Volume 88  ·   Issue 06  ·  2008

Lipotoxicity is one of the important causes of diabetes mellitus. We know that when nutrition is excessive, with the increase of adipocytes, the function of adipocytes appears abnormal, and the anti-lipolysis effect of insulin is weakened, resulting in the increase of free fatty acid (FFA) spillover;

Insulin resistance is not only one of the causes of diabetes, but also a common risk factor of hypertension, dyslipidemia and atherosclerosis. Obesity is one of the important causes of insulin resistance.

Objective To investigate the effects of intervention against gbacotoxicity on improvement of the function and pathological changes of islet β and α cells.Methods Thirty-six male Sprague Dawley rats were randomly divided into four equal groups:normal control(NC)group,fed with standard chow,high-fat(HF)group,fed with extra high-fat chow;diabetes mellitus(DM)control group,fed with high-fat chow for 8 weeks followed by 30 mg/kg streptozotocin iniection to establish DM models;and insulin(INS) group,treated with subcutaneous injection of long-acting insulin(glargine,0.5 U·kg-1·d-1)for 4 weeks after the establishment of DM models.48 h,2 weeks,and 4 weeks after the STZ injection to the 2 DM groups oral glucose tolerance test(OGTT)was performed to all rats.Peripheral blood samples were collected from the caudal vein.Serum insulin level was assayed by radioimmunoassay.Total serum cholesterol(TC) and triglyceride(TG)were measured by enzyme-colorimetric method.By the end of experiment the rats were killed with their pancreases taken out.Immunohistochemistry was used to observe the morphological changes of the islet β and α cells.β cell and α cell masses were calculated by the proportions of positive area in the islet.Proinsulin mRNA level was detected by RT-PCR.Insulin protein content in islets was detected by Western blotting.Results Four weeks after the insulin intervention against glucotoxicity,the fasting blood glucose and blood glucose 2 h after sugar-taking of the INS group were both significantly lower than those of the DM group(both P＜0.01).The relative β cell mass of the INS group was 0.38±0.08,significantly bigger,2.45 times,that of the DM group(0.11 ±0.05,P＜0.01).The relative α cells mass in islets of the INS group was 0.16±0.04,significantly lower,by 43%,than that of the DM group(0.28±0.15,P＜0.01).The insulin contents in β cells of the INS group was 0.58±0.03,significantly higher,by 70.6%,than that of the DM group(0.34±0.14,P＜0.01).The proinsulin mRNA level of the INS group was 1.52±0.14,significantly higher,by 20.6%,than that of the DM group.Conclusion The morphology of islet β、α cells in diabetic rats was improved by four weeks of Intervention against glucotoxicity improves the pathology of islet β and α cells in diabetic and insulin synthesis.

Objective To investigate the impact of single nucleotide polymorphisms(SNPs)in APPL1 gene on body fat and its distribution.Methods 590 unrelated Shanghai residents of Han nationality,including 358 subjects with normal glucose tolerance(NGT)and 232 subjects with type 2 diabetes mellitus(rT2DM),underwent measurement of body mass index(BMI),waist circumference(W),hip circumference(H),and femoral circumference(F).Peripheral blood samples were collected to detect the blood sugar,blood lipids,fasting C-peptide(FCP),fasting insulin(FINS),fasting plasma glucose (FGLU),total cholesterol(TC),and triglyceride(TG)0 and 120 minutes after glucose challenge.Polymerase chain reaction-restriction fragment length polymorphism was used to detect the 2 SNPs (rs3806622 and rs4640525).Results No differences in the frequencies of rs3806622 and rs4640525 genotypes between the subjects with the BMI＜25 kg/m2 and those with the BMI≥25 kg/m2 either in the NGT group or T2DM group.The G allele frequencies of the rs3806622 and rs4640525 genotypes in the T2DM patients with longer W values were significantly higher than those in the patients with shorter W value (OR=2.26,95%CI 1.05-4.86,and OR=4.13,95%CI 1.21-14.09).The W values of the T2DM subiects with G alleles were significantly higher than those of the T2DM subjects without G alleles after adjustment of age,sex,and BMI(all P＜0.05).Stepwise regression analysis showed that in addition to sex and BMI,rs4640525 was also an associated factor of waist circumference(all P＜0.05).Conclusion SNPs(rs3806622 and rs4640525)in APPL1 gene are correlated with body fat distribution in T2DM.

