Volume 95  ·  Issue 14  ·  2015

Standardized training of residents is an integral part of clinical medical education. Without standardized training, it is impossible to generally create qualified clinicians. In 2013, 64 years after the founding of the People's Republic of China, China finally officially launched the establishment of a national standardized training system for residents, which provided a fundamental institutional guarantee for cultivating qualified and excellent clinicians.

Since the 21st century, human beings have made great breakthroughs in the basic research of molecules, genes, proteins and other omics. Due to the integration of clinical and scientific research, the connection of microscopic to macroscopic, and the in-depth development of translational medicine, there have been major breakthroughs in cutting-edge technologies such as stem cells, brain science, synthetic biology, ultra-high-resolution in vivo imaging, nano-resolution observation of molecule positioning in cells, and molecular machines, which have achieved epoch-making changes in disease diagnosis^[1]。 In particular, the national economic take-off, the deepening of policies for benefiting the people, the formation of the concept of big health, and the development of evidence-based medicine and translational medicine have shown new ideas, new ideas and new models for the construction of hospital laboratory departments, and provided a rare opportunity for the rapid development of laboratory medicine in China. Looking back on the history of 30 years' development, summarizing experience and analyzing problems is of great significance for speeding up the pace of discipline construction, improving management ability and academic level.

Diabetes mellitus is a clinical syndrome caused by the combination of genetic and environmental factors, with disorder of glucose metabolism and elevated blood glucose as the main manifestations. Absolute or relative deficiency of insulin is the main pathophysiological feature of diabetes mellitus. Related biomarkers that can predict or directly reflect islet beta cell damage will contribute to early intervention in diabetic patients, thereby improving quality of life and prolonging life span. In recent years, international scholars have conducted in-depth research on new indexes that directly reflect pancreatic islet β cell damage on the basis of traditional indexes, and made some progress. Biomarkers for evaluating islet beta cell damage are described below.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a high incidence in young women of reproductive age. With the in-depth research on the pathogenesis of SLE and the progress of treatment, the long-term survival of patients has been significantly improved. At present, the 20-year survival rate of SLE patients has reached more than 60%. Therefore, with the prolongation of patients' survival time, fertility has become a clinical problem that clinicians must face. However, due to the characteristics of SLE disease itself, the interaction between hormone levels and changes in immune function during pregnancy occurs, which makes the pregnancy of SLE patients a pathological process. Although the pregnancy outcome of these patients has improved significantly with the improvement of SLE treatment, and the fetal loss rate has dropped from 43% in the 20th century to 17%, the incidence of preterm birth, stillbirth, intrauterine growth retardation, preeclampsia and eclampsia in SLE patients is much higher than that in normal people^[1,2]。 Therefore, strengthening and standardizing the management of this high-risk group and improving the maternal and infant survival rate are not only the actual needs of the majority of SLE patients, but also in line with the purpose of building a harmonious society in China, so it is very necessary. However, there is no large-scale prospective clinical study of pregnancy in SLE patients in China, only some retrospective clinical observations and summaries. Therefore, on the basis of referring to foreign guidelines and recommendations on SLE pregnancy and combining with the actual situation in China, we wrote and published the Perinatal Management Recommendations of Chinese Patients with Systemic Lupus Erythematosus (hereinafter referred to as the Recommendations)^[3]The aim is to strengthen and standardize the pregnancy management of this high-risk group, and through multidisciplinary collaboration, reduce the pregnancy complications of these patients, so that they can successfully complete the pregnancy process, conceive healthy fetuses and enjoy family happiness.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, which is mainly affected by women in reproductive age. With the improvement of SLE diagnosis and treatment, the survival rate of SLE patients has been greatly improved in the past 20 years. According to statistics, the 20-year survival rate of SLE patients has reached more than 60%. Because the fertility itself of female SLE patients does not differ from that of non-SLE women of the same age, marriage and childbirth have become an important clinical problem as the survival time of these patients increases. However, due to the role of sex hormones in the pathogenesis of SLE, patients with SLE will relapse or aggravate during pregnancy. About 1/3 of patients finally terminate their pregnancy by cesarean section, and nearly 1/3 of patients have premature delivery. More than 20% of patients develop eclampsia, and nearly 30% of SLE patients have intrauterine growth retardation (IUGR) in their fetuses.^[1]。 Therefore, the pregnancy of SLE patients is itself a high-risk pregnancy. In addition, more than half of SLE patients will have recurrence or aggravation during pregnancy, endangering the safety of the fetus and pregnant women. The maternal and infant mortality rate of pregnant patients with SLE in China is as high as 8.9%^[2]。 Therefore, it is very important and necessary to standardize the perinatal management of SLE patients to improve the pregnancy success rate and reduce the maternal and infant mortality rate of SLE patients. China Systemic Lupus Erythematosus Research Collaborative Group, based on the relevant research data published internationally and management recommendations, combined with the actual situation in China, formulated this recommendation (Table 1), aiming to strengthen the pregnancy management of SLE patients and improve the pregnancy success rate and maternal and infant survival rate of SLE patients in China.

