Objective To analyze the polymorphisms of glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) gene Exon1 and Exon25,GPI-PLD activity of leucocyte in peripheral blood and their relationship in systemic lupus erythematosus patients of Han nationality in Hunan Chinese.Methods The polymorphisms were analyzed by PCR-SSCP and sequencing. GPI-PLD levels were determined by using glycosylphosphatidylinositol (GPI) anchored placental alkaline phosphatase (PLAP) as substrate and triton-X114 partioning.Results There were fourteen variations in the coverage of GPI-PLD gene Exon 1 of both 109 healthy persons' and 62 systemic lupus erythematosus patients',including seven variations at transcriptional start site upstream and seven variations at Exon1. The codons of variation were 14TTG→AAG (Leu14Lys),17CTC→GTC (Leu17Val),20AGA→AAA (Arg20Lys),21GGT→GGG (Gly21Gly),30GTA→ATA (Val30Ile),which leaded to four missense mutations and one synonymous mutation. In addition, the frequency of the variation at transcriptional start site upstream -24 C→T was significantly different between healthy control and systemic lupus erythematosus patients. At meanwhile, there was a variation in Exon25, the +60496 G→A, between two groups. The total various frequency, which was determined by SSCP, of healthy person was 33 03 percent and systemic lupus erythematosus patient was 25 81 percent. On the basis of the percentage of GPI-anchored PLAP conversion, the leucocyte GPI-PLD activities of total 62 systemic lupus erythematosus patients were measured. As compared with 109 healthy persons as control group, the leukocyte GPI-PLD activities of systemic lupus erythematosus patients were significantly raised, but GPI-PLD activities were not correlated with polymorphism sites significantly.Conclusions The leukocyte GPI-PLD gene in peripheral blood, which belongs to healthy persons and systemic lupus erythematosus patients of Han mationality in Hunan Chinses,is polymorphism.The frequency of transcriptional start site upstream -24 is significantly different between healthy control and systemic lupus erythematosus patients.The leukocyte GPI-PLD activeties of patients' also significantly increase.

Objective To assess the right atrial(RA) function using two-dimensional speckle-tracking echocardiography(2D-STE) and the value of predicting WHO functional class in patients with pulmonary hypertension(PH).Methods Fifty-four consecutive PH patients were studied and compared with a control group of 24 healthy volunteers.RA function was evaluated by 2D-STE,and the following parameters were recorded:an average longitudinal strain (LS) curve that included LSpos during RA filling and LSneg representing RA active contraction (their summation is LStot),the phasic RA volumes,total RA emptying fraction (TotEF),RA passive(PassEF) and active emptying fraction(ActEF).The associations between these indices and the results of invasive pulmonary hemodynamics,cardiac structure and function level were evaluated.Results LStot,TotEF,LSpos,PassEF were significantly lower in PH patients than in controls(all P<0.01).ActEF/TotEF were significantly higher in WHO functional class (WHO-FC) Ⅱ and WHO-FC Ⅲ patients than in controls(all P<0.05),while were lower in WHO-FCIV patients than in controls(P<0.001).Among PH patients,LStot was negatively correlated with greater RA size and RA pressure (all P<0.01).LStot was also associated with right ventricular (RV) functional and overload parameters.In receiver-operator characteristic analysis,RA LStot was of optimal accuracy for prediction of WHO-FC≥Ⅲ in PH patients (P=0.002).Conclusions PH is associated with impaired reservoir and conduit function,but active contract function of RA is enhanced in WHO-FC Ⅱ and WHO-FC Ⅲ patients,and reduced in WHO-FCIV patients.RA LStot confers an optimal predictive effect of poor WHO-FC in PH patients and indicating prognosis.

