Advances in anomalous aortic origin of coronary artery in children / 国际儿科学杂志

Anomalous aortic origin of a coronary artery（AAOCA）is a rare congenital malformation of the coronary artery，characterized by the coronary orifice origin from the inappropriate sinus of valsalva. Clinical presentations of this condition are occult，and different types present with various clinical manifestations，including exercise-induced angina，syncope，and even sudden death，particularly when the coronary artery follows an interarterial（intramural）course. Coronary computed comography angiography is an effective diagnostic method for precisely delineating the origin and shape of the coronary artery. Surgical correction is recommended upon evidence of myocardial ischemia and potential risk，and offers favorable long-term prognosis post-surgery. Despite low morbidity，limited experience in diagnosis and treatment，early diagnosis and timely treatment are of great importance because of the high potential risk related to the high-risk types. This paper aims to review the advances in the pathophysiology，clinical manifestations，diagnosis，and treatment of AAOCA to enhance recognition among pediatricians and reduce the incidence rate of sudden cardiac death in children with AAOCA.

Deep Learning Image Recognition-assisted Atomic Force Microscopy for Precise and Efficient Detection of Single-cell Mechanical Properties / 生物化学与生物物理进展

ObjectiveThe advent of atomic force microscope (AFM) provides a powerful tool for the studies of life sciences. Particularly, AFM-based indentation assay has become an important method for the detection of cellular mechanics, yielding numerous novel insights into the physiological and pathological activities from the single-cell level and considerably complementing traditional biochemical ensemble-averaged assays. However, current AFM indentation technology is mainly dependent on manual operation with low efficiency, seriously restricting its practical applications in the field of life sciences. Here, a method based on the combination of deep learning image recognition and AFM is developed for precisely and efficiently detecting the mechanical properties of single isolated cells and clustered cells. MethodsThe YOLO deep learning algorithm was used to recognize the central region of the cell in the optical image, the dual UNet neural network with an embedded vision transformer (ViT) module was used to recognize the peripheral regions of cell, and the template matching algorithm was used to recognize the tip of spherical probe. Based on the automatic determination of the positional relationships between the microsphere tip and the different parts of cell, the AFM tip was accurately moved to the central and peripheral regions of the target cell for rapid measurements of cell mechanical properties. Two types of cells, including HEK 293 cell (human embryonic kidney cell) and HGC-27 cell (human undifferentiated gastric cancer cell), were used for the experiments. The Hertz model was applied to analyze the force curves obtained on cells to obtain cellular Young’s modulus. ResultsAFM probe can be precisely moved to the different parts (central areas and peripheral areas) of cells to perform mechanical measurements under the guidance of deep learning-based optical image automatic recognition. The experimental results show that the proposed method is not only suitable for single isolated cells, but also suitable for clustered cells. ConclusionThe research demonstrates the great potential of deep learning image recognition to aid AFM in the precise and efficient detection of cellular mechanical properties mechanics, and combining deep learning-based image recognition with AFM will benefit the development of high-throughput AFM-based methodology to measure the mechanical properties of cells.

Study on the predictive significance of PLR, SII and RPR in ovarian endometriotic cyst / 中华妇产科杂志

