Abstract:Objective To screen for and validate the principal ultrasonographic features of normal human parathyroid glands, so as to provide guidance for diagnostic ultrasound in parathyroid pathologies and protection of normal parathyroid during total thyroidectomy. Methods From Apr. 2008 to Dec. 2012, the neck ultrasonograms focusing on the thyroids and adjacent structures were obtained from 600 healthy subjects. One-by-one identification and exclusion was performed based on anatomical evidences, and the most probable parathyroid images (termed as presumed parathyroid sonogram) of normal human parathyroid were obtained. Based on those presumed parathyroid sonograms, we compared the detection rates of parathyroid in subjects with or without hypoparathyroidism following total thyroidectomy, and we also analyzed the ultrasonic features of patients with hyperparathyroidism. Moreover, we assessed the influence of intraoperative ultrasonography on the occurrence of hypoparathyroidism following total thyroidectomy. The accuracy and reliability of the presumed parathyroid sonogram were discussed. Results It was verified that the normal parathyroid appeared as a small well-circumscribed nodule with fine and homogenous internal hyperechoes. Their configuration varied, with oval shape as the commonest one; the texture was softer than that of adjacent thyroid parenchyma, with the quantitative strain ratio below 1 on elastography. About 62.5% of the normal parathyroids were filled with color Doppler flow signals. The gland was small, with the mean length, width, and thickness being (6.38±1.46), (3.76±1.02), and (2.75±1.99) mm, respectively, and the mean volume was (0.13±0.06) mL by VOCAL method. The inferior glands were much better displayed than the superior ones. As for the patients who had experienced a total thyroidectomy, among five cases complicated with postoperative hypoparathyroidism, 4 (80%) developed the absence of parathyroid on ultrasonography, which was not seen in 35 patients with normal parathyroid function. As for the patients with hyperparathyroidism, normal parathyroid glands were invisible in the area of adenomatous or hyperplastic parathyroids. One patient (3.3%)with intraoperative ultrasonography and six patients (20%) without intraoperative ultrasonography developed postoperative hypoparathyroidism (P<0.01). Two patients with thyroid agenesis showed 2 normal ipsilateral normal parathyroids. Conclusion In the present study we have successfully obtained the ultrasonic features of normal parathyroids using non-invasive research strategies, which have been preliminarily validated in clinical application.

Abstract:Objective To determine the parathyroid hormone (PTH) content in ultrasound-guided fine-needle aspiration sample of normal parathyroid based on ultrasound characteristics previously screened out, so as to verify the reliability of the ultrasound characteristics of normal parathyroid. Methods Between Oct. 2012 and Jan. 2013, 10 healthy volunteers were enrolled in the present study after obtaining written informed consent and approval by the ethics committee of our institution. Ultrasound-guided percutaneous aspiration from both the ultrasonic parathyroid area and well-recognized neck lymph node was conducted by using 22G fine needles. The aspirates were taken for cytology purpose and the washing of the left-over in the canula was taken for PTH evaluation by electrochemiluminescence. Simultaneously samples of venous blood were obtained also for PTH evaluation as controls. Results The aspiration procedures were successfully for all the 10 subjects, and cytological examination all found cells, with no intraoperative or and postoperative complications. PTH level in the washing of left-over extracted from the parathyroid aspirates averaged (287.12±35.41) pg/mL and ranged 232.53-357.38 pg/mL, and that from the lymph node averaged (16.03±8.47) pg/mL and ranged 8.67-34.28 pg/mL; while the serum PTH level averaged (37.44±7.26) pg/mL and ranged 32.64-47.85 pg/mL. Three of the ten aspirates of parathyroid did not have enough cells to make predication, and the other seven aspirates had enough cells, with four likely from parathyroid and three from indefinite origins. All the ten aspirates from the lymph node areas were confirmed to have definite lymphocytes. Conclusion PTH evaluation results by fine-needle washing after ultrasound-guided aspiration are highly consistent with the ultrasonic parathyroids and lymph nodes, which preliminarily proves the reliability of the previously identified ultrasound characteristics of normal parathyroids.

