Objective : To explore the method of using high-fat diet combined with angiotensin-Ⅱ ( Ang-Ⅱ) and β-aminopropionitrile (BAPN) to establish the model of aortic dissection in mice． Methods : 24 C57BL /6J mice (4 weeks old，male) were randomly divided into control group［intraperitoneal injection of 0．9% sodium chloride solu- tion 10 ml / (kg · d) ］and experimental groups［Ang-Ⅱ 4 mg / ( kg · d) group，Ang-Ⅱ 4 mg / ( kg · d) + BAPN 0. 33 g / (kg · d) group］，each group with 8 mice ; all mice were given a high-fat diet and the mice weights were measured at the same time point and administered according to the weight standard．The dead mice were dissected immediately and the aorta was taken out for pathological section，then observed under the microscope．The morphology of aorta was detected by small animal ultrasound and the mice with obvious dissection were killed and dissected directly. Results : After administration，the activity and appetite of mice in the high-fat diet combined with Ang-Ⅱ + BAPN group decreased most significantly，and the mortality rate of aortic dissection rupture and the success rate of modeling in this group were higher than those in the high-fat diet combined with Ang-Ⅱ group，while there was no significant change in the control group．Under the ultrasound of small animals，compared with the other two groups，the mice in the high-fat diet combined with Ang-Ⅱ + BAPN group showed the formation of abdominal aortic vascular false lumen and vascular enlargement．The mice that died during the administration were dissected immediately，and a large number of blood clots in the abdominal cavity and around the blood vessels could be seen．The mice with aortic dissection or aortic aneurysm could be seen under ultrasound in small animals，and severe adhesion between the vascular wall and the surrounding tissues could be found when dissected，while no obvious abnormalities were found in the blood vessels of the control group．The results of the staining showed that the false lumen of blood vessel wall was formed and the arrangement of elastin and collagen was disordered in the mice of high fat diet com- bined with Ang-Ⅱ + BAPN group．The thickness of blood vessel wall in each group was statistically analyzed，and it was found that the blood vessels in the two experimental groups were thicker than those in the control group，which was statistically significant (P＜0. 001) ．The vascular wall of Ang-Ⅱ + BAPN + high-fat diet group showed severe elastin degradation． Conclusion High-fat diet combined with Ang-Ⅱ 4 mg / (kg · d) and BAPN 0. 33 g / (kg · d) can establish an efficient model of aortic dissection in mice.

Traditional right ventricular pacing is non-physiological pacing, can lead to ventricular electrical and mechanical dyssynchmnization, which increases the risk of heart failure and atrial fibrillation. His-Purkinje system pacing is the hot research of physiological pacing method. The high thresholds and difficult implantation of his bundle pacing limits its application and popularization. In recent years, domestic scholars have proposed left bundle branch area pacing. Many studies have confirmed the safety and feasibility of left bundle branch area pacing. Left bundle branch pacing transmit down the conduction system, which can effectively achieve ventricular electrical and mechanical synchrony, At the same time, it also has many others advantages, such as good and stable electrical parameters, significantly improved cardiac function, and pacing across blocked parts. It will become the main development direction of physiological pacing in the future. This article aims to review the origin, standard and classification, advantages and limitations of left bundle branch area pacing.

