Objective To explore the possible causes of CAST/EiJ mouse susceptibility to multiple pathogens,the immune cell phenotypes in the peripheral blood and spleen of CAST/EiJ mice were analyzed to clarify their composition.Methods Classical dendritic cells(cDCs),natural killer(NK)cells,B lymphocytes,T lymphocytes,and their subsets in the peripheral blood and spleen of CAST/EiJ mice and C57BL/6J mice were detected by flow cytometry using the cell surface markers CD3,CD4,CD8,CD11b,CD11c,CD19,CD27,CD49b,and TCRβ.Results There was no significant difference in the proportion of cDCs between CAST/EiJ and C57BL/6J mice,but the cDC1 cell subset population was smaller in CAST/EiJ.The proportions of NK cells(mainly mature NK cell subsets)and T lymphocytes(mainly CD8+T cells)were both lower in CAST/EiJ mice than C57BL/6J mice,while the proportion of B cells was higher in CAST/EiJ mice than C57BL/6J mice.Conclusions The proportions of NK and T lymphocytes in CAST/EiJ mice were lower than those in C57BL/6J mice.

Objective To observe the changes of renal tubular injury and the extent of interstitial fibrosis in the C57BL/6 mouse models of chronic kidney disease(CKD),and provide experimental animal evidence for study of the pro-gression of acute kidney injury(AKI)to chronic kidney disease as well as its mechanisms. Methods Twenty-four 8-week-old male C57BL/6 mice were randomly and equally divided into control group, low-dose, medium-dose, and high-dose cisplatin groups,6 mice in each group. Mice in the cisplatin groups were administrated with 5,7 or 10 mg/kg cispla-tin by intraperitoneal injection once a week for 4 weeks. Plasma creatinine and 24-hour urinary protein were detected to as-sess the renal function. The mice were sacrificed, and plasma and kidney samples were collected for subsequent tests. Pathological changes were observed using periodic acid-Schiff(PAS)staining. To evaluate renal tubules injury, the ex-pression of kidney injury molecule 1(KIM-1)was examined by immunohistochemistry and the level of urinary N-Acetyl-β-D-glucosaminidase was detected with a commercial kit. The infiltration of CD3-positive T cells and F4/80-positive macro-phages was observed by immunohistochemistry(IHC)and immunofluorescence. The expression of collagen I and α-smooth muscle actin(α-SMA)were tested by immunohistochemistry to assess the renal fibrosis, while total kidney collagen was detected by Picrosirius red staining. Results In contrast to the normal control group,the kidney injury became more seri-ous in the cisplatin-treated mice as cisplatin concentration increased. Particularly,significant kidney damage was observed in the high-dose cisplatin group. Compared with the control group,the plasma creatinine and 24-hour urinary protein were significantly increased in the high-dose cisplatin group(P<0.05 and P<0.001)indicating impaired renal function. Mor-phologically,numerous clear vacuoles and necrosis were present in renal tubule epithelial cells in the high-dose cisplatin group. The expression of KIM-1 was markedly up-regulated and the level of urinary NAG was elevated. Infiltration of CD3-positive T cells and F4/80-positive macrophages was enhanced in the mice of high-dose cisplatin group. Data from immuno-histochemistry and picrosirius red staining showed that mice of the high-dose cisplatin group developed renal fibrosis evi-denced by markedly up-regulated expression of collagen I and α-SMA. Conclusions Repeated administration of 10 mg /kg cisplatin for 4 weeks can induce chronic renal insufficiency in mice,which may serve as a novel model for the research on underlying mechanisms of progression from acute kidney injury to chronic kidney disease.

