Volume 88  ·   Issue 30  ·  2008

At 14: 28 on May 12, 2008, an earthquake of magnitude 8.0 occurred in Sichuan, affecting more than 20 provinces and cities in China. A large number of buildings in Wenchuan and other counties collapsed and were razed to the ground. Statistics show that 69,196 people were killed, 18,381 people were missing, 374,176 people were injured, and 46,240,000 people were affected by the disaster. The CPC Central Committee and the State Council acted quickly and mobilized the national strength to resist the earthquake. Facing the sorrow of life, they united as one, showing the uncrushable national soul of the Chinese nation.

Editor's Note Dr. Calverley is Professor of Respiratory Medicine at the University of Liverpool, England, and Honorary Consultant of Aintree Hospital, University of Liverpool. His main research areas are pathophysiology and treatment of chronic obstructive pulmonary disease, sleep and respiratory diseases, and he is an internationally renowned clinical researcher ISOLDE (Inhaled Steroids in Obstructive Lung Disease) and TRISTAN (Trial of Inhaled Steroids and Long-acting beta 2-agonists) The principal investigator of.

Chronic obstructive pulmonary disease (COPD) is a respiratory disease that seriously endangers human health. It has become a serious public health problem worldwide with a large number of patients, heavy socio-economic burden and high mortality rate.

Objective To study the relationship between the downregulated expression of secretory leukocyte proteinase inhibitor (SLPI) in human bronchial epithelial cells and transforming growth factor (TGF)-β1 /Smads pathway. Methods Normal human bronchial epithelial cells of the line HBE were cultured and divided into 4 groups: TGF-β1 stimulation group stimulated by TGF-β1, interference group preincubated with Smad4 siRNA and then stimulated by TGF-β1, interference control group preincubated with negative siRNA and then stimulated by TGF-β1, and normal control group. Forty-eight hours later immunocytochemistry was used to observe the SLPI positive staining in the cells, and the protein and mRNA expression levels of Smad4 and SLPI were detected by Western blotting and RT-PCR respectively. Results Immunocytochemestry showed that the Smad4 staining was strongly positive in the TGF-β1 stimulation group and interference control group, and the SLPI staining was strongly positive in the normal control group, positive in the interference group, and only weakly positive in the TGF-β1 stimulation and interference control groups. The protein and mRNA expression levels of Smad4 in the HBE cells of the TGF-β1 stimulation group were 1.18±0. 17 and 1.33±0.16 respectively, both significantly higher than those of the normal control group (0.29±0.06 and 0.31±0. 07 respectively, both P <0.01 ) and interference group (0.27±0.08 and 0.34±0.09 respectively, both P < 0.01 ). The protein and mRNA expression levels of SLPI in the HBE cells of the TGF-β1 stimulation group were 0. 17 ± 0. 10 and 0. 11 ± 0. 05 respectively, both significantly lower than those of the normal control group (1.29±0.21 and 0.83±0.13 respectively, both P <0.01 ), and those of the interference group ( 1.22±0.18 and 0.81±0.11 respectively, both P < 0.01 ). There were no significant differences in the expression levels of Smad4 and SLPI between the TGF- 131 stimulation group and interference control group. Conclusion TGF-β1 downregulates the SLPI expression in human bronchial epithelial cell via Smads pathway.

