Volume 95  ·  Issue 24  ·  2015

Carotid endarterectomy (CEA) has a history of more than 60 years and is still recognized as the "gold standard" for the treatment of carotid arteriosclerosis and stenosis to prevent stroke^[1]。 Over 60 years of development, CEA has evolved four different surgical procedures, each with its own advantages and disadvantages. At present, most domestic centers still use in-situ incision and continuous suture, which is not commonly used internationally.

Stroke is an ancient disease that endangers human health, and it is still one of the main diseases that cause human death and disability. The human exploration of the cause of this disease has never stopped, but it was not until more than 60 years ago that scholars first recognized the relationship between stroke and carotid artery stenosis^[1], and gave birth to a brand-new treatment-carotid endarterectomy (CEA). After more than half a century of development, this operation has matured, and through a series of clinical trials in the 1990s, it has achieved the gold standard status for the treatment of carotid artery stenosis and the prevention of stroke. However, a technological revolution in the field of vascular disease treatment in the late 20th century opened an unprecedented new chapter for doctors. The newly born endovascular/interventional technology has become a powerful weapon for the treatment of vascular diseases with its minimally invasive and efficient characteristics. At present, it has become the mainstream technology in the field of coronary atherosclerotic heart disease treatment, and has also made great achievements in the field of carotid artery. Looking back at the development history of carotid artery stenting (CAS), it is not difficult to find that this new treatment has challenged the gold standard status of endarterectomy since its birth, and started a series of controlled studies with endarterectomy. Among them, the recognized milestone study is the CREST study published in 2010, which proved for the first time that there is no significant difference in the safety and efficacy of carotid artery stenting and endarterectomy in the treatment of carotid artery stenosis, which provides strong support for carotid artery stenting to become one of the preferred methods for the treatment of carotid artery stenosis, and promotes this technology to enter the mainstream guidelines.

Ischemic stroke is an important fatal and disabling factor. Once ischemic stroke occurs, the risk of recurrent ischemic events and death (recurrent stroke and myocardial infarction, etc.) is significantly increased, and atherosclerosis at the bifurcation of common carotid artery is one of the main causes of recurrent ischemic stroke^[1]。

The diagnosis of lower extremity ASO must be established by a combination of medical history inquiry, physical examination and related special examinations.

To evaluate the safety and early and late outcomes of carotid endarterectomy in treating extracranial carotid artery stenosis.

From January 2010 to September 2014, 572 consecutive patients with carotid artery stenosis underwent 618 CEA operations. 470 patients were males and 102 patients were females. Their age range was 36-87 years old. Average age was 66 years old. Among these patients, symptomatic carotid artery stenosis is 58.2%, CEA high-risk patient is 26.9% and 35.6% patients combined contralateral carotid artery heavy stenosis or totally occlusion.

All the operations were success. Overall, perioperative major adverse events (death/stroke/MI, MAEs) rates were 3.7%. The risk of MAEs was not associated with whether symptomatic carotid artery stenosis, CEA high-risk patients and the lesions of contralateral carotid artery or not. 511 patients were followed up for a mean period of 42 months. MAEs rate in follow-up period is 8.5% and restenosis rate is 3.3%. The results of Kaplan-Meier survival analysis show symptomatic carotid artery stenosis and CEA high-risk patients couldn't increase the risk of MAEs. However, heavy stenosis in contralateral carotid artery could increase the rate of death and stroke in the late follow-ups.

CEA is a safety and effective method to treat extracranial carotid artery stenosis. The keys to prevent perioperative complications include a comprehensive evaluation of the patients' condition, an optional and personal surgical plan prior to the operations, and a dedicated management during the operations.

To discuss the feasibility, safety and effectiveness of surgical management of post carotid artery stenting (CAS) restenosis, mainly focusing on the surgical options and indications.

This study represented retrospective analysis of 3 kinds of surgical managements of 21 patients with symptomatic post CAS restenosis from April 2012 to April 2014. Patch carotid endarterectomy (pCEA), Eversion carotid endarterectomy (eCEA) or carotid excision and graft interposition (CEGI) was selected to remove the stent and reconstruct the blood flow, based on the preoperative imaging results and intraoperative adhesion degree. Use of carotid shunt, blood loss, operative time, carotid artery cross-clamp time and other data were recorded. Patients were followed for improvement of symptoms, complications and restenosis.

