Objective To investigate the value of ultrasonic two‐dimensional speckle tracking imaging ( 2D‐ST I) layer‐specific strain and transmural gradient in evaluating the changes of hypertensive patients′left ventricular three layers myocardial function . Methods Thirty‐five hypertensive patients without renal insufficiency were selected as group A ,and 25 hypertensive patients with renal insufficiency as group B .For comparison ,40 healthy volunteers were gathered as control group . T hen ,the systolic peak longitudinal strain of the left ventricle( LPS) ,endocardium( LPS Endo ) ,mid‐cardium ( LPSMid ) and epicardium ( LPSEpi ) were collected .After that ,features of transmural gradient ( ΔLS ) and its percentage ( ΔLS% ) were analyzed . Results For each group ,gradient features exist in each layer of left ventricular myocardium :LPS Endo ＞LPSMid＞LPSEpi . For each group ,the differences between LPSEndo and LPSMid ,and that between LPSEndo and LPSEpi were both statistically significant( P ＜0 .05) . When it came to the differences between LPS Mid and LPSEpi ,those of group A and control group were both statistically significant ( P ＜0 .05 ) . Compared with control group ,the LPSEndo of group A ,and LPSEndo ,LPSMid and LPSEpi of group B declined ,all the differences were statistically significant ( P ＜0 .05 ) . Compared with group A ,LPS Endo ,LPSMid and LPSEpi of group B declined ,the differences were statistically significant ( all P ＜0 .05) . For ΔLS′s differences among all three groups ,there was no statistical significance( P ＞0 .05) . Compared with control group ,the ΔLS% Endo‐Mid of group A rised , and the ΔLS% Endo‐Mid , ΔLS% Mid‐Epi of group B rised , the differences were statistically siginificant ( all P ＜ 0 .05 ) . Compared with group A ,the ΔLS% Endo‐Mid ,ΔLS% Mid‐Epi of group B rised ,the differences were statistically siginificant( all P ＜0 .05) . Conclusions T he layer‐specific strain technique can quantitatively evaluate the changes of systolic function of the left ventricular myocardium in hypertensive patients . ΔLS% may have better sensitivity than ΔLS in dection of systolic function damage of the left ventricular myocardium and can provide more reference for the evaluation of left ventricular systolic function .

Objective To identify the role of phosphatidylinositol-3-kinase(PI3K) in mediating necroptosis induced by tumor necrosis factor alpha (TNFα) and the involved mechanism.Methods Knockdown of p110α,receptor-interacting protein 1(RIP1) or both p110αand RIP1 was mediated by the specific short hairpin RNA (shRNA) lentivirus and verified by RT-PCR or Western blotting .In addition , Western blotting was used to detect phosphorylation of mixed lineage kinase domain-like protein(MLKL) and protein kinase B(AKT) or tetramerization of MLKL.Cell death was measured by micros-copy and flow cytometry.Results AKT phosphorylation and TNFα-induced necroptosis of L929 cells were suppressed by the inhibitors of PI3K or AKT, as well as p110αknockdown.Moreover, RIP1 knockdown did not inhibit L929 cell death induced by TNFαplus Z-VAD, but the RIP1-independent necroptosis was inhibited by p 110αknockdown.In addition, p110αknockdown suppressed MLKL phosphorylation and tetramerization induced by TNFαwith Z-VAD in L929 cells. Conclusion PI3K mediates necroptosis of L929 cells induced by TNFαby activating AKT and MLKL, respectively.

Objective To detect different animal erythrocyte hemolysins titer,and compare the application of these hemolysins in immunological experimental teaching,for selecting the better method of preparing high titer hemolysin for experimental teaching of medical immunology.Methods A total of 40 experiment rabbits were divided into 4 groups in this study,and immunized by sheep red blood cell(SRBC) and porcine red blood cell(PRBC) through different immunization procedures to prepare the hemolysin,detect and compare these 4 groups hemolysins titer by the complement hemolysis test.Results Rabbit Anti-SRBC in the group A was 1∶4 800,rabbit Anti-PRBC in the group B was 1∶1 200,rabbit Anti-SRBC in the group C was 1∶1 000,rabbit Anti-PRBC in the group D was 1∶200.Conclusion The hemolysin titer of the rabbit Anti-PRBC was lower than that of the rabbit Anti-SRBC by the same immunization procedures,and the immunization procedure by intradermal multi-point and auricular vein injection is the better method of preparing high titer hemolysin,so PRBC could replace SRBC as antigen,and immunize the rabbits for preparing hemolysin,which could be used in experimental teaching of medical immunology.

