Objective To investigate the mechanism of TNF-related apoptosis-inducing ligand (TRAIL) promoting apoptosis of pancreatic cancer cells SW1990, Patu8988 and BxPC3. Methods Three kinds of pancreatic cancer cells SW1990, Patu8988 and BxPC3 were transfected with the pCA13 plasmid carrying TRAIL gene ( pCA13 TRAIL group) and the blank plasmid control ( pCA13 group) , respectively. The expression of TRAIL mRNA in transfected cells was detected by RT-PCR, and the expression of TRAIL protein was detected by Western blot. The apoptosis rate and expression of TRAIL receptor R1 and R2 were detected by flow cytometry. Apoptosis was detected by TUNEL and Hoechst double staining, and observed by electron microscopy. The expression of caspase-3 in transfected cells was detected by immunohistochemistry. Results SW1990, Patu8988 and BxPC3 cells can expresse TRAIL mRNA and protein within 24 h after transfection. The apoptotic rate at 24 h after transfection was (27. 30 ± 5. 14)％, (13. 52 ± 0. 95)％ and (31. 40 ± 8. 70)％,respectively, which was higher than that of pCA13 group [(10. 58 ± 1. 88)％,(8. 42 ± 0. 46)％ and (16.11 ±1.66)％], respectively. The expression rates of TRAIL-R1 were (61.37 ± 3.05)％,(42.10 ± 5. 11)％ and (36. 64 ± 4. 84)％, respectively, and the expression rates of TRAIL-R2 were (36. 20 ± 4. 83)％,(37. 26 ± 8. 46)％ and (24. 32 ± 3. 71)％, respectively,which were higher than those of pCA13 group except PATU8988 cells. Positivity rates of caspase-3 were ( 14. 64 ± 5. 35 )％, ( 9. 92 ± 5. 50 )％ and (16. 12 ± 6. 74)％, which were obviously higher than ( 3. 01 ± 1. 50 )％, ( 1. 75 ± 0. 50 )％ and ( 3. 79 ± 1. 58)％ in pCA13 group,and the differences were statistically significant(P<0. 05). Conclusions TRAIL could up-regulate the expression of TRAIL R1 and R2 in multiple pancreatic cancer cell lines in vitro, and thus promote cell apoptosis.

Objective To discuss the practicability and safety of 3.5 mm superfine bronchoscope in children's difficult airway.Methods Twenty-eight children with difficult airway,aged 4 months to 8 years were selected.Intravenous anesthesia was used and autonomous respiration was maintained.The 3.5 mm superfine bronchoscope was used to guide tracheal intubation by nose(mouth).Results Among 28 cases, 1 case had oral bleeding and succeeded after suction and pressurized oxygen supply, and the rest was successful in the first time.The intubation time was(1.50 ± 0.25)min.There was no damage to the whole airway.Success rate was 100%.Conclusions The 3.5 mm superfine bronchoscope in guiding tracheal intubation of children's difficult airway has obvious advantages and security, and it deserves clinical attention and promotion.

Objective    To compare the clinical effect of three operations for one-stage radical correction of small left ventricle in children with tetralogy of Fallot (TOF). Methods    We retrospectively analyzed the clinical data of 120 patients with left ventricular dysplasia and TOF undergoing one-stage radical surgery in the First Hospital of Hebei Medical University from December 2004 to May 2017. According to the different types of operation used, they were divided into 3 groups, including a routine group (30 patients, 16 males and 14 females, aged 11.58±2.05 months ranging from 3-24 months), a large patch group (40 patients, 22 males, 18 females, aged 11.22±2.24 months ranging from 3-25 months) who were treated with a large patch, and an enlarged ventricular septal defect group (50 patients, 26 males, 24 females, aged 10.17±2.15 months ranging from 3-22 months) using new left ventricular enlargement technique to enlarge ventricular septal defect. The clinical effect of the three operations were compared. Results    The incidence of postoperative low cardiac output syndrome (6.0% vs. 40.0% vs. 50.0%, P<0.05), renal failure (4.0% vs. 37.5% vs. 46.7%, P<0.05), infection rate (10.0% vs. 50.0% vs. 66.7%, P<0.05), mortality (2.0% vs. 12.5% vs. 20.0%, P<0.05), ventilator-assisted time (8.34±5.24 h vs. 36.14±10.91 h vs. 38.58±10.12 h, P<0.05), ICU stay (4.13±1.01 d vs. 7.64±2.11 d vs. 8.03±3.03 d, P<0.05), hospital stay (10.48±4.26 d vs. 21.02±3.23 d vs. 22.52±2.93 d, P<0.05) and hospitalization costs (51 300±9 400 yuan vs. 103 200±39 300 yuan vs. 115 500±35 200 yuan, P<0.05) were less in the enlarged ventricular septal defect group compared with the other two groups. Conclusion    The clinical effect of enlarged ventricular septal defect is better than that of the routine and large patch methods, and long-term efficacy should be further followed up.