Objective: To investigate the predictive value of platelet-to-lymphocyte ratio (PLR), red blood cell distribution width to platelet count ratio (RPR) and systemic immune inflammation index (SII) in the staging and postoperative recurrence of ovarian endometrial cysts. Methods: Retrospective analysis was made on the clinical data of patients who underwent laparoscopic surgery for ovarian cysts in the Affiliated Hospital of Qingdao University from January 2018 to January 2020. The patients with ovarian endometriosis cyst confirmed by pathology after surgery were the observation group (n=350), and the patients with other benign ovarian cyst were the control group (n=150). The preoperative platelet count, platelet distribution width, absolute number of neutrophils, lymphocyte absolute number, absolute number of monocytes, red blood cell distribution width, and serum cancer antigen 125 (CA125) of the patients in two groups were recorded, and PLR, neutrophil-to-lymphocyte ratio (NLR), RPR, SII, and systemic inflammation response index (SIRI) were calculated and analyzed. The general data of all patients and the follow-up data within 2 years after the operation of the observation group were statistically recorded to evaluate the diagnostic value of PLR, RPR and SII for ovarian endometrial cyst, and the predictive value of staging and recurrence within 2 years after the operation. Results: PLR, NLR, SII (median: 147.53, 1.86, and 488.70 respectively) and CA125 (median: 59.41 kU/L) in the observation group were significantly higher than those in the control group, while RPR (median: 0.16) was lower than that in the control group, with significant differences (all P<0.01). There was no significant difference in SIRI between the two groups (P>0.05). The PLR and SII (median: 122.73, 345.00) of the observation group at stage Ⅲ and Ⅳ were higher than those of patients at stage Ⅰ and Ⅱ, and the RPR was lower than that of patients with stage Ⅰ and Ⅱ, with significant differences (all P<0.001). The PLR, NLR, SII, SIRI (median: 179.63, 2.75, 762.96, and 1.06 respectively) and CA125 (median: 108.83 kU/L) in patients with recurrence were significantly higher than those in patients without recurrence 2 years after the operation, and the differences were statistically significant (all P<0.001). The area under curve (AUC) of CA125 in the diagnosis of ovarian endometriosis cyst was 0.951, the sensitivity was 85.7%, and the specificity was 93.0%, which were higher than those of PLR and SII; the AUC of PLR+SII+CA125 in the diagnosis of ovarian endometriosis cyst was 0.952. The AUC of RPR predicting the stage of ovarian endometriosis cyst was 0.713, higher than PLR and SII, lower than CA125; the AUC of RPR+SII+CA125 in predicting the stage of ovarian endometriotic cyst was 0.825, with sensitivity of 68.7% and specificity of 85.7%. The AUC predicted by SII for recurrence of ovarian endometriotic cyst within 2 years after the operation was 0.803, higher than NLR, PLR, SIRI and CA125; the AUC of PLR+SII+CA125, sensitivity, specificity was 0.813, 81.5% and 73.0%, higher than SII. Conclusion: PLR, RPR and SII are related to the staging of ovarian endometriotic cyst, and SII has a certain predictive value for the recurrence of ovarian endometriotic cyst after surgery.

Formononetin enhances the antitumor effect of H22 hepatoma transplanted mice / 细胞与分子免疫学杂志

Objective To explore the effect of formononetin on immunity of mice with transplanted H22 hepatocarcinoma. Methods Male C57BL/6 mice were subcutaneously inoculated with H22 cells (4×105) to establish a tumor-bearing mouse model. The mice were treated with formononetin [10 mg/(kg.d)] or [50 mg/(kg.d)] for 28 days, and then the tumor inhibition rate was calculated. Carrilizumab was used as a positive control drug. The expressions of CD8, granzyme B and forkbox transcription factor 3 (FOXP3) in HCC tissues were analyzed by immunohistochemical staining. The mRNA and protein expression of programmed cell death protein 1 (PD-1) and its ligand 1 (PD-L1) in HCC tissues were detected by real-time PCR or Western blot analysis, respectively. The serum levels of interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) were detected by ELISA. Results Formononetin increased the tumor inhibition rate and the positive rate of CD8 and granzyme B staining in tumor-bearing mice. There was no significant difference in the positive rate of FOXP3 staining in tumor tissues of mice in each group. Formononetin decreased the levels of IL-10 and TGF-β in serum of tumor-bearing mice, and decreased the relative expression of mRNA and protein of PD-1 and PD-L1 in tumor tissue of tumor-bearing mice. Conclusion Formononetin can activate CD8+ T cells and reduce the release of immunosuppressive factors in regulatory T cells by blocking PD-1/PD-L1 pathway and play an antitumor role.

Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study / 中山大学学报(医学科学版)

ObjectiveTo investigate the effects of epidural analgesia plus dexmedetomidine infusion on postpartum depression in parturients with natural childbirth. MethodsWe selected 70 parturients aged between 22 and 36， with singleton， term， cephalic presentation， natural delivery and ASA class I or Ⅱ. The cases undergoing epidural analgesia with ropivacaine and sufentanil were randomly divided into two groups by using a random number table （n=35 for each group）. The control group （Group C） used intravenous infusion of normal saline， while the experimental group （Group D） used equivalent volumes of intravenous infusion of dexmedetomidine. Participants were followed up at 1， 6， 12 weeks after childbirth to assess the severity of postpartum depression. Blood samples were collected at 12 h and 48 h after childbirth to measure the serum prolactin levels. The hemodynamic （HR and MAP） changes， VAS scores， and Ramsay scores were recorded at five time points： before analgesia （T1）， 10 min after analgesia （T2）， 30 min after analgesia （T3）， 12 h （T4） and 24 h （T5） after delivery. The number of analgesia pump presses and adverse events were also documented. ResultsCompared with Group C， Group D showed significantly lower EPDS scores at 1 week after childbirth， significantly higher prolactin concentrations at 12 h and 48 h after childbirth， significantly lower VAS scores at T2， T3 and T4， significantly higher Ramsay score at T3 and significantly reduced number of analgesia pump presses （P < 0.05）. ConclusionEpidural analgesia plus intravenous infusion of dexmedetomidine can alleviate early postpartum depression in women undergoing natural delivery， promote early prolactin secretion and provide a safe and effective adjunctive analgesic and sedative effect.

