Objective To observe the incidence of orthostatic hypotension and hypertension in the elderly hypertensive inpatients and investigate the effect of antihypertensive medication on the orthostatic blood pressure changes in the elderly hypertensive inpatients.Methods A total of 185 aged hypertensive inpatients was divided into elderly group(n =126,60～79 years old) and very elderly group(n =59,≥80 years old) according to the age.The orthostatic blood pressure was measured in supine position and after standing.Subjects were divided into 3 subgroups:orthostatic hypotension (OH),orthostatic hypertension (OHT),and orthostatic normotension (ONT) groups according to the standing blood pressure levels.Clinical characteristics of each subgroup were evaluated and analyzed according to the antihypertensive medication.Results Among 185 patients,the OH incidence was 31 (16.76％) cases,the OHT incidence was 23 (12.43 ％) cases,and the ONT incidence was 131 (70.81％) cases.There were 16 (12.70％) patients with OH and 10(7.90％) patients with OHT in elderly group,but 15 (25.42％) patients with OH and 13 (22.03％) patients with ONT in very elderly group.The prevalence of OH and OHT in each elderly group was both higher than elderly group (P ＜ 0.05).Antihypertensive medications such as Calcium channel blockers,angiotensin Ⅱ receptor-blockers,Beta-blockers,diuretics,and angiotensin converting enzyme inhibitors were not significantly different among three subgroups.Conclusions OH and OHT were common in the elderly hypertensive inpatients,especially in the very elderly people.The five-class antihypertensive medication that doctors commonly used at present might be not related to the orthostatic hypotension and hypertension.

Objective To investigate the genes differentially expressed in prostate cancer and to determine some prostate cancer associated genes for diagnosis and treatment prostate cancer. Methods cDNA microarray chips containing 4 366 human genes in full length were used to investigate the differential gene expression patterns of samples from human prostatie cancers and normal prostate tissues. Results A total of 287 genes differentially expressed with prostatie cancers and normal prostate were screened out,comprising 165 unknown genes and 122 known genes.Among the known genes we further identified 56 genes which were markedly differentially expressed (20 up-regulated and 36 down-regulated genes). Conclusions cDNA microarray chips for analysis of genes expression patterns is a powerful method for identification of novel prostatie cancer associated genes.

Objective To evaluate the role of differentially expressed genes in human prostate carcinoma initiation and progression. Methods cDNA microarray chips which consist of a set of 4366 human genes were used to investigate the gene expression pattern of samples from human prostate cancer and normal prostate tissues. Results Of 4366 genes,287 genes differentially expressed in prostate carcinoma and normal prostate tissues were screened out,including 165 unknown genes and 122 known genes. Among the 122 known genes we further identified 20 up-regulated and 36 down-regulated genes. Conclusions Our results suggest that significantly differential expression of genes may be associated with the pathogenesis and progression of the prostate cancer.

Objective:To have a history of perinatal asphyxia newborns, 72h expert cranial ultrasound examination, observe the structure and hemodynamic changes in brain tissue, discusses the children early common type of brain injury and ultrasound findings. Methods:Children born in the first ultrasound examination in 72h, the anterior temporal skull detect cerebral artery, middle cerebral artery blood flow dynamics, the main parameters: the peak systolic blood flow velocity(Vs), end-diastolic velocity(Vd), resistance index(RI). Results: Seventy cases in 90 cases of brain injury, to different extent in the positive rate of 77.8%.Conclusion: Cerebral ultrasound can early detect brain tissue structure change and hemodynamic changes, ultrasonic has the advantages of bedside examination.

Objective To investigate the effects of c-Jun N-terminal kinase (JNK) 2 on NKG2D-mediated natural killer ( NK) cell cytotoxicity .Me thods NK cells were activated by polyinosinic-polycyti-dylic acid ( Poly I∶C ) .The activation status of JNK signaling pathway was detected .The cytotoxicity of ac-tivated NK cells and the level of IFN-γproduced were measured to determine the function of NK cells in the absence of JNK2.Tumor growth in wild type and JNK2-knockout (JNK2-/-) mice with lymphoma xenograft were measured to evaluate immune surveillance of NK cells .Results The phosphorylation of JNK and up-stream kinases were observed in the early stage of cell activation after treatment of Poly I ∶C.The expressed ligands of the activating receptors NKG2 D significantly increased NK cell cytotoxicity to lymphoma cells . JNK2 deficiency impaired the antitumor effects of NK cells , and then resulted in enhanced tumor growth in JNK2-/-mice.Conclusion JNK2 signaling pathway is involved in the NKG2 D-mediated activation of NK cells and regulates immune surveillance of NK cells against tumor .

Objective To identity the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia in parturients.Methods A total of 204 parturients,scheduled for elective cesarean section,were divided into either control group or SHS group depending on whether or not SHS (systolic blood pressure [SBP] in the upper extremity decreased by ＞ 30 mmHg or decreased to ＜ 80 mmHg) developed after spinal anesthesia.The baseline patient characteristics such as age,body height and weight,gestational weeks and biparietal diameter were recorded.Supine stress test (SST) was performed.Heart rate,blood pressure in upper and lower extremities,perfusion index,pleth variability index and intravesical pressure were recorded when patients were in supine position and in left lateral position before spinal anesthesia.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for SHS.Results Among the 204 patients,99 cases developed SHS after spinal anesthesia,and the incidence was 48.5％.Logistic regression analysis showed that maternal body weight,biparietal diameter,the difference in SBP between upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST were risk factors for SHS after spinal anesthesia (P＜0.05 or 0.01).Conclusion Maternal body weight,biparietal diameter,the difference in SBP between the upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST are risk factors for SHS after spinal anesthesia in parturients.

