Objective：To investigate microRNA-29b (miR-29b) expression in cerebral cortex, spinal cord, fore limb muscle, and serum of SOD1-G93A amyotrophic lateral sclerosis (ALS) mice, and to identify the biomarker and to assess diagnostic values for ALS. Methods: Cerebral cortex, spinal cord, fore limb muscle and serum from 16 SOD1-G93A ALS mice and 16 wild-type mice were taken and then microRNA extracted, detecting the expression of miR-29b by real-time quantitative polymerase chain reaction (RT-qPCR). The diagnostic performance of miR-29b for ALS was estimated by the receiver operating characteristic (ROC) curve. Results: The results from the validation indicated that the differences in miR-29b between the cerebral cortex of SOD1-G93A ALS and the healthy control subjects were statistically significant (P=0.001). Meanwhile, the expressions 8, 12, and 16 weeks later were higher than those of the controls (ALS vs. Control: 8 weeks, P=0.044; 12 weeks, P=0.018; 16 weeks, P=0.045). When the relative expression level of miR-29b was used to diagnose ALS in SOD1-G93A ALS mice, the area under the ROC (area under the curve, AUC) was 0.885, if the diagnostic threshold was set at 0.185 6, the sensitivity and specificity were 92.9% and 71.4%. Conclusion: MiR-29b may act as medical monitoring indices of ALS in early time.

Objective：The aim of this study was to investigate the mechanism underlying transforming growth factor-β1 (TGF-β1) induced differentiation of bone marrowderived mesenchymal stem cells (BMSCs)into myofibroblasts.Methods:Primary mouse BMSCs were isolated from bone marrow by flushing the tibias and femurs of mice, and passage 3 to passage 5 of BMSCs were used in the experiments. BMSCs differentiation into myofibroblast was induced by different doses of TGF-β1. In addition, reactive oxygen species (ROS) inhibitor (N-acetylcysteine, NAC) was added to test its effect on the action of TGF-β1. Expressions of BMSCs differentiation parameters, α-smooth muscle actin (α-SMA), collagen α1(Ⅰ) ［Col α1(Ⅰ)］ and collagen α1(Ⅲ) ［Col α1(Ⅲ)］ were measured by real-time quantitative PCR (RT-qPCR) and Western blot analysis. BMSCs were preloaded for 15 min with 2’, 7’-dichlorohydro-fluorescein diacetate (DCFH-DA), then stimulated with TGF-β1 for different times, and fluorescence of ROS was measured using high content analysis. Results:TGF-β1 stimulated differentiation of BMSCs into myofibroblasts and up-regulated expression of α-SMA, Col α1(Ⅰ) and Col α1(Ⅲ) in a dose-dependent manner, which blocked by ROS inhibitor NAC. In addition, TGF-β1 could induce a significant rapid and transient increase in ROS production in BMSCs, and the effect of TGF-β1 on ROS production was peaked at 30 min.Conclusion:TGF-β1 induced differentiation of BMSCs into myofibroblasts via production of ROS.

Objective：To investigate the effect and mechanisms of Phloroglucinol (PG) on renal ischemia and reperfusion injury (IRI). Methods: Forty-eight male Wistar rats were divided into 3 groups (16 rats per group): sham operated, saline-treated I/R （I/R）, and PG-treated I/R (PG). I/R model: After removing the right kidney, renal I/R injury was induced by clamping the left renal artery for 45 min followed by reperfusion. The rats were administered with PG (30 mg/kg, intraperitoneally) or saline 15 min before renal ischemia. The blood and kidneys were harvested 6 and 24 h after reperfusion. Renal function and histologic changes of serum creatinine (SCr) and blood urea nitrogen(BUN)were assessed. Malondialdehyde (MDA),catalase (CAT）,superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px）were measured. Nuclear factor-kapa B (NF-κB) and caspase-3 in the kidneys were also measured. Results: SCr and BUN were (103.9±10.4) μmol/L and (15.2±1.0) mmol/L in I/R group, and (81.8±13.4) μmol/L and (11.5±1.2) mmol/L in PG group 6 h after reperfusion. SCr and BUN were (154.9±12.1) μmol/L and (28.1±1.4) mmol/L in I/R group, and (103.8±5.9) μmol/L和(16.0±1.0) mmol/L in PG group 24 h after reperfusion.PG treatment significantly attenuated renal dysfunction and histologic damage caused by I/R injury（P<0.05）.The I/Rinduced elevation in kidney MDA level decreased, where as reduced kidney SOD,CAT and GSH-Px were increased. What is more, the apoptotic tubular cells, the levels of active caspase-3,and active nuclear factor kappa B dramatically decreased after PG treatment. Conclusion: PG protects murine kidney I/R injury by suppres-sing oxidative stress, inflammation, and cell apoptosis.

Objective： To observe an abnormal expression of humoral immune response induced by memory B cells in tonsils and peripheral blood of patients with IgA nephropathy (IgAN), the variation of memory B cells after tonsillectomy, and to discover the role of tonsillectomy in IgAN.  Methods: In the study, 28 patients were diagnosed as IgAN via renal biopsy, and 27 patients suffering from chronic ton-sillitis without nephritis and 10 normal human beings were selected as controls. The expression of memory B cells in the tonsils and peripheral blood was tested by flow cytometry, and the same method was used to test the variation of the expression of memory B cells in peripheral blood of patients with IgAN after tonsillectomy. Results: In this study, higher percentages of memory B cells were observed in tonsil and peripheral blood of IgAN patients, which were 5.72%±5.26%, 4.92%±5.10%. After tonsillectomy, the percentage of memory B cells was 1.10%±0.65%, lower than that before tonsillectomy (P<0.05). Meanwhile, in tonsils and peripheral blood, the percentage of memory B cells varied with the variation of the urinary findings of the IgAN patients. Conclusion: The percentage of memory B cell in tonsils and peripheral blood could predict disease progression of IgAN to a certain extent.

