Objective To investigate the role of FTY720, an agonist of the sphingosine 1-phos-phate (S1P) receptor, in acute graft-versus-host disease (aGVHD) caused by allogeneic hematopoietic stem cell transplantation and to further elucidate its possible mechanism .Methods BALB/c ( H2 d ) recipient mice were given whole body lethal irradiation (750 cGy) for 4 hours.A mouse model of aGVHD was estab-lished by intravenously injecting recipient mice with 1×107 C57BL/6 (H2b) mice derived bone marrow cells (BMCs) and 5×106 whole splenic cells.FTY720 (3 mg/kg) was intraperitoneally injected into recipient mice from the day before allogeneic bone marrow transplantation ( allo-BMT) to day 4 thereafter to monitor the survival rate .The mice in control group were perfused with equal volume of control reagent .Fluores-cence-activated cell sorting ( FACS) was used to analyze the phenotypes of immune cells in spleen , liver, lung as well as intestines of mice on the fourth day of allo-BMT with or without FTY720 treatment. Results FTY720 significantly prolonged overall survival in mice with allo-BMT induced aGVHD .FACS analysis showed that FTY720 significantly inhibited the distribution of matured dendritic cells ( DCs) in lung and small intestines .Conclusion FTY720 could significantly alleviate the symptom of aGVHD in mice re-ceived allogeneic hematopoietic stem cell transplantation .The possible mechanism might be associated with the inhibited distribution of matured DCs in lung and intestines .

Objective To explore the expression characteristic of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 in colorectal cancer , evaluate the clinical significance of candidate miRNAs in CRC diagnosis.Methods Case-control study was used.The expression levels of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 from 50 CRC patients and 27 normal controls were detected by real-time PCR, the levels of miRNAs expression in serum of 8 CRC patients 1 day before and 7 days after radical surgery were analyzed.The sensitivity and specificity of serum miRNAs expression for the diagnosis of colorectal cancer were evaluated using the receiver operating characteristic ( ROC) curve.Results The expression level of mir-16, miR-21, mir-92a in serum of patients with CRC were (75.55 ±37.73), (35.96 ±23.81), (24.79 ±8.97) fmol/ml, significantly higher than that of the healthy control group (32.73 ±18.94), (24.36 ±13.27), (16.36 ±5.58) fmol/ml (tmir-16 =2.77, tmir-21 =2.34, tmir-92a =3.85,P <0.05).However, the expression levels of mir-29a and mir-143 showed no significant difference between two groups (tmir-29a=-0.17, tmir-143 =1.59,P>0.05).In addition, serum miR-16 and miR-92a levels of CRC patients 7 days after tumor resection were (36.02 ±19.95), (14.82 ±7.78) fmol/ml, significantly lower than that before operation (62.18 ±34.17), (24.06 ±12.99) fmol/ml (tmir-16 =3.59, tmir-92a =2.60,P<0.05).Area under the ROC curve ( AUC) of combined detection of mir-16, miR-21and mir-92a was 0.877, the sensitivity and specificity were 88% and 85%, respectively, which was higher than any of 3 miRNAs alone and the conventional tumor marker CEA.Conclusion Combination of mir-16, mir-21 and mir-92a in the diagnosis of CRC shows a better sensitivity and specificity , which would be expected as new tumor biomarkers for noninvasive diagnosis and monitoring progression of colorectal cancer.

