Volume 87  ·   Issue 48  ·  2007

Objective to investigate the application value of FAIR as a non-invasive imaging method without contrast agent in MRI perfusion imaging of lung parenchyma. Methods Two coronal scans (central descending aorta and hilar) were performed in 20 healthy volunteers with SSFSE-FAIR sequence. The relative perfusion value (rPBF) and its ratio (rPBFR/rPBFL, R/L) of both lungs at different layers were calculated. Results (1) There was no statistically significant difference in rPBF of both lungs at the same layer:central descending aorta, left and right lung perfusion (P>0.05, right rPBF 87±24, left rPBF 87±27); At the hilar level, the perfusion of both lungs was significantly different (P<0.05, rPBF on the right side was 41±15, and rPBF on the left side was 74±25). (2) rPBF at different levels of ipsilateral lung tissue: rPBF of both lungs was significantly different between the two different levels (both P<0.05); The rPBF of central descending aorta was higher than that of hilar. Conclusion FAIR is feasible for pulmonary parenchymal perfusion imaging. Due to the proton saturation effect, the left and right lung perfusion were different at individual levels; And FAIR can be more sensitive to the non-uniformity of pulmonary blood flow distribution caused by gravity.

Objective to investigate the distribution of intron 4 polymorphism of endothelial nitric oxide synthase (eNOS) gene in Chinese diabetic patients in Shandong and Singapore and its relationship with diabetic nephropathy.Methods 237 patients with type 2 diabetes mellitus were enrolled (87 in Shandong and 150 in Singapore). DNA was extracted from whole blood for polymerase chain reaction, cloning and sequencing.Results There were three alleles of this gene polymorphism in Singapore Chinese, and a new allele, named c, with six 27 bp repeats was discovered; There are only two alleles in native Chinese. Alleles A, b and c have no significant correlation with diabetic nephropathy, but there is a statistically significant difference in the distribution of allele A between Shandong and Singapore (P<0.01). Conclusion There are three alleles in the polymorphism of intron 4 in eNOS gene; The gene polymorphism was not associated with diabetic nephropathy.

Objective to establish two-dimensional gel electrophoresis maps of liver fibrosis tissues and preliminarily analyze the changes of proteome and differential expression. Methods 2-DE was used to separate the total proteins of liver fibrosis tissues and normal liver tissues, and the differential protein spots were identified by image analysis. The differential protein spots were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and the expression levels of 3 of them were verified by Western blot method. Results The 2-DE maps of liver fibrosis tissues and normal liver tissues were compared and analyzed, and 59 differential protein spots were found, of which 30 were up-regulated and 29 were down-regulated in liver fibrosis tissues. The peptide mass fingerprint analysis was performed on 15 protein spots with more than 3 times difference in expression, and 10 proteins related to cell signal transduction, cell proliferation and oxidative stress were identified. The Western blot validation results of 14-3-3 β, DJ-1 and PEBP proteins were consistent with those of 2-DE. Conclusion There are some differentially expressed proteins between liver fibrosis tissues and normal liver tissues, It lays a foundation for further elucidation of the mechanism of liver fibrosis.

Objective to explore the role of epigenetic mechanism on the expression of retinoic acid receptor β gene (RAR β) in leukemia cells and its significance. Methods DNA methylase inhibitor decitabine (DAC), histone deacetylase inhibitor sodium valproate (VPA) and all-trans retinoic acid (ATRA) were used to treat leukemia cells. Methylation and expression quantification of RAR β gene; Chromatin immunoprecipitation. Results The total positive rate of RAR β gene methylation in 56 patients with acute myeloid leukemia (AML) was 64.3%. DAC and VPA significantly increased the activation of ATRA on RAR β expression. Chromatin immunoprecipitation experiment showed that DAC and VPA upregulated RAR β expression through DNA demethylation and histone acetylation. The combination of these three drugs can induce the appearance of myeloid differentiation marker CD11b in some U937 cells, which significantly decreased the ability of clone formation. Conclusion The combination of epigenetic regulators and ATRA can activate the expression of RAR β and have a synergistic anti-leukemia effect.

