Abstract:Outdoor air pollution is one of the major environmental problems for China, and it has drawn wide concerns. This paper described the current status of air pollution in China and reviewed the research on air pollution and human health in China from the following perspectives: the acute health effects, chronic health effects, and interventional research; finally the authors discussed the prospect of future related researches.

Abstract:Objective To evaluate the effects of key insulin gene transcription regulators (PDX-1, NeuroD1 and MafA) on the differentiation of induced pluripotent stem cells (iPSCs) into insulin-producing cells. Methods Mouse embryonic fibroblasts (MEFs) were infected with lentivirus (LV-ef1a-Hygromicin-TRE-Oct4/Sox2/Klf4/cMyc) at a multiplicity of infection, and iPSCs were selected and identified. Then the iPSCs were infected with adenovirus (Ad-mPDX-1-IRES-GFP, Ad-mNeuroD1-IRES -GFP and Ad-mMafA-IRES -GFP) to induce differentiation into insulin-producing cells in vitro. RT-PCR was applied to detect expression of functional genes in pancreatic islet B cells; immunofluorescence was used to examine the expression and location of insulin protein; and ELISA was used to determine the volumes of secreted insulin at different concentrations of glucose (0,5,10,20,30, and 40 mmol/L). Results The iPSCs derived from MEFs could form intensive clones with smooth boundary, express embryonic stem cell-specific cell surface markers, including Nanog, SSEA-1 and Rex-1, and differentiate into three embryonic layers, which indicating that MEFs were successfully reprogrammed into iPSCs. Mouse iPSCs infected with Ad-PDX-1-IRES-GFP, Ad-mNeuroD-IRES-GFP, and Ad-mMafA-IRES-GFP could differentiate into pancreatic islet B cells. RT-PCR results showed that polygene-modified iPSCs and pancreatic islet B-cell line MIN6 had similar gene expression profile. Immunofluorescence analyses confirmed insulin expression in the differentiated cells. Results of ELISA showed that polygene-modified iPSCs had a satisfactory response to different concentrations of glucose. Conclusion Key insulin gene transcription regulators PDX-1, NeuroD1 and MafA can work synergistically to induce mouse iPSCs differentiation into pancreatic islet B cells capable of insulin biosynthesis and secretion.

Abstract:Objective To investigate the effect of resveratrol on oxidative stress of rat primary cortical neurons during different time windows of oxygen-glucose deprivation/reperfusion (OGD/RP) injury. Methods Rat cortical neurons were cultured under oxygen and glucose deprivation for 150 min and returned to normal culture for 24 h. The experiment was divided into 6 groups, including the normal group, model group, pre-treatment group (treated with resveratrol for 24 h prior to OGD), OGD-treatment group (treated with resveratrol during 150 min of OGD and 24 h of reperfusion), post-treatment group(treated with resveratrol during 24 h of reperfusion), and the whole processing group (treated with resveratrol for 24 h prior to OGD, during 150 min of OGD, and 24 h of reperfusion). Invert microscope was used to observe cell morphology. Chemical colorimetry was used to detect the activity of superoxide dismutase (SOD) and the content of nitric oxide (NO). Immunofluorescence was used to detect the nuclear translocation of nuclear factor erythroid 2-related factor 2 (Nrf2). Western blotting analysis was used reveal the the protein expressions of Nrf2, heme oxygenase-1 (HO-1) and NADP (H):quinone oxidoreductase-1 (NQO-1). Results The stereoscopic effect and refraction of neurons were enhanced at the sixth day of culture. Compared with the model group, resveratrol of various concentrations (10, 20, 40, 60 and 80 μmol/L) significantly elevated the activity of SOD and decreased NO content in the whole processing group (P<0.05) , with the effect being the best when at 40 μmol/L. Compared with model group, resveratrol significantly alleviated neuronal OGD/RP injury, promoted translocation of Nrf2 from the cytoplasm into the nuclei, and upregulated Nrf2, HO-1 and NQO-1 protein expression at all stages of OGD/RP injury, with the best effect found in the whole processing group, followed by the pre-treatment group. Conclusion Resveratrol has a dose-dependent anti-oxidative stress effect on rat cortical neurons during OGD/RP injury, with the best effect seen in the whole processing group, followed by the pre-treatment group. The mechanism might be associated with activation of Nrf2/antioxidant response element (ARE) signaling pathway and the sbusequent upregulation of antioxidant protein expression.