ObjectiveTo discuss the role of transient receptor potential vanilloid 1 (TRPV 1) in the regulation effect of electroacupuncture on gastric motility.MethodTRPV1 gene knock-out mice (KO mice) and wild-type C57BL/6 mice (WT mice) were selected to receive acupuncture at Zusanli (ST36),Quchi (LI11), Zhongwan (CV12), and Weishu (BL21), and the intragastric pressure was observed before and after acupuncture.ResultElectroacupuncture at Zusanli caused both excitation and inhibition in WT mice, predominated by mild excitation, while electroacupuncture at Weishu, Quchi and Zhongwan all caused inhibition effect; in the KO mice, electroacupuncture at Zusanli, Quchi, Zhongwan, and Weishu all inhibited gastric motility.Conclusion TRPV1 bears certain regulating effect on gastric motility, andacupuncture can inhibit the gastric motility in TRPV gene KO mice.

Objective To investigate the role of hypoxia-inducible factor-1α/ hexokinase Ⅱ (HIF-1α/HKⅡ) signaling pathway in the inhibition of hypoxia/reoxygenation (H/R)-induced apoptosis in the rat cardiomyocytes by hypoxic preconditioning (HPC).Methods Primarily cultured cardiomyocytes obtained from the neonatal rats were seeded in culture dishes at the density of 5× 105cells/ml.The cardiomyocytes were attached to the wall for 72 h and then randomly divided into 6 groups (n=15 each) using a random number table:control group (group C);group H/R;group HPC;HIF-1o inhibitor YC-1 group (group YC-1);group HPC + YC-1;dimethyl sulfoxide (DMSO) group.The ceils were exposed to D-Hank solution saturated with 95％ N2 and 5％ CO2 for 4 h,and then cultured in the normal culture atmosphere for 2 h.The cells in YC-1 and DMSO groups were incubated in the culture medium containing 10 μmol/l YC-1 and 0.1％ DMSO (100 μl) for 24 b,respectively.HPC was induced by 3 cycles of 10 min hypoxia followed by 30 min reoxygenation,and H/R injury model was then established in group HPC.In group HPC+YC-1,the cells were incubated for 5 min in the M199 culture medium supplemented with 10 μmol/L YC-1 and 10％ fetal bovine serum,and the other treatments were similar to those previously described in group HPC.After the end of treatments,the apoptosis in cardiomyocytes was detected by TUNEL,the expression of HIF-1α,HKⅡ and cytochrome c was detected by Western blot,and the mitochondrial membrane potential was quantitatively measured using fluorescence.Apoptotic rate was calculated.Results Compared with group C,the apoptotic rate was significantly increased,the mitochondrial membrane potential was significantly decreased,and the expression of HIF-1α,HKⅡ and cytochrome c was significantly up-regulated in group H/R (P＜0.05).Compared with group H/R,the apoptotic rate was significantly decreased,and the mitochondrial membrane potential was significantly increased,and the expression of HIF-1αt and HKⅡ was significantly up-regulated,and the expression of cytochrome c was significantly down-regulated in group HPC (P＜0.05).Compared with group HPC,the apoptotic rate was significantly increased,the mitochondrial membrane potential was significantly decreased,the expression of HIF-1α and HKⅡ was significantly down-regulated,and the expression of cytochrome c was significantly up-regulated in group HPC+YC-1 (P＜0.05).Conclusion The mechanism by which HPC inhibits H/R-induced apoptosis in rat cardiomyocytes is associated with activation of HIF-1α/HKⅡ signaling pathway.