Abstract:Objective To establish treatment strategies using percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) for benign parathyroid nodules and to investigate the related techniques, procedures, safety and efficacy. Methods Percutaneous RFA and MWA were conducted on 317 benign parathyroid nodules in 96 patients using an auto-controlled bi-polar electrode system (Celon ProBreath, Germany) and thyroid-specified microwave antenna (Thy-ablation^TM, China). The ablation strategy, optimal puncture route, protection of vital neck vessels and recurrent laryngeal nerve, reduction of bleeding from core-needle biopsy, indicator for complete therapy, ablation time (AT) for single nodule, and total operation time (TOT) for each case were investigated and analyzed. The focal changes of ablated region on multimode ultrasound, serum parathyroid hormone (PTH) level, serum calcium values, clinical manifestations and pathological alterations were assessed during follow-up. Results Cross section simultaneously demonstrating the ablation target, ablation needles and vital anatomic structures was essential for a safe ablation procedure of parathyroid lesions. Liquid isolating zone maneuver was beneficial for creating safe puncture route and for protecting laryngeal nerves, esophagus and trachea from heat damage. “Thermal blocking of blood flow” prior to core-needle biopsy effectively reduced bleeding and successfully treated one patient with intensive subcutaneous hemorrhage. Contrast-enhanced ultrasound was an important and essential indicator for a complete therapy. In primary hyperparathyroidism (PHPT) group the TOT for each case was about (572.47±75.79) s and AT for single nodule was about (194.82±46.39) s, and the numbers in secondary hyperparathyroidism (SHPT) group were (1 548.47±323.83) s and (217.55±52.42) s, respectively. Two months after ablation, the ablated region began to shrink, and RFA was superior to MWA regarding the speed and extent of shrinkage. At the end of twelfth month, ultrasound scanning revealed that the ablated region was completely dissolved in 73.1%(19/26) of nodules in PHPT group and 53.6% (156/291) of nodules in SHPT. Pre-ablative ^99mTc-MIBI disclosed 93.1% (295/317) of the parathyroid lesions and none of them were visible after ablation. Ultrasound elastography disclosed hardening of the ablated region, and it gradually became soft, paralleling with shrinkage of the ablated region. Serum PTH level decreased rapidly after ablation, particularly in PHPT patients. In the later course PTH levels had relapse in some patients, but the relapses were quite different in timing and extent between PHPT and SHPT groups. Two cases with hyperparathyroidism crisis regained consciousness two hours after ablation therapy. Conclusion Ultrasound-guided percutaneous thermal therapy of parathyroid benign nodules is a new modality of surgical intervention for hyperparathyroidism. The ablative procedure is precise, accurate, safe, and time-saving. The lesion can be completely inactivated and the absorbed. Rapid dropping of PTH level makes it valuable for emergency treatment of crisis. The relapse of PTH may indicate new parathyroid lesion.

Abstract:Objective To explore the clinical strategy and efficacy of ultrasound-guided radiofrequency ablation for parathyroid adenoma. Methods Ultrasound-guided percutaneous radiofrequency ablation was used to treat 5 patients with solitary parathyroid adenomas. The ultrasonography of procedured area was closely observed. The symptoms of patients,serum parathyroid hormone (PTH) and electrolytes were compared before and after treatment, and the efficacy and safety were assessed. Results The ablative procedures were successful in all the 5 cases. Intraoperative contrast-enhanced ultrasound revealed that the previous distinct vascularities of the adenomas were completely destroyed. Hoarseness was found in two patients, and they recovered in one week postoperatively. No subcutaneous heamorrhage was found beneath the neck skin or along the puncture tract. And there were no hypoparathyroidism, dysphagia or breathing difficulties. The symptoms of ostealgia, skin itching and vomitting were greatly improved in patients on the next day of operation, with PTH obviously declined (71.4%-94.1%) and serum calcium returned to the normal level. Conclusion Ultrasound-guided percutaneous radiofrequency ablation is safe and effective for parathyroid adenoma, with less trauma and slight complications.