Abstract:Objective To compare the expression of Ku70 and Bax in hippocampus CA1 between normal rats and diabetic rats following cerebral ischemia/reperfusion,so as to explore the roles of Ku70 and Bax in aggravating cerebral ischemia/reperfusion injury in diabetes. Methods Totally 72 male SD rats were divided into 3 groups randomly: sham operated (SO) group, normoglycemia global cerebral ischemia/reperfusion (NCI) group, and diabetic global cerebral ischemia/reperfusion (DCI) group. The rats in DCI group were treated by streptozocin (STZ) and improved Pulsinelli’s four-vessel occlusion method to establish diabetic global cerebral ischemia/reperfusion model. And animals in NCI group were not given STZ, and other treatments were similar to those in the DCI group. Animals in the SO group only had blood vessels exposed. Changes of neuron pathology in hippocampus CA1 were observed by H-E staining under light microscopy at 1, 6, 24, and 48 h after ischemia/reperfusion; expression of Ku70 was detected by immunohistochemistry and Western blotting analysis, and expression of Bax was detected by immunohistochemistry. Results The neuron structure in hippocampus CA1 of rats was damaged in NCI group, and the density of survival neurons was significantly lower than that in the SO group at all studied time points(P<0.05); the neuron structure damage in DCI group was more severe, and the density of survival neurons was significantly lower than that of the NCI group at all studied time points(P<0.05). The expression of Ku70 at 1 and 6 h in NCI group was significantly higher than that in the SO group (P<0.05), and that at 24 and 48 h was significantly lower than that in the SO group(P<0.05); Ku70 expression in DCI group was significantly lower than that in the NCI group at all studied time points(P<0.05). Bax expression in NCI group was significantly higher than that in the SO group at all studied time points(P<0.05), and that in DCI group was significantly higher than that in the NCI group at all studied time points (P<0.05). Conclusion Diabetes can aggravate global cerebral ischemia/reperfusion injury, which may be related to aggravated Ku70 expression decrease and Bax expression increase.

Abstract:Objective To investigate the clinical benefits and role of robot-assisted laparoscopic partial nephrectomy (RAPN) by comparing the clinical data of patients receiving the RAPN or conventional laparoscopic partial nephrectomy (CLPN). Methods A retrospective analysis was performed for 67 patients who underwent either RAPN (n=24) or CLPN (n=43) between January 2011 and December 2012 at our institution. Preoperative clinical stages of both groups were T₁N₀M₀. Univariate analysis and logistic regression model were used to detect factors affecting indication selection in RAPN. The intraoperative parameters and postoperative outcomes were compared between RAPN and CLPN groups matched for DAP score. Results Univariate and multivariate logistic regression analysis revealed that DAP score (β=1.987, P=0.022, 95%CI\[1.34, 39.79\]) was the only predictor of RAPN approach in logistic regression analysis. Only 38 DAP matched cases in RAPN (n=19) and CLPN (n=19) were included for analysis, and the demographics were comparable between the matched two groups except for the preoperative estimated glomerular filtration rate (eGFR). One open conversion was required in the RAPN group due to intra-operation bleeding, and all the cases were smoothly completed in the conventional laparoscopic group. There were no significant differences between the matched two groups regarding the estimated blood loss, time off oral-intake, highest visual analog pain scale, length of stay, complication rate or transfusion rate (all P>0.05). Patients undergoing RAPN had a significantly shorter warm ischemia time (\[27.0±5.3\] min vs \[34.2±7.3\] min, P<0.05) and a longer operative time (\[249.5±49.6\] min vs \[212.9±57.11\] min, P<0.05) compared with CLPN group. The surgical margins were negative in both groups. During a mean follow-up of (5.6±2.2) months and (6.6±2.6) months, only one tumor recurrence was notice in the CLPN group. At the last follow-up, the decrease percentage of eGFR was (12±8)% in the RAPN group versus (17±15)% in the CLPN group (P>0.05). Conclusion RAPN requires a shorter warm ischemia time and provides a more rapid learning curve, good surgical safety and good short-term efficacy. For surgeons with experienced CLPN technique, they can use RAPN to treat high-complexity tumors which are beyond the conventional laparoscopic technique.