Eleven, 4 and 6 patients received pCEA, eCEA or CEGI respectively. All the stents were successfully removed. Shunts were deployed in 14 cases. The mean bleeding was (152.6±38.0) ml, the mean operation time was (100.7±34.8) min and the mean carotid artery clamping time was (29.1±4.6) min. In the early postoperative period, there were no infection, strokes, cranial nerve injury, myocardial infarction or mortalities. One patient developed neck hematoma, while 2 patients had the symptoms of hyperperfusion such as headache, irritability and multi-lingual but no intracranial hemorrhage happened according to the brain CT scan, who all fully recovered within 3 days. Within a median follow-up of (13.2±4.3) months, no strokes, myocardial infarctions or recurrent restenosis (>50%) on duplex ultrasound imaging or CTA was discovered except for 1 patient who died of lung cancer.

Surgical management to remove the stent and reconstruct the blood flow, which offered new options in the treatment of post CAS restenosis, with its initially confirmed simplicity, feasibility, safety and validity.

To analyze the outcomes of synchronous revascularization for patients concomitant carotid and coronary artery severe stenosis.

From May 2012 to April 2014, 12 cases who received one-stage operation was retrospective analyzed, including the characteristics, methods of treatment, perioperative complications and health survey 30 days post procedure. Two subgroups were divided according to the different treatment methods on carotid artery, WIC and SF-36 scale were applied to compare the basic condition and recovery situation between 2 groups, the hospital stay time, costs, ventilation time, drainage and blood transfusion volume were also be compared.

Totally 30 coronary vessels 8 carotid endarterectomy (CEA) and 5 carotid artery stenting (CAS) were performed on 12 patients. One patient also received coronary artery bypass grafting and bilateral carotid artery revascularization (CEA on right and CAS on left). Two (16.67%) minor stroke, 1 (8.33%) TIA, 1 wound infection occurred within 30 days post procedure, and 11 (91.67%) received blood component transfusion. No myocardial infarction and death occured. The average hospital stay time were (36.5±25.3) days, ventilator application (37.5±31.2) hours, postoperative drainage volume from pericardial and mediastinal was (347.92±105.69)ml, infusion of concentrated red cell was 4.3 U. WIC was (5.57 ± 1.51) in CEA and (4.25 ± 1.50 )in CAS subgroup, there was no significantly statistical difference (t=1.40, P>0.05). the results of SF-36 was (3.63 ± 1.76) and (5.44 ± 1.05) in CEA and CAS subgroup, there was no significantly statistical difference(t=-1.85, P>0.05). In hospital stay time, ventilator application time, transfusion and drainage volume, hospitalization costs were also no significant statistical difference between two groups.

The early outcome of synchronous revascularization on concomitant carotid and coronary severe stenosis disease is satisfactory. The clinical results are similar in the CEA and CAS subgroup.

To test the antitumor effects of the mTOR inhibitor everolimus in breast cancer stem cells and total cells in vitro and in vivo.

In vitro studies, we sorted ESA⁺ CD44⁺ CD24^-/low cells as stem cells using flow cytometry from primary breast cancer cells. Apoptosis and the cell cycle distributions of stem cells were examined by flow cytometry. The tumorigenicity of stem cells after treatment was investigated by soft agar colony formation assays. BALB/c mice were injected with stem cells and the different treatments were administered. After necropsy, the expression of Ki67, CD31, AKT1, and phospho-AKT (Thr308) was analyzed by immunohistochemistry.

Treatment with everolimus resulted in growth inhibition of all stem cells in a dose-dependent manner. An increase in G0-G1 cell cycle arrest and an increased population of cells in early apoptosis were seen in everolimus treatment. In vivo, the volumes of the xenograft tumors significantly decreased in everolimus alone group compared to control group.

Everolimus could inhibit the growth of both total breast cancer cells and sorted stem cells in vitro and in vivo.

To explore the therapeutic effects of sequential intensified conditioning regimen followed by graft-versus-1eukemia (GVL) induction in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for refractory advanced acute myeloid leukemia (AML).

