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Objective: To investigate the effect and specific mechanism of heat shock protein 47 (HSP47) on streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM). Methods: A mouse model of type 1 diabetic cardiomyopathy was established by intraperitoneal injection of STZ. After 8 weeks of successful modeling, HSP47 was overexpressed by tail vein injection, and the heart of the mouse was harvested after 6 weeks. Hematoxylin-eosin (HE) staining and Sirius red (PSR) staining were used to detect the cross-sectional area of myocardial cells and myocardial fibrosis, respectively. Immunofluorescence staining with α-smooth muscle actin (α-SMA) and collagen Ⅰ was used to detect the degree of fibrosis activation. The expression level of fibrosis-related proteins was determined by Western blot. Results: The expression level of HSP47 in the myocardium of the diabetic group up-regulated (2.014±0.264 vs 1.004±0.064, P< 0.001). The area of myocardial cells in the diabetic group was increased compared with the control group [(235.3±20.7) μm(2) vs (172.8±13.6) μm(2), P< 0.001] and the cross-sectional area of myocardial cells in the HSP47 overexpression-diabetes group was further increased [(302.2±41.0) μm(2) vs (235.3±20.7) μm(2), P= 0.009], while the mRNA levels of mouse cardiac hypertrophic markers atrial natriuretic peptide (ANP), type B brain natriuretic peptide (BNP), myosin heavy chain β (β-MHC) further upregulated (all P< 0.001). Compared with the control group, the myocardial fibrosis content in the diabetic group increased [(7.333±1.127)% vs (4.837±0.775)%, P= 0.002] and the left ventricular fibrosis content of the HSP47 overexpressing diabetic group further increased [(9.175±1.008)% vs (7.333±1.127)%, P= 0.025] and the mRNA levels of fibrosis index collagenⅠ, collagen Ⅲ, connective tissue growth factor (CTGF) and transforming growth factor β (TGFβ) further up-regulated (all P< 0.001). Immunofluorescence results showed that compared with the control group, the expression of collagenⅠ up-regulated in the endothelial stroma of the diabetic group and the content of collagenⅠ in the HSP47 over-expressing diabetic group was higher ( P< 0.001). Western blot results indicated that the phosphorylation level of Smad3 and the protein levels of α-SMA and TGFβ in HSP47 overexpressing diabetic group increased, compared with those of diabetic group (all P< 0.001). Conclusion: HSP47 ameliorates STZ-induced diabetic myocardial fibrosis by activating the TGFβ/Smad3 signaling pathway.

Objective: Toobserve the damage effects of cytomegalovirus (CMV) infection on hematopoietic cells and to investigate the clinical significance. Methods: (1) ELISA assay wasused to detect IL-17 and IFN-γ levels in the peripheral blood serum of 36 patients on pretherapy and posttherapy. (2) Changes of peripheral blood lymphocyte subsets were detected by FACS. (3) Cytological observation of cervical lymph nodes was executed by needle aspiration cytology. (4) Cellular immunochemistry and immunofluorescence staining were performed to observe the POX release, HLA-DR expression, IL-17A and IFN-γ secretion-like expression status of activated immune cells in the bone marrow hematopoietic microenvironment. Serum samples from healthy individuals were used as controls. Bone marrow smears from patients without iron deficiency anemia were compared as bone marrow immunostaining. Results: (1) Serum levels of IL-17 and IFN-γ were significantly increased in CMV-infected patients [IL-17 (48.23±3.86) ng/L vs (20.16±1.05) ng/L,respectively; IFN-γ (40.16±3.11) vs (8.17±1.92) ng/L, P< 0.01]. (2) The proportion of CD16+/CD56+NK cells was significantly increased in patients [(43.54±6.01)% vs (14.01±3.25)%, P< 0.01]. The proportion of CD3+CD4+T and CD3+CD8+T cells decreased,(20.91±53.15)% vs (35.10±4.88)%, and (15.41±5.13)% vs (25.11±3.92)%,respectively, P< 0.05. (3) Large numbers of abnormal lymphocytes and macrophages (MΦ) that engulf large quantities of CMV inclusion bodies were observed in bone marrow and lymph nodes. CMV infected and destroied the hematopoietic cells of various lines in the bone marrow. The activated MΦ phagocytizedthe CMV inclusion bodies and also phagocytosed CMV-infected blood cells. (4) Activated MΦ in bone marrow hematopoietic microenvironment released POX strongly positive, highly expressed class Ⅱ HLA-DR, and highly expressed inflammatory factors IL-17A and IFN-γ. (5) Twenty-twopatients with elevated WBC were treated with ganciclovir combined with antibiotics for 2 weeks after the disappearance of the foci, WBC counts and CMV-IgM levels of 16 cases were reduced to normal.Six patients with CMV who were not turned negative were tprolonged,and the granulocyte and/or platelet counts fell below normal range. Fourteenpatients withreduced granulocyte or platelet count, CMV-IgM levels were slow descend,and the ganciclovir treated more than 4 weeks. Conclusions: CMV can infect hematopoietic bone marrow nucleated blood cells and destroy hematopoiesis. NK and MΦ cells are important effector cells against CMV infection. Activated macrophages are dual in nature, they can engulf CMV virus and virus-infected blood cells,and also aggravate bone marrow immune damage by releasing inflammatory factors such as POX and IL-17A and IFN-γ.

