Volume 88  ·   Issue 36  ·  2008

Primary liver cancer (hereinafter referred to as liver cancer) is a common malignant tumor in China.In recent years, the clinical application of various new technologies has made more options for the treatment of liver cancer, but at the same time, it is also faced with the problem of how to rationally apply various treatment methods and comprehensive application of various methods.Comprehensive treatment of liver cancer refers to the use of more than one method and drug at a certain treatment stage in a planned way in the whole treatment process of liver cancer patients, and the sequential application of different treatment methods and drugs at different treatment stages.It includes three meanings, one is the comprehensive treatment of resectable liver cancer before and after operation, so as to achieve the purpose of preventing and treating the recurrence of liver cancer; The second is the palliative surgery for the liver cancer that cannot be radically resected, combined with further treatment after operation, the purpose is to relieve the pain of patients and prolong the survival time of patients; The third is the comprehensive treatment of non-surgical patients, with the aim of second-stage resection and prolongation of tumor-bearing survival.

Objective to investigate the expression of c-jun-activation-domain binding protein(JAB1)in hepatocellular carcinoma(HCC)and the clinicopathoiogic significance thereof.Methotis Immunohistochemistry was used on 76 specimens of HCC tissues and native liver tissues adjacent to the HCC tissues,and 10 specimens of normal liver tissues near the liver angioma to detect the expression of JAB1 and the cell proliferative factor Ki67.Results The expression rate of JAB1 in the HHC tissues was 68.85%,significantly higher than that in the adjacent liver tissues and normal fiver tissues hear liver angioma(38.72% and 34.36% respectively,both P＜0.001).The expression of JAB1 was correlated with the histological difierentiation,serum alpha-fetoprotein level,and metastasis(P=0.000,0.015,and 0.000),but not with gender,age,tumor size,serum HBsAg,and existence of necrosis and cirrhosis.The expression rate of Ki67 protein in the HCC tissues was 41.45%,significantly higher than that in the adjacent liver tissues and normal liver tissues near liver angioula(2.11% and 2.01% respectively,both P＜0.001).There was a positive correlation between JAB1 and Ki67(P＜0.001).Conclusion JAB1 is highly expressed in HCC and may play an important role in the oncogenesis and development of HCC.JAB1 may be used as a marker for neoplastic change in liver cells and thus has potential clinicopathologic value.

Objective To analyze the short-term and long-term effectiveness of radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)in the treatment of hepatocellular carcinoma(HCC).Methotis The clinical data of 114 HCC patients,104 males and 10 females,aged 55(30-81),treated by RFA combined with TACE and followed up for 20(1-82)months were analyzed.Results Complete necrosis was achieved in 101 patients(88.6%).10 patients showed incomplete necrosis and 3 patients showed new neoplasm.and they all underwent repeated RFA or TACE.No therapy-relative death was found.The overall 1-,2-,3-,4-,and 5-year survival rates were 90.4%,82.6%,73.2%,63.5%,and 49.1% respectively.The 1-,2-,3-,4-,and 5-year tumor progression-free survival rates were 77.1%,64.6%,54.6%,46.8%,and 36.4% respectively.The overall 1-,2-,3-,4-,and 5-year survival rates for the tumors with the size≤5 em and the tumors with the size of 5.1-7 cm were 95.5%,84.6%,73.1%,61.5%,and 50.6% and 80.2%,64.9%,56.3%,45.3%,and 39.5% respectively(P=0.041).The overall 1-,2-,3-,4-,and 5-year survival rates for the solitary tumor and multiple tumors(no more than 3 tumors)were 95.8%,89.1%,78.1%,67.1%,and 56.7% and 80.0%,60.6%,46.6%,33.4%,and 21.5% respectively(P=0.001).The levels of albumin and α-fetoprotein,and boundary and number of tumors were proved to be independent risk factors of survival.Conclusion RFA combined with TACE is an effective treatment for HCC with satisfactory short-term and long-term effects,especially for the patients with tumor of the size of 5.1-7 cm or multiple lesions.