Objective：To explore the effects of superparamagnetic iron oxide-short hairpin RNA (SPIO-ShRNA) dual functional molecular probes of different concentrations on morphology and biological beha-vior of ovarian cancer SKOV3 cells in vitro. Methods:The dual functional molecular probes at an iron concentration of 5, 15, 30, 45, 75, and 100 mg/L were transfected into SKOV3 cells. The transfection rate of the probe was observed by fluorescence microscope. The distribution and content of iron particles in SKOV3 cells were determined by Prussian blue staining, atomic adsorption spectrometer and electron microscopy. Cell viability was observed by cell counting kit-8 (CCK-8).The apoptosis was detected by flow cytometry. The expression of protein within the cells was detected by Western blot. The changes of the signal intensity were measured by magnetic resonance imaging (MRI). Results: The SPIO-ShRNA dual functional molecular probe was uptaken in aconcentrationdependence manner within a certain range (5-30 mg/L). When the concentration of the probe was 45 mg/L, the labeling rate of the cell was close to 100%; With the increase of the concentration of probe, the cell survival rate decreased gradually. The cell survival rate of each experimental group were 94.626%±1.050%, 93.373%±1.180%, 91.700%±3.122%, 75.100%±4.362%, 72.983%±3.233%, 71.010%±2.910%，5, 15, 30 mg/L cell survival rate was not significantly decreased, the difference was not statistically significant (P=0.226, P=0.068, P=0.475); When the concentration of the probe was greater than or equal to 45 mg/L，the survival rate decreased obviously (P<0.001); Group of 45 mg/L protein expression rate was 68.905%±3.510%, When the concentration of the probe was greater than or equal to 45 mg/L, the inhibition rate of the protein expression level of epidermal growth factor receptor was obviously higher than those of 5, 15, and 30 mg/L groups, the difference was statistically significant (P<0.001, P=0.001, P=0.003, all P<0.01); the MRI displayed that the signal intensity was decreased with increasing concentrations of the probe. The signal intensity of 45 mg/L group was 165.55±4.92, compared with the blank control group(same volume of phosphate buffer saline), normal group(unlabeled ovarian cancer SKOV3 cells), 5, 15, and 30 mg/L groups , the signal intensity of 45 mg/L group decreased significantly (all P<0.001). Conclusion:The dual functional molecular probe can effectively transfect and specifically inhibit the expression of SKOV3 cell lines at the iron concentration of 45 mg/L, and can also be detected by MRI. The role of diagnosis and treatment of the dual functional molecular probe has been initially confirmed.

Objective：To explore the influence of treatment with HMG-CoA reductase inhibitors (sta-tins) on the expression profile of microRNAs (miRNAs) in the plasma of patients with unstable angina (UA). Methods: The Taqman low-density miRNA array (TLDA) and significance analysis of microarrays (SAM) were used to identify distinct miRNA expression profiles in the plasma of UA patients treated with long-term and regular statins (UA receiving statins, n=6) compared with UA patients who had not received statins therapy before (UA received no statins, n=6). These differentially expressed miRNAs discovered in the profiling were further validated by real-time PCR in another 20 controls with non-cardiac chest pain, 26 UA patients received no statins, and 19 UA patients received statins. Results: By using TLDA and SAM, significantly decreased expression levels of 21 miRNAs were observed in the UA patients receiving statins compared with those who received no statins (fold change > 3 and false discovery rate< 0.0001%). The unsupervised hierarchical clustering based on miRNA expression clearly separated the UA patients receiving statins from those who received no statins. Consistent with the profiling data, the levels of 5 inflammation-associated miRNAs (miR-106b, miR-21, miR-25, miR-451, and miR-92a) were down regulated (P<0.05) in the UA patients receiving statins compared with those who received no statins. Conclusion: A group of inflammation-associated miRNAs, consisting of miR-106b, miR-21, miR-25, miR-451, and miR-92a, could be decreased by treatment with statins and may be used as a novel biomarker for effectiveness of statins therapy in patients with UA.

Objective：To investigate the predicting value of European system for cardiac operative risk evaluation (EuroSCORE) and sino system for coronary operative risk evaluation (SinoSCORE) in early quality of life of patients after coronary artery bypass surgery (CABG). Methods:A total of 218 consecutive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation. Health related quality of life (QoL) was estimated by using 36-item short form health survey (SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two systems in early postoperative QoL. Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test．Discrimination was tested by determining the area under the receiver operating characteristic (ROC) curve．Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P<0.001).Except for bodily pain (BP) and mental health (MH), statistically significant correlation was found between the preoperative risk evaluation scores and the postoperative QoL scores (r:-0.203 to －0.493, P＜0.05). Logistic regression analyses indicated that both the scores emerged as the independent predictor for a relatively worse QoL (OR>1, P＜0.05). Furthermore, the EuroSCORE predicted the outcome with a higher OR. For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754．For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854．Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL, while EuroSCORE might have a greater predicting value.

