Volume 86  ·   Issue 10  ·  2006

Recently, the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) jointly initiated to designate the second Thursday of March every year as "World Kidney Day", and the first "World Kidney Day" will be celebrated on March 9 this year. The "World Kidney Day" activity is launched to encourage governments, medical staff and the general public to pay full attention to chronic kidney diseases (CKD), understand its harm, and strengthen prevention and treatment [1].

Objective to investigate the inhibitory effect of norcantharidin (NCTD) on angiogenesis of gallbladder carcinoma tumors and its mechanism.Methods A randomized intervention experiment was carried out by establishing a tumor-bearing nude mouse model of gallbladder carcinoma and a GBC-SD cell model of gallbladder carcinoma. The experiments were divided into control group, 5-fluorouracil (5-FU) group, different concentrations of NCTD group, endostatin (ES) group, NCTD +5-FU group and NCTD + endostatin group, 10 in each group. The tumor size, apoptosis rate, peritumoral vessel morphology and microvessel density (MVD), vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2), angiogenesis inhibitory factor (TSP) and metalloproteinase-2 tissue inhibitory factor (TIMP2) expressions were observed by pathological examination, flow cytometry (FCM), immunohistochemical SABC method, CD34 staining and polymerase chain reaction (PCR) techniques<0.01); Compared with ES group (4.5 ± 2.1), the difference was not statistically significant. In NCTD group, apoptosis and lamellar necrosis tumor cells were observed under microscope. The tumor-bearing MVD and tumor-bearing volume (r =0.985, t =8.069, P<0.05), cell proliferation/apoptosis ratio (r =0.956, t =4.61, P<(2) The expressions of VEGF (32.3%±5.6%) and Ang-2 protein (22.6%±3.7%) in tumor-bearing cells in NCTD group were significantly lower than those in control group (44.7%±4.2% and 36.8%±8.7%) and 5-FU group (41.0%±4.4% and 31.7%±1.8%) (both P<0.01), TSP (166.9%±8.9%), TIMP2 (180.4%±4.1%) protein expressions were significantly higher than those in the control group (14.7%±1.1% and 56.7%±0.8%) and 5-FU group (99.1%±2.8% and 100.6%±18.4%) (all P<The expressions of VEGF and Ang-2 were positively correlated with tumor-bearing MVD, while the expressions of TSP and TIMP2 were negatively correlated. (3) Reverse transcription (RT) -PCR detection after NCTD application showed that the net area of specific bands (Pix) of VEGF mRNA (578 vs 435) and Ang-2 mRNA (236 vs 139) in GBC-SD cells was significantly decreased, while that of TIMP2 mRNA was significantly increased (191 vs 421), which was consistent with the changes of angiogenesis-related proteins in nude mice.

Objective to compare the expression difference of Pro370Leu mutant myocilin (mMYOC) and wild-type myocilin (wMYOC) gene in eukaryotic cells, and to understand the pathogenesis of primary open-angle glaucoma (POAG). Methods The recombinant expression vector pEGFP-N3-wMYOC with wMYOC gene and the recombinant expression vector pDsRed2-N1-mMYOC with mMYOC gene were respectively and co-transfected into eukaryotic cells Hela. The expression and localization of the protein were observed by fluorescence microscope, and the protein secretion was analyzed by Western blot. Results The results showed that both wMYOC protein and mMYOC protein were successfully expressed and localized in the cytoplasm, but the distribution of wMYOC protein was uniform, while the mMYOC protein was aggregated. When co-expressed, wMYOC protein was also aggregated, and there was a tendency to co-localize with mMYOC protein. Conclusion Both genes can be successfully expressed and localized in cytoplasm; mMYOC protein showed aggregation tendency and secretion disorder, and affected the expression and secretion characteristics of wMYOC protein.