Effect of Yipi Yanggan prescription on malignant transformation of liver stem cells in rats with liver precancerous lesion and its mechanism of action / 临床肝胆病杂志

Objective To investigate the effect of Yipi Yanggan prescription on the malignant transformation of liver stem cells in liver precancerous lesion induced by diethylnitrosamine (DEN) and its possible molecular mechanism. Methods A total of 35 male Sprague-Dawley rats were randomly divided into normal control group (blank group), DEN model group (model group), DEN+Yipi Yanggan prescription group (Yipi Yanggan prescription group), and DEN+Hugan tablet group (Hugan tablet group), with 5 rats in the blank group and 10 rats in the other three groups. Intraperitoneal injection of DEN was performed to establish a model of liver precancerous lesion, the rats were sacrificed after 16 weeks of administration. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (Alb) were measured; liver tissue was collected to observe the changes in size and appearance and calculate liver weight ratio (liver index); HE staining and Sirius Red staining were used to observe the pathological and morphological changes of rat liver tissue; immunohistochemistry was used to measure the expression of OV6 and glutathione S-transferase-Pi (GST-Pi); RT-PCR was used to measure the mRNA expression of EpCAM, CD133, and CD90, and Western blot was used to measure the protein expression of PI3K, Akt, and mTOR and their phosphorylation level. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the model group, the Yipi Yanggan prescription group and the Hugan tablet group had significant improvements in liver pathology and morphology, significant reductions in liver index and the levels of ALT and AST, and a significant increase in the level of Alb (all P < 0.05), as well as significant reductions in the protein expression levels of GST-Pi, OV6, p-PI3K, p-Akt, and p-mTOR and the mRNA expression levels of EpCAM, CD133, and CD90 (all P < 0.05). Compared with the Hugan tablet group, the Yipi Yanggan prescription group showed a more significant protective effect on the liver, with significant reductions in liver index and the levels of ALT and AST, and a significant increase in the level of Alb (all P < 0.05), as well as significant reductions in the protein expression levels of GST-Pi, OV6, p-PI3K, p-Akt, and p-mTOR and the mRNA expression levels of EpCAM, CD133, and CD90 (all P < 0.05). Conclusion Yipi Yanggan prescription can improve liver precancerous lesion induced by DEN in rats by inhibiting the malignant transformation of liver stem cells, and its mechanism of action may be associated with the PI3K/Akt/mTOR signaling pathway.

Absolute bioavailability,dose proportionality,and tissue distribution of rotundic acid in rats based on validated LC-QqQ-MS/MS method / 药物分析学报

Rotundic acid(RA),an ursane-type pentacyclic triterpene acid isolated from the dried barks of Ilex rotunda Thunb.(Aquifoliaceae),possesses diverse bioactivities.To further study its pharmacokinetics,a simple and sensitive liquid chromatography with triple quadrupole mass spectrometry(LC-QqQ-MS/MS)method was developed and validated to quantify RA concentration in rat plasma and tissue using etofesalamide as an internal standard(IS).Plasma and tissue samples were subjected to one-step protein precipitation.Chromatographic separation was achieved on a ZORBAX Eclipse XDB-C18 col-umn(4.6 mm×50 mm,5 μm)under gradient conditions with eluents of methanol:acetonitrile(1∶1,V/V)and 5mM ammonium formate:methanol(9∶1,V/V)at 0.5mL/min.Multiple reaction monitoring transitions were performed at m/z 487.30 → 437.30 for RA and m/z 256.10 → 227.10 for IS in the negative mode.The developed LC-QqQ-MS/MS method exhibited good linearity(2-500 ng/mL)and was fully validated in accordance with U.S.Food and Drug Administration bioanalytical guidelines.Dose proportionality and bioavailability in rats were determined by comparing pharmacokinetic data after single oral(10,20,and 40 mg/kg)and intravenous(10 mg/kg)administration of RA.Tissue distribution was studied following oral administration at 20 mg/kg.The results showed that the absolute bioavailability of RA after administration at different doses ranged from 16.1％to 19.4％.RA showed good dose proportionality over a dose range of 10-40 mg/kg.RA was rapidly absorbed in a dose-dependent manner and highly distributed in the liver.In conclusion,this study is the first to systematically elucidate the absorption and distribution characteristics of RA in rats,which can provide additional information for further development and evaluation of RA in drug metabolism and pharmacokinetic studies.