Objective To investigate the effects of epigalloeateehin-3-gallate(EGCG)on human hepatocellular carcinoma(HCC)cells and mechanism thereof.Method Human HCC cells of the lines HepG2 and SMMC-7721 were cultured and treated with of EGCG of the concentrations of 6.25,12.5,25,50,100,200,and 400 μg/ml respectively for 24 h and 48 h.The cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT)assay.Trypan blue staining was used to count the cells.Flow cytometry was conducted to detect the cell apoptosis.The protein levels of Bcl-2,an anti-apoptosis factor,and cyclooxygenase-2(COX-2),an up-regulator of Bcl-2.The activities of caspase-9 and caspase-3 hat promote the apoptosis of HCC cells,were measured using colorimetric method.RT-PCR was used to dmect the mRNA expression of COX-2 and Bcl-2 family.Results The viabilities of the HepG2 and SMMC-7721 cells treated with EGGG of the concentrations of 50-400 μg/ml for 48 h reduced to 93.8%±2.8%.62.3%±5.4%,33.9%±2.5%,and 17.6%±3.2% respectively,all significantly lower than that of the control group[(100.0%±2.8%),all P＜0.05];and the viabilities of the SMMC-772 cells treated with EGCG of the concentrations of 50-400 μg/ml for 48 h reduced to 49.6%±3.5%,30.3%±3.8%,17.7%±2.2%,and 13.0%±2.5%respectively,all significantly lower than that of the control group[(100.0%±0.8%),all P＜0.05].After treatment with 100 μg/ml EGCG for 24 h,48 h,72 h,and 96 h,the live HepG2 cell numbers were(8.0±1.5),(22.0±3.1),(37.0±5.4),and (61.0±8.7)104 respectively,all significantly lower than those of the control cells[(15.0±2.5),(45.0±5.3),(86.0±11.0),and(210.0±23.0)104 respectively,all P＜0.05];and the live SMMC-7721 cell numbers were(7.0±2.2),(13.0±2.5),(20.0±3.7),and(31.0±4.0)104 respectively,all significantly lower than those of the control cells[(15.0±2.5),(45.0±5.3),(86.0±11.0),and(210.0±23.0)104 respectively,all P＜0.05].The apoptotic rates of HepG2 cells treated with EGCG of the concentrations of 50,100,and 200 μg/ml for 12 h were 8.7%±0.4%,18.1%±1.1%,and 22.1%±1.8% respectively,all significantly higher than that of the control group(3.3%±0.3%,P＜0.05);and the apoptotic rates of SMMC-7721 ceHs were 5.9%±0.3%,7.8%±0.6%,and 12.2%±0.8% respectively,all significantly higher than that of the contrel group(3.7%±0.4%,P＜0.05).After treatment with EGCG of the concentrations of 100 and 200 μg/ml for 12 h,the caspaae-9 activities of the HepG2 cells increased to(1.8±0.4)and(2.5±0.4)respectively,both significantly higher than that of the control group(1.0±0.1.both P＜0.05);and the caspase-3 activities of the HepG2 cells increased to(2.0±0.4)and(2.8±0.5)respectively,both significantly higher than that of the control group(1.0±0.2.P＜0.05);and the caspase-9 activities of the SMMC-7721 cells increased to(1.7±0.4)and(2.5±0.4),both significantly higher than that of the control group(1.0±0.1,both P＜0.05),and the caspase-3 activities of the SMMC-7721 cells increased to(1.9±0.4)and(2.6±0.3)respectively,both significantly higher than that of the control group[(1.0±0.2),both P＜0.05].When the concentration of EGCG was over 200μg/ml,it down-regulated the expression of COX-2 and Bcl-2 in both cell lines,however,ECCG resulted in no significant changes of Bcl-xl,Bax,Bad,and Bid.Conclusion EGCG induces apoptosis in HCC cells through down-regulation of COX-2 and Bcl-2 and consequently activating caspase-9 and caspase-3.

Objective To summarize the diagnosis and treatment of breast lumps in childrenMetMds The clinical data of 61 children with breast lumps,20 with physiological breast masses,5 male and 15 female,aged 1-14,38 with benign tumors,1 male and 37 female,aged 10-14,3 with malignant tumors,aged 7 months,and 10 and 13 years.diagnosed and treated 2001-2006 were analyzed.Results The 20 cases of physiological masses did not undergo any treatment and were followed up for 2 years.The masses disappear by itself within one year in 17 cases,disappear within 2 years in 2 cases,and remained the same size in 1 case.The 38 cases with benign tumors all underwent regection,36 cases were cured and 2 cases recurred.Recurrence Was not seen in 2 of the 3 cases of malignant breast tumors,and the patient of liomyosarcoma died one year after the operation.Conclusion Physiological breast masses in children needn't treatment;mostly enjoy spontaneous cure.The outcomes of benign breast tumors in children are good after operation.Malignant breast tumor is rage,and it is still difficult to predict its prognosis now.