A total of 72 patients with refractory AML undergoing allo-HSCT from May 2001 to June 2013 were enrolled in this prospective study. Intensified conditioning included fludarabine+ cytarabine plus total body irradiation+ cyclophosphamide+ etoposide. Cyclosporine A was withdrawn rapidly in a stepwise fashion if patients who did not experience acute graft-versus-host disease (aGVHD) at Day + 30 post-transplantation. Donor lymphocytes were infused in patients without grade Ⅱ or more than grade Ⅱ aGVHD at Day + 60 post-transplantation.

The median follow-up time was 655(1-4 200)d post-transplantation. Except for one died of infection and one died of regimen-related toxicity (RRT), the other 70 patients achieved complete remission at the time of neutrophil reconstitution. The mortality of RRT was 1.4%(1/72). The 1-year cumulative incidence of aGVHD and 2-year incidence of chronic GVHD (cGVHD) post-transplantation were 60.7%±5.0% and 58.5%±4.7%. The 5-year cumulative incidence of relapse post-transplantation was 29.6%±6.6%. The 5-year non-relapse mortality was 28.8%±6.0%. The 5-year overall and disease-free survival were 51.0%±6.5% and 49.9%±6.4%. Multivariate analysis revealed that donor lymphocyte infusion, cGVHD and bone marrow blasts at Day 0 were independent prognostic factors for relapse(HR(95%CI): 0.042 (0.007-0.688), 0.009 (0.003-0.345), 3.385 (1.451-7.899)) and survival(HR(95%CI): 0.315 (0.146-0.621), 0.416 (0.200-0.866), 1.332 (1.158-1.533)).

The strategy of sequential intensified conditioning followed by GVL induction has an acceptable toxicity profile, and could decrease the relapse rate and improve the survival for refractory AML.

To evaluate the efficacy of enhanced CT and contrast-enhanced endoscopic ultrasonography(CE-EUS)for assessment of the resectibility of periampullary neoplasm.

a retrospective analysis of 93 patients with periampullary neoplasm underwent CT and CE-EUS was conducted to compare the imaging data with the surgical and pathological findings, in order to evaluate their efficacies for the resectibility assessment.

There was no significant difference in sensitivity and specificity between CT and CE-EUS for the evaluation of adjacent organ invasion, lymph node metastasis and liver metastasis (P>0.05). For the diagnosis of periampullary neoplasm and assessment of vascular invasion, CE-EUS was better than CT(94.6% vs 84.1%,P=0.023; 96.2% vs 85.9%, P=0.041). Logistic regression indicated that the accuracy of CE-EUS in determing adjacent organ invasion was correlated with the tumor size, and vascular invasion was correlated with the tumor location and size.

CE-EUS has advantages in the assessment of the resectibility of periampullary neoplasm, especially for the assessment of vascular invasion, and can be used as a supplementary Image technology to the enhanced CT.

To compare the relevant indicators of coagulation and fibrinolysis in patients with varying severity of community-acquired pneumonia (CAP).

A total of 107 CAP hospitalized patients at Department of Respiratory Medicine, Affiliated Hospital, Chengde Medical College from July 2013 to June 2014 were enrolled as pneumonia group while another 52 healthy outpatients served as control group. The levels of routine blood test, coagulation function, procalcitonin and C-reactive protein (CRP) were measured and compared among different groups. All hospitalized CAP patients were divided into low and high-risk groups according to pneumonia severity index (PSI). And all indicators were measured to examine the differences among different groups.