Objective to observe the inhibitory effect of urinary polyacid peptide (CDA-2) on the growth and differentiation of imatinib (IM) -resistant cell line K562R in chronic myeloid leukemia (CML) in vitro.Methods MTT and colony formation assay were used to observe the inhibitory effect of CDA-2 on the growth of bone marrow cells in CML cell line K562, IM-resistant cell line K562R, IM-resistant and non-resistant CML patients.Cell morphology was observed by Jimsa staining, apoptosis was analyzed by Annexin-V/propidium iodide (PI) staining, the expression of cell differentiation antigens CD11b and CD14 was analyzed by flow cytometry, and the expression of cell differentiation related genes, cell cycle regulatory genes and DNA methyltransferase genes were detected by reverse transcription PCR (RT-PCR). Results CDA-2 could inhibit the growth of bone marrow cells in K562, K562R, IM-resistant and non-resistant CML patients, and the growth inhibition of bone marrow cells in K562R cells and IM-resistant CML patients was more obvious. CDA-2 changed the morphology of K562 and K562R cells, induced the cells to mature differentiation, and caused the cell cycle to arrest in G1 phase; Conclusion CDA-2 has a strong growth inhibition and differentiation induction effect on K562R cell line in vitro, suggesting that CDA-2 may be a new drug for the treatment of IM-resistant CML patients.

Objective to observe the changes in the number and activity of circulating endothelial progenitor cells (EPC) in patients with coronary stent restenosis. Methods the subjects who had undergone coronary stenting were divided into two groups: restenosis group (15 cases) and control group (17 cases). The total mononuclear cells of peripheral blood were obtained by density gradient centrifugation, inoculated into 24-well culture plates coated with human fibronectin. After 7 days, the cell surface specific antigens CD34 and KDR were identified by immunofluorescence microscopy, and the ability of EPC to uptake DiI-acLDL and bind to FITC-UEA-Ⅰ was identified by laser confocal microscopy. The migration ability of EPC was measured by scratch test, the proliferation ability of EPC was measured by MTT colorimetry, and the adhesion ability of EPC was measured by adhesion test. Results the number of EPC in restenosis group was significantly lower than that in control group (4.97±1.42 vs 17.2±3.90, P =0.001), and the proliferation ability of EPC in restenosis group was significantly lower than that in control group (proliferation fold 1.37 Conclusion The number of EPC, the proliferation and migration capacity of EPC in patients with coronary stent restenosis decreased significantly, which may be involved in the mechanism of stent restenosis.

Objective to investigate the clinical efficacy and influencing factors of percutaneous transhepatic TH glue embolization in the treatment of esophageal varices.Methods TH glue was injected into lower esophageal varices,gastric fundus cardia veins and main coronary veins by percutaneous transhepatic portal vein puncture intubation to achieve permanent embolization of varicose veins and their blood-supplying veins. 92 cases of cirrhotic esophageal varices were treated with this technique, all of whom had a history of gastrointestinal bleeding before operation, and 18 cases were embolized during acute bleeding. The treatment effect was evaluated by gastroscopy and CT after operation. Results 89 cases were successfully embolized, with a success rate of 96.7% (89/92), and 3 cases died within 1 month. The remaining 86 cases were divided into esophageal-fundus type according to the range of TH glue embolization, 40 cases; 33 cases of gastric fundus-cardia embolism; 13 cases of main coronary vein embolism, 40 cases of esophageal-gastric fundus embolism, esophageal varices improved (100%), 29 cases of varices disappeared (72.5%); In 33 cases of gastric fundus-cardia embolism, 29 cases were significantly relieved (87.8%), and 15 cases of varicose veins disappeared (45.5%); The recurrence rate of total varicose veins was 14.1% (10/71), and the recurrence rate of the three types of embolism was 7.5% (3/40), 17.2% (5/29) and 2/2, respectively. The difference between the groups was statistically significant. The recurrence rate of varicose veins in the esophagogastric embolism group was significantly lower than that in the gastric cardia type and the main coronary vein type (P<0.01); The rebleeding rate was 16.3% (14/86), the rebleeding rate of esophagogastric fundus type was 7.5% (3/40), the rebleeding rate of gastric fundus type was 15.2% (5/33), and the rebleeding rate of main trunk type was 69.2% (9/13). The difference was statistically significant (P =0.0092). During the follow-up period, the total mortality rate was 24.7.6% (22/89). There was no statistically significant difference between the mortality rate of esophagogastric fundus type and gastric fundus type, but the mortality rate of main trunk type was significantly higher (P =0.013). No serious ectopic embolism occurred in 89 patients. Conclusion Percutaneous transhepatic TH glue embolization can permanently embolize the lower esophageal varices and their blood supply vessels, which is an effective method to prevent and treat esophageal varices rupture and bleeding. Its long-term efficacy is closely related to the extent of TH glue embolization.