Objective To investigate if type Ⅱ alveolar epithelial cells express Toll-like receptor 4( TLR4 ) and to investigate the role of TLR4 in airway inflammation of chronic obstructive pulmonary diseases (COPD). Methods A549, the line of human type Ⅱ alveolar epithelial cells were cultured and divided into 3 groups: normal control group, E1A+ group transfected with adenovirus E1A plasmid, E1A- group transferred with blank plasmid without adenovirus E1A. Lipopolysaccharide (LPS) of the concentrations of 0, 0. 1, 1, and 10 μg/ml, IL-1 β of the concentrations of 0, and 0. 1 ng / ml, and cigarette smoking extract (CSE) of the concentrations of 0, 10%, 20 %, and 40% were used to stimulated the A549 cells for 12 and 24 h. Reverse transcription polymerase chain reaction was used to detect the mRNA expression of IL-8 and TLR4. Western blotting was used to detect the protein expression of nuclear factor κB (NF-κB) subunit P65. Results Twenty-four hours after the stimulation of 10 μg,/ml LPS, 0. 1 ng/ml IL-1β, and 20% CSE, the IL-8 mRNA expression of the E1A+ group was 2.82, 1.87, and 4.70 respectively, all significantly higher than those of the normal control group (0. 95, 0.78, and 1.02 respectively, all P<0. 05) and those of the E1A- group (0.97, 0.81, and 1.12 respectively, all P<0.05). Twelve and twenty-four hours after the stimulation of 10 μg/ml of LPS, the TLR4 mRNA expression of the E1A + group were 4.52 and 7.99, both significantly higher than those of the normal control group ( 1.91 and 3.81 respectively, both P < 0. 05 ) and these of the E1A- group (2.00 and 3.88 respectively, both P < 0.05 ). IL-1β increased the expression of TLR4 mRNA too, but CSE did not change the expression of TLR4 mRNA in all these groups. LPS, IL-1β, and CSE all increased the expression levels of NF-κB subunit P65 protein. Conclusions Pulmonary type Ⅱ epithelial cells express TLR4. LPS and IL-1β up-regnlate the release of IL-8 which may be mediated via the activation of NF-κB induced by TLR4.

Objective To compare the difference in the ventilatory equivalent for carbon dioxide (EqCO2 ) between the patients with chronic obstructive pulmonary disease (COPD) and normal adults at maximal exercise, and to identify the factors inducing the abnormal change of EqCO2 in COPD patients. Methods Forty male COPD patients and fifteen normal males underwent symptom-limited cardiopulmonary exercise testing. Oxygen uptake and carbon dioxide output were measured breath-by-breath. Arterial blood samples were collected at maximal exercise to undergo gas analysis so as to calculate the dead space/tidal volume ratios ( VD/VT ) and alveolar-arterial PO2 difference [P(A-a)O2]. Results The maximal oxygen uptake, maximal carbon dioxide output, and arterial partial pressure of carbon dioxide (PaCO2) of the COPD patients were (14.8±3.6) ml·kg-1· min-1, (19.4±5.9) ml·kg-1· min-1, and (87.6± 13.9) mm Hg respectively, all significantly lower than those of the normal controls [( 18.9 ± 4.2) ml· kg-1· min-1 , (25.3±7.1 ) ml·kg-1· min-1, and ( 113.9±13.6) mm Hg respectively,all P <0.01]; and the EqCO2, PaCO2, P(A-a)O2, and VD/VT of the COPD patients at maximal exercise were 33.0±5.1, (43.5±3.1 ) nun Hg, (43.5±3.1 ) mm Hg, 0.33 +0.12 respectively, all significantly higher than those of the normal controls [28.5±2.6, (39.6±4.9) mm Hg, (12.6±6.3) mm Hg, and 0.26±0.07 respectively, P < 0.01, P < 0.01, P < 0.01, P < 0. 05]. Multiple regression analysis showed that EqCO2 was significantly positively correlated with VD/VT at maximal exercise in the COPD patients ( r = 0.57,P < 0.01 ). Conclusion Increased VD/VT may play an important role causing increase in EqCO2 during exercise in patients with COPD.

