[A randomized single blind comparison of conventional bowel preparation and unplanned preoperative preparation for pelvic organ prolapse]

Objective: To investigate the influence of conventional preoperative intestinal preparation and unplanned preparation on the visual field of pelvic organ prolapse repair surgery. Methods: The patients who underwent transvaginal pelvic organ prolapse repair surgery in Peking University People's Hospital from September 2017 to July 2018 were selected as the research objects except those who had undergone colorectal surgery and chronic constipation. The surgery doctor was blinded by intestinal preparation. There was no intestinal preparation in non intestinal preparation group and polyethylene glycol was taken orally in intestinal preparation group. The main outcome measures were the effect of intestinal contents on the surgical field, the presence of fecal leakage, and the nature and volume of fecal leakage. The standard of fecal contamination was: mild, less than 15 ml, moderate, 15-30 ml, and severe, >30 ml. Secondary indicators were patient satisfaction and symptoms of routine bowel preparation. Results: A total of 120 patients (60 cases of non intestinal preparation group, 60 cases of intestinal preparation group) were selected, including transvaginal hysterectomy, vaginal anterior or posterior colporrhaphy (some patients with anterior prolapse repair with mesh), sacrospinal ligament suspension, total colpectomy and colpocleisis, laparoscopic sacral colpopexy, anti-incontinence surgery. The median age of the patients in non intestinal preparation group was 62 years, and the median age of intestinal preparation group was 60 years. There were no significant differences in median age, anesthesia, operation method, blood loss, operation time and perioperative infection between the two groups (all P>0.05). Fecal contamination occurred in 10% (6/60) of the patients without intestinal preparation and 32% (19/60) of the patients with intestinal preparation (P=0.042). Comparing the two groups, 10% (6/60) of the patients with intestinal preparation had moderate and severe contamination, and the patients without intestinal preparation was only 2% (1/60), there was significant difference (P=0.017). In intestinal preparation group, nausea (8%, 5/60), vomiting (5%, 3/60), abdominal distension (22%, 13/60), fatigue (5%, 3/60) and palpitation (2%, 1/60) were higher than those in non intestinal preparation group. Conclusions: Intestinal preparation with oral laxatives before pelvic organ prolapse repair surgery is not beneficial to the cleaning of the surgical field and increases the discomfort of intestinal preparation. It is safe and feasible for most patients with pelvic organ prolapse to perform pelvic organ prolapse repair surgery without intestinal preparation.

[Prognostic significance of miRNA-223 targeting SOX11 in mantle cell lymphoma]

目的

探讨miR-223在套细胞淋巴瘤（MCL）患者中的表达及预后意义，并探讨可能的作用机制。

方法

以21例骨髓受累初治MCL患者为研究对象，以20例健康正常供者为正常对照，采用RQ-PCR法检测miR-223、SOX11 mRNA表达水平。构建过表达miR-223的MCL细胞系Granta519细胞，采用CCK8法和流式细胞术检测其增殖、周期和凋亡水平，采用Western blot法检测其SOX11蛋白表达水平，并利用双荧光素酶报告基因实验验证miR-223的靶基因。

结果

①21例MCL患者中，男15例，女6例，中位年龄58（37~72）岁，其中17例为中高危组。与正常对照组比较，MCL组患者miR-223表达水平显著下调（1 244.1±1 935.2对14.7±10.5，P<0.001），且其低表达与MCL的IPI评分高危组（P=0.001）、LDH升高（P=0.001）、ECOG评分≥2分（P=0.035）等高危临床特征相关。②以患者组miR-223中位表达水平为阈值，将患者分为高表达组（10例）和低表达组（11例），生存分析结果显示前者的总生存时间较后者延长（36个月对12个月，P=0.021）。③体外实验结果显示，与对照组比较，过表达miR-223的Granta519细胞增殖受抑（96 h时最明显，P<0.001）、处于G₂/M期的细胞明显减少（P<0.001）、细胞凋亡比例增加（P<0.001）；Granta519细胞的SOX11蛋白表达水平较对照组明显降低。④miR-223可抑制SOX11的3′非翻译区；MCL患者的miR-223与SOX11 mRNA表达水平呈明显负相关（r=−0.81，P<0.001）。

结论

miR-223在MCL患者中低表达，且与不良预后相关，机制上可能通过靶向SOX11而发挥作用。

[Relationship between blood pressure variability and target organ damage in children with essential hypertension]

