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Objective: To analyze the incidence and risk factors of ventricular septal defect (VSD) in Qingdao. Methods: A prospective cohort study design was used to include pregnant women who underwent prenatal screening in Qingdao between August 2018 and June 2020 (the whole population coverage). VSD was diagnosed according to the pulse oxygen saturation and heart auscultation, and the final diagnosis was made according to the echocardiography of VSD positive newborns within postnatal day 7. Results: The study included 115 238 live births, among which 388 were diagnosed as VSD, with an incidence of 3.37‰. The results of multivariate logistic regression analysis showed that mother with postgraduate level ( OR =1.61, 95% CI : 1.00-2.58, P =0.049) (compared with junior high school and below), preterm birth history ( OR =2.90, 95% CI : 1.47-5.70, P =0.002), and pregnancy history of congenital heart disease ( OR =5.98, 95% CI : 2.63-14.73, P <0.001) were risk factors for VSD. Compared with female infants, the overall risk of VSD in male infants was relatively low ( OR =0.74, 95% CI : 0.60-0.91, P =0.005). Conclusions: The incidence of VSD in Qingdao is 3.37‰. The risk factors of VSD include higher maternal education level, pregnancy history of congenital heart disease and preterm birth history. Moreover, the overall risk of VSD in male infants is low.

Objective: To evaluate the clinical outcomes of on-pump total arterial revascularization with bilateral radial artery (BRA) and left internal mammary artery (LIMA) as conduits in coronary artery bypass grafting (CABG) patients with left ventricular dysfunction (LVD). Methods: All the perioperative medical records and follow-up results of coronary artery disease patients with left ventricular ejection fraction (LVEF) ≤ 40% undergoing CABG from 24 heart centers of 15 provinces and autonomous regions in China between July 2015 and December 2019 were retrospectively analyzed. Results: A total of 87 consecutive patients (55 males and 32 females) underwent on-pump CABG with BRA and LIMA, with a mean age of (57.5±9.1) years old. There were 22 patients complicated with primary hypertension, 12 with diabetes mellitus, 8 with peripheral vascular disease, 7 with chronic obstructive lung disease, 12 with mild renal injury and 3 with partial aortic calcification. There were 43 cases with in-stent stenosis, and 21 had left main disease. The mean LVEF and left ventricular end-diastolic diameter (LVEDD) was (35.5±7.3)% and (65.5±2.6) mm, respectively. The mean graft number, aortic cross-clamp time and cardiopulmonary bypass duration was 3.2±0.9, (90.5±22.7) min and (113.4±19.2) min, respectively. There were 32 mitral and 9 aortic valve replacements, and 5 tricuspid annuloplasties. Prophylactic intra-aortic balloon pumps were implanted in 27 patients. There were 2 operative deaths from acute heart failure. After surgery, there were 15 cases of atrial fibrillation, 1 case of acute kidney injury, 1 case of acute myocardial infarction, and 1 cases of stroke. All the patients fulfilled the follow-up, with a mean time of (39.5±7.7) months. At 3 months after surgery, LVEDD was decreased and LVEF was improved significantly compared with pre-operative indicators [(53.0±1.5) mm vs (65.5±2.6) mm, t= 9.51 P= 0.02; (45.2±3.3)% vs (35.5±7.3)%, t= 13.79, P= 0.001]. No major cardiac events were reported during the follow-up. At (30.5±7.4) months after surgery, 62.4% of patients (53/85) underwent coronary CT angiography examination, and the results indicated that the graft patency was 98.8%, with only one case of RA occlusion occurred. Conclusion: In selected patients of LVD, on-pump total arterial revascularization with BRA and LIMA conduits was proved to be safe and effective.

Objective: To determine the effects of different computed high b-value on diffusion weighted imaging (DWI) scores in Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) of prostate cancer in peripheral zone. Methods: A retrospective study of 104 cases of prostate cancer in peripheral zone was conducted, all of the patients were histopathologically confirmed by transrectal ultrasound guided saturation biopsy or radical prostatectomy in Tongji Hospital of Tongji University from January 2012 to December 2015.All MRI imaging examinations were performed by using a 3.0T Siemens Verio MRI scanner.The imaging protocol consisted of high-resolution axial and sagittal T(2) weighted imaging (T(2)WI), axial acquired diffusion weighted imaging (aDWI) with b=0, 50, 1 000 s/mm(2) and dynamic contrast-enhanced (DCE) scans.Computed diffusion weighted imaging (cDWI) images with b=1 000, 1 400, 2 000 s/mm(2) were processed by Matlab.These three groups of cDWI images were analyzed according to the PI-RADS v2 criteria, and signal intensity of ratio (SIR) of lesions were analyzed by independent t test and one-way ANOVA in each group. Results: The numbers of cases with a DWI score of 2 and 5 were similar among three groups.Nine cases (33.3%) in all 27 cases with a DWI score of 3 on b=1 000 s/mm(2) upgraded to score 4 when b-value rose to 1 400 and 2 000 s/mm(2).The ratios of SIR of lesions in cases upgraded from DWI score 3 to 4 to those unchanged cases on b=1 400 and 2 000 s/mm(2) were 1.86±0.21 to 1.61±0.27 and 2.18±0.26 to 1.75±0.30, respectively ( t =2.486, t =3.671, both P <0.05). In these 9 cases who upgraded to DWI score 4, SIRs of the lesion were significantly different between groups when b=1 000, 1 400 and 2 000 s/mm(2) ( F =10.907, 33.768, 8.043, all P <0.05), and their SIRs increased with the rising of b-value. Conclusions: The computed high b-value (b≥1 400 s/mm(2)) mainly affects cases with a DWI score of 3, but DWI scores would not change neither in b=1 400 s/mm(2) nor in 2 000 s/mm(2) cases. For DWI score in PI-RADS v2 of prostate cancer in peripheral zone, b=1 400 s/mm(2) is probably of more scoring value than b=1 000 or 2 000 s/mm(2).

