Transgastric Single-Incision Laparoscopic Resection for a Gastric Submucosal Tumor Located at the Cardia.

INTRODUCTION: Surgical treatment of gastric submucosal tumors (SMTs) located near the gastroesophageal junction can be technically challenging, especially regarding preservation of the integrity and function of the lower esophageal sphincter. We introduce a novel minimally invasive surgery, successfully performed in a patient with a gastric SMT located at the cardia. A 24-year-old lady presenting with acid reflux for 1 year underwent esophagogastroscopy that showed a gastric SMT located at the cardia. Endoscopic ultrasonography showed a 20×19 mm homogeneous hypoechoic lesion originating from the muscularis propria layer. Transgastric single-incision laparoscopic resection of the tumor was performed. CONCLUSION: Transgastric single-incision laparoscopic resection of gastric SMTs is technically feasible and safe. This presents an alternative surgical choice for resection for gastric SMTs located in difficult regions such as the fundus, cardia, or prepyloric antrum.

CypB promotes cell proliferation and metastasis in endometrial carcinoma.

BACKGROUND: The molecular pathogenesis of endometrial cancer is not completely understood. CypB upregulated in many cancers, however, its role in endometrial carcinoma has not been studied. Here, we determine the effect of CypB on the growth of endometrial cancer. METHODS: In this study, we examined the expression of CypB in endometrial cancer tissues using immunohistochemistry. CypB silenced in HEC-1-B cell line by shRNA. CCK-8, colony formation assays, wound healing assays, and transwell analysis were performed to assess its effect on tumor cell proliferation and metastasis. Furthermore, microarray analysis was carried out to compare the global mRNA expression profile between the HEC-1-B and CypB-silenced HEC-1-B cells. Gene ontology and KEGG pathway enrichment analysis were performed to determine the potential function of differentially expressed genes related to CypB. RESULTS: We found that CypB was upregulated in endometrial cancer, inhibit CypB expression could significantly suppress cell proliferation, metastasis, and migration. We identified 1536 differentially expressed genes related to CypB (onefold change, p < 0.05), among which 652 genes were upregulated and 884 genes were downregulated. The genes with significant difference in top were mainly enriched in the cell cycle, glycosphingolipid biosynthesis, adherens junctions, and metabolism pathways. CONCLUSION: The results of our study suggest that CypB may serve as a novel regulator of endometrial cell proliferation and metastasis, thus representing a novel target for gene-targeted endometrial therapy. TRIAL REGISTRATION: YLYLLS [2018] 008. Registered 27 November 2017.

Preventable Deaths in Multiple Trauma Patients: The Importance of Auditing and Continuous Quality Improvement.

BACKGROUND: Management errors during pre-hospital care, triage process and resuscitation have been widely reported as the major source of preventable and potentially preventable deaths in multiple trauma patients. Common tools for defining whether it is a preventable, potentially preventable or non-preventable death include the Advanced Trauma Life Support (ATLS®) clinical guideline, the Injury Severity Score (ISS) and the Trauma and Injury Severity Score (TRISS). Therefore, these surrogated scores were utilized in reviewing the study's trauma services. METHODS: Trauma data were prospectively collected and retrospectively reviewed from January 1, 2018, to December 31, 2018. All cases of trauma death were discussed and audited by the Hospital Trauma Committee on a regular basis. Standardized form was used to document the patient's management flow and details in every case during the meeting, and the final verdict (whether death was preventable or not) was agreed and signed by every member of the team. The reasons for the death of the patients were further classified into severe injuries, inappropriate/delayed examination, inappropriate/delayed treatment, wrong decision, insufficient supervision/guidance or lack of appropriate guidance. RESULTS: A total of 1913 trauma patients were admitted during the study period, 82 of whom were identified as major trauma (either ISS > 15 or trauma team was activated). Among the 82 patients with major trauma, eight were trauma-related deaths, one of which was considered a preventable death and the other 7 were considered unpreventable. The decision from the hospital's performance improvement and patient safety program indicates that for every trauma patient, basic life support principles must be followed in the course of primary investigations for bedside trauma series X-ray (chest and pelvis) and FAST scan in the resuscitation room by a person who meets the criteria for trauma team activation recommended by ATLS®. CONCLUSION: Mechanisms to rectify errors in the management of multiple trauma patients are essential for improving the quality of trauma care. Regular auditing in the trauma service is one of the most important parts of performance improvement and patient safety program, and it should be well established by every major trauma center in Mainland China. It can enhance the trauma management processes, decision-making skills and practical skills, thereby continuously improving quality and reducing mortality of this group of patients.

