Volume 92  ·   Issue 30  ·  2012

With the development of social economy and the change of people's lifestyle, the prevalence of metabolic diseases, especially diabetes, is increasing rapidly. According to the statistics of the International Diabetes Federation (IDF) in 2011, the number of adult patients with diabetes and pre-diabetes has reached 366 million and 280 million respectively in the world. It is estimated that by 2030, the number of diabetic patients in the world will reach 552 million. Such a large number of diabetic patients not only consumes a lot of financial resources and resources, but also seriously affects the development of social economy.

disease assessment is an important part of the diagnosis, treatment and comprehensive management of chronic obstructive pulmonary disease (COPD). In recent years, the evaluation of COPD has shown a trend of developing from a single index to a composite index, and the evaluation content is more comprehensive. However, in fact, the severity of airflow obstruction based on the forced expiratory volume in the first second (FEV1) is still the focus of COPD assessment, even the only index. With the deepening of understanding of disease and the further expansion of research, especially the theoretical challenge brought by new COPD treatment, and the need of clinical research (drug trial), besides the disease severity, the evaluation of disease activity has gradually attracted people's attention. At the same time, the indexes that can reflect disease activity, namely the so-called biomarkers, have also become an important direction of COPD research.

With the development of social economy, obesity has become an important social and public health problem that seriously threatens people's health. The World Health Organization (WHO) warns that overweight and obesity are the fifth largest risk of death in the world. At present, the prevalence of obesity-related diseases such as hypertension, cardiovascular and cerebrovascular diseases and diabetes is increasing year by year. It is estimated that the number of deaths of coronary heart disease and stroke in China will reach 800,000 and 3 million each year by 2030 [1].

Objective To explore the protective effects of astragaloside Ⅳ on retinal ganglion cells (RGC) incubated under high glucose.Methods Cultured RGC-5 were divided into 3 groups:control,high glucose and high glucose + astragaloside Ⅳ.The survival rate of cell was measured by CCK-8 kit and flow cytometry.The changes of mitochondrial membrane potential were monitored by confocal laser scanning microscopy while those of RGC-5 mitochondria observed by electron microscopy.Results When the cell survival rate was 100％ in the control group,the survival rate improved after 1 h 5,10,50,100,200 μg/ml astragaloside Ⅳ pretreatment and high-glucose culture.The cell survival rates for 100 mg/L,200 mg/L of astragaloside Ⅳ were 81.6％,80.0％,the difference from the high glucose group (66％) was significant (P ＜ 0.05 ) and 100 mg/L of astragaloside Ⅳ was the best protection concentration.The apoptotic rate for 100 mg/L astragaloside Ⅳ pretreated group of RGC-5 cell was 6.1％.And it could partially inhibit the RGC-5 cell apoptosis caused by high glucose ( 8.2％ ) ( P ＜ 0.05 ).In the high-glucose group,the cells showed marked increases in mitochondrial swelling,especially for cristae. Numerous normal mitochondria were observed in 100 mg/L astragaloside Ⅳ pretreated group.Astragaloside Ⅳ could elevate mitochondrial membrane potential and alleviate mitochondrial swelling.Conclusion Astragaloside Ⅳ can protect RGC from high-glucose induced damage and may benefit the patients with diabetic retinopathy.