Objective: To study the effect of sub-anesthetic doses of isoflurane and propofol on the postoperative cognitive function of rats with mild cognitive impairment (MCI) following orthopedic operation., Methods: Male sprague-dawley rats (n=100) were randomly divided into sham group and model group.Bilateral carotid artery was separated with no bilateral narrowing in the sham operation group while bilateral carotid artery was occluded in model group.After 30 days, Morris Water Maze test were used to select MCI rats. The proportion of the value that average escape latency in model group minused average escape latency in sham group less than 20% was marked as MCI rats. After 36 days, the rats with mild cognitive impairment were randomly divided into 4 groups (n=18). Iso group: Isoflurane (1.9%) 3 h, combination group: propofol (20 mg·kg(-1)·h(-1))+ isoflurane (1%) 3 h. Inhibitor with these two groups were respectively used the selective KCC2 inhibitor-DIOA 30 μg 15 min before anesthesia. Then rats received an open tibial fracture on the hind paw with an intramedullary fixation. The rats in sham group were only sutured skin incision. At the day 7 postoperatively, the Y maze test were used to test the change of cognition, nissl staining was used to observe the neurons apoptosis. Immunofluorescence was adopted to observe the neurons expressing GAD67/KCC2 and Western blot were applied to observe the protein level of KCC2 in hippocampus., Results: The rate of time spent in novel arm, the number of surviving neurons, the number of neurons expressing GAD67/KCC2 and protein expression levels of KCC2 in hippocampus in combination group were (52.94±2.04)%, (176.81±13.07), (196.72±8.02), (80.67±3.46)% respectively. The indexes in sham group were (53.44±2.45)%, (183.79±10.88), (207.45±13.17), (81.42±3.59)%, respectively. There was no significant difference compared with the sham group (all P>0.05). However these indexes in above two groups were higher than that in Iso group( (36.10±1.57)%, (97.21±8.23), (158.94±13.47), (43.22±4.91)%, all P<0.05). The indexes in inhibitor with Iso groups, combination group was lower compared with groups without inhibitor respectively (all P<0.05)., Conclusion: Compared with isoflurane, sub-anesthetic doses of isoflurane and propofol has no significant effect on postoperative cognition in rats with MCI, and its mechanism is to maintain KCC2 expression in hippocampus.

Objective: To explore the regulative effects of hydrogen-rich medium on lipopolysaccharide (LPS)-induced monocytes adhesion to human umbilical vein endothelial cells (HUVEC) and vascular endothelial permeability in vitro., Methods: Endothelial cells were seeded in 6-well plates and randomly divided into 4 groups (n = 42 each):control (A), hydrogen-rich medium (B), LPS (C) and LPS+hydrogen-rich medium (D). Cells were cultured in plain culture medium in groups A and C or in hydrogen-saturated culture medium in groups B and D.LPS 1 µg/ml was added into groups C and D.When forming a monolayer, monocytes were added into each group after 6, 12 and 24 h respectively. After a 90-minute co-culturing, adhesion status was detected by Wright-Giemsa stain.Supernatants were collected to detect the concentrations of vascular cell adhesion molecule-1 (VCAM-1) and E-selectin by enzyme-linked immunosorbent assay (ELISA). The expression of VE-cadherin was measured by Western blot. Cells were stained with immunofluorescence to show the distribution of VE-cadherin after a 24-hour incubation., Results: Compared with group A, the adhesion of monocytes to endothelial cells increased (P < 0.05) in group C, the levels of E-selectin and VCAM-1 became elevated (P < 0.05) while the expression of VE-cadherin decreased significantly (P < 0.05). Compared with group C, adhesion decreased in group D (P < 0.05), the levels of E-selectin and VCAM-1 decreased (P < 0.05) while there was an increased expression of VE-cadherin (P < 0.05). Three timepoints showed the same tendency. The results of 24 h fluorescence indicated that, compared with group A, VE-cadherin was incomplete in cell-cell connections in group C.However it was complete and well-distributed in group D versus group C., Conclusion: Hydrogen-rich medium may reduce the LPS-induced release of adhesion molecules, lessen monocytic adhesion to HUVEC and regulate the expression of VE-cadherin to protect vascular permeability.

Objective: To explore the relationship between the protection of hydrogen sulfide (H(2)S) against hepatic ischemia-reperfusion injury and thioredoxin system in rats., Methods: Eighteen adult rats were divided randomly into 3 groups, i.e. sham, ischemia-reperfusion (IR) and sodium hydrogen sulfide (NaHS). The rats in the IR and NaHS groups were subjected to ischemia for 60 min and followed by reperfusion for 6 hours. In the NaHS group, there was an intraperitoneal dosing of NaHS (28 µmol/kg) at 5 min pre-reperfusion. Blood samples were collected for the measurements of alanine transaminase (ALT) and aspartate transaminase (AST). Liver tissue samples were collected for measurements of Trx and TrxR activity by enzyme-linked immunosorbent assay (ELISA), Western blot detection of Trx system proteins and thioredoxin interacting protein (TXNIP) expression. Hematoxylin-eosin staining was used to observe the hepatic histopathological changes., Results: Compared with the sham group, increased activities of ALT and AST were found in the IR group, accompanied by aggravated pathological injury. In addition, NaHS administrated at pre-reperfusion could alleviate hepatic injury. Compared with the sham group, the IR group had decreased Trx activity and Trx1 protein expression and increased TXNIP protein expression (P < 0.05) while the NaHS group had increased Trx activity and Trx1 protein expression and decreased TXNIP protein expression (P < 0.05). It indicated that the postconditioning with H(2)S could reduce the inhibition of Trx system and boost tissue antioxidant capacity., Conclusion: Hydrogen sulfide postconditioning can enhance the cellular Trx system and play a protective role in hepatic ischemia-reperfusion injury.

Objective: To investigate the change in glycogen synthase kinase-3β (GSK-3β) in spinal cord neurons in rats with incisional pain (IP)-remifentanil-induced hyperalgesia., Methods: 32 SD male rats (240 - 260 g) were randomly divided into 4 groups (n = 8 each): group R, group I, group R + I and group C. IP was established as Brennan's description. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were measured 24h before anesthesia and 2, 6, 24, 48 h after anesthesia. The rats were sacrificed after the last threshold measurement. The expressions of GSK-3β mRNA in rats' spinal cord neurons were determined by real-time PCR. The expressions of GSK-3β and pGSK-3β in rats' spinal cord neurons were determined by Western blot., Results: Remifentanil-induced hyperalgesia developed in group R, I and R + I. The expression of GSK-3β mRNA and the expression of GSK-3β in rats' spinal cord neurons were highest in group R + I. In addition, the ratio of pGSK-3β/GSK-3β was smallest in group R + I., Conclusion: These data indicate that the increased GSK-3β activity in rats spinal cord neurons is involved in remifentanil-induced hyperalgesia.

