Objective To evaluate the value of echocardiography on the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),and to improve the diagnositic accuracy of ARVC by echocardiography.Methods According to the 2010 European Heart Association guideline,twenty-one patients with ARVC were diagnosed from September 2003 to June 2014.The patients were divided into four groups (confirmed,suspiciously diagnosis,miss diagonisis,misdiagnosis) and the echocardiographic features were retrospectively analyzed including the right ventricular (RV) movement,the diameter of RV outflow tract (RVOTd),fractional area change of RV (RVFAC),the severity of tricuspid regurgitation (TR) and peak pulmonary artery systolic pressure (PASP).Results Of 21 patients,15 (71.4％) were confirmed by echocardiography,which had the typical ARVC echocardiographic features including the hypokinetic,akinetic or aneurysm of RV,dilation of RVOTd [mean RVOTd (40 ± 3)mm],and RV FAC＜33 ％ [mean (21 ± 7)％].TR were noticed in all the 15 patients but the PASP were normal [mean (27 ± 9)mmHg,1 mmHg =0.133 kPa].Three (14.3％) were suspiciously diagnosed which had the RV wall hypoakinetic,1 with pure RVOTd dilation and 2 with RV and RVOTd dilation,all 3 patients had mild TR,33％＜RVFAC ≤40％ and PASP were in normal range.Two patients had normal echocardiography which was miss diagnosed,one patient was misdiagnosed as dilated cardiomyopathy.Conclusions The different stages of ARVC patients had different echocardiographic features,the patients were easily diagnosed when the ARVC patients in RV failure stage.But for the early and late stage,the diagnosis should combine the clinical manifestation and other imaging facilities to avoid miss diagnosis and misdiagnosis.

Objective To compare the formation and evolution of left ventricular flow between the patients with the bileaflet artificial mechanical mitral valve and normal adult using vector flow mapping (VFM). Methods Thirty healthy controls and 30 severe mitral stenosis patients with bileaflet prosthesis mitral valve were involved. The left ventricular flow and the vortex description parameters were comparatively studied between two groups. Results Two small symmetric rotating vortexes and a big counter-clockwise rotating vortex appeared alternately in the left ventricular through cardiac cycle with control group. In case group,only large vortex could be seen in the mid-late diastolic and maximum vector velocity was faster than that in control group in statistics( P <0. 05). Especially the postoperative direction of blood flow was clockwise shif ting from the interventricular septum to the posterior and lateral left ventricular wall inversely to control group. Conclusions VFM can show the complex vortex flow patterns in left ventricular in the patients with bileaflet prosthesis mitral valve preliminarily and may be useful to assess and improve the function of prosthesis valve in future.

Objective To compare the clinical efficacy of different treatments based on radical surgery in stage Ⅰ b2 and Ⅱ a2 cervical cancer through prospective randomized controlled study. Methods A total of 133 patients with stage Ⅰb2 and Ⅱa2 cervical cancer treated at Beijing Obstetrics and Gynecology Hospital of Capital Medical University during January 2009 to December 2012 were enrolled and randomly assigned to receive one of the following three treatments: preoperative intracavitary irradiation (PII) group, radical hysterectomy (RH) group, and neoadjuvant chemotherapy (NACT) group. Operation method included uterine extensive resection, pelvic lymph node excision, with or without para-aortic lymph node resection. The recent curative effect and side effect of preoperative treatment were observed. The operation time, intraoperative blood loss, surgical complications, postoperative pathological risk factors and postoperative adjuvant therapy and side effect, the survival situation were evaluated among the 3 groups. Results (1)The response rates were 88%(37/42) and 82%(37/45) respectively of the PII group and NACT group. The difference was insignificant (P=0.528). Side effects were less in the PII group. Only 5 patients (12%,5/42) had slight gastrointestinal reaction. Myelosuppression and gastrointestinal reaction in NACT group were 76%(34/45) and 67%(30/45) respectively, which were more serious than that in group PII group (P<0.05). (2) Intraoperative blood loss and operation time in PII group [(678 ± 239)ml and(181 ± 39)minutes] and NACT group [(625 ± 137)ml and(168 ± 25)minutes] had a decreasing trend compared with that in RH group [(711 ± 319) ml and (202 ± 64) minutes], but the differences were no significant (P>0.05). NACT group could shorten operation time compared with the RH group (P<0.05). The lymph node metastases rate were 30%(14/46), 29%(12/42)and 29%(13/45)and the deep stromal invasion rate were 22%(10/46), 31%(13/42)and 31%(14/45)in RH group, PII group and NACT group respectively (all P>0.05). The lymph-vascular space involvement (LVSI) in NACT group was significantly lower than that in RH group [31%(14/45) vs 57%(26/46), P=0.015]. The number of patients with histological risk factors in NACT group was higher thanthat in RH group [27%(12/45)vs 9%(4/46),P=0.024]. All surgery were successfully completed and no treatment-related deaths occurred in three groups. The incidence of 3-4 grade adverse reactions evaluated by the common terminology criteria for adverse event (CTCAE) was 13% (6/46), 14% (6/42), 18% (8/45) in RH group, PII group and NACT group respectively (P=0.855). Three-year disease free survival (PFS) were 74.0%, 78.5%and 80.0%, and 3-year overall survival (OS) were 80.4%, 83.3%and 84.4%in RH group, PII group and NACT group respectively (all P>0.05). Conclusions The recent curative effect of PII and NACT were similar. They couldn′t improve 3-year of PFS and OS of the patients withⅠb2 andⅡa2 stage cervical cancer. But NACT can reduce the operation difficulty and can reduce the incidence of postoperative pathological risk factors, which could reduce postoperative adjuvant therapy.

