Volume 89  ·   Issue 46  ·  2009

Influenza A (H1N1) first appeared in Mexico on March 18, 2009, and the epidemic spread rapidly and swept across the world ~ [1]. The pathogen was identified by the US Centers for Disease Control and Prevention (CDC) as a novel influenza A (H1N1) virus containing nucleic acid sequences of avian and swine influenza viruses ~ ([2-4]).

Objective To analyze whether Oxaliplatin (OXA) is effective in advanced gastric cancer.Methods Clinical trials of OXA-based chemotherapy (treatment group) versus DDP-based chemotherapy (control group) in advanced gastric cancer which published in 6 years were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information database and PubMed of U.S.National Library of Medicine and NIH.Review Manager 4.2 was used for meta-analysis and main outcome measure ineluded objective response rate.survival and toxicities.Results There were 2121 patients (1062 cases in treatment group and 1059 cases in control group) from 16 controlled clinical trials were enrolled.Response rate increased (46.3% vs 40.6%.OR-1.28,P=0.006)and 1-year survival rate increased (44.6% vs 39.3%,OR=1.25,P=0.04) in treatment group than that of control group.Peripheral neurotoxity was more frequently observed in treatment group (70.6% vs 21.9%,OR=10.76,P<0.01) while anemia and nausea/vomiting were reversed (58.0% vs 70.1%,61.4% vs 75.6% respectively,both P<0.05).Conclusion Oxaliplatin-based chemotherapy is well-tolerated and more effective than cisplatin in advanced gastric cancer.

Objective To explore the possibilities and efficiency of Sigma covered stents for the treatment of tracheoesophageal fistula (TEF).Methods Between 2006 and 2009,10 Sigma covered mental stents had been placed by guidance of bronchoscopy and/or fluoroscopy in 8 patients with 9 tracheoesophageal fistulas.Among them,7 fistulas were caused by cancer and 2 by mechanical damage. Seven fistulas were located in lower part of trachea and 1 each in the middle and upper parts.Results Six Y-shaped.2 L=shaped and 2 l-shaped stents were placed respectively in 8 patients with 9 TEFs.All the TEFs were effectively sealed by the stents except for 1 massive lower and 1 upper fistulas.One mechanical fistula was cured within l year of stent placement.The mean survival period of all patients was 8 months.Conclusion By sealing the fistula with a Sigma covered stent,severe respiratory infection may be successfully controlled in patients with TEFs with a major improvement of quality of life.

Objective To assess the effects and potential role of percutaneous balloon valvuloplasty as an alternative therapy of surgery in young infants with severe and critical pulmonary vatve stenosis.Methotis Eighteen patients aged 8 days to 6 months with severe and critical pulmonary vatve stenosis admitted to our hospital from June 2006 to August 2008 underwent batloon valvuloplasty.Among them.11 infants including 2 neonates had critical pulmonary stenosis.Severe tricuspid regurgiiration was seen jn 5 and moderate in 3.Right ventricular systolic pressure in all patients was greater than systemic pressure wilh right-to-left or bi-directional shunt at atrial level.Dilatation was Deriormed under general anesthesia with intubation in 12 patients and caudal block combined with sedation in 6 patients.Dilatation with 2 balloons sequentially in one procedure was performed in 6 patients and dilatation with 1 balloon in other 10 patients.Results Of the 18 patients,there was failure to cross the pulmonary valve with balloon catheter in one and cardiac tamponade in oue.The dilatation success rate was 88.9%.Immediately after dilatation,the systemic pressure gradient from right ventricle to pulmonary artery decreased from (87±24) mm Hg to (30±19)mm Hg(P<0.01).No complication was found in all patients during or post dilation. During a follow-up of 6 to 32 months,pressure gradient crossing pulmonary valve measured by echocardiography further decreased or remained stable iu 16 cases.except one neonate and one infant whose pressure gradient gradually increased and required a second dilatation.Re-dilatation rate was 12.5%.Tricuspid regurgitation was reduced in all patients.Mild pulmonary regurgitation was seen in most of patients post-dilatation.except moderate in one.AIl patients fared well and stayed asymptomatic.Conclusion Percutaneous balloon valvuloplasty for severe and critical pulmonary stenosis in infants is relatively safe and effective and should be considered a vatid alternative to surgicat operation.It should be the first choice for such patients based on its excellent outcome.less trauma and fewer complications.