Objective：To find the correlation of wrist bone mineral density (BMD) to wrist synovitis and erosion, by comparing wrist BMD and ultrasonography.Methods: A number of 80 female RA patients were examined by BMD measurement of the femoral neck, spine and non-dominant wrist using dual-energy X-ray absorptiometry (DXA). Synovitis of the wrist was examined by ultrasonography. The wrist joint (radiocarpal joint, dorsal midline, and carpoulnar joint) was assessed in the same side of DXA, with transverse and longitudinal scans for USGS synovial hypertrophy and proliferation, tenosynovitis,tendinitis and bone erosion. Colour and power doppler ultrasonography (PDUS) were used to sum the synovitis score.Results:We found: (1) In the study, 80 female RA patients were enrolled, the mean age was 54.6±13.3 (27.0-80.0) years, the disease duration was 48 (12-116) months, and the body Mass Index was 23.0±4.0 (14.8-31.2) kg/m2. The Wrist BMD (g/cm2) in RA significantly reduced, compared with normal controls(0.297±0.121 vs. 0.420±0.180，P<0.01). (2) The Wrist BMD (g/cm2) exceeded in early RA compared with the established RA(0.326±0.103 vs. 0.285±0.132，P<0.01); the positive rate of severe osteoporosis in wrist was lower in early RA compared with the established RA(47.8% vs. 64.9%, P<0.05); the positive rate of bone erosion in wrist by ultrasound was lower in early RA compared with the established RA (39.1% vs.  56.1%, P<0.01). (3) The wrist BMD (g/cm2) in RA with high disease activity reduced compared with moderate and low disease activity (0.267±0.140 vs. 0.280±0.126) and (0.267±0.140 vs. 0.320±0.103) respectively, P<0.05). The percentages of positive ACPA in the high and moderate disease activity groups were significantly higher than those in the remission group (85% vs. 81.8% and 92.6% vs.  81.8%, respectively). DAS28ESR was correlated with wrist BMD (r=-0.288， P<0.01). (4) A significant positive correlation was found between wrist and spine/femur BMD (r=0.634， P<0.01， r=0.795， P<0.01), and a negative correlation between wrist and disease duration and DAS28ESR (r=-0.286，r=-0.301，P<0.01). There was a highly significant positive correlation between wrist BMD and femur BMD (r=0.95，P<0.05). (5) RA patients in wrist osteoporosis group had higher RF positive rate and ACPA rate than wrist osteopenia group (75.5% vs.  55.6%，P<0.05,100% vs.  83.3%， P<0.05). The patients of BMD osteoporosis group had higher DAS28ESR compared with osteopenia group (5.3±1.8 vs.  3.7±1.5， P<0.01). The percentages of synovitis (61.5% vs.  51.7%, P<0.05), tendenitis (14.3% vs. 10.0%, P<0.05) and bone erosion (54.2% vs.  46.2%, P<0.05) in wrist by ultrasonography in osteoporosis group were higher than those of osteopenia group. (6) The wrist BMD in ne-gative bone erosion group by ultrasonography was lower than that in positive bone erosion group ［(0.333±0.107) g/cm2 vs.  (0.264±0.125) g/cm2, P<0.01］, also the PDUS score was higher than positive bone erosion group (4.53±1.40 vs.  2.55±2.66，P<0.01). Compared with negative bone erosion group, the patients in positive bone erosion group had longer disease duration (96.0±104.7) months vs.  (66.2±78.0) months， P<0.05), higher percentage of RF (81.0% vs.  53.8%，P<0.01), ACPA (92.7% vs. 79.5%, P<0.05). and higher DAS28ESR (5.4±1.8 vs.  4.2±2.0，P<0.05). The percentage of wrist synovitis in positive bone erosion group was higher (75.6% vs.  30.8%，P<0.01) than that of negative bone erosion group, and moreover, the percentage of severe osteoporosis in the wrist was significantly higher (75.0% vs.  46.4%， P< 0.01). (7) A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low wrist BMD. Statistically significant variables were age (P=0.001), disease duration (P=0.017), DAS28ESR (P=0.021), and ACPA (P=0.05).Conclusion:This study shows a highly significant correlation between hand BMD with disease duration and disease activity, and female RA patients with high titer of ACPA have lower wrist BMD.

Objective：To verify the fracture risk assessment tool (FRAX) to estimate the probability of osteoporotic fracture in patients with rheumatoid arthritis (RA) with or without bone mineral density (BMD), and identify associated risk factors of osteoporosis. Methods: In the study, 200 patients with rheumatoid arthritis aged more than 40 years in Peking University First Hospital from Dec. 2009 to Dec. 2012 were recruited. Clinical information was obtained from a questionnaire of their case history and medical records. FRAX tool was administered. Their lumber spine and left femoral BMD were determined by dual energy X ray absorptiometry. The gender, age, disease duration, menopause status, body mass index (BMI) and accumulative dose of glucocorticoid were obtained in retrospect. Correlation analysis was conducted between the BMD and clinical information. Results:The study population (female, 77.5%) had a mean age of 59.4 years, in which 10 (13%) patients showed a normal BMD, 67 (87%) were osteopenia or osteoporosis, while 32 patients (16%) had fragile fracture. Compared with the patients with normal BMD, the subjects with low BMD had significantly older age, longer period for corticoids usage, higher day dose and accumulated dose of corticoids.The 10-year fracture risk of sustai-ning major osteoporotic fractures and hip fracture was higher. No significant difference was observed between the 10-year fracture risks calculated with BMD and without BMD. The values of the different area under the receiver operating characteristic (ROC) curve (AUC) for major and hip fractures calculated in three ways: without BMD, with the femoral neck BMD, and with T-score. The best result was for FRAX tool for hip fracture with the T-score (AUC 0.899). A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low BMD. Three statistically significant variables for lumber BMD were pain on visual assessment scale (VAS) (P=0.02), fracture history (P=0.003) and a higher steroid accumulated dose (P=0.008). Three statistically significant variables for left hip BMD were age (P<0.001), fracture history (P=0.05) and lower BMI (P=0.03). Conclusion: Low BMD is a common complication in RA patients. Risk factors for major fracture and hip fracture are increased. There is a positive correlation between FRAX calculated with and without BMD or T score. FRAX with the femoral neck T score or BMD presents a discriminatory capacity better than FRAX without BMD, according to the AUC ROC.

