Objective To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Objective To investigate the value of narrow band imaging (NBI) and lugol chromo-endoscopy (LCE) in the diagnosis of advanced esophageal carcinoma.Methods The clinical data of 162 patients with advanced esophageal carcinoma who received NBI and LCE at the Cancer Hospital of Peking University from November 2010 to May 2012 were retrospectively analyzed.Esophageal mucosa was first examined using white light imaging (WLI),and then followed by NBI and LCE,and the lengths of the lesions were recorded.Biopsy histology was obtained in all abnormal mucosa which were detected by NBI or LCE.Difference in the length of lesions detected by the NBI/LCE and WLI was calculated.Surgical approach and method of anastomosis were recorded for patients who received surgical treatment,and the final treatment method was recorded for patients who did not receive surgical treatment.Difference in the treatment methods was compared before and after endoscopy.Results The length of the lesions detected by the 3 methods was identical in 121 patients,different in 41 patients.The difference ranged between 1 and 3 cm was observed in 22 patients,＞3 cm and ≤5 cm in 8 patients,＞5 cm and ≤10 cm in 7 patients,＞ 10 cm in 4 patients.Of the patients in the above mentioned 4 categories,there were 1,2,2,4 patients in each category received neo-adjuvant therapy,and the rest patients received operation.Superficial cancer contiguous to the primary lesion was found in 41 patients,including squamous cell carcinoma in 31 patients,carcinoma-in-situ in 3 patients and severe dysplasia in 7 patients.Of the 153 patients who received surgery,the surgical plan for 12 patients was modified.Intrathoracic anastomosis was changed to cervical anastomosis in 2 patients,anastomosis under the aortic arch was changed to anastomosis above the aortic arch in 3 patients,trans-abdominal operation was changed to thoraco-abdominal operation in 7 patients.Conclusions The combination of NBI and LCE is more accurate to evaluate the extent of lesions of advanced esophageal carcinoma,and is useful to decide the treatment protocol.Pathological examination of the adjacent abnormal mucosa should be carried out for patients whose lesion length was inconsistent under different observation methods.

Objective To evaluate the accuracy and influencing factors of mini-probe endoscopic ultrasonography (EUS) in determining the T stage for early gastric cancer (EGC).Methods The clinical data of 103 patients with EGC who were admitted to the Peking University Cancer Hospital from March 2011 to June 2014 were retrospectively analyzed.The diagnosis results of mini-probe EUS were compared with postoperative pathological findings,of which the differences in the accuracy of mini-probe EUS in determining the T stage of EGC were analyzed according to tumor location,diameter,differentiated types,with or without ulceration and Lauren classification.The rate comparison and univariate analysis were done by the chi-square test,and multivariate analysis was done using the Logistic regression model.Results Among 107 lesions,75 lesions were detected in uT1a stage by mini-probe EUS and 32 lesions in uT1b stage.The results of pathological examination showed that 61 lesions were detected in T1 a stage,40 lesions in T1 b stage and 6 lesions in T2 stage.The accuracy of mini-probe EUS in the T1 stage of EGC was 66.4％ (71/107),including 70.7％ (53/75) in the uT1 a stage and 56.3 ％ (18/32) in the uT1b stage of EGC.There were significant differences in the accuracy of mini-probe EUS for determining the T stage of EGC among the patients with different tumor diameters,different differentiated types and with or without ulceration (x2=7.834,7.432,6.461,P ＜0.05).The results of multivariate analysis showed that tumor diameter more than 30 mm and undifferentiated types of tumors were independent risk factors affecting the accuracy of miniprobe EUS in determining the T stage of EGC (OR =0.340,0.332,95％ confidence interval:0.563-0.932,0.582-1.022,P ＜ 0.05).Conclusions The clinical value of mini-probe EUS in the T stage of EGC is relatively high.The accuracy of mini-probe EUS detecting in the T1 a stage of EGC is higher than the T1 b stage of EGC,and the factors affecting the accuracy of mini-probe EUS in determining preoperative stage of EGC include tumor diameter more than 30 mm and undifferentiated type of tumors.

