in those undertaking a activity once daily was 0.52 (P =0.027) Conclusions There is a high prevalence of albuminuria in elderly population(higher in female than in male) in a community of Tianjin.Hypertension and diabetes have the greatest influence on ACR.Additionally,the physical activity once daily can reduce the risk of albuminuria.

BACKGROUND:Activation of Notch signaling plays a critical role in stem cel differentiation, and this effect seems to be cel-type dependent. Little is reported on the role of activation of Notch1 signaling in the differentiation of c-Kit+ bone marrow mesenchymal stem cels. OBJECTIVE:To analyze the influence of activation of Notch1 signaling on the differentiation of c-Kit+ bone marrow mesenchymal stem cels. METHODS:The Notch1 intracelular domain (N1-ICD) was obtained from the cDNA library by PCR and cloned intoBamHI/AgeI digested adenoviral GV314 plasmid to construct N1-ICD overexpressing shuttle plasmid, and the positive clones were verified by sequencing. N1-ICD shuttle plasmid and helper plasmids pBHGloxΔE1,3 Cre were used to co-transfect HEK293T cels to obtain N1-ICD overexpressing adenoviral particles (N1-ICD-Ad). The c-Kit+ subpopulation were isolated from bone marrow mesenchymal stem cels of the Sprague-Dawley rat femurviamagnetic activated cel sorting. After transfection of the c-Kit+ BMSCs with N1-ICD-Ad adenovirus, we assessed the activation of Notch1 signaling and differentiation in c-Kit+ bone marrow mesenchymal stem cels by quantitative RT-PCR and immunofluorescent staining. RESULTS AND CONCLUSION:N1-ICD coding sequence was successfuly generated from the cDNA library, and then was cloned into the linearized adenoviral vectors GV314. The resistant clones were verified by sequencing. With the assistance of packaging plasmids, recombinant N1-ICD-Ad adenovirus plasmids were successful packaged in HEK293T cels, and its title was 2×1012 PFU/L. c-Kit+ bone marrow mesenchymal stem cels with the purity of 91.6% were successfuly isolated from the bone marrow mesenchymal stem cels of the Sprague-Dawley rat femur. Compared with the blank and negative controls, N1-ICD-Ad infection in the c-Kit+ bone marrow mesenchymal stem cels led to substantial accumulation of N1-ICD in the cytoplasm and nuclei, significantly unregulated expressions of Hes1 (a downstream gene of Notch) and cardiomyocyte differentiation genes Nkx2.5 and cTnT, significantly increased the expression of von Wilebrand factor, an endothelial cel differentiation gene, and mildly increased the expression of smooth muscle22α, a smooth muscle cel differentiation gene. These experimental results indicate that the activation of Notch1 signaling contributes to multi-lineages differentiation of c-Kit+ bone marrow mesenchymal stem cels, and the construction of N1-ICD overexpressing adenoviral vector makes the foundation for further research on the role of Notch1 signaling in stem cel biology.

Objective To analyze and summarize the experiences in diagnosis and treatment of patients with severe traumatic brain injury (sTBI) so as to increase the cure rate and survival rate. Methods A retrospective study was made on the diagnoses and treatment of 4 462 cases of sTBI inclu-ding 3 298 males (73.9%) and 1 164 females (26.1%). The most frequent cause for injury was traffic accident, accounting for 35.5% (1 583/4 462). Closed bead injury ocurred in 3 654 cases (81.9%) and open head injury in 808 (18.1%). The most commen clinical manifestations included unconscious-ness, changes of pupils and life signs. Of all, 1 158 cases (26.0%) were found with combined injury and 1 356 (30.4%) with complications. Treatment measures included first aid, surgery or conventional treatment. Emphasis was put on the treatment of secondary insults. Results Surgery was performed in 3 023 cases (67.7%) including craniotomy for hematoma clearance in 856 cases and hematoma clearance plus decompression in 2 167, with mortality rate of 17.9%. Conventional treatment was carried out in 1 439 cases (32.3%), with mortality rate of 23.7%. There were 2 462 eases (55.2%) with fair recov-ery, 508 (11.4%) with mild disability, 339 (7.6%) with severe disability, 272 (6.1%) under vege-tative state and 881 (19.7%) deaths on discharge according to the Glasgow Outcome Scale. Conelu-sions Active diagnoses and treatment, strict medication rules and prevention and treatment of secondary insults may be key to higher eure rate as well as lower morbidity and mortality of sTBI.