Objective To evaluate the safety and efficacy of Firebird drug-eluting stent(DES)combining Tirofiban and Cypher DES combining Tirofiban in patients with acute coronary syndrome(ACS).Methods 323 ACS patients were divided into 2 general conditions-matched groups:Firebird group(n=161)undergoing Firebird DES implantation and Tirofiban intravenous injection 10μg·kg-1 within 3 minutes followed by Tirofiban 0.15 μg·kg-1·min-1 intravenous maintenance infusion with micro pump for 36 hours,and Cypher group(n=162)undergoing Cypher DES implantation and Tirofiban.The safety was observed instantly and 36 h after the implantation.The patients were followed up for 30 d.Some patients in the Firebird group underwent coronary angiography and intravascular ultrasound because of angina and part of target vessels underwent revaseularizition.Results There were no significant difierences between the 2 groups in ejection fraction target coronary lesion type,blood platelet count,HB and HCT before treatment.The success rates of operation were both 100% in these 2 groups.No complication occurred in both groups.There were not significant difiefences in the blood platelet count.hemoglobin.hematocrit,acute stent thrombosis rate(1.2% vs 1.2%),acute myocardial irffarction rate(1.3% vs 1.3%),target vessel revaseularization rate(0.6% vs 1.3%),and rehospitalization rate(1.3% vs 0.7%)(all P＞0.05).30 d no in-stent restenosis was found by angiographic and intravascular ultrasound follow-up in the Firebird group.Condusion Firebird DES combining Tirofibun and Cypher DES combining Tirofiban are both safe and effective in treating ACS.

Objective To evaluate the effect of testosterone replacement thempy in patients with hypogonatrophic hypogonadism(HH)on insulin sensitivity and high sensitivity C reactive protein(hsCRP).Methods 21 males with HH,aged 15-30,and 18 age,and BMI-matched healthy males underwent detection of homeostasis model assessment insulin resistance index(HOMA-IR).Second,the values of weight,abdominal circumstance,gips strength,body composition,total testosterone(TT),fast blood glucose and insulin,serum lipid profile,and hsCRP were compared before and after 9-month testosterone replacement therapy in the HH patient group.Results(1)Before treatment the TT level of the HH patients WAS(0.9±0.6)nmol/L,significantly lower than that of the healthy control group(18.8±3.2)nmol/L.The fast insulin level of the HH patients was(16.0±9.8)mIU/L,significantly higher than that of the control group[(8.4±3.3)mIU/L,P=0.018].The HOMA-IR of the HH patient was 3.7±2.4,not significantly different from that of the control group(1.8±0.7,P=0.021).(2)After testosterone therapy,the fast insulin level of the HH patients decreased from(16.0±9.8)mIU/L to(12.1±7.4)mIU/L(P=0.03);the HOMA-IR decreased from(3.7±2.4)to(2.7±1.7)(P=0.045);and the total cholesterol,LDL-c,HDL-c,and Triglyceride all decreased,but not significantly(all P＞0.05).The hsCRP decreased from(1.49±1.18)mg/L to(0.70±0.56)mg/L(P=0.025).Conclusion Short period of testosterone replacement therapy in young HH male patients significantly improves the insulin sensitivity and decreases the risk of cardiovascular disease.