To construct a scFv library by phage display technique from the spleen cells of mice immunized with B3HM cells. Three mice were immunized with B3HM cells, and their spleen cells were harvested. The genes of VH and Vk were amplified by RT-PCR from the cDNA of the immunized spleen cells and a scFv-phage display antibody library was constructed. The capacity of library was measured,and the variety of the library was analyzed by digesting with restriction endonuclease BstNI.ScFv phage clones were randomly picked and identified phage-scFv clone by binding B3HM cells using immunofluorescein.A scFv library containing 5?106 individual clones which showed different patterns after digested with restriction endonuclease BstNI was produced. Individnal phage-scFv clone showed B3HM cells positive using immunofluorescein. A scFv library of anti-B3HM cell surface molecules has been constructed. It will be useful for finding out some novel genes of causing leukemia, and establishs the infarctate foundation of clarifying the pathogenesis of leukemiagenesis.

OBJECTIVETo investigate the clinical safety and effectiveness of percutaneous embolization in treating the late failed renal allograft in patients with graft intolerance syndrome (GIS).

METHODSTranscatheter embolization of renal graft artery was performed in 18 patients with late graft dysfunction and GIS. The subsequent complications, postoperative symptom remission rate, and prognosis were assessed.

RESULTSGIS was relieved in 15 patients (83.3%), of which 6 patients (33.3%) had severer fever and pain in the area of renal graft after embolization, which lasted for a mean of 3.5 days (range: 2-5 days). GIS persisted for more than 2 weeks in 3 patients (16.7%), who ultimately underwent surgical removal of grafts. No severe embolism-associated complications were noted.

CONCLUSIONPercutaneous embolization can effectively avoid surgical graft removal in patients with late renal allograft failure, and therefore can be used as a safe and effective treatment for the late failed renal allograft combined with GIS.

Adult ; Aged ; Embolization, Therapeutic ; Female ; Graft Rejection ; complications ; therapy ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Renal Insufficiency ; complications ; therapy ; Transplantation, Homologous ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the clinical value of combination of human epididymis protein 4 (HE4), CA125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosis of ovarian carcinoma.

METHODSTo detect the serum concentration of HE4 using ELISA and CA125 using ECL in patients of ovarian carcinoma group (n = 119), borderline ovarian tumor group (n = 36), benign ovarian neoplasm group (n = 96) and female healthy control group (n = 53). The ROMA based on the serum level of CA125, HE4 and a woman's menopausal status was used to calculate the predicted probability (PP) and diagnostic results of ovarian cancers.