Objective To explore the renoprotective effect of Compound Xueshuantong Capsule (XST) on diabetic rat model with nephropathy.Methods Twenty-eight male Sprague Dawley diabetic rats were induced to hyperglycerimia (3 days later,fasting bood glucose ＞ 16.7 mmol/L) by peritoneal injection with streptozotocin (STZ,50 mg/kg). And they were divided into four groups:diabetic nephropathy (vehicle treatment),irbesartan (20 mg · kg-1 · d-1),low-dosage XST (900 mg· kg -1 · d-1) and high-dosage XST (1800 mg · kg-1 · d-1). Seven normal rats were used as control. After a 12-week intervention,urine protein was examined. Pathological morphology was observed by hematoxylin-eosin ( HE),Masson and ( periodic acid Schiff) PAS stains.Blood nitric oxide ( NO),malondialdehyde (MDA)and blood superoxidedismutase (SOD) and urine SOD were detected. And the expression of (matrix metalloproteinase-2) MMP-2 was detected by Western blot in each group.Results The model rats presented with hyperglycemia,polydipsia,hyperphagia,polyuria and hypermicroalbuminuria.The intervention groups showed decreased microalbuminuria and there was no effect on blood glucose or body weight. Glomerular sclerosis and extracellular matrix (ECM) increased in model group and improved in irbesartan and XST groups as judged by HE,Masson and PAS stains.Three intervention groups had no effect on the elevated expression of MMP-2 in diabetic rats.Compared with the model group,the irbesartan,low-dosage and high-dosage XST groups had significantly decreased blood levels of NO ( ( 104.9 ± 11.0) μmol/L vs (41.9 ±9.6) μmol/L and (14.7±1.9) μmol/L,P＜0.05)and MDA ((19.6±1.6 ) nmol/L vs (6.6±0.9) mol/L and (4.5 ± 1.2 )nmol/L,P ＜0.05),increased blood and urine activities of SOD (blood:(222 ±20) ×103 vs (231 ±18) ×103 and (237±24) ×103 U/L,P ＜0.05),urine:(11.8 ±1.1) ×103 vs(23.3 ±2.0) × 103 and (25.7 ± 1.8 ) × 103 U/L).Conclusion Compound Xueshuantong Capsule may decrease proteinuria through its suppression of oxidative stress and not its improvement of ECM metabolism.

Objective To explore the associations of the level of glycated albumin (GA) with coronary artery disease (CAD).Methods A total of 306 patients undergoing coronary angiography (CA) were collected.There were 201 males and 105 females with an age range of 38 - 86 years.CA was the major diagnostic criteria of CAD.Metabolic syndrome was diagnosed according to the Guideline on Prevention & Treatment of Blood Lipid Abnormality in Chinese Adults.Results ( 1 ) CAD was found in 227 patients (74.2％ ).The levels of 2 h postprandial glucose,GA and hemoglobin A1 c in the CAD patients were higher than those in the non-CAD counterparts ( all P ＜ 0.05 ).(2) In the subgroup of normal glucose tolerance ( NGR),the CAD patients had a higher level of GA than the non-CAD patients ( ( 15.0 ± 2.1 ) ％ vs (13.3±1.7)％,P＜0.01).And the level of GA was higher in the patients with 1-vessel ((14.8 ±2.1)％ vs (13.3±1.7)％,P＜0.05) and multi-vessel lesions ((15.1 ±2.1)％ vs (13.3±1.7)％,P ＜ 0.05) than that in the non-CAD counterparts ( all P ＜ 0.05 ). Similar results were obtained in the hyperglycemia subgroup. (3) Logistic regression demonstrated that the level of GA was independently correlated with CAD after adjusting other traditional factors among all subjects,NGR and hyperglycemia subgroup.Conclusions The serum level of GA becomes significantly elevated the CAD patients.And it is an independent risk factor of CAD in both hyperglycemic and NGR patients.

Objective To explore the biological features and clinical efficacies of absorbable plates and screws for rigid internal fixation.Methods From June 2006 to June 2010,201 FIXSORBTM-MX absorbable plates were used in 57 patients,including 41 males and 16 females aged from 11 - 81 years.And 185 plates were used in 53 patients of maxillofacial fracture and 16 plates in 4 undergoing orthognathic operations with rigid internal fixation.Results All wounds healed primarily and there were no major complications.Forty-five cases were followed up for an average period of 12 months (range:3 -36). No obvious adverse effect and absorbable implants rejection were observed.The fracture lines were in the right position in 56 cases.Conclusion As a kind of fine material for internal fixation with strong elasticity and strength,absorbable plate shall be widely used clinically.

