[Comparison of early outcome between one-stage hybrid technique and frozen elephant thunk technique in the treatment of Stanford A aortic dissection involving the arch].

Objective: To analyze the early outcome of one-stage hybrid technique in the treatment of Stanford type-A aortic dissection involving the arch and compare its therapeutic efficacy with the classical frozen elephant trunk technique (FET). Methods: A total of 106 patients with Stanford type-A aortic dissection involving the arch in Department of Cardiac and Vascular Surgery, 1st Affiliated Hospital of Soochow University from October 2015 to October 2019 was collected. All patients in this group were treated with one-stage hybrid technique (modified arch debranching technique) without deep hypothermia circulation. Meanwhile, 30 patients with Stanford type A dissection involving the arch who underwent FET from January 2014 to September 2015 were collected. The therapeutic effects of the two surgical methods were analyzed and compared. Results: The age [M (Q1, Q3)] of 106 patients in hybrid group was 49.0 (40.0, 55.0) years, including 89 males and 17 females. The age [M(Q1, Q3)] of 30 patients in FET group was 49.5 (41.5, 65.3) years, including 24 males and 6 females. The time [M(Q1, Q3)] of using ventilator in hybrid group was 56.0 (38.0, 72.0) h, which was shorter than 127.0 (92.0, 145.0) h in FET group (P<0.001). The incidence of cerebral infarction in hybrid group was 2.8% (3 cases), which was lower than 13.3% (4 cases) in FET group (P=0.042); the incidence of postoperative renal insufficiency in hybrid group was 7.5% (8 cases), which was lower than 23.3% (7 cases) in FET group (P=0.023); the ICU time [M (Q1, Q3)] in hybrid group was 8.0 (6.0, 10.0) d, which was shorter than 14.0 (8.3, 24.0) d in FET group (P<0.001). Conclusion: Compared with FET, one-stage hybrid technology is safer and more effective in the treatment of Stanford type A aortic dissection involving the arch. Its short-term therapeutic efficacy appears good.

[Mechanism of T lymphocyte subsets in the malignant transformation of non-alcoholic fatty liver disease].

Nonalcoholic fatty liver disease is becoming the main cause of global liver disease-related morbidity and mortality. Notably, its pathological mechanism is complicated and not yet fully understood. Therefore, immune regulation is undoubtedly an important link in its pathogenesis, especially the change of T lymphocyte subsets. This article introduces the research progress of T lymphocytes involved in steatosis, inflammation, fibrosis, malignant transformation and immunotherapy.

[Hypoxia-inducible factor-1α mediates and regulates angiogenesis-related factors expression in hepatocellular carcinoma].