Objective: To investigate the effect of triptolide, a specific inhibitor of heat shock protein 70 (HSP70), on apatinib resistance in gastric cancer cells line MKN45. Methods: The apatinib-resistant cells (MKN45/AR) and MKN45 parental cells were treated with apatinib, triptolide and apatinib combined with triptolide, respectively. CCK-8 assay was performed to determine the half maximal inhibitory concentration (IC₅₀) of MKN45/AR and MKN45 cells in the presence of different treatment. The mRNA expression of heat shock protein gene (HSPA1A and HSPA1B) was detected by RT-PCR, while the protein expression of heat shock protein 70 was analyzed using Western blot in MKN45/AR and MKN45 cells. Results: The IC₅₀ values of apatinib-sensitive and apatinib-resistant MKN45 cells were 10.411 μmol/L and 70.527 μmol/L, respectively, showing a significant difference (P<0.05). The mRNA expression of HSPA1A and HSPA1B in MKN45/AR cells was significantly higher than that in MKN45 cells (P<0.001). The protein expression of heat shock protein 70 was significantly decreased after 0.25 μmol/L triptolide treatment in MKN45/AR cells (P<0.01). When heat shock protein 70 was inhibited by triptolide, the IC₅₀ value of apatinib in MKN45/AR cells was reduced to 11.679 μmol/L, which was significantly lower than cells treated with apatinib alone (P<0.05). Conclusions The apatinib-resistant MKN45 cells have high levels of heat shock protein 70. Low doses of triptolide can significantly inhibit heat shock protein 70, leading to reverse the resistance phenotype of MKN45/AR cells. Therefore, inhibition of heat shock protein 70 provides a new therapy strategy for patients with apatinib resistance.

BACKGROUND/AIMS: The association between the kinesin family member 1B (KIF1B) gene polymorphism and the risk of hepatitis B virus-related hepatocellular carcinoma (HCC) has been investigated in many peer-reviewed studies. However, scholars have failed to replicate these results in validation tests. The purpose of the present study was to explore whether the KIF1B rs17401966 polymorphism was associated with susceptibility to HCC. METHODS: The results of case-controlled studies on the correlation between the KIF1B rs17401966 polymorphism and HCC susceptibility were collected using Google Scholar and the EMBASE, PubMed and CNKI databases. Based on inclusion and exclusion criteria, 5 papers with a total of 12 cohorts were included in this study. RESULTS: The 12 cohorts were integrated, and the results showed that the rs17401966 polymorphism reduced the risk for HCC under the allele, heterozygous, homozygous, and dominant models but not under the additive or recessive models. Moreover, the merged results showed strong heterogeneity, and the cumulative meta-analysis results were unreliable. A genetic differentiation analysis of the 12 cohorts found different degrees of genetic differentiation between the 5 cohorts in Zhang et al.’s study and the cohorts in the other studies. We further divided the 12 study cohorts into 2 subgroups based on fixation index value; however, the results of that analysis were inconsistent. CONCLUSIONS: The results of this meta-analysis were not able to verify the association between the KIF1B rs1740199 polymorphism and HCC risk. Therefore, a well-designed, large-scale, multicenter validation study is needed to confirm the relationship.
Alleles ; Carcinoma, Hepatocellular* ; Case-Control Studies ; Cohort Studies ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Kinesin* ; Polymorphism, Single Nucleotide ; Population Characteristics