The white blood cell count in pneumonia group was significantly higher than that in control group ((9.3±5.1) vs (7.5±2.9)×10⁹/L, P<0.05). The red blood cell count, hemoglobin and platelet count in pneumonia group were significantly lower than those in control group ((4.3±0.6) vs (4.8±0.5)×10¹²/L, (131.1±18.7) vs (144.9±17.4) g/L, (199.3±69.4) vs (237.9±72.5)×10⁹/L, all P<0.05). The D-dimer, fibrinogen degradation products (FDPs), fibrinogen (FIB), activated partial thromboplastin time (APTT) and prothrombin time (PT) in pneumonia group were significantly higher than those in control group ((1.86±1.28) vs (0.48±0.38) mg/L, (6.42±3.27) vs (2.17±1.46) mg/L, (3.87±1.17) vs (3.42±0.96) g/L, (35.64±8.34) vs (31.29±11.19) s, (12.21±1.40) vs (11.36±2.19) s, allP<0.05) while thromboplastin time (TT) was lower than that in control group ((13.43±3.38) vs (16.16±2.89) s,P<0.05). The levels of D-dimer, FDPs, procalcitonin, CRP, APTT and PT in high-risk group were significantly higher than those in low-risk group ((2.94±1.14) vs (1.16±0.78) mg/L, (8.85±2.82) vs (4.85±2.49) mg/L, (1.72±1.16) vs (0.40±0.51) μg/L, (104.2±61.9) vs (67.4±59.5) mg/L, (38.80±8.41) vs (33.60±7.69) s, (12.64±1.76) vs (11.94±1.03) s, allP<0.05) while platelet count and TT were lower than those in low-risk group ((172.8±57.1) vs (216.5±71.6)×10⁹/L, (12.10±2.66) vs (14.28±3.53) s, all P<0.05). The abnormal rates of procalcitonin, D-dimer and FDPs in high-risk group were significantly higher than those in low-risk group (100% (42/42) vs 86.2% (56/65), 95.2% (40/42) vs 75.4% (49/65), 95.2% (37/42) vs 44.6% (29/65), allP<0.05). The plasma levels of D-dimer, FDPs, procalcitonin and CRP were well-correlated with index of pneumonia severity (r=0.636, 0.608, 0.629, 0.250, all P<0.05). And the plasma level of platelet was negatively correlated with index of pneumonia severity (r=-0.320, P<0.01).

The red blood cell, hemoglobin and platelets are lower in patients with pneumonia than those in normal subjects. And the patients with pneumonia have coagulation and fibrinolysis disorders. The plasma levels of D-dimer, FDPs, procalcitonin, CRP and platelets are well-correlated with severity of CAP.

To compare the efficacy, safety and efficiency of sensor augmented insulin pump (SAP) versus double-C therapy in poorly controlled type 2 diabetes (T2DM).

A total of 81 patients with T2DM, HbA1c ≥9%, were divided randomly into SAP or continuous subcutaneous insulin infusion and retrospective continuous glucose monitoring (double C) group for both 6 days.

In both groups, mean blood glucose (MBG), mean amplitude of glycemic excursion (MAGE) and 24 h area under the curve at 10 (AUC₁₀) significantly decreased after therapy (P<0.05). These parameters in SAP group were lower than those in double C group (P<0.05). No significant difference existed in 24 h area under the curve at 3.9(AUC_3.9) (P>0.05). Compared with double C group, time spend to-blood glucose-target was shorter and in-target range proportion higher in SAP group(P<0.05). Logistic regression analysis showed that 2 h C peptide (CP)/ fasting C peptide (FCP), HbA1c and sensor alert on (allP<0.05) were independently correlated with up-to blood glucose target.

Compared with double C, SAP therapy may decrease blood glucose(BG), reduce glucose fluctuation and improve up-to target proportions without a higher risk of hypoglycemia.

To evaluate the impact of preoperative dual antiplatelet therapy of aspirin and clopidogrel on perioperative blood loss and blood transfusion requirements.

A total of 60 patients underwent off-pump coronary artery bypass grafting (OPCABG) performed by the same surgeons. And they were assigned to receive dual antiplatelet therapy of aspirin and clopidogrel (group AC, n=30) and discontinue antiplatelet therapy more than 5 days before surgery (group control, n=30).

No significant inter-group differences existed in basic clinical characteristics (all P>0.05). Itraoperative blood loss volume was similar for two groups (637±257 vs 635±196 ml,P=0.978). No significant inter-group difference existed in 24 h chest drainage volume (522±160 vs 524±204 ml, P=0.961) or total volume of chest drainage (1044±337 vs 1118±198 ml, P=0.306).

Preoperative dual antiplatelet therapy of aspirin and clopidogrel does not increase the total volume of postoperative chest drainage.

To study the significance of modified Mohs micrographic surgery in the treatment of cutaneous melanoma with the most appropriate margins.