Objective: To investigate the correlation between blood pressure variability (BPV) and target organ damage in children with essential hypertension. Methods: A retrospective review identified 144 children (104 boys (72.2%) and 40 girls (27.8%), age (11.7±2.5)years) diagnosed with essential hypertension at Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2013 to June 2018. Data on indicators for assessing fundus, cardiac, and renal damages obtained included 24-hour ambulatory blood pressure monitoring, BPV, fundus oculi examination, electrocardiogram, echocardiography, renal function, 24-hour urine protein quantitation, urine microalbumin, serum and urine β(2)-microglobulin. According to the existence of target organ damage, subjects were divided into target organ damage group and non-target organ damage group. Comparison between groups was analyzed using independent sample t test, chi square test and pearson correlation analysis. Results: The study included 144 children. There were 108 children (75.0%) diagnosed with phase 1 hypertension and 36 children (25.0%) diagnosed with phase 2 hypertension. Patients in target organ damage group (n=86, 59.7%) had a higher coefficient of 24 h diastolic BPV (14.5%±3.2% vs. 13.2%±2.5% t=2.558, P=0.012), a higher coefficient of daytime systolic BPV (8.2%±2.1% vs. 7.4%±2.0%, t=2.253, P=0.026) and a higher coefficient of daytime diastolic BPV (12.8%±3.4% vs.11.1%±2.4%, t=3.188, P=0.002) compared with patients in non-target organ damage group (n=58, 40.3%). The coefficients of daytime systolic BPV and daytime diastolic BPV were significantly associated with cardiac damage (r=0.190, P=0.023; r=0.366, P<0.01) and renal damage (r=0.167, P=0.046; r=0.167, P=0.045). The coefficient of daytime diastolic BPV was positively correlated with left ventricular mass index (r=0.366, P<0.01). Conclusions: There is a correlation between BPV and target organ damage in children with essential hypertension. Daytime BPV is strongly associated with cardiac and renal damage, and daytime diastolic BPV may predict early cardiac hypertrophy. As a noninvasive method, daytime BPV can provide evidence for early identification of hypertensive target organ damage.

[A cross-sectional study of the clinical features and physician visit patterns at onset of immunoglobulin G4 related disease]

OBJECTIVE

To comprehend clinical features and patient's physician visit patterns at onset of immunoglobulin G4 related disease (IgG4RD).

METHODS

In the study, 100 patients with IgG4RD who received treatments in the Department of Rheumatology and Immunology of Peking University People's Hospital from Apr. 1st, 2017 to Apr. 1st, 2018 were investigated, including gender, age, height, body weight, age of onset, physician visit history, primary history and how did the disease affected their life, etc. RESULTS: In this 100 IgG4RD cohort (57 males and 43 females), the male/female ratio was 1:0.75, the mean age of onset was (51.51±12.9) years, and the median duration was 49 months (ranging from 4 to 231 months). The onset age of males was significantly older than that of females (P<0.01). The manifestations showed that up to 69% patients had submaxillay glands lesion, 59% patients had lacrimal glands lesion, 28% patients had pancreas involvement and 28% patients had parotid glands involvement. The females had more lacrimal glands involvement (P<0.05). 62% patients were complicated with anaphylactic disease. The primary physician visit departments concentrated upon general surgery department (19/100), oral and maxillofacial surgery department (17/100), rheumatology and immunology department (16/100), ophthalmology department (15/100) and gastroenterology department (10/100). The departments where the confirmed diagnose was made concentrated upon rheumatology department (67/100),oral and maxillofacial surgery department (16/100) and gastroenterology department (7/100). The mean diagnosis duration after 2010 was (16.96±2.163) months, significantly shorter than that before 2010, which was (113.3±11.01) months. Before the definite diagnose was made, 43% patients underwent surgeries and 12% patients had more than one time surgeries. The patients whose first-visit department was a surgery department were more likely to undergo surgeries (P<0.01). 18% patients (18/100) stated that the disease had affected their work.

CONCLUSION

In this cohort of the IgG4RD patients, female is common and has earlier onset age than male. The major manifestations of IgG4RD are salivary glands, lacrimal glands and pancreas involvement. The common chief complains are salivary glands and lacrimal glands enlargement. Accompanied by anaphylactic disease is a marked manifestation of this disease. Delayed diagnoses are not rare, though this situation has been improved since 2010, and more attention still should be paid to the disease.

