Objective To investigate clinical features and the early recurrence factors of watershed infarction(WSI).Methods Two hundred and eighty-three patients with acute anterior circulation vascular infraction confirmed by CT or MRI were collected in Heilongjiang Province Hospital from January 2010 to December 2012.Patients' information including gender,sex,risk factors for stroke and vascular stenosis was colleced.Patients were divided into the lacunar infarction group (n =83),large infarction group(n =60) and the WSI group (n =140).All patients were followed up for 6 months to observe cerebral infarction recurrence status.The national institutes of health stroke scale(NIHSS) test of all patients was performed.Meanwhile the information including disease stage was collected and analysed.Results (1) The recurrent rate in WSI group,large infarction group and lacunar infarction group were 40.0％ (56/140),30.0％ (18/60),9.6％ (8/83)respectively.The difference between recurrent rate and lacunar infarction group was statistically significant(x2 =23.5,x2 =9.7,P ＜ 0.05),and the recurrent rate of WSI was highest.(2)The symptoms of patients with WSI were relatively mild in most patients after the initial stroke.75.7％ (106/140)WSI patients were 0-4 points regarding of NIHSS score,22.9％ (32/140) for 5-9 points and only 1.4％ (2/140) for more than 10 points.The clinical symptoms aggravated obviously in recurrent WSI patients.Of recurrent patients,28.6％ (16/56) were with high NIHSS score (score ≥ 10 points).(3)The difference between recurrent group and unrecurrent group in terms of unstable plaque,baseline systolic blood pressure,degree of stenosis ≥ 70％ was statistically significant(P ＜ 0.05).Conclusion The recurrent rate is higher in WSI group than other infarction type.The clinical symptoms are relatively mild in most of the WSI patients after the initial stroke,but the symptoms turn serious when stoke recurrent and the prognosis is poor.The unstable plaque,baseline systolic blood pressure,degree of stenosis ≥ 70％ may be the risk factors of stroke recurrence.

Objective To observe the expression of MMP-1, TNF-a in cholesteatoma and to determine their roles in the destruction of bone and their correlation. Methods Immunohistochemical method and the computer image quantitative analysis were used to examine the expression of TNF-α and MMP-1 in 22 cases of chotesteatomamiddle ear and 20 cases of normal external acoustic meatus skin. Results Positive stainings of MMP-1 and TNF-α were both localized in cytoplasm. The MMP-1 positive cells were found in all strata of cholesteatoma epithelium and active multiplication stromal cell. TNF-α was expressed in both epithlium and stromal cells. The results of the computer image quantitative analysis showed that the mean optical density of MMP-1 (0. 2013±0. 0106) and TNF-α (0.3852±0.0318) in cholesteatoma were higher than that in normal skin epithelial tissue( P＜0.05 ). Conclusion (1)MMP-1 and TNF-α are overexpressed in cholesteatoma. (2)MMP-1 and TNF-α have a correlation in their expression. (3)MMP-1 and TNF-α are both observed in stromal cells which indicates that stromal cells play an irnportant role in bone destruction.