[ ABSTRACT] AIM:To explore the role of superoxide dismutase ( SOD) and malondialdehyde ( MDA) in chronic pancreatitis ( CP) induced by dibutyltin dichloride ( DBTC) combined with ethanol, and the mechanisms for prevention and treatment of pancreatic fibrosis by Chaihushugansan.METHODS: The KM mice were randomly divided into control group, CP group ( DBTC combined with ethanol) and Chaihushugansan group ( CP+Chaihushugansan) .Except for control group, the mice in other groups were intravenously injected in tail with DBTC (8 mg/kg) and drank 10% ethanol.The mice in Chaihushugansan group were administered intragastrically with Chaihushugansan (6 g· kg-1 · d-1 ) at the follow-ing experimenal period.Before modeling and 1 week, 2 weeks, 4 weeks and 8 weeks after modeling, the mice were anes-thetized and sacrificed.The activity of amylase and the content of hyaluronic acid in the serum were measured.The mor-phology and the degree of fibrosis in the pancreas were observed by HE staining.The activity of SOD and the level of MDA in the pancreas homogenate were analyzed.The protein of pancreas was extracted to detect the expression of type I collagen by Western blotting.RESULTS:DBTC combined with ethanol induced CP with increased serum amylase and hyaluronic acid levels, while the serum amylase and hyaluronic acid levels in Chaihushugansan group were significantly lowered ( P<0.05).In 1 week, 2 weeks, 4 weeks and 8 weeks, the pancreas were obviously injured and appeared different degrees of fibrosis.The content of MDA and the expression of type I collagen in the increased significantly, but the SOD was de-creased.In Chaihushugansan group, the pathological damage and the degree of fibrosis of the pancreas were improved.The level of MDA and type I collagen expression in the pancreas were significantly reduced, but the SOD was increased.CON-CLUSION:The oxidative stress may take part in the development of CP.Inhibition of oxidative stress in the pancreas is one of the mechanisms that Chaihushugansan attenuates the development of CP.

Objective:To analyze and discuss the characteristics of cardiopulmonary and cerebral resuscitation (CPCR) in patients after out-of-hospital cardiac arrest (OHCA).Methods:The data of OHCA patients admitted to the directly-managed branch of the Wuxi Emergency Medical Center, covering the period from December 26, 2016, at 7:45 to August 26, 2022, at 7:45. The analysis included the first electrocardiogram (ECG), clinical characteristics, pre-hospital emergency measures, and follow-up conditions in the hospital. Based on the Glasgow-Pittsburgh cerebral function grading at discharge, patients were divided into a CPCR group (grades 1-2) and a non-CPCR group (grades 3-5). The study compared the basic conditions, resuscitation times, and vital signs after resuscitation between the two groups to evaluate the factors affecting CPCR.Results:A total of 6 040 OHCA cases were treated, 3 002 cases received pre-hospital resuscitation. The initial ECG indicated a shockable rhythm in 185 cases, with a shockable rhythm rate of 6.16%. There were 293 pre-hospital survivors, with a pre-hospital survival rate of 9.76%. 170 cases survived to be discharged, with a discharge survival rate of 5.66%. Ultimately, 44 cases achieved CPCR, accounting for 25.88% of the cases that survived to discharge. There were statistically significant differences in terms of first-witness treatment, defibrillable rhythm ratio, defibrillation, response to pain stimulation after return of spontaneous circulation (ROSC), spontaneous breathing, light reflex, pulse oxygenation, and blood pressure between the CPCR and non-CPCR groups (all P<0.05). The CPCR group showed significantly higher proportions than the non-CPCR group in the defibrillatable rhythm (75.00% vs. 10.44%), undergoing defibrillation (70.46% vs. 9.24%), having spontaneous breathing after ROSC (86.36% vs. 17.27%), and having oxygen saturation >92% with systolic blood pressure >90 mmHg (86.36% vs. 39.76%).There were statistically significant differences between the CPCR and non-CPCR groups in the time from cardiac arrest (CA) to doctor reception, CA to first defibrillation, CA to ROSC, and CA to discharge or in-hospital death (all P<0.05). Conclusions:The patients with successful pre-hospital resuscitation and finally cerebral resuscitation were characterized by short times from OHCA to first medical contact (FMC) and from FMC to ROSC, appropriate pre-hospital vital sign management accompanied by partial neurological recovery, and comprehensive in-hospital neurological prognosis assessment.

Objective: To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR). Methods: Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed. Results: The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes. Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.

Objective:To investigate the effectiveness of balloon-assisted technique for the treatment of intraprocedural aneurysmal rupture (IAR) during intracranial aneurysm coil embolization and its impact on the clinical outcomes of patients.Methods:Patients with intracranial aneurysm received coil embolization and complicated with IAR in Xijing Hospital of Air Force Medical University from January 2013 to January 2019 were enrolled retrospectively. They were divided into balloon-assisted hemostasis group and rapid packing hemostasis group according to the methods of intraoperative hemostasis. The modified Rankin Scale was used to evaluate the clinical outcomes at 3-month postoperative follow-up. A score of 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent influencing factors of clinical outcome. Results:A total of 77 patients with IAR were enrolled, of which 46 (59.74%) used balloon-assisted hemostasis, and 31 (40.26%) used rapid packing hemostasis. In 51 patients (66.23%) with 3-month follow-up data, 32 (62.75%) had good outcomes, and 19 (37.25%) had poor outcomes. Univariate analysis showed that there were significant differences in time from IAR to treatment, time from IAR to confirmed hemostasis, postoperative Fisher grade changes, and good outcomes between the balloon-assisted hemostasis group and the rapid packing hemostasis group (all P<0.05). There were significant differences in IAR treatment methods, time from IAR to treatment, time from IAR to confirmed hemostasis, and postoperative Fisher grade changes between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that balloon-assisted hemostasis (odds ratio 0.234, 95% confidence interval 0.056-0.990; P=0.048) and time from IAR to confirmed hemostasis ≤10 min (odds ratio 0.097, 95% confidence interval 0.024-0.397; P=0.001) were the independent protective factors of the good outcomes in patients with IAR. Conclusion:Using balloon-assisted technique to treat IAR during intracranial aneurysm coil embolization can achieve satisfactory hemostatic effect and improve the clinical outcomes of patients.