Objective To explore the relationship between psychological status of depression and anxiety and asthma control.Methods A total of 144 definite physician-diagnosed asthmatics at First Affiliated Hospital,Zhengzhou University from March 2011 to March 2012 were evaluated with the self-rating anxiety scale (SAS) and self-rating depressive scale (SDS).And 85 healthy subjects were selected as the controls and evaluated by the asthma control test (ACT).The incidence of anxiety and depression and scores of SAS and SDS was compared between the asthma group and health controls.The relationship was analyzed between the scores of ACT and SAS or SDS respectively. The subjects were divided into anxiety,non-anxiety,depression and non-depression groups according to the scores of SAS and SDS. The inter-group differences in ACT scores were compared.According to the asthma control test scale,the asthmatics were divided into the control,non-control and partial control groups.And the inter-group differences in the scores of SAS and SDS were compared.Results Anxiety(20.1％ ) and depression (35.4％) was more common in asthmatics than healthy controls (both P ＜ 0.01 ).Scores of SAS (40.8 ± 8.1 ) and SDS (44.9 ± 9.1 ) in physician-diagnosed asthmatics were higher than the controls and general community ( both P ＜ 0.01 ).Scores of ACT in non-anxiety group ( 18.6 ± 4.4 ) were higher than those in anxiety group,higher in non-depression group ( 18.5 ± 4.6 ) than depression group ( both P ＜ 0.01 ).Scores of SAS ( control group:33.6 ± 4.3,non-control group:43.7 ± 7.8 and partial control group:37.6 ± 7.1 ) and SDS ( control group:35.1 ± 6.7,non-control group:47.2 ± 9.7 and partial control group:43.3 ± 6.6 ) in physician-diagnosed asthmatics varied among different control levels ( both P ＜ 0.01 ).The anxiety,depression scores and ACT scores were negatively correlated in asthmatics (r =0.52 and 0.23,both P ＜0.01 ).With the rising scores of SAS and SDS,ACT score decreases ( b =- 0.29 and - 0.12,both P ＜ 0.01 ).Conclusions Anxiety and depression moods are more common in asthmatics than healthy controls.The worse asthma control,the more severity of anxiety and depression,and vice versa.

Objective To explore the effects of precoated RetroNectin on the proliferation and cytotoxicity of natural killer cells(NK) from acute leukemia (AL).Methods Mononuclear cells (MNCs)were isolated from peripheral blood of complete remission AL patients.The MNCs were cultured in vitro precoated with 50 μg/ml RetroNectin ( group Ⅰ ),25 μg/ml RetroNectin (group Ⅱ ) and by the raditional method (control group) to generate NK.The changes of growth rate,phenotypic characterization,secretion of cytokines of NK,cell cycle,apoptosis and cytotoxicity of NK were determined.Results The amplification of NK in group Ⅰ ( (51 ±9) × 106 ) and Ⅱ ( (79 ± 16) × 106 ) were higher than that in control group( (37 ±11 ) × 106 ) ( both P ＜ 0.05 ),and the amplification of NK in group Ⅱ was higher than that in group Ⅰ ( P ＜0.05).There were no differences among three groups with regards to the phenotypic characterization of CD3- CD56 +.The secretions of interleukin 2,interleukin 12,tumor necrosis factor alpha and interferon gamma in group Ⅰ and Ⅱ were higher than that in control group( all P ＜ 0.05 ).The expression of CD25 positive cells in groups Ⅰ (38.2％ ±4.1％ ) and Ⅱ (37.5％ ±5.1％ ) were higher than that in control group(24.2％ ±5.8％ ) (both P ＜0.05).The expression of NKG2D positive cells in groups Ⅰ (81.6％ ±17.9％ ) and Ⅱ (85.7％ ± 20.1％ ) were higher than that in control group (63.6％ ± 21.9％ ) ( both P ＜0.05 ).The percentages of G1 stage cells in groups Ⅰ (50％ ± 10％ ) and Ⅱ (49％ ± 11％ ) were lower than that in control group(71％ ± 15％ ) while the percentages of S stage cells in groups Ⅰ (36％ ± 14％ ) and Ⅱ( 37 ％ ± 8 ％ ) were higher than that in control group ( 19％ ± 10％ ) ( all P ＜ 0.05 ).But no difference existed between two groups (all P ＞ 0.05).The expression of cell cycle regulatory genes p21 and p27 were reduced in groups Ⅰ and Ⅱ.The percentages of apoptotic cells in groups Ⅰ ( 10.7％ ± 2.1％ ) and Ⅱ (9.4％ ±3.1％ )were lower than that in control group(29.6％ ± 10.3％ ) (both P ＜0.05).The cytotoxicity to AL cells in groups Ⅰ (82％ ±21％ ) and Ⅱ (80％ ± 18％ )were higher than that in control group (61％ ± 14％ )(both P ＜ 0.05 ) at the E/T scope 20 ∶ 1. But no difference existed between two groups ( all P ＞ 0.05 ).Conclusion The proliferation and cytotoxicity of NK cells may be boosted by precoated RetroNectin.