BACKGROUND:Stem celltherapy for renal ischemia-reperfusion injury has been the hot topics for many scholars. Its mechanism is very complex, which could not be explained by simple mechanism of stem cells differentiation. It is the result involving a variety of mechanisms. OBJECTIVE:To investigate the influence on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, then to preliminary summarize the immune regulation mechanism of bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury. METHODS:First, we established a model of renal ischemia-reperfusion injury in rats and, cultured and purified rat bone marrow mesenchymal stem cells in vitro. Then, the bone marrow mesenchymal stem cells were transplanted into the rat models. Using flow cytometry detection technology, we analyzed the proportion of CD4+CD25+regulatory T cells of rat spleen cells, discussed the effects on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, and then transferred the rat’s spleen cells to the nude mice which were subjected to renal renal ischemia-reperfusion injury. Renal function and renal histological changes of nude mice were assessed. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem celltransplantation could significantly inhibit the decrease of CD4+CD25+regulatory T cellof spleen cells in rats with renal ischemia-reperfusion injury. The transplantation of spleen cells from the above-mentioned rats to nude mice could obviously protect nude mice from renal ischemia-reperfusion injury, characterized by lower serum creatinine, blood urea nitrogen and renal tubule pathologic damage score. Therefore, bone marrow mesenchymal stem cells have protective effects on renal ischemia-reperfusion injury by regulating the immune system.

Objective:To evaluate the quality of the current foreign clinical practice guidelines (CPG) on obstetric venous thromboembolism (VTE), providing reference for standardizing the prevention and treatment of domestic VTE clinical practice.Methods:The GPGs for the management of obstetric VTE published abroad from inception to July 2020 were electronically searched. Two researchers independently evaluated the quality of the included guidelines in accordance with the internationally recognized guideline evaluation tool, AGREE Ⅱ.Results:A total of 12 guidelines, 2 recommendations and 1 consensus for obstetric VTE were included, covering 3 continents and 9 countries, and the published time span was 2009-2020. The standardized scores of the six domain (scope & purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) included in the guidelines were: 99.44%, 62.78%, 70.35%, 95.74%, 68.80% and 76.94% respectively, and the scores in each domain were ≥ 50.00%, indicating that the included CPGs were of good quality. Except for the domain scope & purpose, the ranges of the other five domains were ≥ 50.00%, suggesting that the quality of the CPGs differed significantly. Among the 15 included CPGs, 4 CPGs were level A (recommended), 11 CPGs were level B (recommended after being revised), and there was no CPG in level C (not recommended). The difference in the recommended content of obstetric VTE management mainly focused on the risk assessment, drug type, dosage and period.Conclusions:The overall quality of the CPGs for obstetric VTE management is high, while the quality of the CPGs varies greatly. In addition, there are differences in the recommended content of obstetric VTE management. More high-quality researches are required to provide evidence-based support for the improvement of the CPGs.

Objective To investigate the diagnostic value of intraductal ultrasonography (IDUS) for unconfirmed microlithiasis under endoscopic retrograde cholangiography ( ERC). Methods The data of 22 patients who were definitely diagnosed as having microlithiasis by IDUS and endoscopic sphincterotomy (EST) from July 2007 to September 2009 were retrospectively analyzed. Microlith was defined as choledo-cholith equal to or less than 3 mm in diameter. Using IDUS plus EST findings as golden standard of bile duct microlithiasis, the accuracy of diagnosis and rate of missed diagnosis of transabdominal ultrasonography, magnetic resonance cholangiography (MRC) and ERC were evaluated and compared. Results Diagnosis rates of trans-abdominal ultrasonography, MRC and ERC for extra-hepatic duct microlithiasis were 27. 3% (6/22), 38. 5% (5/13) and 27. 3% (6/22) , respectively. Detection rates of common bile duct dilation by 3 methods were 68. 2% (15/22) , 84. 6% (11/13) and 68. 2% (15/22) , respectively. The microlithiasis in 2 patients, which manifested as repeated acute pancreatitis, were missed by transabdominal ultrasonography , MRC and ERC, and were finally confirmed by IDUS. Conclusion Sensitivity of ERC in diagnosis of extra-hepatic microlithiasis is not superior to that of transabdominal ultrasonography or MRC. IDUS is a technically easy, safe, highly sensitive and accurate procedure, which is helpful in differentiation of etiology of recurrent acute pancreatitis.

Objectlve To investigate the value of basic and contrast-enhanced ultrasound in the diagnosis of superficial cervical lymph nodes.Methods Five hundred and forty-five cases of superficial cervical lymph nodes were sacned by basic ultrasound,in which 52 cases were also scaned by contrast-enhanced ultrasound.All cases were performed ultrasound-guided biopsy.Lymph nodes were divided into benign group and malignant group according to pathology reports.The differences of the two groups were analysed,and statistical analysis was performed.Results Two hundred and thirty cases were benign,315 cases were malignant.S/L(P＜0.01),RI(P＜0.01),vascular pattern(P＜0.01)and contrast enhancement pattern(P＜0.01)between benign and malignant group showed statistical significant differences,while no statistical difference in coefficient correlation of the time-intensity curve between the two groups was found.Conclusions A combination of basic and contrastenhanced ultrasound can significantly enhance the ability to identify malignant lymph nodes from benign lymph nodes.