Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

Objective To investigate the association between single nucleotide polymorphisms (SPN) of Tbx20 gene and congenital atrial septal defects (ASD) in the Xinjiang Han population.Methods A total of 214 ASD patients and 382 controls were included in the present study.Two SNPs (rs17675131,rs4720169) in Tbx20 gene were genotyped by TaqMan SNP genotyping method.Results The distribution of the rs17675131 of Tbx20 were significantly different between normal controls and ASD patients (P =0.014),in which both the A/G allele distribution (P =0.004) and the dominant model (GG vs AG + AA) were significantly different between the 2 groups (P =0.007,OR =0.626).Same is true for the rs4720169 SNP.Its genotype showed significantly different distributions between the 2 groups (P =0.016) specifically for the A/G allele distribution frequencies (P =0.016) and the recessive model (AA vs AG + GG) (P =0.008,OR =1.96).The A-A haplotype was found to be associated with ASD.Conclusion Both rs17675131 and rs4720169 of Tbx20 gene are associated with congenital ASD in the Xinjiang Han population in China.

Objective : To study plasma N terminal pro brain natriuretic peptide (NT-proBNP ) level difference be-tween Han nationality and Uighur nationality patients with acute coronary syndrome (ACS) in Xinjiang .Methods : A total of 482 Uygur and Han nationalities ACS patients (uighur : 212 cases , han : 270 cases) hospitalized from May 2012 to Aug 2013 were selected . According to ACS types , they were divided into unstable angina pectoris (UAP) group (n = 234) ,acute ST segment elevation myocardial infarction (STEMI) group (n = 166) and acute non- ST segment elevation myocardial infarction (NSTEMI) group (n = 82) .All patients received coronary angiography (CAG) and their NT-proBNP levels were compared .Results : ① CAG results indicated that Uygur nationality ACS patients were mainly multi-vessel coronary disease and the percentage was significantly higher than that of Han na - tionality ACS patients (61.32% vs .40.00% ) ; ② Compared with Han nationality ACS patients ,there were significant rise in NT-proBNP levels [UAP : 168.5 (70.6 ~ 272.5) pg/ml vs .383.2 (210.3 ~ 739.5 ) pg/ml ,STEMI : 618.5 (231.7 ~ 1387) pg/ml vs .1209.5 (908 ~ 3214) pg/ml ,NSTEMI : 446.7 (252.21 ~ 831.92) pg/ml vs .1066 (928 ~ 3448.25) pg/ml] in Uygur nationality ACS patients ; ③ Compared with Han nationality ACS patients ,there were significant rise in NT-proBNP levels [Single vessel : 221.7 (20 ~ 2851) pg/ml vs .557.1 (125 ~ 1956.2) pg/ ml ,double-vessel : 421.2 (75.2 ~ 3401.5) pg/ml vs .610.5 (174.4 ~ 5679.1) pg/ml ,multi-vessel : 648.2 (142.4 ~ 3850) pg/ml vs .812.3 (154.8 ~ 6832.5) pg/ml] in Uygur nationality patients with different number of diseased coronary vessels , P < 0.05 ~ < 0.01 .Conclusion : NT-proBNP level in Uygur nationality ACS patients is significant - ly higher than that of Han nationality patients ,it may be related with hereditas ,living habit ,risk factor control , early diagnosis and treatment of disease ,post-discharge compliance of treatment ,which possesses important value for assessing patient′s condition .