Dephosphorylation of cGAS by PPP6C impairs its substrate binding activity and innate antiviral response

The cyclic GMP-AMP (cGAMP) synthase (cGAS) plays a critical role in host defense by sensing cytosolic DNA derived from microbial pathogens or mis-located cellular DNA. Upon DNA binding, cGAS utilizes GTP and ATP as substrates to synthesize cGAMP, leading to MITA-mediated innate immune response. In this study, we identified the phosphatase PPP6C as a negative regulator of cGAS-mediated innate immune response. PPP6C is constitutively associated with cGAS in un-stimulated cells. DNA virus infection causes rapid disassociation of PPP6C from cGAS, resulting in phosphorylation of human cGAS S435 or mouse cGAS S420 in its catalytic pocket. Mutation of this serine residue of cGAS impairs its ability to synthesize cGAMP upon DNA virus infection. In vitro experiments indicate that S420-phosphorylated mcGAS has higher affinity to GTP and enzymatic activity. PPP6C-deficiency promotes innate immune response to DNA virus in various cells. Our findings suggest that PPP6C-mediated dephosphorylation of a catalytic pocket serine residue of cGAS impairs its substrate binding activity and innate immune response, which provides a mechanism for keeping the DNA sensor cGAS inactive in the absence of infection to avoid autoimmune response.

Dephosphorylation of cGAS by PPP6C impairs its substrate binding activity and innate antiviral response

The cyclic GMP-AMP (cGAMP) synthase (cGAS) plays a critical role in host defense by sensing cytosolic DNA derived from microbial pathogens or mis-located cellular DNA. Upon DNA binding, cGAS utilizes GTP and ATP as substrates to synthesize cGAMP, leading to MITA-mediated innate immune response. In this study, we identified the phosphatase PPP6C as a negative regulator of cGAS-mediated innate immune response. PPP6C is constitutively associated with cGAS in un-stimulated cells. DNA virus infection causes rapid disassociation of PPP6C from cGAS, resulting in phosphorylation of human cGAS S435 or mouse cGAS S420 in its catalytic pocket. Mutation of this serine residue of cGAS impairs its ability to synthesize cGAMP upon DNA virus infection. In vitro experiments indicate that S420-phosphorylated mcGAS has higher affinity to GTP and enzymatic activity. PPP6C-deficiency promotes innate immune response to DNA virus in various cells. Our findings suggest that PPP6C-mediated dephosphorylation of a catalytic pocket serine residue of cGAS impairs its substrate binding activity and innate immune response, which provides a mechanism for keeping the DNA sensor cGAS inactive in the absence of infection to avoid autoimmune response.

Effect of electroacupuncture on expression of CREB and its ability to bind to synaptic proteins in amygdala and hippocampus of rats with post-traumatic stress disorder / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the expression of cAMP-response element binding protein (CREB, a key protein for BDNF-TrkB signaling) and it's blinding ability to synaptic key protein in the amygdala and hippocampus of rats with post-traumatic stress disorder (PTSD), so as to lay a foundation for further study of the interaction mechanism between BDNF-TrkB signaling and synaptic plasticity. METHODS: Twenty-four male SD rats were randomly divided into blank, model and electroacupuncture (EA) groups, with 8 rats in each group. The PTSD model was established by psychological stress (bondage) and physiological stress (forced swimming and anesthesia). After modeling, EA (2 Hz/100 Hz, 1 mA) was applied to "Baihui"(GV20) "Shenting"(GB24) and bilateral "Shenshu"(BL23) for 20 min, once daily for 21 days. The behavioral changes (spontaneous locomotor within 30 min and contextual fear conditioning tests in 7 days) were detected by using a spontaneous locomotor detection box, and a conditioned fear response test chamber, respectively. The expression of CREB was detected by immunohistochemistry and Western blot, separately. The binding abilities of CREB to synaptic proteins (post synaptic density 95 [PSD95], synaptophysin [SYN] and growth-associated protein 43 [GAP43]) were verified by chromatin-immunoprecipitation (CHIP) technique. RESULTS: After modeling, the spontaneous locomotor distance, the expression levels of CREB and the binding ability of CREB to PSD95 protein in the amygdala and hippocampus were significantly decreased (P0.05). CONCLUSION: EA can improve the motor activity in PTSD rats, which may be associated with its effect in increasing the binding ability of CREB to the synaptic key protein PSD95 to regulate the interaction between the synaptic plasticity and BDNF-TrkB signaling pathway of the amygdala and hippocampus.