Effects of AMPD1 gene C34T polymorphism on cardiac index, blood pressure and prognosis in patients with cardiovascular diseases: a meta-analysis.

BACKGROUND: The meta-analysis was aimed to evaluate the effects of AMPD1 gene C34T polymorphism on cardiac function indexes, blood pressure and prognosis in patients with cardiovascular diseases (CVD). METHODS: Eligible studies were retrieved through a comprehensive search of electronic databases and manual search. Then the high-quality studies met the rigorous inclusion and exclusion criteria, as well as related to the subject was selected for the study. Comprehensive data analyses were conducted using STATA software 12.0. RESULTS: The study results revealed that CVD patients with CT + TT genotype of AMPD1 C34T polymorphism presented elevated left ventricular ejection fraction (LVEF) (%) and reduced left ventricular end diastolic dimension (LVEDD) (mm) as compared with CC genotype, moreover, the subgroup analysis found that the LVEF (%) was markedly higher in heart failure (HF) patients carrying CT + TT genotype than CC genotype. Besides, the systolic blood pressure (SBP) (mmHg) in CVD patients with CT + TT genotype was obviously decreased in contrast with the CC genotype. Patients suffered from HF with different genotypes (CT + TT and CC) of AMPD1 C34T polymorphism exhibited no significant differences in total survival rate and cardiac survival rate. CONCLUSIONS: Our current meta-analysis indicated that the T allele of AMPD1 gene C34T polymorphism may be correlated with LVEF, LVEDD and SBP, which plays a protective role in the cardiac functions and blood pressure in CVD patients, but had no effects on total survival rate and cardiac survival rate for HF.

The role and mechanism of action of activin A in neurite outgrowth of chicken embryonic dorsal root ganglia.

Activin A, a member of the transforming growth factor ß (TGFß) superfamily, plays an essential role in neuron survival as a neurotrophic and neuroprotective factor in the central nervous system. However, the effects and mechanisms of action of activin A on the neurite outgrowth of dorsal root ganglia (DRG) remain unclear. In the present study, we found that activin A is expressed in DRG collected from chicken embryos on embryonic day 8 (E8). Moreover, activin A induced neurite outgrowth of the primary cultured DRG and maintained the survival of monolayer-cultured DRG neurons throughout the observation period of ten days. Follistatin (FS), an activin-binding protein, significantly inhibited activin A-induced neurite outgrowth of DRG, but failed to influence the effect of nerve growth factor (NGF) on DRG neurite outgrowth. Furthermore, the results showed that activin A significantly upregulated mRNA expression of activin receptor type IIA (ActRIIA) and calcitonin gene-related peptide (CGRP) in DRG, and stimulated serotonin (5-HT) production from DRG, indicating that activin A might induce DRG neurite outgrowth by promoting CGRP expression and stimulating 5-HT release. These data suggest that activin A plays an important role in the development of DRG in an autocrine or paracrine manner.

[Effects of lead on protein kinase C expression in U251 cell line].

OBJECTIVE: To observe the effects of lead on mRNA and protein expression of PKC in U251 cell line. METHODS: After U251 cells were exposed to 0.05, 0.50, 5.00, 50.00, 500.00, 900.00 and 1000.00 micromol/L Ph(Ac)2 for 24 hours, the cytotoxicity of Pb on U251 cells was measured by MTT assay. RT-PCR and Western blot assay were used to detect the mRNA and protein expression levels of PKC in U251 cells exposed to 0.05, 5.00 and 500.00 micromol/L Ph (Ac), for 24 hours. RESULTS: The survival rates of U251 cells treated with 5.00, 50.00, 500.00, 900.00 and 1000.00 micromol/L Pb (Ac)2 were 84.5%, 78.2%, 76.5%, 50.3% and 43.2%, respectively, which were significantly lower than those of control group (P < 0.01). The PKC mRNA expression level (0.40 +/- 0.01) of U251 cells treated with 500.00 micromol/L Pb (Ac)2 was significantly lower than that (0.51 +/- 0.02) of control group (P < 0.01). The PKC protein expression levels of U251 cells treated with 0.05, 5.00 or 500.00 micromol/L Pb(Ac)2 were 0.68 +/- 0.02, 0.62 +/- 0.01 and 0.33 +/- 0.02, respectively, which were significantly lower (0.98 +/- 0.01) than those of control group (P < 0.01). CONCLUSION: Lead can decline the cell viability, PKC mRNA and protein expression levels of U251 cells.