Objective To explore the long-term effects of permanent pacemaker implantation (PPI) on tricuspid valve regurgitation (TR) in Chinese patients so as to determine the incidence and related factors,evaluate its effects on heart structure and function and ascertain the exact mechanism of TR after PPI.Methods A total of 430 patients undergoing permanent pacemaker replacement at our hospital between January 2000 and June 2011 were recruited.The patients with isolated atrial lead implantation procedures,significant heart valve disease or chronic obstructive pulmonary disease were excluded. The data of 108 patients who had Doppler echocardiograms performed before the first pacemaker implantation procedure and this pacemaker replacement procedure were obtained and retrospectively analyzed. According to the post-implant grade of TR,the patients were divided into two groups:normal tricuspid ( n =79 ) and abnormal tricuspid(n =29 ). Their clinical characteristics and echocardiographic data between two groups were analyzed and compared.Results The mean follow-up time (from the first pacemaker implantation) was ( 13 ± 6) years( range:4 -34 ).Among 108 patients with initially normal tricuspid post-implant,29 patients (26.9％ ) developed significant TR during the follow-up.In comparison to those in normal tricuspid group,the patients in abnormal tricuspid group had a longer time from the first pacemaker implantation ( ( 16 ± 7 )vs (12±5) years,P=0.003),more transtricuspid leads (1.31 ±0.66 vs 1.10 ±0.30,P=0.026),larger right atrial size ( (38 ±7) vs (35 ±4) mm,P =0.028) and higher prevalence of mild TR and mitral valve regurgitation (MR) pre-implantation(TR:21％ vs 4％,P =0.015,MR:28％ vs 5％,P=0.003).The size of right atrium,right ventricle and left atrium in abnormal tricuspid group were more than those in normal tricuspid group.The prevalence of significant MR post-implantation in abnormal tricuspid group was higher than that in normal tricuspid group.The ejection fraction in abnormal tricuspid group was lower than that in normal tricuspid group during the follow-up.Conclusions Abnormal TR after PPI during a long-term follow-up is quite common. The related factors include the time interval from the first pacemaker implantation,number of transtricuspid lead,right atrial size,mild TR and MR pre-implantation.

Objective To evaluate the rationality of different radical operative modalities for proximal gastric cancer. Methods A total of 366 cases of proximal gastric cancer undergoing radical dissection were screened from data base. According to the operative modalities,they were divided into proximal gastrectomy group (PG) ( n =77) and total gastrectomy group (TG) ( n =289 ).Through the comparisons of clinical pathologic features,surgical profiles,postoperative complications,postoperative quality-of-life and prognosis in two groups,the rationality of different operative modalities was evaluated.Results No significant differences existed in age,gender or carcinombryonic antigen (CEA) value between two groups ( all P ＞ 0.05 ). The rates of tumor diameter ≥ 5 cm,organic infiltration,lymph nodes metastasis,distal organs metastasis,infiltrative type,poorly differentiated tumor in PG and TG groups were 15.6％(12/77) vs 49.8％ (144/289),16.9％ (13/77) vs 37.7％ (109/289),67.5％ (52/77) vs 79.9％ (231/289),3.9％ (3/77) vs 11.4％ (33/289),45.5％ (35/77) vs 68.9％ ( 199/289),32.5％(25/77) vs 57.8％ ( 167/289 ) respectively ( all P ＜ 0.05 ).Operative duration,volume of blood transfusion,number of dissected lymph nodes and positive lymph nodes,rate of combined organic resection and complications in groups of PG and TG were (256 ± 83 ) vs (298 ± 86) main,0 vs 400 ml,15 ± 12 vs 26 ±15,0 vs 3,15.6％ (12/77) vs 43.2％ (125/289),14.3％ (11/77) vs 7.6％ (22/289) respectively (all P ＜ 0.05 ). In two groups,the evaluating indices of posteroperative quality-of-life showed no significant differences ( P ＞ 0.05 ).In two groups,the median survival time of the cases with tumor diameter ＜ 5 cm,no-organic infiltration,no-peri-tumor lymph nodes metastasis,no-distal organic metastasis had no significant difference ( all P ＞ 0.05). However,in groups of PG and TG,the median survival time of the cases with tumor diameter ≥5 cm,organic infiltration,peri-tumor lymph nodes metastasis and distal organic metastasis was 15.0 months vs 29.0 months,15.0 months vs 30.0 months,34.0 months vs 45.0 months,4.0 months vs 18.0 months respectively( all P ＜ 0.05).Conclusion As compared with radical proximal gastrectomy,radical total gastrectomy improves significantly the prognosis of patients of proximal gastric cancer with organic infiltration,peri-tumor lymph nodes metastasis,distal organic metastasis and tumor diameter≥5 cm.