A total of 20 cases with cutaneous melanoma treated by the technique of modified Mohs micrographic surgery from July 2013 to July 2014 were reviewed. Modified Mohs micrographic surgery set safe margin according to Guideline of Chinese Melanoma Treatment (2011) first, and then decide whether to adopt wider margins according to the pathology of the resected margin. Data concerning the numbers of additional resection and the final total width of margins were analyzed and the latter compared with the initial margins.

Among 20 cases, 7 cases (35%) needed more than two resections to obtain a clear margin. The final widths of margin in 7 cases (35%) are different from the guideline.

Modified Mohs micrographic surgery could ensure the thorough removal of primary tumor, while avoiding residual tumor as well as over-excision, which reflect the trend toward individualized treatment and minimally traumatic surgery.

To discuss the variation of intestinal barrier and its clinical significance in patients with ulcerative colitis(UC).

Specimens were obtained from 200 patients of UC and 40 controls respectively from March 2010 to June 2013. UC samples were classified into three groups as mild (n=68), moderate (n=70) and severe (n=62) according to Mayo classification. Immunohistochemistry was performed to examine the expression of occludin, β-defensin and sIgA, which respectively reflect the changes of mechanical barrier, chemical barrier and immune barrier in intestinal tissue. The result and the clinical data were analyzed.

Compared with controls, the expression of occludin and sIgA significantly decreased (28.53%±2.21% vs 44.28%±1.94%, 19.26%±1.09% vs 28.36%±2.36%, both P<0.05), β-defensin significantly increased(29.13%±1.75%比19.71%±1.83%,P<0.05)in UC group. There was a significant difference of occludin levels among different active subgroups (P<0.05), and the levels decreased significantly with the increase of UC classification(r=-0.753, P<0.05). β-defensin levels were significant differently among different active subgroups (P<0.05), and the levels increased significantly with the increase of UC classification(r=0.698, P<0.05). There was no significant difference in the sIgA levels among the three stages (P>0.05). In different gender, age and lesion site, there was no statistically significant difference in expression of three kinds of protein (allP>0.05).

UC patients exist intestinal barrier function injury, with the increase of UC classification, the damages of intestinal mechanical barrier and chemical barrier were more obvious.

To explore the clinical features and treatment options of patients undergoing surgical masses excision for preoperatively misclassified complicated renal cysts.

Retrospective analysis was performed on clinical records of patients who received partial or radical nephrectomy at Department of Urology of Peking Union Medical College Hospital with postoperatively pathological examination as benign renal cysts from January 2008 to December 2014.

There were a total of 31 patients meeting the inclusion criteria for analysis. Among them 4 patients were classified as Bosniak Ⅱ renal cysts by preoperative ultrasonography and/or computed tomography (CT), 7 patients as Bosniak ⅡF and Ⅲ respectively, 3 patients as Bosniak Ⅳ, as well as 10 patients as renal solid masses. The average max diameter of the lesions was 3.34±2.45 cm (ranging from 0.8 cm to 14.3 cm), with 83.87% lesions less than 4 cm. Eighteen patients (58.06%) received open partial nephrectomy, while 13 patients underwent laparoscopic partial or radical nephrectomy.

A considerable number of patients received unnecessary partial or even radical nephrectomy for misclassified benign renal cysts. Small high-density renal cysts could not only mimic solid renal masses on ultrasonography and plain CT, but also present pseudoenhancement on enhanced CT, thus easily leading to a misdiagnosis as solid renal tumors.

To explore the computed tomography (CT) features and pathological correlations of primitive neuroectodermal tumor (PNET) of the kidney.

The CT features of 5 cases of pathologically confirmed PNETs were retrospectively reviewed along with a literature review to analyze the CT features and pathological correlations.

The age range was 19-78 years. CT image showed solitary mass of heterogeneous density with ill-defined margins. One case had multifocal necrosis. Among 3 cases of cystic changes, there were mural nodule (n=2) and patchy calcification (n=1). Four cases showed invasive growth into renal cortex and pelvis with cortical interruption (n=3) and destruction of renal capsule and invasion into perirenal fat space (n=1). The tumors were confined to kidney contour with enlarged kidney (n=3). All 5 cases showed slight heterogenous enhancement in cortico-medullary phase with persistent moderate enhancement (n=4) and persistent mild enhancement (n=1) in nephrographic phase.