Objective To investigate clinical effects and prognostic factors of transabdominal laparoscopic-assisted and open radical resection for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cohort and case-control studies were conducted.The clinicopathologieal data of 84 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to the First Affiliated Hospital of Xiamen University from January 2014 to January 2017 were collected.Among 84 patients,42 undergoing transabdominal laparoscopic-assisted radical gastectomy (LARG) were allocated into LARG group and 42 undergoing transabdominal open radical gastectomy (ORG) were allocated into ORG group.Observation indicators:(1) comparison of intraoperative and postoperative recovery situations between groups;(2)comparison of follow-up and survival situations between groups;(3) prognostic analysis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival situations,tumor recurrence and metastasis of patients up to January 2018.Measurement data with normal distribution were representde as-x±s,and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparison of count data were analyzed using the ehi-square test or Fisher exact probability.Ordinal data were compared between groups using the Mann-Whitney U nonparametric test.The survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method,and Log-rank test was used for survival and univariate analyses.Multivariate analysis was done by COX proportional hazard model.Results (1) Comparison of intraoperative and postoperative recovery situations between groups:patients with Siewert type Ⅱ and Ⅲ AEG in the LARG and ORG group underwent successful transabdominal radical resection,without conversion to thoracotomy.All patients in the LARG group underwent esophagojejunostomy with circular stapler device,38 and 4 patients in the ORG group underwent esophagojejunostomy with circular stapler and linear cut stapler respectively.Operation time,volume of intraoperative blood loss,length of incision,time of postoperative analgesia,cases with anastomotic bleeding,anastomotic leakage,abdominal bleeding,incisional infection,pulmonary infection,abdominal infection and reflux esophagitis of grade Ⅰ ～ Ⅱ postoperative complications and duration of postoperative stay were respectively (261±50)minutes,(119±111)mL,(7.8±1.6)cm,(2.1±1.3)days,1,1,0,0,1,0,0,(12.8 ± 1.9) days in LARG group and (216 ± 52) minutes,(230± 178) mL,(17.3± 1.8) cm,(3.4±1.2)days,2,0,2,2,2,1,2,(18.4±15.3)days in ORG group,with statistically significances between groups (t =2.357,2.960,2.195,2.013,x2 =5.486,t =2.125,P＜0.05).All patients with complications were improved by symptomatic treatment.(2) Comparison of follow-up and survival situations between groups:81 of 84patients including 41 in LARG group and 40 in ORG group were followed up for 6-48 months,with a median time of 29 months.The postoperative 2-year overall and tumor-free survival rates were respectively 85.1％ and 82.1％ of 41 patients in LARG group and 83.1％ and 79.3％ of 40 patients in ORG group,with no statistically significance between groups (x2 =0.013,0.049,P＞0.05).(3) Prognostic analysis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection:results of univariate analysis showed that tumor diameter,tumor TNM staging,tumor T staging,tumor N staging and postoperative adjuvant chemotherapy were related factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection (x2 =8.349,14.376,9.732,17.250,8.012,P＜0.05).Results of multivariate analysis showed that tumor TNM staging and postoperative adjuvant chemotherapy were independent factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection (risk ratio =4.305,0.031,95％ confidence interval:1.858-9.977,0.004-0.246,P＜0.05).Conclusions Transabdominal laparoscopicassisted radical resection for AEG is safe and feasible,with advantage of minimally invasiveness,having equivalent long-term effects compared to open surgery.Tumor TNM staging and postoperative chemotherapy are independent factors affecting prognosis of patients with Siewert type Ⅱ and Ⅲ AEG undergoing transabdominal radical resection.

BACKGROUND: The treatment of multilevel cervical spondylotic myelopathy (MCSM) aims at sustaining the spinal cord compression and restoring the stability of the cervical vertebrae at most.OBJECTIVE: To analyze the clinical characters of anterior cervical discectomy with fusion and expansive open-door laminoplasty for MCSM.METHODS: Sixty-seven patients with MCSM were divided into two groups, and treated with anterior cervical discectomy with fusion (group A) or posterior cervical expansive open-door laminoplasty (group B). All the patients were followed up for 12 months, and the range of motion of cervical vertebrae, cervical curvature index were observed,as well as the Visual Analogue Scale and Japanese Orthopaedic Association scores were condueted. Moreover, the operation time, blood loss and adverse reactions were recorded.RESULTS AND CONCLUSION: (1) The loss of range of motion of the cervical vertebrae in the group B was significantly less than that in the group A (P < 0.05). (2) The cervical curvature index in the group A was significantly improved (P < 0.05), but the index had no significant change in the group B. (3) The axial systems were significantly improved in both groups, especially in the group A (P < 0.05). (4) The neurological function was significantly improved in both groups (P < 0.05), which showed no significant difference between two groups (P > 0.05). (5) The intraoperative blood loss in the group B was significantly more than that in the group A (P < 0.05). (6) The incidence of hoarseness and dysphagia in the group A was 19％. The incidence of wound infection, cerebrospinal fluid leakage and C5 nerve root palsy in the group B was 9％. (7) These results suggest that during choosing an appropriate method for MCSM,surgeons' skills and patients' situation should be considered.