Objective To investigate the applicable value of tissue synchronization imaging (TSI)by real-time thriplane echocardiography (RT3PE)in cardiac resynchronization therapy (CRT).Methods Twenty-four patients with heart failure scheduled for CRT and 24 healthy controls were enrolled.Two dimensional echocardiography was performed to get the left ventricular internal diameter at end-diastole and end-systole(LVIDd,LVIDs ),left ventricular ejection fraction (LVEF ),velocity time integral of left ventricular outflow tract flow (VTILVOT ).The RT3PE TSI was performed to measure the time to peak systolic velocities(Tp)of left ventricle basal and middle segments(12 segments),software will automatically calculate the maximal difierence (12-Tp-DIF)and standard deviation (12-Tp-SD)of Tp in 12 segment. Identity the segment where wall motion most delay and to guide electrode placement.AV and VV interval optimization were performed under guidance of TSI after 1 month of CRT.Results In before CRT,after CRT,after optimization and control group,LVIDd,Tp,LVIDs,12-Tp-DIF and 12-Tp-SD were decreased in the order,LVEF and VTILVOT were increased in the order.There were significant difference between the groups(all P < 0.05 ).TSI showed that left ventricular systolic dyssynchrony was present in all patients before CRT.The most delay segment and electrode location was consistent.There were close correlation between 12-Tp-DIF and LVEF (r =-0.70,P =0.000),between 12-Tp-SD and LVEF(r =-0.73,P =0.000).Conclusions Left ventricular systolic synchronicity can be evaluated accurately and intuitively using TSI by RT3PE.It has important clinical significance in prospectively select patients for CRT,help to guide electrode placement and to optimize device programming.

Objective To explore the protective effects of adipose - derived stem cells (ADSCs) with phosphodiesterase 5 inhibition by lentivirus-mediated stable gene silencing on the proliferation and apoptosis of renal tubular epithelial cells induced by ischemia-reperfusion injury in vitro. Methods To isolate cultivate and indentify ADSCs from rats. Lentiviral expression vector of carrying PDE5 shRNA gene was transfected into ADSCs, and a negative control group was set up.Western blotting was used to detect PDE5 protein expression levels. ADSCs were co-cultured with NRK-52E in a transwell system, and NRK-52E cells were treated with ischemia/reoxygenation protocol. Edu assay was performed to evaluate the proliferation of NRK cells, flow cytometry to detect the apoptosis of NRK cells, and ELISA to quantify the protein expressions of fibroblast growth factor (FGF) and hepatocyte growth factor (HGF). The expression of E - cadherin and cytokeratin 18 (CK18) was quantified by real time PCR and flow cytometry. Results Western blotting for PDE5 protein indicated a significant reduction of PDE5 protein levels in PDE5 shRNA transduced population. After the treatment of ischemia/reoxygenation in vitro, the proliferative viability and apoptosis of NRK-52E cells co-cultured with ADSCs induced by PDE5 gene inhibition were significantly improved, compared to the normal group (all P<0.05). And the release of HGF, FGF were markedly enhanced (all P<0.05). Moreover, the NRK-52E cells survival, the expression of E-cadherin and CK18 on PDE5 inhibited ADSCs co-cultured with I/R injured NRK cells was significantly increased compared to that in the negative control group (all P<0.05). Conclusion ADSCs preconditioned by inhibition of PDE5 can be a powerful novel approach to improve the survival of renal tubular cells following ischemia-reperfusion injury, and have an obvious tendency to transform epithelial cells.