Objective To investigate the expression of toll-like receptor-2 ( TLR2), TLR4 on the CD14 + monocytes of patients with stable chronic obstructive pulmonary disease (COPD) and healthy smokers, and to explore the role of TLR2 and TLR4 in COPD pathogenesis. Methods Thirty COPD patients without evidence of acute exacerbation, 21 healthy smokers, and 25 healthy non-smokers underwent measurement of forced expiratory volume in 1 second ( FEV1 ) % predicted and FEV1/forced vital capacity (FVC) by spirometry. The expression of TLR2 and TLR4 surface molecules on human CD14 + monocytes was assessed using fluorescence activated cell sorter analysis by flow cytometry, expressed as relative mean fluorescence intensity (rmfi) and relative positive cell percent (rpcp), and the correlation of TLR expression with lung function parameters was analyzed. Results The rmfi and rpcp of TLR2 on CD14 + monocytes of the COPD patients were (6.3 ± 1.4) % and (52.9±20.5 ) % respectively, both significantly lower than those of the healthy smokers [(8.2 ± 2.2) % and ( 73.5 ± 19.0) % respectively]and those of the nonsmokers [(11.0 ±2.4)% and (82.8 ± 17.9)% respectively, all P<0.01)]. The rmfi of TLR4 of the COPD patients was 2.2 ± 0.9, significantly lower than that of the nonsmokers (3.0 ± 0.5, P < 0.01 ) , while similar to that of the healthy smokers (2.5 ± 0.6, P 0.05 ). The rpep of TLR4 of the COPD patients (M = 1.3% , Q1 - Q3 : 0.7% - 2.4% ) was significantly lower than that of the healthy smokers ( M = 4.7%,Q1 -Q3: 2.7% -9.4%, P<0.01) and nonsmokers (M=5.3%, Q1 -Q3: 2.6% -8.4%, P< 0.01 ). The rmfi of TLR2 and TLR4 on CD14 + monocytes of the healthy smokers was lower than that of the nonsmokers (P <0.05), while the rpcp of TLR2 and TLR4 on CD14 + monocytes of the healthy smokers was similar to that of the nonsmoker ( P < 0.05 ). The expression of TLR2 and TLR4 on monocytes was positively correlated with the lung function parameters, including FEV1% predicted and FEV1/FVC (all P < 0.01 ). Conclusions The expression levels of TLR2 and TLR4 on CD14 + monocytes of the stable COPD patients and healthy smokers decreased significantly. The innate immune response may be depressed in the COPD patients and smokers, and the down-regulation of TLR is associated with reduced lung function parameters.

Objective To investigate the relationship between beta2-adrenoceptor (β2-AR)expression in inflammatory cells and airflow limitation in patients with chronic obstructive pulmonary disease (COPD). Methods According to the severity of COPD,37 patients with stable COPD were divided into three groups. Samples of peripheral blood and induced sputum were collected from 37 COPD patients, 11 of Ⅱ grade, 12 of grade Ⅲ, and 14 of grade Ⅳ. Counting and classification of white blood cells in the peripheral blood and induced sputum were made. Radioligand binding assay was used to detect the maximum binding capacity (Bmax) reflecting the density, and balance dissociation constant (Kd) reflecting the affinity of β2-AR in the peripheral blood mononuclear cells (PBMC) from both kinds of specimens. Thirteen normal smokers were used as control group. Results No significant differences were found in peripheral blood leukocyte count, classification and induced sputum cell count among the 3 COPD groups and control group, but the neutrophil cell count levels of induced sputum of the COPD groups were all significantly higher than that of the control group (all P = 0.00). For the control, and COPD grade Ⅱ , Ⅲ, and Ⅳ groups, the Bmax levels of PBMC β2-AR were ( 106 ± 52), ( 156 ± 72), ( 135 ± 57) and ( 123 ± 58) fmol/mg respectively ( F = 1.45, P = 0.24) ; the Kd levels of PBMC β2-AR were ( 548 ± 267 ), (343 ± 144), (297 ± 150), and (375 ± 95 ) pmol/L respectively ( F = 4.84, P = 0.01 ) ; the Bmax levels of β2-AR of induced sputum cells were ( 126 ± 46), ( 116 ± 54 ), ( 106 ± 36 ), and ( 76 ± 30 ) respectively ( F = 3.46,P =0.02) ; and the Kd levels of β2-AR of induced sputum cells were (570±290), (405±197), (404 ± 139), and (347 ± 123) respectively (F=2.97,P =0.04). There was a positive correlation between the forced expiratory volume in one second in percentage of predicted and density of β2-AR in induced sputum cells from the COPD patients ( r = 0.43, P = 0.01 ). There was a positive correlation between the Bmax of β2-AR in PBMC and induced sputum cells ( r = 0.40, P = 0.02 ). Conclusions The expression of β2-AR in PBMC and induced sputum cells from COPD patients is down-regulated with progression of the disease. The expression of β2-AR in the induced sputum cells changes more significantly than that in the PBMC. The expression of β2-AR in inflammatory cells in the airway may play a more important role in the COPD progress.