Objective To investigate the changes of the electrocardiograms (ECG) and the cardiac markers in patients with acute insular infarction,and analyze the relationship between them and the prognosis.Methods A total of 202 patients with acute middle cerebral artery territory infarction (patients group) and 150 control subjects (control group) was selected in this study.Patients included insular infarction (insular infarction group,136 cases),non-insular infarction (non-insular infarction group,66 cases),left-side insular infarction(71 cases) and right-side insular infarction(65 cases).ECG recordings and plasma cardiac troponin I (cTnI),creatine kinase-MB (CK-MB) were measured and compared.Death in 6 months was followed-up.Results There was significant difference in the incidence of abnormal changes of ECG and plasma cTnI,CK-MB increasing between patients group and control group (P ＜0.01).The incidence of abnormal changes of ECG and fatality rate were higher in insular infarction group than those in non-insular infarction group [80.88％(110/136) vs.46.97％(31/66) and 11.76％ (16/136) vs.3.03％ (2/66),P ＜ 0.05 or ＜ 0.01].The incidences of ectopy and prolonged QT were higher in right-side insular infarction patients than those in left-side insular infarction patients [44.62％(29/65) vs.11.27％ (8/71),P ＜0.01 ; 55.38％ (36/65) vs.35.21％ (25/71),P ＜ 0.05].The incidences of sinus bradycardia and ST segment deviation were higher in left-side insular infarction patients than those in right-side insular infarction patients [22.54％(16/71) vs.7.69％(5/65),P ＜ 0.05 ;47.89％(34/71) vs.13.85％ (9/65),P ＜ 0.05].The increased rates plasma cTnI and CK-MB level were mainly seen in insular infarction [insular infarction group:47.79％ (65/136),34.56％ (47/136); non-insular infarction group:4.55％ (3/66),1.52％ (1/66),P ＜ 0.01].The incidence of plasma cTnI increasing in right-side insular infarction patients was higher than that in left-side insular infarction patients [67.69％(44/65) vs.29.58％(21/71),P＜ 0.05].There was no significant difference in the incidence of plasma CK-MB increasing between left-side insular infarction patients and right-side insular infarction patients(P ＞ 0.05).The fatality rates in plasma cTnI,CK-MB increasing patients were higher than those in normal plasma cTnI,CK-MB patients [16.18％ (11/68) vs.5.22％ (7/134),P ＜0.05;29.17％ (14/48) vs.2.60％ (4/154),P ＜0.01].Conclusions The effects of acute hemispheric cerebral infarction on heart are mainly associated with destruction of insula.Patients with insular infarction have more abnormal changes of cardiac markers and ECG,which is correlated with poor prognosis.

Purpose To assess left ventricular diastolic function in the patients with essentialhypertension. Methods 25 normotensives,93 hypertensiives without hypertrophy (NLVH) and 47 withhypertrophy (LVH)(LVMI, left ventricular mass index ＞ 124 g/m2 in males and 110 g/m2 in females)underwent 2DE and Doppler echocardiography. Results The ratio of early to late peak velocity (E/A)was 1.21 ± 0.24 in normotensives and 1.03 ± 0.23 in NLVH patients( P ＜ 0.01 ); reversed pulmonaryvenous flow at atrial systole PA wave was (32.7 ± 7.5 ) vs (38.9 ± 8.7) cm/s (P ＜ 0.01 ) in normotensivesand in NLVH patients respectively. The isovolumic relaxation time (IVRT) and left atrial dimension (LAD)have significant differences in three groups ( P ＜ 0. 05 - 0. 001 ). EF value was similar betweennormotensives and NLVH patients, but it was lower in LVH patients ( P ＜ 0.01 ). Conclusions E/Aratio, PA wawe, Pai, IVRT and LAD are sensitive parameters indicating mild diastolic left ventriculardysfunction. Systolic left ventricular function has no change in NLVH patients.