Objective To evaluate the efficacy of r oxaliplatin plus 5-fluorouracil/leucovorin calcium(LV)combined with concurrent radiotherapy in the treatment of local advanced gastric cancer.Methods 83 patients with local advanced gastric cancer were randomized into 2 groups.Group Ⅰ(n=40)underwent irradiation at the dose of 40-45 Gy 5 times a week on the primary tumor and the lymph nodes with the size≥10 mm in short axis,and receiving intravenous drip of OXA 85 mg/m2 for 2 h,intravenous injection of LV 200 mg/m2,and then intravenous injection of 5-fu 300 mg/m2,followed by continuous intravenous infusion of 5-fu 500 mg/m2,for 22 h,with 2 weeks as a cycle.Three cycles of chemotherapy were given during the radiotherapy.Then operative evaluation was conducted.Those resectable underwent operation and then 3 cycles of adjuvant chemotherapy.Those un-resectable underwent continuous 3 cycles of chemotherapy.Group Ⅱ(n=43)received only chemotherapy.The treatment was repeated until disease progression or prohibitive toxicity.Results 38 patients were evaluated in Group Ⅰ,the result showed complete remission(CR)in 4 patients(10.5%),partial remission(PR)in 23(60.5%),no-change(NC)in 7(18.4%),progressive disease(PD)in 5(13.2%),with the remission rate(RR)of 71%(27/40).42 patients were evaluated in Group Ⅱ,the result showed CR in 3 patients(7.14%),PR in 16(14.3%),NC in 13(30.9%),and PD in 9(26.2%)with the RR of 45%(19/43).The resection rates of Groups Ⅰ and Ⅱ were 32.5% and 27.9% respectively(P=0.649).The R0 resection rates of Groups Ⅰ and Ⅱ were 77.8% and 57.1% respectively(P=0.161).The mean survival times of the resectable patients in Groups Ⅰ and Ⅱ were45 months and 28 months respectively,and the 2-year overall survival(OS)of the resectable patients in Greups Ⅰ and Ⅱ were 65.8% and 56.3% respectively(P=0.371).The mean survival times of the un-resectable patients in Groups Ⅰ and Ⅱ were 14 months and 9 months respectively,and the 2-year OS rates of the un-resectable patients in Groups Ⅰ and Ⅱ were 28.3% and 20.7% respectively(P=0.017).The toxic and adverse effects included gastrointestinal and hematological toxicity.There was no treatment-related death.Conclusion Radiotherapy combined with concurrent chemotherapy may be an effective and well-tolerated regimen in patients with advanced and metastatic gastric cancer.

Objective To investigate the changes of the concentration of serum adiponectin in patients of chronic pulmonary heart disease(CPHD)with cardiac failure.Methods Thirty-eight CPHD patients with cardiac failure underwent conventional treatment,and were divided into 2 subgroups:remission subgroup(n=32)and non-remission subgroup(n=6)according to the therapeutic effects 2 weeks later.Peripheral blood samples were collected from these 38 CPHD patients(CPHD group),including the remission subgroup and non-remission subgroup,and 30 healthy persons(as normal control group).Enzyme linked immunosorbent assay(ELISA)was usedto detect the serum levels of adiponectin,interleukin(IL)-6,and tumor necrosis factor(TNF)-α before and 2 weeks after treatment.Results The serum adiponectin of the CPHD group was(9.5±7.1)ng/L in general,significantly lower than that of the normal control group[(21.5±9.0)ng/L,P＜0.01].The serum adiponectin of the remission group was(17.0±6.3)ng/L,significantly higher than that of the non-remission group[(8.1±4.8)ng/L,P＜0.01],but still significantlv lower than that of the normal control group(P＜0.05).The IL-6 and TNF-α levels of the CPHD group were(50.0±17.6)and(53.8±16.2)ng/L respectively,both significantly higher than those of normal control group[(24.4±9.1)and(28.4±11.4)ng/L respectively,both P＜0.01].The IL-6 and TNF-α levels of the remission group were(29.0±12.1)ng/L and(32.3±13.5)ng/L respectively,beth significantly lower than those of the non-remission group[(56.0±16.0)and(59.3±19.1)ng/L respectively,both P＜0.01],but not significantly different from those of the normal control group.There were no significant differences in the adiponectin,IL-6,and TNF-α levels between the non-remission group and the CPHD group.Conclusions Adiponeetin is involved in the pathophysiological process of heart failure in the CPHD patients.It may be a useful index to guide treatment and judge prognosis by dynamically determining the seruln adiponectin.

Obiective To analyze the inheritance character of type 2 diabetes mellitus(T2DM)pedigrees.Methods 4468 persons from 715 T2DM pedigrees(including the spouses)undergo peripheral blood sample collection to examine blood sugar and physical examination.Questionnaire survey was conducted to explore the family history.Type 1 DM and maturity-onset DM of young people were to be ruled out.Pedigree chart were made.Results The prevalence rates of 12 DM and impaired glucose regulation(IGR)wsa 47.62%,including 218 T2DM and 422 IGR newly discovered.The prevalence rates of T2DM and IGR were 38.33% and 14.25% in the siblings,and 56.81% and 12.58% in the parents,all significantly higher than those in the second-degree relatives(9.55% and 6.10%)and spouses(10.57% and 9.55% respectively,all P＜0.01).The prevalence and newly discovered rates of IGR in the offspring were 12.46% and 11.73% respectively,both significantly higher than those in the spouses(9.55% and 9.55% respectively,all P＜0.01).Conclusion There is significant familial aggregation in T2DM.The first-degree relatives of T2DM patients are high risk populations,so long term monitoring and early screening should be performed.

