Mitogen activated protein kinase(MAPK)is one of the four biggest signal transduction systems which contain four subtribes named p38,ERK5/BMK1,ERK and JNK/SAPK respectively.Previous studies have shown that MAPK pathway is involved in growth,cell differentiation,perishing,the synchronization of cell function and so on.ERK/MAPK,one of the members of MAPK family,and Sma-and MAD-related(Smad)play important roles in the proliferation of fibroblast,modulating inflammation mediator production as well as transferring factors activity in the process of pulmonary fibrosis(PF).This review focuses on relationship between Smads and ERK in the pathogenesis and progression of PF.

Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid (n=62) or vancomycin (n=62) for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients(33.87%), and decline of hemoglobin occurred in 17 patients (27.42%).No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI (1.408,42.090),P=0.019], treatment duration>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034], baseline eGFR<80 mL·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008], baseline ALB<25 g·L-1[OR=4.078,95%CI(1.017,16.351),P=0.047] and baseline platelet count<200×109·L-1[OR=6.148,95%CI(1.705,22.172),P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI(1.308,14.365),P=0.016] and baseline ALB<25 g·L-1[OR=5.424,95%CI(1.824,16.129),P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.

Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc?tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with pa?tients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur?vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P<0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms,P<0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(<0.35)[RR: 2.167(1.384-4.661), P=0.013]and DC (DC<4.5 ms)[RR: 3.706(2.709-5.374),P=0.020]were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1%and 76.4%respectively, and the specificity was 84.5%and 86.1%respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.

Objective To investigate the effect and mechanism of Imatinib mesilate (Imatinib) on intimal hyperplasia of rabbit carotid arteries after balloon injury. Methods Thirty adult Newzealand rabbits were randomly divided into three groups:group A, B and C. Their right carotid arteries were injuried then administered with 0, 25 or 50 mg/kg of Imatinib dai?ly for 14 consecutive days when the rabbits were sacrificed. The carotid arteries were harvested and sectioned for HE-stain?ing and immunohistochemisty staining. Real-Time PCR was used to examine transcription levels of PDGF-B and PDGFR-βmRNA. The plasma level of PDGF-BB was assayed by ELISA. Results Arterial intimal hyperplasia and stenosis following balloon injury were seen in three groups. Thickness and area of neointima, ratio of thickness of intima to media, ratio of area of intima to media and mRNA level of PDGF-β are all higher in group A than those in group B than those in group C (P<0.01). By contrast, the mRNA transcription level of PDGFR-β increased significantly in group C than that in group A (1.236±0.356 vs 0.708±0.372;t=2.91;P<0.01). Plasma level of PDGF-BB increased in all three groups after balloon injury than that in the baseline (P<0.01). The transcription level of PDGF-BB is higher in group A than that in group B and in group C (ng/L:23.464±3.542, 19.504±2.454, 16.588±1.207, F=17.322, P<0.05). There was no difference between group B and C. There was positive correlation between mRNA transcription level of PDGF-B and plasma level of PDGF-BB ( r=0.806, P<0.01). Conclusion Vascular injury can cause intimal hyperplasia and increased PDGF-B mRNA transcription. Imatinib mesilate could inhibit the intimal hyperplasia through down regulating PDGF-B mRNA transcription.

Objective To study the pattern of cerebral gray matter and white matter volume changes among smokers with differ-ent level of nicotine dependence (addition)using voxel-based morphometry (VBM).Methods The current case-control study recrui-ted 53 healthy male smokers and 53 healthy non-smokers from outpatients of our hospital during January 2013 to May 2014.Personal information (including for example age,sex and addition dependence of subjects)was collected using a questionnaire.3D-T1 images of whole brain structure were collected and were analyzed using DARTEL toolbox of SPM8.Smokers were divided into mild to mod-erate nicotine dependence group (n=23)and severe nicotine dependence group (n=30)based on Fagerstr?m Test for Nicotine De-pendence (FTND)score.Independent sample t-test analyses were performed to compare the volumes of gray matter and white mat-ter between smokers with different levels of nicotine dependence and non-smokers.Results Compared with non-smokers,gray and white matter volumes of smokers were smaller in multiple brain areas,mainly in the middle occipital gyrus,posterior cingulate,cer-ebellum anterior lobe,precuneus,caudate body and insula,which however,had larger number and scope of focal areas with gray and white matter atrophy in the mild to moderate nicotine dependence group than that in the severe nicotine dependence group.Conclusion Smokers with mild to moderate nicotine dependence have more pronounced gray and white matter atrophy than that smokers with severe nicotine dependence have.

Purpose To explore the significance of MR diffusion tensor imaging (DTI) in diagnosing and predicting the motor function of patients with acute ischemic stroke in the brainstem. Materials and Methods Twenty patients with acute ischemic stroke in the brainstem and 20 normal controls were enrolled in the study. DTI was performed on all 40 subjects. Fractional anisotropy (FA) in specific regions were measured including infarction lesions, cerebral peduncle, the posterior limb of the internal capsule in the affected side and corresponding unaffected regions. The number and the length of the corticospinal tracts (CST) of both affected and unaffected sides were also measured. The correlation of FA, the number and the length of the CST, the NIH stroke scale (NIHSS) at the admission, 3 months and 6 months was analyzed. Results The FA values of infarction, cerebral peduncle, and the posterior limb of the internal capsule, and the number of CST in the affected side were significantly less than that of the corresponding unaffected regions (P<0.05). The rFA (<7 d) in the affected cerebral peduncle was negatively correlated with NIHSS and the score of the upper and lower extremity muscle strength at the admission, after 3 months and after 6 months (P<0.05). However, the rFA of the infarction and the posterior limb of the internal capsule, the ratio of the number and the length of CST of affected/unaffected sides had no correlation with NIHSS score and the score of the muscle strength. Conclusion The rFA in the cerebral peduncle is helpful for early evaluation and predicting recovery of the motor function in the patients with acute ischemic stroke in the brainstem.