Objective To evaluate the effect and timing of continuous blood purification (CBP) in treatment of acute renal failure (ARF) following cardiac-vascular surgery. Methods Twenty-five patients with ARF following cardiac-vascular surgery were divided into systematic inflammatory response syndrome (SIRS) Group (n = 13) and multiple organ dysfunction syndrome (MODS) Group (n = 12) according to the illness state prior to CBP and were divided into Group A (n = 5, with the APACHE Ⅲ score prior to CBP≤60), Group B (n = 9, with the APACHE Ⅲ score 61 - 90), and Group C (n = 11, with the APACHE Ⅲ score 90 ) . All of the 25 patients underwent continuous veno-venous hemofiltration (CVVH). Before and 24h after the CVVH APACHEⅢ score was calculated and [peripheral; blood samples were collected to detect the levels of blood urea nitrogen (BUN) and serum creatinine (Scr) and the plasma levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-or (TNF-α). Results The APACHEⅢ score, BUN, Scr, IL-6, IL-8, and TNFα 24 h after the CBP of the 25 patients were 61±15 retool/L, (19±5) mmol/L, (312±87) μmol/L, (544±154) ng/L, (18±7) ng/L, and( 43±15 )ng/ L respectively, all significantly lower than those before CBP (81±20, 26± mmol/L, 458 ± 107 μmol/L, ( 842 ± 132) ng/L, (25 ± 8) ng/L, and (59 ± 17 ) ng/L respectively, all P =0.000). The survival rate of SIRS Group was 84.62%, significantly higher than that of MODS Group (41.67%, P < 0.05 ). The APACHEⅢ score, and the levels of BUN, Ser, IL-6, IL-8, and TNF-α of Group MODS were significantly higher than those of Group SIRS. The higher the level of Scr, IL-6, IL-8, and TNF-α and the APACHEⅢ score the lower the survival rate. Conclusion CBP has a positive effect on ARF following cardiac-vascular surgery. The APACHEⅢ score 60 to 90 reflects an opportunity to treat the ARF following cardiac-vascular surgery using CBP.

Objective To explore the proportion, clinical and laboratory features, chemotherapy responses and long term survival of different kinds of newly diagnosed multiple myeloma (MM) in China. Methods The clinical data of 223 cases of newly diagnosed MM patients were gathered in the First Affiliated Hospital of Sun Yat-sen University from Jan, 2000 to Seb, 2007 were retrospectivley analyzed. Results The proportions of each kind of MM including IgG, IgA, light chain, IgD, IgM and biclonal MM were 48.0% ,20. 6% ,25.6% ,4.0% ,0. 9% and O. 9% respectively. No IgE and nonsecretary myeloma was found. The median age of onset was 58 years, of which that of the lgA type was the oldest one and the light chain type was the youngest (P = 0. 004). Bone pain, renal insufficiency, and anemia were the most common symptoms which accounted for 67. 7% ,61.0% and 45.3% respectively. The incidences of renal inadequacy, hypercalcemia and pathological fracture in light chain type were higher than those in IgG and IgA types. Besides, no M protein were found in serum protein electrophoresis and no elevation of total globulin. The cinical features of IgD type were similar to that of the light-chain type. The total chemotherapy efficacy rate of 89 patients who were treated with more than 3 cycles in our hospital is 61.8%, which has no difference in all types. Median overall survival of the 89 patients was 33.0 months. Conclusion IgG is the most common type in MM. Bone pain, anemia, hypercalcemia and renal insufficiency are common symptoms. Immunofixation electrophoresis should be performed routinely to avoid missed diagnosis of light-chain and IgD types of MM.

Objective To investigate the preliminary efficacy and safety of bosentan, a dual endothelin-receptor antagonist, in Chinese pulmonary arterial hypertension (PAH) patients. Methods 21 patients with PAH, idiopathic or associated with congenital heart disease or connective-tissue disease received 62.5 mg of bosentan twice daily for 4 weeks, and then 125 mg twice daily for 8 weeks if without serious side effects. At week 12, the patients underwent 6 min walk test, hemodynamic variables examination, right heart catheterization, ultrasound cardiography, and electrocardiography. Results The six-minute walking distance 12 weeks after bosentan treatment was 461 m ± 84 m, significantly longer than that before the therapy ( 374 m ± 113 m, P < 0.001 ). The pulmonary vascular resistance 12 weeks after the bosentan treatment was (1236±729) dyn · s-1· cm-5, significantly lower than that before [(1440±766) dyn·s-1· cm-5, P = 0.007]. The cardiac index 12 weeks after the bosentan treatment was ( 3.02 ±1. 71 ) L·min-1· m2, significantly higher than that before treatment [(2.35 ± 1.20) L·min-1·m2 , P = 0. 002]. No patient was withdrawn from this study for safety reason. Conclusion Improves the exercise capacity and hemodynamic parameters in Chinese PAH patients; bosentan is safe in treating PAH and can be well tolerated.