Objective To investigate the effects of visfatin gene overexpression on insulin sensitivitv in insulin-resistant(IR)rats induced by high-fat diet.Methods The recombinant visfatin Dlasmid was constructed and transfected into IR rats induced by high-fat diet.The euglycemic hyperinsulinemic clamp experiments were performed for evaluation the change of insulin sensitivity before and after administration.Results The expression plasmid of visfatin were successfully constructed.After 3 days for plasmid injecting,plasma visfatin levels and glucose infusion rates were significantly increased(2.19±0.36 vs 0.98±0.27 and 32.6±1.2 vs 24.0±1.2 mg·kg-1·min-1,respectively,all P＜0.01),and total cholesterol and high-density lipoprotein cholesterol(HDL-C)were significantly decreased(2.36±0.22 vs 1.60±0.21 mmol/L and 1.41±0.24 vs 0.88±0.11 mmol/L,respectively,all P＜0.05)in high-fat diet rats.Conclusion The transfection of visfatin plasmid enhanced plasma visfatin level and improved insulin sensitivity in IR rats induced by high-fat diet.

Objective To investigate the effects of intense pulse light(IPL)on the mRNA expression of type Ⅰ procollagen in human fibroblasts.Methotis Four healthy female subjects aged 19-41,underwent IPL on the back skin 3 times with an interval of 2 weeks.Before the IPL and after 1,2,and 3 times of treatment samples of back skin were obtained to undergo real time quantitative PCR to detect the mRNA expression of type Ⅰ procollagen.Results The mRNA expression level of type Ⅰ procollagen after one time of IPL treatment was [(4.7±1.0)× 10-1],not significantly different from that before treatment [(2.1±0.7)×10-1,P=0.100].The mRNA expression levels of type Ⅰ proeollagen after treatment for 2 times and 3-time were(7.9±1.7)×10-4 and(11.1±2.4)×10-4 respectively,both significantly higher than that before treatment(both P＜0.05).Conclusion Promoting the mRNA transcription of type Ⅰ procollagen in dermal fibroblasts,IPL therapy is effective in dermal remodeling and wrinkle removing.

Objective To investigate the diagnostic and treatment methods of pancreatogenic portal hypertension and to summarize the experience in surgical treatment of these patients,especially in dealing with the complications and sophisticated eases.Methods Twenty-six patients with pancreatogenic portal hypertension,19 males and 7 females,aged 37(29～57),underwent pericardial vessel ligation and splenectomy during the period from January 1990 to November 2006 and were followed up for 8 years(2～15years).The clinical data were analyzed.Results Seven patients received Roux-en-Y operation for huge pancreatogenic cysts and 3 patients received regional dissection operation of diaphragmatic muscle for severe adhesion.One died of acute myocardial infarction 5 days after the operation,and 25 patients were cured without recurrence during the follow-up.Conclusion Pericardial vessel ligation and splenectomy are rational and reliable methods to treat pancreatogenic portal hypertension.The key issue is how to diagnose pancreatogenic portal hypertension correctly and deal with its complications reasonably.

Objecfive To explore the effects of treatment of unresectable pancreatic tumors by radiofrequency ablation(RFA)with"cool-tip needle".Methods 18 patients with unresectable pancreatic tumors,8 with pancreatic head carcinoma and 10 with pancreatic body and tail carcinomas,12 males and 6females,aged 66.2,underwent RFA under laparotomy for 3 times and simultaneous infusion of iced normal saline.The clinical data were retrospectively analyzed.Results The level of CA19-9,a tumor marker,returned to normal after RF in 2 patients.Back pain was alleviated in 14 patients.B mode ultrasonography or CT examination showed decrease of tumor volume in 14 patients after RF.Pancreatic fistula occurred in 3 patients(16.7%)and then healed smoothly in 7～10 days with after routine abdominal drainage.The mortality was 22.2%(4/18).In the 4 death cases,tumors were all located in the pancreatic head;three patients died suddenly of massive gastrointestinal hemorrhage at Days 4,30,and 40 days postoperative respectivelyafter RF and the other patient died of acute renal failure at Day 2 postoperatiVedays after RF.8patients died 1～8 months after RF.After 51 months,1 patient still survived.Conclusion RFA is effective in relicving the back pain for in unresectable pancreatic tumor patientsis efficiently relieving the back pain.Standard use of cool-tip RFA is dangerous for pancreatic head tumor carcinoma close to portal vein,but safe for those located in the body and tail of the pancreas.Making the Infusion of icedcooling-water flow via a gastric tube into the duodenum and changing change of the parameters of the RF system can reduce the associated complications.