Objective To explore the characteristics and prognostic significance of molecular cytogenetic aberrations in Chinese patients with chronic lymphocytic leukemia(CLL)and the significance thereof in diagnosis of CLL.Methods A panel of probes(LSI D13S319,LSI p53,LSI ATM,CEP 12,LSIMYB,and LSI IGHC/IGHV)and interphase fluorescence in situ hybridization(FISH)were used to prospectively detect the cytogenetic abnormalities in 106 CLL patients,82 males and 24 females,aged 62(34-86).Results Molecular cytogenetic aberrations were found in 79 of the 106 CLL patients(74.5%)and 35 patients(33.0%)showed more than two kinds of abnormalities.The most frequent abnormality detected was del(13q14)in 48 cases(45.3%),followed by trisomy of chromosome 12 in 27 patients(25.5%),IgH translocation in 25 patients(23.6%),del(17p13)in 17 patients(16.O%),del(11q22)in 11 patients(10.5%)and del(6q23)in 5 patients(4.7%).The Del(13q14)rate of the group younger than 60 was 56.5%,significantly higher than that of the group aged≥60(36.7%,P=0.033).There was no significant relationship between molecular cytogenetic aberrations and sex and Binet stages(both P＞0.05).Kaplan-Meier survival analysis showed that the survivat time was shorter in the patients with p53 or ATM gene deletion.Patients with sole Del(13q14)had longer survival time than those with other abnormalities.Conclusion The frequencies of the chromosomal abnormalities in Chinese CLL patients are similar to those in Western countries.Panel FISH has greatly increased the sensitivity of cytogenetic analyses.Del(13q14)is the most frequent abnormality in CLL.Molecular cytogenetie aberrations detected with FISH have important prognostic significance in CLL.

Objective To investigate the role of Luxs gene on the regulation of virulence factors in Salmonella typhimuriumn.Methods Luxs gene knock-out strain of Salmonella typhimurium of the line 14028S was constructed.Media with Luxs gene knock-out 14028S or wild type 14028S bacteria were added into the media of cultured human intestinal epithelial cells of the line Caco.The numbers of colony formation unit(cfu)were calculated so as to compare the invasion abihty.Northern blotting was performed to examine the Luxs gene expression.Results When the 14028S cells were in the early logarithmic phase the cfu number was 590,and in the middle and late logarithmic,and stationary phases,the cfu numbers were 246,57,and 13 respectively.The Luxs gene expression levels increased gradually along with the bacterial growth into different phases.The cfu number A600nm=0.25 of the Luxs gene knock-out strain was 597,significantly higher than that of the wild type(315,P＜0.05).Conclusion Luxs gene may be a negative regulator on the invasion ability of Salmonella typhimurium.

Objective To investigate the effect of platelet rich plasma(PRP)on the regeneration of injured cavernous nerve(CN).Methods Blood was collected from the hearts of 6 SD rata to prepare PRP.24 male adult rats were randomly divided into 3 equal groups:pure suture group undergoing bilateral CN transaction and pure suture immediately,PRP group undergoing bilateral CN transaction+suture+PRP 200 μl to the site of suture,and sham operation group.3 months later intracavernous pressure(ICP)was measured by CN electrostimulation and then samples of CN were obrained to undergo pathological examination.Results 3 months later after surgery,the ICP of the pure suture group was(46±8)cm H2O,significantly lower than that of the sham group[(109±13)cm H2O,P＜0.01],and that of the PRP group was(94±13)cm H2O,significantly higher than that of the pure sutured group(P＜0.01),however,still significantly lower than that of the sham operation group(P＜0.05).The number of axons of CN in the PRP group was(121±16),significantly higher than that of the pure sutured group(70±14,P＜0.01);however,still significantly lower than that of the sham operation group(181±21,P＜0.01).Conclusion PRP can promote the regeneration of injured CN and the recovery of erectile function.