Objective To investigate the effects of high-fat diet on pancreatic acinar cells' IP3 expression and CCK-induced amylase release in rats.Methods Male Wistar rats were divided into high-fat diet group and normal diet group,they were fed for 4 weeks.Blood triglycerides,cholesterol,amylase and glucose levels were determined by automatic biochemical analyzer.Pancreatic tissues were taken for histopathological observations.Pancreatic acinar cells were isolated and cultured,and intracellular inositol 1,4,5-trisphosphate (IP3) was detected using a commercial kit.Amylase release rates were measured after CCK-8 stimulation.Results The rats in high-fat diet group appeared hyperlipidemia,vacuolization of acinar cells and the lymphocytes appeared around the acinar cells can be seen on the pancreatic tissue pathology staining.The levels of IP3 in acinar cells of rats fed a high-fat diet were higher than that of normal rats [(31.807 ± 3.448) pmol/106 cells vs (24.632 ± 3.649) pmol/106 cells,t=7.479,P＜0.001];and amylase release rate in these rats'acinar cells were also higher than those of normal rats [when CCK-8=0.01 nmol/L:( 11.056 ±3.369)％ vs (7.354 ± 2.181) ％,t=3.912,P＜0.001;when CCK-8=1 nmol/L:( 13.854 ± 4.087 ) ％ vs (9.432 ±2.477) ％,t=3.939,P＜0.001 ) after CCK-8 stimulation in different concentrations.Additionally,there was a positive co-relationship between acinar cell's IP3 level and amylase release (r=0.896,P＜0.001 ).Conclusion Chronic high-fat diet induces hypersensitivity for pancreatic acinar cells' exocrine function,and IP3 as a signal molecule may play an important role in this process.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

Objective:To study the correlation of β-fibrinogen-854G/A,-455G/A,-249C/T,-148C/T,448G/A and BcI-1G/A polymorphisms, functional expression of plasma fibrinogen concentration, molecular reactivity, and the type of cerebral infarction.Methods: A casecontrol study was used to analyze 54 patients with main-think cerebral infarction(MCI), 106 patients with penetrating-arterial cerebral infarction (PCI)and 160 heathy cases as control group in Kailuan Hospital between July 2002 and June 2003.Gene polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Fg concentration, fibrin monomer polymerized velocity(FMPV), absorbance maximum(Amax), FMPV/Amax and biochemistry factors including TG were measured, Results: Fg concentration, FMPV, FMPV/Amax in the MCI group and TG, VLDL and FMPV in the PCI group were higher than in the control group(P＜0.05).The frequencies of854A and Bcl-1A alleles had significant difference among three groups,and the frequencies of GA and AA genotypes in the MCI and PCI groups were higher than in the control group(P＜0.05), however, no different genotypes and allele frequencies of the remaining sites were found in the three groups(P＞0.05).Fg concentration and FMPV of allele T carriers in the MCI group were less than that of-249C/C homozygous ones(P ＜0.05); FMPV/Amax of allele T carriers in the PCI group was higher than that of-148C/C homozygous ones(P＜0.05);with allele A carriers, Fg concentration of control group and FMPV of PCI group were higher than that of Bcl-1 wild homozygote(P＜0.05).Conclusion: Bβ-249 C/T polymorphism in the 5-flanking promoter region can influence the expression of plasma FMPV, Bβ-148 locus is the main regulation location of Fg molecular conglomerate function.Bcl-1 locus in the 3-flanking region is an important gene regulator of plasma Fg concentration, moreover,people with its mutated genotypes are susceptible to MCI.The abnormal plasma Fg concentration, FMPV/Amax and FMPV simultaneously are important risk factors for MCI, and only abnormal FMPV and TG are prone to PCI.

BACKGROUND:Digital three-dimensional model which can reflect the fine structure of the chambers inside heart not only enhances the understanding of cardiac physiology, but also provides basic medical data for the study of cardiac electrophysiology simulation and endocardial electrophysiological mapping navigation. OBJECTIVE:To construct the digital three-dimensional model of cardiac cavity from sectional data and in conformity with the actual anatomical structure. METHODS:Image segmentation was accomplished in MATLAB environment. Firstly, registration of human cardiac cavity slice dataset was realized. Secondly, classifying each composition was achieved by clustering method according to color characteristics of the image. Then, both cardiac cavity and related connected region was distinguished by region growing method. At last, the processed image was reconstructed through dedicated medical processing software into three-dimensional model of the cardiac cavity. RESULTS AND CONCLUSION:The proposed method could reconstruct quite exquisite three-dimensional model of the cardiac cavity. In models, left and right atrial and ventricular structure was clear. Aorta and superior vena cava were visible. Three tricuspid and mitral valve were also observed. Results indicated that reconstructed model can reflect the anatomical characteristics of cardiac cavity accurately, and provide basic medical data for the study on electrophysiological simulation and endocardial electric mapping.