To explore the relationship between histone acetylation modification in spleen CD4⁺ T cells and diabetic nephropathy.

Non-obese diabetic (NOD) mice were randomly divided into 4 groups and random blood glucose at 12, 18, 24 and 30 weeks were detected. Urinary albumin and creatinine were detected by enzyme-linked immunosorbent assay (ELISA). The global acetylation levels of H3 and H4 in CD4⁺ T cells were measured by H3/H4 acetylation kit. The relevant mRNA expression level of histone acetylation modification enzymes was detected by real-time quantitative polymerase chain reaction (PCR) and the altered expression genes verified by Western blot.

Compared with mice from 12 weeks, there were significant increases in blood glucose levels and urinary albumin/creatinine ratio (ACR) from 24 and 30 weeks (glucose: (18.1±6.3) and (20.7±7.5) vs (7.2±3.1)mmol/L, ACR: (4.04±1.54) and (8.11±1.77) vs (2.12±0.56)mg/g). Conversely, the global acetylation levels of H3 (0.068±0.023 and 0.043±0.017 vs 0.127±0.036) and H4 (0.058±0.022 and 0.041±0.019 vs 0.082±0.032) in spleen CD4⁺ T cells from 24 and 30 weeks were obviously lower. The mRNA levels of such histone acetylases as P300(15.53±6.31 and 13.76±3.62 vs 22.94±7.40) and P300/CBP-associated factor(PCAF) (3.21±0.81 and 2.74±0.36 vs 5.31±0.73) declined while the protein and mRNA of histone deacetylase 5 (HDAC5) significantly increased from 24 and 30 weeks. All the above differences were statistically significant(P<0.05). The levels of H3(r=-0.590, P=0.043) and H4 (r=-0.702, P=0.011)were negatively correlated with urinary ACR while HDAC5 level was positively correlated with urinary ACR from 24 and 30 weeks (r=0.673, P=0.016).

With aging and progression of nephropathy in NOD mice, the global acetylation levels of H3 and H4 decrease while the expression level of HDAC5 increases in spleen CD4⁺ T cell. And altered HDAC5 expression in spleen CD4⁺ T cells is closely correlated with kidney damage in NOD mice.

To evaluate the effects of a new body shape index (ABSI) on the prevalence of diabetes mellitus (DM) and Fasting blood-glucose (FBG) in elders in Chengdu.

In May 2007, a total of 685 subjects were recruited by random sampling, with an average age of (63.3±10.2) years. All subjects received standardized questionnaires, physical examinations and laboratory tests for analyzing the relationship between ABSI with the prevalence of FBG and DM.

The overall trend of FBG increased with rising ABSI (P<0.001). But the impact of ABSI on the prevalence trend of DM was not obvious(P=0.334). According to logistic regression analysis adjusting for confounders, ABSI was not a risk factor of DM. Relative to the lowest quartile of ABSI, the odds ratio of DM prevalence was 1.093(95%CI: 0.617-1.937, P=0.761), 0.844(95%CI: 0.469-1.517, P=0.570) and 0.684(95%CI: 0.373-1.256, P=0.221)at the second, third and fourth quartiles respectively.

ABSI is not associated with the prevalence of DM in middle-aged and elderly people in Chengdu. Further cohort study are required for clarifying the ethnic difference of ABSI.