Objective To explore the effect of syndecan-1(Sdc-1)in the pathogenesis of colitis.Methods Thirty BALB/c mice were forced to drink 4% dextran sodium sulphate(DSS)in distilled water as the sole source of drinking fluid for 7 days,distilled water for 10 days,and 4% DSS in distilled water for another 7 days so as to establish colitis models and then were randomly divided into 3 equal groups:model groups 1,2,and 3 to be killed 8,18,and 25 days after the DSS drinking respectively to take their colons.Another 10 mice were fed with distilled water as control group and were killed on Day 8.Microscopy was used to evaluate the histological score of the colon.RT-PCR was used to detect the expression of Sdc-1 mRNA and IL-1 mRNA in the colon mucosa.Immunohistochemistry was conducted to detect the Sdc-1 protein level.Results The histological scores of the 3 model groups were all significantly higher than that of the control group(F=448.717,P＜0.01)and the score was the highest in the model group 1 and then gradually decreased.There was not significant diffefences in the Sdc-1 mRNA expression among different groups(F=0.822,P＞0.05).The levels of Sdc-1 protein of the 3 model groups were all significantly lower than that of the control group(F=865.586,P＜0.01),and the Sdc-1 protein level was the lowest level in the model group1,and then increased gradually.The expression of IL-1 mRNA of the 3 model groups were all significantly higher than that of the control group(F=103.833,P＜0.01),and the IL-1 mRNA level was the highest in the model groupl and then decreased gradually.Conclusion The severity of colitis is associated with the reduction of Sdc-1 protein level,but not with the Sdc-1 mRNA level in the colon mucosa.The reduction of Sdc-1 protein Ievel may be associated to incroase of IL-1 level.

Obiective To explore the protein expression of tenascin-X(TN-X)and the relation between TN-X and cardiac remodcling and myocardial fibrosis in alcoholic cardiomyopathy(ACM).Methods 60 Wistar rats were randomly dirided into 2 equal groups:alcohol-fed group fed with alcohol to establish ACM madels and control group fed with common food.6 months later the rats were killed and the cardiac structure and funotion,and myocardial collagen content were measured.Western blotting and immunohistochemistry were used to detect the protein expression of TN-X,and smad-3 and smad-7,the signal transduction proteins.Results The levels of left ventricle ejection fraction(LVEF)and fraction shortening(FS)of the alcobol-fed group were both significantly lower,and the levels of left ventricle enddiastolic diameter(LVEDd)and collagen volume fraction(CVF)were both higher than those of the control group(both P＜0.05).The protein expression levels of TN-X and smad-3 of the alcohol-fed group were(88%±6%,82%±8%),both significantly higher than those of the control group(33%±11%,29%±8%)(both P＜0.01),and the protein expression level of smad-7 of the alcohol-fed group were(37%±9%),both significantly lower than those of the control group(79%±10%,P＜0.01).The protein expression of TN-X was significantly negatively correlated with LVEF,FS,and smad-7,and positively correlated with LVEDd,CVF,and smad-3(all P＜0.01).Conclusion Protein expression of TN-X is upregulated in alcoholic cardiomyopathy which may facilitate the myocardial fibrosis in ACM.

Objective To observe the correlation of the arterial remodeling at the reference site and the lesion site and the effect of granulocyte-macrophage colony-stimulating factor(GM-CSF)on arterial remodeling.Methods 28 healthy New Zealand White rabbits were randomized to 2 equal groups:GM-CSF group receiving subcutaneous injection of GN-CSF(10μg·kg-1·d-1)for 7 days,and pure damage group given subcutaneous injection of equivalent normal saline foe 7 days.Seven days later the iliac arteries of all animals were damaged by balloon.The levels of nitrogen monoxide(NO)were detected before and 4 weeks after angioplasty.Histological sections of iliac from rabbits killed 4 weeks after angioplasty were analyzed.Lumen area(LA),external elastic lamina area(EELA),and intimal plus medial areas(I+M)were measured at the lesion(L) and reference(R) sites.Results The NO levels 4 weeks later of the GM-CSF group was 98±10 μmol/L,significantly higher than that of the pure damage group(83±12 μmol/L,P＜0.05).Morphometric analysis showed that the LA(L) of the pure damage group was(0.87±0.40)mm2,significantly smaller than thal of the GM-CSF group[(1.34±0.52)mm2,P＜0.05].The I+M(L) of the pure damage group was(2.62±0.48)mm2,significantly greater than that of the GM-CSF group[(2.26±0.43)mm2,P＜0.05].There was no statistical significance in the EEL(L) between the 2 groups[(3.48±0.80)mm2 versus(3.60±0.91)mm2,P＞0.05].Morphometric analysis showed that the LA(R) of the pure damage group was(1.60±0.48)mm2,significantly smaller than that of the GM-CSF group[(1.99±0.54)mm2,P＜0.05],whereas there was no statistical signiticance in the I+M(R)between the 2 groups.In both groups,LA(R).was significantly correlated with LA(L)(r=0.919,P＜0.001);and EELA(R)was significantly correlated with EELA(L)(r=0.909,P＜0.001)and I+M(R)(r=0.685;P＜0.001).Conclusion Remodeling affects both the lesion and the reference sites and appears to occur in parallel and proportionately at both sites.GM-CSF treatment increases re-endothelialization of the injured artery and inhibits unfavorable remodeling.