Objetive To evaluate the carotid artery stiffness of acquired immune deficiency syndrome (AIDS) and analyze the mechanism and influence factors. Methods Fifty cases of AIDS patients and Fifty healthy people were enrolled in this study according to the principles of randomize and control. Quantitive inter-media thickness (QIMT) and quantitive artery stiffness (QAS) technique were employed to evaluate the inter-media thickness (IMT) and stiffness of right carotid artery. The parameters included IMT, compliance coefficent (CC), stiffness β (β), and pulse wave velocity (PWV). Unpaired t test was used to compare the parameters between two groups, and Pearson correlation analysis was used for linear correlation analysis. Results There were no statistically difference of carotid artery IMT between two groups [(0.569±0.095) mm vs (0.512±0.114) mm, P>0.05]. There was statistically difference of stiffness parameters (CC,β, PWV) between two groups [(0.59±0.21) mm2/kPa vs (1.04±0.41) mm2/kPa, 13.01±6.10 vs 8.14±1.37, (8.70±1.65) m/s vs (6.81±1.37) m/s, all P<0.05]. There was statistically signification association between HIV-infection time and CC,β, PWV ( r value was-0.575, 0.380, 0.417, all P<0.05 ), but there was no association between HIV-infection time and IMT( r value was 0.191, P>0.05 ). There was no statistically signification association between IMT, CC,β, PWV and CD4+, CD8+T cell count (r was 0.000, 0.012,-0.093,-0.097, 0.096, 0.012, 0.056, 0.024, all P>0.05). Conclusion The carotid artery stiffness of AIDS patients is reduced. HIV may play a role in the development of artery stiffness in AIDS patients.

OBJECTIVETo assess the association of copy number variations of SMN1, SMN2, NAIP, GTF2H2 and H4F5 genes with clinical classification of spinal muscular atrophy in children, and determine the copy number of the SMN gene among pregnant women. A carrier screening was also performed in Sichuan province.

METHODSThe copy number variations of the above genes among 53 confirmed SMA patients were determined with MLPA technique. The copy number variations were analyzed by the Fisher's exact test. Deletion of exon 7 in the SMN1 gene was screened with denaturing high performance liquid chromatography (DHPLC) for 427 pregnant women.

RESULTSAmong the 53 cases of type I, II, and III SMA patients, the rate of homozygous deletion of both exons 7 and 8 of the SMN1 gene were 100%, 94.44% and 87.50%, respectively, whereas those of homozygous deletion of exon 7 of SMN1 gene were 0, 5.56%, and 12.50%, respectively. The patients with 1, 2, 3, and 4 copies of exon 7 of the SMN2 gene were 11.32%, 67.92%, 13.21% and 7.55%, respectively. The patients with 0, 1, and 2 copies of exon 5 of NAIP gene were 11.32%, 62.26%, and 26.42%, respectively. No deletion was detected in GTF2H2 or H4F5 genes. The heterozygous loss rate of exon 7 in SMN gene in the pregnant women population of Sichuan region was approximately 2.11%.

CONCLUSIONCopy number variations of SMN2 and NAIP genes in patients are related to SMA clinical types (P < 0.05). In contrast, there was no relationship between SMA clinical types and deletion of exons 7 and 8 in the SMN1 gene (P > 0.05). Analysis of copy number change in SMN1 gene can assist SMA carrier screening. However, when the general population without SMA family history is screened for disease-causing genes, it should be noted that the type "2+0" carriers may affect the screening result, and the result should be interpreted with caution.

Adolescent ; Child ; Child, Preschool ; DNA Copy Number Variations ; Female ; Genetic Carrier Screening ; Humans ; Infant ; Male ; Neuronal Apoptosis-Inhibitory Protein ; genetics ; Spinal Muscular Atrophies of Childhood ; genetics ; Survival of Motor Neuron 1 Protein ; genetics

Objective To investigate the ultrasonic image characteristics of Zenker diverticulum(ZD).Methods The ultrasonographic features were summarized using the analysis confirmed by surgery pathology or X-ray imaging of the ZD in six eases.Results The diverticulum of Zenker located behind the thyroid gland in all the six cases,with five cases to the left and one to the right.The internal hyperechoic foci caused by air was found for all the six cases.The diverticulum wall appeared to be semicircular,narrow-band and acoustic halo low echo with an average thinckness of 0.53 mm.The Doppler sonogram of the six diverticulums showed no vascular signal.Conclusions The ZD had several unique characterisitics for identification by ultrasonic diagnosis,which included hyperechoic foci caused by air,internal changes of echo after drinking water and the special layered structure of the five-layer ZD wall.