Objective To investigate the effect of acupuncture combined with minimally invasive hematoma aspiration on a rabbit model of brain injury in the acute stage of intracerebral hemorrhage (ICH). Methods A total of 65 healthy New Zealand white rabbits were randomly divided into a sham operation (SO) group, an ICH group,a hematoma aspiration (HA) group, and an acupuncture and hematoma aspiration (AHA) group. Models of ICH were established in the latter three groups. The HA group was treated with minimally invasive hematoma aspiration and the AHA group was treated with both acupuncture and minimally invasive hematoma aspiration. At 6 hours and 1, 3 and 7 days after the ICH models were established, brain water content (BWC) was measured, and the expression of matrix metalloproteinase-9 ( MMP-9 ) in the rabbits' brains was detected by immunohistochemistry. MMP-9activity was detected by gelatin zymography. Results The BWCs of the ICH group, HA group and AHA group rabbits were significantly higher than those of the SO group. The BWCs of the HA group and AHA group animals descended significantly more than those in the ICH group as time went on, especially on the 3rd day in the AHA group. Immunohistochemistry and gelatin zymography showed that the expression and activity of MMP-9 in these test groups decreased with time, especially on the 3rd day in the AHA group. Conclusions Acupuncture combined with hematoma aspiration can reduce injury in the acute stage of ICH, and inhibition of the expression of MMP-9 may be the mechanism.

ADP-ribosyl Cyclase 1 ; immunology ; Biopsy ; Bone Marrow ; immunology ; pathology ; Epoxy Resins ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; immunology ; Plastic Embedding ; Staining and Labeling ; methods

BACKGROUND:Qingre Huoxue Xiaozhong composition Ⅰ and Ⅱ made by ourselves are effective in treating bone fracture complicated by soft tissue injury.However,its mechanism is still unclear.OBJECTIVE:To observe the effect of Qingre Huoxue Xiaozhong composition on the levels of intedeukin 1β(IL-1β) and interleukin 6(IL-6) in serum of patients with closed bone injury-induced soft tissue injury.DESIGN:Randomized controlled observation.SETTING:Wards of the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA.PARTICIPANTS: Eighty-eight inpatients with bone fracture at early and moderate stages accompanied by soft tissue injury were chosen as volunteers to be studied in the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA between February 2000 and February 2002.The involved inpatients were assigned into 2 groups according to the table of random digit:Oingre Huoxue Xiaozhong composition Ⅰ + Ⅱ group (n=45) and Qingre Huoxue Xiaozhong composition Ⅱ group (n=43).Oingre Huoxue Xiaozhong composition Ⅰ was for internal administration,and Qingre Huoxue Xiaozhong composition Ⅱ was for external fumigation.METHODS:①Treatment of bone injury:Both caltrate D pellets and pills for strengthening bone joints were used in two groups.②Treatment of soft tissue injury: In the Qingre Huoxue Xiaozhong composition Ⅰ+ Ⅱ group,Qingre Huoxue Xiaozhong composition Ⅰ was decocted.Each decoction was 450 mL,and was packed into 3 pouches, 150 mL/pouch,three times a day;Qingre Huoxue Xiaozhong composition Ⅱ was decocted.Each decoction was 600 mL,and was packedinto 4 Douches,150 mL/pouch.Four pouches of Qingre Huoxue Xiaozhong composition Ⅱ was diluted by 2 000 mL water,then heated and used for fume-washing, twice a day, 20 to 30 minutes once. Four pouches could be used for fume-washing for 2 days successively. In the Oingre Huoxue Xiaozhong compositionⅡgroup, only Oingre Huoxue Xiaozhong composition Ⅱ was used to fume-wash the lesioned region.The concrete method was the same as that in the Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group.In each group, ten days were set as one course of treatment,and totally, there are 2 courses of treatment.IL-1β and IL-6 levels in serum of patients were detected by with ELISA kit before.one and two courses after treatment, and compared separately.MAIN OUTCOME MEASURES: Levels of IL-1β and IL-6 in serum of patients in two groups before, one and two courses after treatment.RESULTS: In the eingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly lower after 2 courses of treatment as compared with the previous one and one course after treatment (P＜0.05-0.01), also at the same time point in compared with the Qingre Huoxue Xiaozhong composition Ⅱ group (P＜0.05).In addition, in the Oingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly decreased after one course of treatment as compared with before treatment (P＜0.05). In the Oingre Huoxue Xiaozhong composition Ⅱ group,after 2 courses of treatment,the level of IL-1β was significantly decreased as compared with before treatment, and the level of IL-β was also significantly decreased as compared with before treatment and after one course of treatment (P＜0.05).CONCLUSION: Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ can be used to treat bone fracture accompanied by soft tissue injury by inhibiting the levels of IL-1β and IL-6. The effect of the combination of Oingre Huoxue Xiaozhong composition Ⅰ and Ⅱ is superior to that of each alone.