Objective: To investigate the mechanism of glucocorticoid receptors (GR) participating in morphine tolerance development via the extracellular signal-regulated kinase (ERK) signal pathway., Methods: Forty healthy male SD rats were implanted with intrathecal catheters and then randomized into 4 groups: Group C received an intrathecal injection of 10 µl saline, Group M 10 µg morphine, Group MR 10 µg morphine followed by 2 µg GR antagonist RU38486 and Group MD 10 µg morphine followed by 4 µg GR agonist dexamethasone (DEX) respectively. Each intrathecal drug was administered twice daily for 7 days. Tail-flick test was employed to evaluate the thermal hyperalgesia. After tail-flick test at Day 8, the lumbar intamescentias were isolated by Western blot to examine the protein expressions of Mu opioid receptor (MOR), GR and pERK. And terminal deoxynucleotidyl transferase mediated X-dUTP nick end labeling (TUNEL) stain was performed., Results: DEX and RU38486 enhanced and inhibited morphine induced hyperalgesia to heat respectively. Compared with Group M (count of spinal dorsal horn apoptotic cells 5.4 ± 1.1, protein expression: MOR 37 ± 5, GR 20 ± 6, pERK(1) 39 ± 4, pERK(2) 41 ± 5), apoptotic cells decreased in Group MR (3.2 ± 0.4) (P < 0.01) and increased in Group MD (16.0 ± 1.6) (P < 0.01); the protein expressions of MOR (28 ± 5), GR (12 ± 6), pERK(1)(33 ± 4) and pERK(2)(34 ± 5) were down-regulated in Group MR (P < 0.01) while up-regulated in Group MD (55 ± 6, 28 ± 9, 49 ± 6, 59 ± 5) (P < 0.01)., Conclusion: The activity of glucocorticoid receptors affects the morphine-induced spinal neural apoptosis and the expression of spinal pERK in morphine tolerance.

Objective: To evaluate the value of reflux diagnostic questionnaire in the diagnosis of children with gastroesophageal reflux disease (GERD)., Methods: Forty-five children aged 7-16 years old referred for suspected GERD with vomiting/regurgitation, nausea, heartburn/retrosternal pain, abdominal pain, epigastric pain, acid regurgitation and pain while swallowing were assessed. Each symptom was rated from 0 to 3 according to its severity and frequency. The items of questionnaire were validated against the results from upper gastrointestinal endoscopy and esophageal 24 h pH monitoring. And the results were compared with symptom scores to determine the threshold value for GERD., Results: In 45 patients, the ratio of male to female was 1.37:1 and the mean age (11.1±2.6) years old. Composite score in 23 patients with GERD (20±10) was significantly higher than that in 22 patients without GERD (13±4) (P<0.05). There was no significant difference of composite scores among patients with grades 0, I, II and III according to upper gastrointestinal endoscopy (P>0.05). With 13.0 as threshold score for GERD, the sum of sensitivity and specificity was maximal. The area under the receiver operating characteristic curve (ROC) was 0.79 while true positive diagnostic rate 72.0% and true negative diagnostic rate 75.0% with a sensitivity of 78.3%, a specificity of 68.2% and an accuracy of 73.3%., Conclusion: Reflux diagnostic questionnaire is a suitable method in initial diagnosis of GERD. It may serve as a screening test for GERD in 7-16-year-old children.

Objective: To study the difference in prevalence of major risk factors of coronary heart disease (CHD) in resident from Beijing communities in different age groups so as to offer suggestions for prevention of CHD in Beijing., Methods: The samples were selected by random cluster multistage method. Serum lipid level and CHD factors were determined through questionnaire, physical examination and biochemical detection for 10 054 subjects in Beijing communities during June 2007 to August 2007. According to age, the subjects were divided into 3 groups: 20 - 44 yr group, 45 - 59 yr group and > or = 60 yr group., Results: After age and sex standardization the prevalence of hypercholesterolemia, hypertension, diabetes, smoking and obesity was 9.30%, 41.57%, 10.18%, 35.81% and 22.89% respectively. The prevalence of hypercholesterolemia, hypertension and diabetes showed an rising trend with advancing age (trend chi(2): 15.6, 31.7 and 18.0, all P < 0.001). The group of 45 - 59 yr had the highest prevalence in smoking and obesity 28% and 25.27% respectively. Over 30% in the groups of 45 - 59 yr and > or = 60 yr were in the borderline of hypercholesterolemia and hypertension and over 40% were overweight. After age and sex standardization, 67.15% of community residents had at least 1 CHD risk factor, 21.37% and 8.50% 2 or over 3 CHD risk factors. As compared with group 20 - 44 yr, the odds ratio (95%CI) for clustering of CHD risk factors in groups 45 - 59 yr and > or = 60 yr were 2.63 (95%CI 2.371 - 2.924) and 4.3 (95%CI 3.764 - 4.913) respectively. The odds ratio (95%CI) for clustering of CHD risk factors for male vs female was 4.392 (95%CI 3.938 - 4.899)., Conclusion: The prevalence of CHD major risk factors of Beijing community residents is high. Groups of 45 - 59 yr and > or = 60 yr have a higher prevalence and clustering of CHD major risk factors than 20 - 44 yr group. So these age groups deserve a higher priority of comprehensive prevention and control strategies of CHD.

