Volume 95  ·  Issue 28  ·  2015

Achalasia is a rare esophageal motility disorder, which is currently believed to be caused by the loss of visceral neurons, which leads to esophageal peristalsis disorder and low esophageal sphincter (LES) relaxation disorder, thus causing a series of clinical symptoms. The diagnosis of achalasia mainly depends on the patient's symptoms and related auxiliary examinations. Common complaints of patients include: dysphagia, food reflux, chest pain, and some respiratory symptoms. Auxiliary examinations include: X-ray examination, gastroscopy combined with ultrasound gastroscopy, and esophageal motility detection. The treatment of achalasia mainly includes drug therapy, endoscopic therapy (including endoscopic botulinum toxin injection, balloon and stent expansion therapy, endoscopic myotomy) and surgical therapy (traditional surgical therapy and endoscopic surgical therapy). Drug therapy has limited efficacy and is only applicable to patients who are intolerable to other treatments; Endoscopic botulinum toxin injection was replaced by endoscopic dilatation treatment because of its high short-term recurrence rate; Traditional thoracotomy has been abandoned by surgeons with the popularization of laparoscopic techniques. Endoscopic balloon dilatation (PD) and laparoscopic Heller myotomy (LHM) have become two preferred measures for clinicians in the era of lack of precision medicine concepts and technologies because of their respective characteristics and good long-term efficacy.

colorectal cancer (CRC) is a malignant tumor originating from colorectal mucosal epithelium, and is one of the most common malignant tumors in clinic. There are more than 250,000 new cases of colorectal cancer and about 140,000 deaths in China every year. Both new and death cases account for 20% of colorectal cancer cases in the same period in the world [^1]。 Therefore, it is an urgent and important clinical scientific problem to reduce the morbidity and mortality of colon cancer in China.

To explore the association between sleep disorder and osteoporosis in elderly female patients with type 2 diabetes mellitus (T2DM).

A total of 536 elderly female T2DM patients from July 2011 to July 2014 were divided into two groups of patients without sleep disorder and those with sleep disorder based upon the Pittsburgh Sleep Quality Index. The bone mineral density of femoral neck, Wards triangle, greater trochanter and lumbar spines (L2-L4) were measured by dual-energy X-ray absorptiometry. Biochemical indicators were detected in two groups. Oral glucose tolerance and insulin releasing tests were performed. We compared the differences of bone mineral density and β-cell function after fasting and glucose-load. The logistic regression analyses were performed between sleep disorder and osteoporosis and other indicators.

The levels of high sensitivity C-reactive protein (hs-CRP), HbA1c, cortisol (COR), adrenocorticotropic hormone (ACTH), fasting insulin (FINS) and homeostasis model assessment-estimated insulin resistance (HOMA-IR) were significantly higher in patients with sleep disorder compared to those without sleep disorder [(3.5±1.1) vs (2.6±0.9) mg/L, (8.0±1.9)% vs (7.3±1.6)%, (512±88) vs (436±76) nmol/L, (6.4±2.3) vs (5.1±2.0) pmol/L, (13.4±4.3) vs (12.4±4.0) mU/L, 4.7±0.8 vs 3.8±0.8, all P<0.05]. Insulin sensitivity index (ISI) was lower in patients with sleep disorder than that in patients without sleep disorder (-4.2±0.5 vs -4.0±0.4,P<0.05). The bone mineral density of femoral neck, Wards triangle, greater trochanter and lumbar spines (L2-L4) were significantly lower and the prevalence rate of osteoporosis was significantly higher in patients with sleep disorder compared to those in patients without sleep disorder (allP<0.05). Logistic regression analysis showed that sleep disorder was positively correlated with HOMA-IR, HbA1c, COR and ACTH (allP<0.05) and negatively with ISI (P<0.05). Logistic regression analysis showed that osteoporosis was positively correlated with postmenopausal duration, HbA1c, COR, ACTH and sleep disorder (allP<0.05) and negatively with ISI (P<0.05).

Sleep disorder causes osteoporosis through various mechanisms in elderly female T2DM patients. Improving sleep disorder may help to reduce the prevalence of osteoporosis.

To study the risks of cardiovascular events of elderly hypertensive patients with different risk stratification during the perioperative period.