RESULTSThe receiver operating characteristic (ROC) analysis showed the cut-off value was 67.3 pmol/L (the AUC was 0.906, the sensitivity was 80.7% and specificity was 94.6%). The serum levels of HE4 and CA125 in the ovarian carcinoma group were significantly higher than that in the borderline ovarian tumor group, benign ovarian neoplasm group and female healthy control group (P < 0.01). The serum levels of CA125 and HE4 showed statistically no significant difference between the borderline ovarian tumor group and benign ovarian neoplasm group (P > 0.05). The levels of HE4 and CA125 were reduced significantly in ovarian patients after surgery therapy (P < 0.01). The sensitivity and specificity of HE4 + CA125 combination was 92.7% and 72.5%. The ROMA that can classify patients into high and low risk groups was established as 9.3% in premenopausal and 27.3% in postmenopausal women.

CONCLUSIONSHE4 is a helpful biomarker for ovarian carcinoma diagnosis. Biomarker combination of HE4 and CA125, and applying of the ROMA are helpful to improve the accuracy in diagnosis of ovarian cancers.

Adenocarcinoma, Mucinous ; blood ; diagnosis ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; CA-125 Antigen ; blood ; Cystadenocarcinoma, Serous ; blood ; diagnosis ; surgery ; Cystadenoma, Serous ; blood ; diagnosis ; surgery ; Endometriosis ; blood ; diagnosis ; Female ; Humans ; Menopause ; Middle Aged ; Ovarian Neoplasms ; blood ; diagnosis ; surgery ; Proteins ; metabolism ; ROC Curve ; Sensitivity and Specificity ; Teratoma ; blood ; diagnosis ; surgery ; Young Adult

Objective To evaluate the effects of parthenolide on estradiol?synthesizing enzyme, steroidogenic acute regulatory protein (StAR), and ER isoforms,VEGF in human endometriotic stromal cells. Methods Primary endometriotic stromal cells were treated with different concentrations (1, 5, 10 and 20 μmol/L) of parthenolide. The mRNA of StAR, ER isoforms (ERα and ERβ), PR, vascular endothelial growth factor (VEGF), interleukin?6 (IL?6), tumour necrosis factor?α (TNFα), tumour necrosis factor receptor (TNFR) 1, TNFR2 were measured by real?time PCR. The levels of estradiol and progesterone in the cell supernatant were measured by ELISA. Results Different concentrations of parthenolide could up?regulate the mRNA of StAR in primary endometriotic stromal cells (F=5.722, P<0.05); the mRNA of StAR in the group of 20 μmol/L was significantly higher than that of the control group [2.6 ± 0.3 versus 1.0, P<0.01]. Different concentrations of parthenolide could down?regulate the mRNA of ERα (F=6.921, P<0.01); the mRNA of ERα in the group of 20 μmol/L and 10 μmol/L were significantly lower than those of the control group [0.2 ± 0.3 versus 0.3 ± 0.3 versus 1.0, all P<0.05]. Different concentrations of parthenolide could down?regulate the ratios of ERα/ERβ mRNA levels (F=4.209, P<0.05). Different concentrations of parthenolide could up?regulate the mRNA of VEGF and TNFR1 (F=10.964, P<0.01; F=7.286, P<0.01). There were no statiscal significances with different concentrations of parthenolide on the mRNA of ERβ, PR, IL?6, TNFα and TNFR2, and the levels of estradiol and progesterone in the cell supernatant (all P>0.05). Conclusions Parthenolide may regulate the expression of estradiol?synthesizing enzyme, ER isoforms and angiogenesis in endometriotic stromal cells. Parthenolide may promote the development of endometriosis.