Objective: To investigate the prevalence of dyslipidemia and borderline dyslipidemia and other coronary heart disease (CHD) risk factors in residents from Beijing communities., Methods: Resident samples were selected by random cluster multistage method. Serum lipid level and CHD factors were obtained through questionnaire, physical examination and biochemical analysis during June 2007 to August 2007 from 10 054 residents., Results: Age- and sex-adjusted standardized prevalence of hypercholesterolemia, high low-density lipoprotein cholesterolemia, low high-density lipoprotein cholesterolemia, and triglyceridemia were 9.3%, 2.56%, 18.79% and 16.84%, respectively. Incidence of borderline hypercholesterolemia was 23.96%. Incidence of dyslipidemia and borderline dyslipidemia was 31.23% and 23.30% respectively, 71.17% residents have at least 1 CHD major risk factor and 20.23% residents were in borderline CHD risks. Prevalence of hypertension, diabetes, smoking and obese was 41.57%, 11.08%, 35.81% and 22.89%, respectively. The odds ratio for dyslipidemia (95% confidence interval) in residents having 1 borderline CHD risk factor (RF), 2 RF, and 3 RF versus none RF was 1.668, (95%CI: 1.319 - 2.110), 2.537 (95%CI: 1.989 - 3.235), and 3.203 (95%CI: 2.007 - 5.114)., Conclusions: The prevalence of dyslipidemia of residents from Beijing communities is higher the average level of China (25.1%). Over 1 out of 5 residents were in increased risk for borderline dyslipidemia or CHD risks. Intensive control of dyslipidemia and CHD risk factors are warranted in Beijing residents.

Objective: To evaluate the abstinence rate and relapse rate of smoker with ACS after discharged from hospital, to evaluate the effect of simple smoking cessation interventions., Methods: 150 smokers with ACS were collected and was divided into simple intervention group (n = 87) and control group (n = 63), respectively, followed up for 6 months. 2 months, 6 months abstinence rate, relapse rate were compared between two groups, logistic regression model was used to analyzed the relevant factors for relapse., Results: The smoking rate in patients with ACS was 31.14%, 6-month continuous abstinence rate and 6-month relapse rate was 64.6%, 36.4%, respectively. 6-month continuous abstinence rate and relapse rate between simple quit-smoking intervention group and control group showed no difference. Nicotine dependence score more than 4 points can be used as predictor of relapse., Conclusions: The smoking rate and the abstinence rate of smoker with ACS is higher than the general population, simple quit-smoking intervention do not increase the success rate of quit-smoking, indicated the need to strengthen the intervention in patients with ACS and smoking.

Objective: To compare the prognostic value of B-type natriuretic peptide (BNP) and GRACE score in patients with acute coronary syndrome., Methods: A total of 246 patients with chest pain to hospital time < 24 hours were followed up to 30 days. Admission plasma B-type natriuretic peptide was measured by point-of-care. Endpoints included death, reinfarction, recurrent ischemia and new onset of congestive heart failure. The receiver operating characteristic (ROC) curve was used to evaluate prognostic value of BNP and GRACE score. The logistic regression models were used to assess the prognostic contribution of BNP level and GRACE score., Results: The mean age was (67.6 +/- 12.0) years (61.8% males) and ST elevation myocardial infarction (STEMI) was diagnosed in 135 patients (54.9%). During the follow up, 34 endpoints (13.8%) were recorded including 9 deaths (3.7%). The systolic blood pressure [(121 +/- 29) mm Hg vs. (130 +/- 23) mm Hg, P = 0.034; 1 mm Hg = 0.133 kPa] was significantly lower while the heart rate and plasma creatinine were significantly higher in the endpoints group than in non-endpoints group. TNI and CRP levels were similar between the two groups. The BNP level at admission (median 883.5 ng/L vs. 216.5 ng/L) and GRACE score (median 164.5 vs. 142.0) were significantly higher in the endpoints group than in non-endpoints group (all P < 0.05). The prognostic criteria for BNP level (area under cure, 0.704) was 194.5 ng/L determined by ROC (P = 0.043). For GRACE score, the predictive value for endpoints was 0.742 (P = 0.003) and the cut-off point was 158. In the logistic regression model, BNP concentration (> 194.5 ng/L, OR = 3.174) and GRACE score (> 158, OR = 4.031) were independent predictors of endpoints in patients with ACS., Conclusion: Both BNP level at admission and GRACE score were independent predictors for endpoints at 30 days in patients with ACS.

Objective: To investigate the clinical characteristics of postinfectious irritable bowel syndrome (PI-IBS) in Qingdao., Methods: Two hundred and four PI-IBS and 2068 non-PI-IBS patients were investigated with questionnaire including general information, symptoms and quality of life scores with microecological study before and after therapy., Results: (1) The morbidity rate of PI-IBS in female was 2. 2 times of that in male, which was similar to that in non-PI-IBS. (2) Brain work labors dominated in both PI-IBS and non-PI-IBS patients. (3) As to the simultaneous presence of extra-gastrointestinal symptoms, there was no statistical difference between the rate of physical symptoms in PI-IBS and non-PI-IBS patients (chi2 =10.5, P > 0.05), but the rate of mental symptoms was higher in PI-IBS than in non-PI-IBS patients, and the difference was significant (chi2 = 28.7, P < 0.05). (4) The alteration of intestinal microflora rate in PI-IBS was obviously higher than that in non-PI-IBS patients. (5) The quality of life scores in PI-IBS was improved after treatment with Birid Triple Viable , and there was significant difference (t = 3.8, P < 0.01), but there was no statistical difference in non-PI-IBS (t = 1.5, P > 0.05)., Conclusion: There was some difference in certain clinical characteristics between PI-IBS and non-PI-IBS patients in Qingdao.

Objective: To evaluate the effects of mesenchymal stem cell (MSC) transplantation on the growth of liver cancer., Methods: MSCs were isolated from the bone marrows of SD rats. Walker-256 cancer cells were isolated from the cancerous ascites of rat and cultured. Forty-five SD rats were randomly divided into 3 equal groups: mixed transplantation group undergoing laparotomy and transplantation of cancer cells mixed with MSCs into the liver, MSC IV transplantation group undergoing injection of MSCs into the caudal vein, and control group undergoing only MSC transplantation into the liver. MR imaging was performed s at days 3, 6, 9 and 12 after modeling to measure the maximum cross section area of the tumor. At day 12 the rats were killed after MR imaging with their livers taken out to undergo HE staining and pathological examination. Immunohistochemistry was used to detect the expression of vascular endothelial cell growth factors (VEGF), nm23 gene, a tumor metastasis inhibiting gene, and proliferating cell nuclear antigen (PCNA), a nuclear polypeptide necessary in the DNA synthesis., Results: No significant evidence of tumor formation was detected by MRI at days 3 and 6 after modeling in all rats and tumor nodules were observed since day 9. The maximum cross section areas of tumor of the mixed transplantation group and MSC IV transplantation group were significantly larger than that of the control group at days 9 and 12 (F = 4.21, P < 0.05; F = 8.52, P < 0.01). Immunohistochemistry showed that VEGF expression levels of the two study groups were both significantly higher than that of the control group (F = 9.58, P < 0.01), while the nm23 gene expression levels of the 2 study groups were both significantly lower than that of the control group (F = 4.61, P < 0.05). The PCNA expression level of the mixed transplantation group was significantly higher than that of the control group (d'((1, 0.05)) = 0.34, d'((1, 0.01)) = 0.63, P < 0.05), however, there was no significant difference in the PCNA expression level between the MSCs IV transplantation group and the control group (d'((1, 0.05)) = 0.32, d'((1, 0.01)) = 0.48, P > 0.05). There was no significant difference in the tumor apoptotic index between the 2 study groups and the control group (F = 1.25, P > 0.05)., Conclusion: MSC transplantation increases the expression of VEGF and PCNA, while decreases the expression of nm23 gene in cancer cells, thus favoring the tumor growth.

