Objective To investigate the predicting value of serum sST2 on risk stratification and prognosis in elderly patients with acute heart failure (AHF).Methods Total of 75 AHF patients aged 60 to 93 were selected in our study who were in Beijing Hospital during 2013.1-2014.8,including 40 cases of male and 35 cases of female.Moreover,38 healthy people aged 70 to 80 were chosen as control group,which contains 18 cases of male and 20 cases of female.Follow-up was performed 1 year after acute attack.We defined the end of observation as recurrence of heart failure or any causes of death.The data was analyzed by SPSS19.0.Results Compared with control group,sST2 level (pg/mL) was significantly elevated in AHF group [(596.9 ±181.2) vs.(1 698.9 ±797.0),P ＜0.001].No significant difference was found between male and female (1 713.1 ± 1 322.2 vs.1 727.5 ±867.1,P =0.956).sST2 level was significantly different between patients with different clinical heart function grade [1 439.5 ±694.5 (mild-Ⅰ and Ⅱ grade) vs.2 057.8 ± 1428.6 (severeⅢ and Ⅳ grade),P =0.026].Among the 75 AHF patients,sST2 level was higher in patients with endpoint events than those without endpoint events [(2 234.4 ± 1 308.5) vs.(1 162.3 ±452.6),P=0.000].According to the independent risk factors of unconditioned logistic bivariate regression model analysis,the levels of sST2,NT-proBNP and the clinical heart function Grade had independent predicting value of AHF (OR value were 1.003,1.001 and 7.46 respectively).We found that the cutoff value of sST2 (1 760 pg/mL) may be an valuable evaluation marker of prognosis,the sensitivity and specificity was 64％ and 92％,and the positive and negtive predictive rate were 89％ and 70％.The accuracy rate was 77％.Combined with NT-proBNP to predict the prognosis of AHF,the result would be more exciting.The area under the ROC curve is 0.889.The endpoint event rate of the patients whose level of sST2 was below 1400pg/mL and NT-proBNP level below 4000pg/mL was 7％,while the data in patients whose level of sST2 is above 1400 pg/mL and NT-proBNP above 4000pg/mL was 95％.Conclusions Early at admission of AHF in elderly patients,sST2 began to elevate markedly related with the extent of heart failure.The result shows that the level of sST2 may be used to evaluate patient.The elevation of sST2 has independent predictive value to the prognosis of AHF.It will be better to predict the prognosis combining ST2 with other biomarkers such as NT-proBNP.

Objective To open pterygopalatine artery using autologous blood clot clogged the middle cerebral artery, resulting in cerebral infarction model of middle cerebral artery in the distal blood supply area.Methods Open PPA, ligation of ECA, embolus through CCA blood flow, rushed into the MCA distal embolus, cause infarction model. According to Bederson rating score the neural function.TTC staining to determine the infarction volume.Results Comparison of two operation models, scores were increased, and white infarcted area appears.There is no significant differences detected by statistical analysis.Conclusion Open PPA manufacturing cerebral infarction model rats of autologous blood clots could shorten the operation time, reduce the mortality rate.

BACKGROUND:The effect of dimethyl sulfoxide cryoprotectants has been got a lot of verification in the low-temperature medical applications. But there is no literature addressing microdialysis detection of dimethyl sulfoxide cryoprotectants. OBJECTIVE:To investigate the microdialysis relative recovery of different concentrations of dimethyl sulfoxide cryoprotectants used for limb reattachment. METHODS:In vitro linear probe relative recovery of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) was detected by retrodialysis gain and loss method. The correction in vivo experiment was done to estimate dimethyl sulfoxide relative recovery in rabbit amputated limbs. RESULTS AND CONCLUSION:The relative recoveries of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) were (49.49±3.56)%, (46.30±1.48)%, (52.66±2.54)%using retrodialysis gain method and (50.99±6.89)%, (43.86±1.35)%, (50.67±0.75)%using retrodialysis loss method. The average recoveries were (49.48±3.18)%and (48.51±4.03)%, respectively. There was no difference in the relative recovery of dimethyl sulfoxide detected using two methods. The change of dimethyl sulfoxide concentration could not influence the retrodialysis gain and loss method calibration results. The recovery was (15.45±4.8)%in vivo. These findings indicate that the microdialysis technology is suitable for dimethyl sulfoxide sampling in vivo that has no obvious influence on the relative recovery.