To explore the characteristics of glycemic variability in normal glucose tolerance (NGT) subjects with metabolic syndrome (MetS).

A total of 40 NGT subjects diagnosed by oral glucose tolerance test (OGTT) were divided into two groups of metabolic syndrome (MetS) or without MetS (Non-MetS) according to the National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATPⅢ) criteria. Fasting blood glucose (FBG), OGTT 2 h blood glucose (2 h BG), hemoglobin A1c (HbA1c) and glycemic variability were assessed. Glycemic variability was assessed by calculating standard deviation of MBG (SDBG), mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE) and means of daily differences (MODD) from the 72 h data of continuous glucose monitoring system (CGMS) in real life. The time of diurnal glycemic variability was also calculated.

No significant inter-group difference existed in FBG, 2 h BG or HbA1c. Glycemic variability was higher in MetS than that in Non-MetS group. But only MAGE (2.12±0.92 vs 1.50±0.68 mmol/L, P=0.02) showed significant inter-group difference. Logistic regression analysis revealed that MAGE was significantly correlated with MetS (OR=2.74, 95% CI: 1.08-6.97, P=0.03) and independently from FBG, PBG, HbA1c and other glycemic variability indices.

Glycemic variability increases in NGT subjects with MetS. And MAGE may better describe the population′s glucose metabolism.

To observe the role of autophagy in maintaining diabetic neuropathic pain in rats model.

A total of 44 male Sprague-Dawley rats were randomly divided into diabetic neuropathic (n=36) and normal control (n=8) groups. Diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ) (60 mg/kg body weight, i. p) freshly dissolved in citrate buffer (pH=4.5). For assessing the presence of mechanical hyperalgesia in diabetic rats, mechanical paw-withdrawal threshold (MWT) in response to punctuate mechanical stimuli was measured. At Week 4 post-injection, the rats with mechanical pain threshold decreasing over 50% as compared to baseline were designated as diabetic neuropathic pain rats. They were randomly divided into three groups of neuropathic pain (DP), neuropathic pain plus rapamycin (DR) and neuropathic pain plus 3-methyladenine (3-MA) (DA). The DR group received an intraperitoneal injection of rapamycin (1 mg/kg body weight) for Day 1 to Day 14 after grouping. At the same timepoint, the DA group had an intraperitoneal injection of 3-MA (2 mg/kg body weight) and the other group phosphate buffered saline (PBS) (1 ml/kg body weight). MWT was measured at week 1, 2, 3, 4 after STZ injection and at day 1, 3, 5, 7, 9, 14 after rapamycin, 3-MA or PBS injections. Spinal cord tissues were used to examine the expression of LC3, Beclin-1 and P62 protein by Western blot at Day 14 after medication.

The mechanical threshold of group DR decreased further from Day 3 to Day 14 after rapamycin injection compared to baseline [(4.8±0.8), (4.3±0.7), (4.1±0.6), (3.6±0.5), (3.3±0.6) vs(5.3±0.9)g, P<0.05]. The mechanical threshold of group DA began to increase from Day 5 to Day 14 after 3-MA injection [(7.0±0.8), (7.7±1.0), (9.1±0.9), (9.6±1.1) vs (5.3±0.6)g,P<0.05]. The expressions of LC3-II and Beclin-1 protein in spinal cord of rapamycin-treated rats was significantly higher than those of non-supplemented diabetics (1.32±0.12 vs 1.02±0.11; 1.03±0.08 vs 0.80±0.06,P<0.05). Otherwise the expressions of these protein in spinal cord of 3-MA-treated rats were significantly lower than those of non-supplemented diabetics (0.70±0.09 vs 1.02±0.11; 0.55±0.05 vs 0.80±0.06,P<0.05).

Up-regulated autophagy in spinal cord partially contributes to the maintenance of diabetic neuropathic pain.

To explore the expression of pendrin in sinonasal mucosal tissue of patients with chronic rhinosinusitis (CRS) and examine its relationship with mucin5AC (MUC5AC).

Thirty mucosal tissue (located on anterior wall of maxillary sinus ostium and close to uncinate process) of patients with CRS with or without nasal polyps and 10 normal sinonasal mucosal tissue located at the same sites as CRS were collected. Histological changes of sinonasal mucosa were examined by hematoxylin and eosin (HE) staining. The expression of total mucins was evaluated by periodic acid Schiff staining (PAS). And the expressions of pendrin and MUC5AC in sinonasal mucosa were determined by immunohistochemistry (IHC), quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot.