Objective：To evaluate the change in hamstring (H):quadriceps (Q) ratio following anterior cruciate ligament (ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function. Methods: A study was performed in 25 male complete unilateral ACL ruptures. Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively. At 30 degrees of flexion, the average torque of quadriceps and hamstring, Qe∶Qc ratios (ratios of eccentric quadriceps to concentric quadriceps muscle torque), He∶Hc ratios (eccentric hamstring to concentric hamstring), Hc∶Qc ratios (concentric hamstring to concentric quadriceps), He∶Qc ratios (eccentric hamstring to concentric quadriceps), and Hc∶Qe ratios (concentric hamstring to eccentric quadriceps) were calculated. Wilcoxon matched-pairs signed-ranks test was used. Results: At 30 degrees of knee flexion, a significant reduction (P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side. In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side. Conclusion: The change in H ∶Q ratio in the mode of isokinetic 60°/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee.

Objective：To investigate the differences between emergency surgery and selective surgery treatment of ankle fractures with dislocation. Methods: In the study, 40 patients with ankle fracture and dislocation were treated and followed up from May 2013 to May 2014, and all the data were collected and analyzed. The subjects involved 29 male patients and 11 female patients. The patients were randomly separated into two groups, and the patients in group A were given surgical intervention within 6 hours after injury, while those in group B were initially given close reduction and given selective operation when the soft tissue condition got better. Group A contained 13 male patients and 7 female patients with average age of 37.10; Group B consisted of 15 male and 5 female, with average age of 37.85. Results:The Baird-Jackson score was applied for assessment of the patients’ outcomes. According to the score, the outcomes were classified into excellent, good, fair, and poor. In group A (emergency group), the outcomes were 13 (65.0%), 4 (20.0%), 3 (15.0%), and 0, respectively. In group B (selective group), they were 11 (55.0%), 7 (35.0%), 2 (10.0%), and 0, respectively. The numbers of the patients from excellent to poor were 24 (55.0%), 11 (27.5%), 5 (12.5%), and 0, respectively. Conclusion: There is no significant difference in postoperative function between the two groups, however, early surgical intervention can benefit in accomplishing anatomical reduction much easier and shortening the time of hospitalization, which is costsaving for the patients.

Objective：To evaluate the endothelial functions and autoregulation capacity of cerebral blood flow in patients with Fabry disease. Methods：Brachial artery vasodilation was assessed in 8 patients with Fabry disease and 14 healthy controls by means of flow-mediated dilation (FMD) and Nitroglycerin-mediated dilation (NMD). Cerebrovascular reactivity was calculated in terms of breathholding index (BHI) and vascular motor reactivity (VMR) by TCD-CO2 test in 4 patients and 14 healthy controls. Results：Compared with the controls, brachial artery vasodilation experiment showed no difference (the patients: FMD 15.94%±5.03% and NMD 23.92%±7.23%, the controls: FMD 14.57%±5.84% and NMD 22.64%±6.96%), there was no relationship between FMD or NMD and the age, course of disease, MSSI or enzyme activity. In respect of cerebrovascular autoregulation capacity, there was no difference in anterior circulation, while cerebrovascular reactivity tended to be impaired in posterior circulation. Conclusion：Endothelial function showed no decline in patients with Fabry disease, but cerebrovascular autoregulation capacity tended to be impaired in posterior circulation.

Objective： To evaluate whether urological patients at nutritional risk are at higher risk for complications after radical cystectomy than those not at nutritional risk. Methods: We performed a retrospective observational study in the consecutive patients undergoing radical cystectomy between 2010 and 2013. A total of 147 patients were enrolled in this study. The nutritional risk score was assessed preoperatively by a specialized study nurse. The patients with NRS （nutritional risk screening，NRS2002）scores≥3 were considered to have nutritional deficiency. Postoperative complications were defined using the standardized Clavien-Dindo classification. Univariate and multivariate analyses were performed to identify the predictors of complications. Results:The patients aged ≥70 years（50.57%） were more prone to nutritional risk than those aged ＜70 years （31.67%, P=0.023). Of the 63 patients at nutritional risk, 39 (61.90%) presented with at least 1 complication compared with 29 of the 84 controls (34.52%, P=0.001）. The patients at nutritional risk were at threefold risk for complications on binary Logistic analysis (OR=3.128，95%CI 1.538－6.361，P=0.002). The length of hospital stay of the patients at higher nutritional risk was longer than that of those without nutritional risk ［(12.9±5.7) d vs. (10.4±4.3) d, P=0.003］. Conclusion: The patients aged ≥70 years are at higher nutritional risk than that of those aged ＜70 years. Patients at nutritional risk are more prone to complications after radical cystectomy.

Objective：To analyze correlation factors of hemodynamic damage after carotid artery stenting. Methods: In this study, 66 cases (71 lesions) who undertook carotid artery stenting were collected and the correlation factors of hemodynamic damage were analyzed. Results: Hemodynamic damage emerged in 23 cases (32.4%), of which, 11.3% developed hypotension. The distance between bifurcation and lesions (P=0.002 0), plaque distribution (P=0.000 2), plaque character (P=0.001 9), postdilation (P=0.002 6) were associated with hemodynamic damage by single factor analysis. However, only eccentric plaque (P=0.015 3) and calcified plaque (P=0.009 7) were associated with hemodynamic damage by multiple factors analysis. All the patients could reach stable circulation by drugs during operation, and no cerebral ischemic events (transient ischemic attack or stroke) and cardiovascular ischemic events happened. Conclusion: The distance between bifurcation and lesions, eccentric plaques, calcified plaques are correlation factors of hemodynamic damage.

