Objective To investigate the role of plasma matrix metalloproteinase-9 (MMP-9) and nuclear factor kappa B (NF-κB) in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension.Methods The patients were selected in the respiratory medicine and neurology of our hospital from January 2014 to June 2014.Polysomnography(PSG) monitoring was employed to assess the patient.All patients were divided into 3 groups,including snoring group(23 cases),OSAHS group(32 cases),OSAHS with hypertension group(31 cases).And then according to the hypertension stage,OSAHS with hypertension group was divided into 3 groups,including OSAHS with stage 1 hypertension group(9 cases),OSAHS with stage 2 hypertension group(9 cases),OSAHS with stage 3 hypertension group(13 cases).The plasma MMP-9 was measured by ELISA.The mRNA expression levels of MMP-9 and NF-κB were detected by real-time quantitative PCR.Results The levels of MMP-9 and MMP-9 mRNA and NF-κB mRNA in OSAHS with hypertension group were significantly higher than those of snoring group and OSAHS group and the differences were statistically significant(P<0.05).The expression of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with stage 3 hypertension group was significantly higher than those of OSAHS with stage 1 hypertension group and OSAHS with stage 2 hypertension group and the differences were statistically significant(P<0.05).The plasma MMP-9 was positively correlated with AHI and oxygen desaturation index and negatively correlated with LSaO2(P<0.05).The plasma MMP-9 was positively correlated with the MMP-9 mRNA expression(P<0.05).The MMP-9 mRNA expression was positively correlated with the NF-κB mRNA expression(P<0.05).Conclusion The plasma concentrations of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with hypertension patients was significantly high,which is associated with disease severity and degree of hypoxia.The MMP-9 might play an important role in the pathogenesis of OSAHS with hypertension and be regulated by NF-κB pathway.

Objective To evaluate ultrasound-guided percutaneous ablation for recurrent hepatocellular carcinoma.Methods In this study, 141 patients with recurrent hepatocellular carcinoma (628 lesions) were treated by percutaneous ablation therapies, including microwave, radiofrequency, ethanol injection and hot distilled water ablation.Results The complete ablation rate was 92.0% (578/628) in this group, and was 96.3% ( 105/109 )? 92.9%(119/128)? 91.5% (311/340) and 84.3% (43/51), respectively, for microwave, radiofrequency, ethanol and hot distilled water ablation subgroups.The local recurrence rate was 13.5% ( 78/578 ), and was 11.4% (12/105)? 13.4% (16/119)? 11.9% (37/311) and 30.2% (13/43), respectively, for microwave, radiofrequency, ethanol and hot distilled water ablation subgroups.After a follow-up period of 2-66 months, liver function remained unchanged in 117 patients (81%) after ablation therapies.Patients were followed-up for 2-66 months, the 1, 3 and 5-year survival rate was 75%, 53% and 26%, respectively.Conclusion Ultrasound-guided percutaneous ablation therapies for recurrent hepatocellular carcinoma are safe and effective, while incuring minimal damage to liver function and improving long-term survival.

Objective To retrospectively compare the safety and local efficacy of multiple-electrode switching based radiofrequency ablation (RFA) and the conventional RFA in treating single early-stage hepatocellular carcinoma (HCC).Methods A total of 82 patients with single early-stage HCC received either RFA with a multiple-electrode switching system (n =43) or conventional RFA (n =39) as the first-line treatment.The rate of initial local complete response,major complications and local tumor progression (LTP) were compared between two groups.Results The total ablation time was significantly shorter in the switching-RFA group [(16.7 ± 3.4) mins] than in the conventional RFA group [(29.8 ± 10.4) mins] (P ＜ 0.05).The rate of initial local complete response was 100％ (43/43) in the switching-RFA group and 94.9％ (37/39) in the conventional RFA group (P ＞0.05).After a mean follow-up period of (26.4 ± 21.8)months (ranging 3.0-91.6 months),the rates of LTP in the switching-RFA group and conventional RFA group were 16.3％ (7/43) and 17.9％ (7/39),respectively.The LTP rates in two groups were 16.1％ versus 11.2％ atyear1,and20.5％ versus 20.6％ at year2 (P=0.666).Conclusions The multiple-electrode switching based RFA is safe and effective with shorter ablation time in treating single early-stage hepatocellular carcinoma.

Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.

Objective To study the efficacy of percutaneous ablative therapy for malignant liver lesions under real-time virtual guidance. Methods Percutaneous ablations were applied to 76 patients with 125 malignant liver lesions under the guidance of a real time virtual system (RVS). 64. 8% (81/ 125) lesions were undetectable on conventional ultrasound (US). The time spent on image fusion and the local treatment response were studied. Results The average time taken to synchronize the ultrasound and CT images was (19. 2±12. 8) min (range 5～55 min). Complete ablations were achieved in 86. 4% (38/44) of distinctly visualized lesions and in 91. 6% (74/81) of poorly visualized lesions on US. No treatment associated complications were found. Conclusion Ablation assisted by RVS and CT was safe and efficacious, especially for lesions undetectable by conventional ultrasound.