Objective to investigate the feasibility and safety of resection of pancreatic body and tail with preservation of spleen and splenic vessels.Methods Four patients with solid pseudopapillary tumor of pancreatic body and tail were treated from December 2003 to January 2005.The resection of pancreatic body and tail with preservation of spleen and splenic vessels.The pancreas was transected on the right side of the tumor to expose the splenic arteries and veins, and the splenic arteries and veins were separated from the pancreas from the body to the splen.There was no need to separate the splenic arteries and veins and short stomach vessels, and no need to free the splene.Results All 4 patients successfully completed resection of pancreatic body and tail with preservation of spleen and splenic vessels.The average operation time of all cases was 208 min ± 52 min; The mean intraoperative bleeding was 475 ml ± 96 ml; None of the surgeries required blood transfusion; The average length of hospital stay after operation was 18 d ± 13 d. One patient developed pancreatic fistula after operation, which was cured by conservative treatment. There were no other complications. There was no recurrence or metastasis at follow-up. Conclusion Distal pancreatectomy with preservation of spleen and splenic vessels is safe and feasible, and it is the best choice for resection of benign and borderline pancreatic tumors.

Objective to evaluate the effect of homologous valve catheter in the treatment of children with complex congenital heart disease of pulmonary oligaemia. Methods 212 children with complex congenital heart disease of pulmonary oligaemia were selected from September 1996 to August 2005. The patients aged 0.5 to 15 years (mean 2.6 years). During the operation, the homologous valve catheter was used to reconstruct the right ventricular outflow tract and pulmonary artery. The postoperative interval was 6 months to 7 years (mean 2.6 years). The reconstruction of pulmonary valve regurgitation and calcification was reviewed by color Doppler ultrasound. Results 8 cases died early after operation, the success rate was 96.5% (204/212). The right ventricular pressure/aortic pressure was ≤0.55. After the follow-up, 4 cases (1.96%) had homologous valve calcification and failure, 7 cases (3.43%) had moderate valve regurgitation, 23 cases (11.2%) had mild valve regurgitation, and 170 cases (83.3%) had no valve regurgitation and calcification. Conclusion the homologous valve catheter can obviously prevent pulmonary valve regurgitation Calcification and failure of the same type valved tube should be prevented after operation.

Objective to investigate the evolutionary differences and clinical significance of hepatitis B virus (HBV) genotypes in chronic hepatitis B (CHB) patients from different ethnic groups. Methods Polymerase chain reaction (PCR) was used to amplify HBV pre-S2/S and C (core, C) genes in 50 CHB patients (25 CHB patients from ethnic minorities and 25 CHB patients from Han nationality) in Yunnan, China. The PCR amplification products were cloned into pBS vector (pBluescriptⅡSK, pBS) for sequencing analysis. Results The total length of HBV preS2/S gene in 50 patients was 846 bp, the GC content accounted for 49.1%, and encoded 281 amino acids (aa); The total length of C gene is 552 bp, the content of GC accounts for 46.1%, and it encodes 183 aa. It is registered in GenBank (AY517619, AY517620, AY517488, AY517489, AY517598, AY517599). By comparing with the HBV gene and subtype sequences in GenBank database, it was found that the HBV gene of all patients is highly homologous to ayw1 subtype, and the aa homology of preS2/S gene is 97.5% ~98.6%, and the aa homology of C gene is 94.5% ~97.8%. The S gene of all patients is arginine (AGA) at position 122 and lysine (AAA) at position 160 of "A" antigenic determinant aa. It was found that the HBV genotype of all patients is B (belonging to ayw1 subtype), and no other genotype was found. The frequency of HBV quasispecies was 4%. The difference of HBV genotype B between 25 minority CHB patients and 25 Han patients in the control group was not statistically significant (P>0.05). aa 124 arginine (R<There were aa mutations in T cell and B cell epitopes of 27~63,80~110,135~153 in 50 patients. In 45 patients, aa substitutions in V27, N38, V63, Q135 and A147 were caused by mutations in nt 1979A→G, nt 2012T→A, nt 2088G→T, nt 2304C→A and nt 2339A→G, respectively. The frequency of substitution was>1%. In 5 patients with severe CHB, aa substitutions in glycine (G87) and leucine (L97) were caused by mutations in nt 2159A→G and nt 2189A→C, respectively. No insertion or deletion of bases was found in the preS2/S and C genes of all patients. Conclusion The HBV epidemic strain in Yunnan minority area of China is genotype B (belongs to ayw1 subtype, including 25 minority CHB patients with genotype B). Genotype B has no correlation with different ethnic groups. HBV viral load can be used as an important parameter to judge the prognosis of CHB patients.