Analysis of mortality relative factors in patients with ventricular septal rupture complicating myocardial infarction / 中华外科杂志

To examine the mortality rate and relative factors associate with ventricular septal rupture in myocardial infarction patients. A total of 51 patients who suffered from myocardial infarction complicating with ventricular septal rupture received operative procedures between January 2005 and December 2018 in Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, were retrospectively analyzed. There were 34 males and 17 females, with an age of (63±8) years (range: 44 to 82 years). The time between ventricular septal rupture and surgical procedure was (44±39) days (range: 3 to 187 days). The test and χ(2) test were used for univariate analysis, Logistics regression model was used for multivariate analysis of in-hospital mortality relative factors. There were 8 patients dead in hospital, 43 patients survived, the overall mortality rate was 15.7% in hospital. The post-operation mortality rate was 2/3 of who suffered ventricular septal rupture and underwent operation within 1 week, but it's markedly decreased to 6.5% if the time over 4 weeks. Univariate analysis showed that renal failure before operation, creatinine before operation, left ventricular ejection fraction, cardiac function (New York Heart Association) grade Ⅳ, severe tricuspid regurgitation, dialysis post-operation, creatinine of the first day of post-operation, the time between and operation more than 4 weeks were in-hospital mortality relative factors. Multivariate analysis reflected that advanced age (1.32, 95: 1.05 to 1.75, 0.033), cardiac function grade Ⅳ (2.25, 95: 1.62 to 2.82, 0.003), severe tricuspid regurgitation ( 1.82, 95: 1.31 to 2.43, 0.001), renal failure before operation (1.78, 95: 1.26 to 2.32, 0.015), the time between ventricular septal rupture and operation less than 1 week (2.50, 95: 1.52 to 2.98, 0.012), were independent in-hospital mortality relative factors. The surgery operation is an effective way to deal with ventricular septal rupture combined with myocardial infarction. The independent relative factors of in-hospital mortality are advanced age, cardiac function grade Ⅳ, renal failure before operation, severe tricuspid regurgitation, the time between ventricular septal rupture and operation less than 1 week.

Effect of electroacupuncture on expression of CREB and its ability to bind to synaptic proteins in rats with post-traumatic stress disorder

Objective: To observe the effects of electroacupuncture on the expression of CREB and its ability to blind to synaptic key proteins in rats with post-traumatic stress disorder (PTSD), thus to lay the foundation for further study of the mechanism of electroacupuncture treatment of PTSD (i.e., electroacupuncture promotes the interaction between synaptic plasticity and BDNF-TRKB signaling pathway). Methods: SD male rats were randomly divided into blank group, model group and electroacupuncture treatment group, with 8 rats in each group. The model of PTSD was established by single continuous stress method (this modeling method is dominated by forced drowning, and tropical disasters are also mostly related to drowning). After modeling, the treatment group received electroacupuncture therapy, followed by retaining the needles for 20 min. The treatment was conducted once daily for 21 d. The behavioral changes were evaluated by spontaneous activity and conditional fear reaction. The expression of CREB was detected by immunohistochemistry and Western Blot. The binding ability of CREB to synaptic protein was verified by CHIP. Results: Compared with the model group, the spontaneous activity distance of the treatment group rats increased (P<0.01) and the percentage of stiffness time decreased (P<0.01), the expression of CREB protein in the treatment group was significantly increased (P<0.01), the binding ability of CREB to PSD95 protein was increased in treatment group (P<0.05). Conclusions: Electroacupuncture regulates the interaction mechanism between synaptic plasticity and BDNFTrkB signaling pathway of the rat model of PTSD, most likely by increasing the binding ability of CREB to the key synaptic protein-PSD95.