Objective: The aim of this study is to investigate the underlying mechanism of cinnamaldehyde attenuating pressure overload-induced cardiac fibrosis. Methods: The mice were randomly divided into control group, model group and treatment group by random number table and each group had 8 mice.Cardiac hypertrophy was induced by aortic banding. Heart vascular density was detected by immunohistochemical staining of CD31.The expression level of stromal cells marker α-smooth muscle actin (α-SMA) was detected by immunofluorescence staining in different groups.The expression levels of endothelial cell associated markers and stromal cell associated markers were detected by using Western blotting.The possible molecular pathway was also screened by using Western blotting. Human umbilical vein endothelial cell (HUVECs) were stimulated with TGFβ1 and cultured with 10 nmol/L cinnamomum for 24 hour to further confirm the mechanism. Results: Eight weeks after operation, the vascular density was significantly decreased in model group mice heart.The expressions of stromal cells markers were increased (α-SMA: 2.57±0.38; Vimentin: 0.58±0.02) and endothelial cell markers were reduced (CD31: 0.58±0.29; CD34: 0.62±0.21). While cinnamicaldehyde treatment significantly increased the mouse heart vascular density, increased endothelial cell markers expression (CD31: 1.51±0.11; CD34: 2.37±0.44; P <0.05), and reduced stromal cells marker expression (α-SMA: 1.22±0.14; Vimentin: 0.35±0.03; P <0.05). Further studies showed that the anti-fibrosis effect of cinnamicaldehyde was mainly through the TGFβ /smad signaling pathway.10 nmol/L cinnamomum attenuated TGFβ1 induced endothelial mesenchymal transition in HUVECs. Conclusion: Cinnamaldehyde may be able to retard the progression of cardiac fibrosis, via blocking endothelial to mesenchymal transition, which, in verse, is through regulating TGFβ /smad signaling pathway.

Objective: To explore the application value of assisted laparoscopic ultrasound in myomectomy. Methods: One hundred and fifty six patients who underwent myomectomy in Beijing Obstetrics and Gynecology Hospital from 2011 to 2013 were enrolled.The patients were randomly divided into laparoscopic ultrasound guided group ( n =57), laparoscopic group ( n =54) and open resection group ( n =45). The patients were followed up to calculate the residue and recurrence rates of uterine fibroids by vaginal ultrasound at 6th month and 12th-18th month after the operation. The residual and recurrence rates of the three methods were calculated and compared. Results: The recurrence rate of laparoscopic ultrasound guided group wassignificantly lower than that of laparoscopic group and open resection group ( P <0.01) and ( P <0.01). The residual rate of laparoscopic ultrasound guided group was also lower than that of laparoscopic group( P <0.05). However, there was no difference between the residual rates of laparoscopic ultrasound guided group and open resection group ( P >0.05). When compared with open resection group, no difference was found in the residual and recurrence rates of laparoscopic group. The number of myoma was proportional to the residual rate and the recurrence rate. When the number of the myoma was more than 10, most of the cases existed residue. Conclusion: The application of assisted laparoscopic ultrasound in myomectomy couldreduce the residual and recurrence rate of uterine fibroids.

Objective: To evaluate the application value of laparoscopic ultrasonography (LUS) in gynecological surgery., Methods: Retrospective analyses were performed for 52 cases undergoing LUS during laparoscopic extirpation/excision of gynecological tumors. Aloka 7.5-MHz laparoscopic probe was used to detect the residual lesions during laparoscopic operations. The findings of LUS were compared with those of preoperative transvaginal ultrasound and postoperative pathohistological examinations., Results: Preoperative diagnoses were corrected by LUS in 9 cases. And 34 residual lesions located by LUS were successfully removed., Conclusion: With a high detection rate and diagnostic accuracy rate in the diagnosis of gynecologic disease, LUS can locate invisible lesions during laparoscopic operations and provide guidance for radical tumor removal. It is a safe and valuable assistance for gynecologic surgery.