Objective to investigate the value of hyperfibrinogenemia and hyperuricemia in the joint assessment of the risk of acute coronary events. Methods 195 patients with acute coronary events (including unstable angina pectoris and acute myocardial infarction) diagnosed by coronary angiography and 69 patients without acute coronary events with normal coronary angiography were studied to analyze the difference of fibrinogen (FIB) level and uric acid, and the combined role of both in the risk of acute coronary events. Results the level of fibrinogen and uric acid in patients with acute coronary events was higher than that in the control group (FIB was 4.09 g/L ± 1.36 g/L and 3.52 g/L ± 1.37 g/L, P<Uric acid was 320 μ mol/L ± 91 μ mol/L and 302 μ mol/L ± 104 μ mol/L respectively, P>0.05). After excluding the influence of other factors such as age, sex, hypertension and diabetes, there was a meaningful regression relationship between fibrinogen level and the occurrence of acute coronary events, but uric acid level did not enter the regression equation.The combined assessment found that the risk of acute coronary events in patients with high fibrinogen level and high uric acid level was higher than that in patients with single increased index.Conclusion High level of fibrinogen and uric acid can promote the occurrence of acute coronary events together.

Objective to investigate the characteristics of ambulatory blood glucose profile in patients with impaired glucose tolerance (IGT) and newly diagnosed type 2 diabetes mellitus (T2DM) by dynamic blood glucose monitoring system (CGMS), so as to guide the formulation of reasonable intervention and treatment plans.Methods The CGMS data of 6 patients with normal glucose tolerance (NGT), 10 patients with IGT and 20 patients with newly diagnosed T2DM were analyzed. Results (1) With the worsening of glucose tolerance impairment, the mean blood glucose value, standard deviation of blood glucose value and the time percentage of blood glucose ≥7.8 mmol/L of CGMS increased gradually (all P<(2) The peak time of postprandial blood glucose in IGT group was 109 min±32 min postprandial, and the time of whole day blood glucose ≥7.8 mmol/L was 3.0 h±0.8 h; In the newly diagnosed T2DM group, the postprandial blood glucose peak time was 92 min±22 min, and the whole day blood glucose ≥11.1 mmol/L time was 12.6 h±1.3 h.In the IGT group and the newly diagnosed T2DM group, the blood glucose increase after breakfast was faster, the amplitude was higher and the duration was longer. Conclusion (1) CGMS can accurately show the dynamic blood glucose fluctuation law of IGT and newly diagnosed T2DM patients, which is beneficial to guide the formulation of targeted intervention and treatment plan. (2) The whole day blood glucose ≥7.8 mmol/L in IGT patients for about 3 h. (3) With the aggravation of glucose tolerance impairment, the postprandial blood glucose increase speed, the peak value increased, and the fluctuation amplitude of blood glucose curve increased gradually.