126 elderly hypertensive patients without cardiac surgery were selected and divided into following 3 groups: group Ⅰ (in danger), group Ⅱ (high-risk), group Ⅲ(very high-risk), each group with 42 cases.Control group was randomly selected 42 elderly patients without hypertension and other cardiovascular risk factors. Sevoflurane, Etomidate, Propofol, Cisatracurium Besilate for Injection, Fentanyl were used to induction and maintenance of anesthesia. Patients′ cardiac index(CI), cardiac output(CO), stroke volume(SV), systemic vascular resistance(SVR), peak velocity(Vpk), heart rate(HR), mean arterial pressure(MAP) were monitored by ultrasonic cardiac output monitor (ultrasonic cardiac output monitor, USCOM). Pre- and post-operative myocardial ischemia and arrhythmia were monitored by dynamic electrocardiogram (dynamic electrocardiography, DCG).

Incidence myocardial(9.5%, 31.0%, 40.5%), ischemia frequency [(10.4±1.7)time, 13.3±1.9)time, 17.4±2.3)time], ischemic time [(116.4±9.7)min, (174.3±19.8)min, (212.4±20.5)min] and arrhythmias incidence(28.6%, 52.4%, 92.9%) were specially more significant for group Ⅰ, group Ⅱ and group Ⅲ patients within the postoperative 24 hours (P<0.05). Comparison between group Ⅰ, group Ⅱ and group Ⅲ each other, myocardial ischemia incidence(11.9%, 21.4%, 31.0%), ischemia frequency[(9.5±1.5)time, (11.6±2.0)time, (15.0±2.2)time], ischemic time[(98.5±9.4)min, (158.3±16.7)min, (198.0±18.1)min] and arrhythmias incidence(16.7%, 45.2%, 81.0%) gradually increased for 3 groups within the postoperative 48 hours (P<0.05).

Risk of cardiovascular events significantly increases for elderly patients with cardiovascular high-risk factors in the perioperation period, and especially cardiovascular function is inhibited most obviously in the general anesthesia intubation immediately before and after 24 hours and is prone to cardiovascular events, such as myocardial ischemia and arrhythmia.

To discuss the indexes related to the efficacy of lapatinib after failure in trastuzumab in HER2-positive metastatic breast cancer (MBC) such as the status of PTEN, p-4EBP1 and clinical features.

Sixtymatched patients were included. Immunohistochemical (IHC) test of tissue specimens of metastatic lesions were applied to determine the status of PTEN and p-4EBP1.The correlation betweenclinical efficacy andthestatus of PTEN, p-4EBP1 and clinical features were analysed by long-rank test and Cox regression.

In all patients, themedian progression free survival (PFS), ORR and CBR was 4.6 months, 36.7% and 50.0% respectively.Univariate analysis revealed that lapatinib-treated patients with PTEN loss (P=0.015) and liver metastasis (P=0.02)had significantly shorter median PFS . Multivariate analysis revealed that patients with PTEN lossandliver metastasis had higher risk of diseaseprogression (P=0.005, 0.006, respectively).

HER2-positive MBC with trastuzumab-resistance could benefit from lapatinib regimen. PTEN statusand liver metastasis couldpredict theclinical efficacyof subsequent lapatinib therapy. The detection ofrelated biomarkers could provide some referenceto optimize the personal treatment with HER2-positive breast cancer.

This study aimed to clarify the clinical and histological parameters, and survival difference between right- and left-sided colon cancer.

We retrospectively analyzed the medical records (2006.1-2009.12) of 1 088 consecutive colon cancer patients who received surgery at our hospital. Right- and left-sided colon cancers were compared regarding the clinical and histological parameters. The survival analysis was performed by the Kaplan-Meier method, and the log-rank test was used to determine the statistical significance of differences.

Right-sided colon cancer was associated with older age, a more advanced state, and poorly differentiated and undifferentiated adenocarcinoma (25.2% vs 13.2%), mucinous adenocarcinoma (33.5% vs 17.3%) and vascular invasion (9.9% vs 3.9%) were more commonly seen in right-sided colon cancer compared with right-sided colon cancer, and all these differences were statistically significant. Median overall survival was right, 67 months; and left, 68 months. The five-years overall survival of right- and left-sided colon cancer was Ⅰ/Ⅱ stage, 91.4% vs 88.6% (P=0.819); Ⅲ stage, 66.1% vs 75.4% (P=0.010); and Ⅳ stage, 27.8% vs 38.5% (P=0.020) respectively.