Objective To explore the effects of 7-day quadruple regimen as the first-line therapy strategy for Helicobacter pylori ( H.pylori) infection and compare the eradication rate of ilaprazole versus esoprazole-based regimen.Methods A total of 440 patients with H.pylori infection,who had never received H.pylori eradication treatment,were enrolled from 10 domestic hospitals from October 2010 to July 2011.Diagnosed as chronic gastritis or duodenal ulcer according to their endoscopic examination results,they were randomized into ilaprazole and (or) esoprazole-based bismuth-containing quadruple regimen group with amoxicillin and clarithromycin (n =110 each). After a 7-day eradication treatment,all patients with duodenal ulcer received PPI (ilaprazole and (or) esoprazole) treatment for 14 days and 13C urea breath test was performed at least 28 days after the end of therapy. The patients with failed eradication treatment underwent endoscopy examination and biopsy. H.pylori culture and detection of antibiotic-resistant genes were also performed.Results In gastritis patients,the eradication rate (per-protocol,PP value ) were 78.2％ (79/101) and 82.0％ (82/100) in ilaprazole and esoprazole groups ( P =0.50) while the ( intention-to-treat) ITT value of eradication rate were 71.8％ (79/110)and 74.5％ (82/110)in ilaprazole and esoprazole groups respectively (P =0.65).And there was no statistical difference (P ＞ 0.05 ).In duodenal patients,the eradication rate (PP) were 92.1％ (93/101) and 91.4％ ( 96/105 ) in ilaprazole and esoprazole group (P=0.86)while the ITT value of eradication rate were 84.5％ (93/110)and 87.3％ (96/110)in ilaprazole and esoprazole groups respectively (P =0.56).And no significant difference existed between two groups in gastritis and duodenal ulcer patients ( P ＞ 0.05 ). In total,the eradication rate was 80.1％ ( 161/201 ) (PP) and 73.2％ (161/220) (ITT),91.7％ (189/206) (PP) and 85.9％ (189/220) (ITT)in chronic gastritis and duodenal ulcer patients respectively.The symptomatic improvements of stomachache,burning,belching and nausea remained almost unchanged.No severe side effect was observed.The point mutations for clarithromycin resistance were detected in all 53 H.pylori strains ( 100％ ) isolated from the patients with failed eradication treatment.Conclusions The eradication rate of PPI based bismuth-containing quadruple regimen as the first-line treatment is satisfactory in chronic gastritis and duodenal ulcer patients.No significant difference exists between the effects of ilaprazole and esoprazole-based groups.And the treatment failure may be attributed mainly to the clarithromycin resistance of H.pylori.

Objective To investigate the protective effects of rosiglitazone intervention on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) in rats and the possible mechanisms.Methods Thirty-two Sprague-Dawley rats were randomly divided into 4 groups:control group with a subcutaneous injection of normal saline.PAH group,high-dose and low-dose rosiglitazone intervention groups all with a subcutaneous injection of MCT and then gastric infusion of normal saline ( 1.5 ml/d),rosiglitazone (5,2.5 mg· kg-1 · d-1).At Day 21,the mean pulmonary arterial pressure (mPAP) was detected by right heart catheter. Then rats were sacrificed and their lungs extracted. Perivascular inflammation was scored with the subjective scale of 0 to 4.The tunica media thickness percentage of small pulmonary arteries ( WT％ ) of rats was calculated.Interleukin 6 ( IL-6),tumor necrosis factor alpha ( TNF-α) and monocyte chemotactic protein 1 (MCP-1) of lung tissue were detected by enzyme-linked immunosorbent assay (ELISA).Results Compared with the PAH group ( ( 37 ± 5 ) mm Hg ( 1 mm Hg =0.133 kPa),45.5％ ±5.5％),the mPAP and WT％ of the high-dose ((27 ±4) mm Hg,13.1％ ±3.9％ ) and low-dose ( ( 28 ± 4 ) mm Hg, 16.7％ ± 1.7％ ) rosiglitazone intervention group were significantly lower ( P ＜ 0.01 ),but were still higher than those of the control group ( ( 17 ± 3 ) mm Hg,8.9％ ± 2.3％ ) ( P ＜ 0.05 or P ＜ 0.01 ).The perivascular inflammation score and levels of IL-6,TNF-α,MCP-1 of high-dose and low-dose rosiglitazone intervention groups were significantly lower than those of the PAH group (P ＜0.01 ).Compared with the low-dose rosiglitazone intervention group,all the above indices of the high-dose rosiglitazone intervention group appeared much lower (P ＞ 0.05 ).Conclusion The protective effects of rosiglitazone against MCT-induced PH are correlated with drug dose and may be due to the inhibition of inflammation.

