Volume 90  ·   Issue 26  ·  2010

The low quality of clinical research is an important link that restricts the improvement of the overall level of clinical research in China, and improving the quality of research is an urgent problem that needs to be solved at present. In the work of improving the quality of clinical research, we should first do top-level design and reach a consensus on the goals and principles, but there is no systematic discussion on this problem so far. Now the author puts forward the following views for academic discussion.

Objective To evaluate the relationship between red cell volume distribution width (RDW) and cardiac function in acute coronary syndrome (ACS) patients. Methods We analyzed the baseline clinical data of 228 ACS patients consecutively admitted into our hospital according to the classification of RDW and NYHA function class. Correlation analysis was made respectively between RDW and plasma creatinine and left ventricular ejection fraction ( LVEF) . Results There were significant differences of age [Group Q1 to Group Q4: (60±12),(65 ±11),(64 ± 11), (71 ± 12) years old],plasma creatinine [Group Q1 to Group Q4:(70±19),(76 ±24),(74±20),(85 ±26)μmol/L] and LVEF [Group Q1 to Group Q4:(57±9)%,(55±10)%,(53±11)%,(49 ± 11)%] among different RDW groups (P =0.0000,0.0054,0.0002,respectively).Comparing to NYHA function I, patients of NYHA function IV had a higher RDW (13.9%±1.2% vs 13.1%±5.1%,P<0. 05).There were significant negative correlations between RDW and LVEF( r=-0. 30, P<0.01). Conclusion RDW may be significantly related to cardiac function in Chinese ACS patients.

Objective Off-pump coronary artery bypass grafting (off-pump CABG) after off-pump coronary endarterectomy (CE) for myocardial revascularization is a way to rescue the patients with diffuse coronary artery disease (CAD). This study retrospectively analyzed its clinical outcomes and experiences,and explored the safety and effectiveness. Methods From October 2003 to December 2008, 177 diffuse CAD patients with 229 vascular lesions received off-pump CABG plus CE. Incision was made at the hardest part of coronary artery and≥ 2cm from the distal intervention site. Then bypass graft was performed by internal mammary artery or saphenous vein. Results The intra-operative blood tests showed that 215 (93. 9% ) bridges were satisfied with (27 ± 12) ml/min blood flow while 14 bridges were dissatisfied. The blood flow was (7 ± 4 ) inl/min. Six (3. 4% ) cases suffered peri-operative myocardial infarction. Among them, 3 patients had no significant cardiac homodynamic changes. Three suffered a low cardiac output and improved by intra-aortic balloon counter pulsation support. And they were then discharged after treatment After 3-40 months, 98 patients underwent coronary angiography to measure the graft latency. And the blood flow was excellent Conclusions Off-pump CABG plus CE for diffuse coronary artery disease is both feasible and safe. And it is an effective treatment with a high degree of vascularization.

Objective To understand the effect of resiniferatoxin on neurogenic bladder by intravesical filling. Methods Twenty-four male spinal cord injury patients with an obviously low cystometric capacity, 2 incomplete cervical cord injury, 5 complete thoracic cord injury, 4 incomplete thoracic cord injury, 5 incomplete lumbar cord injury and 8 complete lumbar cord injury were examined. The age range was 24-58 years old and the course of disease 1-6 years. There were 0. 0063 mg/4 ml RTX in each bottle.it was dissolved in 50 ml physiologic saline and was infused into bladder slowly, keeped 30 min, then was discharged by intermittent catheterization (IC). During the process, the patients were requested to fill a micturition chart and conduct urodynamic examination before and after the infusion. We regulated that it was utility when the amount of increased maximal cystometric capacity(MCC) exceeded or was 100 ml, otherwise it was invalid. Results The urodynamic examination before intravesical filling and 1 week after intravesical filling showed that the average MCC were (210 ±23) ml and (360 ±30) ml respectively, the average bladder compliance were (17 ±3) ml/cm H2O and (24 ±5) ml/cm H2O, there were statistic difference between them(both P < 0. 01 ). The overall effective rate was 62. 5% . It lasted 1-4 months. Conclusion Resiniferatoxin is effective to increase the cystometric capacity and booster the bladder compliance.

Objective To explore the association of genetic polymorphism (rsl2218) of serum amyloid protein Al (SAA1) with serum high density lipoproteins cholesterol (HDL-C). Methods A total of 607 healthy subjects were recruited into the Cardiovascular Risk Survey between June 2007 and March 2009. Their genotypes of SAA1 were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Results There was no significant difference between each genotype of SAA1 in triglyceride, total cholesterol and low density lipoprotein cholesterol ( LDL-C). But marked significance existed between CC genotype and TT genotype in serum HDL-C level both before[ (1. 28 ±0. 38) mmol/L vs (1.44±0.43) mmol/L, P = 0.017] and after adjusting for gender and age [(1.27 ±0.07) mmol/L vs (1.41 ±0.03) mmol/L, P=0.048]. Conclusion In Chinese Han people, the genetic polymorphism of SAA1 may reflect the serum concentration of HDL-C. The carriers with CC genotype have a lower HDL-C level.

Objective To explore the clinical efficacy of using forehead expansive skin flap doublepedicled with superficial temporal vessels for repairing male cervicofacial scar. Methods From July 2005 to June 2009, 13 male patients with an average age of 27 years old (range; 21-38) were operated by the above method. The scar-repairing area was from 14 cm × 5 cm to 32 cm× 15 cm. The procedure was carried out in three stages. Firstly, ultrasound Doppler was used to detect and mark the location and orientation of superficial temporal artery. A proper cavity was created under the forehead muscle and then the appropriate expander embedded through the scalp incision. The expander was expanded first by injecting normal saline at 1 or 2 weeks post-operation. After that, the injection was repeated by 3 or 5 days. The volume ratio of injection to expander was (1. 5 - 3. 5) : 1. Secondly the forehead expansive skin flap was designed with proper hair follicle scalp pedicled by bilateral superficial temporal artery when the expansion was completed. After removal of the expander, the rectangle expansive skin flap with hair follicle scalp was transferred through the double pedicle. The cervicofacial scar was excised according to the size of the transferred expansive skin flap (25 cm ×6 cm to 32 cm ×9 cm). And the flap was adjusted with hair follicle scalp to the middle of the chin area in order to obtain the normal beard appearance. Donor site were closed directly. Thirdly, the pedicle skin flap were cut and restored after one month. Results The volume expanded for each expander ranged from 420 to 800 ml (mean: 660). The average expansion time was 4 months (range: 3 - 5 ). All flaps survived well. Donor site were closed directly. Both chin and beard looked normal. Conclusions Repairing hypertrophic scar and reconstructing beard in cervicofacial area with forehead expansive skin flap pedicled by bilateral superficial temporal artery is a valuable and safe method.The donor site is scarless. And the reconstructed chin and beard are normal both functionally and aesthetically.

Objective To evaluate the pulmonary function in patients with pectus excavatum before and after Nuss procedure and stratified according to age. Methods A total of 45 patients treated at our hospital from March 2007 to January 2008 were recruited retrospectively. Pulmonary function was assessed 3 days before and 3 months after surgery. Non-thoracoscopy-aided Nuss procedure was performed for correction. The data were analyzed and stratified according to age ( < 12 years and ≥12 years). Results The post-operative value of VC (vital capacity,74% ± 17% ) significantly decreased compared to its preoperative value(89% ±25%). RV (residual volume) and TLC (total lung capacity) also significantly decreased ( 135% vs 139% , 93% vs 96% ) while RV/TLC was elevated (157% vs 148% ) ( all P <0.05). When stratified according to age, post-operative TLC value decreased in older group and no significance was noted in younger group. As to the indices of ventilation function, post-operative MVV ( maximal voluntary ventilation) , PEF (peak expiratory flow) , MMEF (maximal mid-expiratory flow) , V75,V50, and V25 improved, FVC (forced vital capacity) decreased (all P<0.05) while FEV1 (forced expired volume in one second) and BR ( bronchial responsiveness) had no significant change. When stratified according to age, the post-operative values of PEF, MMEF, V50, V25 improved in younger group in contrast to those in older group. No significant post-operative change of FEV, was noted in younger group while a significant decrease was found in older group. No significant change of MVV was noted in younger group and significant post-operative improvement was present in the older group. Conclusions In general, the Nuss procedure brings no significant improvement of pulmonary function in short-term follow-up. Most of the indices pertaining to lung capacity decrease whereas most of those pertaining to ventilation function increase.A decrease of lung caacity is significantly lower in younger patients than in dlders .And the inprovement of ventilation function es better in younger patients than in elders.

Objective To evaluate the efficacy and safety of weekly or 3-week docetaxel in combination with capecitabine. Methods 83 Patients with at least one measurable lesion were randomized to receive the treatment arms: docetaxel 37. 5 mg/m2 on days 1 and 8, oral capecitabine 950 mg/m2 twice daily on days 1 -14 (Group A) ; docetaxel 75 mg/m2 on days 1, oral capecitabine 950 mg/m2 twice daily on days 1-14 (Group B). Each cycle was repeated every 3 weeks. Results Eighty-three patients were enrolled,78 eligible for tumor assessment. The overall clinical response rate of all groups was 61. 4% (51/83). There was no progressive disease (PD) after two cycles. Efficacy outcomes were similar in the two groups. The response rate of group A and B were 61.8% (21/34) and 61.2% (30/49) respectively. There were no drug-related deaths observed.Neutropenia was the most common toxicity. In all, the frequence of Grade 3/ 4 neutropenia were 45. 8% (38/83) , but Grade3/ 4 neutropenia of Group B 55. 1% (27/49) was higher than Group A 32. 4% ( 11/34), P = 0. 04. Conclusion The study confirmed the superior activity of docetaxe-capecitabine combination therapy in anthracycline resistant MBC, and comparing with 3-week schedule, weekly docetaxel plus capecitabine has same high efficacy with a favourable safety profile.

Objective To evaluate the influence of mutations in epidermal growth factor receptor (EGFR) gene on the prognosis of non-small cell lung cancer (NSCLC). Methods A total of 107 NSCLC patients undergoing tumor resection from December 2005 to August 2009 at our hospital were recruited.Mutations of exons 18-21 of EGFR gene in patients were detected by polymerase chain reaction (PCR) amplification and gene sequencing. The influence of mutations in EGFR gene on the growth, metastasis and survival rate of NSCLC was evaluated. Results EGFR mutations were detected in 30 (28. 0% ) of 107 patients. The mutation distribution was as follows: exon 18(n=1),exon 19(n=8),exon 21(n=20),and exons 18 and 19 multiple(triple mutations,n=1).NSCLC with EGFR mutations had a higher growth velocity than that without EGFR mutations[M(Q1-3):0.42(0.17-1.04)mm/d vs 0.21(0.19-1.00)mm/d.P<0.05].EGFR mutations had no significant impaction on neither the lymph node metastasis of NSCLC(P>0.05)nor on the tumor metastasis to other organs(P>0.05).The mean survival time of patients with and without EGFR mutations were(18.2±8.9)and(25.5±7.8)months respectively.The 1.2 and 3-year survival rate were 62.2%vs 72.2%.47.7% vs 57.3%and 46.9%vs 56.3%respectively between patients with and without EGFR mutations.Log-rank test didn't show a significant difference among them(X2=0.59,P>0.05).Conclusiom The EGFR mutations promote the growth of NSCLC.But it may not be a factor of predieting prognosis.

Objective To explore the clinical characteristics and the prognostic factors of patients with colorectal cancer. Methods The data of 2042 cases of colorectal cancer, pathologically confirmed at our hospital from January 1995 to December 2007, were summarized and analyzed. Results The median age of all cases with colorectal cancer was 59 years old. The high-risk age ranged from 50 to 70 years old. The ratio of male and female was 1.4: 1. The lesions located in rectum accounted for 46.2% and those for 22.0% in sigmoid. Patients under age 40 had a higher percentage of poor differentiation (33.5%) and mucinous carcinoma(16.7%).The cases with confirmed stage Ⅰ,Ⅱ,ⅢandⅣwere 5.8%,42.9%,31.0%and 20.3%respectively.For all cases,the 1-,3-,5-and 10-year sunrvival rates were 92.3%,73.9%.65.1%and 57.5%respectively.The independent risk factors for patient prognosis were age,gross type,differentiation,TNM staging and surgical type.Adjuvant chemotherapy was a protective factor.As compared with phase Ⅰ(1995-2001),phaseⅡ(2002-2007)had a higher pmportions of employing stapler,Dixon operation and adjuvant chemotherapy.The 1-,3-and 5-year survival rates of phase Ⅱ were higher than phase Ⅰ(93.4%,78.0%and 73.2%vs 90.6%,69.2%and 58.8%).Conedusion The prognostic factors of patients with colorectal cancer are age, gross type, differentiation, TNM staging, surgical type and adjuvant chemotherapy.

Objective To study the anti-influenza A virus effects of traditional Chinese medicine Kanggan granules in chicken embryo and BALB/c mice. Methods The influenza A virus ( H1N1, FM1) was used in the experiments. FM1 was cultured in chicken embryo and the anti-FM1 activity of Kanggan granules was evaluated through the post-medication hemagglutination titer of FM1. In animal test, 120 healthy BALB/c mice were randomly divided into six groups, normal control, virus control, ribavirin, highdosage, middle-dosage and low-dosage. The FM1 infection model was established by dripping FM1 into nasal cavity and then the appropriate treatments were prescribed. The effective anti-FMl indices of Kanggan granules included survival status, protective percentage of death and life elongation percentage of mice infected with FM1. Results The high and middle doses of Kanggan granules could inhibit the replication of FM1 remarkably in chicken embryo, and could reduced hemagglutination titer to 5 and 3 times. In animal experiments, all mice treated with Kanggan granules could improve the general status of infected mice, the protective percentages of death were 35. 0% to 55. 0% , the life elongation percentages were 73. 0% to 88. 9% and the minimal effective dose was 3. 00 g/kg. Conclusion Kanggan granules can inhibit the replication of influenza A virus and protect the mice infected with FM1.

Objective To investigate the effect of TIEG-siRNA on Smad2, p-smad2 and collagen IV in diabetic nephropathy rats induced by streptozotocin (STZ) . Methods Ten Sprague-Dawley rats injected with STZ were randomly divided into TIEG-siRNA and Control groups. Other five normal rats were used as control. Each of the TIEG-siRNA and Control groups were injected with TIEG-siRNA and Control 0. 5 ml via tail vein at 0 and 72 hours respectively. All rats were sacrificed at week 4 after a successful modeling. To confirmed the efficacy of TIEG-siRNA in rat kidney, the TIEG levels were determined by fluorescence quantitative PCR. The expressions of Smad2, p-smad2 and collagen IV protein were detected by immunohistochemical method while Smad2 and p-smad2 examined by Western blot Results The TIEG levels were greatly down-regulated in the TIEG-siRNA treated group (0.0636 ± 0.0066) versus the empty vector treated group (0. 1054 ± 0. 0111) ( P < 0. 05). The immunohistochemical semi-quantitative method indicated that there was a decrease in the TIEG-siRNA treated group versus the empty vector treated group:(2. 13 ±0.19)% vs (2.53 ±0.34)% in Smad2, (21. 77 ± 2. 00)% vs (27. 03 ±2. 51)% in p-smad2 and (3.67 ±0.42)% vs (4. 85 ±0.43) % in collagen IV. Western blot also showed that smad2 in the TIEG-siRNA treated group (0. 32 ± 0. 09 ) was much lower than that in the empty vector treated group (0. 50 ±0. 04). And p-smad2 in the TEEG-siRNA treated group(0. 16 ±0. 01)was much lower than that in the empty vector treated group ( 0. 32 ± 0. 02 ) (P < 0. 05). Conclusion TIEG-siRNA may be useful in preventing the progression of diabetic nephropathy through influencing the expression of Smad2 and its activation and down-regulating collagen IV.

Objective To detect the expressions of nuclear factor-Kappa B ( NF-κB ) and intercellular adhesion molecule-1 (ICAM-1 ) after hepatic ischemia-reperfusion injury so as to study the protective effect of Salvia in rats. Methods The hepatic ischemia-reperfusion rat model was established by the method of Nauta. The rats were randomly divided into 3 groups: sham operation ( S), ischemiareperfusion ( I/R) and Salvia preconditioning (P). At 2, 8, 24 h after ischemia-reperfusion,immunohistochemistry was employed to detect the hepatic expressions of NF-kB and ICAM-1. Measurement of hepatic tissue myeloperoxidase (MPO) concentration was used to reflect the neutrophilic infiltration of heaptic tissue. And the injury severity of hepatic tissue was evaluated by the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the examinations of light microscopy and electron microscopy. Results The NF-kB level at 2 h (0.418 ±0.039) post-reperfusion was significantly higher in the I/R group. And it decreased gradually at 8 h (0. 308 ±0. 028) and 24 h (0. 240 ± 0. 032).And the ICAM-1 level increased at 2 h (0. 367 ±0. 034) post-reperfusion, peaked at 8 h(0.451 ±0. 031)and began to decrease at 24 h (0. 293 ± 0. 025). The changes of MPO, ALT and AST were similar to ICAM-1. The above-mentioned indicators at different time-points were lower in the P group than those of the I/R group (P <0. 05) , but higher than the S group (P <0.05). The changes in ALT, MPO, NF-κB and ICAM-1 had a positive correlation ( P < 0.01 ) . Light and electron microscopy observations showed significant differences in different groups. Conclusion The rat hepatic ischemia-reperfusion increases the expressions of NF-kB and ICAM-1 and they are involved in hepatic ischemia-reperfusion injury. Salvia significantly reduces the expressions of NF-κB and ICAM-1 in ischemia-reperfusion hepatic tissue and it mayeffectively protect the injury of hepatic ischemia-reperfusion.

Objective To evaluate the effect of calcium ionophore (CI) A23187 and human recombinant granulocyte/macrophage colony stimulating factor (rhGM-CSF) on the cultivation of dendritic cell (DC) from healthy human peripheral blood mononuclear cell (PBMC) and to evaluate the in vitro effect of DC stimulated by K562 cell lysate on inducing specific cytotoxic T lymphocyte ( CTL) against K562 cell Methods Human PBMCs isolated from healthy subjects were separated into two groups. In Group A,the cells were cultured with additional rhGM-CSF, recombinant human interleukin 4 and recombinant human tumor necrosis factor-a only as control group. In Group B, the cells were cultured in the presence of rhGMCSF and CI A23187. The cells in both groups were pre-incubated with K562 cell lysate at 37℃for 30 min.The cells were harvested after a 4-day cultivation. Morphology of DC was continuously observed under inverted microscope. The surface antigens of induced cells were analyzed by flow cytometry (FCM). Then the proliferation of allogenetic T cell and the specific cytotoxicity of T cell primed with DC were examined by colorimetry. Also, the nonspecific inhibition of DC loaded K562 cell lysate against K562 cell was detected.Results Typical morphological features of DC could be observed in both groups. The expressions of CD83,CD1a, CD86 and CD40 were stronger in Group B than those in control group (45. 2% ±1.8%, 31.5% ± 3.9%,40.1%±7.8%,36.4%±6.3% vs 16.9%±1.3%,20.4%±3.4%,26.5%±2.2%,22.3%±3.0%)(all P<0.05).The expression of CD14 Was weaker in Group B than that in control group (5.7%±0.8% vs 19.0%±1.6%)(P<0.05).As compared with the control group,DC in Group B loaded with K562 lysate could evidently stimulate the Proliferation of allogenetic T cell(P<0.05.exclusion of effector-to-target ratio of 1:40)and inhibit the growth of K562 cell(P<0.05).In addition.both groups of DC-stimulated CTL had specific cytotoxicity against K562 cell.At the effector-to-target ratios of 10:1 and 40:1.the DC-stimulated CTL of Group B had stronger cytotoxicitiy against K562 cell(both P<0.05).Conclusion In combination with rhGM-CSF.CI A23187 induces PBMC into DC in a more effective way.DC loaded with K562 lysate can stimulate CTL and maintain high immunocompetence with specific cytotoxicity against K562 cell.

Objective To explore the microRNA(miRNA) differential expression profile between nephroblastoma cell line G401 and normal embryonic kidney cell line CCC-HEK-1 so as to provide rationales for the role of miRNA in the pathogenesis of nephroblastoma. Methods Three samples from G401 cell line and another 3 samples from CCC-HEK-1 cell line were chosen as the experimental group and the control group respectively. miRNA profiles in these samples were analyzed by microarray. The threshold value used to screen up and down-regulated miRNAs was fold change≥2 or≤50.0%. And real-time PCR was used to validate the reliability of microarray. Results Seventy-one miRNAs were found up-regulated in the experimental group and 11 of them were more than 8 times versus control group. In addition, 59 miRNAs were found down-regulated and 11 of them were 12. 5% versus control group. Overall, there were significant differences in the expression of miRNA between G401 and CCC-HEK-1 cell lines. Conclusions There is a differential expression of miRNA between G401 and CCC-HEK-1 cell lines. It may be related with occurrence and metastasis of nephroblastoma.

Objective To investigate the change of selenoprotein S1 ( SEPS1) hepatic expression in septic mouse induced by LPS attack. Methods The septic murine model induced by LPS attack was established. Ten mice were randomly selected as control group from 84 BALB/c mice and others as septic group. The mice were sacrificed after anesthesia in control group and 10 mg/kg LPS was injected intraperitoneally into septic group mice. Liver and blood samples were taken at 6, 12, 24, 48, 72 and 96 h after LPS injection. Ten mice were randomly selected at each time point The levels of blood ALT, AST,LDH and liver IL-6, TNF-a were detected. And the SEPS1 expression was simultaneously detected by Western blot Results There was liver damage in septic group compared with normal control group. The levels of ALT, AST and LDH markedly increased And all peaked at 24 h. The levels were (99±11 ) ,(299±48) and (1523±131) U/L respectively ( versus level at zero hour, P < 0. 05). Then there was a gradual decrease and the pre-damage levels were restored during 24-72 h. The levels of IL-6 and TNF-a also markedly increased. The damage deteriorated rapidly and peaked at 48 h. The levels were (30 325±17 901) and (36 509±0 794) ng/L respectively [versus level at zero hour (23 802±11 150), (29 799±239) ng/L, P <0. 05]. Western blot showed that SEPS1 protein expression markedly increased simultaneously in liver of septic mouse. And the peak value was reached at 24 h post-injury. Then there was a gradual decrease and normal level returned at 72 h. Immunohistochemical results showed that SEPS1 protein expression in liver of septic mouse also markedly increased. And the peak value was reached at 24 h postinjury. Pathologic results showed that liver lesion was apparent in septic mouse and it was the worst during 6-12 h. Conclusion Liver damage to different extents may be induced by LPS attack in septic mouse. The levels of IL-6 and TNF-a markedly increase. The SEPS1 protein expression in liver of septic mouse is also markedly elevated. And it peaks at 24 h post-injury and returns to normal at 72 h.

Objective To observe the effects of candesartan on the expressions of JAK2 and protein tyrosine phosphatase-1 B (PTP-1B) in adipose tissue of obese rats induced by high-fat diet Methods A total of 45 male Wistar rats were randomly assigned into 3 groups of normal control ( NC group), high fat diet (HF group) and high-fat diet with daily Candesartan treatment (FC group). The rats of FC group were treated with orally taken Candesartan at a dose of 8 mg/kg body weight per day. Blood chemistry and insulin were assayed at Week 16. Euglycemic-hyperinsulinemic clamp technique was performed to evaluate the peripheral insulin resistance. The expressions of JAK2 and PTP-1B in adipose tissue were confirmed by both reverse transcription-polymerase chain reaction (RT-PCR) and Western blot Results (1)The body weight and peri-renal fat weight of HF group were significantly higher than those of FC and NC groups (all P <0.05). (2)total cholesterol (TC) and fasting insulin (FINS) of FC group were lower than those of HF group [TC,FC group:(1.37 ±0.39) mmol/L vs HF group:(2. 01 ±0. 26)mmol/L, P<0.05; FINS,FC group: (3. 03 ± 1. 37) mU/L vs HF group: (4.76 ± 2. 75) mU/L, P < 0. 05] while insulin sensitive index (ISI) and angiotensin Ⅱ( AngⅡ ) of FC group were much higher than those of HF group [ ISI, FC group: (58 ±12) × 10-3 vs HF group: (29 ±9) × 10-3, P<0.05; Ang Ⅱ , FC group: (61 ±11) mmol/L vs HF group: (52 ±10) mmol/L, P <0. 05]. (3) The steady-state glucose infusion rate (SSGIR) of FC group was significantly higher than that of HF group [FC group: (22 ±5) mg · kg-1 · min-1 vs HF group: ( 14 ± 4 ) mg · kg-1 · min -1, P < 0. 05 ]. (4) Both the mRNA and protein expressions of JAK2 and FTP-1B in FC group were significantly lower than those in HF group respectively. Conclusion There are insulin resistance and a high expression of JAK2 and PTP-1B in adipose tissue of obese rats induced by high-fat diet And both are related with the elevated Ang Ⅱ level. Candesartan can reverse these effects.

The patient was a 60-year-old female who underwent radical nephrectomy for right nephrocarcinoma in 1991. The postoperative pathology was clear cell carcinoma with Fuhrman grade Ⅱ. No abnormalities were found after 5 years of follow-up, and the patient did not insist on re-examination after that. In April 2008, the B-ultrasound examination in another hospital found "tumor at the middle and upper pole of the left kidney, about 5.5 cm in diameter", and no metastatic cancer or tumors in other organs of the whole body were found, so she was admitted to our hospital for treatment in June 2008.

Rho kinase (ROCK) is one of the downstream effector molecules of Rho protein, and it has been confirmed to play an important role in intracellular signal transduction in vascular smooth muscle cell contraction, cell migration, proliferation and apoptosis [1]. Abnormal activation of ROCK has been found in patients with various cardiovascular diseases such as atherosclerosis, restenosis, hypertension, pulmonary hypertension and myocardial hypertrophy [2]. Animal experiments and clinical studies have shown that ROCK inhibitors can safely and effectively treat pulmonary hypertension.

Idiopathic pulmonary interstitial fibrosis (IPF) is an unexplained chronic and progressive lung disease with a high mortality rate within 5 years after onset, and there is no effective drug treatment at present. The clinical trial of sildenafil, a phosphodiesterase 5 inhibitor, in the treatment of IPF (STEPIPF) was conducted by the IPF Clinical Research Working Group of the National Heart, Lung and Blood Association of the United States. The results were published on the New England Journal of Medicine website (www.nejm.org) on May 18, 2010.

Vitamin A deficiency affects 190 million preschool children and 19 million pregnant women worldwide.Chronic vitamin A deficiency may increase the risk of pregnancy complications and mortality.Vitamin A acts on nuclear receptors through its active metabolite retinoic acid,and plays an important regulatory role in early lung development and alveolar formation.Animal experiments have shown that vitamin A plays an important role in embryo growth,organ development and maturation.Vitamin A deprivation in pregnant rats will lead to lung dysplasia in their offspring, but vitamin A supplementation in early pregnancy will prevent this phenomenon.

Thyroid adenolipoma is a rare benign thyroid disease [1], with limited domestic reports. A case found in Huaihe Hospital of Henan University is reported as follows. The patient was a 60-year-old female who accidentally discovered a neck mass for more than 2 months. She came to our hospital for treatment and admission on December 29, 2009. The patient had no other symptoms such as palpitation, shortness of breath, polyphagia, emaciation, voice change, dyspnea, etc., and the tumor did not grow obviously. Physical examination at admission showed that a medium nodule of about 1.0cm ×1.0cm could be palpable at the lower pole of the right lobe thyroid gland, with clear boundary, no tenderness, and good movement up and down with swallowing.