Objective： To investigate molecular mechanism involved in nicotine in combination with Porphyromonas gingivalis (P.g) caused monocyte-endothelial cell adhesion. Methods: The effect of nicotine, P.g-lipopolysaccharide (P.g-LPS) and their combination on the proliferation of U937 cells was determined by CCK-8 method. Interleukin-6 (IL-6) expression was investigated by Real-time PCR after U937 cells were treated with nicotine, P.g-LPS and their combination. In human umbilical vein endothelial cells (HUVECs), the expressions of monocyte chemoattractant protein CCL-8 and adhesion molecules including vascular cell adhesion molecule 1 (Vcam-1), very late antigen 4 alpha (VLA4α), tumor necrosis factor receptor superfamily member 4 (OX40) and OX40 ligand (OX40L) were detected by Real-time PCR or Western blotting assays after HUVEC cells were treated with nicotine, P.g-LPS and their combination. Adhesion of monocytes to endothelial cells was detected after the HUVECs and U937 cells were stimulated with nicotine, P.g-LPS and their combination, respectively. Results: P.g-LPS did not affect the proliferative ability of nicotine in U937 cells. However, the ability of P.g-LPS induced IL-6 expression was inhibited by 100 μmol/L nicotine in U937 cells. In HUVECs, the expressions of CCL-8, Vcam-1, VLA4α, OX40 and OX40L were significantly up-regulated by nicotine and P.gLPS combination compared with nicotine alone, P.g-LPS alone and the untreated control. Adhesion of monocytes to HUVECs results showed that the two types of cells treated with nicotine in combination with P.g-LPS could markedly increase the adhesion ability of monocytes to HUVECs. Conclusion: P.g-LPS in combination with nicotine could recruit monocytes to endothelial lesion through up-regulation of CCL-8, and promote adhesion of monocytes to endothelial cells through enhancement of Vcam-1/VLA4α and OX40/OX40L interactions, which could be involved in the initiation and development of atherosclerosis.

Objective：To identify the healing effect of electrospun silk fibroin-BMP-2 as a biologic pulp capping agent to inflammatory pulp in rat caused by lipopolysaccharide (LPS). Methods: A total of 30 healthy adult male Wistar rats were randomly divided into five groups:(1) normal control group without operation; (2) blank control group without capping agents; (3) calcium hydroxide capping group; (4) electrospun silk fibroin capping group; (5) electrospun silk fibroin-BMP-2 capping group. Bilateral upper first molars of each rat in group 2-5 were drilled to expose the pulp to LPS which was used to establish a model of inflammatory pulp. The exposed pulp was capped with different capping agents or without capping agents. Then the hole was sealed. The animals were sacrificed on days 3, 7, and 14 post-operation and histological analysis was carried out, including HE stain and CD14 immunohistochemical stain. Results: On day 7 and 14, the lowest inflammatory reaction score in HE stain among pulp capping groups was that of silk fibroin-BMP-2 group. The next were calcium hydroxide group and silk fibroin group. That of blank control group was the highest. The ranking of reparative dentine scores of those groups was just reversed. The D values of immunohistochemical stain of CD14 were not significantly different in groups applied pulp capping agents but significantly lower than blank control group on days 3 and 7. However, the D value of silk fibroin-BMP-2 group (0.145±0.011) was significantly lower than blank control group (0.287±0.019), calcium hydroxide group (0.170±0.017) and silk fibroin group (0.175±0.018) on day 14. Conclusion:Electrospun silk fibroin compounded with BMP-2 promoted wound hea-ling of exposed pulp and had better potential to stimulate formation of reparative dentine to establish a suitable environment for pulp recovery.

Objective：To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans(Aa) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls, unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa (PCR method). Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay (ELISA).Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%. The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1±1.9 vs. 9.1±1.8, P<0.01). There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients. Serum IgG titers to Aa serotype c in the Aa-positive AgP patients (the patients who were Aa-positive in subgingival plaque or saliva) were significantly higher than those of the Aa-negative patients (11.9±1.3 vs. 10.7±2.1, P<0.05). Conclusion:Serotype c was the main serotype of Aa in Chinese patients with AgP. Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients.

Objective：To evaluate the microtensile bond strength changes and patterns of fractures of the bonding interface after dentine surface treatment with carbodiimide-ethanol solution. Methods:1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) dissolved in ethanol was diluted into different concentrations of 2, 1, 0.3, 0.1 and 0.01 mol/L EDC-ethanol solutions. Twenty-eight caries-free extracted human third molars were ground metallurgically to prepare flat occlusal mid-coronal dentin surfaces and etched with 35% (mass fraction) phosphoric acid gel. Then they were treated with EDC-ethanol solution for 60 s before the bonding procedure and randomly divided into five experimental groups corresponding to the tested EDC-ethanol concentrations. The ethanol treated and no pre-treated surfaces were used as controls. Single Bond 2 adhesive was applied and resin composite disk was stacked on the treated dentine surface. The teeth with resin composite disks were stored in water at room temperature for 24 h and then sectioned longitudinally to produce stick specimens for microtensile bond strength test. Fracture patterns were observed with a stereomicroscope. Results: The dentin surfaces pre-treated with 2 mol/L ［(22.17±13.31) MPa］ and 1 mol/L ［(45.31±17.80) MPa］ EDC-ethanol solutions resulted in statistically significant lower bond strength value (P<0.05). Increasing numbers of fracture pattern at the resin-dentin interface were also found in this two groups with percentages of 81.2% and 41.3% respectively. No significant difference was observed in the groups with 0.3, 0.1, 0.01 mol/L EDC surface treatment (P>0.05). Conclusion: No significant difference of immediate bond strengths was found in the 0.3, 0.1, 0.01 mol/L groups compared with the control group. EDC-ethanol solution surface treatment with concentrations of 2 mol/L and 1 mol/L resulted in decreasing of the bonding strength.