objective Primary premature ejaculation (PPE) is a prevalent sexual dysfunction among men while its precise pathologic mechanism has remained poorly understood.In current study the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of prostatic urethra and primary premature ejaculation was studied.Methods Forty-two patients with PPE and 20 normal potent male volunteers were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra to record the sensory thresholds of BCR to stimulation of prostatic urethra.thresholds to evoke stable BCR and latencies of BCR Also the sensitivity of glans penis to electrical stimulation was detected by two surface electrodes.Resulis The mean sensory thresholds of BCR to stimulation of prostatic urethra. Thresholds to evoke stable BCR.latencies of BCR and sensory thresholds of glans penis were (18.2±2.7) Ma(0.2 ms in duration,1 Hz),(34.8±4.2)mA (0.2 ms,1 Hz),(71.2±5.8) ms and(14.2±1.9) mA(0.04 ms in duration.3 Hz) in normal potent men respectively and were (12.4±3.7)mA(0.2ms,1 Hz),(23.8 ±5.6)mA (0.2 ms,1 Hz),(70.5±6.3)ms and(11.9±2.3)mA(0.04 ms,3 Hz) in patients with PPE respectively.Statistically significant difierences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra.the thresholds to evoke stable BCR and the sensory thresholds of glans penis between two groups(all P<0.01).No statistically differences were seen regarding the latencies of BCR between two groups (P>0.05).Conclusion Patients with PPE have hyperexcitable BCR to stimulation of prostatic urethrft It is probably one of the important etiological factors.Moreover the findings may provide new therapeutic modalities of PPE.

Objective Using Kansas city cardiomyopathy questionnaire (KCCQ) to evaluate the quality of life (QOL) of the patients with chronic heart failure.Methods A total of 271 hospitalized patients with heart failure symptoms in cardiology department,Peking Union Medical College Hospital,who undergone coroluLry angiography from December 2007 to December 2008,were included in this study.QOL of the subjects was measured,and their demographic and clinical data were collected.Patients were divided into 2 groups according to heart function and they were compared by QOL Multiple linear regression analysis was conducted to identify the variables associated with the quality of life.Results KCCQ physical limitation scores of the patients of left ventricular ejective fraction(LVEF) <50% (n=50) and LVEF≥50%(n=221) were (66±22) points and (73±22) points (P<0.05).In the patients of NYHA I/Ⅱ(n=227) vs NYHA Ⅲ/Ⅳ(n=44),KCCQ scores of physical limitation,symptoms and QOL were (74±20) vs (60±27) points,(62±22) vs (49±25) points and (61±16) vs (53±18) points (all P<0.05).In the patients of heart failure grade A/B (n:197) vs grade C/D (n=74),KCCQ scores of physical limitation.symptoms and QOL were (75±19) vs (61±26) points,(63±22) vs (52±24) points,(61±16) vs (56±18) points (all P<0.05).Multiple linear regression analysis of QOL KCCQ showed that,age,NYHA cardiac function classification,gender and Judkins score were the risk factors of patients' physical limitation (P<0.01);gender and stages of heart failure were the risk factors of patients'symptoms (P<0.01);gender was the risk factors of patients'social function (P<0.01).Conclusion The patients with poor cardiac function have a poor QOL.KCCQ is more sensitive for the evaluation of heart function. Age,NYHA,gender,Judkins score and stages of heart failure Call change QOL for the patients with chronic heart failure.

Objective To investigate the effects and mechanisms of methylene chloride (MC) in hepatic ischemic reperfusion injury.Methods Eighty SD-rats were divided equally into 4 groups:control group(n=20),donors without any treatment;CoPP group (n=20),donors injected with CoPP (5 mg/kg, ip) at 24 h;ZnPP group (n=20),donors injected with ZnPP (20 mg/kg,ip) at 24 h;MC group (n=20),donors fed with MC (500 mg/kg) per day for 7 days before graft procurement.Syngeneic orthotopie liver transplantation was performed in rats with modified Kamada's two-cuff technique.And SD rats were used as donors(n=10) and recipients respectively.5 recipients in each group were sacrificed and the grafts were procured at day 3 after transplantation,the pest-operative survival time was observed in the remnant.The tests were determined as following:the level of serum ALT,AST in recipients;heme oxygenase-1(HO-1)expression of graft was tested by immunohistochemistry and Western blot;the index of graft apoptosis examined by TUNEL method:the pathology of graft assessed by Suzuki's criteria.Results The level of serum ALT [(65±28)U/L],AST[(187±43)U/L] in CoPP and ALT [(75±16)U/L],AST[(185±42)U/L] in MC group was significantly lower than that ALT [(346±45)U/L],AST [(474±90)U/L]in control group and ALT [(578±75)U/L],AST [(1084±128)U/L] in ZnPP group (P<0.01).The median expression of HO-1 in MC group wag no significantly different with that in control group (P>0.05).While the median expression of HO-1 in CoPP group wag higher than that in control group (P<0.05).The index of graft apoptosis in MC group and CoPP group,4.1%±0.6%and 3.2%±0.8% respectively,was significantly lower than that (12.5% ± 2.4%) in control group and (25.8%±3.1%) in ZnPP group (P<0.05).Compared with the other two groups.MC and CoPP groups had lesser neutrophil infilibation and a lower grade of hepatocytie injury in grafts.Suzuki's scores in grafts of MC and CoPP groups were lower than that in control and ZnPP groups (P<0.05).The median post-transplantation survival time of the recipients in MC and CoPP groups was 1 00 and 93 days respectively while that in control and ZnPP groups was 85 and 12 days(P<0.05).Conclusion Over-expression of HO-1 and MC both have protective effects in hepatic ischemic reperfusion injury.

Objective To explore the role of transfected plRES-p21~(waf1)-p27~(kip1) gene on the centrosome duplication and cell proliferation of MCF-7.a breast cancer cell line.Methods The pIRES- p21~(waf1),plRES-p27~(kip1) and pIRES-p21~(waf1)-p27~(kip1) genes were transfected into the MCF-7 cells by lipofection.The effect on proliferation was evaluated by MTT assay and cell growth curve was drawn.The cell cycle was analyzed by flow cytometry.The centrosome duplication was detected by using indirect immunofluorescence microscopy. Results After transfected 24 hours.the p21~(waf1) and p27~(kip1) protein expressions were significantly increased as compared with untransfected MCF-7 cells (P<0.01),and cell growth was obviously inhibited and resulted in all accumulation of cells in G_1(P<0.01),presenting that the proportion of cells in G1 phase was obviously illcreased from (47.28±2.25)% to (69.52±3.21)% of p21~(waf1) transfected cells,(60.83±3.02)% of p27~(kip1) transfected cells,and (78.37±2.83)% of p21~(waf1)- p27~(kip1) traasfected cells.The proportion of cells which contained urmormal centrosomes was obviously respectively.Conclusion The transfer of p21~(waf1) and p27~(kip1) genes could inhibit the growth of human breast carcinoma cells and the unnormal duplication of centrosomes.p21~(waf1) had a really synergy with p27~(kip1) in these effects,suggesting p21~(waf1)-p27~(kip1) combined gene can inhibit the genesis and development of breast cancer and might have potential clinical significance as therapeutic agents of breast cancer.

Objective To investigate the cross-talk between Notch1 and epidermal growth factor receptor (EGFR) signaling in regulating the cellular proliferation of human tongue squamous cell carcinoma (SCC).Methods Hulnan tongue SCC cell line Tca8113 cells was transiendy transfected with the vector encodinz exogenous intracellular fragment of Notchl and the vector encoding the specific short hairpin RNA (shRNA) targeting EGFR respectively and were treated by AG1478,an inhibitor of receptor tyrosine kinases,for elucidating the effects of constitutive activation,EGFR gene silencing and blocking EGFR signaling upon cellular proliferation and expression of Notchl and EGFR.The mRNA and protein levels of Notch1 and EGFR were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot,respectivelv.The cellular proliferation was evaluatcd by methyl thiazolyl tetrazolium (MTT) assay. Results Constitutive activation of Notch1 resulted in inhibition of cellular proliferation,and up-regulation of Notchl(1.102±0.135,0.243±0.032,P<0.05) but down-regulation of EGFR (0.083±0.009,0.605±0.075.P<0.05) at the the mRNA and protein levels.Silencing of EGFR gene resulted in inhibition of cell proliferation,and down-regulation of EGFR (0.148±0.019,1.175±0.132,P<0.05) but up-regulation of Notch1 (0.978±0.115,0.083±0.009,P<0.05) at the mRNA and protein levels.Blocking EGFR signaling had no significant effect upon EGFR expression (P>0.05),but resulted in inhibition of cellular proliferation and up-regulation of Notch1 (P<0.05) at the mRNA and protein levels.Conclmion There might be a cross-talk of bi-directional control between Notch1 and EGFR signaling in regulating the cellular proliferation of human tongue SCC cells.

Objective To explore the optimal method for protein expression in rhES (recombinant human endostatin ) and study the anti-tumor activities of rhES in solid tumor and established cell line.Methods Different IPTG concentrations.the timing of adding IPTG into the culture medium and the different time of expression were employed to explore the optimized conditions of protein expression.Activity examination:(1) animal experiment:nude mice bearing subcutaneous cancer in treated group and controlled group were observed.(2) cellular experiment:the inhibitory effect of rhES in T-24 established cell line were observed by MTT assay and cancer cell growth curve.ResulIs The expression of rhES protein was 58.65%.Of all the E.coli body proteins.the protein purity after purification was 96.22%.Activity examination indicated that rhES could inhibit the growth of solid tumor and the established cell line.In animal experiment.the tumor inhibition rate Was 66.8%.Cell experiment:the 50% inhibitory concentration (IC_(50)) was 22 μg/ml.The cell population decreased 58.75% than the control group at Day 7 in the tumor cell growth curve.Conclusion A high expression and activity of rhES protein can be obtained by the optimized expression conditions.rhES can inhibit the cellular growth in both solid tumor and established cell line of bladder cancer.

Objective To investigate the effects of α-zearalanol on the expression of heine oxygenase-1(HO-1) gene and cytosolic free calcium level in the tumor necrosis factor α(TNF-α)-stimulated human umbilical vein endothelial cell (HUVEC) and the mechanisms involved.Methods The siRNA exDression vector for p47~(phox) was coflstructed and used to block the NADPH oxidase in the HUVEC.The intracellular ROS Droduction was detected by using 2,7-dichlorofluorescin diaeetate as probe.The mRNA expression of the HO-1 was determined by semiquantitative RT-PCR and the protein expression was measured by immunocvtochemistery analysis.The level of cytosolic free calcium was determined by using Fluo-3/AM as probe with laser confocal microscope. Results TNF-α stimulation caused ROS output increased by 155% of control (228±51 vs 89±24,P<0.05);α-zearalanol was able to reduce the production of ROS in a dose-dependenl manner. Knock down of the p47~(phox) subuuit for NADPH oxidase by siRNA abolished the Droduction of ROS.TNF-α stimulation caused HO-1 mRNA increased by 145% of control (0.88±0.10 vs 0. 36±0. 11 , P<0.01) , and also obviously increased HO-1 protein expression; α-zearalanol inhibited the expression of HO-1 mRNA in a dose-dependent manner; Pretreatment with α-ZAL and p47~(phox) siRNA both attenuated TNFa-induced HO-1 proein expression. The treatment of TNF-α for 24 hours up-regulated cytosolic free calcium level by 179% (107. 3±4. 9 vs 38. 5±0. 6, P<0.01); Pretreatment with α-ZAL and p47~(phox) siRNA depressed TNFα-induced cytosolic free calcium level by 46% (58. 5±0. 3 vs 107. 3± 4. 9, P<0.01) and 57% (46.3±2.1 vs 107.3±4.9, P<0.01)respectively.Conclusion ROS only partly mediated HO-1; expresson in the TNF-a- stimulated HUVEC; α-ZAL has a potent inhibitory effect on the HO-1 expresson and cytosolic free calcium level in the TNF-α- stimulated HUVEC, mainly through the inhibition of ROS generation derived from NADPH oxidase.

Objective It was reported that a negative feedback loop might exist between pemxisome proliferator-activated receptor alpha (PPARa) and glucocorticoid receptor (GR).However,it is unclear whether GR expression is regulated by PPARct activation.To further demonstrate this possibility,we conducted the present study to investigate the regulatory effects of the PPARα agonist fenofibrate on GR expression in Sprague-Dawley rats.Methods GR gene and protein expression levels were determined in liver,visceral and muscle tissues.Adrenal 11 β-hydroxylase (CYP11B1) expression was examined by RT-PCR and circulating corticosterone level was measured by RIA method.Results GR expression was reduced by fenofibrate in a time-and does-dependent manner.The GR mRNA in the three fenofibrate groups of rats were 55%(FE1),54%(FE2) and 68% (FE3) lower than that of the control rats.The GR protein were 28%.77% and 99% lower than the control.The inhibition was observed in liver,but not in fat and muscle.The coaicosterone level in the blood was increased significantly by fenofibrate (the levels of corticorsterone in control.FE1,FE2,FE3,MK886 groups were (393±23)、(495±44)、(516±18)、(622±93)、(382±37) ng/ml respectively.These effects of fenofibrate were abolished by PPARα inhibitor MK886.suggesting that fenoffbrate activated throush PPARα.Conclusion A new molecular mechanism has been found for a negative feedback regulation of GR activity by PPARα in SD rats.

Objective To study the expression of exogenous LacZ gene in brain via a delivery of OX26-pGFAP-IL.Methods pCMV-Liposome,OX26-pCMV-IL,OX26-pGFAP-IL and blank liposome were injected into rats via femoral vein.At 24 h post-injection,the method of Q-PCR was adopted to calculate the relative quantities of LaeZ gene mRNA in brain and peripheral organs.At 48 h post-injection, the protein expression of LacZ gene waS detected by the activity of β-galactosidase and the method of histochemical stain.Results The result of Q-PCR showed that,at 24 h post-injection,the relative quantities of LacZ mRNA in OX26-pCMV-IL group (49.2×10~(-6)) and OX26-pGFAP-IL group (44.9×10~(-6)) were significantly hisher than pCMV-liposome and blank liposome groups (P<0.05).In peripheral organs,the relative quantity of LacZ mRNA in OX26-pCMV-IL group were significantly higher than that in OX26-pGFAP-IL group(P<0.05).At 48 h post-injection,the activity of β-galactosidase in OX26-pCMV-Ⅱ.(0.67 pg/mg) and OX26-pGFAP-IL groups (0.92 pg/mg) were significantly higher than pCMV-liposome and blank liposome groups (P<0.05).There was no significant difference between OX26-pCMV-IL group and OX26-pGFAP-IL group in terms of the expression of β-galactosidase.The result of histochemical stain showed that OX26-pGFAP-IL achieved a specifically positive expression in brain and had a decreased expression in peripheral organs.Conclusion OX26-pGFAP-IL injected via femoral vein can cross the brain-blood barrier and achieve a specific expression in brain under the control of GFAP promoter.OX26-pGFAP-Ⅱ,decreases the non-specific expression in peripheral organs and it may be used as an non-viral gene therapy for intra-cranial diseases.

Objective To investigate the effects of positive end-expiratory pressure (PEEP) ventilation upon respiratory function and lung surfaetant protein B (SP-B)/SP-C in seawater respiratory distress syndrome (SW-RDS) rabbit.Methotis Twenty-four female New Zealand rabbits were randomly equally divided into three groups:conventional mechanical ventilation (CMV) group,PEEP group,and control group.After anesthesia and tracheal intubation followed by 20 minutes of CMV,SW-RDS model wsa established by lung perfusion of artificial seawater throulgh tracheal intubation.Then the CMV group ventilated for 6 hours (each parameter unchanged);PEEP group ventilated with PEEP of 8 cm H_2O for 2 hours based on Drior parameters and subsequently with CMV for 4 hours;control group without ventilation after modeling.Oxygenation indices and lung compliance were continuously monitored during ventilation. After ventilation,the rabbits in study groups were sacrificed while those dying a natural death in the control group selected.Bronchoalveolar lavage fluid of the left lung was collected to determine the alveolar surface tension and the right lung was harvested to measure the mRNA expression of SP-B/SP-C by real-time PCR as well as SP-B protein by Westem blotting.Resuits After modeling,the data of lung compliance and oxygenation indices became significantly worse in every group but without statistical difference in three groups.All rabbits in control group died within 15 minutes of ventilator withdrawaL After receiving PEEP ventilation for 30 minutes.these indices significantly improved compared with CMV group in which there was no significant change of the indices (P<0.05).Minimal alveolar surface tension in CMV group (mN/m,30.8±6.3) was greater than in PEEP group (21.1±4.4,P<0.05) and control group (23.6±4.6,P<0.05);SP.B/SP.C mRNA relative expression (0.37 ±0.15/0.60±0.19) and SP-B relative protein abundance (0.38±0.17) in CMV group were obviously lower than in PEEP group (0.73±0.15/0.92±0.40,0.52±0.22,P<0.05).Conclusions PEEP ventilatioil call improve the oxygenation indices and lung compliance in SW-RDS animals.And such an effect is correlated with both the mRNA expressions of SP-B/SP-C and mechanical distension.

The patient was a female, born in October 1997. During pregnancy, her mother did not take or contact any drugs. After pregnancy, she gradually developed a large number of facial acne, thickened voice, growing beard on her lips, and greasy skin. The symptoms lasted throughout the pregnancy, and the symptoms gradually relieved more than one year after delivery. During this period, the blood testosterone level was not measured. When the patient was born, the family found vulvar deformity, the clitoris was obviously enlarged into penis shape, and the urethra was located at the top of the clitoris.

In the field of physical medicine, infrared rays are divided into near infrared rays (0.8~1.5 μ m), middle infrared rays (1.5~5.6 μ m) and far infrared rays (5.6~1000 μ m) according to their wavelength ~ [1].

The form and content of modern clinical research are undergoing great changes. The methodological progress of large-sample multi-center research, prospective research, high-quality and standardized research plan design, application of clinical research quality management practice (GCP), relatively independent data management and statistical analysis, on-site monitoring, and process management of clinical research are dazzling. More and more complex research methods make clinical research difficult to control and confuse researchers.

The metabolic wastes in the late-stage blood of middle-aged and elderly patients with kidney disease accumulate in the body, which cannot be excreted through the kidney like normal people, but need dialysis to maintain their life.According to relevant data, the functional state of middle-aged and elderly patients before and after dialysis will change to some extent, and when the patient's condition progresses to dialysis, the functional state will begin to decline sharply.

GDC-0449, an orally active small molecule, inhibits the hedgehog signaling pathway, which runs through the whole process of embryogenesis.

At present, due to the relationship between diet and other environmental factors and genetic factors, the number of diabetic patients is increasing, and the hormones in the body have some influence on the occurrence and development of diabetes.