Objective: To investigate whether the infusion of propofol during early reperfusion provides ischemic postconditioning (I-postC) on myocardial ischemia-reperfusion injury in rats., Methods: Sixty adult rats were randomly divided into 5 groups (n = 12 each): sham operation (group S); normal saline (group C); propofol 1 mg/kg (group P1); propofol 2 mg/kg (group P2); propofol 5 mg/kg (group P3). The left anterior descending coronary artery (LAD) was occluded for 60 min and reperfused for 120 min. Normal saline, propofol 1 mg/kg, 2 mg/kg or 5 mg/kg (propofol diluted to 2.5 ml with normal saline equally) were intravenously infused 3 min before reperfusion until 5 min after reperfusion. The heart were obtained for determination of (1) the size of area at risk and infarct size (Evans Blue and TTC staining); (2) expression of Caspase-3 (immunohistochemistry staining); (3) percentage of apoptotic cardiomyocytes (flow cytometry); (4) levels of phosphorylated Akt (Western blot)., Results: Compared with group C [size of area at risk (41.5 +/- 1.0)%, infarct size (45.5 +/- 1.0)%, expression of caspase-3 (5.87 +/- 0.29), percentage of apoptotic cardiomyocytes (26.8 +/- 1.3)%, level of phosphorylated Akt (10.8 +/- 1.9)%], propofol 1 mg/kg and 2 mg/kg significantly reduced the size of area at risk and infarct size [size of area at risk (38.3 +/- 1.0)% and (37.3 +/- 1.2)%; infarct size (33.8 +/- 1.2)% and (30.2 +/- 1.7)%, P < 0.05], inhibited the expression of caspase-3 (1.50 +/- 0.36 and 1.48 +/- 0.30, P < 0.05), decreased the percentage of apoptotic cardiomyocytes [(16.3 +/- 1.2)% and (16.5 +/- 1.0)%, P < 0.05] and promoted the phosphorylation of Akt [(68.7 +/- 4.0)% and (58.3 +/- 2.8)%, P < 0.05]., Conclusion: Propofol 1 mg/kg and 2 mg/kg can provide I-postC to myocardial ischemia-reperfusion injury in rats by activation of Akt pathway.

Objective: To explore the impact of patient compliance on the long-term outcomes in hypertensive patients receiving hydrochlorothiazide (HCTZ) based combination therapy with spironolactone or captopril., Methods: A total of 853 patients with mild to moderate hypertension were recruited and randomly divided into HCTZ group (HCTZ 12.5 mg q.d), spironolactone group (HCTZ 12.5 mg q.d and spironolactone 20 mg q.d), and captopril group (HCTZ 12.5 mg q.d and captopril 25 mg bid) after 2-week placebo washout period and 6-week loading period for HCTZ. Since the efficacy of combination therapy was proven to be better than monotherapy 1 year after therapy beginning, patients in HCTZ group were randomly assigned to spironolactone group or captopril group. The patients were followed up for 4 years. Patients were divided to compliance (n = 424) or non-compliance group (n = 429) according test drug taking questionnaire. During the follow-up time, the blood pressure and the outcomes were recorded monthly, and blood biochemical parameters were determined once a year., Results: At the end of follow up, incidence of cardio-cerebral vascular events was significantly lower in compliance group (2 fatal, 8 non-fatal) than that in noncompliance group (7 fatal, 21 non-fatal, P < 0.05). Systolic blood pressure [-(19.4 +/- 20.6) mm Hg, 1 mm Hg = 0.133 kPa] and diastolic blood pressure [-(10.7 +/- 13.5) mm Hg] were significantly reduced compared values at baseline and noncompliance group (all P < 0.001) while the reduction did not reach statistically significance in noncompliance group [-(7.3 +/- 18.2) mm Hg and -(3.5 +/- 10.2) mm Hg, all P > 0.05 vs. baseline]. The serum BUN, Cr and UA levels in the compliance group were significantly higher and the serum K(+), CHO, LDL-C level were significantly lower than baseline values. The serum BUN, UA levels in the compliance group were significantly higher while the serum K(+), cholesterol levels were significantly lower than those in the noncompliance group (all P < 0.05)., Conclusions: This study indicates that patient compliance could affect the long-term outcome and antihypertensive efficacy in hypertensive patients receiving HCTZ based combination therapy with spironolactone or captopril.

Objective: To evaluate the diagnostic value of CT in pancreas intraductal papillary mucinous neoplasm (IPMN) by analyzing its CT feature and pathological findings., Methods: The clinical and CT data was analyzed among 39 patients with IPMN whose diagnosis was confirmed by pathology. The CT manifestations were classified into 3 types: simple main pancreatic duct enlargement; main pancreatic duct enlargement combined with pancreatic cystic lesion; and simple pancreatic cystic lesion. The correlation between the CT types and Takada pathological types (main duct type, branch type, and mixed type) was analyzed. All the cases were pathologically classified into benign and malignant/boundary groups. Statistical tests of the difference of CT features (mural nodule, septa, size, caliber of main pancreatic duct and common bile duct) between the 2 groups were performed., Results: The CT type I matched the main duct type, the CT type II mainly matched the branch type and mixed type, and the CT type III matched the branch type (P < 0.001). The probability of benign lesion was 92% with no mural nodule in the lesion, while the probability of benign lesion was only 42% with mural nodule presented (P = 0.003). In terms of the septa, there was no significant difference between benign and malignant lesions (P = 0.793). The size of malignant/boundary lesions exceeded that of benign lesions (P = 0.016). There were no significant difference in calibers of main pancreatic duct and common bile duct between the benign and malignant/ boundary groups. Without considering pathological grouping the caliber of main pancreatic duct exceeded that of the common bile duct in all the cases (P = 0.02)., Conclusion: CT typing of IPMN well matches the pathological typing which benefits the CT diagnosis of IPMN. The caliber of main pancreatic duct usually exceeds that of common bile duct in IPMN. This feature contributes to its diagnosis.