Objective to evaluate the applicability of glomerular filtration rate calculated by Cockcroft-Gault formula and simplified dietary modification test (MDRD) formula to estimate renal function in diabetic patients. Methods The serum creatinine concentration of 189 patients with type 2 diabetes mellitus was measured. The glomerular filtration rate calculated by the two formulas was compared with the glomerular filtration rate (gold standard) determined by 99Tcm-DTPA (99Tcm-labeled diethylenetriamine pentaacetic acid) renal dynamic imaging, respectively, in order to evaluate and select a more suitable formula for estimating renal function in diabetic patients. Results Both formulas deviated from the actual value for calculating GFR. The Cockcroft-Gault formula underestimated the actual value, while the simplified MDRD formula overestimated the actual value. Correlation analysis, consistency test and analysis of subject operating characteristic curve showed that the correlation coefficient, consistency rate and accuracy of simplified MDRD formula and gold standard were higher than that of Cockcroft-Gault formula. Conclusion Simplified MDRD formula is better than Cockcroft-Gault formula for estimating renal function in diabetic patients

Omental cyst is a rare and benign disease. It rarely causes obvious clinical symptoms, so that most cysts develop larger and compress the stomach wall, or the cysts appear strangulating pain due to torsion of pedicle. Laparoscopic complete resection of small omental cyst is rarely reported.

The patient was a 30-year-old woman with 31 weeks of first pregnancy. She was admitted to hospital because of mucous bloody stool for 6 months, which was aggravated by 1 1/2 months. The patient developed blood in stool at the fourth week of pregnancy, without diarrhea, and the hemoglobin was found to be 68g/L, and was diagnosed as "hemorrhoids". At 23 weeks of pregnancy, the patient developed mucous bloody stool, and the frequency of stool was 3~4 times/d, and was diagnosed as "acute gastroenteritis". After fluid replacement and other treatment, the symptoms aggravated, and the frequency of stool increased to 6~8 times/d.

Objective to construct tissue engineering blood vessels using bone marrow cells as seed cells and acellular tissue matrix as scaffold. Methods Piglet bone marrow mononuclear cells were isolated and cultured in endothelial cell culture medium and smooth muscle cell culture medium respectively to observe the antigen markers of differentiated cells; The undifferentiated bone marrow mononuclear cells were planted into the acellular matrix to construct tissue engineering blood vessels, which were transplanted into bone marrow donor piglets to replace part of pulmonary artery blood vessels.Results the morphological changes of mature endothelial cells or smooth muscle cells appeared in piglet bone marrow cells after being cultured in endothelial cell culture medium or smooth muscle cell culture medium, and the specific antigens of endothelial cells or smooth muscle cells were expressed respectively; After 100 days of tissue engineering vessel transplantation, the lumen was unobstructed, without thrombus, calcification or aneurysm formation, and the endothelial cells and smooth muscle cells differentiated and proliferated well; The maximum load of the grafted vessel is 2.76 N and the maximum elongation is 20.31 mm. Conclusion the tissue engineering vessel can be successfully constructed by bone marrow mononuclear cells combined with acellular matrix.