Right- and left-sided colon cancers are significantly different regarding clinical and histological parameters. Right-sided colon cancers in stage Ⅲ and Ⅳ have a worse prognosis.

To explore the mean resting heart rate (RHR), usage and safety status of β-blocker, and associated changes after conducting clinical pathway training on patients with coronary heart disease(CHD).

We performed an open-label, multi-center prospective study. The ethical approval documents was prepared before the study. A total of 3 204 hospitalized participants with CHD were enrolled, from June 2012 to February 2013 in 24 hospitals in Beijing, and informed consent was obtained from each patients this trial was divided into two continuous stages (each stage lasted for 8 weeks). 1 570 participants were enrolled at the first stage, the clinicians used the standard method to administer β-blockers to these patients. At the second stage, β-blockers were administered to 1 634 enrolled patients by trained clinicians. The mean RHR, β-blocker usage status were recorded on the day of admission and discharge. We also described adverse events and severe adverse events.

The average RHR at baseline and discharge were(71±13)bpm and (63±9)bpm. The proportion of patients reaching the RHR goals when discharged was 35.9% in stage 1 vs 48.3% (P<0.001)in stage 2. The rate of β-blocker usage was 80.1% vs 81.0% (P=0.162) in stage 1, 90.3% vs 91.3%(P<0.001) in stage 2. The average dose of metoprolol succinate sustained-release tablet was (38±18) vs (39±42)mg/d(P<0.001)in stage 1, (40±23) vs (46±23) mg/d(P<0.001)in stage 2. The severe adverse events at both stages had no significant differences.

The proportion of patients with CHD reaching the RHR goals and the average dose of β-blocker was low. However, the proportion of patients reaching the RHR goals, the rate of β-blocker usage and the average dose of β-blocker were all increased after clinical pathway training.

To compare the efficacy of two approaches to ultrasound-guided fascia iliaca compartment block (FICB) for postoperative analgesia after total hip arthroplasty (THA).

Approved by the Peking University Third Hospital ethics committee, Sixty patients undergoing selective total hip replacement in Peking Third Hospital during Oct.2013 to May.2014 were included. Before induction of general anethesia, ultrasound-guided FICB were administered. According to probe parallel to the inguinal ligament or perpendicular to the inguinal ligament, patients were randomly divided into the Parallel group and the Perpendicular group. Both groups was administered an equal volume mixture of 1% ropivacaine and 1% lidocaine, 30 ml in total. All patients received sufentanil postoperative intravenous analgesia after surgery. Time to ultrasonic imaging, time to perform the block and total blocking time were recorded. Loss of sensation in the distribution areas of the femoral nerve and lateral femoral cutaneous nerve within 30 mins were recorded. Patients were interviewed at 4, 8, 12, 24, 36, 48 h after block for pain intensity, time of first using PCA, sufentanil consumption and loss of skin sensation due to the block. The occurrence of adverse events (nausea, vomiting, respiratory inhibition, pruritus or urinary retention) was also recorded.

The imaging time of the Parallel group was shorter than the Perpendicular group[ (3.1± 1.2) min vs( 5.0± 1.7) min , t=-5.128 , P<0.05)], and performance time of the Parallel group was shorter than the Perpendicular group [(5.2±1.3) minvs (7.1± 2.0) min, t=-4.376 , P<0.05)]. The successful rate for femoral nerve block was 100% both in 2 groups, while the successful rate for lateral femoral cutaneous nerve block in the Perpendicular group was 100%, and 83.3% in the Parallel group(χ²=5.455, P<0.05). The block rates for lateral femoral cutaneous nerve at 4, 8, 12 h after block in the Perpendicular group was higher than the Parallel group(P<0.05). The consumption of sufentanil in the Parallel group was significantly higher than the Perpendicular group at 8, 12, 24, 36, 48 h after block (P<0.05). There were no statistically differences in postoperative pain score, time of first using PCA, incidence of complications and patient′s satisfaction score between the two groups.

Comparing the two approaches to ultrasound-guided FICB, ultrasonic probe perpendicular to the inguinal ligament may offer better blocking effect of lateral cutaneous nerve and reduce postoperative sufentanil consumption, and might be more suitable for analgesic after THA.

To explore the cell population data (CPD) parameters of DxH800 hematology analyzer in predicting engraftment after hematopoietic stem cell transplantation.

