AIM:To explore the effect of the combination of ACEI and ARB on left ventricle in pressure-overloaded hypertrophy rats, and also the relationship between left ventricular hypertrophy (LVH) and cytokines, matrix metalloproteinases, apoptosis, and apoptosis genes. METHODS: IL-6, IL-10, MMP-2 and MMP-9 were evaluated by ELISA method. TNF-alpha was measured with radioimmunoassays. Flow cytometer was used to measure the apoptosis ratio and the expression of Fas, Bcl-2 and Bax. RESULTS: 6 weeks after abdominal aortic coarctation operation, the weight of the left ventricle ( 0.983 ? 0.316 g ) and heart weight/body weight ( 0.382 ? 0.154 ) were significantly increased in control group compared with the sham operated group. And also IL-6 ( 208.71 ? 84.51 pg?ml -1 ), TNF-? ( 1.983 ? 0.842 ng?ml -1 ), MMP-2 ( 74.63 ? 37.62 ), MMP-9 ( 57.74 ? 25.61 ), apoptosis ratio ( 8.47 ? 4.18 ) and apoptosis genes (fas, bax, bcl-2, bcl-2/bax) expression were increased, but IL-10 ( 86.23 ? 40.13 pg?ml -1 ) was decreased compared with sham operated group. The 3 groups with drugs (CP, LT, CP+LT) decreased the increasing weight of LV and ventricular weight/body weight and inhibited the changes of influencing factors (IL-6, IL-10, TNF-?, MMP-2, MMP-9, apoptosis ratio and apoptosis genes expression), especially in the group of combination of 2 drugs. CONCLUSION: LVH might be related with many influencing factors. ACEI and ARB may have the positive importance in the treatment and prevention of LVH.

Objective To explore the application of the part of the orbicularis oculi muscle above the cutting margin and the orbital septum fixed to pretarsal fascia in construction of double eyelid.Methods We selected 30 aesthetic seekers asking for construction of double eyelid.We fixed the part of the orbicularis oculi muscle above the cutting margin and the orbital septum to pretarsal fascia in double eyelid operation and then evaluated the surgical effects,complications and satisfaction.Results 30 cases were successfully operated in this group,and the operation time was 1.0 ±0.2 hour.Five days after operation,we removed upper eyelid skin suture and observed that wound healing was good and double eyelid line was natural and smooth.Postoperative follow-up of 1 to 6 months,the effects were satisfactory.Conclusions This method is simple and effective in producing a satisfactory eye shape.

Objective:To explore the methods of emergency terminating refractory tachyarrhythmia.Methods:Data of 117 cases,Who received emergency termination of tachyarrhythmia in emergency department of Taihe Hospital in the last five years,Were summarized and revieWed.Results:All 117 cases With tachyarrhythmia Were successfully terminated in emergency.A total of 21 cases (17.9%)Were successfully terminated in emergency using tWo or more methods (12 cases With supraventricular tachycardia,five cases With ventricular tachycardia,one case With atrial flutter and three cases With atrial fibrillation),in these patients concluded as refractory tachyarrhythmia,five pa-tients (23.8%)Were terminated via synchronous electrical cardioversion.Conclusion:Termination of refractory tachyarrhythmia needs individualization treatment strategy,its treatment may be drugs first and then electrical car-dioversion,or electrical cardioversion directly if necessary.

ObjectiveTo explore the changes of systemic inflammatory response syndrome (SIRS)after cardiopulmonary resuscitation to provide basis for clinical prevention and treatment. MethodsForty rabbits were divided into the sham-operated group; the cardiac arrest for 4 minutes, 5 minutes and 6 minutes groups randomly (random number). Then the rabbits were anaesthetized, retrograde tracheal intubated .The cardiac arrest were induced by aphysia to all rabbits except the sham-operated group and the cardiopulmonary resuscitation were performed after 4, 5 and 6 minutes. The physiological parameters were evaluated at 24, 48, 72, 96 and 120 h after cardiac arrest. The serum samples were taken at the same to detect the level of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and white blood cell.The data were analysed by repeated measure variance. ResultsThe SIRS were presented at all cardiopulmonary resuscitation groups after 24 h of cardiac arrest. Compared to the sham-operated group, the level of TNF-α and CRP in resuscitation groups was significantly increased ( P ＜ 0. 01 ). To the group arrested for 4 minutes, the SIRS were higher at 24 ～ 48 h and dissipated at 72 h. To the groups arrested for 5 or 6minutes, SIRS were lasted for 96 h. ConclusionsSIRS is easy to recover if resuscitation was taken within 4 minutes after cardiac arrest. After 5 minutes, SIRS is severe and hard to recover. Serum TNF-α is a sensitive marker to evaluate SIRS and can be used as the supplymentary diagnosic marker of SIRS to providing early treament and prevention.