Objective to investigate the characteristics of class I and class II T cells in patients with chronic idiopathic thrombocytopenic purpura (ITP). Methods Peripheral blood of 30 patients with chronic ITP and spleen cells of 8 patients with chronic ITP and 6 patients with hereditary spherocytosis (patients undergoing splenectomy) were collected. The ratio of cytokine interferon γ (IFN-γ) /interleukin (IL) -4 in the cytoplasm of helper T cells (Th) CD4+ and cytotoxic T cells (Tc) CD8+ was detected by flow cytometry. The expression levels of T-bet and GATA-3 mRNA were detected by real-time quantitative polymerase chain reaction (PCR). Results the ratios of Th1/Th2 and Tc1/Tc2 in peripheral blood of patients with active disease (25.62 and 30.23) were significantly higher than those of normal controls (8.29 and 12.58, both P<0.01); The ratio of Th1/Th2 and Tc1/Tc2 in peripheral blood of patients in remission period (9.86 and 10.10) was not significantly different from that of control group. The ratio of Th1/Th2 in splenocytes of patients with ITP (41.46) was significantly higher than that of control group (16.30, P<0.01); The ratio of Tc1/Tc2 (35.80) was higher than that in the control group (16.88), but the difference was not statistically significant. The levels of GATA-3 mRNA in peripheral blood of patients with active disease and spleen cells of patients with ITP were significantly lower than those in the control group (0.20 and 0.34 times, both P<The expression level of T-bet mRNA in peripheral blood and spleen cells of ITP patients was not statistically significant compared with the control group (1.17 and 1.04 times compared with the control group). Conclusion ITP is an autoimmune disease with predominance of class I T cells. Promoting the transformation of class I T cells into class II T cells may provide a potential immunotherapy for ITP patients.

Objective to investigate the occurrence and outcome of hospital and community infections in hematology ward.Methods the bacterial and fungal infections occurred in 2388 hospitalized patients in hematology department of Peking Union Medical College Hospital from 1993 to 2004 were retrospectively analyzed.Results Among all hospitalized patients, 819 infections occurred (34.3%), including 237 community infections (9.9%) and 582 nosocomial infections (24.4%). In the community infection, parainfluenza bacilli (9 strains, 15%) and coagulase-negative staphylococci (9 strains, 15%) were the main sputum; Staphylococcus (9 strains, 28%) and Escherichia coli (9 strains, 28%) were the main fungi in blood. The fungi in nosocomial infection were more common than community infection, mainly Candida. In the past 12 years, Pseudomonas aeruginosa was the main sputum in nosocomial infection, while the proportion of Escherichia coli and Enterobacter cloacae in blood culture increased year by year; The proportion of Staphylococcus aureus in sputum and Klebsiella in blood in community infection increased year by year, and the proportion of fungal infection in all parts also increased year by year. 36 cases died from nosocomial infection (6.1%) and 9 cases died from community infection (3.8%, P =0.17). The mortality rate of community infection decreased gradually in recent years, but the mortality rate of nosocomial infection changed little. Conclusion The incidence of infection in hematology department is high, the proportion of nosocomial infection is higher than that of community infection, and the mortality rate is higher, and Gram-negative bacteria are the main, and there are many drug-resistant bacteria, and the proportion of fungal infection is high, and it tends to increase year by year.

Objective to screen polypeptides that specifically bind to gastric cancer peritoneal hypermetastatic cells by phage random peptide library, and to screen drugs and carriers for targeted therapy of tumor cells. Methods Three rounds of differential screening and enrichment were performed on human gastric cancer cell line GC9811 and its peritoneal hypermetastatic subline GC9811-P by phage random peptide library, and phage clones that are affinity to gastric cancer peritoneal hypermetastatic cells were obtained. The affinity of phage clones to GC9811-P and GC9811 cells was determined by enzyme-linked immunosorbent assay (ELISA), and the positive phage DNA was extracted and DNA sequence was determined. The polypeptide sequences that are affinity to gastric cancer peritoneal hypermetastatic cells were obtained and synthesized. The binding specificity of phage clones and synthesized peptides to gastric cancer peritoneal hypermetastatic cells in vivo and in vitro was identified by fluorescence staining and flow cytometry. Results The results of screening and ELISA showed that phage clones that specifically bind to GC9811-P cells and internalized into cancer cells were obtained. The sequencing results showed that 45% of the phages exhibited the same polypeptide sequence The results showed that SMSI was a specific binding peptide motif for hypermetastatic peritoneal cells of gastric carcinoma (P<0.01). The mean fluorescence intensities were 17.19±0.42 and 16.89±0.31 (mean of 3 samples in each group), respectively, compared with the mean fluorescence intensities of unrelated peptide PC (4.33±0.53) in the control group (P<0.01). The mean fluorescence intensities of the synthesized peptide were 23.58±0.71 and 24.95±0.15 (mean of 3 samples in each group), compared with the mean fluorescence intensities of unrelated peptide PC (4.16±0.24) in the control group (P<0.01). In vivo experiments in nude mice showed that the synthesized peptide could bind to tumor-forming tissues of GC9811-P cells but not to tumor-forming tissues of GC9811 and other cells The synthesized polypeptide has specific affinity for hyperperitoneal metastatic cells of gastric cancer, which provides an ideal marker and targeting vector with high specificity and sensitivity for further clinical diagnosis and treatment of early peritoneal metastasis of gastric cancer.