Objective To evaluate the application value of cardiopulmonary ultrasound(CPUS) in patients with interstitial lung diseases(ILD).Methods Ninety patients with clinically diagnosed interstitial lung diseases and 30 healthy subjects were included in this study.The conventional echocardiographic parameters and right ventricular free wall longitudinal strain (RVLS_FW) were measured in all patients and healthy subjects.The degree of pulmonary fibrosis or the disease severity of each ILD patient was scored using a semi-quantitative scoring method.Patients’ pulmonary function parameters and clinical outcome score (GAP score) were recorded.Fourteen patients belong to other types of ILD and 19 patients with incomplete clinical data were unable to perform GAP scoring,finally 57 patients' clinical and ultrasonographic parameters were measured.On the basis of the pulmonary arterial systolic pressure (PASP) obtained by Doppler echocardiography,90 patients were divided into two groups:ILD patients with pulmonary hypertension(ILDpH,PASP ≥36 mmHg,1 mmHg =0.133 kPa) and ILD patients without PH (ILDNpH,PASP＜ 36 mmHg).Comparsion between ILDpH,ILDNpH and healthy subjects were then evaluated.According to the GAP score,all cases were divided into three groups:low risk,moderate risk and high risk.Statistical analysis was performed to examine the relationship between CPUS parameters and clinical parameters.Results ①Compared with ILDNpH patients,ILDpH patients had significantly lower right ventricular function,wider basal right ventricular diameter (RVD),proximal right ventricular outflow diameter (DRvor1) and right pulmonary artery diameter (DRPA).Compared with healthy subjects,ILDNpH patients had mildly lower right ventricular function and wider left pulmonary artery diameter (DLPA) and right ventricular outflow tract dimensions at the distal or pulmonic valve (DRvoT2).②A good correlation was found between lung ultrasound (LUS) scores and pulmonary function parameters,especially diffusion capacity for carbon monoxide of the lung(DLco)(r =-0.68,P ＜0.001).③With the increased risk of patients,the right ventricular function was gradually decreased,DRVOT2,DRPA,DLPA were gradually widened,and the lung ultrasound score was gradually increased.A weak correlation was found between GAP scores with RVLS_FW,LUS scores,DRpA(r =0.44,0.34,0.31,P ＜0.05).Conclusions CPUS parameters are useful in the assessment of interstitial lung disease and could reflect the prognosis of ILD patients to some extent.Therefore,on the basis of GAP scores,addition of RVLS_FW and LUS score will be more helpful to evaluate the prognosis ofILD patients.

Objective To investigate the influencing factors for left atrial appendage (LAA) spontaneous echo contrast (SEC) or thrombosis in patients with non-valvular atrial fibrillation(NVAF) and normal left ventricular ejection fraction(LVEF).Methods This study prospectively enrolled 255 patients with NVAF [paroxysmal atrial fibrillation(PaAF) 196 cases and persistent atrial fibrillation(PeAF) 59 cases].Patients were divided into two groups according to the findings on transesophageal echocardiography (TEE):positive group with the presence of the LAA SEC or thrombosis (group Ⅰ) and negative group (group Ⅱ) without this two presences.The clinical and echocardiographic data were compared between the two groups.The multivariate logistic regression analysis was used to explore the independent risk factors for development of LAA SEC or thrombosis.Receiver operating characteristic (ROC) curve was performed to determine the predictive value of the factors.Results A total of 255 patients were enrolled.There were 26 cases(10.2％) in group Ⅰ,and 229 cases (89.8％) in group Ⅱ.The age,NT-proBNP,occurrence rate of PeAF,left atrial volume index(LAVI),and LAA orifice long diameter and depth were higher in group Ⅰ than those in group Ⅱ (all P ＜0.01).The left atrial appendage emptying velocity(LAAV),global left atrial longitudinal strain(GLALS) and LVEF were lower in group Ⅰ compared with those in group Ⅱ (all P ＜ 0.01).Multivariate logistic regression analysis and ROC curve showed that GLALS＜12.2％ and LAAV＜ 31.2 cm/s were independent risk factors of LAA SEC or thrombosis in patients with NVAF and perserved LVEF.Conclusions The impairment of left atrial and LAA function are potential risk factors for cardiogenic embolism.GLALS and LAAV can be used as useful referenced parameters for prediction of stroke in patients with NVAF.

OBJECTIVE:To compare the economics of interferon α1b and α2b in the treatment of chronic hepatitis C. METH-ODS:By retrospective study,114 patients with chronic hepatitis C who received interferon were selected,60 patients received interfer-on α1b were divided into group A and 54 patients received interferon α2b were divided into group B. Negative conversion rate of HCV-RNA,normalization rate of ALT and the incidence of ADR in 2 groups were compared,and pharmacoeconomic analysis was conducted. RESULTS:Negative conversion rates of HCV-RNA in group A in 4,12,24,36,48 weeks were 55.00%,71.67%, 63.33%,61.67% and 65.00%,group B were 64.81%,66.67%,62.96%,55.56% and 61.11%,respectively,there were no signifi-cant differences between 2 groups (P>0.05);after treatment,normalization rate of ALT in group A was 95.23%,group B was 96.10%,there was no significant difference between 2 groups(P>0.05);and there were no significant differences in the incidence of ADR between 2 groups (P>0.05),so cost-minimization analysis was used to evaluate pharmacoeconomics. Therapy cost in group A was 13 216.56 yuan,group B was 7 929.60 yuan,group B was lower to group A;sensitivity analysis received the same results. CON-CLUSIONS:Interferonα2b is more economical thanα1b in the treatment of chronic hepatitis C.