Abstract:Objective To study the role of high lipid-mediated endoplasmic reticulum stress in human glomerular mesangial cells (HMCs) injury under inflammation condition, and to explore the mechanism of lipid-induced kidney injury.Methods HMCs were divided into control group, high lipid group, inflammatory stress group, high lipid plus inflammatory stress group, and high lipid plus inflammatory stress plus 4-phenylbutyric acid (4-PBA) group. After culture for 24 h, 48 h, and 72 h, Oil red O staining was used to evaluate lipid droplet accumulation in the cells; cell proliferation was assessed by MTT assay; expression of GRP78 protein was measured by immunocytochemistry method; and the levels of GRP78 and FN mRNA were examined by real-time PCR.Results (1) Compared with control group, the high lipid group, inflammatory stress group and high lipid plus inflammatory stress group had significantly increased intracellular cholesterol levels (all P<0.01), significantly higher FN mRNA levels (all P<0.01), and significantly faster cell proliferation (all P<0.01), which was in a time-dependent manner. Compared with high lipid plus inflammatory stress group, 4-PBA group had significantly reduced lipid deposition (all P<0.01), slower cell proliferation (all P<0.01) and lower FN mRNA expression (P<0.05, P<0.01) induced by high lipid. (2) Compared with control group, high lipid group, inflammatory group and high lipid plus inflammatory stress group had significantly increased expression of GRP78 mRNA and protein (P<0.05,P<0.01), and the expression in 4-PBA treatment group was significantly lower than that in the high lipid plus inflammatory stress group (all P<0.01). (3) After treatment with high lipid or inflammation for 24 h, 48 h and 72 h, the intracellular cholesterol level was positively correlated with mesangial cell proliferation and expression of GRP78 protein and FN mRNA (all P<0.01). The cellular expression of GRP78 protein was positively correlated with mesangial cell proliferation and FN mRNA expression (all P<0.05). Conclusion High lipid can induce glomerular mesangial cell injury through activating endoplasmic reticulum stress in HMCs under inflammation stress condition.

Abstract:Objective To observe the distribution and expression of exogenous gene delivered by oral administration of recombinant attenuated Salmonella typhimurium in nude mouse model carrying human saliva gland adenoid cystic carcinoma. Methods The attenuated Salmonella typhimurium of green fluorescent protein (GFP) gene expression was constructed by transfecting prokaryotic and eukaryotic expression plasmid vector into the attenuated Salmonella typhimurium SL7207, and the recombinant attenuated Salmonella typhimurium SL7207-pUC-GFP for prokaryotic expression and SL7207-pEGFP-N1 for eukaryotic expression were obtained. The expression stability of GFP gene in the prokaryotic SL7207-pUC-GFP was tested for 10 times in vitro. The nude mouse models carrying human saliva gland adenoid cystic carcinoma were orally administered with prokaryotic SL7207-pUC-GFP (0.1 mL,1×10⁹ cfu/mL), and then the distribution of the attenuated Salmonella typhimurium in the liver, spleen and tumor tissues were assessed by observing GFP expression in SL7207-pUC-GFP clones cultured out of the tissues homogenate at 24 h, 48 h, 5 d, 10 d, 20 d, and 30 d after oral administration. The nude mouse models were also orally administered with eukaryotic SL7207-pEGFP-N1, and the expression of GFP in the liver, spleen and tumor tissues was observed in frozen tissue sections 5 d later under fluorescence microscope. Results The expression of GFP harbored by the recombinant attenuated Salmonella typhimurium SL7207-pUC-GFP was not reduced or lost after 10 times of in vitro passaging. After the oral administration of prokaryotic SL7207-pUC-GFP, the attenuated Salmonella typhimurium could survive in the liver, spleen and tumor tissues for a long time, with the clone numbers in tumor tissues being significantly higher than those in the liver and spleen tissues at all the time points (P<0.05). After oral administration of eukaryotic SL7207-pEGFP-N1, the expression of GFP was higher in tumor tissues than in the liver and spleen tissues. Conclusion The recombinant attenuated Salmonella typhimurium can be enriched in human saliva gland adenoid cystic carcinoma cells and deliver the harbored exogenous gene into the tumor cells for expression, showing a double advantage for gene therapy.