Objective：To investigate the effect of segmental Le FortⅠosteotomy and bilateral sagittal split ramus osteotomy (BSSRO) on the condyle position in skeletal class Ⅲ malocclusion patients.Methods: In this retrospective study, 19 patients with skeletal class Ⅲ malocclusion who met the inclusion criteria were enrolled. All the patients underwent the segmental Le FortⅠ osteotomy and BSSRO. Cone beam computed tomography (CBCT) scans were performed in the following phases: T1: within one week before the surgeries; T2: within one week post-surgery;T3:three months post-surgery; T4: 6 to 14 months post-surgery. The posterior spaces, anterior spaces and the superior spaces of the bilateral temporomandibular joints were measured according to the Kamelchuk method respectively. The fossa ratios of the condyle and the distribution of the condyle positions related to the glenoid fossa (anterior, concentric and posterior position)were calculated. The results were analyzed statistically. Results:The posterior space, the anterior space and the superior space of bilateral temporomandibular joints in T2 phase［right: (2.78±1.23) mm, (2.47±0.89) mm, (3.07±0.85) mm; left: (2.93±0.83) mm, (2.69±1.14) mm, (3.44±1.16) mm］ showed significantly larger spaces than those in T1 phase ［right: (1.81±0.95) mm, (1.65±0.55) mm, (2.13±0.52) mm; left: (2.12±1.05) mm, (1.79±0.59) mm, (2.15±0.93) mm］,in T3 phase ［right: (2.08±1.25) mm, (1.79±0.68) mm, (1.80±0.76) mm; left: (2.05±0.75) mm, (1.99±0.94) mm, (2.14±0.71) mm］ and in T4 phase ［right: (1.94±0.77) mm, (1.81±0.69) mm, (2.05±0.69) mm; left: (1.89±0.69) mm, (1.80±0.61) mm, (2.19±0.75) mm］, P＜0.05. No significant differences were observed among T1,T3 and T4 phases in the terms of the joint spaces of both sides(P＞0.05).The fossa ratio and the condyle position related to the glenoid fossa had no significant difference in all the four phases(P＞0.05).The results suggested that the condyle moved downward in T2 phase and changed to the original presurgery position in T3 phase, then keot stable in T4 phase.Conclusion:Segmental Le FortⅠ osteotomy and BSSRO caused significant and transient changes of the condyle position in skeletal classⅢ malocclusion patients. However, the condyle tended to move back to the original pre-surgery position and might keep stable.

Objective： To measure the real temperatures on the pluggers of three continuous-wave devices, and to provide theoretical reference to evaluate thermal damage and heat’s influence on the filling materials.  Methods: The dual channel K type thermocouple was contacted to various sizes’ pluggers in three different continuous-wave devices (BeeFill, Elements, B&L), and the highest temperatures at different points (tip, and 2 mm, 5 mm, 10 mm from the tip) of the pluggers (preset temperature was 200 ℃) were recorded. The measurements were performed 5 times. T-test was used to compare the real temperatures at the tips with that set on the display and one-way ANOVA was used to compare the temperatures of the pluggers in different devices, sizes and points. Results: The highest temperature was at the tip of BeeFill 40/0.03 plugger (198.7±7.7) ℃, but there was on statistical differences between that and the preset temperature 200 ℃. The temperatures of the remaining pluggers were obviously lower than 200 ℃（P<0.05）. The lowest temperature of the pluggers was detected at 10 mm from the tip of BeeFill 60/0.06 plugger (69.9±4.0） ℃. The highest temperature of each plugger was detected at the tip or 2 mm from the tip （112.1 to 198.7 ℃，and the median was 140.8 ℃）. Conclusion: The real temperature of most continuous-wave pluggers included in this study is below the set temperature 200 ℃.

Objective：To find the best synthesis method of 6-benzyl-1-［(benzyloxy)methyl］-3-hydro-xy-5-(hydroxymethyl)pyrimidine-2,4(1H,3H)-dione e for observing the change of its biological activity after N-3 hydroxylation.  Methods: After trying some N-hydroxylation methods, the target compound was successfully synthesized via one-pot oxidizing process by sodium hydride (NaH) and 3-chloroperbenzoic acid(m-CPBA); the anti-HIV reverse transcriptase (RT) activity and integrase (IN) activity of the target compound was assayed via enzyme-linked immunesorbent assay (ELISA) and phosphorylation of DNA package method.  Results:  The target compound could be obtained through the improved m-CPBA oxidative method by only one step, and the yield of the reaction could reach  60%－70%.And the structure of this compound was identified by 1H NMR, 13C NMR and MS; The activity result showed it added  the anti-HIV IN activity after N-3 hydroxylation as well as retained the anti-HIV RT activity. Conclusion: The improved m-CPBA oxidative method is a convenient and efficient way to prepare  the compound 6-benzyl-1-［(benzyloxy)methyl］-3-hydroxy-5-(hydroxymethyl)pyrimidine-2,4(1H,3H)-dione e which has both anti-HIV RT and IN activity.

