Objective To study the effects of nifedipine and mibefradil on the cell proliferation,apoptosis,migration on the HEC-1 A in vitro and also study the mRNA and protein expression levels of the calcium channel alpha1 D( Cav1.3 ) and calcium channel alpha1G (Cav3.1 ) to discuss the effects of the calcium antagonists on the mechanisms of the endometrial carcinoma.Methods ( 1 ) Add 10 μmol/L nifedipine and mibefradil at 15 minutes before adding 10 μmol/L 17β-estradiol( 17β-E2 ) and 100 μmol/L b-estradiol-6-(O-carboxymethyl) oxime(E2-BSA) to the HEC-1A in different time including 0,5,15,30,60,120 minutes.Then the changes of mRNA and protein were detected by reverse transcripiton( RT)-PCR and western-blot.(2)Add 1.25,2.5,5,10,20,40,80,100 μmol/L nifedipine and mibefradil to the HEC-1 A at 24,48,96 hours to detect the cell proliferation by 3-( 4,5 )-dimethylthiahiazo (-z-y1)-3,5-diphenytetrazoliumromide (MTT) method.(3) Add 10 μmol/L nifedipine and mibefradil to the HEC-1A,then detect the apoptosis at 0 minute,30 minutes,1 hour,6 hours,24 hours and migration in vitro at 36 hours with transwell methods.Results ( 1 ) After the pretreated effect of the nifedipine before 17β-E2,the mRNA express of Cav1.3 genes was lowest at 15 minutes,and returned to the control level after 30 minutes.The protein level didn't change very much in 30 minutes,but rose after 60 minutes.The Cav3.1 genes mRNA express was lowest at 5 minutes,rose at 30 minutes and returned to the 0 minute level gradually.(2) After the pretreated effect of the nifedipine before E2-BSA,the Cav1.3 genes mRNA was lowest at 5 minutes and returned at 15 minutes.The protein level rose gradually in 15 minutes but reduced after 15 minutes.The Cav3.1 mRNA and protein level were reduced at every time point.(3) After the pretreated effect of the mibefradil before 17β-E2,there was no change of mRNA expression of Cav1.3 genes.The protein level rose at 15 and 60 minutes,there was no change in any other time.The Cav3.1 genes mRNA were gradually reduced and the protein level rose at 15 minutes,and there was no change in any other times.(4) After the pretreated effect of the mibefradil before E2-BSA,the mRNA and protein of Cav1.3 levels were reduced after 15 minutes.There was no mRNA expression of Cav3.1,while the protein level was lowest at 15 minutes.(5)Nifedipine and mibefradil affected HEC-1A proliferation depended on the different concentration and interval time points.There was significant difference than those in control group ( P ＜ 0.05 ).( 6 ) There were statistical differences in apoptosis rate after adding nifedipine ( P ＜ 0.05 ),while rose at mibefradil treated the same time ( 24 hours:8.41 ± 0.07,0 minute:3.74 ± 0.18 ; P ＜ 0.05 ).(7) The numbers of stained cells after both nifedipine and mibefradil treated reduced more than control group.Conclusions ( 1 ) Nifedipine and mibefradil could inhibit both the effect of the estrogen on the L-type and T-type calcium channel in short time,meanwhile the mibefradil effects last long time. (2) The inhibited effect of the mibefradil on the proliferation,apoptosis and migration of HEC-1A cells in vitro is more significant than that by nifedidipine.