Abstract:Objective To compare the phenotypes and biological characteristics between the rabbit hair follicle stem cells and urethral mucosa stem cells, and to explore the feasibility of using hair follicle stem cells as seed cells for tissue engineering urethra. Methods Rabbit hair follicle stem cells and urethral mucosa stem cells were isolated and cultured in vitro, and the cells with diameter <10 μm and integrin-α6+/CD71- were sorted using flow cytometry. The maximum amplification factor and clone forming ability of the two kinds of cells were calculated. The positive rates of K19, p63 and β1-integrin in the two kinds of cells were detected by flow cytometry. The enriched stem cells were implanted in the urethral stent to construct tissue engineering urethra. Histology and fluorescent staining were used to observe the tissue-engineered urethra. Results The maximum amplification multiples of rabbit hair follicle stem cells and urethral mucosa stem cells were (6.1 ±0.8)×10⁴ and (7.1±1.1)×10³, respectively; and the clone formation rates were (10.1±1.3)% and (4.3±1.1)%, respectively. The positive rates of K19, p63, and β1-integrin in hair follicle stem cells were (90.53±6.77)%, (93.31±5.57)%, and (91.17±6.98)%, respectively; and those in urethral mucosa stem cells were (88.50±4.95)%, (91.63±5.86)%, and (93.35±6.28)%, respectively. Both hair follicle stem cells and urethral mucosa stem cells formed complex layer epithelioid structure on the stents, with positive staining for AE1/AE3. Conclusion Rabbit hair follicle stem cells and urethral mucosa stem cells can both serve as seed cells for constructing tissue engineering urethra. As for the availability of seed cells, hair follicle stem cells are more superior to the urethral mucosa stem cells.

Abstract:Objective To study the changes in expression of peroxisome proliferatoractivated receptor-γ co-activator-1α (PGC-1α) and sirtuin (silent mating type information regulation 2 homolog)1 (S. cerevisiae)(SIRT1) in the hippocampal tissues of type 2 diabetes mellitus rats and to discuss its significance. Methods Diabetic models were induced by highfat diet and intraperitoneal injection of streptozotocin (STZ) in SD rats. Then the rats were divided into model group and αlipoic acid group randomly. Healthy rats served as controls. All of the rats were tested by Morris water maze after 8 weeks, and then the hippocampus tissues of animals were prepared for TUNEL assay and transmission electron microscopy (TEM) observation. The expression of PGC-1α mRNA was examined by RTPCR, and the expression of PGC-1 α and SIRT1 protein were examined by Western blotting analysis. Moreover, the activities of superoxide dismutase (SOD), glutathione (GSH), and the content of malondialdehyde (MDA) were all examined using corresponding kits. Results Compared with the control group, 8 weeks later the model group had significantly decreased cognitive function (P<0.05), with evident apoptotic neurons and prominent ultrastructure damage in the hippocampus tissues. Moreover, the model group had significantly lower SOD and GSH activities, PGC-1 α mRNA and protein expression, and SIRT1 protein expression (P<0.01), and significantly higher MDA content (P<0.01). When compared with the model group, rats in the α-lipoic acid group showed significantly improved cognitive function (P<0.05) and lower levels of neuron apoptosis and ultrastructure damage; and the expressions of PGC1α mRNA and protein, SIRT1 protein and the activities of SOD and GSH were significantly increased in the αlipoic acid group (P<0.01), while the content of MDA was significantly declined (P<0.05).Conclusion High glucose condition inhibits the expression of SIRT1, resulting in the dysfunction of PGC-1α, which might be an important factor for diabetes cognitive impairment.

Abstract:Objective To develop a percutaneous technique with expandable balloon catheter for establishing a sheep model of acute cervical spinal cord compression injury. Methods Twelve adult male sheep were randomized into 3 groups: control (A, n=4), 0.6 mL compression (B, n=4) and 1 mL compression (C, n=4) groups. All animals received epidural balloon catheter (3Fr) insertion using a percutaneous trans-lumbosacral interlaminar space technique similar to the method used in vascular access for angiography. The balloon catheter was advanced under fluoroscopic guidance until its distal tip reached the C_6/7 level. One week later, the balloons of group B and C were inflated by 0.6 mL and 1 mL half-strength contrast material; the balloons were left inflated for 1-hour and then deflated. Animals in group A received no treatment. CT and MR images were taken before and after surgical procedures. Quantitative assessment of spine canal occupying rate was accomplished by using a software program based on CT results. Motor functions of animals were assessed by modified Tarlov scale. Two animals were sacrificed each time at 24 h and 48 h after inflation in each group. Spinal segments of the injured level were then obtained for pathologic examination. Results Balloon catheters were successfully inserted in all animals, and the spinal-canal-occupying rates were (9.1 ±0.2)% in group A, (9.1±0.2)% in group B, and (8.9±0.2)% in group C after insertion. After inflation, the rates increased to (45.5±2.5)% in group B and (78.3±2.3)% in group C, and MRI findings indicated ventral compression of the cervical spinal cord. Hind limb movement remained normal after catheter insertion in all groups. Animals in group B and C became paraplegic after inflation, and a positive correlation between injection volume and Tarlov score was observed. Pathological results demonstrated neuron atrophy, increased gap around the neurons, mild demyelinated and vacuolar degeneration in both group B and C at C_6/7 level 24 h after injury. Pathological changes deteriorated at 48 h after injury. Conclusion Percutaneous epidural balloon catheter insertion can avoid surgical exposure of normal tissues around the spinal cord, and it may serve as a method for establishing acute cervical spinal cord injury model simulating the clinical condition.