Renal PNET is common in young patients with a high degree of malignancy. CT features include large mass with heterogenous density and poor-defined border confined within renal contour. Necrosis and cystic changes occur commonly with invasive growth. Persistent enhancement is found during nephrographic phase. A definite diagnosis is dependent upon pathological and immunohistochemical examinations.

To explore the influence and mechanism of PinX1 gene on the chemotherapy sensitivity of nasopharyngeal carcinoma cells in response to Cisplatin.

Transfected nasopharyngeal carcinoma 5-8F cell lines with pCDH-CMV-PinX1-copGFP vector constructed by lentivirus to generate Lenti-PinX1-5-8F cells containing PinX1 gene, using Lenti-Ctrl-5-8F cell (blank vector without PinX1 gene was used to transfect 5-8F cell lines) and 5-8F cell as controls. Expression of PinX1 gene, telomerase activity, the inhibition of cancer cells proliferation, combined anticancer effect with Cisplatin and the expression of lung resistance protein (LRP) and Bcl-2 were detected with fluorescent quantitation polymerase chain reaction (PCR), flow cytometry, thiazolyl blue (MTT) method, areole test, Western blot and drug sensitivity test, respectively, in four groups (Lenti-PinX1-5-8F cell + Cisplatin, Lenti-PinX1-5-8F cell, Cisplatin and 5-8F cell) so as to explore the influence and mechanism of PinX1 gene on the chemotherapy sensitivity of nasopharyngeal carcinoma cells in response to Cisplatin.

The telomerase activity in Lenti-PinX1-5-8F cell (0.146±0.004) was lower than those in the other two control cells (Lenti-Ctrl-5-8F cell: 0.967±0.016, 5-8F cell: 1.000±0.034, both P<0.01). The cancer cell biological activity could be intensively inhibited by 16 μg/ml Cisplatin after lower level telomerase activity induced by PinX1 gene. Proliferation index (PI) (%) in Lenti-PinX1-5-8F cell + Cisplatin (14.39±3.66) was also less than the other groups (Lenti-PinX1-5-8F cell, Cisplatin and 5-8F cell groups, 32.97±3.00, 31.18±4.24 and 47.19±4.19, allP<0.01). And same time, the expressions of LRP (0.64±0.14) and Bcl-2 (0.57±0.12) protein in Lenti-PinX1-5-8F cells were obviously reduced than those in other two group cells (Lenti-Ctrl-5-8F cell: 0.84±0.19 and 0.81±0.16; 5-8F cell: 0.83±0.35 and 0.78±0.27; allP<0.01).

PinX1 gene can enhance the chemotherapy sensitivity of nasopharyngeal carcinoma cells in response to Cisplatin, which may be mediated by the down-regulation of telomerase activity and the inhibition of LRP and Bcl-2 gene in nasopharyngeal carcinoma cells.

To explore the therapeutic effects of chrysin for steroid-resistant asthma in a murine model.

Lipopolysaccharide (LPS) was used to induce steroid-resistant asthma in a murine model sensitized and challenged with ovalbumin (OVA). Forty-eight female BALB/c mice were randomly divided into 6 groups of control (A), OVA (B), LPS+ OVA (C), LPS+ OVA+ dexamethasone (D), LPS+ OVA+ chrysin (E) and LPS+ OVA+ dexamethasone+ chrysin (F) (n=8 each). At Day 1 and 14, group A received an intraperitoneal injection of phosphate buffered saline (PBS); groups B, C, D, E and F had an intraperitoneal injection of a mixture of OVA (20 μg) and aluminum hydroxide for sensitization. At Day 27, groups A and B were intranasally instilled with PBS while groups C, D, E and F had an intranasal instillation of LPS (10 μg). At Days 28, 29 and 30, groups B, C, D, E and F were challenged via airway with 1% OVA in PBS for 30 min and group A with PBS. Group D was intraperitoneally injected with dexamethasone (3 mg/kg) 30 min pre-challenge and PBS one day pre-challenge; group E received an intraperitoneal injection of chrysin (50 mg/kg) at one day and 1h pre-challenge; group F received dexamethasone (3 mg/kg) 30 min pre-challenge and chrysin (50 mg/kg) at one day and 1 h pre-challenge; groups A, B and C had PBS as above. Hematoxylin-eosin (HE) staining and periodic acid-Schiff (PAS) staining of lung tissues were performed to observe the pathologic changes. The total cells in bronchoalveolar lavage fluid (BALF) were counted under microscope. And enzyme-linked immunosorbent assay (ELISA) was applied for detecting interleukin-4 (IL-4) and interleukin-13 (IL-13) in BALF and IgE in sera.