Objective The purpose of study was to investigate the differences in the value of urine acute kidney injury ( AKI) biomarkers in the diagnosis and prognosis of AKI in patients with or without acute respiratory distress syndrome ( ARDS ) . Methods We collected the clinical data about 304 ICU patients, in-cluding 105 ARDS (49 in the lungs and 48 outside the lungs) and 199 non-ARDS cases.Using ELISA, we determined the levels of uN-GAL, uL-FABP, uKIM-1, and uIL-18 in the first 48 hours, compared the clinical data and AKI biomarkers between different groups of patients.We analyzed the differences in the diagnostic value of the AKI biomarkers using the ROC curve and their value in predicting hospital mortality by logistic regression analysis. Results Compared with the patients without AKI, the AKI cases exhibited a signif-icantly increased level of uKIM-1 (1.02 [0.57, 3.01] vs 4.68 [54.74, 270.54], P=0.000) in the ARDS group and that of uL-FABP in the non-ARDS group (102.69 [37.98, 348.09] vs 53.52 [10.86, 141.39], P=0.009).In the ARDS group, the area under the ROC curve (AUC) for the combined efficiency of the four AKI biomarkers was 0.81 (95% CI 0.70-0.92), markedly higher than that of uNGAL (0.57 [95%CI 0.43-0.70]), uL-FABP (0.55 [95%CI 0.39-0.71]), and uIL-18 (0.56 [95%CI 0.40-0.72]) alone (P<0.05), so was the AUC for the combined efficiency of the four biomarkers than that of each biomarker alone in the patients with ARDS in or outside the lungs (P<0.05).The OR value of uKIM-1 for predicting hospital mortality was 1.529 (95%CI 1.148-2.036) in the ARDS group, 1.593 (95%CI 1.070-2.369) in the patients with ARDS in the lungs, and 1.512 (95%CI 1.005-2.274) in those with ARDS outside the lungs. Conclusion There were differences of diagnostic and predictive value of Urine AKI biomarkers have different values in the diagnosis and prognosis of AKI in ARDS and non-ARDS patients and in those with ARDS in or outside the lungs.

Objective To evaluate the prostate imaging reporting and data system(PI-RADS) version 1 and version 2 for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (MpMRI) in a consecutive cohort of patients with magnetic resonance imaging/transrectal ultrasonography (MRI-TRUS) fusion-guided biopsy.Methods 30 suspicious lesions including 15 prostate cancer and 15 non cancer at 3.0 T MpMRI were scored according to the PI-RADS V1(≥ 3 scores in at least one MRI sequence)system before MRI-TRUS fusion guided biopsy and correlated to histopathology results.PI-RADS V2 and Likert scores were determined retrospectively,diagnostic accuracy was determined using receiver operating characteristic curve analysis.Results The PI-RADS score of the dominant lesion was significantly higher in patients with PCa compared to patients with negative histopathology (PI-RADS V1:12.10±2.60 vs 7.47±1.98,P<0.05;PI-RADS V2:4.21±1.18 vs 2.79±0.92,P<0.05);Using a Likert score cut-off ≥ 4,a sensitivity of 73.7%,a specificity of 78.9%, positive predictive value of 77.74% and a negative predictive value of 75.00% (AUC=0.778,95%CI:0.63-0.93), a PI-RADS V1 cut-off ≥ 10,a sensitivity of 73.7%,a specificity of 94.7%,positive predictive value of 93.29% and a negative predictive value of 78.26% (AUC=0.911,95%CI:0.82-1.00) and PI-RADS V2 cut-off ≥ 4,a sensitivity of 57.9%, a specificity of 100%, positive predictive value of 100% and a negative predictive value of 73.37% (AUC=0.837,95%CI:0.70-0.97) were achieved.Conclusion The described fusion system is dependable and efficient for targeted MRI-TRUS fusion-guided biopsy.MpMRI PI-RADS scores combined with a novel real-time MRI-TRUS fusion system facilitate sufficient diagnosis of PCa with high sensitivity and specificity,PI-RADS scores appears to be the preferable method for the evaluation of prostate cancer than Likert score, while V2 does not perform better than V1.