Objective To explore the regulation of p14ARF expression and induction of cell apoptosis with the mutant and wild-type c-myc genes in a p53-independent pathway of signal transduction.Methods The mutant and wild-type c-myc genes were transfected by lentivirus into HCC1937 to form the stable over-expression cell lines.Uninfected cells and lentivirus-infected ones carrying no c-myc gene acted as blank and infection controls respectively. And c-myc and p14ARF mRNA and protein,proliferation and apoptosis in HCC1937 with mutant and Mild-type c-myc were detected by reverse transcription (RT)-PCR,Western blotting,thiazolyl blue tetrazolium bromide (MTT) and terminal deoxynucleotidyl transferase mediated X-dUTP nick end labeling (TUNEL) respectively.Results After the lentivirus-mediated gene transfer,c-myc mRNA and protein expression increased in the mutant and wild-type groups.p14ARF mRNA and protein increased in the wild-type group and the mutant group and there were significant difference between them with blank and infection controls (mutant groups:0.560 ± 0.010,0.154 ± 0.011,wild-type groups:0.651 ±0.010,0.382 ± 0.013,both P ＜ 0.05 ).The group of mutant and wild-type c-myc could promote the proliferation of cell growth. And c-myc was more effective to induce apoptosis in the wild-type group as compared with the mutant group (7.1％ ± 0.7％ vs 3.2％ ± 0.4％,P ＜ 0.05 ).Conclusions In a p53-independent pathway,the over-expression of wild-type c-myc obviously up-regulates the expression of p14ARF.And cell apoptosis may be induced through the regulation of p14ARF-related gene,keep balance of proliferative promotion and apoptosis induction. When there is a loss-of-function of mutant c-myc,tumorigenicity increases via a disturbed balance of proliferative promotion and apoptosis induction.

Objective To observe the effects of mesenchymal stem cells (MSC) modified by human receptor activity-modifying protein 1 (hRAMP1) on restenosis and cardiac function post-myocardial infarction (MI) and explore the therapeutic safety for gene modification of MSC.Methods The double-injury rabbit model with MI reperfusion and sacculus damaged atherosclerotic carotid were established according to the previous study. MSC were transfected with adenovirus vector with enhanced green fluorescence protein (EGFP) and then introduced into rabbit model.The animals were randomly divided into Ad-EGFP-hRAMP1-MSC transfection group ( hRAMP1 -MSC group,n =24) and Ad-EGFP-MSC transfection group (MSC group,n =24), and PBS transfection group (C group, n =24 ). At Day 28 post-transplantation,the injured carotid arteries and infarction myocardium were harvested to detect the expression of EGFP-positive MSC and assess organization morphology by hematoxylin and eosin,triphenyltetrazolium chloride or immunohistochemical stains and heart function by echocardiography.Results On flow cytometry,most cells expressed CD29 and CD90 while few ones expressed CD45. MSC with EGFP and a continuous expression of CD31 were found in intima of damaged carotid of both hRAMP1-MSC and MSC,but the expression of EGFP was not found in the control group.At Day 28 post-transplantation,the improvement of heart function and the decrease of infarct size were found in the hRAMP1-MSC and MSC groups compared with that in the control group( EF:60.6％ ± 1.5％,50.8％ ± 3.2％ vs 38.2％ ± 2.0％,infarct size:20.7％ ± 1.4％,33.2％ ±3.7％ vs 35.6％ ±2.7％,all P ＜0.05),especially much higher in hRAMP1-MSC group.At Day 28 post-transplantation,the area of intima hyperplasia and the rate of neointima and media in the hRAMP1-MSC group were lower than those in the MSC and C groups(0.15 ±0.05 and 0.33 ±0.08 vs 0.77 ±0.11,0.24 ±0.07 and 0.51 ±0.11 vs 1.09 ±0.23,all P ＜0.05 ).Also the expression of α-SMA was found in the hyperplasia intima.The expression of proliferating cell nuclear antigen significantly decreased in the hRAMP1-MSC group than those of the MSC and control groups ( 0.120 ± 0.028 vs 0.366 ±0.013 and 0.627 ± 0.049,both P ＜ 0.05 ).And it was much lower in the MSC group than that in the control group.Conclusions Compared with MSC alone,hRAMP1-modified MSC have the potency not only of more improvement on cardiac function and the recovery of damaged endothelium,but also of significant inhibition of the proliferation of vascular smooth muscle cells.The recombinant hRAMP1 adenovirus vectors do not affect the differentiation potential MSC into endothelial cells.