Exercise is the dominant factor affecting the development of teenagers' eyesight-Based on the Bayesian model averaging.

Objective: The model uncertainty may result in inconsistency about the environmental factors of myopia among students, and the Bayesian model average (BMA) is an effective way to eliminate it. We aimed to explore the influencing factors of myopia in primary and middle school students by BMA. Methods: The data came from the 2021 National Surveillance of Common Diseases and Health Influencing Factors of students. By stratified random cluster sampling, the physical and mental health status of students in Tianjin and the factors affecting their physical health, such as diet, exercise, mental stress, school bullying, sleep time, and internet use, were investigated. The sample consisted of 8,457 primary school students, 8,191 junior middle school students, and 5,901 senior middle school students. Besides the physical examination, we used computer optometry (non-ciliary paralysis) to screen myopia. And we used BMA to select the risk factors through the BMS package in R. Results: The exercise was the only factor that affected the eyesight of junior and senior middle schoolers by BMA, with the posterior probability of 0.9736 and 0.9762, but not for the primary students. And we failed to select variables that affected eyesight in grades 4-6 of primary school. Conclusion: The exercise was a strong influencing factor for the eyesight of students in Tianjin's junior and senior middle schools.

Association of body fat distribution and metabolic syndrome with the occurrence of colorectal adenoma: A case-control study.

OBJECTIVE: Visceral fat is thought to play different roles in the carcinogenesis of the colon with peripheral fat. Our aim was to evaluate the association of body fat distribution measured by bioelectrical impedance analysis (BIA) with the incidence of colorectal adenoma (CRA). METHODS: A total of 410 asymptomatic participants who underwent a screening colonoscopy from July 2017 to December 2019 in our center were recruited, including 230 with adenomas and 180 without detected adenomas. The participants' body fat was measured by BIA, including their body fat mass (BFM), body fat percentage (BFP), and waist-to-hip ratio. Parameters of metabolic syndrome (MetS), including waist circumference, blood pressure, fasting blood glucose (FBG), blood level of triglyceride, cholesterol, and high-density lipoprotein were measured as well. RESULTS: According to univariate analysis, age, male sex, body mass index, waist circumference, BFM, waist-to-hip ratio, blood pressure, and FBG were higher in the adenoma group than in the adenoma-free group (P < 0.05). On multivariate logistical analysis (adjusted for age, sex, smoking, drinking, and family history of CRC), a high waist-to-hip ratio was associated with a high incidence of CRA (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.09-3.09, P = 0.02). Only a large waist circumference in components of MetS was independently associated with the incidence of CRA (OR 1.90, 95% CI 1.17-3.08, P = 0.01) in the multivariate analysis. CONCLUSION: Body fat distribution is associated with CRA, central obesity is a core risk factor for CRA in MetS. Chinese Clinical Trial Registration number: ChiCTR-RRC-17010862.

Meta-analysis of laparoscopy-assisted distal gastrectomy and conventional open distal gastrectomy for early gastric cancer.

BACKGROUND AND OBJECTIVE: With the application of laparoscopy, laparoscopic gastrectomy for the treatment of patients with early gastric cancer has been performed, but the safety and effectiveness of this method need to be explored. This study evaluated the safety and effectiveness of laparoscopy-assisted and conventional open distal gastrectomy for patients with early gastric cancer. METHODS: A search of MEDLINE, EMBASE, the Chinese Biomedical Database (CBM), and Cochrane Central Register of Controlled Trials (CENTRAL) identified all the randomized clinical trials that compared laparoscopy-assisted gastrectomy with open distal gastrectomy for patients with early gastric cancer published in the last 10 years. Quality assessment was done on each trial and relevant data were extracted from qualified trials. Meta-analysis was performed using RevMan 4.2.2 software (Cochrane). RESULTS: Six randomized controlled trials (RCTs) involving 218 patients were included. Comparing laparoscopic resection with open resection, results showed less estimated blood loss (WMD (weighted mean difference): -121.86; 95% CI (confidence interval): -145.61, -98.11; P < 0.001), earlier postoperative first flatus (WMD: -0.95; 95% CI: -1.09, -0.81; P < 0.001), and shorter durations of hospital stays (WMD: -2.27; 95%CI: -3.47, -1.06; P = 0.0002), but longer surgery times (WMD: 58.71; 95% CI: 52.69, 64.74; P < 0.001) and fewer lymph nodes dissected (WMD: -3.64; 95% CI: -5.80,-1.47; P = 0.001). There was no significant difference between the two groups in postoperative complications (OR (odds ratio): 0.57; 95% CI: 0.31,1.03; P = 0.06). CONCLUSIONS: The short-term outcome of laparoscopy-assisted distal gastrectomy for patients with early gastric cancer is superior to the open procedure, but its long-term outcome should be proven by further outcomes of RCTs.