Data from 109 patients who underwent hematopoietic stem cell transplantation at Peking University First Hospital between July 2013 and September 2014 were selected, all CBC data including CPD parameters from the beginning to engraftment (absolute neutrophil count >500/μl) were gathered and analyzed to find the early markers of myeloid engraftment and establish the cut-off value.

The makers which could predict myeloid engraftment were mean neutrophil volume (MNV) and mean monocyte volume (MMV) , the cut-off value was ≥180 fl and≥190 fl, respectively, and engraftment was predicted earlier (2.2±1.3) days and (2.3±1.7) days than absolute neutrophil count.

By analyzing the CPD data of DxH800 hematology analyzer, engraftment can be predicted approximately 2 days earlier than absolute neutrophil count.

To investigate the clinical, endoscopic and pathologic characteristics of gastric hyperplastic polyps.

A total of 1 676 gastric hyperplastic polyps patients diagnosed by gastroscopy and pathology from January 2005 to October 2014 were enrolled and analyzed retrospectively.

Among them, 1 030 patients(61.46%)were female, 1 014 patients(60.50%)aged ≥60 years old, 1 093 patients(65.21%)polyps distributed in the fundus and body of stomach. And the concurrent conditions included dysplasia in polyps tissue(n=89, 5.31%), intestinal metaplasia (n=94, 5.61%), focal carcinoma(n=5, 0.30%). In the background gastric mucosa included Helicobacter pylori gastritis (n=368, 21.96%), autoimmune gastritis (n=238, 14.20%), intestinal metaplasia(n=379, 22.61%), dysplasia (n=110 , 6.56%), adenocarcinoma (n=13, 0.78%), carcinoid tumor(n=3, 0.18%).

Hyperplastic polyps are mainly distributed in the proximal stomach, and malignant transformation may be detected in hyperplastic polyps. Whereas, both precancerous lesions and malignant transformation are detected in background gastric mucosa. Therefore, the endoscopist should always pay attention to background gastric mucosa.

To observe the therapeutic effects and security of oral lactulose solution on treatment of puerperal constipation.

A total of 200 patients with puerperal constipation who received regular antenatal cares from early pregnancy in our department and delivered in our hospital from January 2013 to October 2013, were randomly divided into two groups. The patients in control group (n=100)received defecation habits training, diet management and drinking adequate water etc. The patients in therapy group(n=100)received 20 ml oral lactulose solution, twice a day and constantly treatment for 4 weeks. The frequency of defecation per week were recorded (including before treatment, period during the treatment, and the first week after finish the whole treatment). The adverse reactions and recurrence of constipation after treatment were analyzed.

The frequency of defecation per week in the therapy group was higher than that in the control group at the first week after treatment (t=2.178, P=0.869), and significantly increase in the fourth week (t=8.390, P=0.000). The efficiency of the lactulose groups was 92%, and the control group was 21% (χ²=112.530, P=0.000). The total recurrence of constipation in lactulose group was lower than that in the control group by follow up 120 days (4% vs 18%, χ ²=10.010, P=0.001).

Oral lactulose solution is effective and safe for puerperal consipation.

To evaluate the impact value of preoperative neutrophil-lymphocyte ratio (NLR) for the prognosis of pancreatic cancer patients.

The clinical data of 65 patients with resectable pancreatic cancer were analyzed retrospectively. According to preoperative NLR, the patients were divided into high group(NLR≥2.4)and low group(NLR<2.4). Caner-specific survival was assessed using the Kaplan-Meier method. The 1-year survival rates and the clinic pathological factors in the two groups were analyzed using univariate analysis and COX regression model.

The 1- year survival rate of higher NLR group and lower NLR group was 64.5% and 73.5% respectively, with statistic significance. A high NLR was identified as an independent risk factor of poorer prognosis for patients with pancreatic cancer (RR: 1.465; 95%CI: 1.078-1.993; P=0.015).

Preoperative NLR can be a clinically significant factor for the assessment of prognosis of Pancreatic Cancer.

To explore the effects of hydrogen sulfide on nicotine-induced bronchial epithelial cell endoplasmic reticulum (ER) stress and apoptosis.