A 15-year-old male was admitted to the Fourth People's Hospital of Jinan City on May 9, 2005 due to congenital heart disease. He underwent Gleen's operation under general anesthesia on May 15. On the fifth day after the operation, he developed abdominal pain. When defecating, he found an anal drop and about 400 ml of blood in the stool, which was bright red. The anal drop was intestinal mucosa, rosy, about 10 cm. After manual reduction, the barium and rectal mass could not ascend when the barium enema was performed and the barium was seen to the proximal segment of the descending colon. The abdominal wall was pressurized, and the barium scattered on the intestinal lateral wall was seen to ascend about 9 cm until the colon and spleen area stopped (Figure 1).

A 16-year-old male was admitted to hospital due to intermittent rash and fever for 1 month and anuria for 3 days. One month ago, the patient developed a rash on the head, neck and arms within 24 hours after taking roxithromycin 0.25 g for the treatment of "scabies", which was itchy and faded after pressure, and gradually spread to the whole body. 28 days ago, he developed fever, and his body temperature was unknown. He was diagnosed as upper respiratory tract infection locally. After being treated with amikacacin and amoxicillin, his body temperature gradually increased to 38.6℃. The original rash area expanded and sclera was yellowed. Blood alanine aminotransferase (ALT) 121 IU/L, aspartate aminotransferase (AST) 63 IU/L, total bilirubin 35.4 μ mol/L, direct bilirubin 9.4 μ mol/L, and his renal function was normal. He was considered to be "measles with liver damage". He was treated with penicillin, Taineng, gamma globulin, ribavirin, antipyretic and analgesic drugs, methylprednisolone and other drugs. The body temperature was continuously high, up to 40℃, and the rash was worse than before.

Brain metastasis is a common distant metastasis of non-small cell lung cancer (NSCLC). The prognosis is usually very poor, and the natural course of the disease is generally not more than 2 months. Even if non-surgical treatment such as palliative radiotherapy and/or chemotherapy is taken, the median survival time is not more than 6 months [1]. Although there are literature reports that the comprehensive treatment of some selected cases with surgery can achieve long-term survival, there are still different opinions on the results of surgical treatment, surgical methods and factors affecting prognosis [1-6]. We made a retrospective analysis of 41 cases of non-small cell lung cancer with brain metastasis. The analysis of the results is reported as follows.

the 2nd China North-South lung cancer summit, jointly organized by the China cancer Foundation (CCRF), the Chinese Anti-Cancer Association (CACA), the lung cancer Diagnosis and Treatment Center of Capital Medical University, and the cancer Hospital of Chinese Academy of Medical Sciences, was held in Beijing on September 24, 2005.

February 2006<Stroke, 2006, 37:419-424 reported that endovascular recanalization therapy (ERT) is a relatively safe and effective option for Stroke patients who are not suitable for intravenous thrombolysis. It is increasingly used in the United States to treat acute ischemic Stroke.

<The journal Nature (2006, 439:248-249) reported on January 19th that the alarm bell of the mutation of avian influenza virus has sounded, and avian influenza has increased the threat to mankind. The report said that the short-term outbreak of avian influenza in Turkey has sounded the alarm bell to the world. Scientists from the National Institute of Medical Research (NIMR), a cooperative center of the World Health Organization in London, have identified three mutations in the sequence of avian influenza virus, of which at least two make the virus more adaptable to humans. These scientists are eager to know how the spread of these viruses in Turkey is different from the previous spread of avian influenza viruses in Asia, and they are particularly concerned about the possibility of avian influenza transmission between humans.