Abstract:Objective To evaluate the effect of the pre-operative health status on outcome of thoracic endovascular aortic repair (TEVAR) in patients with type B aortic dissection (T_BAD). Methods The clinical data of 328 T_BAD patients, who underwent TEVAR between September 1998 and December 2011, were retrospectively analyzed. The patients were divided into ASA≤3 group and ASA>3 group according to American Society of Anesthesiologists (ASA) classification before TEVAR. Univariable and multivariate Cox proportional hazard regression model analysis were used to evaluate the difference in outcomes of patients in the two groups. Results There was no significant difference in the complication rates between the two groups during the peri-operation period. During follow-up, the all-cause mortality rates and risks of transferring to open operation were similar between the two groups; however, patients in ASA>3 group had a significantly higher re-TEVAR rate than those in ASA≤3 group (Hazard ratio=2.50, 95% CI: 1.05-5.91, P=0.037). Conclusion TEVAR is a safe alternative for T_BAD patients. Poor pre-operative health status has negative effect on the postoperative outcome of TEVAR. Patients with a good health status are suitable for TEVAR.

Abstract:Objective To investigate the role of thromboelastography (TEG) in predicting cytochrome P450 2C19 (CYP2C19) genotype and its value in guiding clopidogrel treatment following percutaneous coronary intervention (PCI). Methods From January 2012 to August 2012, 70 patients with coronary artery disease undergoing PCI were enrolled and treated with aspirin and clopidogrel. They were divided into clopidogrel resistance (CR) group and clopidogrel sensitive (CS) group according to adenosine diphosphate (ADP)-induced platelet aggregation inhibition rate. Genotyping of CYP2C19 in the 70 patients was classified as: extensive metabolizers(*1/*1), intermediate metabolizers(*1/*2, *1/*3) and poor metabolizers(*2/*2, *2/*3, *3/*3). The clinical data, biochemical parameters, and CYP2C19 genotypes were compared between two groups. The independent risk factors of CR were analyzed by multiple logistic regression analysis. A receiver operating characteristic (ROC) curve was used to evaluate the efficacy of ADP-induced platelet aggregation inhibition rate in predicting the genotype of CYP2C19. Results High-density lipoprotein and genotypes of CYP2C19 were significantly different between the CR group (n=31) and CS group (n=39)(P<0.05). Stepwise forward multiple logistic regression analysis found that CYP2C19 poor metabolizers and lower HDL level were independent risk factors for CR (P<0.05). The results of ROC curve demonstrated a satisfactory predictive value for ADP-induced platelet aggregation inhibition rate, with the area under the curve (AUC) being 0.847 (95% CI: 0.729-0.965,P=0.003). When the ADP-induced platelet aggregation inhibition rate was at the optimal cut-off value (39.45%), the sensitivity, specificity, positive predictive value and negative predictive value in diagnosing the poor metabolizers of CYP2C19 were 85.7%, 77.8%, 30% and 98%, respectively. Conclusion CYP2C19 poor metabolizers and lower HDL level are selected as the independent risk factors of CR. When the ADP-induced platelet aggregation inhibition rate is lower than 39.45%, the genotypes of CYP2C19 should be detected to adjust the treatment.