Objective: To explore the feasibility of transplanting the skin from chimeric rats to rabbits., Methods: Chimeric rats were produced by transplanting the haematopoietic stem cells (HSCs) from rabbit marrows into fetal rats in uterus and followed by injecting the HSCs into the livers of the rats at newborn stage. After six weeks, the skin from chimeric rats was transplanted to the rabbits. In group A, the skin grafts from chimeric rat donors were transplanted to the HSCs donating rabbits, with the skin from non-chimeric rat to normal rabbits were used as control. In group B, the skin grafts from chimeric and non-chimeric rats were transplanted to the HSCs donating rabbits at the same time. Gross observation and the surviving time of heterogenic-skin graft were observed. The wound healing time was also recorded., Results: In group A, the surviving time and the wound healing time of non-chimeric grafts were (9.3 +/- 1.8) days and (20.9 +/- 2.1) days, respectively, while those in chimeric grafts were (15.1 +/- 2.6) and (18.5 +/-1.3) days, respectively. In group B, the surviving time and the wound healing time of non-chimeric grafts were similar to those of group A. Compared with those in non-chimeric grafts, the surviving time of chimeric grafts in both groups were prolonged (P < 0.01), and the wound healing time shortened (P < 0.05 or 0.01). Most of the wounds healed quickly after rejection of chimeric grafts, while the wounds with non-chimeric grafts were re-opened with exudation and some necrotic tissue., Conclusion: Immunologic tolerance for skin graft can be induced by the skin from chimeric donors, which can prolong the surviving time of skin grafts and shorten the wound healing time.

The formation of the theories of visceral manifestations as well as channels and collaterals in the books Huangdi Neijing (Inner Canon of Huangdi) and Nan Jing (Classic of Questioning) laid down the theoretical foundation for the theories of syndrome differentiation of zang--fu viscera. From the early occurrence of syndrome classification to that of the disease manifestations of zang and fu viscera, the theories of syndrome differentiation of zang--fu viscera were basically not put into practice until Shanghan Zabing Lun (Treatise on Cold Pathogenic and Miscellaneous Diseases) appeared. The theories of syndrome differentiation of zang--fu viscera in the Qin and Han Dynasties were not systematic and were scattered, indicating that it was a period of gestation for the theories.

Objective: To investigate the chronic efficacy of low-dose hydrochlorothiazide (HCTZ) in patients with mild-to-moderate hypertension., Methods: After a 2-weeks placebo run-in period, 232 patients with mild or moderate hypertension were recruited and received HCTZ (12.5 mg once daily) therapy for one year. Patient compliance and blood pressure were monitored and serum BUN, Cr, glucose, electrolytes, and lipids were measured before, 6 weeks and 1 year after treatment., Results: (1) Reduction of SBP, DBP and MAP were more significantly at 1 year [(10.45 +/- 17.28) mm Hg, (8.45 +/- 11.06) mm Hg, (9.12 +/- 10.88) mm Hg] than that at 6 weeks post therapy [(6.01 +/- 16.05) mm Hg, (2.90 +/- 10.33) mm Hg, (3.94 +/- 10.68) mm Hg, all P < 0.05]. Blood pressure were reduced to normal in 35.1% patients at 1 year and in 20.3% patients at 6 weeks (P < 0.05). (2) No patient developed diabetes mellitus or hypokalemia during therapy while the serum uric acid at 1 year post therapy was significantly higher than that at before therapy (P < 0.05)., Conclusion: The study indicates that low dose HCTZ is an effective and safe antihypertensive agent for patients with mild-to-moderate hypertension and uric acid changes during therapy need to be monitored.

Objective: To investigate the association of aldosterone synthase (CYP11B2) -344T/C polymorphism with plasma renin activity (PRA), and concentrations of angiotensin II (Ang II) and aldosterone (Aldo) in patients with essential hypertension (EH)., Methods: 421 EH patients, 296 males and 125 females, aged 56.3 +/- 11.2, and 207 sex and aged-matched normotensive subjects were genotyped for the CYP11B2 -344T/C polymorphism by polymerase chain reaction-restriction fragment length polymorphism. PRA and plasma Ang II and Aldo concentrations were measured by radioimmunoassay among 328 EH patients in the supine position and 279 of the 328 subjects in the upright position., Results: No significant difference in genotype and allele frequencies of CYP11B2 -344T/C polymorphism was observed between the EH and normotensive subjects (P = 0.61 and P = 0.34 respectively). In the 328 EH patients undergoing measurement of PRA, Ang II, and Aldo, the plasma Aldo concentration of the TT subjects was 76.8 pg/ml, significantly higher than those of the TC subjects (58.8 pg/ml) and CC subjects (58.8 pg/ml, P = 0.02), after adjustment for age, sex and body mass index. No association was found between the -344T/C polymorphism and PRA and plasma Ang II in the supine position (P = 0.63 and P = 0.28 respectively). However, with similar adjustment applied, the plasma Ang II concentration in the upright position was higher in the CC subjects (85.7 pg/ml) than in the TC subjects (54.6 pg/ml) and TT subjects (51.8 pg/ml. P = 0.02)., Conclusion: In the EH patients, CYP11B2 -344T/C polymorphism is associated with plasma Aldo and the plasma Ang II concentration when the patients are in the upright position.