A 57-year-old female was admitted to the Department of Endocrinology of Shandong Provincial Hospital due to diabetes. After 8 days of hospitalization, she suffered from sudden abdominal pain at 5 a.m. Physical examination: body temperature: 38.6℃, painful appearance, forced posture, unpalpable and swollen superficial lymph nodes such as neck, flat abdomen, plate-like abdomen, tenderness and rebound pain in the whole abdomen, most notably in the lower abdomen, and the liver void boundary disappeared. Blood routine: hemoglobin: 89 g/L, white blood cells: 21.3×109/L, neutrophils: 0.91, blood glucose: 8.72 mmol/L, abdominal X-ray film showed free gas under the bilateral diaphragm, and the diagnosis result was upper gastrointestinal perforation. Then, the patient was transferred to general surgery for treatment, and the medical history was asked. The patient suffered from abdominal discomfort, dull pain, occasional severe pain, sometimes melena, and weight loss in the past half month, and denied any history of ulcer.

15-hydroxyprostaglandin dehydrogenase (15-PGDH) is widely distributed in human and mammalian gastrointestinal tract, lung and other normal tissues [1]. It can catalyze 15-hydroxyprostaglandin (PG) to become weakly active 15-keto PG, and can reduce carcinogens and procarcinogens [2]. Recent studies have shown that the loss or decrease of 15-PGDH expression is related to the occurrence and development of malignant tumors (such as intestinal cancer, lung cancer, etc.) [3-5], but the relationship between 15-PGDH and gastric cancer is still unclear.

high altitude polycythemia (HAPC) is a common chronic disease in groups under high altitude low atmospheric pressure and hypoxic environment.The pathogenesis of HAPC is manifested by the abnormal increase of the number of red blood cells per unit volume of circulating blood, and the consequent increase of hemoglobin (Hb) and hematocrit (Hct), which causes damage to all tissues and organs of the body, and even leads to the loss of life and labor ability of patients. Although many scholars at home and abroad have done a lot of research on HAPC, the pathogenesis of HAPC is still not elucidated. Many previous studies have suggested that HAPC has a direct correlation with erythropoietin (EPO). However, the current research results [1] have found that there is no statistically significant difference between EPO level of patients with Andean plateau polycythemia in South America and that of normal group. What role does EPO play in HAPC? Aiming at this problem, we have explored the relationship between EPO level and patients with Qinghai plateau polycythemia.

In recent years, it has been found that nuclear transcription factor kappa B (NF-κ B) is constitutively activated in many kinds of tumor cells, and it is closely related to the drug resistance of tumors [1-3]. P-glycoprotein (P-gp), the product encoded by MDR1 gene, is an energy-dependent transport pump, which can pump intracellular drugs out of the cell [4]. Therefore, overexpression of P-gp can reduce intracellular drug concentration, which is one of the important factors causing chemotherapy failure. Fluorescent dye Rho123 can be pumped out of the cell by P-gp as a substrate, resulting in a decrease in intracellular fluorescence distribution, which is often used to detect the function of P-gp ion pump. Recent studies have found that NF-κ B can bind to the first intron region of MDR1 gene, and specifically inhibit NF-κ B and reduce MDR1 expression by expressing NF-κ B inhibitor protein (I κ B α) in colorectal cancer cell lines [1].

The first branchial sulcus fistula, also known as congenital auricular and cervical fistula, is rarely seen in clinic and easy to be misdiagnosed and misdiagnosed. In treatment, the fistula is closely related to the facial nerve and parotid gland, and in some cases, the fistula is complicated, deep in location and many branches, so it is difficult to operate. Full understanding of this disease is beneficial to early diagnosis, complete removal of fistula and reduction of surgical complications.