Abstract:Objective To study the effect of hemofiltration plus hemoperfusion (HF+HP) on removal of serum TNF-α in severe acute pancreatitis (SAP) patients with lung injury and on RhoA serine 188 phosphorylation (p-RhoA) in endothelial cells. Methods Totally 35 SAP patients, including 28 with acute lung injury (ALI)/ acute respiratory distress syndrome (ARDS), and 20 healthy subjects were involved in this study. All the SAP patients were treated in ICU, and the 9 combined with ARDS underwent continuous veno-venous hemofiltration (CVVH) and HP therapy (HF+HP group). The serum TNF-α in SAP patients with different degrees of lung injury and the serum TNF-α in SAP patients with ARDS was determined by ELISA at different time points during HF+HP. For in vitro study the human umbilical vein endothelial cells (HUVECs) were treated with sera from SAP patients with ARDS during HF+HP, and those treated with recombinant TNF-α were taken as a positive control. The changes of p-RhoA and total RhoA were observed by Western blotting analysis. Subcellular distribution of p-RhoA protein was observed by immunofluorescence staining. Results We found that, compared with SAP patients without ALI/ARDS, those with ALI/ARDS, especially those with ARDS (about 7 folds that of the normal control) had a significantly increased serum TNF-α level (P<0.05). The serum TNF-α level began to decrease in the 9 SAP patients with ARDS 6 h after HF+HP treatment, with the decrease reached maximal 20 h after treatment, closing to the level of the normal control group. Meanwhile, the arterial blood PaO₂ , HCO3- and PaO₂/FiO₂ ratio were significantly elevated after HF+HP treatment in SAP patients with ARDS(P<0.05). Western blotting analysis showed that p-RhoA level was significantly increased in HUVECs treated with the serum of HF+HP-treated SAP patients with ARDS (P<0.05), and the total RhoA protein expressions were not significantly different among different groups (P>0.05). Immunofluorescence indicated that p-RhoA was largely distributed in the cytoplasm of HUVECs, and the changes were consistent with the data from Western blotting analysis. Conclusion SAP patients with ALI/ARDS have high circulation TNF-α. Treatment with HF+HP can effectively remove the excessive TNF-α in the blood of SAP patients with ALI/ARDS and inhibit activation of RhoA, subsequently decreasing the high permeability of endothelial cells.

Abstract:Objective To evaluate the laryngeal function recovery following laryngeal defect reconstruction with anterior cervical turnover myocutaneous flap after partial laryngectomies. Methods The swallowing, respiration and phonation functions of 43 patients, who received vertical partial laryngectomy, extended vertical partial laryngectomy, expanded frontovertical partial laryngectomy or subtotal laryngectomy, and laryngeal reconstruction with turnover myocutaneous flap between 2008 and 2010, were retrospectively analyzed. Thirty-two patients had glottic carcinoma (15 phase Ⅱ,16 phase Ⅲ, 1 phase Ⅳ) and 11 had transglottic carcinoma (5 phase Ⅱ,6 phase Ⅲ). The aspiration rate and decannulation rate were recorded. The swallowing function score, respiration function score, and voice parameters were analyzed and compared before and after operation. Results Six months after operation all the cases had normal swallowing and respiration functions, with no aspiration and with a decannulation rate of 100%. The swallowing function scores were similar before and after operation (U=903.1,P=0.559), and the respiratory function was significantly improved after operation (U=713.5,P=0.012). All the cases had normal voice. Six months after operation, the voice quality (such as Jitter, Shimmer and normalized noise energy \[NNE\]) were significantly better than that before the operation (P<0.05). The fundamental frequency (F0) of voice was significantly decreased after operation (P<0.05), and the NNE at >12 months after operation was significantly better than that at 6 months after operation (P<0.05). Conclusion Anterior cervical turnover myocutaneous flap for reconstruction of laryngeal defects following partial laryngectomies can achieve high decannulation rate and better phonation recovery, showing a satisfactory restoration of laryngeal function.