Objective: To investigate the expression of hypoxia-inducible factor (HIF)-1α, vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) during the progression of liver diseases and the molecular mechanism of HIF-1α in regulating the expression of angiogenic factors in hepatocellular carcinoma (HCC). Methods: Serum samples from hospitalized patients with liver cancer, liver cirrhosis, and chronic hepatitis were collected, and healthy people were used as controls. Mouse models of hepatocarcinogenesis were used to detect the dynamic expression of HIF-1α, VEGF and Ang-2. Enzyme-linked immunosorbent assay was used to quantitatively analyze the serum levels of HIF-1α, VEGF and Ang-2 in patients with liver disease and mice. HIF-1α-specific miRNA expression plasmids was constructed to transfect HepG2 human HCC cells. HIF-1α mRNA transcriptional interference effects were analyzed on biological behavior, VEGF and Ang-2 expression, and epithelial mesenchymal transformation (EMT) in human HCC cell line. The sample means of multiple groups were compared by analysis of variance and q test and the sample rate was compared by χ (2) test. Results: In patients with chronic liver disease, the serum expression of HIF-1α, VEGF and Ang-2 in the liver cancer group (145.6 ± 32.6) µg/L, (458.9 ± 125.3) µg/L and (42.9 ± 5.1) µg/L was significantly higher than the liver cirrhosis (P < 0.001) (79.5 ± 28.4) µg/L, (206.8 ± 56.8) µg/L and (26.2 ± 6.1) µg/L and chronic hepatitis group (60.1 ± 18.8) µg/L, (178.1 ± 85.4) µg/L and (21.8 ± 6.9) µg/L. In addition, HIF-1α was positively correlated with VEGF (r = 0.937, P < 0.001), HIF-1α and Ang-2 (r = 0.933, P < 0.001), and VEGF and Ang-2 (r = 0.910, P < 0.001). Mouse models of hepatocarcinogenesis confirmed that HIF-1α, VEGF and Ang-2 had progressively increased during the process of malignant transformation from normal hepatocytes, hepatocyte degeneration, and precancerous lesions to canceration. HIF-1α miRNA intervention plasmid had transformed HepG2 cells. Compared with the blank group, HIF-1α mRNA, HIF-1α, VEGF and Ang-2 were decreased by 88.1%, 59.8%, 54.0% and 36.0% at 72h, respectively. The expression level of EMT-related protein Snail (0.26 ± 0.02 and 0.67 ± 0.09, q = 6.75, P < 0.003), VIM (0.27±0.08 and 0.73±0.04, t = 10.35, P < 0.001) and Twist (0.24 ± 0.07 and 0.73 ± 0.02, q = 12.08, P < 0.001) was significantly reduced, but the expression level of E-cadherin (0.76 ± 0.08 and 0.27 ± 0.09, q = 7.05, P < 0.002) was significantly increased. Conclusion: HIF-1α mediates and regulates angiogenesis-related factors such as VEGF and Ang-2 expression in hepatocellular carcinoma. Furthermore, HIF-1α transcriptional interference can significantly affect the biological characteristics and EMT transformation of hepatocellular carcinoma cells.

[A randomized controlled study of peramivir, oseltamivir and placebo in patients with mild influenza].

Objectives: To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza. Methods: This was a randomized, double-blind, double-dummy, placebo and positive control, multicenter clinical trial, comparing peramivir trihydrate with oseltamivir and placebo. The inclusive criteria were 15-70 years old, onset within 48 h, positive rapid influenza antigen test, and febrile (>38℃) accompanied with at least two associated symptoms. The severe cases complicated with chronic pulmonary and cardiac diseases, malignancies, organ transplantation, hemodialysis, uncontrolled diabetes, immunocompromised status, pregnancy and coexistence of bacterium infections were excluded. All patients were randomized 2∶2∶1 to receive peramivir, oseltamivir and placebo respectively. The primary endpoint was the disease duration, the secondary endpoints included time to normal axillary temperature and normal living activities, viral response, and adverse effects. Results: Following informed consent, 133 patients were included in this study. Four patients were exclude due to missing medical records, not fitting inclusion or exclusion criteria and poor compliance. A total of 129 patients were finally analyzed, including 49 cases, 54 cases and 26 cases in peramivir group, oseltamivir group and placebo group. The median disease duration were 96 (76, 120) hours, 105 (90,124) hours, and 124 (104, 172) hours in three groups respectively (P>0.05) . The time to normal axillary temperature, normal living activities and viral response were not significantly different in three groups (P>0.05) . Conclusion: The value of antiviral therapy in patients with mild influenza needs to be further determined.

Effect of IL-6-mediated STAT3 signaling pathway on myocardial apoptosis in mice with dilated cardiomyopathy.