Objective To investigate hydrogen peroxide (H2O2) and transforming growth factor-β2 (TGF-β2) induced fibronectin (FN), collagen 1 (COL1), nuclear factor (NF)-κB P65 proteins and interlukin (IL)-1βgene expression in human trabecular meshwork cells (HTMCs), and the interventional mechanism of resveratrol (RSV). Methods (1) HTMCs with 70 to 80%confluency were divided into 5 groups. The experimental groups were treated with serum-free medium and with H2O2 at concentrations of 150, 300, 450 and 800μmol/L. The control group was treated with 0μmol/L H2O2. The protein levels of FN, COL1, NF-κB P65 and NF-κB P65 phosphorylation (P-NF-κB P65) were measured by Western blot assay. The expression of IL-1βgene was measured by qPCR. (2) HTMCs were divided into 3 groups. The control group was treated withserum-free medium and without H2O2 and RSV. The H2O2 group was treated with 300μmol/L H2O2. The H2O2+RSV group was treated with 300μmol/L H2O2 and 25μmol/L resveratrol (RSV). The expressions of proteins and genes mentioned above were detected in three groups. NF-κB P65 nuclear translocation was assessed by immunofluorescence technique. (3) HTMCs were divided into 3 groups. The control group was treated with serum-free medium and without TGF-β2 and RSV. The TGF-β2 group was treated with 5μg/L TGF-β2. The TGF-β2+RSV group was treated with 5μg/L TGF-β2 and 25μmol/L RSV. The expressions of proteins and genes mentioned above were detected in three groups. Results (1) Compared with control group, the protein levels of FN and P-NF-κB P65 were significantly increased in 150, 300, 450 and 800μmol/L groups,the expression levels of COL1 protein and IL-1β gene were significantly increased in 300, 450 and 800 μmol/L groups (P <0.05). There were no statistical significances between other indicators. (2) The expression levels of FN, COL1, P-NF-κB P65 proteins and IL-1βgene were significantly higher in H2O2 group than those in control group, and which were significantly lower in H2O2+RSV group than those in H2O2 group. Compared with control group, only the expression of IL-1βgene was decreased in H2O2+RSV group (P < 0.05). NF-κB P65 was only expressed in cytoplasm in control group, while it was expressed in both cytoplasm and nucleus in H2O2 group. Compared with H2O2 group, NF-κB P65 was mainly expressed in cytoplasm. (3) Compared with control group, the expressions of FN, COL1, P-NF-κB P65 proteins and IL-1β gene were significantly increased in TGF-β2 group (P < 0.05). Compared with TGF-β2 group, the indicators mentioned above were significantly decreased in TGF-β2+RSV group (P<0.05). Conclusion H2O2 and TGF-β2 can upregulate the expression of FN, COL1, P-NF-κB P65 proteins and IL-1βgene in HTMCs, which may be involved in the development and progression of glaucoma. RSV can inhibit the influence of H2O2 and TGF-β2 in HTMCs and exert a protective effect on glaucoma.