Abstract:Objective To assess the relationship between early mortality and degree of prosthesis-patient mismatch(PPM) after aortic valve replacement surgery using risk-adjusted mortality of EuroSCORE Ⅱ . Methods The clinical data of 1 247 consecutive patients who underwent aortic valve replacement from Jan. 1, 2007 to Dec. 31, 2011 in our hospital were retrospectively analyzed. The EuroSCORE Ⅱ-predicted mortality and the effective orifice area index (EOAi) of artificial aortic valve were calculated for each patient. The patients were divided into three groups according to aortic EOAi: non-to-mild PPM, moderate PPM, and severe PPM. Risk-adjusted mortality and 95% confidence interval were calculated for each group. The EuroSCORE Ⅱ-predicted mortality and risk-adjusted mortality were compared among three groups. Results The observed mortality was 2.79% (29/1 040) for patients with non-to-mild PPM, 5.00% (8/160) for patients with moderate PPM, and 8.51% (4/47) for patients with severe PPM, with significant differences found between groups (P<0.05) . There were no significant differences in EuroSCORE Ⅱ-predicted mortalities among the three groups (2.82% for the non-to-mild PPM group, 2.69% for the moderate PPM group, and 2.72% for the severe PPM group). And the risk-adjusted mortality of non-to-mild PPM group (0.99, 95%CI: 0.93-1.05) was significantly lower than those of moderate PPM group (1.86, 95%CI: 1.68-2.08) and severe PPM group (3.13, 95%CI: 2.56-4.00). Conclusion High degree of aortic PPM after aortic valve replacement is associated with increased operative mortality.

Abstract:Objective To identify the changes of serum alpha-fetoprotein (AFP) and AFP-L3 levels after surgical resection of hepatocellular carcinoma (HCC), so as to evaluate the role of AFP-L3 in predicting post-operative HCC recurrence. Methods A total of 67 HCC patients who received surgical resection from Jan. 2007 to Dec. 2007 were enrolled in the present study. The detailed clinical data were obtained for each patient. Pre- and post-operative serum AFP and AFP-L3 levels were measured continuously, and patterns of their post-operative changes were followed up for a long-term period. Results The overall 1-, 2- and 3-year recurrence rates of the patients were 23.9%(16/67), 38.8%(26/67) and 50.7%(34/67), respectively. There was no relationship between serum AFP and AFP-L3 level before operation (r_s=0.176, P=0.155). The pre-operation serum AFP-L3 level was significantly correlated with tumor recurrence (r_s=0.327, P=0.007), but the relation between pre-operation serum AFP level and tumor recurrence was not clear yet(r_s=0.240, P=0.051). Conclusion Serum AFP-L3 level is associated with HCC recurrence and therefore valuable for predicting HCC recurrence; it can provide clinicians with more information for judging the therapeutic efficacy of HCC patients.