BACKGROUND:Previous studies have shown that kainic acid injected into hippocampus can significantly upregulate the expression of excitatory KA1 subunit of the kainate receptor in the hippocampus, and endoplasmic reticulum stress markers, phosphorylation of the alpha subunit of eukaryotic initiation factor 2, accompanied by celldeath. OBJECTIVE:To explore the mechanism of endoplasmic reticulum stress after kainic acid is injected into the hippocampus.METHODS:0.15 nmol kainic acid was injected into the hippocampal CA1 region of 32 adult male Kunming mice, the injection time was 60 seconds. At different time points (1, 2, 3, 4, 5, 6, 8 and 12 hours) after kainic acid was injected, the Bederson score analysis was performed, and then the brain was harvested after cerebral perfusion. FJB staining of brain sections and immunofluorescence double labeled observation were also performed. RESULTS AND CONCLUSION:(1) At 3, 4, 5, 6, 8 hours after kainic acid injection, Bederson score showed severe injury of central nervous system function, and FJB staining showed the increased of celldeath in the hippocampus (P<0.05);At 1, 2, 12 hours after injection, Bederson score showed no obvious injury of central nervous system function, and FJB staining showed unobvious celldeath in the hippocampus (P>0.05). (2) According to the results of FJB staining, the brain sections were selected at 3, 8 hours for immunohistochemistry. The expressionlevels of KA1 receptors and endoplasmic reticulum stress marker P-eIF2αwere up-regulated at the same time after kainic acid was injected into hippocampus. Two single-staining KA1 and P-eIF2αimmunofluorescence images were synthesized into one over-lapped double-stained image, and two images overlapped, indicating that the up-regulated expression of KA1 and endoplasmic reticulum stress occurred in the same nerve cells. Kainic acid first up-regulated the excitatory receptor KA1 expression, which may cause cellendoplasmic reticulum dysfunction and result in the endoplasmic reticulum stress response, further promoting neuronal celldeath.

Objective To summarize the experience with resurgery for recurrent valvular heart diseases.Methods From June 2004 to June 2015, 28 patients (15 males and 13 females) with ages ranging from 44 to 67 years (55.6±6.5 years) with recurrent heart valve disease underwent resurgery. The reasons for resurgery included perivalvular leakage (7 cases), bioprosthetic valve decline (6 cases in mitral valve and 3 in tricuspid valve), mechanical prostheses dysfunction (2cases), infective endocarditis after valve replacement (2 cases), restenosis of repaired native valve (1 case), and severe tricuspid insufficiency after left-side valve surgery (7 cases). Resurgery included mitral valve replacement in 18 patients and tricuspid valve replacement in 10. All the patients underwent third or fourth or even fifth cardiac surgery for valve replacement.Results There were 2 hospital deaths with a mortality of 7.1% (2/28). The main causes of early-stage deaths were low cardiac output syndrome. The main postoperative complications were respiratory failure in 3, low cardiac output syndrome in 2, reexploration for bleeding in 2 and serious infectious shock in 1. All the patients were found with the great improvement in heart function and the re-implanted prostheses worked well during follow-up.Conclusions Although resurgery for recurrent heart valve disease poses a continuing challenge to cardiac surgeon, it could be performed with the satisfactory results. The keys to a successful cardiac resurgery include appropriate operational timing, refined surgical technique and reasonable perioperative managements.

Objective To analyze the differences in paraoperative morbidity and lymph node dissection between thoracoscopic esophagectomy and open procedure.Methods From October 2012 to April 2014,207 patients with esophageal cancer underwent surgery.125 patients underwent video-assisted esophagectomy,and 82 underwent open procedure.In the minimally invasive group,there were 109 thoracoscopic cases and 16 thoracolaparoscopic cases.Results There were significant differences between the thoracoscope group and the open group in atelectasis(0.8％ vs.7.3％,P ＜ 0.05),pleural effusion (0 vs.4.9％,P ＜ 0.05),acute respiratory distress (0 vs.6.1％,P ＜ 0.05),ligation of thoracic duct (3.2％ vs.15.9 ％,P ＜ 0.05),recurrent laryngeal nerve paralysis (19.2％ vs.32.9％,P ＜ 0.05),c hylothorax (0 vs.4.9％,P ＜ 0.05),number of lymphonode along the right recurrent laryngeal nerve lymphatic chains[1.91 ± 0.73 vs.1.12 ± 0.81,P ＜ 0.05)] and achievement ratio(97.6％ vs.89.0％,P ＜0.05) and number of lymphonode along the left recurrent laryngeal nerve lymphatic chains (0.93 ± 0.71 vs.1.76 ± 0.84,P ＜ 0.05) and achievement ratio(52％ vs.76.8％,P ＜ 0.05).No significant differences were observed in pneumonia,anastomotic leak,thoracic abscess,esophago-tracheal fistula,re-laparotomy,re-thoracotomy,wound infection,arrhythmia,cardia failure,renal failure,hepatic inadequacy,cerbral infarction,and mortality(P ＞ 0.05).There were also no significant differences in number of lymphonode and achievement ratio of periesophagel lymph nodes,subcarinal lymph nodes and hilar lymph nodes (all P ＞ 0.05).Conclusion The thoracoscopic esophagectomy has some obvious advantage associated with less pulmonary complications,lower injury of thoracic duct and recurrent laryngeal nerve,more lymphonode and higher achievement ratio along the right recurrent laryngeal nerve lymphatic chains.But it has still a larger space for improvement of lymphadenectomy along the left recurrent laryngeal nerve lymphatic chains.