Objective: To observe the pathological effects induced by eosinophils (EOS) in the process of cellular damage in immune-related hematocytopenia (IRH) and elucidate the immunologic mechanism and clinical significance of EOS., Methods: Enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum concentrations of interleukins (IL)-2, IL-4, IL-5, IL-6, IL-12 and IL-17 in 117 IRH patients from February 2008 to February 2012 in our hospital. Their quantity, activity, peroxidase (POX) and HLA-DR expression of EOS were observed and analyzed. Immunofluorescent staining was used for detecting anti-human immunoglobulin (IgG) on the surface of hematopoietic cell and the expressions of intercellular adhesion molecule-1 (ICAM-1), Fcγ receptor II (FcγRII), mannose receptor (MR), IL-5 receptor (IL-5R), IL-12, IL-12 receptor (IL-12R), IL-17A and IL-17 A receptor (IL-17RA) on EOS. TdR incorporation method was employed to determine the capability of antigen presentation and IL-17 mRNA expression examined by reverse transcription-polymerase chain reaction (RT-PCR)., Results: The serum levels of IL-4, IL-5, IL-6, IL-12 and IL-17 were (170.9 ± 14.7), (112.9 ± 8.2), (131.8 ± 13.8), (339.2 ± 26.1) and (42.5 ± 2.2) ng/L in patient group versus (60.3 ± 11.0), (34.1 ± 2.2), (91.0 ± 12.3), (94.0 ± 3.3) and (20.0 ± 1.1) ng/L in control group respectively. All incremental percentages of IL-5, IL-12 and IL-17 were 100% (117/117) and they were correlated with disease. Diastrophic EOS could be found in marrow of patient with decreased leucocyte with HLA-B27(+). Hematopoietic cells were adhered, captured and phagocytized actively by activated EOS. Activated EOS showed strongly positive POX while POX of neutrophils attacked by EOS became weakened. Activated EOS could express HLA-DR and played a role in antigen presentation. EOS could secrete cytokine IL-17 through a transcription of IL-17 mRNA. And EOS could also express ICAM-1, FcγRII, MR, IL-5R and IL-12, IL-17A, IL-17RA., Conclusions: Capable of expressing or secreting various cytokines and molecules, EOS have immunological functions of adhering, capturing and phagocytizing pathological hemocytes. It also participates in pathogenic process of IRH. Thus EOS is probably an important immune effector cell in the process of in situ marrow damage.

Objective: To observe the telomerase activity (TA) in bone marrow mononuclear cell (BMMNC) at pre-therapy and post-therapy in patients with immune related hematocytopenia and immune related pancytopenia (IRH/IRP) so as to explore the relationship between TA and disease process., Methods: TA in BMMNC of 108 IRH/IRP patients was detected with telomeric repeat amplification protocol (TRAP)-PCR-ELISA. The expressions of anti-human immunoglobulin IgG, FcγII receptor (FcγIIR), mannose receptor (MR) and interleukin 17A (IL-17A) located on membrane surface were observed by immunofluorescence (IF). A total of 30 iron deficiency anemia patients were selected as case control., Results: The TA of 108 IRH/IRP patients were 0.251 ± 0.021. And it increased as compared with the control group of 0.062 ± 0.031 at pre-therapy (P < 0.01). The HLA-B27(+) patients among them was 0.270 ± 0.020 while HLA-B27(-) patients 0.181 ± 0.013 (P < 0.05). And HLA-B27(+)IgG elevated IRP was 0.341 ± 0.016 and HLA-B27(-)IgG elevated 0.183 ± 0.010, the difference of TA was significant between two groups (P < 0.01). IgG antibody positive immature hemocyte could be observed in marrow of IRH/IRP patients, and FcγIIR was expressed highly on those activated macrophage (Mφ) in bone marrow. Both IL-17A and MR were expressed on activated dendritic cells and Mφ in marrow of HLA-B27(+) patients. After the therapy of glucocorticoids associated with cyclosporine A and other drugs, the patient's hemogram recovered and the telomerase in BMMNC were re-devitalized., Conclusions: The TA of the BMMNC in marrow of IRH/IRP patients is increased, and it shows a close relation between apoptotic degree of hematopoietic cell and the activation of immunocytes. In IRH/IRP, synchronism and equilibrium exist between BMMNC apoptosis and TA.