Objective To observe the influence of oleanolic acid on the ethology of 9-month-old mice,the completeness of synapsis structure and the expression of cAMP-response element binding protein (CREB) in cortex and hippocampus.Methods Thirty 9-month-old healthy male SMAP8 mice were randomly divided into model group,oleanolic acid group and aricept group,and with 10 rats in each group,while 10 healthy male mice of the same age and species as normal group.Oleanolic acid group and aricept group were given intragastric administration with corresponding drugs,while the normal group and model group were given the same amount of physiological saline.4 weeks later,the ethology changes were observed by Morris water maze and morphology changes of hippocampus neurons were viewed by electron microscope and the expression of CREB was detected by Western Blot.Results (1)Morris water maze results suggested that compared with the normal group,the latency time in the model group mice was longer,which were ((83.33±4.96) s,(75.13±6.01) s,(71.75±7.77) s,(63.40± 8.93) s,(60.97±8.38) s),while compared with the model group,the latency time in the oleanolic acid group and the aricept group was remarkably shorter (P＜ 0.05),which were (75.97± 4.49) s,(64.98± 4.93) s,(64.16± 6.23) s,(53.47±5.99) s,(47.91±7.64) s and (71.30±7.65) s,(63.32±7.57) s,(59.82±4.69) s,(52.28±5.90) s,(46.22±7.27) s respectively.In the spatial probe trial,compared with tbe normal group,the crossing times of the model was less,while compared with the model one,the crossing times of the oleanolic acid group and the aricept group was more(P＜0.05).(2)Compared with the normal group,the number of synapses in the model group was smaller,in which the synaptic cleft was mixed with the front of synapses severely swollen,uninform synaptic vesicles and few clear outlines of mitochondrias.While the oleanolic acid group and the aricept group had clear synapses outlines with the front of synapses slightly swollen,intensive and uniform synaptic vesicles and clear mitochondrias with their cristae not easy to be seen.(3) The Western Blot showed that compared with the normal group,there was a decline in the CREB expression both in the cortex and hippocampus in the model group,while compared with the model group,there was a rise in the oleanolic acid group as well as the aricept group(P＜0.05).Conclusion Oleanolic acid can improve the learning and memorizing of model rats,which is possibly related to the increased expression of CREB protein to protect the synapses structure of model mice.

Objective To investigate the predicting value of serial serum human stromelysin-2 (ST2)testing on prognosis in elderly patients with acute heart failure(AHF).Methods 75 AHF patients aged 60 to 90 were selected in our study who were in Beijing Hospital during 2013.1 ～ 2014.8,blood sampling of serum ST2 took place at admission and 72-96 h later.Moreover,38 healthy people aged 70 to 80 were chosen as control group.Follow-up was performed 1 year after acute attack.We defined the end of observation as recurrence of heart failure or any cause of death.The data was analyzed by SPSS19.0.Results Among 55 AHF patients,sST2 level was higher in patients with endpoint events than those without it on the two moment(P=0.000).And we found that the change in sST2 was higher in patients with endpoint events than those without it(P=0.023);and the percentage change in sST2 was also significantly different(P=0.033).Receiver operator curve analysis of the change in sST2 from baseline to 72-96 h later was strongly reflective of prognosis with area under the curve(AUC) of 0.696(P=0.013).And the change in sST2 Combined with the sST2 level at admission to predict the prognosis of AHF,the result would be more exciting,the area under the receiver operating characteristic (ROC) curve is 0.861 (P ＜ 0.001).The endpoint event rate of the patients whose level of sST2 at admission was below 1408 ng/L and the change level in sST2 below 101 ng/L was 21.4％(3/14),while the data in patients whose level of sST2 at admission is above 1 408 ng/L and the change level in sST2 above 100 ng/L was 85.7％(12/14).Conclusions in elderly patients of AHF,sST2 elevate markedly.The result shows that the level of sST2 may be used to evaluate AHF prognosis.And the change in sST2 are able to predict the prognosis of AHF.Compared with NT-proBNP,serial sST2 testing appears to be a promising candidate for monitoring these patients.