The tissue samples demonstrated mucosal thickening, goblet cell hyperplasia and metaplasia, epithelial cilia partial deletion, glandular hyperplasia and a dense infiltration of inflammatory cells in CRS with or without nasal polyps. IHC revealed that positive pendrin was expressed dominantly at apical membrane of epithelial cells and sparsely in submucosal glandular cells, there was a positive expression rate of CRS with nasal polyps and CRS without nasal polyps; MUC5AC was expressed abundantly in goblet cells and pseudostratified ciliated columnar epithelium cells and weakly in submucosal glandular cells in CRS. There were significant increases in positive expression rate of total mucins production, pendrin and MUC5AC in patients of CRS with nasal polyps or without nasal polyps than those in control (86.7% and 80.0% vs 20.0%, 73.3% and 70.0% vs 10.0%, 83.3% and 76.7% vs 20.0%, all P<0.05); the relative expression levels of mRNA and protein expression of pendrin were significantly greater in patients of CRS with or without nasal polyps than those in controls (1.685±0.111 and 1.537±0.262 vs 1.012±0.167, 2.066±0.188 and 1.996±0.153 vs 1.000±0.169, allP<0.05). The relative expression levels of mRNA expression of MUC5AC were significantly greater in patients of CRS with or without nasal polyps than in controls (1.861±0.718 and 1.562±0.428 vs 1.004±0.094,P<0.05). And the expression level of pendrin mRNA was positively correlated with that of MUC5AC mRNA in patients with CRS (r=0.670, P=0.006 and r=0.713, P=0.003).

An up-regulation of pendrin is correlated with an over-expression of MUC5AC in patients with CRS. And pendrin is an important cause of mucus hypersecretion in CRS.

This study sought to investigate the impact of left atrium size on left atrial (LA) thrombus in patients with non-valvular persistent atrial fibrillation (AF).

In a prospectively established database, patients with AF underwent transesophageal echocardiography prior to AF ablation were screened from January 2007 to June 2010. Exclusive criteria included paroxysmal AF, vavular AF, deep vein thrombus, pulmonary embolism, on warfarin, redo procedure. Of 1 524 patients, 367 patients (male 267, female 100) with age 26-89 (mean 56±11 ) were enrolled. The patients were divided into LA thrombus group and non-thrombus group. Receptor-operating curves were used to test the value of CHA2DS2Vasc score and LA diameter predicting LA thrombus. Logistic analysis were used to find the independent predictor of LA thrombus.

Thirty-two (8.7%) patients had LA thrombus. The LA diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter were significantly larger in thrombus group than non-thrombus group. Left ventricular ejection fraction was significantly lower in thrombus group than non-thrombus group. CHA2DS2Vasc score did not differ between the two groups. The area under the receptor-operating curve for LA diameter predicting LA thrombus was 0.656(0.563-0.750), the best cut-off point was 42.5 mm. The incidence of LA thrombus was significantly higher in patients with LA diameter ≥42.5 mm than those with LA <42.5 mm (14.0% vs. 5.1%, χ ²=8.888, P=0.003 ). In univariate analysis, LA diameter ≥42.5 mm increased the risk of LA thrombus with odds ratio 3.05 (95% confidence interval 1.42-6.53, P=0.004. The sensitivity and specificity of LA diameter ≥42.5 mm in predicting LA thrombus were 67.7% and 61.5%, respectively. In multivariate analysis, after adjustment of CHA2DS2Vasc score, left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular ejection fraction, LA diameter ≥42.5 mm was an independent risk factor of LA thrombus (odds ratio 2.77, 95% confidence interval 1.17-6.57, P=0.021).

LA enlargement is an independent risk factor of LA thrombus in patients with non-vavular persistent AF.

To evaluate the prognostic factors of postoperative stroke in general and orthopedic surgeries using a nested case-control design.