Objective to observe and compare the protective effects of heat shock protein 70 on acute experimental hypoxia/reoxygenation injury of cardiomyocytes and the similarities and differences between them and the protective model of heat shock cardiomyocytes. Methods the primary cardiomyocytes of neonatal rats were cultured and divided into four groups: blank group (control), hypoxia/reperfusion group (A/R), heat shock protein group (A/R + HS) and pCDNA heat shock protein plasmid group (pCDNA HSP70). The pCDNA HSP70 plasmid was encapsulated with liposomes and transduced into related cardiomyocytes. The expression of HSP70 mRNA was detected by RT-PCR, and the expression of HSP70 protein was detected by Western blot. The cardiomyocyte survival rate (tetramethylazolazole blue colorimetric method), lactate dehydrogenase activity in culture solution, ultrastructural changes of cardiomyocytes (transmission electron microscopy) and apoptosis index were detected to observe the degree of cardiomyocyte injury. Results the cell survival rate of A/R + HS group and A/R + pCDNA HSP70 group was significantly increased (71.8±10.3) % and (73.4±12.2) %; (LDH) activity was significantly decreased (14.3±2.6) IU/L, (14.6±2.9) IU/L; The ultrastructure of cells was significantly improved; The contents of HSP7o mRNA and protein in A/R group were significantly lower than those in A/R + HS group and A/R + pCDNA HSP70 group (1.87±0.23, 2.05±0.34 times P<0.01), and the apoptosis index of the two groups was also significantly lower than that in A/R group. Conclusion High expression of HSP70 gene can prevent the damage of myocardial cells caused by hypoxia/reoxygenation, and its effect is related to anti-apoptosis.

Objective to investigate the distribution characteristics of sympathetic nerve endings in the atrium and pulmonary vein of dogs and their correlation with the induction of atrial fibrillation. Methods Sixteen healthy breed dogs were subjected to general anesthesia and left and right thoracotomy to stimulate bilateral vagal sympathetic trunk. S1S1 burst stimulation and S1S2 program stimulation were performed in the right atrial appendage, left atrial appendage, left atrium and four pulmonary veins respectively, and the induction rate of atrial fibrillation in different parts of atrium and pulmonary vein was observed. Then, the animals were sacrificed, and the sympathetic nerve antibody staining in atrium and pulmonary vein was performed. The sympathetic nerve density in each part of atrium and pulmonary vein was calculated, and the relationship between sympathetic nerve density and atrial fibrillation induction was compared. Results All the experiments were completed in 14 dogs. The nerve density in atrium and atrial appendage with TH staining was higher than that in pulmonary vein, respectively [(128±65) /mm2, (76±29) /mm2,P =0.02]; The density of TH-positive nerves in dogs that can induce atrial fibrillation is higher than that in dogs that fail to induce atrial fibrillation (P>0.05). Conclusion The density of sympathetic nerves in atrium and atrial appendage is higher than that in pulmonary vein; The induction of atrial fibrillation is related to the density of sympathetic nerves in the atrium and pulmonary vein.

Objective to investigate the mechanism of renal tubulointerstitial fibrosis induced by urinary protein in patients with lupus nephritis.Methods Total protein was extracted from urine of 6 patients with initial lupus nephritis.The expressions of transforming growth factor β 1 (TGF-β 1), collagen type Ⅰ (COL Ⅰ) and α-smooth muscle actin (α-SMA) mRNA in HK-2 cells were detected by reverse transcription-polymerase chain reaction method. The expressions of TGF-β 1, COL Ⅰ and α-SMA were detected by Western blot and indirect immunofluorescence assay. Results Urinary protein in lupus nephritis could stimulate the upregulation of TGF-β 1, COL Ⅰ and α-SMA mRNA and protein expression in HK-2 cells [(TGF-β 1 mRNA 0.39±0.03 vs 0.27±0.02 (P<0.01), TGF-β 1 protein 0.37±0.03 vs 0.27±0.04, (P<0.01), COL Ⅰ mRNA 0.38±0.02 vs 0.22±0.03, (P<0.01), COLⅠ protein 0.44±0.03 vs 0.19±0.02, (P<0.01), α-SMA mRNA 0.66±0.04 vs 0.44±0.03, (P<0.01), α-SMA protein 0.43±0.02 vs 0.24±0.03, (P<0.01)] Conclusion the phenotypic transformation and the increase of extracellular matrix production of HK-2 cells induced by urinary protein in lupus nephritis may be one of the mechanisms of renal interstitial fibrosis.