OBJECTIVE: To investigate the effect of interleukin-6 (IL-6) gene knockout on apoptosis of myocardial cells in mice with Coxsackievirus B3 (CVB3)-induced dilated cardiomyopathy (DCM) and its potential mechanism, so as to provide certain references for the clinical prevention and treatment of DCM. MATERIALS AND METHODS: A total of 40 male C57 mice were randomly divided into Sham group (n=20) and DCM group (n=20) using a random number table. Another 20 mice with IL-6 gene knockout were enrolled into DCM+IL-6 KO group (n=20). The DCM model was established via CVB3 repeated incremental infection. After 9 months, the heart weight/body weight (HW/BW) ratio of mice in each group was detected. The ejection fraction [EF (%)] and fraction shortening [FS (%)] of mice in each group were detected via two-dimensional ultrasonography. The cross-sectional area and pathological changes in myocardial cells in the heart in each group were determined using hematoxylin-eosin (HE) staining. The collagen content in myocardial tissues in each group was detected via Masson staining and picrosirius red (PSR) staining, and the expressions of Collagen I and Collagen III in myocardial tissues in each group were detected via immunohistochemistry. In addition, the myocardial apoptosis in myocardial tissues in each group was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Finally, the protein expression levels of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), phosphorylated signal transducer and activator of transcription 3 (p-STAT3), and total STAT3 (t-STAT3) were detected via Western blotting. RESULTS: The expression of IL-6 messenger ribonucleic acids (mRNAs) in myocardial tissues in DCM group was significantly increased compared with that in Sham group (p<0.05). After IL-6 knockout, the HW/BW ratio of DCM mice significantly declined (p<0.05), and the cross-sectional area of myocardial cells was significantly reduced (p<0.05). According to the results of echocardiography, the cardiac function of mice in DCM+IL-6 KO group was significantly superior to that in DCM group, manifested as the significant increase in FS (%) and EF (%) (p<0.05). The results of Masson staining, PSR staining, and immunohistochemical staining showed that IL-6 knockout could reduce the collagen content and Collagen I and Collagen III expressions in myocardial tissues of DCM mice (p<0.05). Furthermore, it was found via TUNEL staining that the number of apoptotic myocardial cells in DCM+IL-6 KO group was markedly smaller than that in DCM group (p<0.05). At the same time, the Bax/Bcl-2 ratio in myocardial tissues in DCM+IL-6 KO group was lower (p<0.05). Finally, the results of Western blotting revealed that DCM+IL-6 KO group had a lower phosphorylation level of STAT3 than DCM group (p<0.05). CONCLUSIONS: Inhibiting IL-6 gene may improve the DCM-induced myocardial remodeling through reducing myocardial apoptosis.

Risk factors associated with aortic remodeling in patients with Stanford type B aortic dissection after thoracic endovascular aortic repair.

To determine the risk factors associated with adverse aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with Stanford type B aortic dissection, we performed a retrospective analysis of 54 patients between January 2009 and June 2012 at the First Affiliated Hospital of Soochow University. All patients underwent TEVAR of the descending thoracic aorta. Multiple-logistic regression analyses were performed to identify risk factors associated with aortic remodeling. True-lumen and false-lumen volumes were increased (P < 0.001) and decreased (P < 0.001) after surgery, respectively. Therefore, the remodeling index increased after surgery (1.04 ± 0.6 to 2.06 ± 1.12, P < 0.001). Remodeling index and true-lumen volume were higher in the favorable aortic remodeling group compared to the adverse aortic remodeling group (P < 0.001), while the false-lumen volume was lower in the favorable aortic remodeling group (P < 0.001). Multivariate analyses revealed a branch originating from the false lumen (OR = 39.9, P < 0.01) and multiple tears (OR = 27.4, P < 0.01) to be independent risk factors for adverse aortic remodeling. Therefore, a branch originating from the false lumen and multiple tears were determined to be independent risk factors for adverse aortic remodeling after TEVAR in patients with Stanford type B aortic dissection.

Association of CYP2C19*3 gene polymorphism with breast cancer in Chinese women.

Cytochrome P450 (CYP) 2C19 metabolizes arachidonic acid to biologically active epoxyeicosatrienoic acids, which significantly promote proliferation of cancer cells in vitro and in vivo. We looked for a possible association between human CYP2C19*3 gene polymorphism and breast cancer in the Chinese Han population. In a Chinese Han case-control study of breast cancer patients (N = 600) and age- and gender-matched healthy controls (N = 600), we investigated polymorphism in the CYP2C19 gene by PCR-RFLP analysis. The CYP2C19*3 AG + AA genotype was significantly more prevalent in breast cancer patients than in control subjects (6.67 vs 3.00%; P = 0.003). The odds ratio for carriers of AG + AA genotype for breast cancer was 2.31 (95% confidence interval = 1.27-4.43). Among patients, estrogen receptor, tumor size, histologic grade, presence of primary lymphonode metastases, progesterone receptor positivity, and age at diagnosis were not found to be significantly associated with CYP2C19*3 genotypes (all P > 0.05). We conclude that the CYP2C19*3 gene polymorphism is associated with breast cancer risk in Chinese Han women.