Objective To investigate the prevalence of osteoporosis in patients undergoing maintenance dialysis and explore the safety and efficacy of salmon calcitonin in maintenance dialysis patients underwent with osteoporosis.Methods Double-energy X-ray bone density meter was used on 256 patients undergoing maintenance dialysis,126 males and 130 females,aged 60±14(22-79),to measure the bone mineral density (BMD)at the lumbar spine and femoral neck.108 of them with the T values＜-2.5 s were diagnosed as with osteoporosis,and then were randomly divided into 2 equal groups matched in baseline age,sex,mode of dialysis,and levels of iPTH,ALP,and BMD:control group receiving oral administration of calcium carbonate 1500 mg tid and rccaltrol 0.25 μg qn for 18 months,and experimental group,received subcutaneous injection of salmon calcitonin(50 U)three times a week in addition.The BMD levels of lumbar spine and femoral neck,and serum intact parathyroid hormone(iPTH),calcium,phosphorus,and alkaline phosphatase(ALP)were assessed before treatment and 3,6,12,and 18 months after treatment.Resuits (1)The osteoporosis rate of the 256 maintenance dialysis patients was 42.19%.(2)The osteoporosis rate of the 201 patients undergoing maintenance hemodialysis(MHD)was 47.76%,significantly higher than that of the 55 patients undergoing maintenance peritoneal dialysis(21.82%,P＜0.01).(3)At the end of the trial,there was a significant increase of BMD of lumbar spine and femoral neck in the experiment group compared with the control group.(4)Compared with the control group,the serum ALP,iPTH,and BGP levels 3,6,12,and 18 months after treatment were all significantly lower than the baseline level and those of the corresponding control groups(all P＜0.01).The serum calcium of the control group at the end of experiment increased significantly in comparison with baseline level(P＜0.05).(5)No adverse events were found after the treatment of salmon calcitonin.Conclusion Salmon calcitonin effectively increases the BMD of the maintenance dialysis patients and is well tolerated.

Objective To analyzed the indication and prognostic factors of surgical treatment of lung cancer invading left atrium and great vessels(T4).Methods We retrospectively reviewed the database of 136 T4 lung cancer(tumors invading left atrium and great vessels)patients who received surgqical treatment in Cancer Hospital of Chinese Academy of Medical Science (CAMS)from Setember 1981 to January 2007.There are 114 men and 22 women,the median age was 58 years(range 28-76).All patients were divided into three subgroups according to the invading site:tumor invading left atrium group,tumor invading superior vena cavagroup and tumor invading pulmonary artery group.All patients were divided into two subgroups according to the character of operation:complete resection group and incomplete resection group.Patients were divided into three subgroups according to pathological lymph node status:N0,N1 and N2 group.Results One hundred and thirty six lung cancer patients received resection of primary lesions plus arterioplasty of pulmonary artery(PA) (n=83)and/or angioplasty of superior vena cava (SVC)(n=21)and/or partial resection of left atrium(LA) (n=32).Complete resection was possible in 120 patients and 16 patients underwent incomplete resection.Five-year survival was 43.0%for entire group,52.8%for PA group,18.2%for SVC group and 18.4%for LA group.Factors significantly influencing the overall 5-year survival were the pathologic N status(5-year survival 15.1%for N2,5-year survival 44.9%for N1,5-year survival 74%for N0 group;N2 versus N1 versus N0,P=0.028)and the completeness of resection(5-year survival 37.5%for complete resection,5-year survival 22.4%for incomplete resection group;complete versus incomplete,P=0.042).Pathological lymph node status but not histology and character of operation was an independent prognostic factor using Cox regression analysis(P=0.01,RR=1.923,95%CI:1.172-3.157).Conclusion Pathological lymph node status is an independent prognostic factor for T4 lung cancer.Patients with pathological N0-1 lung cancer invading left atrium and great vessels (T4)may benefit from surgical treatment.In the preoperative workup,every possible effort should be made to achieve a careful evaluation of mediastinal lymph noda status.Compared with incomplete resection group,complete resection group may have a better prognosis.Tumor invading extrapericardial PA may be defined as T2.