Objective:To investigate the expression of miR-92a in colorectal cancer (CRC) and its effect on the regulation mechanisms of tumor angiogenesis. Methods:The miRNA-92a expression in 25 CRC tissues and HT29, SW620, SW480, and HCT116 CRC cells was detected using quantitative real-time polymerase chain reaction. The CD31 positive expression of blood microvessels in CRC tissues was measured by immunohistochemistry. Pearson correlation analysis was used to analyze the relationship between miR-92a and tu-mor angiogenesis. The miR-92a mimic or inhibitor was transfected into HCT116 and SW620 cells in vitro to upregulate or downregu-late the miR-92a expression. The effect of miR-92a overexpression or suppression on the formation of human umbilical vein endotheli-al cell (HUVEC) tubules was detected by tube formation assay. Changes in phosphatase and tensin homolog (PTEN) protein expression were measured by Western blot. Results:The expression level of miR-92a in CRC tissues was significantly higher than that in matched adjacent tissues (P<0.01). The expression levels of miR-92a in HT29, SW480, SW620, and HCT116 colon cancer cell lines were signifi-cantly higher than that of the normal colorectal epithelium control (P<0.05). The number of CD31 positive expression of microvessel density (MVD) in CRC tissues was significantly higher than that in adjacent tissues (P<0.01), and the miR-92a expression level was posi-tively correlated with the MVD in CRC tissues (r=0.580, P=0.01). The cell culture supernatant of HCT116 with miR-92a overexpression could significantly promote the formation of HUVEC tubules (P<0.05). The upregulation of miR-92a expression could significantly inhib-it the expression of PTEN protein in CRC cells (P<0.01). Conclusion:The miR-92a was highly expressed in CRC cells and tissues, which was closely related to the formation of tumor angiogenesis in CRC. The miR-92a could promote tumor angiogenesis in CRC by inhibit-ing PTEN expression.

Objective To introduce the clinical application of the extended anterolateral leg flap,which is based on the superficial peroneal artery and lateral supramalleolar artery. Methods Through anatomic study on the blood supplies of the skin over the anterolateral portion of the leg.The combined superficial peroneal artery and lateral supramalleolar artery could extend the size of the traditional anterolateral leg flap.In addition,the point of pivot of the extended anterolateral leg flap could locate at the level of the lateral malleolus,which decreases the distance between the flap and recipient site.Clinically,we have used the extended anterolateral leg flaps in 60 patients to cover skin defect over the feet.The flap ranged from 16 cm×10 cm(pedicle length 8.0 cm)to 26 cm×7 cm(pedicle length 6.0 cm). Results In the series, the flap survived in 53 patients(88.3%)unevently,and partial necrosis occurred in 7 patients(11.7%).Conclusion Based on the combined superficial peroneal artery and lateral supramalleolar artery,the size of the traditional anterolateral leg flap could be inceased,which enlarges its value on the coverage of skin defects over the feet.