Abstract:Objective To summarize the key points for diagnosis and differential diagnosis of hepatocellular carcinoma combined with bile duct tumor thrombi(HCCBDT), and analyze the common reasons for misdiagnosis. Methods A total of 392 patients with HCCBDT over a 18-year period were included in this study. The liable disease types of misdiagnoses were summarized and the main causes of preoperative misdiagnosis were analyzed. The patients were divided into two groups according to the time periods: Group A(from 1993 to 2001, 128 patients) and Group B(from 2002 to 2011, 264 patients). The misdiagnosis rates and types of misdiagnosed diseases were compared between the two groups. The key points of diagnosis and differential diagnosis of HCCBDT were summarized. Results The overall preoperative misdiagnosis rate was 16.6% (65/392) in our patients. The misdiagnosis rate of Group B (9.8%, 26/264) was significantly lower than that of Group A (30.5%, 39/128) (P<0.001). And 91.7%(242/264) patients received ERCP/MRCP examination in Group B, which was significantly higher than that in the Group A(67.9%, 87/128) (P<0.001). The misdiagnosis rate of ERCP/MRCP(5.5%,18/329) was significantly lower than those of B-type ultrasound examination (26.8%, 105/392) (P<0.001) and CT/MRI scan(25.0%, 98/392) (P<0.001). The misdiagnosed diseases included hepatocellular carcinoma with hilar bile duct compression (4.1%, 16/392), hilar bile duct adenoma/carcinoma (4.3%, 17/392), distal bile duct adenoma/carcinoma (including ampullary adenoma/carcinoma) (2.3%, 9/392), mucus-like bile duct adenoma/carcinoma (1.0%, 4/392), metastatic liver cancer with bile duct tumor thrombi (1.0%, 4/392), and bile duct stones (3.8%, 15/392). The proportions of misdiagnosis as liver cancer with hilar bile duct compression in the Group A and Group B were 9.4% (12/128) and 1.5%(4/264), respectively, and those as bile duct stone were 7.8% (10/128) and 1.9% (5/264), respectively (P<0.01). Conclusion More knowledge on the HCCBDT clinical features, effective imaging examination methods, and more efforts on differential diagnosis with the similar diseases can reduce misdiagnosis of HCCBDT.

Abstract:Objective To establish finite element models of universal spinal system (USS) and Isobar TTL on L3-S1 with fine anatomical structures and to compare the characteristics of stress distribution of the two models, so as to explore the influence of dynamic internal fixation system (DIFS) on the lumbar biomechanics, providing a theoretical basis for clinical application of DIFS.Methods The lumbar spine geometries were determined using the CT images of a 26-year-old healthy man. The finite element models of USS and Isobar TTL were constructed by using package Mimics 11.1, Geomagic studio 10.0, HyperMesh 10.0 and Abaqus 6.8. The ranges of motion, intervertebral disc stress of adjacent segments, and stress distribution and peak of internal fixation were recorded when the models were subjected to 150 N preload and 10 Nm moment of forces under different conditions: flexion, extension, lateral bending and axial rotation.Results We have successfully constructed the definite element model of L3-S1 with fine anatomical structures and the postoperation models of Isobar TTL and USS. The stress of Isobar TTL and USS model was mainly distributed on the screws, with the maximal stress on USS model being higher than that on the Isobar TTL model. The screws had high stress at the middle part, with the maximal stress being all less than 100 MPa under different conditions. The intervertebral stability of Isobar TTL model was not greatly different from that of normal model; however, the overall motion of USS model was obviously deceased, especially when at flexion and extension condition. For Isobar TTL model, the increases of intervertebral disc stress of adjacent segments of L3/L4 for forward bending, backward extension, lateral bending and rotation were 6.2%, 9.7%, 3.6%, and 3.8%, respectively, and the numbers for USS model were 8.5%, 13.5%, 4.3% and 4.8 %, respectively.Conclusion The maximal stress of Isobar TTL system can effectively maintain the range of motion of the lumbar spine, reduce the resistance of stress, and delay adjacent segment degeneration in theory.

Abstract:Objective To use high-performance liquid chromatography-time of flight mass spectrometry (HPLC-TOF/MS) for examining the steroidal saponins in rat urine after oral administration of Paris polyphylla extract, so as to lay a foundation for studying the metabolism of steroidal saponins in vivo. Methods SD rats were administered with an oral dose of 1.6 g Paris polyphylla extracts/kg body weight. The urine samples were collected 24 h after administration by oral gavage. The sample analysis was carried out on a reverse phase MG-C₁₈ column (3.0 mm×100 mm, 3.0 μm) using a gradient mobile phase system of acetonitrile-water containing 0.1% formic acid. TOF/MS was applied for qualitative analysis under positive and negative ion modes. The steroidal saponins in rat urine were identified by using the accurate molecular weight obtained by TOF/MS and formula database. Results A total of 20 steroidal saponins were identified in the rat urine, and two pairs of isomers were deduced through their fragment ions and standards: polyphyllin Ⅶ and pennogenin-3-O-α-L-rhamnopyranosyl(1→4)-α-L-rhamnopyranosyl (1→3)-\[α-L-rhamnopyranosyl(1→2)\]-β-D-glucopyranoside; and gracillin and pennogenin-3-O-α-L- rhamnopyranosyl(1→4)-α-L-rhamnopyranosyl(1→4)-β-D-glucopyranoside.Conclusion The established analysis method is accurate, reliable for identifying steroidal saponins in vivo, which paves a way for further pharmacokinetics and pharmacodynamics study of Paris polyphylla.