Objective To investigate the impacts of RAD51G135C and XRCC3C241T genotypes on the response,adverse effects,and prognosis of acute myelocytic leukemia(AML).Methods RAD51 G135C,XRCC3 C241T,GSTF1,and GSTM1 genotypes were analyzed in 372 patients with AML,226 males and 146 females,by PCR-RFLP or PCR.The Complete remission(CR)rate,adverse effects,overall survival (OS),and relapse-free survival(RFS)were compared among the groups with different genotypes.Results (1)During the induction chemotherapy,XRCC3 C241T polymorphic allele was significantly associated with the shorter survival of the AML patients with t(t5;17)/PML-RARα(OR=8.750,P=0.046).Among the non-M3 patients,the complete remission(CR)rate of those with double RAD51G135C and GSTTl wild genotypes was 71.6%,significantly higher than that of those not with double RAD51 G135C and GSTF1 wild genotypes(54.4%,P=0.028).(2)The OS of the non-M3 AML patients with double RAD51G135C and GSTT1 wild genotypes was(39.1±7.1)months,significantly longer than those with double variant types [(22.4±3.2)months,P=0.042].The relapse-free survival(RFS)of the M4EO and M2 patients with double XRCC3C241T and GSTT1 wild type genotype were 48.3 months and 56.5 months,both significantl ylonger than those of the patients with double variant genotypes(28.8 months and 10.0 months respectively,both P＜0.05).The OS of the M2 patients with triple RAD51 G135C,GSqT1,and GSTM1 variant genotypes was(22.4±3.2)months,significantly shorter than those with triple RAD51 G135C,GSTT1,and GSTM1 wild genotypes[(39.1±7.1)months,P=0.042].The RFS of the M2 patients with triple RAD51 G135C,GSTT1,and GSTM1 variant genotypes was 10.0 months,significantly shorter than that of the patients with triple RAD51 G135C,GSTY1,and GSTM1 wild genotypes(64.2 months,P=0.015).(3)The risk levels of neutropenia,nausea and vomiting,and alopecia of the patients with variant XRCC3 C241T genotype were all significantly higher than those of the wild type genotype(all P＜0.05).The risk of hematuria of the patients with variant genotype was significantly higher than that of the patients with wild genotype(P=0.017).Conclusion The polymorphisms of XRCC3C241T and RAD51 G135C genes are significantly related to response to therapy,adverse effects,and prognosis of AML.Detection of the XRCC3C241T and RAD51 G135C genotypes may be useful in selecting individual chemotherapy regimens for patients with AML.

Objective To investigate the prevalence of aac(6')-Ib-cr gene in Enterobacter cloacae isolates.Methotis PCR and sequencing were performed on 81 strains of Enterobacter cloacae isolated clinically in Anhui province to identifv aac(6')-IB-cr gene. Disk diflusion method was used to test the susceptibility of the Enterobacter cloacae isolates with aac(6')-Ib-cr gene to fluoroquinolones,aminoglycosides,and other antimicrobial agents.AmpC and extended-spectrum β-lactamases(ESBLs)were detected by modified three-dimensional extract test,and the molecular typing was analyzed by ERIC-PCR.Resuits aac(6')-Ib-cr gene was identified in 3(3.7%)of the 81 Enterobacter cloacae isolates with different ERIC-PCR patterns.The isolates with aac(6')-Ib-cr gene were resistant to fluoroquinolones.aminoglycosides,chloramphenicol,ampicillin,cefoxitin,and second and third generation cephalosporins.Two of the 3 isolates produced AmpC and ESBLs,and 1 isolate produced only ESBLs.Conclusion aac (6')-Ib-cr gene is prevalent in Enterobacter cloaeae isolates with resistance to most of antimicrobial agents and no clone spread in found in them.

Objective To compare the expressions of PIAS3,an inhibitor of activated STAT3 protein in human androgen-dependent prostate cancer(ADPC)and androgen-independent prostate cancer (AIPC)and to explore the relationship between PIAS3 and the development of AIPC.Methotis (1)cDNA microarray technique was used to detect the PIAS3 gene in 20 samples of ADPC and 5 samples of AIPC obtained during operation.(2)Carcinoma of prostate(CaP)cells of the lines LNCaP,DUl45,and PC3 were cultured and underwent semi-quantitative RT-PCR and Western blotting to detect the mRNA and protein expression of PIAS3 gene.(3)Ten samples of ADPC tissue and 5 samples of AIPC tissue obtained during operation underwent immunohistochemistry to observe the expression of PIAS3 protein,Results (1)cDNA microarray technique showed that there were 17 genes significantly down-regulated and 22 were significantly up-regulated in the AIPC tissues in comparison with the AIPC tissues,(2)The mRNA and protein expressions of PIAS3 in the AIPC cells of the lines PC3 and DUl45 were higher than those in the ADPC cells of the line LNCaP.(3)The expression of PIAS3 protein in the AIPC tissues was significantly higher than that in the ADPC tissues(P＜0.05).Conclusions Our results suggested that PIAS3 gene may play an important role in the development of androgen independent prostate cancer so as to promote the continuous cellular proliferation without androgen.