BACKGROUND:The greatest risk of osteoporosis in total knee arthroplastyisperioperative and long-term periprosthetic fractures. However, limited by the traditional concept of osteoarthritis patientswhousualy not associated with osteoporosis, domestic clinical trials have not given enough attention to the osteoporosis before total knee arthroplasty.
OBJECTIVE:To analyze the osteoporosis and its relative factors in osteoarthritis patients before total knee arthroplasty.
METHODS:Data of 81 cases (81 knees) of knee osteoarthritiswhounderwenttotal knee arthroplasty in the Department of Joint Surgery of Tianjin People’s Hospital from January 2012 to November 2014 were retrospectively analyzed. They received lumbar spine and hip bone mineral density examination before surgery. The correlation of bone mineral density with age, body mass index, knee motion range,and knee deformity was analyzed before surgery. The independent risk factors for osteoporosis before replacement were analyzed.
RESULTS AND CONCLUSION:(1) Of 81 patients, there were normal bone mineral density in 25 cases (31%), osteopenia in 35 cases (43%),andosteoporosis in 21 cases (26%). Al 10 males had no osteoporosis and 21 in 71 female cases suffered osteoporosis (30%). Theincidence of osteoporosis in females was significantly higher than in male patients (P=0.046). (2) There was a linear correlation of bone mineral density with age and body mass index (correlation coefficientr=-0.230, 0.225). (3) The age of≥65 years and body mass index≥25 kg/m2were independent risk factors of osteoporosis before replacement (P< 0.05). (4) Patients with knee osteoarthritis had higher incidence of osteopenia and osteoporosis before total knee arthroplasty. The degree of osteoporosis was negatively correlated with age, but positively correlated with body mass index. The age of≥65 years and body mass index < 25 kg/m2were independent risk factors for preoperative osteoporosis. Thus, bone mineral density examination is essential for those patients before total knee arthroplasty.

Objective To investigate the expression and biological function of miRNA-449 a in lung cancer . Methods A case-control study was conducted in 58 patients diagnosed with lung cancer ( carcinoma and adeno-carcinoma) and normal tissue closely adjacent to tumor.MiRNA-449a simulation was designed and synthesized, was dissolved into two different concentrations as 10 and 20 mg/mL.The expression of miRNA-449a in lung cancer tissues and matched normal tissues were detected by Real time PCR .The expression of luciferase gene was detected by chemiluminescence technique.MiRNA-449a mimics on cell apoptosis was evaluated by MTT assay . Results The mean tissues expression levels of miRNA-449 a in squamous carcinoma group and adenocarcinoma group were 1.48 ±1.63 and 1.52 ±1.54 respectively, and were significantly lower than in control group (2.74 ± 1.55 ) ( P<0.01 ) .The average intensity of fluorescent protein in 10 mg/mL group and 20 mg/mL group were 2 115 ±168 and 1 352 ±159 respectively , and were significantly lower than that in control group ( 4 975 ±115 ) ( P<0.01 ) .Conclusions MiRNA-449 a was down-regulated expression in lung cancer and induced apoptosis .