Nicotine was used to establish the apoptotic model in human bronchial epithelial cell line (16HBE) for mimicing the effect of cigarette smoke on apoptosis. The 16HBE cells were grouped by the concentration gradients of 0 (control), 5, 10, 20, 40, 80 μmol/L nicotine dosing. All groups were treated for 72 h. And 16HBE cells were grouped by the time gradients of 0 (control), 24, 48, 72 h of nicotine dosing. For control group, the nicotine concentration was 40 μmol/L. Then the protein expression level of CCAAT/enhancer binding protein homologous protein (CHOP) was measured by Western blot to define the effect of various concentrations of nicotine and different dosing periods of nicotine on the protein expression level of CHOP. For observing the role of hydrogen sulfide in ER stress-mediated apoptosis, 16HBE cells were divided into 6 groups of control, 40 μmol/L nicotine, 100 μmol/L sodium hydrosulfide (NaHS)+ 40 μmol/L nicotine, 200 μmol/L NaHS+ 40 μmol/L nicotine, 400 μmol/L NaHS+ 40 μmol/L nicotine and 10 mmol/L taurine+ 40 μmol/L nicotine. NaHS or taurine was pretreated for 30 min and then nicotine dosed for 72 h. The protein expression levels of GRP78 and ER stress-mediated apoptosis markers, such as cleaved caspase-12 and CHOP, were measured by Western blot. And chromatin dye Hoechst 33258 was used to detect the morphological changes of apoptotic 16HBE cells and apoptotic index calculated.

Nicotine could concentration and time-dependently improve the expression of CHOP in 16HBE cells. The ratio of CHOP to average absorbance of glyceraldehyde phosphate dehydrogenase (GAPDH) was significantly higher in 40 μmol/L nicotine group than that in control group (1.04±0.32 vs 0.30±0.17, P<0.05). The ratio of GRP78 to average absorbance of β-actin (0.59±0.19 vs 1.00±0.08), cleaved caspase-12 to average absorbance of procaspase-12 (0.06(0.01, 6.06) vs 20.30(12.79, 23.78)) and CHOP to average absorbance of β-actin (0.18±0.10 vs 0.53±0.09) in 200 μmol/L NaHS+ 40 μmol/L nicotine group were all significantly lower than those in 40 μmol/L nicotine group (allP<0.05). The apoptotic index in 200 μmol/L NaHS+ 40 μmol/L nicotine group (3.04±1.83 vs 16.60±3.32) and apoptotic index in 10 mmol/L taurine+ 40 μmol/L nicotine group (4.08±2.04 vs 16.60±3.32) were significantly lower than those in 40 μmol/L nicotine group (allP<0.01).

NaHS exerts its protection against nicotine-induced bronchial epithelial cell apoptosis through suppressing ER stress. And the underlying mechanism may be through a down-regulation of ER stress-mediated apoptosis markers of cleaved caspase-12 and CHOP.

To explore the electrophysiological properties and mechanism of aging for the susceptibility of left atrium (LA) to arrhythmogenesis in rabbits.

A total of 50 male New Zealand rabbits were divided into young (6 months, n=25) and aged (26 months, n=25) groups. According to comparisons before and after isoproterenol (ISO) dosing, young rabbits were further divided into young control and medication groups while aged ones into aged control and medication groups. Electrophysiological study was performed on perfused isolated left atrium and conventional microelectrodes were used for recording transmenbrane action potentials (tAP), resting membrane potential (RMP), amplitude of APs (APA), maximum upstroke velocity (V_max), APs duration at 20%, at 50% or at 90% repolarization (APD_20,APD_50,APD₉₀), atrial effective refractory periods (AERP) and atrial arrhythmia inducibility before and after ISO dosing. L-type calcium current (I_Ca-L) was measured via whole-cell patch clamp technique. And fluorescent intensity of intracellular Ca²⁺ was detected with Flup-3/AM loading by laser scanning confocal microscope in enzymatically dissociated single LA myocytes before and after dosing.

Compared with major parameters of tAP in young control group, APDs and AERP significantly increased and APA, V_max,RMP and AERP/APD₉₀ obviously decreased in aged control group (all P<0.05). Otherwise, the conduction of tAP was rapid and delayed afterdepolarizations (DADs) were induced in both young and aged medication groups after ISO dosing. However, as compared with major parameters of young medication group, APDs dramatically declined while APA, V_max,RMP and DAD amplitude significantly increased. And triggered activity was induced in aged medication group (all P<0.05). With voltage clamp model, I_Ca-L significantly declined in aged control group versus young control group. The peak current density of I_Ca-L dramatically decreased ((6.3±0.8) pA/pF in aged control group vs (9.5±1.3) pA/pF in young control group, P<0.01) under 10 mV clamp voltage. And current-voltage (I-V) curve of I_Ca-L was greatly upgraded in aged control group on the top of all I-V curves without changing direction. The current density of I_Ca-L increased much more in aged medication group than that in young medication group ((15.9±3.1) vs (11.3±2.6) pA/pF, P<0.01). And I-V curve of I_Ca-L shifted the bottom of all I-V curves in aged medication group. Fluorescent intensities of intracellular free Ca²⁺ became completely attenuated ((437.9±21.7)μmol/L in aged control group vs (778.3±19.5) μmol/L in young control group,P<0.01). Under the effect of ISO administration, fluorescent intensities of intracellular free Ca²⁺ significantly increased in both young and aged medication groups. But [Ca²⁺ ]_i were altered more in aged medication group than that in young medication group ((1 635.6±51.6) vs (1 008.7±34.5) μmol/L, P<0.05).