Objective To investigate the effects of Dihuang Yinzi (DY) on the receptor for advanced glycation end-products(RAGE)/reactive oxygen species(ROS)/apoptosis pathway in SH-SY5Y cells induced by amyloid-beta1-42 (Aβ1-42) oligomer. Methods Firstly, we adopted methyl thiazolyl tetrazolium(MTT) method to detect the cell vitality in fetal bovine serum (FBS) group, blank serum group, and low-, middle- and high- dose DY-containing serum groups, so as to confirm the optimal concentration and treatment time of DY-containing serum. Secondly, we applied MTT method to detect cell vitality and applied Annexin V/propidium iodide (PI) staining method to observe the apoptosis of SH-SY5Y cells treated with 0~20 μmol/L Aβ1-42 for 24 and 48 h, so as toconfirm the optimal concentration and treatment time of Aβ1-42 for establishing Alzheimer's disease (AD) model in vitro. Thirdly, MTT method was used for the detection of cell vitality, and Annexin V/PI staining method was used for detection of the apoptosis of SH-SY5Y cells in blank serum group, model group, western medicine control group and low-, middle-and high-dose DY-containing serum groups, and Dihydroethidium (DHE) method was used for the assay of ROS contents, so as to observe the effect of DY on the recovery of injured SH-SY5Y cells induced by Aβ1-42. Finally, we applied Western blot method to detect the expression level of RAGE in SH-SY5Y cells of blank group, model group and DY-containing serum group; after Aβ1-42-induced SH-SY5Y cells were transfected with RAGE gene, we adopted DHE staining method and Annexin V/PI staining method to detect ROS content and cell apoptotic rate in all of the above groups, so as to observe the effect of DY on SH-SY5Y cell apoptosis and RAGE expression. Results The cell vitalities were increased in low- and middle-dose DY-containing serum groups at 24 h (P < 0.05 or P < 0.01 compared with that in the blank serum group). The conditions for the establishment of AD model in vitro were as follows: the optimal concentration of Aβ1-42 was 5μmol/L, and the treatment time was 24 h. The cell vitalities were significantly enhanced, the cell apoptotic rate and ROS content were significantly lowered in Aβ1-42-induced SH-SY5Y cells of the medication groups(P <0.05 or P < 0.01 compared with those in the model group) , and the cell vitality was the highest and the cell apoptotic rate was the lowest in the middle-dose DY-containing serum group. The RAGE expression level was decreased in Aβ1-42-induced SH-SY5Y cells of the middle-dose DY-containing serum group(P < 0.05 compared with that in the model group) . ROS content and cell apoptotic rate were decreased in Aβ1-42-induced SH-SY5Y cells transfected with RAGE gene in the middle-dose DY-containing serum group (P<0.01). Conclusion DY may play an anti-oxidative role through inhibiting the production of ROS and cell apoptosis, thus to suppress RAGE protein and to achieve the preventive and therapeutic effect for AD.

Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.

Objective:To investigate the expression of microRNA (miR) -26a in human skin fibroblasts during photoaging induced by ultraviolet A (UVA) , and to evaluate the effect of up-or down-regulation of miR-26a expression on the methylation level of the whole genome, the target gene enhancer of zeste homolog 2 (EZH2) and cell aging.Methods:Some human skin fibroblasts were irradiated with 10 J/cm 2 UVA once a day for 7 consecutive days, RNA was extracted on days 0, 3 and 7, and real-time quantitative reverse PCR (RT-PCR) was performed to determine the expression of miR-26a; miR-26a mimics and inhibitors were transfected into fibroblasts to up-or down-regulate the expression of miR-26a respectively, and fluorescence microscopy and RT-PCR were performed to determine the expression of miR-26a and evaluate the transfection efficiency. Some human skin fibroblasts were divided into 6 groups: blank control group receiving no treatment, UVA group treated with UVA irradiation according to the above method, miR-26a mimic group transfected with miR-26a-mimics, UVA+miR-26a mimic group transfected with miR-26a-mimics followed by UVA irradiation, miR-26a inhibitor group transfected with miR-26a inhibitors, UVA+miR-26a inhibitor group transfected with miR-26a inhibitors followed by UVA irradiation. On day 7, cells in each group were collected after the end of UVA irradiation. Then, flow cytometry was performed to detect cell cycle, DNA methylation quantitative detection kit was used to detect the methylation level of whole genome, RT-PCR was conducted to determine the mRNA expression of EZH2 (a histone-lysine N-methyltransferase enzyme) , DNA methyltransferase 1 (DNMT1) and miR-26a, and Western blot analysis was performed to determine the protein expression of EZH2 and DNMT1. Statistical analysis was carried out by using one-way analysis of variance and least significant difference- t test. Results:Compared with the unirradiated control group, the expression of miR-26a gradually increased in the UVA irradiation group over time during the culture, and there was a significant difference in the expression of miR-26a between the two groups after 7 days of UVA irradiation ( t=5.295, P < 0.05) . Strong fluorescence signals were observed in the miR-26a mimic-or miR-26a inhibitor-transfected fibroblasts, suggesting a high transfection efficiency. Flow cytometry showed that the proportion of cells at G1 phase significantly differed among the blank control group, UVA group, miR-26a mimic group, UVA+miR-26a mimic group, miR-26a inhibitor group, and UVA+miR-26a inhibitor group (52.82% ± 2.56%, 78.56% ± 4.34%, 53.63% ± 3.13%, 89.52% ± 4.17%, 54.39% ± 3.86%, 65.34% ± 4.78%, respectively; F=46.728, P < 0.01) , and significantly higher in the UVA group than in the blank control group ( t=8.848, P < 0.01) , higher in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group ( t=11.922, 3.154, P < 0.01, < 0.05, respectively) , and higher in the UVA+miR-26a inhibitor group than in the miR-26a-inhibitor group ( t=3.087, P < 0.05) , but significantly lower in the UVA+miR-26a inhibitor group than in the UVA group ( t=3.547, P < 0.05) . Detection of the genome-wide methylation level showed that the methylation level ( A450 value) significantly differed among the above groups (0.676 ± 0.024, 0.323 ± 0.043, 0.506 ± 0.035, 0.169 ± 0.024, 0.602 ± 0.036, 0.422 ± 0.029, respectively, F=97.402, P < 0.01) , and significantly lower in the UVA group than in the blank control group ( P < 0.01) , lower in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group (both P < 0.01) , and lower in the UVA+miR-26a inhibitor group than in the miR-26a inhibitor group ( P < 0.01) , but significantly higher in the UVA+miR-26a inhibitor group than in the UVA group ( P < 0.05) . RT-PCR and Western blot analysis showed significant differences in the mRNA and protein expression of EZH2 and DNMT1 respectively among the 6 groups (both P < 0.05) , which were significantly lower in the UVA group than in the blank control group ( P < 0.05) , lower in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group (both P < 0.05) , and lower in the UVA+miR-26a inhibitor group than in the miR-26a inhibitor group ( P < 0.05) , but significantly higher in the UVA+miR-26a inhibitor group than in the UVA group ( P < 0.05) . Conclusion:In the UVA irradiation-induced photoaging of skin fibroblasts, miR-26a expression was up-regulated, cellular proliferative activity and genome-wide methylation level decreased; up-regulation of miR-26a expression could down-regulate the expression of its target gene EZH2 and methylation-related gene DNM1, and promote cell photoaging, while down-regulation of miR-26a expression could up-regulate the expression of EZH2 and DNMT1, and inhibit cell photoaging.

Objective To investigate the effect ofDihuangyinzi (DHYZ)-medicated serum on receptor for advanced glycation end product (RAGE)/p38 miotgen-activated protein kinase (MAPK) /nuclear factor (NF)-κB pathway in SH-SY5Y cells induced by Aβ1-42.Methods Male SD rats were randomly divided into normal control group and experimental group (n=20);natural sera medium and DHYZ sera medium were prepared.(1) SH-SY5Y cells were divided into control group,model group and DHYZ treatment group;natural sera medium,natural sera medium+Aβ1-42 oligomer,and DHYZ sera medium+Aβ1-42 oligomer were given to the cells,respectively.Westem blotting was used to detect the protein expressions of NF-κB p65,p38 and phosphorylate (p)-p38.(2) SH-SY5Y cells were given DHYZ sera medium+Aβ1-42 oligomer treatment,and at different time points of Aβ1-42 oligomer treatment (15 min,30 min,60 min,12 h,24 h,48 h and 72 h),Western blotting was used to detect the protein expressions of p38 and p-p38.(3) SH-SY5Y cells were divided into 6 groups:mock-transfected RAGE blank group,transfected RAGE blank group,mock-transfected RAGE model group,transfected RAGE model group,mock-transfected RAGE herb group and transfected RAGE herb group;herb groups were given DHYZ-medicated serum;inflammatory factors,interleukin (IL)-1β,IL-6,and tumor necrosis factor (TNF)-a,were measured by ELISA and cytometric bead array.Results (1) As compared with model group,DHYZ treatment group had significantly decreased NF-κB p65 and p-p38/p38 protein expression.(2) The p-p38 protein expression began to increase 30 min after Aβ1-42 treatment,reached to its peak level 24 h after Aβ1-42 treatment,and began to decrease 48 h after Aβ1-42 treatment.(3) The IL-1β,IL-6 and TNF-α levels were increased significantly in the transfected RAGE model group as compared with those in the mock-transfected RAGE model group (P＜0.05);the IL-1β,IL-6 and TNF-α levels were increased significantly in the transfected RAGE herb group as compared with those in the mock-transfected RAGE herb group (P＜0.05);the IL-1β,IL-6 and TNF-α levels were decreased significantly in the mock-transfected RAGE herb group as compared with those in the mock-transfected RAGE model group (P＜0.05);the IL-1β,IL-6 and TNF-α levels were decreased significantly in the transfected RAGE herb group as compared with those in the transfected RAGE model group (P＜0.05).Conclusion DHYZ-medicated serum could inhibit the RAGE-p38 pathway and improve the inflammatory reaction in Aβ1-42-induced SH-SY5Ycells transfected with RAGE gene to protect the SH-SY5Y cells.

Objective To investigate the correlation between apolipoprotein and homocysteine levels with the stability of carotid plaque and the degree of stenosis??Methods One hundred elderly patients with acute cerebral infarction from January 2017 to December 2017 were collected continuously in Harbin Fourth Hospital,All patients underwent color Doppler ultrasound examination of carotid artery??They were divided into stable plaque group and unstable plaque group according to the results of color Doppler ultrasound,then according to the degree of stenosis they were divided into intimal thickening group with 23 cases, mild stenosis (stenosis degree＜50%) with 26 cases,moderate stenosis group (50%≤stenosis degree＜70%) with 28 cases,severe stenosis group (70%≤stenosis degree) with 23 cases??All the patients were selected to collect the blood of the elbow in the early morning to detect the level of apolipoprotein B and Hcy??Results Compared with unstable plaque group, smoking, drinking, hemoglobin A1c ( HbA1c), ApoB and Hcy had significant differences (all P＜0??05)??Gender,history of diabetes mellitus,history of hypertension,systolic pressure,diastolic pressure,low density lipoprotein cholesterol (LDL?C),triglyceride (TG) There was no significant difference in total cholesterol ( TC) and total cholesterol ( all P＞0??05)??Multivariate logistic regression was performed after correcting the related risk factors excluding blood lipids??The results showed that alcohol ( OR＝ 1??247 ( 95%CI: 0??626－1??958), P＝ 0??043), Hcy ( OR＝ 3??163 ( 95%CI: 1??824 －4??772),P＝0??045), bloodpressure ( OR＝1??286 ( 95%CI: 0??688－2??005), P＝0??027), HbA1c ( OR＝3??671(95%CI: 1??904－6??630),P＝0??011),ApoB (OR＝1??717(95%CI: 1??005－2??634),P＝0??036), LDL?C(OR＝1??516(95%CI: 0??968－2??489),P＝0??024),TC( OR＝1??403( 95%CI: 0??801－2??343),P＝0??030) and TG ( OR＝1??342 ( 95%CI: 0??712－2??198), P＝0??019) are independent risk factors for unstablecarotid plaque and severe carotid stenosis??Conclusion Apolipoprotein and homocysteine may be independent predictors of unstable carotid plaque and severity of carotid stenosis??