Abstract:Objective To investigate the value of Charlson’s weighted index of comorbidities (WIC) in predicting the prognosis of patients with sepsis. Methods The clinical data of 234 septic patients in the last three years were retrospectively analyzed. The scores of WIC and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) were calculated. The patients were divided into two groups according to death or survival outcome 28 days later, and the value of WIC score in predicting prognosis was analyzed. Results It was found that 77 (32.9%) of the 234 patients died. Increasing WIC score was associated with increased mortality. Multiple logistic regression analysis revealed that WIC was a risk factor of prognosis of septic patients (OR=1.434, 95% CI:1.097-1.875, P=0.008). The areas under the ROC curves in predicting the mortality of the septic patients were 0.670 (0.591-0.748) for the WIC score, 0.770(0.703-0.837) for APACHEⅡ score and 0.821 (0.757-0.885) for the combination of both. Conclusion WIC score can satisfactorily predict the influence of underlying diseases on the prognosis of septic patients.

Abstract:Objective To analyze the changes of wave intensity (WI) of the left common carotid artery (LCCA) in coronary artery disease (CAD) patients with decreased left ventricular ejection fraction (LVEF). Methods Forty-one CAD patients confirmed by coronary angiography (CAG) were divided into group A, LVEF >50%, 23 cases; group B, LVEF≤50%, 18 cases. The patients included 26 males and 15 females, with an average age of (59.68±7.61) years old. Normal controls (group C) had 35 participants, including 23 males and 12 females, with an average age of (61.69±13.48) years old. All the participants underwent conventional echocardiographic examination and left common carotid WI analysis (2-D color Doppler ultrasound), and the relationship and changes of the LCCA WI values were compared between group A and group B. Results The LCCA intima-media thickness (IMT) in CAD patients were significantly thicker than that in the normal controls(P<0.05), and W1 and W2 values were significantly lower than those in the normal controls (P<0.05). The W1, W2 values in group A and group B showed a decreasing trend with the decrease of LVEF values, with W1 value of group B being significantly lower than group A (P<0.05) ; especially that, for seven participants with LVEF＜35% in group B, the W1 and W2 values were only (3.32±1.91) and (1.09±0.41) mmHg/(m·s²), respectively. Under the same arterial blood pressure level, the W1 and W2 values were positively correlated with each other in all the participants of this study (r=0.41,P＜0.05), and the W1 value was positively correlated with the LVEF (r=0.60,P＜0.05). Conclusion The W1 and W2 indices of LCCA derived from carotid WI analysis can reflect the left ventricular systolic function of CAD patients, and can serve as a valuable indicator for evaluating the peripheral hemodynamic changes.

Abstract:Objective To investigate the effect of various comedications on the plasma concentration of clozapine(CLZ) in inpatients with psychosis disorder. Methods High performance liquid chromatography (HPLC) was used to analyze serum CLZ and norclozapine(N-CLZ) concentrations in 571 psychosis patients. The influence of commedication on plasma CLZ concentration was analyzed using SPSS 17.0 software while considering the dosage of CLZ and the comedications with 12 drugs most often used in combination with CLZ. Results The CLZ dosage, plasma CLZ concentration and plasma N-CLZ concentration in the comedication group were significantly lower than those in pure CLZ group (P<0.01). The CLZ dosage in groups of comedications with clonazepam, paroxetine, venlafaxine, aripiprazole, quetiapine and risperidone were significantly lower than that of pure CLZ group (P<0.05,P<0.01). Comedication with clonazepam, lithium carbonate, valproate and quetiapine significantly decreased the plasma concentration of CLZ (P<0.05,P<0.01). Comedication with clonazepam, lithium carbonate, valproate, sertraline, quetiapine and risperidone significantly decreased the plasma concentration of N-CLZ (P<0.05,P<0.01). Spearman’s correlation analysis found that there were significant positive correlations among any two of dosage CLZ, concentration of CLZ and concentration of N-CLZ in CLZ group (P<0.05,P<0.01). Conclusion Some commonly-used antipsychotics have impact on plasma CLZ concentration. Drug monitoring and dosage regulation of CLZ should be stressed among patients comedicated with clozapine combined with other antipsychotics, so as to timely regulate the dosage of CLZ.