Objective:To evaluate the clinical efficacy of staged surgery in treatment of calf Gustilo-Anderson type IIIC fracture.Methods:A retrospective case series was conducted to analyze clinical data of 16 patients with calf Gustilo-Anderson type IIIC fracture admitted to Shanghai Jiao Tong University Affiliated Sixth People's Hospital from January 2017 to December 2019. There were 12 males and 4 females, with the age of (38.6±8.2)years (range, 18-53 years). All patients had limb salvage treatment at one stage in the emergency department. The survival of the limb and the occurrence of vascular crisis were examined within one week after limb salvage. The second stage involved the repair of skin and soft tissue defects with the defect area from 12.0 cm×5.0 cm to 20.0 cm×8.0 cm using free flaps. The survival of the flap, vascular crisis, and donor site healing within two weeks after the flap procedure. The third stage used bone graft revision and bone lengthening technology to repair bone tissue. The lower extremity functional scale (LEFS) and Mazur ankle joint function score were used to evaluate the function of the affected limb before bone repair and at the last follow-up. The fracture healing and related complications were observed at the last follow-up.Results:All patients were followed up for (14.2±4.6)months (range, 8-20 months). At one stage, the limb-saving surgery was successful in all patients, among which one had vascular crisis. At second stage, free flaps survived in all patients, among which two had vascular crisis. All donor areas were healed by first intention. At third stage, the LEFS of the affected limb was increased from (32.0±7.4)points before bone repair to (48.0±10.2)points at the last follow-up ( P<0.01) and the Mazur score was increased from (50.9±15.3)points before bone repair to (73.8±11.9)points at the last follow-up ( P<0.01). All bone defects were repaired and healed without complications such as infection or osteomyelitis at the last follow-up. Conclusion:For calf Gustilo-Anderson type IIIC fracture, the staged strategy can effectively save limbs and restore limb function.

On January 20, 2020, WHO defined the epidemic of novel coronavirus pneumonia as a public health emergency of international concern, and the epidemic attracted worldwide attention. While effectively controlling source of infection, cutting off the route of transmission, and protecting the susceptible population, it is of great importance to reduce the delay in the diagnosis and treatment of patients with acute abdominal disease and ensure normal clinical work. Therefore, with reference to the current diagnosis and treatment protocols and guidelines and the actual situation in Baoding Second Hospital, this article summarizes the experience in outpatient triage, treatment process, operation classification, prevention and control, and ward management for patients with acute biliary tract infection. The analysis shows that the formulation of emergency plans for patients with acute biliary tract infection during the epidemic of novel coronavirus pneumonia can help to differentiate such patients from the patients with novel coronavirus pneumonia and avoid transmission and cross-infection of novel coronavirus during standardized diagnosis and treatment of acute biliary tract infection.

Objective To explore the effect of sufentanil combined with sevoflurane inhalation anesthesia on treating children with adenoidal hypertrophy resection.Methods A total of 58 children with adenoid hypertrophy were randomly divided into observation group and control group,29 cases in each group.The observation group was treated with sufentanil combined with sevoflurane inhalation anesthesia,and the control group was treated with propofol and remifentanil anesthesia.The extubation time and awakening time of the two groups were recorded,and the heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups,and the adverse reactions 24 h after the operation were observed.Results In the observation group,extubation time and awakening time were significantly shorter than the control group (P ＜ 0.05).At each time point,the MAP and HR in the observation group were stable,while MAP and HR immediately after intubation in the control group were significantly higher than that before induction (P ＜ 0.05).No nausea and vomiting were observed 24 h after operation in both groups.There were 4 cases of bucking and restlessness (13.8％) in the observation group,which was significantly lower than 7 cases (24.1％) in the control group (P ＜ 0.05).Conclusion Sufentanil combined with sevoflurane inhalation anesthesia for children with adenoidal hypertrophy resection is effective,which has advantages such as stable anesthesia effect,fast postoperative awakening and less complications.

Objective To explore the effect of sufentanil combined with sevoflurane inhalation anesthesia on treating children with adenoidal hypertrophy resection.Methods A total of 58 children with adenoid hypertrophy were randomly divided into observation group and control group,29 cases in each group.The observation group was treated with sufentanil combined with sevoflurane inhalation anesthesia,and the control group was treated with propofol and remifentanil anesthesia.The extubation time and awakening time of the two groups were recorded,and the heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups,and the adverse reactions 24 h after the operation were observed.Results In the observation group,extubation time and awakening time were significantly shorter than the control group (P ＜ 0.05).At each time point,the MAP and HR in the observation group were stable,while MAP and HR immediately after intubation in the control group were significantly higher than that before induction (P ＜ 0.05).No nausea and vomiting were observed 24 h after operation in both groups.There were 4 cases of bucking and restlessness (13.8％) in the observation group,which was significantly lower than 7 cases (24.1％) in the control group (P ＜ 0.05).Conclusion Sufentanil combined with sevoflurane inhalation anesthesia for children with adenoidal hypertrophy resection is effective,which has advantages such as stable anesthesia effect,fast postoperative awakening and less complications.