Objective：To establish a new approach to synthesis of diethyl N-［4-［(2,4-diaminopyrido［3,2-d］pyrimidin-6-yl)methylamino］benzoyl］-L-glutamate. Methods:Target compound (5) was synthesized by the use of (2,4-dioxo-tetrahydropyridopyrimidin-6-yl)methyl acetate (1) as starting material via hydrolysis, chlorination, condensation with diethyl (paminobenzoyl)glutamate and aminolysis. Results: A new approach to synthesis of diethyl N［4［(2,4diaminopyrido［3,2-d］pyrimidin-6-yl)methylamino］benzoyl］-L-glutamatewas established. This synthetic route has hydrolysis reaction, chlorination, diethyl N-(p-aminobenzoyl)-L-glutamate condensation reaction and ammonolysis reaction. The total yield is 36.7%.The structures of those compounds have identified by 1H nuclear magnetic resonance, 13C nuclear magnetic resonance and mass spectrometry. This synthetic route avoid the unstable brominated re-action product and improves the harsh condition of ammonolysis reaction. Conclusion:The new synthetic route has improved the reaction condition and the stability of the intermediate, and increased the extent of the derivative compounds, which has great significance to anti-folic acid of anti-tumor inhibitor synthesis.

Objective：To estimate the pharmacokinetics for two solution types of propofol glycoside injections in rats. Methods: A high performance liquid chromatography-high resolution mass spectrometry (HPLC-MS) was established for measuring propofol in rat plasma. Two kinds of propofol glycoside injections were developed and intravenously administered to rats via tail vein, respectively, and a commercially available propofol emulsion injection was intravenously administered as a control. Propofol plasma concentration-time curves were determined, and the pharmacokinetic parameters were estimated. Results: HPLC-MS measurement was performed by using a quadrupole-orbit trap high-resolution mass spectrometer on a C18 chromatographic column. The mobile phase consisted of water and methanol (20∶80, V/V). The ion source was an atmospheric pressure chemical ion source, and the negative ion was used for detection with a scanning mode of selective ion monitoring in which m/z 177.127 4 was used for propofol and m/z 149.096 1 used for thymol as an internal standard. A linear correlation between concentration and peak area ratio was constructed in the range of 50 μg/L-10.0 mg/L propofol. The limit of quantification was 50 μg/L propofol. The average recoveries of propofol from plasma were in the range of 93.6%-101.1%, and intraday or inter-day relative standard deviation for measurement was <14%. The pharmacokinetic results showed that the two kinds of propofol glycoside injections exhibited the same pharmacokinetic behavior. However, the clearance and area under curve values of propofol for the two propofol glycoside injections were evidently increased as compared with those for propofol emulsion injection, respectively. Furthermore, their apparent distribution volumes were increased as well. Nevertheless, the propofol elimination half-life (t1/2) value of the newly developed propofol glycoside injections was the same as that of commercial propofol emulsion injection (approximately 1.5 h).Conclusion: The established HPLC-MS method can be used for measuring propofol concentration accurately in rat plasma. The clearance and distribution volumes of propofol glycoside injection are bigger than those of the propofol emulsion injection.

Objective： To compare the efficacy and safety of Shikani （S）optical stylet and Macintosh（M） laryngoscope for double-lumen endotracheal tube intubation. Methods:In the study, 60 patients undergoing elective thoracic surgery were randomly allocated to group S(n=30) and group M (n=30). After general anesthesia induction, the patients in group S and group M were intubated double-lumen endotracheal tube (DLT) by Shikani optical stylet (SOS) and macintosh laryngoscope respectively. Intubation time, intubation attempts, cuff broken and oral mucosal or dental injury were recorded; Blood pressure and heart rate at baseline (T0), at the time of intubaiton onset (T1), 1 minute after intubaiton (T2), 3 minutes after intubation (T3) and 5 minutes after intubation (T3) were also recorded; Hoarseness and throat sore of the patients 24 hours after surgery were evaluated. Results:The intubaiton time with the SOS was faster than with the Macintosh ［(37.4±9.7) s vs. (43.9±13.7) s, P=0.039］ and the first attempt success rate (87% vs. 80%, P=0.488) did not differ between the groups; No tube cuff broke in both the groups; Group S had fewer patients who suffered oral mucosal or dental injury than group M (8 vs.2, P=0.038); The blood pressure and heart rate at T0,T1,T2,T3 and T4 did not differ between the groups; Throat sore(7 vs.10, P=0.390) and hoarseness(5 vs.7, P=0.519) incidence did not differ between the groups. Conclusion:By comparison of the Macintosh laryngoscope, the SOS provides faster DLT intubation and causes less oral Mucosal or dental injury.

SUMMARYLynch syndrome is an autosomal dominant genetic disease characterized by the early onset of colon cancer, endometrial cancer and other tumors caused by a genetic mutation within DNA mismatch repair (MMR) genes. A small subgroup (approximately 3%-5%) of endometrial cancer and colorectal cancer is related to Lynch syndrome. Identification of these patients in clinical practice will be of great benefit to the relatives and patients themselves. We reported two cases, and reviewed the literature and clinical diagnostic guideline. MMR protein was lost in the tumors. Meanwhile the two cases had different clinicopathological characteristics. Together with the literature, our findings may suggest that the MMR protein expression, associated molecular alterations and clinicopathological features and biological behavior of endometrial cancer and colorectal cancer related to Lynch syndrome are different. Thus the algorithm for detection the patients at highest risk is different. To detect the MMR loss by immunohistochemistry is a practicalscreening method.