Objective to investigate the feasibility of transfection of human interleukin (hIL) -10 gene via pulmonary vein in vitro, and to observe the effect of local transfection of human interleukin (hIL) -10 gene on ischemia-reperfusion injury (IRI) in transplanted lungs. Methods A modified three-cuff method was used to establish a rat left lung orthotopic transplantation model. Before transplantation, donor lungs were retrograde perfused with 5×109 PFU/ml hIL-10 gene recombinant adenovirus vector (transgenic group) via pulmonary vein, and then transferred into recipient mice after storage for 3 h. 4 h after reperfusion, PaO2 in arterial blood, wet-dry weight ratio (W/D), malondialdehyde (MDA) content, superoxide dismutase (SOD) activity and myeloperoxidase (MPO) activity of transplanted lung were measured. Observe the histological changes; The expression of hIL-10 gene was detected by RT-PCR and immunohistochemical staining, and the expression levels of tumor necrosis factor (TNF) -α and interferon (IFN) -γ were determined by enzyme-linked immunosorbent assay (ELISA). Results the IRI of the transplanted lung was significantly reduced in the empty vector control group and the blank control group, and the IRI of the transplanted lung was significantly reduced in the transgenic group, PaO2 increased, W/D ratio decreased, MDA content and MPO activity decreased (P<0.01), and SOD activity increased (P<0.05). The expression of TNF-α and IFN-γ was down-regulated (P<0.01), the alveolar interstitial edema was reduced, the inflammatory cell infiltration was reduced, and the exogenous hIL-10 gene was expressed in the transgenic lung. Conclusion (1) It is effective and feasible to transfect the exogenous gene in isolated donor lung by pulmonary venous perfusion; (2) Adenovirus-mediated hIL-10 transgene can effectively alleviate IRI and improve early lung function.

Objective to investigate the changes of protein profiles between astroglioma cells and astrocytes.Methods C6 glioma cells derived from astrocytes and astrocytes from rat cortex cultured and purified in vitro were selected for proteomic analysis.The gel images of astrocytes and C6 cells were compared by two-dimensional gel electrophoresis (2-DE) with PDQuest software.The differential protein spots were analyzed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and bioinformation analysis.The differential expression results of some proteins were verified by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Compared with astrocytes, the expressions of phosphoglycerate mutase 1, bioconvertase, glutathione S-transferase P, calreticulin and annexin A2 were higher in C6 cells, while the expressions of vimentin and actin γ-actin were lower in C6 cells. The results of phosphoglycerate mutase 1, annexin A2 and vimentin were confirmed by semi-quantitative RT-PCR. Conclusion The differentially expressed proteins found in this study are closely related to many important cell physiological activities and functions, including anaerobic fermentation, cytoskeleton assembly, biotransformation and signal transduction, which may be related to the rapid growth, infiltration and migration and drug resistance of glioma.

The incidence of mental disorders in patients with hypertensive intracerebral hemorrhage is significantly higher than that in general population.We summarized the clinical data of patients with hypertensive intracerebral hemorrhage in recent 5 years to explore the relationship between hypertensive intracerebral hemorrhage and mental disorders.