Objective To investigate the effects of Kruppel-like factor 6 (KLF6) on the apoptotic and migration ability of HepG2 cell, and the developmental role of KLF6 on zebrafish liver.Methods Constructed plasmid with shRNA-KLF6 was transfected in HepG2 and L-02.The impacts of loss of KLF6 on HepG2 was investigated by Western bolt, apoptosis analyses, cell cycle detection and scratch experiment;KLF6 morpholino oligonucleotides was microinjected into the Tg(lfabp:eGFP) transgenic zebrafish embryos.The morphant phenotype of the liver was imaged and the protein expression of KLF6 after knockdown of KLF6 was analyzed by Immunofluorescence staining.Results The expression of KLF6 in L-02 was significantly higher than in HepG2.After knockout of KLF6, KLF6 protein expression and apoptosis were significantly reduced.In addition, the cell cycle mainly stated in S phase and the migration ability of HepG2 was enhanced.After klf6 knockdown in transgenic zebrafish larvae, the development of zebrafish liver was delayed and KLF6 expression was obviously decreased in the liver.Conclusions The reduction of KLF6 expression increased the proliferation and migration ability, and reduced the apoptosis of HepG2.Loss of KLF6 affects the development of zebrafish liver, which may open a possibility to use zebrafish as a liver cancer model and for anti-liver cancer drug screening.

Objective To compare the curative effects between recombinant human brain natriuretic peptide (rhBNP) and sodium nitroprusside in treatment of the acute attack of elderly patients with chronic heart failure (CHF), and probe the impacts of rhBNP on the heart function,serum B-type natriuretic peptide (BNP), norepinephrine (NE), endothelin 1 (ET-1) and antidiuretic hormone (ADH) levels. Methods The 89 patients aged 65-85 years at acute attack stage of CHF were randomized into two therapy groups: rhBNP group (n= 47) and sodium nitroprusside group (n=42). The clinical effects, heart function, serum BNP, NE, ET-1 and ADH changes were observed before and after the treatment. Results After 24 hours of treatment, the efficacy rate and total effective rate were higher in rhBNP group than in sodium nitroprusside group (51.1% vs. 26.2 %,95.7% vs. 66. 7%, respectively, P＜0. 05 and P＜0. 01), and non-efficacy rate in rhBNP group was lower (4.3% vs. 33. 3%, P＜0. 01). There was one death case in rhBNP group and three in sodium nitroprusside group. In rhBNP group, left ventricular ejection fraction values increased after 2 weeks of treatment [(46.2± 9.5)% vs. (38.1 ±6.0)%], P＜0.05. Serum BNP level significantly decreased in rhlBNP group than in sodium nitroprusside group after 2 weeks of treatment (P＜0.05).In rhBNP group, serum BNP and NE levels decreased 24 hours and 2 weeks after treatment (P＜0. 01) and the levels furtherly reduced after 2 weeks (P＜0.01). Serum ET-1 level decreased in rhBNP group than in sodium nitroprusside group 2 weeks after treatment (P＜0.05). In rhBNP group, there was no significant difference in serum ET-1 level between baseline and 24 hours after treatment (P＞ 0. 05), but the ET-1 level decreased 2 weeks after treatment as compared with 24 hours after treatment (P＜0.01). There were no significant differences between the two groups before and after treatment (P＞0.05). Incidences of headache and hypotension were lower in rhBNP group than in sodium nitroprusside group (4.3% vs. 19.0%, 14.9% vs. 23.8%, both P＜0.05),Conclusions RhBNP can be safely and effectively used for acute attack of CHF.