Objective To evaluate the ability of high resolution pleuropulmonary ultrasonography and bedside chest X-ray in identifying different pathologic abnormalities in patients with dyspnea,using thoracic computed tomography (CT) as a gold standard.Methods Bedside pleuropulmonary ultrasonography was performed in 350 dyspneic patients in the emergency department and ICU,111 patients were enrolled in the study with pleuropulmonary ultrasonography,chest X-ray and chest CT examination performed within 24 hours.Pathologic entities were evaluated:pleural effusion,consolidation,atelectasis,pneumothorax,pulmonary interstitial fibrosis,and pulmonary edema.The sensitivity,specificity,negative and positive prediction value of pleuropulmonary ultrasonography and chest X-ray were compared with the corresponding CT scan results.Results Pleuropulmonary ultrasonography was highly concordant with chest X-ray.Overall ultrasonography exhibited higher sensitivity than chest X-ray and CT for pleural effusion.For atelectasis and pulmonary edema,the sensitivity of ultrasonography was up to 100%.In the diagnosis of pulmonary interstitial fibrosis,the sensitivity of pleuropulmonary ultrasonography was higher than that of chest X-ray,but the specificity was slightly lower.The sensitivity of pleuropulmonary ultrasonography was slightly higher than that of chest X-ray in pneumothorax,and the specificity was coincident with chest X-ray.Although the sensitivity of ultrasonography was slightly lower for consolidation,it was still higher than chest X-ray.The ability of chest X-ray for differentiating pleural effusion from atelectasis or consolidation was worse than that of ultrasonography.Conclusions Our study demonstrates a high concordance between ultrasonography with radiography.The diagnostic performance of bedside pleuropulmonary ultrasonography is better than that of chest X-ray.

Objective To evaluate the effect of sevoflurane postconditioning on microRNA-133a (miR-133a) expression during myocardial ischemia-reperfusion (I/R) in mice.Methods Thirty adult male C57 mice,weighing 20-30 g,were randomized to 3 groups (n =10 each) using a random number table:control group (group C),I/R group,and sevoflurane postconditioning group (group SP).In I/R and SP groups,hearts from adult male C57 mice were exposed and subjected to 30 min of ischemia and 180 min of reperfusion in anesthetized mice according to the method described by Das et al.In group C,only thoracotomy was performed without ligation of the coronary artery.In group SP,2.4％ sevoflurane was inhaled for 5 min starting from the onset of reperfusion to perform sevoflurane postconditioning.At 180 min of reperfusion,blood samples from the femoral vein were collected for determination of serum lactic dehydrogenase (LDH) and creatine kinase (CK) activities using the colorimetric method.The mice were then sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size,miR133a and caspase-9 mRNA expression (by real-time reverse transcriptase polymerase chain reaction),and caspase-9 expression (by Western blot).Results Compared with group C,the serum LDH and CK activities and myocardial infarct size were significantly increased in I/R and SP groups,the expression of miR-133a was significantly down-regulated,and the expression of caspase-9 protein and mRNA was significantly up-regulated in group I/R,and the expression of miR-133a and caspase-9 protein and mRNA was significantly up-regulated in group SP (P＜0.05).Compared with group I/R,the serum LDH and.CK activities and myocardial infarct size were significantly decreased,the expression of miR-133a was significantly up-regulated,and the expression of caspase-9 protein and mRNA was significantly downregulated in group SP (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning inhibits cell apoptosis during myocardial I/R is related to up-regulation of miR-133a expression in mice.