Combined endo-laparoscopic surgery for difficult benign colorectal polyps.

Prevention of colorectal cancer (CRC) depends largely on the detection and removal of colorectal polyps. Despite the advances in endoscopic techniques, there are still a subgroup of polyps that cannot be treated purely by endoscopic approach, which comprise of about 10-15% of all the polyps. These so-called "difficult colorectal polyps" are polyps with large size, morphology, at difficult location, scarring or due to recurrence, which have historically been managed by surgical segmental resection. In treating benign difficult colorectal polyps, we have to balance the operative risks and morbidities associated with surgical segmental resection. Therefore, combined endoscopic and laparoscopic surgery (CELS) has been developed to remove this subgroup of difficult benign polyps. We review the currently use of CELS for difficult benign colorectal polyps which includes laparoscopy-assisted endoscopic polypectomy (LACP), full-thickness laparo-endoscopic excision (FLEX) and colonoscopy-assisted laparoscopic wedge resection (CAL-WR).

Expression and localization of activin receptor-interacting protein 2 in mouse tissues.

Activin plays important roles in reproductive tissues as a stimulator of follicle-stimulating hormone (FSH) secretion. Activin receptor-interacting protein 2 (ARIP2) has been recently identified in mouse tissues as a regulatory protein of activin signal transduction. However, the localization and function of ARIP2 are not well characterized. In this study, we found that ARIP2 mRNA and protein were widely expressed in mouse tissues by reverse transcription-PCR (RT-PCR) and Western blotting. The immunoreactivities of ARIP2 were mainly localized at myocardial cells of heart, Leydig cells in testis, macrophages and epithelial cells of bronchus in lung, renal tubule and collecting tubule, pancreatic islet, adrenal gland, adenohypophysis and hypothalamus by immunohistochemical staining. Furthermore, ARIP2 overexpression down-regulated signal transduction induced by activin A in pituitary gonadotroph LbetaT2 cells and inhibited FSH secretion from primary cultured anterior pituitary cells induced by activin A. These findings suggest that ARIP2 is widely distributed in various tissues and may be a negative regulator of activin action in pituitary cells.

Inhibitory effect of activin A on activation of lipopolysaccharide-stimulated mouse macrophage RAW264.7 cells.

Activin A is a member of transforming growth factor beta (TGF-beta) superfamily, which is also named restrictin-P, and can inhibit the secretion of nitric oxide (NO) and interleukin-1beta (IL-1beta) from LPS-activated mouse macrophages. In this study, the regulation effect and possible mechanism of activin A as an anti-inflammatory factor on lipopolysaccharide (LPS)-activated macrophages were investigated in vitro. It was observed that activin A could not only decrease the secretion of IL-1beta and NO, as well as the mRNA expressions of IL-1beta and iNOS, but also suppress the pinocytosis of mouse macrophage cell line RAW264.7 cells induced by LPS. In addition, activin A could obviously reduce the expressions of CD68 and CD14, as well as Toll-like receptor 4 (TLR4) on RAW264.7 cells induced by LPS, but could not influence the proliferation of RAW264.7 cells. These findings suggest that activin A may play an important down-regulation role in inflammatory factor production and phagocytosis of the activated macrophages via suppressing the maturation of LPS-induced macrophages or LPS-TLR4 signal transduction.

[Effects of lead exposure on protein kinase C and calmodulin expression in hippocampus and neurobehavioral function of baby rats].