First Report of the Cyst Nematode (Heterodera filipjevi) on Wheat in Henan Province, China.

During a survey for cereal cyst nematodes from May to June of 2009, cyst nematodes were detected in four wheat-growing areas (Liying, Xuchang, Weihui, and Yanjing) of Henan Province, China. The main wheat cultivar affected was Wenmai No.4. Almost 5.3 million ha of winter wheat are grown in Henan Province and 73% of the fields surveyed were found to be infested with Heterodera avenae (2). The affected wheat fields had stunted patches. Stunted seedlings had chlorotic or necrotic lower leaves, few or no tillers, and bushy, light brown roots leading to typical witches'-broom symptoms resulting from increased rootlet emergence at the nematode invasion sites. Individual roots had a knotted appearance. Cyst nematodes obtained from soil samples and plant samples at these four locations differed from those of H. avenae and had uniform morphological and molecular characteristics. Cysts were lemon shaped and bifenestrate, with an underbridge and strongly developed bullae. The lateral field of second-stage juveniles (J2) consisted of four incisures. These characteristics indicated that the four populations were H. filipjevi, a member of the 'H. avenae Group' of cereal cyst nematodes (1). Key morphological features were determined for cysts and J2. Cysts (n = 15) had the following characteristics, in addition to those described above: light brown color; bifenestrate vulval cone with horseshoe-shaped fenestrate; body length (not including the neck) ranged from 690 to 790 µm (mean of 750 µm); body width ranged from 410 to 640 µm (mean of 540 µm); neck length ranged from 86 to 100 µm (mean of 96 µm); fenestrate length of 59 to 70 µm (mean of 67.7 µm) and width of 31.3 to 36.7 µm (mean of 35.2 µm); underbridge length from 59 to 71 µm (mean of 68 µm); and vulval slit from 6.9 to 8.6 µm (mean of 7.9 µm). J2 (n = 10) had the following characteristics: body length ranged from 540 to 580 µm (mean of 550 µm); stylet length from 22.5 to 24.5 µm (mean of 23.5 µm) with anchor-shaped basal knobs; tail length of 52.5 to 62.5 µm (mean of 57.7 µm); and hyaline terminal tail ranged from 32 to 39 µm (mean of 33.8 µm). The tail had a sharp terminus. Amplification of the rDNA-internal transcribed spacer (ITS) region with primers TW81 and AB28 yielded a PCR fragment of 1,054 bp (3). Amplification of the D2/D3 fragments of the 28S RNA with universal primers D2A (5'-ACA AGT ACC GTG AGG GAA AGT TG-3') and D3B (5'-TCG GAA GGA ACC AGC TAC TA-3') yielded a PCR fragment of 782 bp. Digestion patterns of the ITS PCR fragments with AluI, CfoI, HifI, SatI, PstI, RsaI, TaqI, and Tru9I showed restriction profiles identical to that of H. filipjevi (3,4). Four ITS sequences (GU083595, GU083596, HM147944, and HM147945) and four D2D3 sequences (GU083592, GU083593, GU083594, and GU083597) from nematode samples collected in Liying, Xuchang, Weihui, and Yanjing, respectively, were submitted to GenBank. These sequences exhibited 99.4% similarity with that of H. filipjevi isolates from Germany (AY148400), Italy (AY347922), Russia (AY148401), Spain (AY148399), Tadzhikistan (AY148402), Turkey (AY148398 and AY148397), the United Kingdom (AY148403 and AF274399), and the United States (GU079654). To our knowledge, this is the first report of H. filipjevi in China. References: (1) Z. A. Handoo. J. Nematol. 34:250. 2002. (2) D. L. Peng et al. Proc. 1st Workshop Internat. Cereal Cyst Nemat. Initiative, Antalya Turkey, p. 29, 2009. (3) S. A. Subbotin et al. Nematology 1:195, 1999. (4) G. Yan and R. W. Smiley. Phytopathology 100:216, 2010.