The retrieval of information was performed from the medical records database in the Peking University Third Hospital. A total of 596 records with stroke diagnosis from January 2009 to December 2011 were recruited as the study cases, among which 29 cases were diagnosed with stroke occurred postoperatively. 174 cases with similar surgical types, date of operation and anesthesia technique were explored as control group according to the principle of the nested case-control design. The data were analyzed using Logistic regression model.

Univariate analysis showed that age, hypertension, diabetes, stroke or TIA history, non-atrial arrhythmias during surgery were prognostic factors for postoperative stroke. Logistic regression analysis showed that patients with stroke or TIA history, atrial fibrillation and age were independent prognostic factors for postoperative stroke, stroke or TIA history were the most significant factor associated with postoperative stroke (OR=13.01), followed by atrial fibrillation (OR=7.77) and age (OR=6.40).

Stroke or TIA history, atrial fibrillation, and age are independent prognostic factors for postoperative stroke. Hypertension, diabetes, and non-atrial arrhythmias during surgery are prognostic factors for postoperative stroke.

To explore the application value of core needle biopsy technique in the pathological diagnosis of locally advanced pancreatic cancer patients.

During April 2007 to April 2014, retrospective analysis was conducted for 36 patients of locally advanced pancreatic cancer to summarize the clinical data of core needle biopsy technique. And the relevant data included clinical features, pathological findings and puncture-related complications. Regular postoperative follow-ups were conducted.

All received pathological examination of core needle biopsy. And the pathological diagnoses were pancreatic cancer (n=29), pancreatic neuroendocrine tumors (n=2) and chronic pancreatitis (n=5). During the follow-ups, liver metastasis was pathologically confirmed postoperatively at Months 4 and 6 months among 5 chronic pancreatitis patients. The remainder was followed up for over 12 months. There was neither change in size nor metastasis. One case was diagnosed at Peking Union Hospital as autoimmune pancreatitis while another 2 cases had a clinical diagnosis of chronic pancreatitis. The accuracy of core needle puncture was 94.4%. There were 2 cases of postoperative pancreatic fistula in class A. Bleeding complication was absent.

The application of core needle biopsy technique is both safe and effective in the pathological diagnosis of locally advanced pancreatic cancer.

To evaluate the long-term outcomes of pylorus-vagus-preserving partial gastrectomy for early gastric cancer in middle third of stomach.

Between January 2004 and June 2009, 46 patients with early gastric cancer in middle third of stomach underwent pylorus-vagus-preserving partial gastrectomy (PPG) while another 85 patients had conventional distal gastrectomy (DG). Clinicopathologic data and follow-up results of two groups were analyzed retrospectively, including the results of subjective nutritional assessments, laboratory blood biochemical data, endoscopic findings of remnant stomach and total 5-year survival rates.

Postprandial dumping syndrome occurred in 7 patients (8.2%) in DG group while no syndrome occurred in PPG group. The incidence of gallbladder stones at 18 months after operation in DG group was higher than that in PPG group. Significant difference existed between two groups (P<0.05). Even though no significant difference existed in laboratory blood biochemical data and endoscopic findings, PPG group recovered better and regurgitation was frequently found in DG group. Food residue in gastric remnant was frequently observed in PPG (31.1%) than in DG (10.8%,P<0.05) by endoscopic findings At 2 years post-operation, the postoperative 5-year recurrence rate was 6.5% (2/46) in PPG group versus 8.2% (7/85) in DG group. However no significant difference existed between 2 groups (P=0.724). No significant difference existed between PPG group (91.3%) and DG group (90.6%) in overall 5-year survival rate.

For early gastric cancer in middle third of stomach, pylorus-vagus-preserving partial gastrectomy is effective in maintaining postoperative function. And it has the same postoperative survival rate as conventional distal gastrectomy.

To compare the long term outcome of The Trans-Atlantic Inter-Society Consensus(TASC)Ⅱ C/D femoropopliteal arterial disease between endovascular treatment and arterial bypass therapy.

A retrospective study was undertaken on 92 patients (97 limbs) receiving endovascular treatment and graft bypass therapy for TASCⅡ C/D femoropopliteal arterial disease from January 2009 to January 2014, 58 male and 34 female. Mean age was (68±9) years (range, 56 years to 86 years), 52 patients over 70 years old (occupied 56.5%). Severe intermittent claudication, rest pain, minor tissue defect and foot ulceration or gangrene were in 51 limbs, 33 limbs, 10 limbs and 3 limbs, respectively. Technical success rate, perioperative complication rate, mortality rate, patency rate and limb salvage rate, ankle brachial index (ABI) were evaluated.

Technical success rate of endovascular treatment was 96.0%, severe complication rate was 8.6%. No death cases at perioperative period, preoperative ABI was (0.40±0.16), postoperative ABI increase to (0.72±0.24). Technical success rate of graft bypass therapy was 95.4%, severe complication rate was 15.9%, perioperative mortality rate was 4.5%, preoperative ABI was (0.36±0.19), postoperative ABI increase to (0.76±0.21). Primary term patency rate, cumulative patency rate and cumulative limb salvage rate at 24 months of endovascular treatment were 67.4%, 79.0% and 93.0% respectively. Graft bypass therapy were 71.4%, 79.4% and 92.3% respectively.

Endovascular treatment of TASCⅡ C/D femoropopliteal arterial disease has the same patency rate and limb salvage rate to graft bypass therapy, lesions is microinvasive, safe and effective.

To explore the effects of low-dose capsaicin (CAP) on lung ischemia-reperfusion (IR) injury and elucidate its possible mechanisms in rats.

A total of 32 Sprague-Dawley rats were randomly divided into 4 groups of S (sham thoracotomy and mechanical ventilation for 5.0 h), IR (an occlusion of left pulmonary hilus for 1.0 h followed by reperfusion for 4.0 h), CAP (an injection of CAP at 5.0 min pre-occlusion) and CGRP8-37 group (an injection of CGRP receptor antagonist CGRP8-37 at 10.0 min pre-occlusion followed by the same treatment as CAP group) (n=8 each). At pre-occlusion, 0.5 h and 4.0 h post-reperfusion, blood samples were collected for blood gas analyses and arterial oxygen pressure (PaO₂) and alveolar arterial oxygen difference (A-aDO₂) measured. At the end of experiment, lung tissues were obtained to measure the level of tumor necrosis factor alpha (TNF-α), lung tissue wet to dry weight ratio (W/D) and lung histological changes.

At 0.5 h post-reperfusion, PaO₂ in S group was significantly higher than that in IR, CAP and CGRP8-37 groups ((147.7±32.4) vs (100.8±18.9), (123.9±16.3), (121.0±15.2) mmHg (1 mmHg=0.133 kPa), all P<0.05) and it was higher in CAP group than in IR group (P<0.05); A-aDO₂ increased in IR and CGRP8-37 groups versus S group ((151.5±21.9), (134.3±15.1) vs (118.4±19.1) mmHg, both P<0.05). At 4 h post-reperfusion, PaO₂ was higher in CAP group than those in IR and CGRP8-37 groups ((146.0±21.1) vs (113.5±21.1), (124.0±16.4) mmHg, both P<0.05). And A-aDO₂ in CAP group was lower than those in IR and CGRP8-37 groups ((111.4±23.4) vs (140.8±22.0), (132.7±16.4) mmHg, both P<0.05); the level of TNF-α in CAP group was lower than that in IR group ((2.7±0.9) vs (3.7±1.1) pg/mg,P<0.05); W/D ratios were remarkably higher in IR, CAP and CGRP8-37 groups than that in S group (5.74±0.52, 6.03±0.78, 5.26±0.24 vs 4.87±0.34, allP<0.05), and it was lower in CAP group than in CGRP8-37 group (P<0.05). Under light microscope, the pathological lesions were more severe in IR and CGRP8-37 groups than those in CAP group at 4 h post-reperfusion.

Low-dose capsaicin exerted protective effects on lung ischemia reperfusion injury in rats. And it is mediated partially by calcitonin gene-related peptide receptor. The underlying molecular mechanism is involved in suppressed inflammatory response.

To explore the effects of renal sympathetic denervation (RSD) on pulmonary vascular remodeling in a model of pulmonary arterial hypertension (PAH).

According to the random number table, 24 beagles were randomized into control, PAH and PAH+ RSD groups (n=8 each). The levels of neurohormone, echocardiogram and dynamics parameters were measured. Then 0.1 ml/kg dimethylformamide (control group) or 2 mg/kg dehydromonocrotaline (PAH and PAH+ RSD groups) were injected. The PAH+ RSD group underwent RSD after injection. At week 8 post-injection, the neurohormone levels, echocardiogram, dynamics parameters and pulmonary tissue morphology were observed.

The values of right ventricular systolic pressure (RVSP) and pulmonary arterial systolic pressure (PASP) in PAH and PAH+ RSD groups were both significantly higher than those in control group ((42.8±8.7), (30.8±6.8) vs (23.2±5.7) mmHg (1 mmHg=0.133 kPa) and (45.1±11.2), (32.6±7.9) vs (24.7±7.1) mmHg). Meanwhile, the values of RVSP and PASP in PAH group were higher than those in PAH+ RSD group (all P<0.01). The levels of serum angiotensin Ⅱ(AngⅡ) and endothelin-1 significantly increased after 8 weeks in PAH dogs ((228±41) vs (113±34) pg/ml and (135±15) vs (77±7) pg/ml, allP<0.01). And AngⅡ and endothelin-1 were higher in lung tissues of PAH group ((65±10) and (96±10) pg/ml) than in those of control group ((38±7) and (54±6) pg/ml) and PAH+ RSD group ((46±8) and (67±9) pg/ml) (allP<0.01). Pulmonary tissues had marked collagen hyperplasia and lamellar corpuscles of type 2 alveolar cells were damaged more severely in PAH dogs than in PAH+ RSD dogs.

RSD suppresses pulmonary vascular remodeling and decreases pulmonary arterial pressure in experimental PAH. And the effect of RSD on PAH may contribute to decreased neurohormone levels.

To determine whether quercetin can suppress retinal angiogenesis in a rodent model of retinopathy of prematurity (ROP).

ROP was induced in C57BL/6 mice by exposing 7-day-old mice to 75% oxygen (hyperoxia) for 5 days followed by 5 days in room air. Quercetin (20 mg/kg body weight) was administered intraperitoneally from Days 12-17. Control group received an intraperitoneal dose of propylene glycol. At Day 17, the eyes were enucleated and retinae diseected for ADPase and hematoxylin and eosin staining. The severity of neovsascularization were graded as the number of clock hour of new vessel (NV) with a masked approach. The proliferative neovascular response was quantifled by counting the nuclei of new vessels extending from retina into vitreous in cross-sections. And vascular endothelial growth factor (VEGF) was detected by enzyme-linked immunosorbent assay (ELISA).

The severity of NV decreased significantly in Quercetin treatment group versus control group (P<0.05). The number of endothelial cells of new vessels extending from retina to viueous decreased significantly in quercetin treatment group versus hyperoxia group (P<0.05). The retinal level of VEGF decreased significantly in quercetin treatment group.

Quercetin attenuates retinal angiogenesis so that it may become a potential preventive chemotherapy for ROP.

Transcatheter mitral valve repair is a new type of transcatheter heart valve implantation and repair. Compared with traditional thoracotomy, mitral valve repair and replacement have the advantages of less trauma and quicker recovery^[1]。 It is suitable for elderly patients with high risk of surgery or obvious contraindications for surgery^[2]。 Since 2013, 11 cases have been completed in our hospital. Now, the perioperative anesthesia management of 11 patients is retrospectively summarized, in order to improve the anesthesia management level of such operations.

translational medicine (translational medicine) is a new concept in the health field proposed by the National Institutes of Health (NIH) in 2003. It is a systematic project with patient-centered, clinical problem-oriented, achievement application as the goal and multidisciplinary cross-integration. Scholars at Harvard Medical School proposed in 2005 that "translational medicine is not an isolated idea or idea that can be applied at any time, but an idea that needs everyone's attention, and it should be the basis of a modern understanding of health provision"^[1]While "health supply" is a big concept involving many subjects related to human health^[2]。 For many years, the Chinese Medical Association has been exploring medical continuing education methods suitable for the characteristics of medical profession. In recent years, it has promoted translational medicine practice in all aspects of the development of academic conferences according to this concept, and achieved good results. As one of the methods widely praised by trainees, on-site operation demonstration has played a very good role in promoting and publicizing the development of translational medicine.