BACKGROUND:Recent studies have found that long non-coding RNAs (lncRNAs) can regulate stem cel proliferation and differentiation. But it is unclear that how lncRNA NR_033474 regulate stem cel proliferation and cel cycle. OBJECTIVE:To investigate the effect of lncRNA NR_033474 on the proliferation and cel cycle regulation in C3H10T1/2 mesenchymal stem cel s after the NR_033474 overexpressed by lentivirus, and to study the possible regulation mechanism of NR_033474 on mesenchymal stem cel s. METHODS:LncRNA NR_033474 was cloned into a lentivirus vector. Lentivirus particles were infected into C3H10T1/2 cel s to upregulate the expression of NR_033474. The NR_033474 expression level was detected by real-time PCR. Compared with the empty lentivirus vector, the proliferation of C3H10T1/2 cel s which overexpressed NR_033474 was detected by cel counting assay and cel cycle was detected using flow cytometry. The expression of cel cycle-associated proteins such as CDK1, Cyclin B1, Cyclin D1 and P53 were detected by western blot assay. RESULTS AND CONCLUSION:Compared with the control group, lncRNA NR_033474 in C3H10T1/2 cel s which overexpressed NR_033474 was increased by about 100 times (P<0.01), and the proliferation of C3H10T1/2 cel s was significantly inhibited after NR_033474 overexpression by lentivirus (P<0.05). In addition, flow cytometry showed that C3H10T1/2 cel s overexpressing NR_033474 were arrested in G2/M phase compared to the control group. Western blot showed that the expression levels of CDK1 and Cyclin B1 were downregulated, while there were no changes in Cyclin D1 and P53 expression. To conclude, these findings suggest that the NR_033474 overexpression significantly inhibits the cel growth of C3H10T1/2 cel s, at least in part, through induction of cel cycle arrest at G2/M phase.

Objective: To investigate the clinicopathologic characteristics of intractable epilepsy. Methods: Based on the classification criteria proposed by the International League Against Epilepsy (ILAE), a retrospective analysis of the pathological characteristics was done in 822 patients who underwent epilepsy surgery in Sanbo Brain Hospital, Capital Medical University, from June 2008 to December 2012. Results: The mean age of epilepsy onset was 9.9 years, mean duration of epilepsy was 11.9 years. Complex partial seizures were the main presenting features. Histopathological study showed 33 cases (4.01%) with mild forms of cortical malformations, 690 cases (83.94%) with focal cortical dysplasia (FCD) and 99 cases with others (including 39 pure hippocampal sclerosis, 20 cystosclerosis, 19 Sturge-Weber syndrome, 8 tuberous sclerosis complex, 6 without significant pathological changes, 5 gyral malformations and 2 hamartoma). Among the 690 FCD cases, 106 were FCD typeⅠ, 91 were FCD typeⅡ and 493 were FCDⅢ(Ⅲa: 160, Ⅲb: 106, Ⅲc: 26 and Ⅲd: 201). Conclusions FCDⅢd is the most common histopathological subtype causing intractable epilepsy, mainly due to focal hypoxia/ischemia in the perinatal period, which results in scarring of local brain tissue; this is followed by other isolated forms of FCD (FCDⅠand FCDⅡ), and then FCD Ⅲa and FCD Ⅲb. The reason to distinguish isolated forms of FCD (types Ⅰ and Ⅱ) from FCD Ⅲ and to subclassify FCD Ⅲ is to allow better definition of cortical dyslamination. Therefore, the pathogenic factors of intractable epilepsy can be grouped in greater details, and facilitate the diagnosis and potential curative treatment of intractable epilepsy.