Objective To explore the distribution of traditional Chinese medicine(TCM)syndrome elements in patients with multi-drug resistant bacteria-infected pneumonia.Methods Clinical data of 126 patients with multi-drug resistant bacteria-infected pneumonia admitted to the intensive care unit of Lung Disease Centre of Qingdao Hospital of Traditional Chinese Medicine from May 2020 to July 2022 were retrospectively collected.The clinical data included the patients'gender,age,underlying diseases,history of bad additions of smoking and alcohol,multi-drug resistant bacteria,and the information of four diagnostic methods of TCM,etc.The disease-nature syndrome elements in patients with drug-resistance to various strains of drug-resistant bacteria were extracted,and then deficiency-excess syndrome differentiation was carried out.Results(1)A total of 201 strains of multi-drug resistant bacteria were detected in 126 patients with multi-drug resistant bacterial pneumonia.The main pathogenic species were Gram-negative bacteria,and the proportion accounted for 95.52%(192/201),which was significantly higher than that of Gram-positive bacteria[4.48%(9/201)],with a statistically significant difference(χ2 = 166.612,P＜0.001).Klebsiella pneumoniae accounted for the highest percentage of 23.38%in the gram-negative bacterium.(2)A total of 12 syndrome elements were extracted from the 126 patients.The excess syndrome elements were predominated by phlegm and heat,and the deficiency syndrome elements were predominated by yin deficiency.There was no statistically significant difference in the distribution of yin deficiency,blood deficiency,heat,phlegm,fluid-retention and damp syndrome elements among patients with different strains of drug-resistant bacterial infection(P＞0.05).(3)Of the 126 patients,62 cases(49.21%)had simple excess syndrome,one case(0.79%)had simple deficiency syndrome,and 63 cases(50.00%)had concurrent deficiency-excess syndrome.Among the 126 patients,there were 19 cases of single syndrome element,41 cases of concurrent two-syndrome element,49 cases of concurrent three-syndrome element,16 cases of concurrent four-syndrome element,and one case of concurrent five-syndrome element.And the combined syndrome element of phlegm-heat-yin deficiency occurred most frequently for 26 times.Conclusion Gram-negative bacteria are the primary infectious pathogens for the patients with multi-drug resistant bacterial infections,and the TCM syndrome elements of the patients are characterized by the concurrence of deficiency and excess and simple excess syndrome,mainly manifesting as phlegm,heat,and yin deficiency.

Objective To evaluate the effects of nerve growth factor (NGF)polybutylcyanoacrylate (PBCA)- nanoparticles (NP) on PC12 cells induced by Aβ1-40 Methods The emulsion polymerization method was used to prepare the NGF-PBCA-NP. Morphology of the NGF-PBCA-NP was observed by transmission electron microscopy. The entrapment efficiency and loading efficiency of NGF-PBCA-NP were measured by means of ultraviolet spectrophotometry. The effects of NGF-PBCA-NP on proliferation and cell apoptosis of β1-40-PC12 cells were observed by MTT and FCM methods. Results The NGF-PBCA-NPs were uniform spheres with drug entrapment efficiency of 80.87％ and loading efficiency of 19.88％.Compared with the cells in the NGF group,cells in the NGF-PBCA-NP group exhibited a significantly better proliferation rate and a significantly lower apoptosis rate (P＜0.05). Conclusion NGF-PBCA-NPs obtained by emulsion polymerization method are uniform in morphology and possess a high drug entrapment efficiency and a high loading efficiency.They can restrain significantly the in vitro growth of Aβ1-40-PC12.

OBJECTIVETo study the expressions and activities of Rho GTPases in hypoxia and its relationship with tumor angiogenesis.

METHODSThree tumor cell lines were used in this study: gastric cancer cell lines AGS, SGC7901 and hepatocellular carcinoma cell line HepG2. Expression level of Rac1 mRNA was detected by semi-quantitative RT-PCR. Activity of Rac1 was determined by pull-down assay and expression of HIF-1alpha, VEGF, p53 and PTEN protein was detected by Westernblot.

RESULTSThe expression level of Rac1 mRNA was significantly increased in hypoxia compared to normoxia. Pull-down assay showed that hypoxia-induced activity of Rac1 was elevated in a time-dependent manner and climaxed at 3 hours. The expressions of HIF-1alpha and VEGF protein were up-regulated, while those of PTEN and p53 protein were down-regulated.

CONCLUSIONThese results indicate that hypoxia enhances Rac1 expression which might be involved in tumor angiogenesis by reacting with hypoxia-responsive genes.

Cell Hypoxia ; Cell Line, Tumor ; Hepatoblastoma ; blood supply ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; biosynthesis ; genetics ; Liver Neoplasms ; blood supply ; metabolism ; pathology ; Neovascularization, Pathologic ; PTEN Phosphohydrolase ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Stomach Neoplasms ; blood supply ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics ; rac1 GTP-Binding Protein ; biosynthesis ; genetics ; rho GTP-Binding Proteins ; biosynthesis ; genetics