High-efficient catalytic reduction of 4-nitrophenol based on reusable Ag nanoparticles/graphene-loading loofah sponge hybrid

Noble metal nanoparticles (NPs) such as Au and Ag have shown many applications in the field of catalysis, sensing etc. due to their excellent photoelectric properties. But agglomeration and a low recovery rate are big problems for their applications. In this research, a novel Ag NPs/graphene (reduced graphene oxide)-loading loofah sponge (Ag NPs/RGO-LS) was synthesized through a one-step reduction method. Where the RGO is used as a nano-support with the high specific surface area and the high conductivity to prevent the agglomeration of Ag NPs and provide a conductive layer. The natural, green, low-cost and high-yield LS is designed as a macro-support to reduce the loss of Ag NPs during recycling. The as-prepared Ag NPs/RGO-LS is stable, uniform, and exhibits high efficiency and reusability in the catalytic reduction of 4-nitrophenol (4-NP) with a high rate constant of 1.893 min^-1 as well as an average conversion of 98% in 6 min during five cycles. The results have not only paved the way for the wide application of Ag NPs but also provide a new road for the application of other metal NPs.

Multiple eigenmodes of the Rayleigh-Taylor instability observed for a fluid interface with smoothly varying density

In this article, multiple eigen-systems including linear growth rates and eigen-functions have been discovered for the Rayleigh-Taylor instability (RTI) by numerically solving the Sturm-Liouville eigen-value problem in the case of two-dimensional plane geometry. The system called the first mode has the maximal linear growth rate and is just extensively studied in literature. Higher modes have smaller eigen-values, but possess multi-peak eigen-functions which bring on multiple pairs of vortices in the vorticity field. A general fitting expression for the first four eigen-modes is presented. Direct numerical simulations show that high modes lead to appearances of multi-layered spike-bubble pairs, and lots of secondary spikes and bubbles are also generated due to the interactions between internal spikes and bubbles. The present work has potential applications in many research and engineering areas, e.g., in reducing the RTI growth during capsule implosions in inertial confinement fusion.

Limits on Light Weakly Interacting Massive Particles from the First 102.8 kg×day Data of the CDEX-10 Experiment

We report the first results of a light weakly interacting massive particles (WIMPs) search from the CDEX-10 experiment with a 10 kg germanium detector array immersed in liquid nitrogen at the China Jinping Underground Laboratory with a physics data size of 102.8 kg day. At an analysis threshold of 160 eVee, improved limits of 8×10^{-42} and 3×10^{-36}  cm^{2} at a 90% confidence level on spin-independent and spin-dependent WIMP-nucleon cross sections, respectively, at a WIMP mass (m_{χ}) of 5  GeV/c^{2} are achieved. The lower reach of m_{χ} is extended to 2  GeV/c^{2}.

Precision Study of η^{'}→γπ^{+}π^{-} Decay Dynamics

Using a low background data sample of 9.7×10^{5}  J/ψ→γη^{'}, η^{'}→γπ^{+}π^{-} events, which are 2 orders of magnitude larger than those from the previous experiments, recorded with the BESIII detector at BEPCII, the decay dynamics of η^{'}→γπ^{+}π^{-} are studied with both model-dependent and model-independent approaches. The contributions of ω and the ρ(770)-ω interference are observed for the first time in the decays η^{'}→γπ^{+}π^{-} in both approaches. Additionally, a contribution from the box anomaly or the ρ(1450) resonance is required in the model-dependent approach, while the process specific part of the decay amplitude is determined in the model-independent approach.

Facile preparation of surfactant-free Au NPs/RGO/Ni foam for degradation of 4-nitrophenol and detection of hydrogen peroxide

The application of Au nanoparticles (Au NPs) often requires surface modification with chemical surfactants, which dramatically reduce the surface activity and increase the chemical contamination and cost of Au NPs. In this research, we have developed a novel Au NPs/reduced graphene oxide/Ni foam hybrid (Au NPs/RGO/NiF) by in situ reduction through ascorbic acid and replacement reaction. This method is green, facile and efficient. The Au NPs are free of chemical surfactants and are homogeneously distributed on the surface of the RGO/NiF. The as-prepared Au NPs/RGO/NiF hybrid is uniform, stable and exhibits not only a high reduction efficiency for the reduction of 4-nitrophenol with a catalytic kinetic constant of up to 0.46 min^-1 (0.15 cm³ catalysis) but also a sensitive and selective detection of H₂O₂ with a detection limit of ∼1.60 μM.