Objective To evaluate the diagnostic value of prostate imaging reporting and data system version 1 (PI-RADS V1) and version 2 (PI-RADS V2) for detection of prostate cancer (PCa) in the transition zone (TZ).Methods Seventy-seven patients with suspicious lesions in TZ on mpMRI were scored according to the PI-RADS system (V1 and V2) before MR-TRUS fusion guided biopsy prospectively.In all of the patients with suspicious tumors,respectively at least one lesion with a PI-RADS V1 assessment category of ≥3,was selected for biopsy.Independent sample t test was used to compare scores of PI-RADS V1 and V2 between PCa and benign prostatic hyperplasia (BPH).The diagnostic performance of PI-RADS V 1 and V2 for detection of PCa in the transition zone was compared by analyzing ROC basing on the results of MR-TRUS fusion guided biopsy.Results A cohort of 77 patients was performed including 31 cases of PCa (32 cores) and 46 cases of BPH (51 cores).PCa (V1:1 1.50±2.79;V2:4.28±0.99) had significantly higher scores of both PI-RADS V1 and PI-RADS V2 than BPH(V1:7.51± 1.63;V2∶2.61 ±0.67) (P＜0.05).Using a PI-RADS V1 score cut-off ≥ 11,sensitivity and specificity in group PCa and BPH were calculated,which were 68.8％(22/32) and 96.1％(49/51) with a area under curve of 0.869;using a PI-RADS V2 score cut-off ≥4,which were 75.0％ (24/32) and 90.2％ (46/51) with a area under curve of 0.888,respectively.Conclusions PI-RADS system can indicate the likelihood of PCa of suspicious lesions in TZ on Mp-MRI.PI-RADS V2 perform better than V 1 for the assessment of prostate cancer in TZ.

Objective To develop an intelligent scheduling system for surgery by setting up constraints in an intelligent working environment to achieve automatic scheduling of surgery and personnel,and to precisely match the sub-professional nurses for surgeries.Methods Scheduling constraints were set up,and finally efficient scheduling was developed.Results During the process of clinical application,the rates of error and omission for surgical schedule fell to 4.78％,the rate of surgery re-adjustment fell to 17.74％,the number of average daily operation increased,the matching degree of sub-professional surgery nurse post reached 94.71％.Conclusion The intelligent surgical scheduling system can improve the scheduling efficiency and quality,improve the utilization of the operation rooms,and improve the collaboration quality and efficiency of the sub-professional nurses.

OBJECTIVETo study the relationship between the TCM Syndrome Differentiation-types of congestive heart failure (CHF) and thyroid hormones, including triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH), and atrial natriuretic peptide (ANP), as well as cardiac function parameters, including left ventricular ejection fraction (LVEF), mean velocity of circumferentid fiber shortening (mVcf) and A peak/E peak (A/E).

METHODSOne hundred patients with CHF were divided into 4 Syndrome Differentiation-type groups, their cardiac function parameters, ANP and thyroid hormones were determined and compared with those in the 23 subjects in the control group.

RESULTSIn CHF patients with edema and blood stasis Syndrome type, the level of plasma ANP was significantly higher than that in the control group (P < 0.05); level of T3 was significantly lower than that in the control group and in CHF patients of other three (Xin-qi deficiency, Yin-deficiency and blood stasis) Syndrome groups (P < 0.01, P < 0.01, P < 0.05 and P < 0.01); levels of LVEF and mVcf were significantly lower than those in the other three Syndrome groups (all P < 0.01). Level of T4 in other three Syndrome groups significantly increased than that in the edema and blood stasis Syndrome type. A/E value showed a higher level in patients of all TCM type than that in the control (P < 0.01). Correlation analysis showed that T3 was positively correlated with LVEF and T4 (r = 0.200, P < 0.05, and r = 0.293, P < 0.01), and negatively correlated with ANP (r = -0.263, P < 0.01); T4 was negatively correlated with A/E (r = -0.226, P < 0.05).

CONCLUSIONThe lowering of T3 and T4 and increasing of ANP may be one of the important reasons for lowering of LVEF in CHF patients with edema and blood stasis Syndrome-type. The decrease of T4 may be one of the important reasons for elevation of A/E and aggravation of left ventricular diastolic dysfunction in CHF patients of all the 4 TCM Syndrome-types.

Adult ; Aged ; Atrial Natriuretic Factor ; metabolism ; Diagnosis, Differential ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myocardial Contraction ; Stroke Volume ; physiology ; Thyroid Hormones ; blood ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood ; Ventricular Dysfunction, Left ; physiopathology ; Ventricular Function, Left

Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.