Objective To investigate the role of p53 in the regulation of heat shock protein(Hsp)84 and 86,and the correlation of their functional imbalances with accelerated brain aging and with suppressed tumorigenesis in SAMP8 mice(senescence accelerated mouse prone 8).Methods The mRNA and protein expressions of Hsp84 and Hsp86,and protein expressions of p53 pathway-related proteins(p21 and MDM2)in hippocampus of SAMP8 mice and their control SAMR1(senescence accelerated mouse resistant 1)mice were determined.Murine Neuro-2a cells were treated with 20 μmol/L Aβ25-35,and then mRNA expressions of p53,Hsp84 and Hsp86 in these cells were detected.Neuro-2a cells were co-transfected with p53 siRNA and pHsp84-Luc or pHsp86-Luc plasmid and treated with 20 μmol/L Aβ25-35,then promoter activity of Hsp84 and Hsp86 were detected in these cells.After co-transfection with pcDNA3.1-p53 or pcDNA3.1-p53DD and pHsp84-Luc or pHsp86-Luc plasmids,the neuro-2a cells were treated with 20 μmol/L Aβ25-35.Then promoter activity of Hsp84 and Hsp86 were detected in these cells at different concentrations of p53.Results The mRNA levels of Hsp84 and Hsp86 in the hippocampus of SAMP8 mice were significantly declined,which were 13.51% and 16.13% of SAMR1 mice,respectively(all P<0.01).Compared with the SAMR1 mice,the protein expressions of Hsp84 and Hsp86 in the hippocampus of SAMP8 mice were obviously declined(all P<0.01).Whereas,p53 pathway-related protein p21 expression was increased and MDM2 expression was decreased(all P<0.01).The mRNA expression of p53 in AD cells was significantly increased by 58%(P<0.01),whereas Hsp84 and Hsp86 mRNA levels were significantly decreased by 32% and 41%,respectively as compared with the normal cells(all P<0.05).Inhibition of p53 in AD cells could increase promoter activity of Hsp84 and Hsp86 significantly in a concentration-dependent manner(both P<0.05),whereas overexpression of p53 in the cells could lead to decreased promoter activity of them in a concentration-dependent manner(both P<0.05).Conclusions The p53 can negatively regulate the expressions of Hsp84 and Hsp86.The activity of p53/p21 pathway is increased,while Hsp84 and Hsp86 are inhibited in the brain of SAMP8 mice.Functional imbalance between p53 and Hsp84/86 might be the part of reasons causing accelerated aging and suppressed tumorigenesis in SAMP8 mice.

OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery

Objective To study the hepatocyte cells infected by hepatitis C virus (HCV) positive serum. Methods Human hepatocyte 7701 was incubated with HCV RNA-positive and HCV antibody(Ab) negative sera BP52. Then, the expression of HCV antigen and the presence of HCV-RNA in cell and supernatant were assayed by RT-PCR, sequence analysis, immunofluorescent staining, Western blot, confocal laser microscopy. The ultrastructural changes of infected cells were observed by electro-microscopy. Results Plus-strand RNA and minus-strand RNA were intermittently detected in cell and/or supernatant on day 7-45 after infection. Sequence analysis demonstrated that the positive DNA nucleic acids were identified with HCV 5′-non-coding region(NCR) sequence. HCV core and NS3 protein were expressed in cytoplasm of infected cells. After 2 or 3 weeks, obvious intracellular ultrastructural changes and virus-like particles were observed. Conclusion human hepatocyte 7701 could support replication of HCV in vitro, which could be a useful tool for setting up cell model of HCV infection and studying the mechanism of HCV infection.

10.3969/j.issn.1007-3969.2013.04.004

Abstract: To analyze the clinical, therapeutic and laboratory characteristics of disseminated cryptococcosis caused by Cryptococcus neoformans invading the blood stream in patient with liver cirrhosis and splenectomy. A 30-year-old male underwent splenectomy plus pericardial devascularization due to "splenomegaly and hypersplenism" in March in 2016. The patient had intermittent fever after operation for many times, and successively accompanied with back pain, left lower limb abscess and right hip pain. The highest body temperature was 39 ℃. CT and MRI revealed the lung lesion and multiple bone destruction. During that period, the effect of antibiotics was not good. On April 19th, 2017, Gram's stain, India ink stain, API 32C, Vitek 2 Compact, ribosomal ITS and IGS sequence analysis were performed to identify the strain isolated from the pus and blood stream. The serum of the patient was detected for cryptococcal antigen. Antifungal susceptibility test was used to determine drug sensitivity and minimum inhibitory concentration (MIC). The Cryptococcus neoformans isolated from fresh pus specimen showed a prominent, thick capsule after India ink stain. The colonies isolated from pus and blood stream were identified Cryptococcus neoformans using API 32C, Vitek 2 Compact, and sequence analysis of rDNA ITS and IGS. Cryptococcal capsule antigen was positive. The minimal inhibitory concentrations of 5-Flucytosine, amphotericin B, fluconazole, itriconazole, voriconazole against the isolate were <4 μg/mL, <0.5 μg/mL, 4 μg/mL, ≤0.25 μg/mL, 0.125 μg/mL respectively. The patient was initially treated with intravenous amphotericin B and flucytosine. After anti-Cryptococcus treatment for two months, the patient clinically improved, and the lesions were reduced on a follow-up CT scan. The patient made a full functional recovery after treatment for six months. Cryptococcosis has hidden onset, atypical clinical symptoms and lack of specificity. Blood stream is the main channel for Cryptococcus to spread and involve many organs of the whole body, including skin, bone and so on. Therefore, early use of blood culture to monitor blood flow dissemination, actively removing the primary focus and cutting off the infection route in time and carrying out effective anti-Cryptococcus treatment are conducive to the patient's early recovery.