The electrophysiological characteristics are significantly altered with electrical remodeling before and after ISO dosing in aging LA in rabbits. And it may contribute to the vulnerability and pathophysiological basis for reentry and atrial arrhythmogenesis. The electrophysiological mechanism is probably attributed to the alterations of I_Ca-L and [Ca²⁺ ]_i before and after ISO perfusion in aging LA myocytes.

To investigate the role and mechanism of BDNF and its receptor TrkB in the disorder of colonic motility in chronic stress rats.

A total of 20 male Wistar rats were randomly divided into two groups using to completely random method after weighed, with 10 rats in each group. Chronic water avoidance stress model was established. Then the fecal pellets of water avoidance stress (WAS) group and sham water avoidance stress (SWAS) group were recorded. Enzyme linked immunosorbent assay (ELISA), real time PCR, Western blot and immunohistochemistry were used to detect the expression of BDNF and TrkB in serum and colon muscle. The amplitudes of contractions of circular smooth muscle strips of each group were recorded after the treatment of TTX, BDNF and K252a.

The number of fecal pellets had obviously increased in WAS group comparing with SWAS group (P<0.05). The level of serum BDNF in WAS group was higher than that of SWAS group ( (158.30±9.82) vs (84.68±7.80) pg/ml) . And the expression of TrkB in the colon muscle in WAS group was higher than that in SWAS group ( 0.44±0.03 vs 0.30±0.02,P<0.05). There was no significant difference between the two groups in expression of BDNF mRNA in colon muscle (P>0.05). TrkB was mainly expressed in the cell nucleus of muscular layer neurons, and the expression of TrkB had obviously increased in WAS rats. The amplitudes of contractions of circular smooth muscle in WAS rats had significantly increased compared with SWAS rats ((0.35±0.02) vs(0.22±0.03) g,P<0.05). After adding TTX to block the function of enteric nervous , the difference was remaining ((0.89±0.07)vs(0.53±0.06)g,P<0.05). BDNF was added to the bath and the R value at different time was recorded. The difference had statistically significant at 6 min and 12 min (bothP<0.05) . BDNF could induced the contraction peak of the circular smooth muscle. The contraction peak induced by BDNF was delayed and reduced when K252a was added to the bath 30 min before adding BDNF.

BDNF plays a modulatory role in the disorder of colonic motility in chronic stress rat by acting on its receptor TrkB.

To study the effects of microRNA (miR) -155 on mice with acute lung injury induced by lipopolysaccharide (LPS).

According to the random number table, 30 C57 mice were divided into group LPS, group miR-155 inhibitor, group miR control, group miR-155 mimics, normal control group, with 6 mice in each group. Mice in group LPS and the other three treatment groups were given 5 μl LPS (20 μg/μl, in the dose of 4 mg/kg) to reproduce acute lung injury model. Half an hour after injury, group LPS, group miR-155 inhibitor, group miR control, group miR-155 mimics were injected with saline, miR-155 inhibitor, miR control and miR-155 mimics through trachea. Mice in normal control group were received no treatment. All mice were anesthetized after 24 h, while lung tissue samples were harvested for histomorphological observation, detection of mRNA expressions of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) with SYBR Green real-time polymerase chain reaction (PCR), detection of miR-155 in group miR-155 inhibitor, group miR control, group miR-155 mimics by Taqman PCR. The protein expression of cyclooxygenase-2 (COX-2) was determined by western blot. Data were statistically analyzed.