A novel HLA-A*24 allele, A*24:231, was identified by sequence-based typing

HLA-A*24:231 has one nucleotide change from HLA-A*24:02:01:01 at position 784 G>C.

[Comparison of prognostic value of (18)F-FDG PET/CT myocardial metabolism imaging and coronary collateral circulation in patients with CTO lesions]

Objective: To evaluate the location, extent of viable myocardial of chronic total coronary occlusions(CTO)lesions by (18)F-FDG PET myocardial metabolism imaging and then compare with coronary collateral circulation(CCC) to evaluate the prognostic evaluation in patients with CTO lesions. Methods: A total of Sixty consecutive patients with CTO lesions referred for viability assessment from April 2016 to April 2017 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. These patients underwent (99m)Tc-sestamibi ECG-gated SPECT rest myocardial perfusion imaging and ECG-gated (18)F-FDG PET/CT myocardial metabolic imaging, as well as coronary arteriography were recruited in this study. LV functional parameters(EDV, ESV, and LVEF) were analyzed by QGS software. The extent of CCC to the area of CTO related artery was graded as poorly, or well developed collaterals, assessed by Rentrop classification. All patients were followed up for a median of 17 months(range 12-20 months) and evaluated the changes of NYHA. Then the prognostic value of (18)F-FDG PET myocardial metabolism imaging and CCC in patients with CTO lesions were analyzed and evaluated. Results: As the standard evaluation of NYHA in patients with CTO lesions after 12-20 months, fifty-three patients were assigned in this study. According to the changes of NYHA, the patients were divided into no progress group and progress group. There were no statistically difference in age, gender, high risk of CTO lesion and drugs in two groups, but there were significant statistical differences in myocardial parameters. LVEF was significantly increased in patients with CTO lesion in no progress group(42.3%±17.2% vs 22.2%±10.4%, P<0.01). The EDV and ESV in no progress group were significantly smaller than patients in progress group.The sensitivity(95.2% vs 75.7%) and specificity(62.8% vs 38.1%) of (18)F-FDG PET myocardial metabolism imaging was much better than CCC in the evaluation of prognosis in patients with CTO lesion. Conclusion: (18)F-FDG PET myocardial metabolism imaging has important role in the prognosis of patient with CTO lesions when compared with CCC.

Effects of low molecular weight heparin in the treatment of venous thromboembolism in patients with gastrointestinal cancer

This study aimed to observe the safety and effectiveness of different dosing regimens of low molecular weight heparin in the prevention of venous thromboembolism (VTE) and to provide a guideline for the treatment of individualized VTE prophylaxisin patients with postoperative gastrointestinal tumors. Forty patients with high risk for VTE after surgery for gastrointestinal tumors treated in Hongqi Hospital of Mudanjiang Medical University in the period October 2016 to May 2017 were included in the study. The patients were randomly divided into two groups, group A that included 24 patients treated with low molecular weight heparin (LMWH) 5000 IU every 12 hours, and group B comprised of 16 patients treated with LMWH 5000IU every 24 hours. On the seventh day post-surgery anti-Xa activity values reached effective anticoagulation (>0.5 IU/mL) in both groups. In group A, there was one case of anti-Xa activity exceeding 1.0 IU/mL, but no bleeding complications occurred. Using LMWH 5000 IU subcutaneous injection every 12 hours could also prevent postoperative VTE of gastrointestinal tumor, but the risk of bleeding complications is higher compared with 24-hour administration. Monitoring of plasma D-dimer within 7 days after gastrointestinal surgery did not show a great value for VTE monitoring. This study demonstrated that subcutaneous injection of LMWH can prevent VTE after gastrointestinal tumor surgery and provide a new alternative for VTE prevention.

[Influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis]

Objective: To investigate the influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis and to analyze influencing factors of the clinical prognosis. Methods: We consecutively included acute ischemic stroke patients with middle cerebral artery occlusion (n=101) from Department of Neurology or Emergency, and patients were divided into two groups according to whether on intravenous thrombolysis therapy (IVT) or not. The Fugl-Meyer scale score (FMS) was used to assess motor function outcome and the National Institutes of Health Stroke Scale (NIHSS) score was used to assess neurologic function. Clinical data were obtained and compared between the two groups. Patients were followed up for 90 days, the primary clinical endpoint events included stroke recurrence and death, and the key secondary endpoint events included other vascular events after IVT. Multivariate linear regression analysis was used to analyze the relevant factors influencing the motor function 90 days later. Results: Among the 101 enrolled patients, 37 (36.6%) were classified as IVT group and 64 (63.4%) as no IVT group. In IVT group, hemorrhagic transformation and symptomatic intracranial hemorrhage were observed in 32.4% (12/37) and 13.5% (5/37) of the patients, which were higher than those in the no IVT group (9.4% (6/64) and 1.6% (1/64) , respectively) (χ(2)=8.511, P=0.004; χ(2)=5.993, P=0.014). And there was no significant difference between the two groups in NIHSS score and FMS score at any time point. In addition, there was no significant increase in 90-day FMS score in the two groups compared with the FMS score on admission (83±9 vs 80±12; 86±8 vs 80±10). After followed up for 90 days, the primary clinical endpoints were obtained in 32 patients (32/101; 31.9%), including 18 cases of stroke recurrence (18/101; 17.8%) and 14 cases of death (14/101; 13.9%). No significant difference was found in primary clinical endpoints between the two groups. Multivariate linear regression analysis revealed that symptomatic intracranial hemorrhage (t=-2.318; P=0.023), baseline NIHSS score (t=-4.263; P=0.000), recurrent stroke (t=-9.114; P=0.000) and hemorrhage transformation (t=-2.121; P=0.037) were risk factors of poor 90-day motor function recovery, but not application of intravenous thrombolysis therapy (t=0.328; P=0.744). Conclusions: Acute ischemic stroke patients with moderate to severe LA have higher risk of hemorrhagic transformation and symptomatic intracranial hemorrhage after intravenous thrombolysis. However, there is no association of intravenous thrombolysis therapy with motor function recovery.

[Four cases of acute respiratory distress syndrome patients transported with veno-venous extracorporeal membrane oxygenation]

Objective: To retrospectively review 4 cases diagnosed with pediatric acute respiratory distress syndrome (ARDS) who were transported with veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) from April 2016 to March 2017. Methods: Four patients were transported to Bayi Children's Hospital Afflicted to the PLA Army General Hospital, with V-V ECMO. Their vital signs, blood-gas analysis and chest X-ray before and after transportation were compared. The length of ECMO, pediatric intensive care unit (PICU) stay and hospitalization, and the prognosis were analyzed. Results: All the four cases were transported to our hospital successfully from distances between 1 000 km to 1 210 km. The 4 cases were 4 to 6 years old with the body weight of 19 to 35 kg, of whom 3 were boys and 1 was girl. The catheters were inserted in the right jugular vein and femoral vein. The vital signs and blood-gas analysis after transportation did not change significantly compared to baseline. The length of ECMO for the four patients were 48, 754, 157 and 438 hours. They stayed in the PICU for 10, 32, 14 and 19 days, respectively. At last, 2 of them were successfully discharged from hospital without any complications; however, the other 2 died of multiple organ failure. Conclusion: Transporting ARDS patients with a satisfactory cardiac function under VV-ECMO by an experienced ECMO team is safe.

[Establishment of myocardial targeted nanoparticles and preliminary evaluation of its effects on prevention and treatment of myocardial injury]