SUMMARYWe reported a case of pulmonary capillary hemangiomatosis (PCH) and introduced its diagnosis, differential diagnosis, pathogenesis and development of treatment based on the review of Dana Point 2008 Classification of Pulmonary Hypertensiona and current literatures. A 43-year-old female presented progressive dyspnea, elevated pulmonary arterial pressures and CT pulmonary angiography (CTPA) imaging of main pulmonary arterial enlargement and wide spread ill-defined centrilobular nodules of ground-glass opacity. Her histologic features were proliferation of capillary channels within alveolar walls as well as muscularization of arterioles and medial hypertrophy of muscular pulmonary arteries. The treatment with diuretics and warfarin was used promptly, but unfortunately was ineffective. The patient died three months after diagnosis. PCH is a very rare vascular disease with poor prognosis. The diagnosis of PCH rests on the integration of clinical and radiographic information with pathologic features, however pathology is the most reliable means. Because clinical symptoms, imaging and histological features of pulmonary venoocclusive disease (PVOD) and PCH broadly overlap, differential diagnosis should be made carefully. Among the various pathologic features proliferation of capillaries within alveolar walls is the key point for diagnosing PCH, which is also the most critical criteria for differentiating PCH from PVOD. So far the only definitive treatment for PCH is lung transplantation, without which the patient will die several months after diagnosis.

We analyzed the clinicopathological characteristics of one patient with Rhupus syndrome associated nephropathy in Peking University People’s Hospital, and reviewed the related literature. The patient was a middle aged female. She developed rheumatoid arthritis first, and then manifested mild systemic lupus erythematosus together with positive anti-neutrophil cytoplasmic antibodies (ANCA) and cryoglobulinemia several years later. The renal biopsy was performed and manifested as lupus nephritis. The transmission electron microscopy revealed cryoglobulinemia associated renal damage. This report shows that the clinicopathological characteristics in patients with Rhupus syndrome associated nephropathy are complicated. The renal pathology can be used as a diagnostic tool.

This case report concerns a 23-year-old woman with chronic periodontitis who had been previously diagnosed with Takayasu arteritis (TA). Her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were decreased before and 3 months after non-surgical periodontal therapy with no change in her prescribed medications (ESR from 31.00 mm/h to 23.0 mm/h, CRP from 21.40 mg/L to 18.46 mm/h). Through the occasional findings, we raised a hypothetical analysis about the potential relationship between periodontitis and TA with respect to inflammatory factors, bacteria and medication. Further studies of large samples are needed to verify the findings.

In this article, different methods to deal with teeth fractures were discussed by presenting a case of traumatic crown-root fracture in the anterior esthetic zone. The traumatic crown-root fracture is a common problem in clinic. When a fracture line locates in close proximity to or below the alveolar bone crest, the fracture most likely involve the junctional epithelium and the connective tissue attachment. This type of fracture becomes a challenge for restorative dentists because it involves biologic, functional, and esthetic considerations, especially when the fracture occurs in an esthetic area. In this case, a young patient presented with two fractured upper anterior teeth to the Department of Periodontics, Peking University School and Hospital of Stomatology. After the comprehensive clinical evaluation, the right central incisor was decided to extract for implant therapy and the right lateral incisor was decided to retain by one modified crown lengthening surgery. The most common technique applied to save a retained root is a clinical crown lengthening procedure. However, the aggressive alveolar bone resection of both target and adjacent teeth to reestablish the bone width and periodontal health may compromise functional and esthetic outcomes. To reduce loss of excessive osseous tissue during osteotomy procedure, the modified crown lengthening of the right lateral incisor was performed, including minor bone resection and root reshaping. Regarding the right central incisor, the retained root was all located below the alveolar bone crest. The extraction and implant procedure, combined with guided bone graft were performed to avoid the damage to neighbor teeth during traditional restorative therapy and to reshape a preferable buccal contour. At the last visit, the patient was recalled with healthy periodontium, normal tooth function and favorable esthetic results.

Here we report a case of cervical spondylosis misdiagnosed as cerebral infarction. The patient was a 55-year-old man with a one-day history of weakness in his right extremities. Brain magnetic resonance imaging (MRI) showed no acute abnormality, cerevical MRI showed that cervical spondylisis, C4/5, C5/6 disc herniation, spinal canal stenosis and compression of the spinal cord. Then the patient was transferred to the Department of Orthopaedics and underwent surgical treatment of cervical spondylosis. Followed-up for six months, the weakness of his right extremities returned to normal.

Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it could be an unpredictable and life-threatening cause during anesthesia. The main purpose of this paper is to report a case of anaphylactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period. A 63-year-old man, with a mass on his adrenal, was scheduled to a laparoscopic adrenal tumor excision. During the anesthesia induction period, after administrated sulfentanil, propofol and rocuronium, the blood pressure was decreased and the heart rate was increased. Then, the patient had rash on his whole body and developed an anaphylactic shock. After being treated with the anti-allergic agents and norepinephrine, the rash disappeared and the vital sign become stable. The patient felt nothing uncomfortable during the two weeks’follow-up. Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period. The most common inducements are muscle relaxant, latex and antibiotics. Anaphylactic reactions in the perioperative period are often serious and potentially life-threatening conditions, involving multiple organ systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils. Before anesthesia, we should acquire the allergic history. During the anesthesia period, the vital sign and the skin should be observed carefully.

An involved internal iliac artery is usually embolized when performing endovascular aneurysm repair for aortoiliac or isolated iliac artery aneurysm.This can lead to complications such as buttock claudication,colon ischaemia and erectile dysfunction.Iliac branch device (IBD) is an endograft designed specifically for iliac bifurcation to preserve internal iliac flow. It was performed with high technical success rates and encouraging mid-term patency. Here we report a case of right iliac aneurysm developed 3 years after endovascular aneurysm repair for an aortoiliac aneurysm, with the patient’s left internal artery been sacrificed then. Using a handmade IBD, we excluded the aneurysm without occlusion of the ipsilateral internal iliac artery or any type of endoleak. Both the design and deployment of this IBD are distinctive that we would like to share our experience with all the colleagues.