Objective To report the inflammatory myopathy with abundant macrophages presenting with abundant foam cells in a Chinese patient.Methods A 44 year-old man with rheumatoid arthritis manifested as progressive proximal muscle weakness in the upper limbs for 13 months and in the lower limbs for 11 months.Laboratory tests showed that serum creatine kinase level was increased,whereas neither the myositis antibody nor paraneoplasma antibodies were detectable,including anti-Jo-1 antibody.Electromyogram showed a classic myogenic pattern with irritable sarcomembrane excitement.Muscle biopsies were carried out in the left and right biceps brechii in 2 months and 13 months of the disease course respectively.The muscle sections were processed with standard histological,enzyme histochemistrical and immunohistochemical workup.Results The first muscle biopsy revealed CD8 positive T lymphocytes infiltrating into major histocompatibility complex (MHC)-Ⅰ positive fibers and distributing around endomysium,accompanied with scattered necrosis and regeneration.The second muscle biopsy showed perifascicular atrophy,fragmented perimysial connective tissue,and a large amount of CD68 positive foam cells and Touton cells accumulating within perimysial connective tissues and endomysium.Some CD20 positive B lymphocytes and plasmacytes were found around perivascular space,but CD8 positive T lymphocytes were only accumulated in the endomysium.MHC- Ⅰ was darkly expressed in the sarcolemma.Conclusions Inflammatory myopathy with abundant macrophages can present with foam cells infiltrating in perimysial and endomysium.The disease can be associated with rheumatoid arthritis and refractory to corticosteroid therapy.

BACKGROUND:Platelet-derived growth factor-B (PDGF-B) is an effective pro-angiogenic growth factor, and adeno-associated virus type 9 (rAAV9) has a strong cardiomyocyte targeting affinity, which is an ideal vehicle for ischemic heart disease gene therapy.
OBJECTIVE:To explore the PDGF-B gene transfection of in vitro neonatal rat myocardial cells mediated by rAAV9 against ischemia and hypoxia-induced cardiomyocytes apoptosis.
METHODRat neonatal myocardial cells were isolated and cultured, and then transfected by rAAV9-PDGF-B and empty virus, rAAV9 with enhance green fluorescent protein (eGFP), under multiplicity of infection (MOI) of 105, 106 and 107, respectively. We observed the expression of eGFP under fluorescence microscopy every day, and used flow cytometry to measure transfection efficiency of vector rAAV9. Western blot and immunofluorescence were used to evaluate protein expression of PDGF-B. Myocardial ischemia and hypoxia injury model was established in vitro on the 5th day of transfection of rAAV9-eGFP and rAAV9-PDGF-B with 107 MOI. The number of myocardial apoptosis was measured by TUNEL assay. Western blot was employed to detect the protein expression of Bax and Caspase-3 which were related apoptosis, and the effect and its possible mechanism of PDGF-B gene overexpression against myocardial apoptosis were explored.
RESULTS AND CONCLUSION:rAAV9 vector can efficiently transfect neonatal rat myocardial cells. eGFP and PDGF-B protein expressed in myocardial cells correctly and efficiently, and the expression intensity increased gradual y with the increasing of time course and MOI. The expression became stable on the 5th day, and the transfection efficiency showed significant difference among these groups (P<0.01). Myocardial apoptosis rate was significantly reduced in the rAAV9-PDGF-B group than the rAAV9-eGFP group (P<0.05), and protein levels of Bax and Caspase-3 in the rAAV9-PDGF-B group were significantly lower than those of the rAAV9-eGFP group (P<0.05). These data indicate that overexpression of PDGF-B gene can effectively reduce ischemia and hypoxia-induced myocardial apoptosis, and the possible mechanism might be by inhibiting Bax and Caspase-3 protein expression, which can provide evidence of rAAV9-PDGF-B vector in the gene therapy of ischemic heart diseases.

Objective To investigate prevalence and risk factors of peripheral artery disease (PAD), metabolic syndrome (MS) and peripheral artery disease complicated with metabolic syndrome among Kazakh adults lived in Xinjiang Yili prefecture. Methods Four-stage cluster sampling method was used to select adults aged 35 years and over for the study from six cities and prefectures of Xinjiang. All the participants were interviewed with questionnaire to collect their demographic characteristics. Physical checksup and blood biochemical measurements were performed for all of them, as well as blood pressure was measured in their lower legs and arms to calculate ankle brachial pressure index ( ABPI), a ratio of the blood pressure in the lower legs to that in the arms. Only data of Kazakh adults in Yili prefecture were analyzed in this paper, including prevalence and risk factors for PAD and MS, as well as their relationship.The patients with PAD were divided into two groups, one complicated with MS and the other without it Logistic regression analysis was used to identify potential risk factors for PAD and MS and their combination.Results A total of 1365 adult Kazakh people were surveyed. Prevalence of MS was 23.7 percent, 30.4 percent for men and 19.0 percent for women, respectively, and that of PAD was 9. 4 percent, 7.0 percent for men and 11.0 percent for women, respectively. Mean age in patients of PAD complicated with MS was older than that in those without MS (t=-5.348, P＜0.01). Risk of PAD complicated with MS in Kazakh people associated with gender ( men), age, systolic pressure, diastolic pressure and blood glucose level.(P＜0.05). Conclusions Both prevalence of PAD and MS are significantly higher among Kazakh people in Yili prefecture of Xinjiang, and increase with age. Prevalence of PAD is significantly higher in those with MS than that in those without MS. Risk factors of PAD complicated with MS include gender(men), age,systolic pressure, diastolic pressure and blood glucose level.