Objective To study the relationship between essential hypertension(EH)with serum homocysteine(HCY),uroten-sinⅡ(UⅡ),angiotensin converting enzyme(ACE)and N-terminal pro-brain natriuretic peptide(NT-proBNP).Methods By collec-ting the clinical cases,UⅡwas determined by ELISA and HCY,ACE and NT-proBNP were simultaneously detected by ELISA.The detection results were analyzed and compared between the patients with essential hypertension(EH group)and the healthy con-trols.Results The levels of serum HCY,UⅡ,ACE and NT-proBNP in the EH group were significantly increased compared with the healthy control group;the area under curve (AUC)of serum HCY,UⅡ,ACE and NT-proBNP in the ROC curve in the EH group were 0.93,0.765,0.792 and 0.972 respectively,which showed clinical diagnostic significance.Conclusion The levels of HCY,UⅡ,ACE and NT-proBNP are highly expressed in EH and have significant differences compared with the healthy popula-tion,which has the diagnostic value to EH.

Objective To explore the correlationship between level of bFGF (basic fibroblast growth factor) in serum and synovia and X-ray severity (Kellgren-Lawrence Grading System) in patients with knee OA. Method 68 patients with knee OA were enrolled into this study. Knee OA grading was evaluated according to the Kellgren-Lawrence classification. bFGF levels in both serum and synovia were examined using enzyme-linked immunosorbent assay. Results The level of bFGF in serum and synovial fluid in patients with knee OA were positively correlated with radiographic severity (r = 0.619, P < 0.001 and r = 0.603, P < 0.001, respectively). Further analysis revealed that there was a positive correlation between the level of bFGF in serum and in synovia fluid (r = 0.688, P < 0.001). Conclusions Levels of bFGF in serum and synovial fluid were significantly increased in patients with OA, and levels of bFGF were positively correlated with radiographic severity. These findings indicate that bFGF levels may be a biomarker of disease severity and could play an crucial part in the pathophysiology of degenerative process in OA.

Objective To explore the clinical efficacy of Shenkang Injection and its influence on C-reactive protein (CRP)and interleukin-6 (IL-6)levels in patients with diabetic nephropathy (DN).Methods A total of 120 patients with type 2 diabetes mellitus combined with DN admitted in our hospital from Jan.2012 to Jan.2014 were randomly divided into observation group and con-trol group,60 cases for each.Control group was treated with high-quality protein diets and insulin to control blood glucose and pressure,on which basis observation group was added with intravenous injection of Shenkang Injection.Clinical efficacy,fasting blood glucose (FBG),Triglyceride (TG), total cholesterol (TC),serum creatinine (SCr),24 h urinary protein (24 hUpro),CRP and IL-6 level changes before and after treatment in both groups were observed.Results Clinical efficacy was 90.00% in observation group,evidently higher than 75.00% in control group (P <0.05). Aboveindexeswere all improvedobviously after treatment than treatment before (P < 0 .0 5 ,P <0.01)and were markedly lower in observation group than in control group (P <0.01).Conclusion Shenkang Injection can effectively reduce IL-6 and CRP levels and decrease blood glucose and pressure,prolong disease progression and improve prognosis in DN patients.

Objective To explore the clinical efficacy of Shenkang Injection and its influence on C-reactive protein (CRP)and interleukin-6 (IL-6)levels in patients with diabetic nephropathy (DN).Methods A total of 120 patients with type 2 diabetes mellitus combined with DN admitted in our hospital from Jan.2012 to Jan.2014 were randomly divided into observation group and con-trol group,60 cases for each.Control group was treated with high-quality protein diets and insulin to control blood glucose and pressure,on which basis observation group was added with intravenous injection of Shenkang Injection.Clinical efficacy,fasting blood glucose (FBG),Triglyceride (TG), total cholesterol (TC),serum creatinine (SCr),24 h urinary protein (24 hUpro),CRP and IL-6 level changes before and after treatment in both groups were observed.Results Clinical efficacy was 90.00% in observation group,evidently higher than 75.00% in control group (P <0.05). Aboveindexeswere all improvedobviously after treatment than treatment before (P < 0 .0 5 ,P <0.01)and were markedly lower in observation group than in control group (P <0.01).Conclusion Shenkang Injection can effectively reduce IL-6 and CRP levels and decrease blood glucose and pressure,prolong disease progression and improve prognosis in DN patients.