Objective To investigate and compare the change of extravascular lung water (EVLW) and levels of cytokines in septic patients without clinical acute lung injury (ALI) /acute respiratory distress syndrome (ARDS) with those in spetic patients with sepsis-induced ALI/ARDS in order to determine the role of EVLW involved in the pathogenesis of lung injury in the patients by quantifying the relationship between EVLW and biomarkers of lung injury in patients with sepsis.Methods A total of 40 septic patients complicated either with or without clinical ALI/ARDS after sepsis. In each patient,transpulmonary thermodilution (PiCCO) was used to measure cardiovascular hemodynamics and EVLWI for 7 days via an arterial cannula indwelled within 72 hours after diagnosis of severe sepsis was made, and serial bronchoalveolar lavages (BAL) were carried out.Other examinations including blood gas analysis,ventilator parameters,chest X-ray and the levels of pro-inflammatory cytokines such as tumor necrosis factor (TNF-oα),interleukin-1 in the BAL were recorded.In-hospital and ICU mortalities were also observed.Results Of total 40 patients,29 were complicated with clinically defined septic ALI/ARDS ( ARDS n =15,and ALI n =14).The septic patients complicated with ALL/ARDS had significantly higher amount of EVLWI and higher levels of TNF-α and interleukin-1 in the BAL than patients without ALI/ARDS ( P ＜ 0.05).The arterial oxygen tension/fractional inspired oxygen ratio,lung injury score,and the levels of TNF-α,IL-1 in the BAL correlated with EVLWI.Moreover,in-hospital mortality,ICU mortality and the length of ICU stay of the patients with high amount of EVLWI were markedly increased than those of patients with low amount of EVLWI. Conclusions In septic patients complicated with ALI/ARDS, the extravascular lung water index correlates with oxygenation,lung injury severity and inflammatory cytokines in lung.Determination of EVLWI may be useful for evaluation of severity of lung injury and prognosis of septic patients.

Objective To detect the expression of aquaporin 1 in pancreas of rats with acute necrotizing pancreatitis (ANP) and to study the effect of Dachengqi decoction on it.MethodsOne hundred and sixty male SD rats were randomly divided into control group ( C group,n =32 ),ANP group ( n =32),Dexamethasone group (De group,n =32),Acetazolamide group (A group,n =32) and Dachengqi decoction group (DD group,n =32).ANP model was induced by retrograde injection of 5％ sodium taurocholate into the biliary and pancreatic duct.Rats in De group received dexamethasone (4 mg/kg) intravenously after ANP induction; while rats in A group received 1 ml acetazolamide via gastric lavage 2 h before ANP induction; rats in DD group received 2 ml Dachengqi decoction via gastric lavage 48,24,2h before ANP induction; rats in C group received laparotomy.Eight rats in each group were sacrificed at 3 h,6 h,12 h and 18h after induction of ANP models.Quantity of ascites and levels of serum amylases were measured.Pathological changes in pancreas tissue were detected by HE and electron microscope.Capillary permeability in pancreas tissue was detected by Evans Blue (EB) extravasations method.AQP1 expression in pancreas tissue was detected by real-time PCR and Western blotting.ResultsLevels of serum amylase in ANP group was significantly higher,and the pancreatic injuries were obvious ; the levels of serum amylase in De group and DD group was lower than that in ANP group,and the pancreatic injuries were attenuated.The levels of serum amylase in A group were higher than that in ANP group,and the pancreatic.injuries were more severe than that in ANP group.Six hours after ANP induction,the levels of EB in pancreas were (13.44 ±2.56),(126.35 ± 14.80),(86.31 ± 14.46),( 108.99 ± 15.07 ),(78.29 ± 16.85 ) mg/L In C group,ANP group,De group,A group and DD group,and the expression of AQP1 mRNA in pancreatic tissue was ( 170.07 ± 22.48 ) ％,( 83.93 ± 8.98 ) ％,( 117.09 ±10.70 ) ％,( 69.00 ± 8.98 ) ％,( 112.82 ± 11.79 ) ％ ; and the expression of AQP1 protein was 0.23 ± 0.06,0.10 ±0.02,0.32 ±0.03,0.13 ±0.02,0.45 ±0.04.The content of EB in ANP group was higher than that in C group,while the expression of AQP1 mRNA and protein in ANP group was significantly lower than that in C group (P ＜ 0.05 ).The content of EB in De group and DD group was significantly lower than that in ANP group,while the expression of AQP1 mRNA and protein was significantly higher than that in ANP group (P ＜ 0.05).ConclusionsAQP1 plays an important role in the pathogenesis of capillary endothelial barrier dysfunction in rats with ANP.Dachengqi Decoction can attenuate pancreatic injuries of rats by regulating the expression of AQP1.