Objective To investigate the association between matrix metalloproteinase-9 (MMP-9) gene polymorphism (-1562C ＞ T/R279Q) and acute coronary syndrome (ACS) in Uygur nationality of Xinjiang Autonomous Region of China. Methods A total of 352 patients with ACS including 213 patients with unstable angina pectoris and 139 patients with acute myocardial infarction evidenced by using coronary arteriography and 421 control subjects were recruited in this study. The MMP-9-1562C ＞ T and R279Q genotypes were detemined by using PCR-RFLP method. The relationship between the polymorphism in the MMP-9 gene and the severity of coronary arterial stenosis was analyzed. All polymorphisms were determined for confimation with Hardy-Weinberg expectations in both groups separately. Differences in distributions of genotypes and alleles between two groups were analyzed with x2 test. The association between the MMP-9 polymorphisms and the risk of ACS was estimated by odds ratio(Ors) and their 95% confidence intervals (CIs), and the comprehensive evaluation of the factors associated with ACS was determined by using multifactor logistic regression. P ＜ 0. 05 was considered to be statistically significant. Results The genotype frequencies for CT + TT genotypes and T allele were 25.9 and14.5 percent in ACS subjects and 15.7 and 8.4 percent in control subjects, respectively. The genotype frequencies were different significantly between the two groups (x2 = 12.26,P ＜ 0.01;x2 = 14.15,P ＜ 0.01, respectively). No relationship between R279Q polymorphism and ACS was found in this study ( P ＞ 0.05). The multifactor logistic regression analysis showed that the T allele carrier (CT + TT) significantly increased the risk of ACS compared with the CC genotype ( OR = 1.791,95 % CI: 1. 088 - 2.951, P = 0.022) after adjustment for tradition risk factors. The frequencies for CT + TT and CC genotypes of the -1562C ＞ T polymorphism were not statistically different among ACS patients with one, two and three or more significantly diseased vessels ( x2 = 1.15, P = 0.56). Conclusions The findings suggest that the polymorphism in MMP-9 gene promoter (-1562C ＞ T) is associated with the susceptibility to the ACS. The T allele might be an independent risk factor for the ACS. But the -1562C ＞ T polymorphism may not be useful as a predictor of the severity of coronary arterial stenosis. The R279Q polymorphism of MMP-9 gene was not significantly associated with ACS in this studied population.

Objective To explore the effects of aging on ventricular remodeling and cardiac rupture after acute myocardial infarction in mice. Methods　Male C57BL/6 mice of 3 months and 12 months old were randomly divided into sham operation group and myocardial infarction(MI)group.Following acute myocardial infarction(AMI)modeling induced by open-chest surgery,the events of cardiac rupture were monitored and the echocardiography and hemodynamics were performed on the 7th day after surgery.Zymography,immunohistochemical method and pathological staining were used to measure the activity of matrix metalloproteinases(MMPs),the content of collagen and the degree of inflammatory cell infiltration on the 3rd and 7th days after surgery,respectively. Results　The incidence of cardiac rupture was higher in elderly group than that in young group(38.0% vs.16.0%,X2=6.139,P＜0.05).Compared with young group,significant infarct expansion,left ventricular (LV)remodeling and hemodynamic deterioration were showed in elderly group on the 7th day after surgery(t=5.754,P＜0.05).The degree of inflammatory cell infiltration and the expression of MMP-9 were significantly increased in elderly group on the 3rd day following AMI modeling(P＜0.05),and the collagen content and the expression of type Ⅲ collagen were significantly increased (P＜0.05)compared with young group. Conclusions　Aging is a risk factor for post-infarct cardiac rupture in the mice model.The mechanisms which are responsible for this age-related difference of cardiac rupture are related to increasing degree of inflammatory cell infiltration, overexpression of MMP-9 and type Ⅲ collagen and aggravated early LV remodeling.