Abstract:Objective To evaluate the functions of a new balloon-expandable valved stent for transcatheter aortic valve implantation and the delivery system, so as to provide evidence for future animal study. Methods A new tube-like balloon-expandable valved stent was designed and made of cobalt-base alloys. Bovine pericardium was sutured by hand into the stent to prepare valved aortic stent, which was placed on the instrument to test the pulsating flow and fatigue property of prosthetic valve. The valved stent, which was compressed on a balloon catheter and pulled into a delivery sheath, was placed in the native aortic valve of isolated goat heart via the ascending aorta, and water was injected into the ascending aorta by a silicon tube to evaluate the competence of the prosthetic heart valves. Results Plusating flow examination showed that the artificial valve opened and closed well, without noticeable reflow, and accorded with human physiology. The prosthetic heart valves also performed well in the testing of fatigue property. The valved stent could be stably placed in the native valves of goat heart by delivery sheath, and the prosthetic heart valves showed satisfactory function. Conclusion The aortic valved stent is well-designed and has satisfactory function. It can be used for animal study of transcatheter aortic valve implantation.

Abstract:Objective To assess the effect of yoga exercise training on the physical and mental qualities of students in military universities. Methods According to the newly issued Physical Standards for Soldiers, we chose 60 naval general practice students (age 18-22 years) for this study and they were divided into test group (n=30) and control group (n=30). The test group undertook yoga exercise once a week (two hours each time) for 10 weeks in addition to ordinary military exercises; the control group only undertook ordinary military exercise. The height, body mass, body mass index (BMI), fat rate, basal metabolic rate (bioelectrical impedance), flexibility (forward split, cross split and stand trunk bending), and anxiety level (internationally acknowledged Self-Rating Anxiety Scale \[SAS\]) were determined and compared between the two groups before and after training. And the effect of yoga exercise on the physical and mental qualities of students was analyzed. Results After ten weeks’ of training, the SAS scores were significantly decreased in both groups (P<0.01), and that of the test group was significantly lower than that of the control group (P<0.01). The BMI and fat rate were significantly decreased in the two groups after training (P<0.01) and the test group had a better body flexibility than the control group. Conclusion Yoga exercise training can help to relieve mental pressure and improve the overall physical and mental qualities of students in military universities, and it is feasible to popularize it in military academies.

Abstract:Objective To establish a multi-incentive model for doctors based on the medical services supply chain theory, so as to provide reference for improving the incentive mechanisms for doctors and for promoting the quality of medical services. Methods Based on the asymmetric information of principal-agent model, the study developed the incentive model of doctors’ behavior with output and surveillance indicators, deduced the formula for incentive intensity, and analyzed the influencing factors of incentive intensity. Results According to the obtained incentive model, the incentive intensity to the doctors and medical service suppliers was mainly correlated with external evaluation and internal surveillance results of medical service quality. Conclusion The key points for high quality medical service are to establish the external evaluation indicator and intensify the internal supervision and assessment to guide the behaviors of doctors.