Objective To explore if lysophosphatidic acid(LPA)can regulate the permeability of blood-brain barrier(BBB)and the possible mechanism.Methods Astrocvtes and blood microvascular endothelial cells (BMECs)of neonatal SD rat were co-cultured to establish BBB model in vitro.The BBB models were divided randomly into 3 groups:blank control group(Group C),LPA group(Group L,treated with LPA 10 μmol/L for 2 h),and Ro31-8220 plus LPA group.(Group Ro+L,pretreated with Ro31-8220,a selective protein kinase inhibitor 5 μmol/L for 2 h and then treated with LPA 10 μmol/L for 2 h).25I-bovine serum albumin(BSA)was added into the culture fluid of the BBB models and then the permeability of the BBB models was detected by γ-events-per-unit-time meter.The cells expressing PKC-α were detected by flow cytometry(FCM).Phalloidin staining and fluorescence microscopy were used to detect the expression of F-actin.The BBB-tight-junction(TJ)was observed by electron microscopy.The expression of claudin-5 was detected by Western blotting.Resuits The throughput of 125I-BSA of Group L was 364 cmp±15 cmp,significantly higher than those of the Group C and Group R0+L(184 cmp±10 cmp and 223 cmp ±9 cmp respectively,both P＜0.01).FCM showed that the rate of PKC-α expressing-BMECs of Group L was 77%±7%,significantly higher than those of Groups C and Ro+L(42%±4%and 52%±3%respectively,both P＜0.01).The claudin-5 expression of Group L was 0.035±0.004,significantly lower than those of Groups C and Ro+L(1.00±0.03 and 0.574±0.07 respectively,both P＜0.01).Phalloidin staining showed that a zone of F-actin filaments in Group C,intercellular spaces were seen in Group L,and F-actin filaments were recombined in Group Ro+L.Transmission electron microscopy showed that there was continuous high-density BBB-TJ in Group C,the BBB-TJ of Group L was obviously opened,and the BBB-TJ of Group Ro+L was partially opened at a lower degree.Conclusion LPA accommodates the BBB-TJ and the permeability of BBB via the activation of PKC-α channel which down-regulates the caudin-5 expression and F-actin recombination.

Objective To investigate the effects of Par-4 gene silencing induced by siRNA on the expression of Smac gene,activity of caspase-3,and apoptosis of human bone marrow mesenchymal stem cells (hBMSCs).Methods Bone marrow was obtained from a healthy young man and hBMSCs were isolated and cultured.Two siRNAs(Par-4-siRNA-1 and-2)targeting Par-4 gene were chemically synthesized.Eukaryocytic expression vectors containing these Par-4 siRNA sequences were established and transfected into the hBMSCs.The hBMSCs were divided into 4 groups:non-transfected hBMSCs(normal control group),blank Pae-4 plasmid transfected hBMSCs(Par-4 control group),Par-4-siRNA-1 transfected hBMSCs,and Par-4-siRNA-2 transfected hBMSCs.The expression of Par-4 mRNA was detected by real-time PCR.Another hBMSCs were inoculated in DMEM and divided into 4 groups:non-transfected normal hBMSCs,glutamate(an apoptosis inducer)+non-transfected hBMSC group,glutamine+Par-4-siRNA-1 hBMSC group,and glutamate+Par4-SiRNS-2 hBMSC group.Flow cytometry was used to detect the apoptotic rate.The relative activity of caspase-3 was determined by colorimetric assay-Western blotting was used to detect the Smac protein expression-Results The relative mRNA expression levels of Par-4 gene of the Par-4-siRNA-1 hBMSCs,Par-4 SIENA-2 hBMSCs,and Par-4 control hBMSCs were 0.12-4-0.03,0.33±0.09,and 0.97±0.02 respectively,decreased by 88%,67%,and 3%respectively compared with that of the normal control.The percentages of apoptotic cells of the glutamate+Par-4-siRNA-1 hBMSCs was (37.2±6.3)%,significantly lower than that of the glutamate+non-transfected hBMSC group[(58.9±8.9)%,F=58.26,P＜0.01).The Smac protein expression level of the glutamate+non-transfected hBMSC group was significantly higher than that of the normal control group(P＜0.01);however,the Smac protein expression level of the Par-4-siRNA-1 hBMSC group was significantly lower than that of the glutamate+non-transfected hBMSC group(P＜0.01).The caspase-3 activity of the glutamate+Par-4-siRNA-1 hBMSC group was significantly lower than that of the glutamate+non-transfected BMSC group(P＜0.01).Conclusion Par-4-siRNA-1 inhibits markedly the apoptosis of the hBMSCs induced by glutamate.Par-4 gene silencing induced by siRNA inhibits the apoptosis of hBMSCs.The mechanism of the inhibition may be closely related to suppression of the up-regulation of Smac gene expression and caspase-3 activity.