Alpinia oxyphylla alleviates diabetic nephropathy through the NLRP3 inflammasome pathway in rats

Objective: Previous studies have confirmed that the tropical traditional Chinese herb-Alpinia (A.) oxyphylla are effective on diabetic nephropathy. The purpose of this experiment was to investigate whether A. oxyphylla could prevent and treat diabetic nephropathy by regulating NLRP3 inflammasome pathway. Methods: Male SD rats and NLRP3 gene silencing rats were assinged into blank group, model group, A. oxyphylla group, valsartan group and NLRP3 gene silencing group, with 8 rats in each group. The model was established by intraabdominal injection of streptomycin after feeding with high sugar and high fat diet for 6 weeks. Based on successful modeling, administration protocal for a period of 8 weeks were performed. A. oxyphylla group was given A. oxyphylla decoction (2.6g/kg/d ), while the model group and NLRP3 gene silencing group were given saline as the same dosage of A. oxyphylla decoction. The valsartan (10 mg/kg/d) was given to the valsartan group. After 8 weeks of treatments, blood glucose, 24 h urinary protein, creatinine, urea nitrogen levels were detected, and the pathological sections of the kidney were examined. The expression of NLRP3 protein was detected by Western-Blot and PCR. NLRP3 protein, caspase-1, IL-18 and IL-1βin renal tubules were detected in each group by immunofluorescence and immunohistochemistry. Results: Compared with the model group, A. oxyphylla significantly reduced blood glucose, 24 h urinary protein, creatinine, urea nitrogen levels (P all<0.05) but the pathological injury in kidney was less. The expression of NLRP3 protein was negative in NLRP3-/-group while positive in the model group, A. oxyphylla group and valsartan group. Expression of NLRP3 protein, NLRP3, caspase-1, IL-18 and IL-1β were also significantly lower in A. oxyphylla trated group compared with the model group (P all<0.05). Conclusions: A. oxyphylla could inhibit the expression of NLRP3 protein, reduce IL-18 and IL-1β and other inflammatory factors and alleviate the damage of kidney caused by inflammatory reaction. This is one of the mechanisms whereby A. oxyphylla prevents and treats diabetic nephropathy.

Risk factors, early screening, and preventing strategy for hepatitis B-related hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide and hepatitis B virus (HBV) infection is one of most important risk factors for HCC. The development of HBV-related HCC involves a complex interaction between host and virus, and related risk factors include HBV viral load, HBeAg, and host susceptibility. Screening methods for HCC include radiological examination such as ultrasound and serological markers such as α-fetoprotein, and protein induced by vitamin K antagonist-II and alpha-fetoprotein (AFP) variants may help with the diagnosis of AFP-negative HCC. Appropriate measures such as HBV vaccination and antiviral therapy can help to prevent HCC. The long-term goal of antiviral therapy for chronic hepatitis B is to reduce complications such as liver cirrhosis and HCC. nucleos(t)ide analogues can effectively inhibit replication of virus, but they cannot eradicate covalently closed circular DNA in the nucleus of hepatocytes. There is still an urgent need for a cure for hepatitis B. This article reviews the epidemiology, risk factors, screening methods, and preventive strategies for HBV-related HCC.

Risk factors, early screening, and preventing strategy for hepatitis B-related hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide and hepatitis B virus (HBV) infection is one of most important risk factors for HCC. The development of HBV-related HCC involves a complex interaction between host and virus, and related risk factors include HBV viral load, HBeAg, and host susceptibility. Screening methods for HCC include radiological examination such as ultrasound and serological markers such as α-fetoprotein, and protein induced by vitamin K antagonist-II and alpha-fetoprotein (AFP) variants may help with the diagnosis of AFP-negative HCC. Appropriate measures such as HBV vaccination and antiviral therapy can help to prevent HCC. The long-term goal of antiviral therapy for chronic hepatitis B is to reduce complications such as liver cirrhosis and HCC. nucleos(t)ide analogues can effectively inhibit replication of virus, but they cannot eradicate covalently closed circular DNA in the nucleus of hepatocytes. There is still an urgent need for a cure for hepatitis B. This article reviews the epidemiology, risk factors, screening methods, and preventive strategies for HBV-related HCC.