Abstract:Objective To perform partial nephrectomy via combined transgastric and transvesical approach in porcine and to use V-loc suture for suturing the renal defect, so as to further assess the safety and feasibility of combined transgastric and transvesical approach. Methods Three female pigs were used in this study. The transvesical access was established by incising the anterior wall of the bladder under ureteroscope, and a self-designed Trocar was inserted. Under the guidance of ureteroscopy, the transgastric access was established by a needle knife with cautery, and the gastroscope was introduced after balloon dilation. Under the guidance of gastroscope, laparoscopic ultrasonic scalpel was introduced via the bladder Trocar; the kidney artery and vein were separated, the arteries were blocked and some lower part of renal parenchyma was resected; and the wound was closed by 2-0 V-loc suture which was introduced percutaneously. The specimens were collected from the bladder. Results Six partial nephrectomy procedures were done in the 3 pigs. The first case was transferred to traditional laparoscopy due to incompleted blocking of the artery, bleeding and loss of vision. The rest 5 cases were successfully completed, with a mean operation time of 174 min(140-220 min), a warm ischemia time of 21 min (17-28 min), and with no significant bleeding. The average size of incised tissue was 1.5 cm×1.5 cm. Conclusion Partial nephrectomy via combined transgastric and transvesical approach is extremely difficult, but it can be done by using the V-loc suture and auxiliary needle laparoscopic instrument; however, its clinical prospect still needs further verification.

Abstract:MicroRNAs (miRNAs) play important roles in regulating inflammatory responses, and the related mechanism and regulation characteristics are unique in immune system. In recent years, a large number of studies have showed that miRNAs can target mRNAs of many target genes in Toll-like receptor/nuclear factor-κB (TLR/NF-κB) signaling pathway, and play regulatory roles in immune recognition and inflammatory responses. In this paper we reviewed the characteristics of miRNA in inflammatory reactions, with special attention on the regulatory roles in TLR/NF-κB signaling pathway.

Abstract:Endothelial progenitor cells (EPCs) were discovered in 1997 and brought new insights for angiogenesis. EPCs can differentiate into mature endothelium and take part in angiogenesis. Studies have found that EPCs is a promising candidate for treating cardiovascular disease. Aspirin has antiplatelet effect and is widely used for prevention of stroke and cardiac infarction. Low dose of aspirin can improve EPCs function through antiplatelet effect, improve endothelial function, and restore the endothelium-dependent vasodilatation. Therefore it is of great significance to understand the effect of aspirin on EPCs and the related mechanisms.

Abstract:Objective To establish a human pancreatic cancer cell line stably transfected with siRNA expression vector targeting GLI1 gene and examine the interference efficiency. Methods The expression of GLI1 gene in five human pancreatic cancer cell lines was detected by quantitative real-time PCR (qRT-PCR); the one with the highest expression level of GLI1 was selected as the target cell line and was transfected with three recombinant plasmids pGCsi-U6-GLI1siRNA-1,-2,and -3. The positive clones were screened by G418, and the transfection rate was observed by fluorescence microscope. The expression of GLI1 mRNA and protein was analyzed by qRT-PCR and Western blotting analysis, respectively. Results Panc-1 cell line was found to have the highest GLI1 expression and was selected as the target cell line for transfection. Plasmids pGCsi-U6-GLI1siRNA-1, -2, and -3 were successfully transfected into Panc-1 cells separately. After 4 weeks of G418 screening, three stably transfected cell lines named Panc-1/GLI1siRNA-1, -2, and -3 were obtained, with the transfection rates all higher than 80%. qRT-PCR and Western blotting analysis showed that the expression levels of GLI1 in Panc-1/GLI1siRNA-1, -2, and -3 cells were all significantly lower than those in Panc-1/siControl cells and the blank control cells(P<0.05), with the lowest expression found in Panc-1/GLI1siRNA-1 cells. Conclusion We have successfully constructed a cell line Panc-1/GLI1siRNA-1 with GLI1 gene stably silenced, which paving a way for future research.