[Clinical application of distal base sural island flap].

OBJECTIVE: To sum up the experience of clinical application of distal base sural island flap. METHODS: From January 1997 to April 1999, the posterior island flap of leg pedicled with sural nerve and its nutrient vessels was applied to repair heel or dorsum of foot in 6 cases, chronic ulcer of heel in 2 cases, chronic osteomyelitis in 2 cases, scar contracture of bone defect accompanying fistulation in 1 case. The range of flap was 5 cm x 8 cm to 8 cm x 12 cm. RESULTS: All the flaps survived completely without vascular crisis. All the wounds healed by first intention. Followed up 3 to 12 months, no ulcer, osteomyelitis, fistulation were recurrence, and the sensation of flap was recovered slightly. CONCLUSION: The flap do not damage critical blood vessels and nerves, the donating region is hidden. The manual of operation is simple and blood supply of flap is sufficient. It can repair the defect of soft tissue on heel and dorsum with high survival rate.

The influence of intracellular cAMP on T cell proliferation.

The role of AC-cAMP-PKA signal system in T cell activation was investigated by lymphocyte proliferation stimulated by anti-CD3 McAb. The results indicated that AC, cAMP and PKA play important roles in determining the responses of lymphocytes to the stimulation. Activation of AC and increase of intracellular cAMP could obviously decrease lymphocyte proliferation, and lymphocyte DNA synthesis was increased to some extent by the pretreatment of PKI.

In vitro development of suramin-resistant clones of Trypanosoma evansi.

By exposure to gradually increasing concentrations of suramin in modified Baltz's cell free culture system, suramin-resistant clones of Trypanosoma evansi, JGcl-160, JX-lcl-160 and ZJcl-140, were derived from suramin-sensitive clones JGcl, JX-lcl and ZJcl, respectively, over a period of 550 days. In vitro tests showed that the IC50 values of JGcl-160, JX-lcl-160 and ZJcl-140 were 358.5, 412.3 and 246.4 micrograms/ml respectively, which were 1792.5, 1874.1 and 1760.0 times higher than those of their parent clones. The values for the curative dose CD100 for intact mice infected with JGcl-160, JX-lcl-160 and ZJcl-140 were 80, 120 and 30 mg/kg respectively, which were 5.3, 8.0 and 3.0 times higher than those of each parent clone. The CD100 values for immunosuppressed mice infected with these clones were 250, 300 and 100 mg/kg, respectively, which were 3.1, 2.5 and 3.3 times higher those for intact mice infected with the same clones.

Study on lymphocyte activation and proliferation induced by anti-CD3 McAb.

T cell activation and proliferation via CD3-TCR complex were investigated by lymphocyte DNA synthesis in vitro. Several interfering factors were also discussed. The result indicated that lymphocyte activation and proliferation are calcium-dependent. A rise of cytoplasmic free Ca2+ quickly following activation with CD3 McAb is mainly due to intracellular mobilization of Ca2+, while lymphocyte proliferation needs both intracellular mobilization of Ca2+ as well as influx of extracellular Ca2+. It was confirmed that CTX sensitive G protein plays a role in regulating T cell proliferation by pretreatment with CTX suppressing lymphocyte H-TdR incorporation obviously. PLC and PKC inhibitor neomycin and P. S. S could also decrease T cell proliferation.

[Studies on double-labelling method for determination of T lymphocyte subpopulations]. / Studie über ein Doppelmarkierungsverfahren zur Bestimmung von T-Lymphozytensubpopulationen.

In order to determine the concurrent expression of DR and CD antigen of T lymphocyte surface markers, the fluorescence-rosette double-labelling technique was developed by employing monoclonal antibody against HLA-DR and sensitized sheep erythrocytes with OKT series of monoclonal antibodies against cell surface antigen. Its reliability was evaluated by comparison with two-step isolating technique for determining DR antigen of activated T lymphocyte subsets in 30 healthy volunteers. The result showed there was no statistic difference between results determined with two methods. The double-labelling technique was characterized by its samplity, no injury for cellular activity and ability for analysing the expression of the single antigen and double antigens on cell surface concurrently.