Objective: To establish 3-{4-[2-hydroxyl-(1-methylethylamino) propoxy] phenyl} propionic acid cetylesters (PAC) modified nanoparticles, and preliminarily explore its cardiomyocyte-targeting function and protection effects on myocardium. Methods: (1) HL-1 myocardial cells were divided into cyanidin-3 (Cy3) marked non-targeted small interference RNA (Cy3-siNC) group and Cy3 marked small interference RNA designed for the nuclear factor kappa B (NF-κB)-p65 gene (Cy3-si435) group according to the random number table, with 3 wells in each group. Cells in Cy3-siNC group were transfected with Cy3-siNC, while cells in Cy3-si435 group were transfected with Cy3-si435. At transfection hour 24, the mRNA expression of NF-κB-p65 of cells was determined by real-time fluorescent quantitative polymerase chain reaction. (2) Multiple emulsificating solvent evaporating method was adopted to prepare PAC modified nanoparticles carried with Cy3-siNC (Cy3-siNC-PAC) and PAC modified nanoparticles carried with Cy3-si435 (Cy3-si435-PAC). The morphology of Cy3-si435-PAC nanoparticles was observed with scanning electron microscope, and the size and potential of Cy3-si435-PAC nanoparticles were detected by nanometer particle size and zeta potential analyzer. The entrapment efficiency and drug loadings of Cy3-si435-PAC nanoparticle were determined with ultraviolet spectrophotometer. The release of Cy3-si435 of Cy3-si435-PAC nanoparticles was determined by dialysis method. (3) Another batch of HL-1 cells were divided into 4 groups according to the random number table, with 9 wells in each group. Cells in negative control group were added with 5 μL phosphate buffer. Cells in 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles groups were added with 5 μL 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles, respectively. At transfection hour 6, 12, and 24, proliferation activity of cells in 3 wells of each group was detected by methyl thiazolyl tetrazolium method, respectively. (4) Another batch of HL-1 cells were cultured for 24 h, and then treated with 100 μL Cy3-si435-PAC nanoparticles. At transfection hour 0, 4, 8, 12, and 24, the percentage of cells uptaking Cy3-si435-PAC nanoparticles in 3 wells were detected by flow cytometry, respectively. (5) Another batch of HL-1 cells were divided into 2 groups according to the random number table, with 3 wells in each group. Cells in Cy3-siNC-PAC group were added with 100 μL Cy3-siNC-PAC nanoparticles, while cells in Cy3-si435-PAC group were added with 100 μL Cy3-si435-PAC nanoparticles. At transfection hour 24, the mRNA expression of NF-κB-p65 of cells was determined by real-time fluorescent quantitative polymerase chain reaction. (6) Six male C57BL/6J mice were divided into 2 groups according to the random number table, with 3 mice in each group. Mice in Cy3-siNC-lipopolysaccharide (LPS) group and Cy3-si435-LPS group were respectively injected with 500 μL Cy3-siNC-PAC nanoparticles and Cy3-si435-PAC nanoparticles (50 mg/mL) in the tail vein. At injection hour 24, mice in the two groups were intraperitoneally injected with 10 mg/kg LPS to induce myocardial injury. At post injury hour 24, the distribution of nanoparticles in mice was detected with small animal imager. (7) Another 9 male C57BL/6J mice were divided into 3 groups according to the random number table, with 3 mice in each group. Mice in Cy3-siNC-normal saline (NS) group and Cy3-siNC-LPS group were injected with 500 μL 50 mg/mL Cy3-siNC-PAC nanoparticles in the tail vein, while mice in Cy3-si435-LPS group were injected with 500 μL 50 mg/mL Cy3-si435-PAC nanoparticles. At injection hour 24, mice in Cy3-siNC-NS group were intraperitoneally injected with NS, while mice in Cy3-siNC-LPS group and Cy3-si435-LPS group were injected with 10 mg/kg LPS to induce myocardial injury. At post injury hour 24, pathological changes of myocardium of mice in each group were observed with HE staining. Data were processed with t test and one-way analysis of variance. Results: (1) The mRNA expression of NF-κB-p65 of cells in Cy3-si435 group was 0.183±0.004, significantly lower than 1.003±0.092 in Cy3-siNC group (t=15.46, P<0.01). (2) The form of prepared Cy3-si435-PAC nanoparticles was good, with particle size of 146.0 nm, potential of -29.2 mV, entrapment efficiency of (86.9±1.1) %, drug loadings of (25.4±0.9) %, and stable Cy3-si435 release. (3) At transfection hour 6, 12, and 24, there were no statistically significant differences in proliferation activity of cells in the 4 groups (with F values from 0.129 to 2.512, P values above 0.05). (4) At transfection hour 0, 4, 8, 12, and 24, the percentages of cells uptaking Cy3-si435-PAC nanoparticles were (0.79±0.06)%, (31.04±1.59)%, (51.64±2.67)%, (68.15±2.60)%, and (83.68±4.67)%, respectively. (5) The mRNA expression of NF-κB-p65 of cells in Cy3-si435-PAC group was 0.286±0.015, significantly lower than 1.002±0.073 in Cy3-siNC-PAC group (t=16.62, P<0.01). (6) At post injury hour 24, uniform distribution of nanoparticles could be observed in cardiomyocytes of mice in Cy3-siNC-LPS group and Cy3-si435-LPS group. (7) The structure of myocardial fibers of mice in Cy3-siNC-NS group was dense, with no inflammatory cells infiltration and uniform distribution of cytoplasm. The structure of myocardial fibers of mice in Cy3-siNC-LPS group were loose, with inflammatory cells infiltration and scattered distribution of cytoplasm. The structure of myocardial fibers of mice in Cy3-si435-LPS group was denser, with no obvious inflammatory cells infiltration and uniform distribution of cytoplasm. Conclusions: Cy3-si435-PAC nanoparticles have good morphology, uniform particle size, normal potential distribution, and no cell cytotoxicity. Cy3-si435-PAC nanoparticles can be effectively uptaked by HL-1 cells and suppress NF-κB-p65 mRNA expression. They also can effectively target to mice cardiomyocytes to reduce inflammatory cells infiltration and alleviate the myocardial injury of mice induced by LPS.