Objective To adopt Fst statistical method to assess the heterogeneity sources of meta‐analysis by dichotomous varia‐ble .Methods The case‐control studies on the relationship between KIF1B gene rs17401966 polymorphism and hepatocellular carci‐noma(HCC) risk were collected by retrieving the databases including Google Scholar ,EMBASE ,PubMed ,ISI Web of Knowledge and CNKI .The meta analysis was performed by using the Stata12 .0 software .The genetic differentiation degree among populations was analyzed and researched by using the Arlequin 3 .5 software .Results A total of 5 case‐control studies were finally included ,in‐volving 12 research populations .The meta analysis on 12 populations showed that KIF1B gene rs17401966G allele was negatively correlated with HCC risk (OR=0 .77 ,95% CI:0 .65-0 .93 ;P=0 .005) .However ,the strong heterogeneity existed in this pooled re‐sults .The genetic differentiation test in the included 12 populations found that Zhang′s five research populations had varying de‐grees of genetic differentiation compared to other populations .Then the proper subgroup analysis was further conducted based on Fst value ,and then the I2 value of the heterogeneity test in the group 8 and 9 was descended to less than 25% .However ,the meta analysis results of the group 8 and 9 were inconsistent .Conclusion This study showed that conducting the meta‐analysis of KIF1B gene rs17401966 polymorphism and the HCC risk can find the heterogeneity sources of meta‐analysis by conducting the genetic dif‐ferentiation test in the included population .

Objective To study the technique and clinical effect of endoscopic surgery using high frequency electrotome with suction device for nasopharyngeal angiofibroma. Methods In this study, we retrospective analyzed the clinical data of 10 patients treated between January 2009 and December 2015. All these patients were treated by endoscopic surgery using high frequency electrotome with suction device. The average blood loss during surgery, tumor residual, recurrent tumor and duration of recovery were evaluated. Results The tumor was completely removed in all 10 patients. The average blood loss was 465 ml, there was no postoperative complication, all patients had no residual tumor, and there was no recurrent tumor over a follow-up of 6~18 months. Conclusion Though it was not preoperative transcatheter arterial embolization, the endoscopic surgery using high frequency electrotome with suction device can be used to treated nasopharyngeal angiofibroma which either limited to nasopharyngeal cavities and paranasal sinus with intraoperative blood pressure control.

Objective:To observe influence of preoperative sufentanil delayed preconditioning (SPC) on perioperative cogni‐tive function and myocardial protection effect in patients undergoing on -pump coronary artery bypass grafting (OP‐CABG) .Methods:A total of 60 patients undergoing selective OPCABG were randomly and equally divided into sufentanil group (SPC group) and routine treatment control group (control group) ,blood sample was collected before operation ,1h , 6h ,12h ,24h and 48h after aorta declamping to measure level of cardiac troponin I (cTnT );and all patients received neu‐ropsychological assessment before and 7d after operation .Results:Compared with control group ,there was significant re‐ductions in serum cTnI levels [1h:(23.66 ± 3.15) ng/ml vs .(14.96 ± 2.13) ng/ml] in sufentanil group from 1h after aor‐ta declamping to 48h after CABG ,P<0.05 all .The inotropic agent usage score on 12h ,24h and 48h after entering ICU of sufentanil group was significantly lower than that of control group [12h:(6.4 ± 0.6) scores vs .(8.4 ± 0.6) scores] , P<0.05 all .Incidence rate of postoperative cognitive dysfunction (POCD) in sufentanil group was significantly lower than that of control group (13.3% vs .30.0% ,P=0.041) .Conclusion:Preoperative sufentanil delayed preconditioning posses‐ses myocardial protection effect , and reduce incidence rate of cognitive dysfunction so also possesses certain brain protection in patients undergoing on-pump coronary artery bypass grafting .