Objective To investigate which sperm retrieval technique is suitable for the non-obstructive azoospermia (NOA) patient, and to identify the relevant predictive parameters. Methods Literatures on NOA patients who had undergone sperm retrieval and pathological examination of testis were identified from Cochrane Library, CNKI and Medline ( 1990 to 2008) and analyzed. Results Twenty-five articles were enrolled. When testicular fine needle aspiration (TEFNA) was compared with testicular sperm extraction (TESE), the sperm retrieval rate of the former was 23.0%, significantly lower than that of the latter (52.2%, RR: 0.49,95% CI: 0. 41-0.60, P < 0. 05 ) ; and when TESE was compared with micro-surgical testicular sperm extraction (mTESE), the sperm retrieval rate of the former was 35. 7% ,significantly lower than that of the latter (54.6%, RR: 0. 70,95% CI: 0. 50-0.98,P <0.05). Sperm retrieval rate was closely correlated with the testicular pathological category of the NOA patients. The sperm retrieval rates of the patients with hypospermatogenesis ( HS ) , maturation arrest ( MA), and Sertoli cell only syndrome (SCOS) were 76.7%, 46.2%, and 32.8% respectively (RR: 1.65, 2.40, 1.50; 95% CI: 1. 21-2.91, 1.85-6.90, 1.02-2.26, P<0.05). Conclusion mTESE is the best sperm retrieval technique. A better to choice before deciding the treatment program of NOA patients is to identify the testicular pathological category in the NOA patients, and then to predict the outcome of TESE before assisted reproduction technology.

Objective To retrospectively investigate the safety and efficacy of mycofenolate mofetil(MMF) in combination with cyclosporine A (CSA) or tacrolimus (FKS06) in the treatment of graft-versus-host disease(GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods 44 patientswith various hematological diseases underwent allo-HSCT: 23 received transplant from HLA-matched siblings and 21 from mismatched related donors. The conditioning regimens included modified busalphan plus cyclophosphamide (Cy) regimen for the patients diagnosed as with leukemia and myelodysplastic syndrome (MDS), and Cy plus antihuman thymocyte globulin (ATG) for severe aplastic anemia (sAA). Cyclosporine A (CsA), short term methotrexate (MTX), and MMF were used for the prophylaxis of GVHD for all patients. Acute GVHD (aGVHD) and chronic GVHD (cGYHD) were diagnosed according to the international commonly accepted GVHD diagnostic criteria. MMF was added to the standard C-sA/FK506 with prednisone (PSE) as either the first line therapy, or the second line salvage therapy. Results 15 patients were diagnosed as with aGVHD, and 29 with cGVHD. MMF was administrated as a first-line therapy drug in 19 patients and as a second-line therapy drug in 25 patients. For aGVHD the overall response rate was 80% with a complete response (CR) rate of 33.33% and a partial response (PR) rate of 46.66%. The response rates were 70% and 100% respectively for the first line and second line therapy. In 58.3% of the responsive patients the daily dose of PSE could be reduced. For chronic GVHD the overall response rate was 86.2% with a CR rate of 41.37% and a PR rate of 44.83%, and the response rate were 100% and 84.21% for the first and second line therapy respectively. PSE taper was realized in 70.83% of the responsive patients. Side effects occurred in 7 patients, all reversible. The infectious complication rate was 34.09%, only one patient died of interstitial pneumonia. The follow-up of 22 months ( 10 ～ 65 months) showed that 36 patients (81.82%) survived. Conclusion MMF combined with CSA/FKS06 is effective and well-tolerated in treatment for aGVHD and cGVHD.