Objective To study the influenee of bone marrow mesenehyrnal stem cells(MSC)on the proliferation and apoptosis of allogeneic peripheral B lymphocytes in vitro.Methods MSCs were jsolated from the peripheral blood of healthy volunteer and cultured.B lymphocytes were isolated from another healthy volunteer and co-cultured with the MSCs at the B:MSC ratios of 50:1,10:1,and 1:1 or with different concentrations of MSC supernatant(12.5%,25%,and 50%)for 72 h,in the presence of antihuman IgM immunoglobubin goat antibodies(Anti-IgM)at a final concenrtration of 10 μg/mlL.The proliferation of B lymphocytes was analyzed with MTT assay.B lymphocytes and MSC were co-cultured at the ratio of 1:1 for 24 h or 48 h,with or without addition of Anti-IgM.Flow cytometric was used to detect the apoptosis of B Jymphocytes.Results The A valne of B lymphocytos co-cultured with MSCs at different ratios were 0.521±0.093,0.418±0.103,and 0.365±0.114 respectively.The A values of Group10:1 and Ggroup1:1 were both significantly lower than that of the control group(0.679±0.049,both P＜0.01),and the A value of Ggroup1:1 was significantly lower than that of Group10:1(P＜0.05).The A value of B lymphocytes co-cultured with 50% MSC supernatant was 0.504±0.099,significantly lower than those of the control group and Group 12.5%(both P＜0.05).MSCs didn't induee apoptosis of B lymphocytes.The apoptosis rates of B lympbocytes co-cultured with MSCs for 24 h or 48 h,in presence or absence of Anti-IgM were 1.90%±0.75%,2.33%±1.01%,2.33%±0.75%,and 1.39%±0.63% respectively,without significant difference between any 2 of the four groups.Conclusion MSC and its sulpernatant inhibit B lymphocyte proliferation with the mechanism correlated with the MSC concentration and the MSC-secreted cytokine,but MSCs does not induce B lymphocytes apoptosis in vitro.

Objective To evaluate the influence of pharmacological postconditioning with edaravone,a new free radical scavenger,on myocardial ischemia/reperfusion injury and the mechanism thereof.Methods Fortv Wistar rats underwent ligation of the left anterior descending coronary artery(LAD)with PTCA balloon to establish ischemia/reperfusion models,with the LAD occluded for 45 min and reperfused for 180 min.The rats were randomly divided into 5 equal groups:(1)I/R group undergoing occlusion of the LAD for 45 min and reperfusion for 180 min;(2)I-postC group undergoing ischemia for 45 min,3 cycles of balloon air relief-aeration(30s reperfusion and 30s ischemia),and then reperfusion for 180 min,(3)iA-1 group undergoing injection of edaravone,3 mg/kg into the aorta root 1 min before reperfusion;(4)iA-2 group undergoing injection of edaravone 10 mg/kg into the aorta root 1 min before reperfusion;and(5)iV group undergoing intravenous injection of edaravone 10 mg/kg 1 min before reperfusion.Another 8 rats underwent sham operation.By the end of experiment arterial blood was collected to mea-qure the dynamic parameters and serum biochemical markers:MB isoenzyme of creatine kinase(CKMB),malondialdehyde(MDA),superoxide diamutase(SOD),and nitric oxide(NO).Then the rats were killed.The ischemlc size and Infarct size of myocardium were measured by Evans blue and TTC staining respectively.Results The myocardial infaret size and Jevels of serum CK-MB,MDA,and NO were all significantly reduced in the I-postC,iA-1,and iA-2 groups compared with the I/R group(all P＜0.01),and the activity levels of SOD of these groups were all enhanced(all P＜0.05).The MI size and levels of serum CK-MB and MDA of the iV group were all reduced,the activity level of SOD was enhaneed compared with the I/R group(all P＜0.05),and the NO level was decreased,but not significantly.Conclusion Edaravone pharmacological posteonditioning applied just before the onset of coronary reperfusion provides potent myocardial infaret size reduction,an effect simifar to the cardio-protective effect of dynamic postconditioning.The common potential mechanism of both practices may be associated with decreasing the injury by reactive oxygen species and strengthening the resistance to oxidation stress.Intra aorta rootcoronary injection may be a more effective pharmacological postconditioning pathway than intravenous pathway.