Objective: To observe the effects of transforming growth factor-β1 (TGF-β1) and atorvastatin on expressions of collagen type I P-Smad2, Smad4 and Smad7 in human atrial ifbroblasts, and to explore the ifbrosis and anti-ifbrosis mechanisms in human atrium. Methods: Human right atrial appendage tissue was obtained from the cardiac surgery in our hospital and the atrial ifbroblasts were isolated and cultured by generations. The effects of TGF-β1 and atorvastatin on atrial ifbroblast proliferation was detected by MTT method and the effect of TGF-β1 at (0, 0.1, 1.0, 5.0, 10.0, 20.0, 50.0) ng/ml and atorvastatin at (0, 0.1, 1.0, 10.0, 100.0) μmol/L on mRNA and protein expressions of collagen type I P-Smad2, Smad4 and Smad7 in atrial ifbroblasts were examined by RT-PCR and Western-blotting analysis respectively. Results: MTT detection presented that compared to TGF-β1 at 0 ng/ml, with the intervention of TGF-β1 at (1 and 10) ng/ml, the mRNA and protein expressions of collagen type I P-Smad2, Smad4 increased,P<0.05 and the expressions of Smad7 decreased,P<0.05. Compared to TGF-β1 at 10.0 ng/ml, with the intervention of TGF-β1 + atorvastatin at 10.0 μmol/L or with atorvastatin at 10.0 μmol/L alone, the mRNA and protein expressions of collagen type I P-Smad2, Smad4 decreased,P<0.05and expressions of Smad7 increased,P<0.05. Conclusion: TGF-β1 promotes human atrial ifbroblast proliferation and collagen type I expression, while atorvastatin inhibits such proliferation and expression, the effect might be done by affecting TGF-β1/Smads pathway in human atrial ifbroblasts.

Objective To discuss the distribution of traditional Chinese medicine (TCM) syndromes of patients with congestive heart failure (CHF) commonly seen in clinic based on data mining technology.Methods A multicenter study was conducted. 1 451 in-patients with CHF in 4 grade Ⅲ hospitals from December 2010 to September 2012 were enrolled. The cluster and factor methods were applied to synthetically analyze the data concerning the patients' information of four diagnostic methods in TCM, and the TCM syndromes commonly seen in patients with CHF and the preliminary diagnostic scheme were summarized.Results In these 1 451 cases, there were 43 items having been experienced standardization, including clinical symptoms and manifestations of tongue and pulse, and in the information concerning four diagnosis in TCM, there were 14 items whose incidences > 10%. The incidence of chest distress was the highest 89.18% (1 294 cases), followed by shortness of breath 66.16% (960 cases), and the lowest constipation 12.20% (177 cases). There were 4 commonly seen syndromes of CHF as follows: qi deficiency blood stasis syndrome (the major diagnostic bases: palpitation, shortness of breath, dark and red tongue with white fur, thin pulse; and the minor bases: chest distress and thin fur), yang deficiency water diffusion syndrome (major bases: edema of lower limbs, cough, expectoration, difficult urination, chilly, poor appetite, greasy fur, string pulse; minor bases: body strength weakness), phlegm heat obstructing lung syndrome (major bases: chest pain, cough and dyspnea in semi-reclining position, constipation, light tongue with yellow fur, deep, slippery or rapid pulse; minor bases: dizziness), and qi yin deficiency blood stasis syndrome (major bases: dry mouth, night sweating, frequent urination at night, teeth-marked tongue, purplish tongue, uneven or irregular pulse; minor bases: loose stool, headache, purplish lips, swollen tongue with little fur, moderate or weak pulse). The load intervals of each of the symptoms in CHF qi deficiency blood stasis syndrome were from -0.520 to 0.881, all the absolute values were greater than 0.520, and the common degrees extracted were 64.3% - 83.6%, which meant the 5 common factors could extract the original index information all over the common degree 64.3%. In yang deficiency water diffusion syndrome, the load intervals of each of symptoms were from0.732 to 0.983, all the absolute values were greater than 0.732, and the common degrees extracted were 58.2% - 96.9%; in phlegm heat obstructing lung syndrome, the load intervals of each of symptoms were 0.670 - 0.992, the all absolute values were greater than 0.670, and the common degrees extracted were 52.0% - 98.5%. In qi yin deficiency blood stasis syndrome, the load intervals of each of symptoms were 0.576 - 0.926, all the absolute values were greater than 0.576, and the common degrees extracted were 54.2% - 87.1%.Conclusion By application of data mining technology combined with clinical practice, the common TCM syndromes of patients with CHF can be analyzed objectively and comprehensively.