Objective To investigate the accuracy of analgesia/nociception index (ANI) in assessing the severity of postoperative pain in patients.Methods Eighty patients,aged 21-77 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective operation,were admitted to the postanesthesia care unit after the patients were extubated at the end of operation,and ANI was monitored.Immediately after admission to the postanesthesia care unit (T0),numerical rating scale (NRS) score was recorded.If NRS score was 0-3,the patients received no treatment,and NRS score was recorded again 10 min later (T1).If NRS score was 4-10,fentanyl 50 μg was injected intravenously,and NRS score was recorded again 5 min later (T2).ANI value was recorded at T0,T1 and T2.NRS score was considered as the criterion for assessment of the severity of pain.The receiver operating characteristic curve was used to analyze the sensitivity and specificity of ANI in determining NRS scores,the cut-off value was determined,and the area under the curve and 95％ confidence interval were calculated.Pearson correlation was used to analyze the correlation between ANI and NRS score.Results The area under the curve (95％ confidence interval) of ANI in determining NRS scores was 0.873 (0.816-0.929),and the cut-off value was 45 with a sensitivity of 74.8％ and a specificity of 87.5％.ANI was negatively correlated with NRS score,and the correlation coefficient was-0.705 (P＜0.05).Conclusion ANI provides high accuracy in assessing the severity of postoperative pain with a cut-off value of 45 in the patients.

AIM:To evaluate the expression level of CXC chemokine receptor 7 (CXCR7) in atherosclerotic apolipoprotein E-deficient ( ApoE-/-) mice induced by high-fat diet ( HFD) and the effects of atorvastatin on it .METH-ODS:ApoE-/-male mice (8-week-old) were used and were randomly divided into 3 groups following 1-week normal ro-dent diet:normal diet control (NDC) group , HFD group and HFD+statins (HFD+Sat) group.HE staining and oil red O staining were used to observe the atherosclerotic lesion burdens in the aortas .The expression of CXCR7 on the aortas was detected by Western blot and immunohistochemistry .The expression of Akt and endothelial nitric oxide synthase ( eNOS) in the aorta was determined by Western blot .RESULTS: Few lesions were found in the aortas in NDC group .Apparent atherosclerotic plaque burdens were seen in HFD group and HFD +Sat group, while the atherosclerotic plaque burdens in HFD+Sat group were notably reduced compared with HFD group .The protein levels of CXCR7, eNOS and Akt in aorta in HFD group and HFD+Sat group were significantly decreased compared with NDC group , while those in HFD+Sat group were increased compared with HFD group .The protein level of p-eNOS in the aorta and the concentration of NO in the plas-ma in HFD group were decreased compared with NDC group and HFD +Sat group.CONCLUSION: In ApoE-/-mice, HFD increases the lipid level and promotes the development of atherosclerosis by downregulating the expression of CXCR 7, Akt and eNOS.Atorvastatin reverses the above effect of hypercholesterolemia on the expression of CXCR 7, Akt and eNOS, thus playing the role in treating atherosclerosis .

Objective:To develop a quantitative HPLC method for the analysis of eight impurities in active pharmaceutical ingredi-ent (API) asenapine maleate. Methods:The substances were analyzed using an Inertsil ODS-3 C18 column (250 mm × 4. 6 mm, 5μm), and gradiently eluted by the mobile phase A of 0. 1% aqueous trifluoroacetic acid and mobile phase B of acetonitrile in a flow rate of 1. 0 ml·min-1 with the detection wavelength of 220 nm and the column temperature of 35℃. Results:Asenapine was separa-ted completely from the impurities. The calibration curve of asenapine was linear within the range of 0. 45-1 458 μg · ml-1 ( r =1. 000 0), and that the impurities was linear within the range of 0. 4-30. 0μg·ml-1(r>0. 999). The mean recovery of the impurities was 93. 1%-106. 7%(n=9). Conclusion:The method is simple,sensitive and reproducible with good specificity and reliability,which can be used in the quality control of asenapine maleate.