OBJECTIVE: To observe the effect of chronic lead contaminant on mRNA expression of protein kinase C (PKC) and calmodulin (CaM) in hippocampus of baby rats. METHODS: The Wistar pregnant rats were randomly divided into 3 groups fed with distilled water and lead contained water (0.2% and 1.0% lead acetate) respectively. The lead exposure period was from the 0 day of pregnancy to the day when the offspring weaned. Then the baby rats were fed with lead water the same as their mothers. The cliff avoidance reflex within postnatal day 8 and step down test at postnatal day 50 were performed. Then pups were killed at postnatal day 8 and 50 respectively. Atomic absorption spectrometry was used to determine lead content of rats' brain. RT-PCR was used to observe mRNA expression of PKC and CaM in hippocampus of baby rats. RESULTS: The brain lead content of test groups were much higher than that of the control group. The completion rate of cliff avoidance reflex and the score of step down test of test groups were lower than those in the control group (P < 0.05). Compared with control group, PKC and CaM mRNA expression of chronic lead exposure baby rats in the hippocampus had the down trend (P < 0.05). CONCLUSION: The decrease of PKC and CaM mRNA expression level in hippocampus has a great link with the impairment of learning and memory induced by lead in baby rats, which might be one of the molecule mechanisms of lead induced impairment of learning and memory.

[Effects of lead exposure on acid-sensing ion channel in hippocampus of baby-rats].

OBJECTIVE: To observe the effects of chronic lead exposure on mRNA and protein expression of ASIC1a, ASIC2a, ASIC2b in hippocampus of baby-rats. METHODS: The Wistar pregnant rats were randomly divided into 3 groups fed with distilled water or lead contained water (0.2% and 1.0% lead acetate) respectively, 5 rats in each group. The lead-exposure ranged from the 0 day of pregnancy to the offspring weaned. Then the baby-rats were fed with lead water like their mothers and killed at postnatal day 8 or 50. Atomic absorption spectrometry was used to determine lead content in the brain. RT-PCR and Western blotting were used to observe mRNA and protein expression of ASIC1a, ASIC2a and ASIC2b in their hippocampus respectively. RESULTS: The brain lead content of test groups was higher than that of the control group (P < 0.01), and the lead content of the postnatal day 50 was higher than that in postnatal day 8 (P < 0.01). Compared with the control group, ASIC1a mRNA expression of 1.0% lead exposure in the hippocampus was uptrend (P < 0.01), ASIC1a protein expression of each test group was downtrend (P < 0.05), while for ASIC2a and ASIC2b mRNA and protein, there was no significant differences observed (P > 0.05). CONCLUSION: ASIC1a expression in hippocampus can be changed by chronic lead exposure.

[Effects of lead exposure on protein kinase C and calmodulin expression in hippocampus of baby-rats].

OBJECTIVE: To observe the effect of chronic lead contaminant on protein expression of protein kinase (PKC) and calmodulin (CaM) in hippocampus of baby-rats. METHODS: The Wistar pregnant rats were randomly divided into 3 groups fed with distilled water and lead-contained water (0.2% and 1.0% lead acetate) respectively. The lead exposure period ranged from the 0 day of pregnancy to the offspring weaned. Then the baby-rats were fed with lead water the same as their mothers. Pups were killed at postnatal day 8 and 50 respectively. Atomic absorption spectrometry was used to determine lead content of rats' brain. Western-blotting was used to observe protein expression of PKC and CaM in hippocampus of baby-rats. RESULTS: The brain lead content of test groups was much higher than that of the control group in the same growth period (P < 0.01). The content of brain lead in rats of postnatal day 50 was significantly higher than that of rats of postnatal day 8 (P < 0.01). Compared with control group, PKC and CaM protein expressions of chronic lead exposure baby-rats in the hippocampus were down trend (P < 0.05). CONCLUSION: The decrease of PKC and CaM protein expression level in hippocampus might be one of the molecular mechanisms of lead induced impairment of learning and memory.

Regulation of activin receptor-interacting protein 2 expression in mouse hepatoma Hepa1-6 cells and its relationship with collagen type IV.