A 51-year-old male was admitted to the hospital on June 27, 2011 due to intermittent fever for more than 2 months and bone pain for more than 1 month. More than 2 months before admission, the patient developed fever without obvious trigger, with the highest body temperature of 38.3℃. The fever mostly appeared in the afternoon and resolved spontaneously at night, accompanied by night sweats and no other symptoms. More than one month before admission, I started to feel pain in lumbosacral region and bilateral lateral thigh, which worsened when I moved. Twenty days before admission, the patient developed numbness in the lower lip and difficulty in speaking.

A series of immunohistochemical and electron microscopic studies confirmed that the tumor originated from vascular endothelial cells. In 1983, 20 cases were analyzed and reported and called "bronchioloalveolar hemangioma". In 1982, Weiss and Enzinger [2] first proposed the name "epithelioid hemangioendothelioma". Epithelioid hemangioendothelioma can occur simultaneously or sequentially in many places, such as skin and soft tissues, bone, liver and lung, among which lung involvement is relatively rare.

primary myelofibrosis (PMF) is a chronic stem cell clonal proliferation disease characterized by cytopenia, dysplasia of megakaryocytes, reactive myelofibrosis, significant splenomegaly, extramedullary hematopoiesis and the appearance of blasts in peripheral blood [1-2]. PMF mainly occurs in the elderly population with a median age of diagnosis of 65 years [3]. It is a subtype of myeloproliferative tumors with low incidence but poor prognosis, with an incidence rate of about 0.5/100 000 and a median survival time of only 3.5 to 5.5 years [4]. The main causes of death include heart failure, infection, hemolysis and conversion to acute leukemia, and about 10% to 15% of patients eventually convert to acute leukemia [5].

Objective To establish the technique and methodology of appendectomy through transvaginal natural orifice transluminal endoscopic surgery (NOTES)under laparoscopy.Methods Three cases of chronic appendicitis were selected to receive laparoscopic transvaginal resection of appendixes with concurrent vaginal hysterectomies for uterine fibroids at Shengjing Hospital of China Medical University from November 2010 to November 2011.The procedure was performed by a multidisciplinary team composed of surgeons and gynecologists.The clinical data such as operative duration,bleeding volume,morbidity and stay duration were collected and analyzed.Results Appendectomies were performed with the working laparoscopic tools inserted through vagina. The en bloc resection was removed transvaginally through laparoscope.It took 34,23 and 26 minutes respectively to complete the appendectomies.And the blood loss volume was minimal.There were no postoperative complications.And the patients were discharged scar-free after 3 days.Conclusions Transvaginal appendectomy is both feasible and safe when performed by a multidisciplinary team.As an emerging innovation,natural orifice transluminal endoscopic surgery is miniinvasive,better tolerated and more respectful of esthetics.

A 19-month-old male was seen on March 12, 2011 due to abdominal swelling for half a year. He had no abdominal pain, hematuria, weight loss and other symptoms. Physical examination showed a solid mass in the right upper abdomen, about 8 cm ×7 cm in size, with clear boundary, hard texture, fixed, and no tenderness. After admission, the relevant examinations were completed, and 24 hours urine 3-methyl-4 hydroxypicrylic acid (VMA) 0.85 mg, alpha-fetoprotein 3.98 μ g/L and carcinoembryonic antigen 1.74 μ g/L.