Objective: To explore the association of single nucleotide polymorphisms (SNPs) of three candidate genes, including T869C of transforming growth factor beta1 (TGF-beta1), -344T/C of aldosterone synthase (CYP11B2) and Gly460Trp of alpha-Adducin with essential hypertension in Chinese Han population., Methods: Three hundred ninety six hypertensive patients and 214 normotensive subjects were genotyped for T869C, -344T/C and Gly460Trp polymorphisms with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and mutagenically separated PCR (MS-PCR), respectively., Results: In single-gene analysis, no association was observed between either CYP11B2 -344T/C or alpha-Adducin Gly460Trp polymorphism and essential hypertension. For female, there were significant difference in genotype distribution and allele frequency of T869C polymorphism (P < 0.02), as compared with subjects with T allele. CC homozygosity had a higher relative risk of hypertension (OR = 2.97, 95% CI, 1.38 to 6.32, P = 0.004), whereas we failed to detect any association between T869C polymorphism and essential hypertension in male. In multiple-gene analysis, the incidence of hypertension was higher in CYP11B2 TT homozygosity than in other CYP11B2 genotypes (OR = 1.99, 95% CI, 1.01 to 3.74, P = 0.03) in the presence of TGF-beta1 CC genotype., Conclusions: Our results indicated that T869C polymorphism of TGF-beta1 gene might be associated with essential hypertension in female, furthermore, the TGF-beta1 T869C and CYP11B2-344T/C polymorphisms appeared to interact in hypertensive population.

Objective: To investigate the effects of granulocyte colony-stimulating factor (G-CSF) on peripheral endothelial progenitor cells (EPC) and atherosclerosis (AS) in cholesterol-fed rabbits., Methods: Male New Zealand white rabbits were randomly divided into control group, G group (Recombinant Human Granulocyte Colony Stimulating Factor Injection rhG-CSF 50 microg/d), AS group (high cholesterol diet) and G + AS group (rhG-CSF 50 microg/d plus high cholesterol diet, n = 8 per group). Peripheral blood was collected at baseline and at 1, 4, 8 and 12 weeks, total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After being cultured for 7 days, EPCs were characterized as adherent cells double positive for DiLDL uptake and lectin binding by direct fluorescent staining under a laser scanning confocal microscope. After being cultured for 3 days, the number of EPC (PE-CD34/FITC-CD133 double-stained positive cells) was quantified by flow cytometric analysis. Serum NO was measured and aortic plaque area analyzed at 12 weeks., Results: EPC number was low in control and AS groups and EPC number was significantly increased ( approximately 13-fold, P < 0.001) compared to baseline at 1 week in G and G + AS groups and remained at this level throughout the study period in G group while decreased gradually in G + AS group and returned to baseline level at 12 weeks. Aortic atherosclerotic plaque was visible in both AS and G + AS groups, however, the aortic atherosclerotic plaque area was smaller in G + AS group than that of in As group (59.8 mm(2) +/- 26.9 mm(2) vs. 251.5 mm(2) +/- 83.4 mm(2), P < 0.01). Serum NO was similar between AS and G + AS groups and significantly higher than that in control and G groups., Conclusion: CSF could attenuate atherosclerosis in cholesterol-fed rabbits by increasing circulating EPC.

Objective: To evaluate the time course of granulocyte-colony-stimulating-factor (G-CSF), estrogen and various doses of atorvastatin on endothelial progenitor cells (EPCs) mobilization., Method: A total of 48 male New Zealand White rabbits were treated with placebo, estrogen (0.25 mg.k(-1).d(-1)), Atorvastatin (2.5, 5, or 10 mg) and G-CSF (50 microg/rabbit/d), respectively. Peripheral EPCs number was surveyed weekly for 4 weeks by FACS analysis (double-positive for PE-CD34/FITC-CD133) and under fluorescent microscope (double-positive for FITC-UEA-1/Dil-acLDL). Serum nitric oxide (NO) and lipids were also measured at the third week., Results: Peripheral EPCs was significantly increased in G-CSF treated animals and remained constant for 4 weeks compared to placebo treated animals. Atorvastatin increased peripheral EPCs dose-dependently from 2.5 to 5 mg and peaked at the third week while peripheral EPCs number was not affected by 10 mg.k(-1).d(-1) atorvastatin during the first 3 weeks and was significantly higher only in the fourth week compared to placebo group. Estrogen also significantly increased peripheral EPCs at the third and fourth week compared to placebo group. At the third week, serum NO was similar in G-CSF group, significantly higher in atorvastatin 5 mg.k(-1).d(-1) and estrogen groups while significantly lower in atorvastatin 10 mg.k(-1).d(-1) group compared to placebo group. Serum lipids were similar among various groups., Conclusion: Atorvastatin, estrogen and G-CSF could mobilize EPCs. The mobilization efficacy is as follows: G-CSF > atorvastatin 5 mg.k(-1).d(-1) > estrogen > atorvastatin 2.5 mg.k(-1).d(-1) > atorvastatin 10 mg.k(-1).d(-1). NO might partly contribute to the mobilizing effect of estrogen and atorvastatin.

Objective: To identify single nucleotide polymorphisms (SNP) in the regulatory and coding regions of human kynureninase (KYNU) gene in a hypertensive candidate chromosomal region 2q14-q23 of Han Chinese, and to investigate the relationship between polymorphisms in KYNU and essential hypertension., Methods: The SNPs in the promoter region and exons of the KYNU gene were detected by direct DNA sequencing. Genotyping of the nonsynonymous Lys412Glu (A/G) polymorphism was performed by DHPLC technology in 456 hypertensive patients and 430 normal controls., Results: Sixteen SNP were identified in the KYNU gene, including 6 in the regulatory region and 2 in the coding region (both of them lead to substitution of amino acid). Significant differences between hypertensive patients and normal controls were observed for the distribution of alleles (chi(2) = 6.693, P = 0.035) and genotypes (chi(2) = 4.188, P = 0.041) of the Lys412Glu polymorphism in all subjects, and for the distribution of alleles in the subgroup of men (chi(2) = 4.424, P = 0.035)., Conclusion: The Lys412Glu polymorphism of the KYNU gene in a hypertensive candidate chromosomal region is associated with essential hypertension in Han Chinese.