[Platysma myocutaneous flaps in reconstruction of defects caused by hypopharyngeal cancer resection]

Objective:To study the method and feasibility in reconstruction of platysma myocutaneous flap of defects caused by hypopharyngeal cancer resection. Method:Twelve cases underwent reconstruction with the platysma myocutaneous flap of hypopharyngeal soft defect were investigated. All cases received 2 times preoperative induction chemotherapy followed by hypopharyngeal cancer resection with laryngeal function preservation and the neck lymph node dissection. Platysma myocutaneous flap was used to repair the hypopharyngeal soft tissue defect. Result:All the flaps survived. Three weeks after surgery, all patients can eat without pharyngeal fistula and dysphagia, but pharyngeal foreign body sensation. Three cases of cough after surgery, improved after training. After postoperative radiotherapy, flap survived without secondary necrosis. Laryngeal function of all cases was retained, and only one case with cannula maintained. Conclusion:Preoperative induction program can effectively reduce the lesion. The placenta myocutaneous flap has rich blood supply, strong anti-infectivity. It is an effective method to repair the hypopharyngeal tissue defect with the placenta myocutaneous flap.

[Effect of high fat on fibrosis in rat hepatic stellate cells]

OBJECTIVE

To investigate the effect of high fat on the expression of high-mobility group box 1 (HMGB1),α-smooth muscle actin (α-SMA), and matrix metalloproteinase-2 (MMP-2) in rat hepatic stellate cells (HSC-T6 cells).

METHODS

HSC-T6 cells were cultured in vitro and treated with palmitic acid (PA) at a concentration of 300μmol/L for 24 hours, and the HSC-T6 cells in the control group were treated with bovine serum albumin (BSA) of the same volume for 24 hours; Western blot was used to measure the expression ofα-SMA and MMP-2. The HSC-T6 cells in the dose-effect group were treated with PA at concentrations of 0, 100, 200, 300, 500, and 1000μmol/L for 24 hours; the HSC-T6 cells in the time-effect group were treated with PA for 0, 4, 8, 12, 24, and 48 hours; in the control group, PA was replaced by BSA of the same volume; Western blot was used to measure the expression of HMGB1,α-SMA, and MMP-2. The HSC-T6 cells were treated with recombinant HMGB1 (rHMGB1) at concentrations of 0, 50, 100, 200, and 500 ng/ml for 48 hours, and in the control group, PA was replaced by phosphate buffer of the same volume. Western blot was used to measure the expression ofα-SMA and MMP-2. The HSC-T6 cells in the PA group were treated with PA at a concentration of 300μmol/L for 24 hours; the HSC-T6 cells in the PA+HMGB1-siRNA group were treated with PA at a concentration of 300μmol/L for 24 hours after HMGB1 in HSC-T6 cells was down-regulated; in the blank control group, PA was replaced by BSA of the same volume. Western blot was used to measure the expression of HMGB1,α-SMA, and MMP-2. One-way analysis of variance was applied for continuous data, and the t-test was applied for comparison between two groups.