Gastroesophageal reflux (GER) is a common disease in pediatrics, and vomiting is its main clinical manifestation, but it is also closely related to respiratory diseases, such as bronchial asthma, chronic cough, pneumonia, etc. [1-3]. Esophageal dynamic pH monitoring is an objective method for diagnosing GER, and it has been used in pediatrics in China for more than 10 years [4-5]. In order to understand the incidence of GER in children with different diseases, we analyzed the results of dynamic pH monitoring of esophagus in 4048 children, and the results are reported as follows.

Sponsored by the Chinese Medical Association and supported by Bayer Healthcare Co., Ltd., the "Chinese Medical Association Collaborative Group on Blood Glucose Management of Cardiovascular and Cerebrovascular Diseases (CGICC)" was established in Beijing in November 2007. The collaborative group will unite experts from cardiovascular diseases, cerebrovascular diseases, diabetology, epidemiology and other disciplines in China to improve the diagnosis and treatment of cardiovascular and cerebrovascular diseases in China with the aim of "early detection of cardiovascular and cerebrovascular diseases with hyperglycemia, comprehensive intervention of multiple risk factors of cardiovascular and cerebrovascular diseases and comprehensive treatment of cardiovascular and cerebrovascular diseases". The founding meeting of CGICC was held in Beijing on the afternoon of November 27th, 2007.

A 60-year-old woman was admitted to hospital on March 13, 2007 due to the discovery of an enlarged neck mass for nearly 2 years, hoarseness, breathing and swallowing difficulties for 10 days. In May, 2005, the patient accidentally discovered a left neck mass, the size of an egg, without redness, heat, pain, excessive sweating, palpitations and shortness of breath, etc., and consciously lost 2~3 kg of weight, which was not paid attention to. After that, the mass increased progressively. She went to the local hospital in March and June 2006, and repeated B-ultrasound showed left goiter and abundant blood flow. 　　

The patient was a 31-year-old woman who was menopaused for 28 weeks and was found to have Rh blood type incompatibility for 1 month. The last menstruation was on March 5, 2005. The early pregnancy reaction was not obvious, and fetal movement was normal at 4+ months of menopause. She came to our hospital for prenatal examination at 24 weeks and was found to have blood type B, Rh (-), and anti-D titer 1:32. She was diagnosed as Rh blood type incompatibility between mother and child. She was treated with Yinzhihuang, vitamin C intravenously, and Yinchen Decoction of Chinese medicine. The anti-D titer 1:64 was re-examined at 27 weeks of pregnancy and was admitted to the hospital. The patient was in general good health. She had a medical abortion once at 1+ month of pregnancy in 2001, twins died intrauterine at 37 weeks of pregnancy in July 2003, and induced labor at 31 weeks of pregnancy in October 2004 due to fetal pleural effusion, ascites and fetal malformation.

A 43-year-old female was admitted to the hospital on June 30, 2006, mainly due to pain and discomfort in her left hip for 1 month and aggravated for 15 days. One month ago, the patient had left hip pain and discomfort without obvious trigger, intermittent dull pain, which aggravated after activity, relieved and disappeared after rest, and did not aggravate at night. She went to a local hospital and was diagnosed with "muscle strain" for physical therapy, but the effect was not satisfactory. In the past half month, the patient felt that the symptoms aggravated, but the nature of the pain remained unchanged. Physical examination: general condition: normal development, good nutrition, and no obvious abnormalities were found in systematic examination. Orthopedic condition: normal physiological curvature of the spine, good activity. There was no tenderness and percussion pain between the spinous processes, tenderness and percussion pain in the front of the left hip, no radiation pain, positive 4-character sign, and no longitudinal percussion pain.

Because of the development of perinatal medicine and emergency medicine, the mortality rate of perinatal infants decreases, and the survival rate of high-risk infants with abnormal neurological development increases gradually. Therefore, it is very important to predict all kinds of abnormal neurological outcomes in early stage, such as cerebral palsy, ADHD, abnormal behavioral development, etc. Traditional neurological examination methods, such as cranial ultrasound and electroencephalogram, which have been used for a long time, have some problems such as high cost, complicated procedure and low value in predicting neurological outcomes.