Abstract:Objective To use numerical simulation technology for analyzing the hemodynamic and morphological factors for rupture status of posterior communicating artery aneurysms. Methods A total of 39 posterior communicating artery aneurysms treated in Changhai Hospital were recruited in the present study during January to December 2011, and they included 28 ruptured and 11 unruptured ones. The 3-dimensional model of the aneurysms were constructed, and the digital subtraction angiography data were obtained. Then the hemodynamic analysis of the aneurysms was done using the method of computational fluid dynamics. Results The aspect ratio (AR) was 1.233±0.483 in the ruptured group, which was significantly higher than that in unruptured group (0.832±0.252, P=0.002). The normalized mean wall shear stress (WSS) was significantly lower in ruptured group than in unruptured group (0.545±0.259 vs 0.761±0.216, P=0 .015). And the percentage of the low WSS area (LSA) in ruptured group was significantly higher than that in unruptured group (\[11.669±16.041\]% vs \[1.236±2.212\]%, P=0.040). Other parameters, including size ratio (SR) and oscillatory shear index (OSI), showed no significant differences, between the two groups. Conclusion Higher AR, lower WSS and higher LSA may be risk factors for aneurysmal rupture.

Abstract:Objective To investigate the color differences of enamel and dentin of natural teeth, so as to lay a foundation for reducing the color differences of natural dentin and core of all ceramic restorations. Methods X-rite Color i7 Spectrophotometer was used to examine the chroma value and chromatic difference (ΔE) of enamel and dentin of natural teeth (thickness 0.9 mm, 0.6 mm and 0.3 mm, n=30) . Results The L^* values (lightness) of enamel and dentin increased with the decrease of slice thickness, and the a^* values (red-green) and b^* values (yellow-blue) decreased with the decrease of slice thickness (P<0.05). The absolute L^*, a^* and b^* values of the dentin were significantly greater than those of enamel of same thickness (P<0.05). There were great color differences between enamel and dentin of different thicknesses, with the mean ΔE values within a range of 5.303-13.109. The color difference gradually increased with the thickness increase of enamel and dentin. The ΔE value of the enamel and dentin of the same thickness was 5.115 (0.9 mm), 5.855 (0.6 mm), and 6.053 (0.3 mm), respectively. Conclusion There is noticeable color difference between the enamel and dentin of natural teeth, and the difference increases with the increase of their thickness difference. The dentin has a more yellowish color and less lightness compared with the enamel. So each laminate of all ceramic restorations needs a shade selection for all ceramic restorations, and more attention should be paid on the color matching of natural dentin and core ceramic laminate.

Abstract:Angiogenesis is essential for tumor growth and metastasis, and it plays a key role in the development and progression of lung cancer. Angiogenesis is determined by the tumor microenvironment and regulated by multiple signaling pathways. Lung cancer angiogenesis process can be summarized as follows: (1) Continuing growth of tumor promotes the so-called “angiogenic switch” in the microenvironment, starting the angiogenic process; (2) Matrix metalloproteinases (MMPs) induce the degradation and remodeling of extracellular matrix (ECM); (3) Endothelial cells migrate through the remodeled ECM as induced by platelet-derived growth factor (PDGF) and chemokines; (4) In presence of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF), endothelial cells greatly proliferates; and (5) Lumen formation and vascular function are achieved by Dll4-Notch signaling. Currently, inhibition of angiogenesis has become an important option for lung cancer. Each stage of angiogenesis may become a potential target for treatment. New lights on the mechanisms of lung cancer angiogenesis is of great clinical significance for seaching effective anti-angiogenic and anti-lung cancer therapeutic methods.