ObjectiveTo investigate the role of SAA in rheumatoid arthritis(RA) pathogenesis by analyzing the expression of serum amyloid protein A(SAA) in serum,synovial fluid and synovial membrane in patients with RA.MethodsSAA levels in the serum and synovial fluid in each group were detected.Sera SAA was tested by Western blotting,while the expression of SAA in RA and osteoarthritis(OA) synovium was detected by immunohistochemistry.Comparisons between groups were performed by t-tests or KruskaWallis test.ResultsThe serum levels of SAA were significantly higher in RA [(318±132) μg/L] than those in OA [(127±47) μg/L] and healey controls [(127±41) μg/L,P＜0.01].In RA,the SAA levels in the synovial fluid [ (571±473) μg/L ] were significantly higher when compared to those in O A [ (129±33) μg/L](t=2.46,P=0.04).Western blotting results showed that SAA bands were found in the serum samples of each group,and higher expression of SAA were seen in RA.Pathology study had showed that SAA was observed mainly in endothelial cells,synovial fibroblasts,macrophages and perivascular areas in RA synovium.In OA,SAA was observed in perivascular areas and synovial fibroblasts.ConclusionIn RA,SAA levels in both serum and synovial fluid are significantly higher than those in the controls.High expression of SAA in RA synovium can be observed.Our results suggest that SAA may play a role in inflammation reaction and joint destruction of RA.

Objective To compare the clinical efficacy and fusion rate of unilateral and bilateral C1 and C2 pedicle screw fixation of unstable Jefferson fractures.Methods This retrospective casecontrol study enrolled 22 patients with unstable Jefferson fractures admitted between April 2012 and May 2015.There were 18 males and four females,with the mean age of 52.9 years (range,35-67 years).Mean preoperative visual analogue scale (VAS) was 6.09 points (range,4-8 points).According to the American spinal injury association (ASIA) classification,two patients were rated grade D and one patient grade C.Mean Japanese orthopedic association (JOA) score was 12.3 points.Bilateral C1 and C2 pedicle screw fixation was performed for 15 patients (bilateral group).Advantage side unilateral C1 and C2 pedicle screw fixation was performed for seven patients with extremely unstable fracture or narrow pedicle (unilateral group).Operation time,blood loss and surgical complications were recorded.VAS was used to evaluate the improvement of neck pain after operation.ASIA classification and JOA score were used to assess nerve function recovery.Atlanto-dental interval (ADI),srew position and bone fusion were evaluated after operation.Results All patients successfully completed the operation.Operation time was (119.5 ±21.2)min,and blood loss was (280.1 ±83.1)ml.A total of 74 screws were placed and CT scan showed satisfactory position of the screws.No complications were noted either during the operation or after surgery.All patients were followed up for mean 20.7 months (range,13-33 months).VAS was improved in both groups after operation (P ＜ 0.01),and there was no significant difference between the two groups (P ＞ 0.05).Two patients with ASIA grade D in bilateral group were improved to ASIA grade E after operation.One patient with ASIA grade C in unilateral group was improved to ASIA grade D after operation.JOA score increased to mean 15.7 points at last follow-up.ADI were decreased in both groups after operation(P ＜0.05),but there was no significant difference between the two groups (P ＞ 0.05).All patients had bony fusion 6 months after operation,with similar fusion rate between the two groups (P ＞ 0.05).Conclusion Advantage side unilateral screw fixation can be used for the patients with bilateral C1 and C2 pedicle screw fixation failure,for the technique can improve cervical pain and provide relatively high stability and fusion rate.