Objective To investigate the effects of HS1-associated protein X-1(HAX-1)on the lupus activity of MRL/lpr lupus-like mice.Methods Fifteen MRL/lpr mice were divided into 3 equal groups:Group A,injected with phosphate-buffered saline,Group B,injected intraperitoneally with control virus AdEGFP and Group C,iniected intraperitoneally with recombinant AdHAX-1 twice a week for 4 weeks.Peripheral blood samples were collected before the injection,and 2 and 4 weeks after the iniection to be detected the white blood cell count,antinuclear antibody(ANA),anti-double strand-DNA antibodies,circulating immune complex(CIC),anti-histone antibodies,and interferon(IFN)-γ.The level of urine protein was measured,too.Then the mice were killed,a kidney underwent direct immunofluorescence (DIF)to observe the deposition of Immune complexes,and the other kidney underwent periodic acid-Schiff (PAS)staining and pathological examination.MTF method was used to detect the proliferation of the lymphocytes in the spleen.Splenocytes were isolated from the other 15 MRL/lpr mice and then divided into 4 groups:Group,transfected with DMRIE-C without plasmid;Group E,as negative control group;Group F,transfected with blank plasmid pGenesil-1:and Group G,transfected with pGenesil-HAX-1.Forty-eight hours later MTY method was used to detect the proliferation rateof the spleen lymphocytes.Results The urine protein 1evel of Group C was significantly higher than those of Groups A and B(both P＜0.01).Four weeks later the levels of ANA,anti-double strand DNA antibodies,and IFN-γ were all significantly higher than those of Groups A and B (all P＜0.01).Hypercellularity and increased deposition of IgG in glomeruli were also observed in Group C.The score of glomemli lesion of Group C(1.50±0.34)was significantly higher than those of Groups A(0.67±0.14)and Groups B(0.81±0.26)(both P＜0.01).MTT method showed that the growth CHIVe of the spleen lymphocytes of Group C was higher than those of Groups A and B.The spleen lymphoeyte proliferation rate and the levels of IFN-γ of Group G was significantly lower than that of Group F (both P＜0.05).Conclusion One of the important factors in apoptosis regulation of SLE,HAX-1 may be involved in the pathogenesis of SLE,and the silence of HAX-1 may be beneficial for the improvement of SLE.