The relative mRNA expression values of TNF-α were 24.49±3.64, 38.92±3.40, 36.00±3.86, 12.56±2.06, 1.04±0.41 in group LPS, group miR-155 inhibitor, group miR control, group miR-155 mimics, normal control group. The relative mRNA expression values of IL-1β were 55.96±4.87, 62.90±6.41, 59.99±6.48, 25.33±3.50, 1.11±0.44 in group LPS, group miR-155 inhibitor, group miR control, group miR-155 mimics, normal control group. The differences of TNF-α and IL-1β in group miR-155 mimics were statistically significant by compared with group LPS, group miR-155 inhibitor, group miR control (P<0.05). The differences were not statistically significant among group LPS, group miR-155 inhibitor, group miR control. Western blot analysis showed the relative expression values of COX-2 were 0.94±0.06, 0.96±0.09, 0.91±0.03, 0.79±0.04, 0.63±0.07 in group LPS, group miR-155 inhibitor, group miR control, miR-155 mimics and normal control group. The value in normal control group was significantly lower than other groups (P<0.05).

Using the miR-155 can effectively alleviate the lung inflammation in mice with acute lung injury induced by LPS.

Postherpetic neuralgia (PHN) is the most serious complication in patients with herpes zoster, which is characterized by persistent or intermittent burning pain, pruritus, numbness, tingling, and tactile-induced pain at the site of nerve involvement [^1,2]。 Although antiviral therapy is currently advocated for acute herpes zoster and vaccination against varicella-zoster virus is recommended to reduce the incidence of PHN, more than 25% of 60-year-old patients with herpes zoster can develop persistent neuropathic pain [^3,4]。 At present, there are many drug treatments for PHN, mainly including antiviral drugs, anticonvulsants, tricyclic antidepressants, local anesthetics, opioids, etc., but the overall efficacy is not good, and a large number of adverse reactions will occur. As a new technology, dorsal root ganglion pulse radiofrequency has achieved good clinical results in the treatment of neuropathic pain [^5]。 In this study, we measured the changes of visual analogue (VAS) scores and Pittsburgh sleep quality index (PSQI) scores before and after treatment, and observed the efficacy of pulsed radiofrequency of thoracic dorsal root ganglion combined with gabapentin in the treatment of elderly patients with PHN. At the same time, we measured CD3 in peripheral blood of patients with PHN^＋CD4^＋CD8^＋To explore the effect of this combination therapy on immune function.

A 31-year-old female was admitted to the hospital on 14 October 2014 mainly due to "headache with nausea and vomiting for 12 days". Twelve days before admission, he had a sudden severe headache in quiet state, accompanied by nausea and vomiting. The vomit was stomach content. There was no numbness and weakness of limbs, no pairing and rotation of vision, no choking and dysphagia during drinking water, unconsciousness and limb twitching. He came to the emergency department of Beijing Chaoyang Hospital on October 8th. High-density shadow of the straight sinus was seen on head CT. On October 9th, head MRI showed straight sinus thrombosis, and head MRV showed poor imaging of the inferior sagittal sinus and straight sinus. He was admitted to the neurology ward considering venous sinus thrombosis. Prior history of lupus erythematosus for 13 years, currently oral methylprednisolone tablets 8 mg, once/d; He has a history of hypothyroidism for 3 years and is currently treated with oral levothyroxine sodium tablets 125 μ g once a day. In vitro fertilization was planned 38 days before admission, and intramuscular injection of recombinant human follicle-stimulating hormone was given for 13 days. During this period, pleural effusion, ascites and oliguria occurred. Furosemide 10 mg, once/d, and diuresis was given for 3 days. Subcutaneous injection of low molecular weight heparin calcium was started 27 days before admission for 7 days to prevent thrombotic events. Physical examination: blood pressure 126/92 mmHg (1 mmHg =0.133 kPa), nervous system and medical examination showed no abnormal signs.

regulatory B cell (Breg) is a kind of B cell subset that has been hotly studied in recent years. It plays a role in immune regulation by producing inhibitory cytokines such as interleukin 10 (IL-10), transforming growth factor β (TGF-β) or secreting inhibitory antibodies to affect other immune cells. At present, the understanding of Breg cells is far less than that of regulatory T cells (Treg), and its application in hematological diseases is still in its infancy, which needs further research.