The inflammatory infiltration in lung tissue of group F was obviously suppressed compared with that of group C. The numbers of PAS-positive cells per bronchus divided by the total number of epithelial cells in group D, E, F were markedly lower than that in group C ((54.5±6.9)%, (53.3±8.2)%, (23.8±7.0)% vs (71.3±12.2)%, all P<0.01). The total cells in BALF of group E and F significantly decreased versus that of group C ((1.22±0.23) ×10⁴/ml, (0.98±0.25) ×10⁴/ml vs (2.56±0.18)×10⁴/ml, both P<0.01). The levels of IL-4 in group D and F were significantly less than that of group C ((118±7), (124±5) vs (138±6) pg/ml, bothP<0.01). The levels of IL-13 in BALF of group E and F significantly decreased compared with that of group C ((787±57), (484±32) vs (1 121±132) pg/ml, bothP<0.01). The levels of IgE in sera of group D, E, F were significantly lower those of group C ((10 310±494), (10 771±650), (7 529±485) vs (12 618±595) ng/ml, allP<0.01).

Chrysin could improve the therapeutic efficacies of glucocorticoid for steroid-resistant asthma.

To explore the effect of recombinant adenovirus Ad-FLT-1/PC on the expression of vascular inflammatory factors in rats with diabetic nephropathy atherosclerosis.

A total of 68 rats of diabetic nephropathy atherosclerosis were randomly divided into three groups of Ad-FLT-1/PC [recombinant adenovirus with protein C (PC) gene, n=23], Ad-green fluorescence protein (recombinant blank adenovirus with GFP, n=23), normal saline (n=22) and compared with normal control (n=23). And 300 μl of each was transfected via caudal vein. At day 1, 3, 7 and 14 post-transfection, 5 or 6 rats of each group were randomly sacrificed to observe the distribution of vascular fluorescence by frozen section. And the expression of PC was examined by immunohistochemistry (IHC). The expressions of tumor necrosis factor-alpha (TNF-α) and intercellular adhesion molecule 1 (ICAM-1) protein in vascular wall were measured by IHC.

At day 3 after an injection of Ad-FLT-1/PC, green fluorescence was observed in vascular endothelium and continued until 14 days. IHC showed protein C in endothelial cells of Ad-FLT-1/PC group was higher than those of Ad-GFP and NS groups at Days 3-14(P<0.05). IHC showed the amounts of TNF-α and ICAM-1 in Ad-FLT-1/PC group were lower than those in GFP and NS groups at Day 7 post-transfection (P<0.05). GFP and NS groups had no difference at all timepoints (P>0.05).

The recombinant adenovirus Ad-FLT-1/PC may be transfected into vascular walls of rats with diabetic nephropathy atherosclerosis. And exogenous PC can effectively express and protect vascular walls by inhibiting the expression of inflammatory cytokines.

systemic sclerosis (SSc) is a connective tissue disease characterized by microvascular disease, tissue fibrosis and immune system activation. The prevalence rate is only 7/1 million ~489/1 million, according to foreign literature^[1]There is no relevant data in China. In the early stage of the disease, there is often only Raynaud's phenomenon, and patients often can't get timely diagnosis and treatment. In a Canadian cohort study, patients were diagnosed with SSc on average 5 years after the onset of Raynaud's phenomenon^[2]。 However, in the later stage of the disease, serious multi-system involvement can occur, such as gastroesophageal reflux disease, pulmonary interstitial disease, pulmonary hypertension, diastolic dysfunction, renal crisis, etc., which has a high disability rate and mortality rate, which seriously affects the quality of life of patients^[3]。 Early diagnosis and early treatment of this disease are particularly critical.