Objective To investigate the effects of tandem mass spectrometry (MS/MS) combined with gas chromatography mass spectrometry (GC-MS) in the diagnosis of inborn errors of metabolism in children. Methods Amino acids and acylcarnitines in the dry blood filter papers were tested by MS/MS, and the organic acid profiles in urea were tested by GC-MS among 4981 children suspected to be with inborn errors of metabolism from more than 100 hospitals in China. A few pediatric patients underwent analysis of activity of enzyme and gene mutation analysis too. Results 319 of the 4981 children (6.4%) were diagnosed as with 24 kinds of diseases: 155 of the 319 cases (48.6%) with 8 kinds of amino acid diseases (97 with hyperphenylalaninemia, 14 with maple syrup urine disease 13 with ornithine transcarbamylase deficiency, 13 with citrullinemia type Ⅱ, 10 with tyrosinemia type Ⅰ , 5 with citrullinemia type Ⅰ ,2 with homocystinuria, and 1 with arginasemia) ; 150 of the 319 cases (47.0%) were diagnosed as with 10 kinds of organic acidemias (81 with methylmalonic acidemia, 17 with propionic acidemia, 17 with multiple CoA carboxylase deficiency, 11 with glutaric acidemia type Ⅱ, 8 with isovaleric acidemia, 6 with β-keto thiolase deficiency, 5 with 3-methylcrotonyl-CoA carboxylase deficiency, and 3 with 3-hydroxy-3-methylglutaryl-CoA lyase deficiency) ; 14 cases (4.4%) were diagnosed as with 6 kinds of fatty acid disorders (5 with medium chain acyl-CoA dehydrogenase deficiency, 3 with very long chain acyl CoA dehydrogenase deficiency, 2 with short chain acyl-CoA dehydrogenase deficiency, 2 with multiple acyl-CoA dehydrogenase deficiency, 1 with carnitine palmitoyl transferase type Ⅱ , and 1 with carnitine palmitoyl transferase type Ⅰ ). Conclusion MS/MS is specific for amino acid diseases and fatty acid disorders. GC-MS is specific for detect organic acidemias. And the diagnoses of part of amino acid diseases need the combination of both methods.

Objective To investigate whether copolymer-1 (Cop-1), a synthesized analogue of myelin basic protein, can protect the retina ganglion cells (RGCs) and possible mechanism thereof. Methods Vortex veins of rats were ligated to induce an increase of intraocular pressure (IOP) so as to establish glaucoma models. 106 rat models were randomly divided into 2 equal groups: Cop-1 Group undergoing subcutaneous injection of 200 μg Cop-1, and phosphate buffered solution (PBS) Group undergoing PBS injection as controls. Fluorogold was used to retrogradely label the RGCs. 10, 17, 24, and 31 days after the immunization some rats were killed with their eyeballs taken out. The fluorogold positive spots were calculated. Anti-rat T cell receptor (TCR) monoclonal antibody was used to mark T cells in the retina. Results 17, 24, and 31 days after the immunization, the RGC density of the Cop-1 Group were (2617 ± 17)/mm±2, (2588±206) /mm2, and (2394± 15)/mm2 respectively , all significantly higher than those of the PBS Group [(2357±37)/mm2, (2277±340)/mm2, and (2129 ± 17)/mm2 respectively, all P<0.05]. 10,17,24, and 31days after the immunization the numbers of T cells in the retina of Cop-1 Group were (11.3±2. 8)/mm2, (36. 7±5.2)/mm2, (33.9±3. 0)/mm2, and (21.4±5.9)/mm2, all significantly higher than those of PBS Group (4.7±3.6) /mm2, ( 19.7 ± 2.4)/mm2, ( 15.3 ± 4.0)/mm2, and (13.3± 4.4)/mm2 respectively, all P < 0.01 ). Conclusion Cop-1 protects RGCs. The injury of RGCs induced by increased lOP results in congregation of T cells. Cop-1 increases the number of T-lymphocyte eells congregating in the retina, which may be related to its neuropretection.