Abstract:Intracranial atherosclerosis constitutes a major reason for ischemic stroke in Chinese population. Progression in magnetic resonance technology has enabled us to display atherosclerotic plaque. This review discussed the recent progress on the performance of 3.0T high-resolution magnetic resonance imaging in depicting middle cerebral artery atherosclerotic plaques.

Abstract:MicroRNAs (miRNAs) are important gene expression regulators and are involved in a variety of pathogeneses such as cancers and autoimmune diseases. Signal transducers and activators of transcription (STAT), the principle signaling proteins of many cytokines and growth factors, play significant roles in regulating immune cell homeostasis, cell differentiation and cell functions. In this review we discussed the recent advances in interactions between STATs and miRs, with focus on their interaction during the promotion and inhibition of immue cells and tumor cells. MiR-STAT interaction is still a new area of study, and more effort is needed to elucidate miR-STAT mechanisms.

Abstract:Objective To evaluate the clinical value of real-time fluorescent quantitative reverse transcription polymerase chain reaction (qRT-PCR) in detecting expression of estrogen receptor alpha (ERα), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2) genes in breast cancer tissues. Methods Totally 48 breast cancer tissues and 28 benign breast tumor tissues (control) were obtained from patients undergoing surgery in our hospital during Mar. 2010 and Oct. 2010. The expression of ERα, PR and Her2 protein was examined by immunohistochemistry (IHC) in breast cancer tissues and the expression levels of ERα, PR and Her2 mRNA were detected by real-time qRT-PCR in breast cancer tissues and benign breast tumor tissues. The values of these two methods in diagnosis of breast cancer were evaluated.Results The expressions of ERα and Her2 mRNA were significantly higher in the breast cancer tissues than in the controls (P<0.05, P<0.01), while the expression of PR mRNA had no significant difference between controls and breast cancer tissues. ERα, PR and Her2 protein expressions were associated with the TNM stage of breast cancer, with the former two being negatively associated with TNM stages (P<0.05) and Her2 being positively associated with TNM stages (P<0.05). The expressions of ERα and Her2 mRNA were significantly higher in breast cancer tissues of patients with lymph node metastasis than in those without lymph node metastasis (P<0.05). The expression of PR mRNA was not significantly different in breast cancer tissues between patients with and without lymph node metastasis (P>0.05). Real-time qRT-PCR in detecting ERα, PR and Her2 mRNA expression had similar capability with IHC method in evaluating the sensitivity, specificity of endocrine therapy; moreover, the two methods also had a consistent pathological diagnosis rates (P>0.05). Conclusion ERα, PR and Her2 genes are important predictive markers for endocrine therapy or targeted therapy of breast cancer. Real-time qRT-PCR method can be used for clinical detection and research of ERα, PR and Her2 mRNA.

Abstract:Objective To develop a reversed phase high performance liquid chromatographic (RP-HPLC) analysis system for hydroxysafflor yellow A (HSYA) in rat model of cold coagulation and blood stasis (CCBS), and to investigate the influence of Sappan lignum on the pharmacokinetics of HSYA in CCBS rats. Methods Rat CCBS models were randomly divided into two groups with each containing 6 animals. Rats were orally given Carthami flos extract or Carthami flos extract combined with Sappan lignum (The dosage: 20.0 g/kg crud drug of Carthami flos). Plasma samples were collected in heparinized tubes from the oculi chorioideae vein at 5, 10, 20, 30, 45, 60, 90, 120, 150, 210, and 270 min after drug administration; and the plasma proteins were precipitated with 20% trichloroacetic acid aqueous solution. Plasma concentrations of HSYA were detected by RP-HPLC at different time points after drug administration. The data were processed by DAS 2.0 software to calculate the pharmacokinetic parameters. Results Compared with the Carthami flos group, the pharmacokinetic parameters V1/F and CL/F of HSYA in the Carthami flos combined with Sappan lignum group were significantly decreased (P<0.01), and the AUC_0-t, C_max, and t_1/2α of HSYA were significantly increased (P<0.01). Conclusion Sappan lignum can promote the absorption of HSYA in rat model of CCBS and reduce the distribution of HSYA, thus exercise an efficacy-enhancing effect.

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