Objective To observe the effect of human immunoglobulin on elderly head and facial post herpetic neuralgia (PHN) and peripheral blood TNF-α.Methods One hundred and twenty-two inpatients with PHN aged ≥65 years old were selected and divided into the observation group (52 cases) and control group (70 cases) by the systematic sampling method.The control group was given the early conventional combined therapy,while on this basis the observation group was intravenously dripped by human immunoglobulin.The incidence rate of PHN and pain visual analog scale(VAS) score at 1,2,3 months after recovery discharge from hospital were recorded in the two groups.Other 20 healthy elderly people were selected as the healthy control group.The TNF-α level was determined in the two patients groups before and after treatment and in the healthy control group.Results The PHN occurrence rate at 1,2,3 months after discharge in the observation group was significantly lower than that in the control group(P＜0.05);the VAS score after treatment and at 1,2,3 months after discharge in the observation group was significantly lower than that in the control group (P＜0.05);serum TNF-α level after treatment in the observation group was significantly lower than that in the control group (P＜0.01),moreover which was close to the level in the healthy control group(P＞0.5).Conclusion Human immunoglobulin can reduce the PHN occurrence in the old people with head and facial herpes zoster and reduce the peripheral blood TNF-α level.

BACKGROUND: The quality of chest compressions can be significantly improved after training of rescuers according to the latest national guidelines of China. However, rescuers may be unable to maintain adequate compression or ventilation throughout a response of average emergency medical services because of increased rescuer fatigue. In the present study, we evaluated the performance of cardiopulmonary resuscitation (CPR) in training of military medical university students during a prolonged basic life support (BLS). METHODS: A 3-hour BLS training was given to 120 military medical university students. Six months after the training, 115 students performed single rescuer BLS on a manikin for 8 minutes. The qualities of chest compressions as well as ventilations were assessed. RESULTS: The average compression depth and rate were 53.7±5.3 mm and 135.1±15.7 compressions per minute respectively. The proportion of chest compressions with appropriate depth was 71.7％±28.4％. The average ventilation volume was 847.2±260.4 mL and the proportion of students with adequate ventilation was 63.5％. Compared with male students, significantly lower compression depth (46.7±4.8 vs. 54.6±4.8 mm,P<0.001) and adequate compression rate (35.5％±26.5％ vs. 76.1％±25.1％,P<0.001) were observed in female students. CONCLUSIONS: CPR was found to be related to gender, body weight, and body mass index of students in this study. The quality of chest compressions was well maintained in male students during 8 minutes of conventional CPR but declined rapidly in female students after 2 minutes according to the latest national guidelines. Physical fitness and rescuer fatigue did not affect the quality of ventilation.

OBJECTIVETo study the major metabolites of antitumor lead compound T-OA (oleanolic acyl-3, 5, 6-trimethyl pyrazine-2-methyl ester) in rat urine, in order to preliminarily infer its metabolic mode in rats.

METHODRat urines of the blank group, the raw material group (ligustrazine TMP and oleanolic acid OA Moore equivalent) and the T-OA group were collected and freeze-dried; Solids were extracted by ethyl acetate; And then the extracts were re-dissolved with acetonitrile. HPLC-HRMS coupling technique was adopted to find the potential mass spectrum peak under ESI(+) (see symbol) ESI(-) modes. Metabolite-related information was obtained by comparing the three groups of spectra.

RESULTOne metabolite of OA and two metabolites of TMP were identified in the raw material group; none metabolite of T-OA but one phase II metabolite was detected in the T-OA group.

CONCLUSIONIt is the first time to identify one phase II metabolite of T-OA and one phase II metabolite of OA were identified in rat urine. On that basis, the researchers preliminarily inferred that T-OA does not show the efficacy in the form of raw material. The HPLC-HRMS method established could be used to identify metabolites of related derivative structures. This paper could also provide certain reference for designing pro-drugs based on oleanolic acid.

Animals ; Antineoplastic Agents ; chemistry ; metabolism ; urine ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Male ; Mass Spectrometry ; methods ; Molecular Structure ; Rats ; Rats, Sprague-Dawley