Aim To explore the effect of meloxicam on the CUMS-induced depressive-like behaviors in rats and its preliminary mechanism. Methods The rats were exposed to CUMS procedure for 6 weeks to estab-lish the model of depression. Meloxicam(1,3 mg· kg-1 ) and sertraline(5 mg·kg-1 ) were administered to rats from 22d of the stress procedure(once a day,for 21 days,p. o. ) . Depressive-like behaviors were evalu-ated by the open-field test and force swimming test. The levels of PGE2 and TNF-αin cortex were measured by ELISA. Moreover, the concentrations of NE, DA, DOPAC and 5-HIAA were also measured by HPLC, and the protein expression of 5-HT1 AR in cortex was analyzed by the immunohistochemistry. Results Com-pared with the rats of normal control group,the vertical and horizontal movement scores of rats in the open-field test were decreased and the immobility time in the forced swimming test was increased in model group. The levels of PGE2 and TNF-α were both increased signifi-cantly,whereas the concentrations of NE, DA, DOPAC and 5-HIAA were decreased and the expression of 5-HT1AR was reduced in cortex. Compared with the rats of model group, meloxicam significantly improved the depressive behaviors of rats in experimental groups and reversed the content of PGE2 ,TNF-α,NE,DA,DOPAC and 5-HIAA, as well as the expression of 5-HT1AR. Conclusion Meloxicam has a significant protective effect on CUMS-induced depressive-like behaviors, and the protective mechanism might be related to atten-uating inflammation response and reconstructing the balance of the monoamine neurotransmitter system in rat cortex.

Objective To evaluate the accuracy and utility of percutaneous ultrasonic cholangiography in Bismuth staging of hilar cholangiocarcinoma. Methods Thirty patients who underwent surgery and obtained pathologic diagnosis of hilar cholangiocarcincoma were perspectively ruled in this study. All patients with hilar obstruction underwent baseline ultrasound (BUS), percutaneous ultrasonic cholangiography (PUSC) and percutaneous transhepatic cholangiography(PTC) respectively. Taking operative findings as reference standard,the accuracy of the three imaging modalities in staging of hilar cholangiocarcinoma was compared. Results Among 30 patients, the accuracy of classification among BUS, PUSC and PTC was 23.3 % (7/30), 73.3 % ( 22/30 ), 73.3 % (22/30), respectively. There was statistically significant difference between BUS and PUSC, but the difference between PUSC and PTC was not statistically significant.Conclusions As a new technique for cholangiography, PUSC expands the application of ultrasound in evaluating hilar cholangiocarcinoma and is comparable to PTC in classifying hilar cholangiocarcinoma by Bismuth classification.

AIM: To investigate the primary culture method for coronary artery smooth muscle cells (CASMCs), and to establish the endoplasmic reticulum stress ( ERS) model in CASMCs of SD rats.METHODS:CASMCs were cultured by tissue explant method .The morphological characteristics were observed under optical micro-scope.The marker proteins of CASMCs , including α-SMA and SM-MHC, were identified by immunofluorescence tech-nique.The protein expression levels of BiP and CHOP , the marker molecules of ERS, were determined by Western blot . RESULTS:The spindle-shaped CASMCs climbed out from the edge of coronary artery tissues after 6 d, and formed the typical hill and valleygrowth pattern of CASMCs at 9~10 d.The result of immunofluorescence technique showed that α-SMA and SM-MHC were positively expressed .The results of Western blot showed that the protein expression of BiP and CHOP in TG ( 1 and 2 μmol/L ) treatment groups was increased compared with control group .Compared with control group, the protein expression of BiP and CHOP was significantly increased after 1 μmol/L TG treatment for 24 and 48 h. CONCLUSION:CASMCs can be successfully cultured by tissue explant method .ERS model of CASMCs was established by 1 μmol/L TG treatment for 24 h.

Objective To assess the characterization and usefulness of contrast enhanced ultrasound (CEUS)to diagnose solid focal lesions of pancreas(s-FLPs)in comparison to contrast enhanced computed tomography(CECT).Methods Forty-nine s-FLPs with final diagnosis were studied with low mechanical index CEUS and CECT.The enhanced patterns and diagnostic capability of CEUS were analyzed,and these results were compared with those from CECT.Results ①In CEUS,the perfusion of capillary could be detected in vascular phase.②The concordance of dual-phases enhanced patterns between CEUS and CECT was 73.5%(36/49).The concordance of enhanced level between early parenchymatous perfusion phase in CEUS and pancreatic phase in CECT could achieve 87.8%(43/49).Hypo/hypo enhancement was the most common enhanced pattern of pancreatic carcinoma in CEUS and CECT.③There was no statistical significance between CEUS and CECT in the differential diagnostic.Conclusions The concordance of enhanted patterns between CEUS and CECT is satisfactory.CEUS is similar to CECT in the differential diagnosis of s-FLPs.CEUS would become an important non-invasive diagnostic method for s-FLPs.

Objective To evaluate the feasilibility of ultrasonic cholangiography(USC)with contrast agent SonoVue in evaluating the obstructive bile duct diseases.Methods Twenty patients with obstructive jaundice(choledocholithiasis in 4,post-operative biliary strictures in 2 and malignant tumors in 14)underwent uhrasound-guided percutaneous transhepatic cholangiodrainge drainage(PTCD).Afterward,USC with contrast agent SonoVue administrated from the PTCD tube and percutaneous transhepatic cholangiography(PTC)were carried out in each patient.By using the surgical or PTC findings as reference standard,accuracy of USC in determining the obstructive level and cause of bstructive was evaluated.Results ①The visualization of contrast agent SonoVue was successfully obtained in all 20 patients,three order of bile duct was visualized in 19 patients.The visualization of the ultrasound contrast agent persisted more than 6 min.There was no side effect occurred during the procedure and no uncomfortable complaint after the procedure.②USC determined correctly in 18 cases.Compared with surgical or PTC findings,the accuracy of USC in determining obstructive levels was 90.0%(18/20),and the accuracy in determining the obstructive cause was 85.0%(17/20).Conclusions As a new and safe technique for cholangiography,USC is comparable to PTC in displaying the intrahepatic bite duct and determining the obstructive levels in patients with obstructive jaundice.