AIM:To validate the association between long noncoding (lncRNA)-H19 and microRNA-199a-5p (miR-199a-5p) through the dual-luciferase reporter gene system by construction of a luciferase reporter vector containing the gene of lncRNA-H19.METHODS:The potential complementary binding sites of lncRNA-H19 and miR-199a-5p were predicted by RegRNA 2.0.The H19 gene or its mutant ( Mut) fragment was cloned into luciferase reporter vector psi-CHECK-2.Restriction enzyme analysis and sequence analysis were used to identify whether the recombinant plasmids of the H19 and H19-Mut were successfully constructed .miR-199a-5p mimics, miR-199a-5p inhibitor, miR-199a-5p mimics neg-ative control or miR-199a-5p inhibitor negative control was co-transfected into the 293T cells with the luciferase reporters containing H19 or H19-Mut.Dual-luciferase reporter assay was performed to detect the luciferase activity in different groups in order to verify the relationship between lncRNA-H19 and miR-199a-5p.RESULTS:The results of double enzyme diges-tion and DNA sequencing showed that the sequence of luciferase reporter vector was correct .The results of dual-luciferase reporter assay indicated that the H 19 reporter gene luciferase activity significantly decreased in miR-199a-5p mimics group by 49%(P<0.01), and the H19 reporter gene luciferase activity was obviously upregulated in miR-199a-5p inhibitor group compared with miR-199a-5p mimics group ( P<0.01).However, miR-199a-5p mimics, miR-199a-5p inhibitor, miR-199a-5p mimics negative control and miR-199a-5p inhibitor negative control showed no effect at H 19-Mut reporter gene.CONCLUSION:lncRNA-H19 binds to miR-199a-5p to exert an inhibitory effect at transcriptional level .

AIM:To analyze the alterations of angiotensin Ⅱ (Ang Ⅱ), connexin 43 (Cx43), angiotenisinⅡreceptor type 1 (AT1) and signaling molecules in the TGF-β1/Smad pathway in different regions of the left ventricular heart tissue for exploring whether Ang Ⅱregulates Cx43 expression via the TGF-β1/Smad signaling pathway in myocardial infarction ( MI) rats.METHODS:MI was induced in 20 male Sprague-Dawley rats by the left anterior descending coronary artery ligation.The rats were then randomized into 2 groups.In the losartan group, 20 mg· kg-1· d-1 of losartan were ad-ministered for 2 weeks.Heart functions were assessed after surgery and 2 weeks later again following the above treatments . All the rats were sacrificed and relevant molecules , including Ang Ⅱ, AT1, and Cx43 were determined thereafter in diffe-rent areas of the left ventricle .TGF-β1 and its downstream signaling molecules , including Smad 2, Smad 3 and Smad 7, were also detected .RESULTS:In losartan group , both left ventricular internal dimension diastole ( LVIDd) and left ven-tricular internal dimension systole (LVIDs) were smaller, with diminished interventricular septal thickness (IVSd) and left ventricular posterior wall depth ( LVPWd ) and distinct improvement of left ventricular ejection fraction ( LVEF ) ( P<0.05 ) .Losartan therapy exhibited a reduction of Ang Ⅱin the infarct zone and the border zone in the cardiac tissues .AT1 was obviously attenuated in the infarct zone with an enhanced expression of Cx 43, which was also elevated in the border zone and none infarct zone .TGF-β1, Smad 2 and Smad 3 were decreased in different zones of the left ventricle , while Smad 7, in contrary to the above factors , presented a converse alteration .CONCLUSION:The activation of Ang Ⅱpro-vokes downregulation of Cx 43 through TGF-β1/Smad signaling pathway in MI rats .