Objective: To investigate the association of peripheral and central blood pressure with the alpha-adducin Gly460Trp polymorphism in Chinese., Methods: We randomly selected 6 villages from JingNing County, ZheJiang Province. We invited nuclear families to take part in our study. We measured each participant's blood pressure at the non-dominant arm by means of a standard mercury sphygmomanometer at subjects' homes. Five consecutive readings were averaged for analysis. Central blood pressures were obtained by use of SphigmoCor pulse wave analysis system. The observers administered a standardized questionnaire to collect information on smoking habits, alcohol consumption and use of antihypertensive drugs. Venous blood was sampled and the adducin genotype was determined by restrictive fragment length polymorphism (RFLP)., Results: Four hundred and forty-two subjects included 230 (52.0%) women, and 116 (26.2%) hypertensive patients, of whom 49 (11.1%) took antihypertensive drugs. The frequencies of alpha -adducin GlyGly, GlyTrp and TrpTrp genotypes were 21.3%, 54.5% and 24.2%, respectively. There was no association between the alpha-adducin Gly460Trp polymorphism and peripheral systolic and diastolic blood pressure and pulse pressure. However, both before and after adjustment for sex, age, age(2), body-mass index, current smoking, alcohol intake, and antihypertensive treatment, the alpha-adducin polymorphism was significantly (P < 0.02) associated with central systolic blood pressure and central pulse pressure. After adjustment, central systolic blood pressure (+/- SE) averaged 122.5 +/- 3.5, 114.1 +/- 1.5 and 109.1 +/- 1.8 mm Hg (P = 0.01) in the GlyGly, GlyTrp and TrpTrp subjects, respectively. The corresponding values for central pulse pressure were 39.4 +/- 1.3, 36.4 +/- 1.0 and 32.9 +/- 0.9 mm Hg (P = 0.002), respectively., Conclusions: In the JingNing population, the adducin 460Trp allele was associated with lower levels of central systolic pressure and pulse pressure.

Objective: To investigate possible association between the single nucleotide polymorphisms (SNPs) of transforming growth factor beta3 (TGF-beta3) gene and essential hypertension (EH) in Chinese., Methods: The promoter region, exons, as well as part of the introns of TGF-beta3 gene were sequenced by a fluorescent labeling automatic sequencing method to detect and characterize the SNPs in 24 DNA samples from a Chinese population. Then we conducted a case-control study using 396 patients with hypertension (case) and 214 nomortensive subjects (control). The three SNPs including Thr63Asn, SS5608219 and SS5608220 were genotyped by PCR-RFLP or real-time allele-specific PCR in subjects studied., Results: Seven SNPs in the exons, introns and 3'untranslated region (3'UTR) of TGF-beta3 gene were identified. Among them, 2 SNPs were found to be novel genetic variants and one of the two located in the exon 1 and produced substitution of amino acid. However, no differences were found between hypertensives and nomortensives in genotype distribution and allele frequency of SS5608219, Thr63Asn or SS5608220 polymorphisms., Conclusions: Two novel SNPs of TGF-beta3 gene were identified in Chinese. One of them produces a threonine to asparagines substitution in codon 63 (Thr63Asn). But no association was found between TGF-beta3 gene polymorphisms and EH in Chinese.

Objective: To evaluate the cardioprotective effects of intravenous diltiazem infusion perioperatively in patients undergoing coronary artery bypass grafting (CABG) under extracorporeal circulation., Methods: Forty patients undergoing CABG were divided into 2 groups of 20 patients according to the operation date: experimental group in which infusion of diltiazem (0.1 mg/kg/h) was given starting from the onset of extracorporeal circulation until 24 h after the aortic cross-clamping, and blank control group. The relative hemodynamic parameters were recorded for 48 hours., Results: (1) 4 approximately 24 hours after the aortic cross-clamping the heart rates of the experimental group was 98 +/- 18 approximately 96 +/- 13 times/min, significantly lower than those of the control group (111 +/- 16 approximately 105 +/- 14 times/min, P<0.05); the values of rate-pressure product (RPP) of the experimental group were 13.0 +/- 3.7 approximately 11.7 +/- 3.0 mm Hg/min/10(3), significantly lower than those of the control group (14.1 +/- 1.9 approximately 5.8 +/- 3.6 approximately mm Hg/min/10(3), P<0.05) (2) The postoperative peak value of creatine kinase (CK) was not significantly different between these 2 groups. The postoperative peak value of creatine kinase-MB (CK-MB) in the experimental group was 83 +/- 33 IU/L, significantly lower than that in the control group (105 +/- 20 IU/L, P<0.05) and postoperative peak value of cardiac troponin-T (cTNT) was 0.38 +/- 0.21 IU/L, significantly lower than that in the control group (0.83 +/- 0.20 IU/L, P<0.05). The values of CK, CK-MB, and cardiac troponin TC (cTNT) of the patients with coronary vasospasm in the experimental group were all significantly lower than those of the patients with coronary vasospasm in the control group. (3) The average number of arrhythmic events per hour was lower in diltiazem group, and the average number of ventricular premature contraction per hour was significantly lower during the period of ST segment depression in particular., Conclusion: Perioperative intravenous diltiazem infusion provides significant cardioprotective effect in patients undergoing CABG.

In this study 22 normotensive (NT) and 12 essential hypertensive (EHT) subjects were included to test the possibility that fish oils might influence the blood pressure, plasma lipids and fibrinogen as well as the erythrocytic membrane lipid composition and pump activity. Each EHT subject was given capsules containing fish oils (6 g/d) for 18 days. At the end of the study, SBP fell (P < 0.05) and plasma fibrinogen level decreased (P < 0.05), while DBP, TG, TC, and HDL-C showed no significant change. The fatty acid composition of erythrocyte phosphatidyl ethanolamine (PE) and phosphatidyl choline (PC) showed the following changes: in PE, C22:6, C20:5 increased (P < 0.05; P < 0.01), CI18:1 decreased (P < 0.01); in PC C22:6, C22:4 increased (P < 0.05; P < 0.01). The activity of Na+, Ca2+ max, CaM-stimulated Ca2+ pumps increased (P < 0.05; P < 0.01; P < 0.01). As compared to NT, EHT subjects had higher C20:4 in both PE (P < 0.05) and PC (P < 0.01) and lower C18:2 in PC. It is also shown in this study that EHT subjects have higher C20:4 in both PE (P < 0.05) and PC (P < 0.01) and lower C18:2 in PC as compared to NT ones.