The study of college students’ physical exercise behavior phase and process of change based on the Transtheoretical model / 中华疾病控制杂志

Objective To analyze the stage characteristics in the exercise behavior improvement of college students and explore the role of Process in the exercise behavior change based on the transtheoretical model, providing basis for the stage-matched intervention for the exercise behavior of college students. Methods There were 932 students who completed the questionnaires, from 5 universities in Shanxi Province were selected by using a stratified random cluster sampling method. Descriptive analysis was used to describe the exercise behavior of college students. Variance analysis and multivariate Logistic regression model were used to analyze the difference of the process of with stage of change among college students’ physical exercise. Multivariate variance analysis was used to analyze how personal characteristics affect process of change. Results Among all participants, 89.4% students knew the importance of physical exercise, and 29.4% students were satisfied with their physical exercise condition. The distribution of students’ physical exercise stage showed an inverted U-shape with left-side peak, and there was a significant difference between gender( 2=54.657, P<0.001). There were significant stage characteristics in the process of students' exercise behavior, gender had a significant main effects on mutual aid relation(F=7.400, P=0.07)and conscious control (F=7.778, P=0.005), gender and grade had interaction effects on social release (F=3.614, P=0.013). Conclusions The college students' exercise behavior showed the characteristics of “knowing but not to do”, which conformed to the Transtheoretical model. It is essential to develop targeted phased exercise intervention strategies according to the relationship between change of phase and change of procedure.

The practice and enlightenment of teaching ability development in American medical colleges and universities / 中华医学教育探索杂志

The United States attaches importance to teachers' teaching ability development in higher medical colleges and universities. The measures include integrating the promotion of teacher development into the certification standards of colleges and universities, establishing a specialized service organization, updating the training content and form , and evaluating the effectiveness of the training programs . The enlightenment for medical colleges and universities in China is to improve the status of teaching in colleges and universities, strengthen the construction of teaching service organization, scientifically plan the teachers' career development, enrich the teacher training content, and diversify the training model.

Expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/Tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary diseases and their relationships with pulmonary vascular remodelling

SUMMARY OBJECTIVE: This study aims at investigating the expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/ tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary disease (COPD) and their relationships with pulmonary vascular remodelling (PVR). METHODS: 60 para-tumour tissues were divided into the COPD group and the control group (n=30); the inflammations, pulmonary artery wall area/total artery area (WA%), and wall thickness/vascular outer diameter (WT%) were compared. The expressions of TLR-4, MMP-9/TIMP-1, and PCNA in pulmonary vascular smooth muscle cells were detected, and their relationships with PVR were then analysed. RESULTS: The inflammations (1.6±0.8), WA% (44.0±6.4), and WT% (27.3±3.3) in the COPD group were higher than in the control group (0.3±0.5, 26.1±2.8, 15.6±1.8), and the expressions of TLR-4 (31.4±147) and MMP-9/TIMP-1 (2.2±2.6) were increased compared to the control group (4.7±4.5, 1.9±12). Correlation analysis: TLR-4 and MMP-9/TIMP-1 were positively correlated with the inflammations (r=0.18, P<0.01), WA% (r=0.68, P<0.01), and WT% (r=0.73, P<0.01), as well as positively correlated with the expression of PCNA (r=0.44, P<0.01); the upregulation of TLR-4 was positively correlated with the expressions of MMP-9 and TIMP-1. CONCLUSIONS: The upregulation of TLR-4 in the pulmonary arterial smooth muscle cells of COPD patients could promote the inflammations and the MMP-9 expression, thus causing abnormal degradation of extracellular matrix, so it played an important role in the process of PVR.