Abstract:Objective To investigate the effect of artesunate on the cell cycle of human multiple myeloma RPMI8226 cells and explore the related molecular mechanisms. Methods RPMI8226 cells were treated with 0, 25, and 50 μg/mL artesunate. The morphology change of cells was observed under transmission electron microscope, the cell cycle distribution was detected by flow cytometry, and the expression of cyclin B1 and p34^cdc2 protein was examined by Western blotting analysis. Results After treated with 50 μg/mL artesunate for 48 h, most RPMI8226 cells showed characteristic morphology of apoptosis. With the increase of artesuate concentration, the proportion of RPMI8226 cells in G0/G1 phase was significantly decreased (P<0.05) and that of cells in G2/M phase was significantly increased (P<0.05), suggesting that artesunate induced noticeable G2/M arrest. Cyclin B1 level was increased and the p34^cdc2 level was decreased with the increase of artesuate concentration. Conclusion Artesunate can induce G2/M arrests in RPMI8226 cells, which may be related to the increased cyclin B1 expression and decreased p34^cdc2 expression.

Abstract:Objective To use high frequency ultrasound for scanning the lower uterine segment during the third trimester of scar uterus pregnancy, so as to provide reference for selecting the way of delivery. Methods Totally 118 scar uterus pregnancy cases were selected. Transabdominal ultrasound scan was done for the fetus between 36^th and 40^th week of pregnancy, and then the transducer was switched to a high frequency of 7.5-12 MHz to observe the lower uterine segment. The scan results were compared with the observations of incomplete rupture of lower uterine segment and defective scars in the repeated caesarean section. Results Three types of high frequency ultrasound images were found for the lower uterine segment during the third trimester of scar uterus pregnancy: truncation sign (6.8%,8/118), rat tail sign (44.1%,52/118), and homogeneous echoes (49.1%,58/118). The diagnosis efficacies of truncation sign for incomplete rupture of uterus, rat tail sign for defective scars, and homogeneous echoes for intact caesarean scars were significantly higher than those of the other two types (χ2 valued 20.42, 19.03, and 33.08, respectively, P＜0.001). The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of the truncation sign were 80.0%, 96.5%, 50.0%, and 99.0%; those of the rat tail sign were 70.0%, 73.8%, 67.3%, and 76.2%; and those of homogeneous echoes were 72.9%, 74.6%, 74.1%, and 73.3%, respectively. Conclusion High frequency ultrasound scan can display the changes of the scars on the lower uterine segment, and may serve as an effective method to diagnose incomplete rupture of uterus, defective and intact scars in the third trimester pregnancy of a caesarean-scarred uterus. To avoid uterine rupture, vaginal trial of labor should be carefully chosen for patients showing truncation sign or rat tail sign.

Abstract:Objective To study the safety and feasibility of modified endoscopic thyroidectomy via chest and breast areola approach for benign thyroid disease patients. Methods A total of 56 female benign thyroid disease patients, who received endoscopic thyroidectomy in our hospital from March 2011 to March 2012,were included in this study. And 28 of them underwent modified endoscopic thyroidectomy (modified group). Taking the advantage of movable female breast and the long rod-shaped endoscopic instrument, the operation was modified based on endoscopic thyroidectomy via chest and breast areola approach, without subcutaneous dissection of the chest wall. Another 28 patients received conventional approach treatment (conventional group). The two groups were matched in mean age and disease causes. The operation time, blood loss, post-operative pain degree, post-operation hospital stay, and complications were compared between the two groups. Results The operation time, blood loss, post-operation hospital stay, and post-operation drainage volume were not significantly different between the two groups. Compared with patients in the conventional group, patients in modified group suffered significantly less post-operation pain, with mean visual analogue scale scores being 3.0±1.6 vs 4.5±1.8 (P=0.042). The modified group also had significantly reduced incidence of skin redness and subcutaneous ecchymosis, edema and chance of effusion on the anterior chest wall (0 vs 21.4%, P=0.01). There were no damages to recurrent laryngeal nerve or parathyroid glands or postoperative hemorrhage in the 56 patients. Conclusion The modified endoscopic thyroidectomy via chest and breast areola approach is a safe and effective method, and it can greatly reduce the trauma of conventional endoscopic thyroidectomy.

Abstract:

Abstract: