AIM:To construct the recombinant eukaryotic expression plasmid pEGFP-C1-SR-A I for the high expression in 293T cells in order to identify functions of savenger receptor-A I(SR-A).METHODS:The primer was designed according to MSR1 cDNA and pEGFP-C1-SR-A I was constructed by standard molecular cloning technique and enzyme digestion.After sequencing,the plasmid was transfected into 293T cells by lipidosome method.The expression of scavenger receptor-A I was identified by RT-PCR and Western blotting.The foam cells were evaluated by the formation of lipid granules in the cells with oil red staining.Cell adhesion was analyzed by cell adhesion assay.RESULTS:24 h after transfection,SR-A I mRNA was highly expressed and the high level of the protein was detected.The ratio of foam cell formation was doubled,the efficacy of cell adhesion was enhanced two times compared to the control group and the empty vector group.CONCLUSION:The recombinant eukaryotic expression plasmid has been constructed successfully with enhancing the function of uptake ox-LDL and adhesion in 293T cells by overexpression of SR-A I.

Objective To investigate the effect of adenosine A2A receptor on pituitary-adrenal axis response in acute phase of moderate craniocerebral trauma.Methods Eighteen adenosine A2A receptor knock-out mice in a C57BL/6 background and another eighteen their wild-type littermates were divided into normal control group and craniocerebral trauma for 4 hours group,and craniocerebral trauma for 24 hours group according to random number table,with siμ mice per group.Plasma levels of adrenocorticotropic-hormone (ACTH) and corticosterone at hours 4 and 24 postinjury were determined using ELISA method.Results At 4 and 24 hours,brain water content in wild-type mice [(80.950 ± 0.184) ％,(82.178 ± 0.255)％ respectively] was higher than that in gene knock-out mice [(80.006 ± 0.199)％,(81.091 ± 0.295)％ respectively,P ＜ 0.01].Besides,brain water content in both wild-type and gene knock-out mice increased after injury (P ＜ 0.01).Plasma levels of ACTH and corticosterone were higher in geneknock-out sham mice than in wild-type sham mice [(120.214 ± 2.472) ng/L vs (91.767 ±7.395) ng/L,(27.814 ±0.888) μg/L vs (11.430 ±0.644) μg/L respectively,P ＜0.0l].At 4 and 24 hours,plasma levels of ACTH [(174.776-± 5.040) ng/L,(189.613 ± 4.802) ng/L respectively] in geneknock-out mice showed a higher increase than those in wild-type mice [(119.594 ± 6.945) ng/L,(124.93-± 11.001 7) ng/L respectively,P ＜ 0.05].Moreover,plasma levels of corticosterone [(40.138 ±-0.805) μg/L] at 4 hours and [(37.440-0.485)μg/L] at 24 hours in gene knock-out mice showed a same result as compared with that in wild-type mice [(19.702 ± 0.804) μg/L,(17.602 ± 0.743) μg/L respectively,P ＜ 0.05].Conclusions Knock-out of adenosine A2A receptor increases the release of ACTH and corticosterone in acute stage of moderate craniocerebral trauma and promotes pituitary-adrenal stress response.This may provide a novel explanation for the neuroprotective effect of A2A receptor deficiency.

Objective:A retrospective analysis was performed on clinical characteristics and deoxyguanosine kinase DGUOK gene mutations in a family with hepatocerebral mitochondrial DNA depletion syndrome (MTDPS). Methods:The clinical data, treatment process and gene detection results of a child with MTDPS in the second hospital of Hebei Medical University in April 2019 were analyzed and summarized.Results:Proband was a girl.From the first week of infantile, she suffered from recurrent hypoglycemia, hyperlactic acid, progressive cholestatic liver dysfunction, coagulopathy, difficult feeding, slow growth of body mass, microcephaly, hypotonia, and gradul intermittent binocular tremors, and eventually failed to thrive.Gene testing identified two compound heterozygous mutations c. 42-c.43insTTCA(p.F15fs129X)/c.808-1(IVS6)G>A in DGUOK gene.The former was a frame-shift mutation resulted in truncated protein and the later was a splicing mutation resulted in abnormal splicing.Each parent was a heterozygous carrier, and there were no mutations in the two sites with her elder sister. Conclusions:Both mutations were first reported worldwide. DGUOK gene mutations with MTDPS are important causes of infant liver failure.When hypoglycemia, hyperlactic acidemia and liver dysfunction occur in newborn and infant, MTDPS related gene DGUOK gene sequencing screening should be considered for early definitive diagnosis, or, when acute liver failure happen in infant and childhood, neuromuscular involvement is insufficient.

ObjectiveTo investigate the mechanism of dexamethasone (Dex) in inhibiting monocyte adhesion and phagocytose function.Methods Under the stimulation of phorbo1-12-myristate-13-acetate (PMA),U937 monocytes cultured in vitro were treated with Dex and Fasudil respectively.The adhesion rate of U937 monocles to human umbilical vein endothelial cells (HUVECs) and their phagocytic ability of India ink were studied.The protein content and activity of rho-associated coiled-coil protein kinase 1 ( ROCK1 ) as well as the effects of mifepristone and cycloheximide on Dex were determined.ResultsBoth DEX and Fasudil could significantly inhibit the adhesion tate and phagocytosis of U937 cells stimulated by PMA and suppressed the activity of ROCK1.While mifepristone and cycloheximide could not alter these effects of DEX.ConclusionDEX interferes with the adhesion and phagocytosis function of U937 cells by inhibiting ROCKI activity.

Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Tripterygium wilfordii Hook. F. (TWF) belongs to celastraceae under Tripterygium family. It is a traditional Chinese medicine with a variety of pharmacological effects such as anti- inflammatory, analgesic, anti- tumor, immunomodulation and so on, which is applied for many diseases because of its significant effects. However, its toxic and side effects frequently occur, especially liver injury, affecting its safety in clinical practice. In this paper, the clinical characteristics of liver injury of TWF were preliminarily explored by combining with literature analysis and single center clinical epidemiological investigation. Furthermore, the main toxic constituents and mechanism of TWF are reviewed. Finally, the key issues have been raised and analyzed on clinical diagnosis, clinical characteristics and toxicological mechanism of liver injury of TWF, and brought forward the future research directions.

Objective: To investigate the correlation between clinicopathologic features like human epidermal growth factor receptor type 2(HER2) status and lymph node metastasis, meanwhile, to establish a prediction model for the risk of lymph node metastasis in early gastric cancer. Methods: Multiple data of 157 patients who underwent early gastric cancer radical gastrectomy were involved and analyzed. Further, the risk prediction model was established for lymph node metastasis of early gastric cancer. Results: Among these 157 patients, 31 cases were reported lymph node metastasis, with a rate of 19.7%. Analysis showed that female patients, HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion accounted for a large proportion in lymph node metastasis(P<0.05). Analysis also showed that HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors for lymph node metastasis in early gastric cancer(P<0.05). According to the above analysis results, the prediction models for lymph node metastasis risk of early gastric cancer were established respectively included or excluded HER2 status, and the area under the ROC curve(AUC) was 0.800 and 0.759, respectively. Meanwhile, differentiated tumor accounted for a large proportion in HER2 IHC(3+)(P<0.05). Conclusion HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors of lymph node metastasis in early gastric cancer. The new established model including HER2 status has good sensitivity and specificity, which may provide a reference for predicting the risk of lymph node metastasis in early gastric cancer.

Objective : To compare the diagnostic efficacy of three screening methods，including the epidemiological survey and the new gastric cancer scoring system proposed in the Expert Consensus Opinion on Early Gastric Cancer Screening Process in China ( Shanghai，2017) ，and the Kyoto classification score for screening gastric in early gastric cancer diagnosis． Methods: Patients who underwent endoscopic submucosal dissection and were pathologically confirmed were included in the gastric cancer group，patients with non-gastric cancer in the same period were consecutively included in the control group．Questionnaires and serological tests were performed in all enrolled patients，and the endoscopic presentations was recorded according to the classification of Kyoto gastritis during gastroscopy．The risk stratification and the detection rates of gastric cancer were estimated by different screening methods，and the receiver operating characteristic curve (ROC curve) of subjects diagnosed with each screening method alone and in combination were plotted to compare the area under the ROC curve (AUC) and the diagnostic efficacy . Results: Among all participants，84 were patients with gastric cancer and 120 were normal people without gastric cancer．The Kyoto risk score had the highest diagnostic value (AUC = 0. 79) among the others，and its sensitivity and specificity were 72. 6% and 79. 1% ，respectively，but the combined diagnosis of different methods did not significantly improve the diagnostic efficacy．The Kyoto risk score had a more discriminative value in the medium to high-risk group delineated by the new scoring system． Conclusion The Kyoto risk score has high clinical value in the diagnosis of early gastric cancer and can be used in conjunction with the new scoring system for early gastric cancer risk assessment.

Objective:To summarize the clinical and pathological features of intravascular NK and T cell lymphoma for better understanding of such disease to reduce misdiagnosis and miss-diagnosis.Methods:Clinical and pathological features were analyzed retrospectively in one case of intravascular peripheral T-cell lymphoma, not otherwise specified (IVPTCL, NOS) , with literatures review.Results:The case presented in this study was a 66-year-old man. PET/CT scan showed multiple lymph nodes enlargement throughout the body. Normal lymph node structure could not be observed by tissue biopsy, while lymph follicles were partially disrupted. High-power light microscope revealed a large number of blood vessels with diffuse proliferation and dilation, where atypical lymphoid cell mass was restricted in the lumen and partially infiltrated the large blood vessel wall. These tumor cells were medium to large with moderate cytoplasm. The nucleus was irregular, single or multiple nucleoli could be seen, chromatin was condensed, some were empty and bright, and mitotic figures could be seen. Immunohistochemical staining showed that the neoplastic cells were positive for expression of CD3, CD43, CD8, GrB, TIA-1 and perforin. EBER in situ hybridization result was negative. Polymerase chain reaction test identified a clonal gene rearrangement of T-cell receptor γ. The patient was treated with CHOP in combination with chidamide, but died of infection and cardiopulmonary failure within 2 months. 56 cases of intravascular NK/T cell lymphoma with definite classification were collected from relevant literatures, including 47 cases with nasal type of extranodal NK/T cell lymphoma (27 were male and 20 were female) , 8 cases with anaplastic large cell lymphoma (3 males and 5 females) , and only one case with de nova IVPTCL, NOS in brain. We report the second case of IVPTCL,NOS, and notably originated from lymph node for the first time.Conclusions:Intravascular NK/T cell lymphoma is a highly aggressive disease with no effective treatment at present. Involvement of Lymph node has rarely been reported, and further studies on more cases are necessary.

OBJECTIVE To investigate the awareness of the patients receiving Sanjin tablets in knowledge-attitude-practice （KAP） aspect， and its influential factors. METHODS Demographic characteristics， medication knowledge， attitude and practice of outpatients and inpatients who used Sanjin tablets in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June to December 2020 were investigated online and offline for questionnaire survey and scale scoring.Oneway variance analysis and multiple linear regression analysis were used to screen the influential factors for KAP of the patient receiving Sanjin tablets. RESULTS A total of 503 valid questionnaires （effective recovery rate of 99.60%） were collected in this survey. The drug use knowledge score of Sanjin tablet users was （26.74±6.82） points， the drug use attitude score was （7.82±3.75） points， and the drug use practice score was （21.72±5.56） points. The overall scores were good， excellent and good， respectively.The results of oneway variance analysis showed that there were significant differences in drug use knowledge and drug use practice scores among the patients receiving Sanjin tablets with different ages，occupations and medical insurance types （P＜0.05）； there were significant differences in drug use attitude scores among the patients receiving Sanjin tablets with different ages， occupations， education levels and medical insurance types （P＜0.05）. The results of multiple linear regression analysis showed that ages， occupations， education levels and medical insurance types were the main factors affecting the drug use knowledge and drug use attitude of the patients receiving Sanjin tablets （P＜0.05）； education levels and medical insurance types were the main factors affecting the drug use practice of the patients receiving Sanjin tablets （P＜0.05）. CONCLUSIONS Most of the patients receiving Sanjin tablets have a good attitude towards the acquisition of safe medication information， but the knowledge to drug use and the actual drug use practice still have certain hidden danger in security； it is necessary to strengthen drug use education and publicity for individual age groups， low-educational background groups and other people， carry out the drug education among the population with different vocational characteristics and medical insurance types in order to promote safe and rational drug use.