Hematopoietic stem cells (HSC) are a class of adult stem cells with self-renewal and multidirectional differentiation potential, which can differentiate into all cells of the hematopoietic system. It was found that HSC is not randomly distributed in the bone marrow cavity, and it needs a specific microenvironment to maintain its relative homeostasis, keep HSC self-renewal but not differentiation, that is, maintain HSC "dryness". This hematopoietic microenvironment, also known as hematopoietic stem cell niche, is composed of various tissue cells, signaling molecules and extracellular matrix. We can think of the niche as a place to store stem cells, which not only protects HSC from depletion, but also prevents HSC from excessive proliferation, and also protects HSC from damage by the external environment. Without a proper niche, the HSC cannot perform its normal functions. In 1978, Schofield [^1]The concept of a stem cell niche was proposed for the first time. He used niches to describe the specific environment in the bone marrow, which is suitable for the survival of HSC, and also has an important regulatory role in the growth, proliferation, differentiation and apoptosis of HSC. On the one hand, the self-renewal of stem cells is determined by their own internal genes; On the other hand, it is influenced by the microenvironment in which it is located. According to the difference of position and function, we can divide the niches in the bone marrow into two categories, namely, endosteal niches [^2,3]and vascular endothelial cell niches [^4,5]。

Sepsis is a systemic inflammatory response syndrome caused by infection, and further development can lead to septic shock or even death. Sepsis is a common pathophysiological process manifested in the development of many diseases, which is widely involved in the transduction mechanism of multiple signal pathways. Mitogen-activated protein kinase (MAPK) is a class of molecules that carry extracellular stimulatory signals into the cell and amplify them in cascade. Its family members are widely involved in the pathological process of sepsis. The mechanism of action of MAPK in sepsis has attracted increasing attention.

Acid-base metabolism imbalance is very common in patients with end-stage renal disease (ESRD), among which metabolic acidosis is the most common. Cardiovascular events are a common cause of death in ESRD patients, accounting for more than 50% of their causes of death, while cardiovascular calcification is a common cause of cardiovascular disease development and development in ESRD patients [^1]Cardiovascular calcification is an active process involved in many genes and proteins regulated by cells. It is affected by the acid-base environment in vivo, and once it occurs, it is difficult to reverse, and even successful kidney transplantation cannot alleviate its progression [^2]。 Therefore, understanding the influence of acid-base environment on vascular calcification and its mechanism in ESRD patients is of great significance for preventing and treating vascular calcification, reducing the occurrence of cardiovascular events, improving the quality of life and reducing mortality.

In order to celebrate the 100th anniversary of the founding of Chinese Medical Journal, the first medical journal in modern times in China, the High-tech Medical Development and Internet Medical Summit Forum (Beijing Station) to celebrate the 100th anniversary of the founding of Chinese Medical Journal was jointly sponsored by the Editorial Committee of Chinese Medical Journal of Chinese Medical Association and the Sino-Japanese Hospital of the National Health and Family Planning Commission (SFPC). This academic activity is one of the series of activities organized by the Editorial Committee of Chinese Medical Journal "Celebrating the 100th Anniversary of the Founding of Chinese Medical Journal-A Hundred Expert Hospital Tour". This conference is co-sponsored by the Sino-Japanese Hospital of the National Health and Family Planning Commission and co-organized by Registration Network. Professor Gao Runlin, Editor-in-Chief of the Editorial Committee of Chinese Medical Journal and Academician of Chinese Academy of Engineering, Professor Hejie, Director of National Cancer Center, President of Cancer Hospital of Chinese Academy of Medical Sciences and Academician of Chinese Academy of Sciences, Professor Wang Chen, President of Sino-Japanese Hospital of National Health and Family Planning Commission and Academician of Chinese Academy of Engineering, respectively delivered speeches at the opening ceremony, congratulating the 100th anniversary of the founding of Chinese Medical Journal, highly appraising and fully affirming the contribution made by Chinese Medical Journal to the progress and development of Chinese medical science and the improvement of people's life and health in the past 100 years, and warmly congratulating the convening of the meeting and wishing the meeting a complete success. Vice President Liu Bing and Deputy Editor-in-Chief Shi Chaoyun of Chinese Medical Association Magazine attended the meeting and congratulated the meeting. More than 500 medical colleagues, including Professor Zhu Yuanjue, a famous respiratory expert in China, Professor Cui Liying, a neurology expert, and medical staff from Chinese and Japanese hospitals attended the conference. Forty media friends, including Fan Cunbin, editor and reviewer of the Journal Department of People's Medical Publishing House, and Sun Yu, president of PLA Military Medical Science Press, attended the commemorative conference.