Objective To investigate whether endostatin, a potent antianglogenic agent, synergizes with doxorubicin to suppress human hepatocellular carcinoma (HCC). Methods An endostatin expression plasmid, Endo-cDNA3.1, was constructed and transfected into COS-1 cells. Human HCC cells of the line HepG2 and human umbilical vein endothelial cells of the line HUVEC were cultured and stimulated by the supernatant of the COS-1 cells transfected with Endo-pcDNA3.1 and doxorubicin of different concentrations. MIT method was used to detect the proliferation of the cells. ( How many ) BALB/c mice were inoculated with HepG2 cells to establish HCC models, and then divided into 4 groups to undergo intratumoral injection of pcDNA3.1, End-pcDNA3.1, doxorubicin, or doxorubicin + Endo-pcDNA3.1. Other mice were used as untreated control group. Two weeks later 5 mice from each group were killed with the tumors taken out. Immunostaining was used to calculate the microvessel density and Western blotting was sued to detect the expression of endostatin, hypoxia-inducible factor (HIF) and vascular endothelial growth factor (VEGF). Results The proliferation of the HUVEC cells, but not that of the HepG2 cells, transfected with Endo-pcDNA3.1 + doxorubicin was inhibited. Doxorubicin dose-dependently inhibited the proliferation of both HUVEC and HepG2 cells. Endostatin was strongly expressed in the cells treated with Endo-pcDNA3.1 the tumor size of the Endo-pcDNA3.1 and doxorubicin groups were ( 1545 ± 180) mm3 and (953 ± 250) mm3 respectively, both significantly lower than that of the untreated and pcDNA3.1 groups [(2360 ± 330) mm3 and (2235±268) mm3, respectively, all P < 0. 01], and the tumor size of the Endo-pcDNA3. 1 +doxorubicin group was (426 ± 87) mm3, significantly lower than any other groups ( all P < 0.01 ). The number of microvessels of the Endo-pcDNA, doxorubicin, and doxorubicin + Endo-pcDNA3.1 groups were all significantly less than those of the pcDNA3.1 and untreated groups ( P < 0.05 or P < 0. 01 ). The expression of HIF-1αwas downregnlated in the Endo-pcDNA3.1 and Endo-pcDNA3.1 + doxorubicin groups, but not in the doxorubicin group. The VEGF expression was down-regulated in the Endo-peDNA3. 1, doxorubicin, and Endo-pcDNA3.1 + doxorubicin groups, especially in the latter. Conclusion Endostatin gene therapy synergizes with doxorubicin to suppress HCC.

Renal colic caused by ureteral calculi is the most common emergency in urology. Since January 2006, the People's Hospital of Longchuan County, Guangdong Province has used Hale (tamsulosin hydrochloride) combined with indomethacin to embolize the anus to treat terminal ureteral calculi, and the curative effect has been achieved, which is reported as follows.

Adult congenital megaureterosis is also known as congenital functional obstruction of the terminal ureter. It is relatively rare in clinic. From February 1992 to July 2002, 16 cases of adult congenital megaureterosis were diagnosed and treated in our hospital. The clinical manifestations, diagnosis and treatment of this disease are discussed as follows.

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by incompletely reversible airflow restriction; Airflow restriction is progressively aggravated, which is related to the abnormal inflammatory response of lung to harmful gases or particles [1]. The imbalance of oxidation and antioxidation, chronic inflammation, protease and antiprotease imbalance and abnormal apoptotic activity are closely related to the pathogenesis of COPD.

As the most ideal natural food for infants, breast milk is not only easy to absorb all kinds of nutrients, but also rich in antibodies and immune cells, which is very important for the psychological, intellectual and physical development of infants. The time of exclusive breastfeeding for infants is generally 6 months. Worldwide, the most common respiratory diseases of infants and young children in winter are mostly caused by virus infection.

Standard triple therapy, including proton pump inhibitor (PPI) combined with amoxicillin, clarithromycin or metronidazole, has been recognized as the first-line treatment for eradicating Helicobacter pylori (Hp) infection. However, with the increasing resistance rate of metronidazole and clarithromycin, the eradication rate of standard triple therapy has gradually decreased, and even dropped to below 75% in some areas. Therefore, it is urgent to seek new eradication strategies and drugs. In recent years, Italian scholars have proposed a new method for eradicating Hp, 10-day sequential therapy, but its efficacy and safety are still controversial.