AIM: To investigate the regulation of activin receptor-interacting protein 2 (ARIP2) expression and its possible relationships with collagen type IV (collagen IV) in mouse hepatoma cell line Hepal-6 cells. METHODS: The ARIP2 mRNA expression kinetics in Hepal-6 cells was detected by RT-PCR, and its regulation factors were analyzed by treatment with signal transduction activators such as phorbol 12-myristate 13-acetate (PMA), forskolin and A23187. After pcDNA3-ARIP2 was transfected into Hepal-6 cells, the effects of ARIP2 overexpression on activin type II receptor (ActRII) and collagen IV expression were evaluated. RESULTS: The expression levels of ARIP2 mRNA in Hapel-6 cells were elevated in time-dependent manner 12 h after treatment with activin A and endotoxin LPS, but not changed evidently in the early stage of stimulation (2 or 4 h). The ARIP2 mRNA expression was increased after stimulated with signal transduction activators such as PMA and forskolin in Hepal-6 cells, whereas decreased after treatment with A23187 (25.3% +/- 5.7% vs 48.1% +/- 3.6%, P < 0.01). ARIP2 overexpression could remarkably suppress the expression of ActRIIA mRNA in dose-dependent manner, but has no effect on ActRIIB in Hepal-6 cells induced by activin A. Furthermore, we have found that overexpression of ARIP2 could inhibit collagen IV mRNA and protein expressions induced by activin A in Hapel-6 cells. CONCLUSION: These findings suggest that ARIP2 expression can be influenced by various factors. ARIP2 may participate in the negative feedback regulation of signal transduction in the late stage by affecting the expression of ActRIIA and play an important role in regulation of development of liver fibrosis induced by activin.

Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases.

BACKGROUNDS AND AIMS: The association of melanosis coli with the development of colorectal polyps remains uncertain. METHODS: From a total of 18263 patients who had received colonoscopy in our hospital, 219 with melanosis coli cases and 438 controls matched by age and sex (at 1:2 ratio) were included in this study. The association of incidence, number, location, and pathology of colorectal neoplasm with grades and distribution of melanosis coli were analyzed. RESULTS: Melanosis coli was associated with significantly more colorectal polyps than control, a higher incidence of numerous colorectal polyps (number ≥ 20) (7.3% vs 0.5%; p < 0.001), and higher number of small colorectal polyps (diameter ≤ 5 mm; p < 0.01). Patients with melanosis coli had higher incidences of low-grade adenomas (31.1% vs 23.3%, p < 0.05) and non-adenoma polyps (20.1% vs 12.8%, p < 0.05) than the controls. On multivariate analysis, melanosis coli was independently associated with increased detecting rates of low grade adenoma (OR = 1.54; 95%: 1.06-2.23; p < .05), non-adenoma polyp (OR = 1.72; 95%: 1.11-2.70; p < .05) and numerous polyps (OR = 16.2, 95%: 3.66-71.6; p < .05). There was no significant difference in the incidence of high-grade adenomas or adenocarcinomas in the two population groups, but the numbers of these lesions were insufficient to permit firm conclusions. No significant differences in incidence, number, and pathology of colorectal polyps between individuals with melanosis coli of three different grades of severity were found. Melanosis located predominantly in the right colon had an interestingly lower incidence of colonic polyps in right colon than did melanosis located predominantly in the left colon or total colon (8.9% vs. 26.3%, 24.0%, p < 0.05). Patients with melanosis coli had significantly more nonspecific distal ileal ulcers than did controls (8.0% vs 0%, p < 0.001). CONCLUSION: Melanosis coli is associated with a higher incidence and number of colonic non-adenoma polyps and low-grade adenomas, and higher incidence of distal ileal ulcers. Melanosis coli may not be a harmless pigmentation, but a sign of chronic injury of colonic and intestinal mucosa.

Effects of activin A on the activities of the mouse peritoneal macrophages.

Activin A is a kind of pre-inflammatory factor that belongs to the transforming growth factor-beta (TGF-beta) superfamily. To investigate the effect and mechanism of activin A on the activities of mouse macrophages, the secretion of NO in the supernatant of cultured mouse peritoneal macrophages was examined by NO assay kit, and the expression of iNOS, ActRIIA and ARIP2 mRNA in mouse peritoneal macrophages was analyzed by RT-PCR. The results showed that activin A stimulated the secretion of NO and the expression of iNOS mRNA in non-activated mouse macrophages in a time- and dose-dependent manner. In contrast, activin A in the same concentration inhibited the secretion of NO in LPS-activated mouse macrophages in a dose-dependent manner. ActRIIA was highly expressed on macrophages, and activin A upregulated the ActRIIA mRNA expression in macrophages. Anti-ActRIIA antibody can block the secretion of NO from the macrophages stimulated by activin A. Furthermore, RT-PCR analysis revealed that activin A enhanced the ARIP2 mRNA expression in macrophages. These results indicated that Activin A may be a weak activator compared with LPS to mouse macrophages, and activin A may modulate the secretion of NO through ActRIIA-ARIP2 signal pathway in mouse macrophages.