RESULTS

(1) The expression ofα-SMA and MMP-2 increased significantly after HSC-T6 cells were treated with PA at a concentration of 300μmol/L for 24 hours (P< 0.05). (2) Compared with the HSC-T6 cells in the untreated group (0μmol/L), the HSC-T6 cells treated with different concentrations of PA showed significant increases in the expression of HMGB1 and MMP-2 (P< 0.01), as well as a significant increase in the expression ofα-SMA at concentrations of 200, 300, 500, and 1000μmol/L (P< 0.01); the HSC-T6 cells treated with PA at a concentration of 300μmol/L for different periods of time showed varying degrees of increase in the expression of HMGB1,α-SMA, and MMP-2, with significant increases at 16, 24, and 48 hours (P< 0.01). (3) Compared with the HSC-T6 cells in the untreated group (0 ng/ml), the HSC-T6 cells treated with rHMGB1 at concentrations of 100, 200, and 500 ng/ml for 48 hours showed significant increases in the expression ofα-SMA and MMP-2 (P< 0.05). (4) Compared with the HSC-T6 cells in the PA group, the HSC-T6 cells treated with PA+HMGB1-siRNA for 24 hours showed significant reductions in the expression of HMGB1,α-SMA, and MMP-2 (P< 0.05).

CONCLUSIONS

High fat can increase the expression ofα-SMA and MMP-2 through up-regulating the expression of HMGB1 in HSC-T6, and thus lead to the development of liver fibrosis.

[Research advances in diagnosis and treatment of liver failure in 2016]

Liver failure has various clinical types, a complex pathogenesis, and rapid disease progression, as well as a high mortality rate. Liver failure caused by hepatitis B virus infection is the most common type in China with severe conditions, various complications, and a mortality rate as high as 40%-90%. Invasive fungal disease secondary to acute-on-chronic liver failure can affect patients' prognosis and increase mortality rate. This article introduces the research advances in hepatitis B-related liver failure, artificial liver, and invasive fungal disease secondary to acute-on-chronic liver failure in 2016.

[The combined effects of family history of cardiovascular disease and overweight on ischemic stroke incidence among the Mongolian population]

Objective: To investigate the cumulative effect of family history of cardiovascular disease(CVD)and overweight on ischemic stroke events in the Mongolian population. Methods: Study participants were recruited from 32 villages from May 2002 to August 2012 in Kezuohou Banner(county)and Naiman Banner in Inner Mongolia, China. Among 3 457 Mongolian people aged ≥20 years old living in these villages, 2 589 were selected to participate in this study. None of the participants had chronic kidney disease, malignant tumor, thyroid disease or adrenalopathy, or acute infectious disease. The 2 589 participants were followed for a mean of 9.2 years. Six participants were lost to follow up, resulting in a follow-up rate of 99.8%. Information collected included demographic characteristics, lifestyle risk factors, alcohol consumption, cigarette smoking, history of disease, family history of CVD, and physical examination. Ischemic stroke incidence information was collected during follow-up. All participants were categorized into four subgroups according to family history of CVD and overweight status. Cox proportional hazards models were used to estimate the hazard ratios(HR)and 95% CI of ischemic stroke events among subgroups, compared with the subgroup with no family history of CVD and body mass index(BMI)<24 kg/m²(the reference group). Results: Among 2 589 participants, 76 ischemic stroke events occurred after follow-up, and 8 were excluded because of lack of key data. Finally, 2 581 participants were included in the analysis, and the incidence density was 323/100 000 person-years. The cumulative incidence rates of ischemic stroke were 2.48%, 1.86%, 6.67% and 9.00% in the no family history of CVD and BMI <24 kg/m², no family history of CVD and BMI ≥24 kg/m², family history of CVD and BMI <24 kg/m² and family history of CVD and BMI ≥ 24 kg/m² subgroups, respectively. Using the Cox proportional hazards model, after further adjustment for age, gender, smoking, drinking, FPG, hypertension, total cholesterol, triglycerides, and heart rate, the risk of ischemic stroke in the subgroup with a family history of CVD and BMI ≥24 kg/m² was higher than the reference group(HR: 2.61, 95% CI: 1.16-5.87). However, the risk of ischemic stroke in other two groups was not statistically significant compared with the reference group. The HR(95% CI)values in the no family history of CVD and BMI ≥24 kg/m²and family history of CVD and BMI <24 kg/m² subgroups were 1.18(0.5- 2.39)and 1.27(0.67- 2.42), respectively. Conclusion: In the Mongolian population, a family history of CVD and coexistent overweight may increase the risk of ischemic stroke events, suggesting that in people with family history of cardiovascular disease, weight control is conducive to the prevention of ischemic stroke.