Pullulanase is a starch debranching enzyme, which is difficult in secretory expression due to its large molecular weight. Vibrio natriegens is a novel expression host with excellent efficiency in protein synthesis. In this study, we achieved secretory expression of the full-length pullulanase PulA and its truncated mutant PulN2 using V. natriegens VnDX strain. Subsequently, we investigated the effects of signal peptide, fermentation temperature, inducer concentration, glycine concentration and fermentation time on the secretory expression. Moreover, the extracellular enzyme activities of the two pullulanases produced in V. natriegens VnDX and E. coli BL21(DE3) were compared. The highest extracellular enzyme activity of PulA and PulN2 in V. natriegens VnDX were 61.6 U/mL and 64.3 U/mL, which were 110% and 62% that of those in E. coli BL21(DE3), respectively. The results indicated that V. natriegens VnDX can be used for secretory expression of the full-length PulA with large molecular weight, which may provide a reference for the secretory expression of other large molecular weight proteins in V. natriegens VnDX.
Escherichia coli/genetics* ; Fermentation ; Vibrio/genetics*

Objective To compare the clinical effects of posterior pedicle screw fixation combined with anterior monosegmental or bisegmental fusion reconstruction in patients with unstable Denis type B thoracolumbar burst fractures.Methods A retrospective case-control analysis was made on 62 cases of Denis type B thoracolumbar burst fractures treated from June 2010 to June 2014.There were 51 males and 11 females,aged 19-55 years (mean,35.1 years).The injury causes included fall from height in 32 cases,traffic accidents in 24,hit by heavy objects in 6.Fifty cases were with monosegmental burst fractures,and 12 with monosegmental burst fractures combined with other vertebral compressive fractures.The burst fracture levels were at T~in 8 cases,T12in 20,L1 in 24,L2 in 6,and L3 in 4.According to the different surgical methods,the patients were divided into two groups:Group A (n =30,treated with posterior pedicle screw fixation combined with anterior monosegmental fusion reconstruction) and Group B (n =30,treated with posterior pedicle screw fixation combined with anterior bisegmental fusion construction).The operation time and intraoperative blood loss were compared between the two groups.Visual analogue scale (VAS),Oswestry disability index (ODI),and Frankel scale of neurologic function were compared at last follow-up.The changes of anterior height of fracture vertebrae and Cobb angle of the two groups were also compared preoperatively,postoperatively and at last follow-up.Implant looseness and breakage,titanium mesh tilt,and bone fusion were recorded postoperatively.Results All patients were followed up for 18-24 months (mean,20.8 months).The operation time and blood loss in Group A was (208.2 ± 15.6) min and (598.3 ± 55.3) ml,respectively.The operative time and blood loss in Group B was (260.1 ± 17.4)min and (662.2± 58.3)ml,respectively.There were significantly statistical differences between two groups in operation time and blood loss (P ＜0.05).There were no statistical differences between two groups in terms of Cobb angle restoration and fracture height restoration rate after surgery,Cobb angle loss and fracture vertebral body front height loss rate at final follow-up (P ＞ 0.05).At the final follow-up,VAS in Group A was (2.5 ± 0.8) points,less than (3.2 ± 1.1) points in Group B (P ＜ 0.05);ODI in Group A was (20.3 ± 5.8) points,less than (28.2 ± 5.1) points in Group B (P ＜ 0.05).Frankel scale was improved to some degree after operation (P ＜ 0.05).One case did not achieve bone fusion in Group A versus three cases in Group B (P＜0.05).No implant Loosening,titanium mesh tilt or settlement was found in Group A,while there were eight cases of titanium mesh tilt or settlement in Group B (P ＜0.05).Conclusions For unstable Denis type B thoracolumbar burst fractures,posterior pedicular fixation combined with anterior monosegmental fusion or bisegmental fusion can achieve equal clinical effects.However,posterior pedicular fixation combined with anterior monosegmental fusion can have less injury,higher bone fusion rate,better function restoration,and less incidence of complication.

Starch is composed of glucose units linked by α-1, 4-glucoside bond and α-1, 6-glucoside bond. It is the main component of foods and the primary raw material for starch processing industry. Pullulanase can effectively hydrolyze the α-1, 6-glucoside bond in starch molecules. Combined with other starch processing enzymes, it can effectively improve the starch utilization rate. Therefore, it has been widely used in the starch processing industry. This paper summarized the screening of pullulanase-producing strain and its encoding genes. In addition, the effects of expression elements and fermentation conditions on the production of pullulanase were summarized. Moreover, the progress in crystal structure elucidation and molecular modification of pullulanase was discussed. Lastly, future perspectives on pullulanase research were proposed.
Glycoside Hydrolases/genetics* ; Starch/metabolism*