Obesity is a kind of chronic low-grade inflammation, which is closely related to diabetes, atherosclerosis, thrombosis, hyperinsulinemia, cardiovascular disease, stroke, etc. The occurrence of obesity-related inflammation is closely related to the abnormality of serum inflammatory factors, including adipokines.Recently, foreign laboratories have found that there is local hypoxia and increased macrophage infiltration in adipose tissue of obese mice, and it is closely related to the increase of inflammatory factors [1-2], which provides new directions and ideas for the study of the mechanism of obesity and inflammation.

Recent studies have found that hydrogen sulfide (H2S) is a new type of gas signaling molecule [1-3], which is produced continuously in vivo and plays an important role in regulating various pathophysiological processes. 1. Generation and metabolism of endogenous H2S Endogenous H2S is produced by cysteine as a substrate in vivo, mainly by cystathione-β-paleogenase (CBS) and cystathione-γ-lyase (CSE). These two enzymes are widely distributed in mammalian tissues and cells [4], among which CBS is mainly distributed in brain tissue [5], while CSE is the most active in peripheral tissues, mainly including liver, kidney, heart and blood vessels [6].

Hormone replacement therapy treats diseases caused by decreased or deficient hormone secretion by supplementing hormones.In the broad sense, hormone replacement therapy covers all hormones.In the narrow sense, hormone replacement therapy is mostly aimed at female hormones,especially estrogen replacement therapy.There are many benefits of hormone replacement therapy, but it also brings health risks.Despite this, many women still use this therapy to alleviate menopausal syndrome.

Non-invasive ventilation is relative to invasive ventilation. Invasive ventilation requires tracheal intubation or tracheotomy. For patients, local pain, inability to speak, emotional depression, and some complications, such as respiratory mucosal damage, tracheal intubation obstruction, ventilator-related pneumonia, etc., are prone to laryngeal edema and hoarseness after extubation.

Physical examination: 20 breaths/min, blood pressure 140/70 mm Hg (1 mm Hg =0.133 kPa), no cyanosis on the lips, absolute irregular heart rhythm, grade Ⅲ/Ⅳ rough systolic murmur could be heard in the apical area, which was conducted to the neck and axillary. No dry or wet rales were heard in auscultation of both lungs. ECG showed rapid atrial fibrillation, heart rate 150~200 beats/min, no ST segment and T wave changes. Color Doppler showed enlargement of left atrium, remained normal, and a moderately strong echo mass 4.85 cm ×3.36 cm was seen in the left atrium, with clear boundaries, attached to the left atrial lateral wall, and no pedicle-like structure was found connected to the lateral wall of the heart. Some tissue of end-diastolic mass protruded from the mitral valve opening and entered the left ventricle.

The patient was an 11-month-old male with weakness in both lower limbs for 3 months. Physical examination: clear consciousness, slightly worse reaction, patent anterior fontanel, slightly higher tension, widening of nasal root and progressive aggravation of bulge, slightly higher muscle tension of limbs, muscle strength of both upper limbs grade IV, muscle strength of both lower limbs grade III, bilateral Pap sign (+), mutaxia examination was not cooperative. There were no abnormalities in family history and pregnancy and childbirth history. X-ray examination of the head showed hypertrophy of the frontal top of the skull, sclerosis of the skull base and facial skull, poor gasification of paranasal sinuses and mastoid (Figure 1). MRI of the brain showed Chiari malformation, supratentorial ventricle dilation, thickening and deformation of the skull (Figure 2). X-ray examination of the long bones (upper and lower limbs) showed poor metaphyseal plasticity, trumpet-like dilation of the long bones, and sclerosis of the diaphyseal cortex (Figure 3).