Objective To investigate the association between acute myocardial infarction (AMI) and the (GT)n repeat sequence polymorphism in promoter region of heme oxygenase-1 (HO-1) , and to study the influence of serum bilirubin on AMI as well for HO-1 as a rate-limiting enzyme of bilirubin production in patients from Uighur national minority. Method Totally 287 patients with AMI evidenced by coronary arteriography admitted from January 2006 to June 2008 were eligible for being studied, and another 190 healthy subjects without anomaly in coronary arteriography, and with normal findings in physical examination and in variety of biochemical assays were enrolled as controls. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDL-C), serum bilirubin were detected. Polymerase chain reaction-nondenaturing polyacrylamide gel electrophoresis was used to detect HO-1 promoter (GT)n repeat polymorphism, and at the same time the serum bilirubin was determined. The group representation of samples was tested with HardyWeinberg balance test. Differences in distributions of genotypes and alleles between AMI patients and control subjects were analyzed using Chi-square test. Comprehensive evaluation of the factors associated with myocardial infarction using multi-factor Logistic regression analysis. P < 0.05 was considered as significantly different. Results Body mass index, triglyceride, high density lipoprotein cholesterol and the proportion with hypertension in myocardial infarction group was significantly higher than those in control group ( P < 0.01) . The X~2 values of HO-1genotype distribution in the myocardial infarction group and the control group were 2.09 and 0.05, respectively (P > 0.05), consist with the results of Hardy-Weinberg balance test. The HO-1 genotype was classified into three groups, L/L, L/S and S/S. The L/L genotype frequency (35.5%) and L-allele frequency (57.8%) in AMI group and in control group showed statistically significant differences, respectively (X~2 = 11.65, P = 0.001; X~2= 11.32, P = 0.003). The bilirubin level of L/L genotype significantly decreased compared with that of S/S, L/S genotype ( P all < 0. 001) . Logistic regression analysis showed that body mass index, high blood pressure,triglycerides, blood bilirubin and HO-1 gene polymorphism are risk factors of myocardial infarction. Conclusions To the Xinjiang Uighur ethics, HO-1 promoter ( GT) n repeat polymorphism and the occurrence of myocardial infarction are relevant. People with L allele genotype have lower serum bilirubin and higher risk of myocardial infarction.

Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P < 0.05). ② The minimum, mean and maximal atmospheric temperatures on the AAD day were lower than no AAD day [℃: 4.10 (-9.55, 14.60) vs. 7.75 (-6.70, 16.20), 14.10 (-1.50, 25.00) vs. 17.50 (0.60, 26.78), 8.50 (-6.22, 19.45) vs. 12.10 (-3.60, 20.90), allP < 0.05], sunshine duration was significantly shorter than no AAD day [hours: 8.50 (4.60, 10.70) vs. 8.90 (5.50, 11.50), P< 0.01], and atmospheric pressure were higher than no AAD day [kPa: 91.24 (90.66, 91.75) vs. 91.12 (90.62, 91.61), 19.11 (18.99, 19.22) vs. 19.09 (18.98, 19.19), bothP < 0.05]; there were no significant differences in the incidence of daytime temperature difference, average relative humidity, precipitation, average wind speed, and maximum wind speed between the two groups. ③ the peak period of AAD occurrence was December (38 cases), which was followed by January (36 cases); and there were 26 cases of each month in May, June, July, and September, which were lower than the rest of months. It was shown by the temperature distribution that the minimum average temperature was in January (-12.46 ℃), followed by December (-9.03 ℃); the maximum average temperature was in July [(24.59±3.21)℃], followed by August [(23.14±3.64)℃]. ④ The patients was sorted according to the quartile of daily mean temperature, into < -5.2 ℃, -5.2-10.7 ℃, 10.7-20.4 ℃, and > 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.