RESUMO OBJETIVO: Este estudo tem como objetivo investigar as expressões de TOLL-like receptor 4 (TLR-4) e metaloproteinase 9 da matriz (MMP-9)/inibidor de tecido da metaloproteinase 1 (TIMP-1) em vasos sanguíneos pulmonares com doença pulmonar obstrutiva crônica (DPOC) e suas relações com o remodelamento vascular pulmonar (PVR). MÉTODOS: Sessenta tecidos paratumorais foram divididos em grupo COPD e o grupo controle (n = 30). Foram comparadas as inflamações, área da parede da artéria pulmonar/área da artéria total (WA%) e espessura da parede/diâmetro externo vascular (WT%). As expressões de TLR-4, MMP-9/TIMP-1 e PCNA em células de músculo liso vascular pulmonar foram detectadas, e suas relações com PVR foram então analisadas. RESULTADOS: As inflamações (1,6 ± 0,8), WA% (44,0 ± 6,4) e WT% (27,3 ± 3,3) no grupo COPD foram maiores que no grupo controle (0,3 ± 0,5; 26,1 ± 2,8; 15,6 ± 1,8). E as expressões de TLR-4 (31,4 ± 14,7) e MMP-9/TIMP-1 (2,2 ± 2,6) foram aumentadas em relação ao grupo controle (4,7 ± 4,5, 1,9 ± 1,2). Na análise de correlação, TLR-4 e MMP-9/TIMP-1 foram positivamente correlacionadas com as inflamações (r = 0,18; P <0,01), WA% (r = 0,68; P <0,01) e WT% (r = 0,73; P <0,01), bem como correlacionadas positivamente com a expressão de PCNA (r = 0,44; P <0,01). A elevação da TLR-4 foi correlacionada positivamente com as expressões de MMP-9 e TIMP-1. CONCLUSÕES: A regulação positiva do TLR-4 nas células do músculo liso arterial pulmonar de pacientes com DPOC poderia promover as inflamações e a expressão de MMP-9, causando assim uma degradação anormal da matriz extracelular, por isso desempenhou um papel importante no processo de PVR.

Identification of 22q11.2 microdeletion among patients with congenital heart diseases using droplet digital PCR / 中华医学遗传学杂志

OBJECTIVE To develop a new method for detecting 22q11.2 deletion syndrome (22q11.2 DS) in clinical settings. METHODS Specific primers and fluorescence probes were designed to target the TBX1 gene within the 22q11.2 deletion region and a reference gene RPP30. Multiplexed droplet digital PCR (ddPCR) was run to detect the 22q11.2 microdeletion by calculating the ratio of positive droplet number of TBX1/RPP30. RESULTS Three cases of 22q11.2 microdeletion previously confirmed by array comparative genome hybridization were successfully identified. Subsequently, the ddPCR detected two further cases of 22q11.2 microdeletion among 14 children with congenital heart diseases. CONCLUSION The ddPCR technique has provided a rapid and cost-effective method for detecting 22q11.2 microdeletion in clinical settings.

Prevalence and distribution of hypertension in population aged 15 years and over in Guizhou province / 中华流行病学杂志

Objective: To understand the prevalence and distribution of hypertension in population aged 15 years and over in Guizhou province and provide evidence for the prevention and management of hypertension. Methods: Face to face interviews using national standard questionnaire were conducted among the study subjects selected in Guizhou through multi-stage random sampling. Blood pressure measurement for them was done with Omron HEM-1300 professional portable blood pressure monitor. SPSS 19.0 software was used for statistical analysis. The ratio was compared by the χ(2) test. The influencing factors of hypertension was analyzed by multivariate logistic regression analysis. Results: A total of 13 480 participants were investigated, including 5 509 (40.8%) men and 7 971 (59.2%) women; 6 558 (48.6%) urban residents and 6 922 (51.4%) rural residents. Among the subjects surveyed, 3 232 (23.9%) were smokers, 2 412 (17.9%) were alcoholic and 4 859 (36.0%) were obese or overweight. A total of 3 937 (29.2%) hypertension patients were found. The prevalence of hypertension was 29.2%. The standardized prevalence of hypertension were 18.97% (compared with national population composition) and 21.16% (compared with Guizhou province population composition), respectively. The hypertension prevalence in men and women were 29.8% and 28.8%, respectively. The hypertension prevalence in rural population (35.8%) was higher than that in urban population (22.2%). The difference was statistically significant (P<0.001). The hypertension prevalence in people aged 65 years and over was 56.2%. The prevalence of hypertension were 34.3% and 27.6% in smokers and non-smokers, 39.2% and 27.0% in alcoholic and non-alcoholic and 40.7% and 22.7% in obese or overweight group and normal or less weight group, respectively. There were significant statistical differences in prevalence of hypertension among the population in urban area and rural area, with different age, education levels, smoking status, drinking status and BMI (P<0.001). Conclusions: The prevalence of hypertension in Guizhou was at a high level. The hypertension prevalence in rural area was higher than that in urban area. Hypertension prevalence increased significantly with age. The prevalence of hypertension was negatively associated with the education level of the people. Older age, living in rural area, smoking, drinking, obesity were the risk factors for hypertension.