Objective To examine the effects of monocyte chemoattractant protein-1(MCP-1)on epithelial-myofibroblast transition(EMT)of renal proximal tubular epithelial cells and the possible mechanism involved.Methods Human renal proximal tubular epithelial cells of the line HK-2 were cultured and divided into three groups:negative control group;positive control group,treated with transforming growth factor(TGF)-β15 μg/L,and MPC-1 group,treated with MCP-10.1,1,10,and 100μg/L for 24 h,36 h,48 h,and 72 h respectively.Thc expressions of α-smooth muscle actin(α-SMA)mRNA and protein of cells were detected by s.Western blotting and RT-PCR were used to detect the expression of P-Erk1/2,Erk1/2,P-P38MAPK,P38MAPK,and RhoA protein levels of the HK-2 cells,and RT-PCR was used to detect the expression of RhoC and Snail mRNA.Specific inhibitors of the Erk,P38MAPK,and Rho signal transduction pathways PD98059,SB203580,and Y27632 were added into the culture fluid of HK-2 cells respectively,1 h later MCP-1 μg/L was added for 48 h,and Western blotting was used to detect the protein expression of α-small muscle actin(SMA).Resuits The expression levels of α-SMA protein and mRNA significantly increased in the MCP-1 treated HK-2 cells,and these expression levels were the highest in the HK-2 cells treated with MCP-11 μg/L for 48 h.The ratios of(P-Erk1/2)/(Erk1/2)and P-P38MAPK/P38MAPK were significantly increased(all P＜0.05)in the MCP-1 treated HK-2 cells with the highest ratios seen in the HK-2 cells treated bv 100 μg/L of MCP-1.The expression levels of RhoA protein and RhoC mRNA of the HK-2 cells stimulated with MCP-1 of different concentrations were not significantly difierent (all P＞0.05).MCP-1 jnduced expression of a-SMA was only partly inhibited by PD98059 but not by SB203587 or Y27632.MCP-1 dose-dependently increased the expression of Snail mRNA of the HK-2 cells compared with those of the negative control cells.The level of Snail mRNA was the highest in the HK-2 cells treated with 100 μg/L MCP-1.Conclusion MCP-1 may induce the EMT of renal proximal tubular epithelial cells in vitro,and this effect may involve upregulation of Erk1/2 Map kinase signal pathways and Snail mRNA expression.P38 MAPK or Rho kinase signal pathways can not be proven to be involved in MCP-1 induced EMT.

The patient was a 21-year-old Han nationality soldier of a fire brigade of Shanghai Armed Police. He was admitted to the hospital on 23 December 2006 due to chest tightness, shortness of breath and syncope three times after activity. The patient suddenly felt chest tightness when going downstairs on the afternoon of 18 December 2006, followed by loss of consciousness, refused to respond to the call, and woke up by himself after about 2 minutes.

In the past 10 years, public coverage of medical problems has become more and more common. While most reports focus on medical quality, some institutions such as hospitals or insurance companies have begun to pay attention to how to evaluate medical efficiency. What methods can be used to properly evaluate medical efficiency and how can these evaluation results be correctly used?

Spinal fractures are the most common osteoporotic fractures. There are 700 000 cases of spinal fractures per year in the United States, and the prevalence of spinal fractures in women over 50 years of age is 35% to 50%. Women with low bone mineral density (BMD) and those with initial spinal fractures have a higher probability of recurrent spinal fractures in the short term, but the absolute risk of long-term spinal fractures is currently unknown.

Urinary tract infection (UTI) is a common disease in pediatrics, and if ignored, it can lead to renal dysfunction. It can be seen that accurate diagnosis of urinary tract infection is crucial. In order to clarify the role of different symptoms and signs in accurate diagnosis of urinary tract infection in infants and young children, Nader Shaikh from the Department of Pediatrics, University of Pittsburgh School of Medicine and his colleagues searched the relevant articles published in MEDLINE and EMBASE databases from 1966 to 2007. In addition, they reviewed all the references of articles that met the inclusion criteria, one previously published systematic review and three clinical skills textbooks, and exchanged opinions with two experts in this field. Finally, a total of 6988 possible relevant articles were found, of which only 12 articles met all the inclusion criteria.

neuroglobin (NGB) belongs to the family of hemoglobin-like proteins. It was first discovered by Burmester et al. [1] in 2000. Because it is mainly expressed in brain tissue, it is called "cerebroglobin". A series of subsequent studies have found that it plays an important role in the physiological processes such as oxygen uptake, transport and utilization of nervous system, and also plays an important role in the adaptive response of nervous system to hypoxia. Its expression increases in hypoxic injury and central system ischemia experiments, and the lower its content, the worse its tolerance to hypoxia.

Insulin resistance and decreased islet β cell function are two key factors in the pathogenesis of type 2 diabetes mellitus (T2DM), but the etiology and pathogenesis of T2DM have not been fully elucidated. In recent years, numerous evidences have shown that the levels of oxidative stress and endoplasmic reticulum stress (ERS) in different tissues of diabetes mellitus are increased, and both of them can play an important role in insulin resistance through the activation of c-Jun N-terminal kinase (JNK) pathway.

A 47-year-old male was admitted to the hospital due to chest tightness and shortness of breath for 5 months and aggravated for 20 days. Five months ago, he had no obvious trigger of chest tightness, shortness of breath, palpitation and facial edema. He was diagnosed as "hypertrophic cardiomyopathy" and was discharged after diuresis and symptomatic treatment.