Objective To study the effect of cyclophosphamide pulse therapy combined with leflunomide (LEF) on refractory lupus nephropathy (RLN).Methods Thirty-six patients diagnosed as RLN were selected.Several observation parameters were compared before and after cyclophosphamide pulse therapy combined with LEF.The observation parameters included serum albumin,serum complement C3 and C4,systemic lupus erythematosus (SLE) activity index and urinary protein change.The side effects of cyclophosphamide pulse therapy combined with LEF were observed.Results The serum albumin was (20.17 ± 4.09) g/L,complement C3 was (0.40 ± 0.19) g/L,complement C4 was (0.08 ± 0.03) g/L,SLE activity index was 16.06 ± 4.17,and urinary protein was ( 9.79 ± 3.42 ) g/24 h before treatment and (38.10 ± 5.16) g/L,(0.78 ± 0.11 ) g/L,(0.16 ± 0.13)g/L,4.01 ± 1.24,( 1.14 ± 0.59) g/24 h after treatment,and there were significant differences between before treatment and after treatment (P ＜ 0.01 ).During the therapy,side effects were reported in 22 patients.However,these side effects had no impact on the therapy.After further treatment,these side effects gradually decreased and eventually disappeared.Conclusions Cyclophosphamide pulse therapy combined with LEF is effective in treating RLN.Patients' tolerance to the therapy is generally very good.

Objective:To investigate the expressions and their clinical significance of vascular endothelial growth factor (VEGF) and extracellular matrix (ECM) components in non-small cell lung cancer (NSCLC). Methods:Expressions of VEGF and ECM components (fibronectin, FN and collagen Ⅳ, cⅣ) in 50 cases of NSCLC tissues and 20 cases of normal lung tissues were detected by immunohistological analysis. Their relationship with clinical features of NSCLC and the correlation of expression of VEGF and Fn and cⅣ were analyzed.Results:The positive expression rates of VEGF, Fn, and cⅣ were 96%, 78%, and 50% in NSCLC tissues. The expressions of VEGF and Fn were significantly higher than those in normal lung tissues (P<0.05). The expression of Fn and over-expression of VEGF were associated with lymph node metastasis (r=1.00, P<0.001). The survival rate of patients with over-expression of VEGF was greatly lower than that with weak expression of VEGF (P=0.022). The survival rate of Fn-negative patients was markedly higher than that of Fn-positive patients (P=0.046). Conclusion:VEGF and ECM component Fn were highly expressed in NSCLC, which correlated with lymph node metastasis and survival rate. Expression of ECM and VEGF had positive correlations, suggesting that ECM might be one of the anti-angiogenesis targets for tumor therapy.

Objective:To make a prospective study on the effectiveness and safety of toremifene (TOR) combined with novelbine/cisplatin (NP) in the treatment of patients with advanced non-small cell lung cancer (NSCLC) whose first line platinum-based chemotherapy was failure. Methods:Forty-four patients with stage ⅡB-Ⅳ NSCLC, who failed in the first line cisplatin-based chemotherapy from January 2004 to February 2006, were enrolled in this study. All the patients received TOR combined with NP second line chemotherapy for two cycles. The response rate and adverse reaction were evaluated. The survival rate was analyzed.Results:The 44 patients received average 1.8 cycles of chemotherapy (1-3 cycles). The response of 37 patients could be evaluated including 21 patients who received NP regimen before and 16 patients who received platinum-based chemotherapy. After second line therapy, 4 of the 37 patients had partial response (PR), 19 had stable disease (SD), 14 had progressive disease (PD), and no patient had complete response (CR). The total response rate (CR+PR) was 10.8% (4/37). The disease-controlling rate (CR+PR+SD) was 62.2% (23/37). The response rate and disease-controlling rate of squamous cell lung cancer (SCC) were 27.3% (3/12) and 72.7% (8/12), which were significantly higher than adenocarcinoma [0% (0/18) and 44.4% (8/18), P<0.05]. The median survival time was 8.2 months, the median time for SD was 4.0 months (1.0-10.2 months), and the 1-year survival rate was 24.4%. The median survival time and 1-year survival rate of SCC patients had no significant difference compared with adenocarcinoma patients (9.2 vs 7.1 months; 33.3% vs 27.7%, P＝0.72). There was no significant difference in survival rate between male and female patients. One patient stopped therapy for liver function injury (hyperbilirubinemia). The adverse reactions induced by chemotherapy mainly included gastrointestinal reaction, bone marrow suppression, and liver function injury. No serious adverse reaction occurred. Conclusion:The clinical efficacy of second line TOR combined with NP regimen is similar with the first line regimen for NSCLC patients, especially for SCC patients. The frequency of adverse reaction is not increased.

Objective To investigate the effect of fluoride on expression of Runx2 mRNA and protein in bone tissue of rats. Methods Fourteen SD rats were randomly divided into two groups: control group(tap water with fluoride ＜ 0.06 mg/L), and fluorosis group(fluoride 50 mg/L in water). After 4 moths, expressions of both mRNA and protein of Runx2 in rat bone tissue were determined by RT-PCR and Western blotting. Results The results showed that the expression of Runx2 mRNA and protein in fluoride-treated bone tissue were 2.287 ± 0.261 and 0.929 ± 0.229, respectively, both of which were significantly higher than those of control group(0.995 ± 0.123,0.317 ± 0.068, t = 11.85,6.78, P ＜ 0.05). Conclusions Fluoride can increase the expression of Runx2 mRNA and protein in bone tissue of rats, and Runx2 may be involved in the pathogenesis of bone injury caused by fluoride.

Objective To explore a new simpler method for the preparation of recombinant alpha virus as a novel vaccine at the DNA level. Methods Plasmids expressing ? gal protein and helper plasmids were transfected into BHK cells. Virus in culture supernatant of the transfected BHK cells were collected and purified and used to infect BHK cells in vitro to identify the expression of target gene and the titre of the recombinant virus. Results Recombinant virus with high titre, prepared by this method, could be expressed well in mammalian cells in vitro . Conclusion High titre recombinant alpha virus can be produced at the DNA level and this method can be applied for vaccine preparation and gene therapy.

Objective To investigate the biofilm formation,the alginate biosynthetic gene ex- pression and analyze the mucA gene sequence of mucoid Pseudomonas aeruginosa PA17 and nonmu- cold Pseudomonas aeruginosa PA01.Methods The modified plate culture method was used to estab lish the biofilm model in vitro.Semi-quantitative RT-PCR was used to determine the expression level of algD in planktonic condition and during the formation of biofilm.The mucA gene of PA17 and PA01 was amplified and the products were sequenced.Results PA17 biofilm was mature at 6th day, and PA01 biofilm was mature at 3rd day.The structures of the biofilms were both like pellicle.In planktonic condition,the algD expression of PAl7 was higher than PA01;in biofilm formation,the algD expression was maximal when the biofilm was mature.There was a 166～333 deletion mutation and 342A→G in mueA gene of PA17,the mucA gene of PA01 was the same with the sequence of Genbank.Conclusions The mucA gene mutation of PA17 was a new type,which maybe the reason for the little expression difference of algD between PA17 and PA01 during the biofilm formation than it in planctonic condition and the same structure of PA17 and PA01 biofilm.

Objective To study the inhibitory effects of stachyose on the hyperacute rejection in pig-to-human heart xenotransplantation.Methods A pig-to-human xenogeneic heart transplantation model was established based on an in vitro free heart blood perfusion system.The pig hearts were di- vided into two groups:group A(pig hearts treated with human blood perfusion as control)and group B(pig hearts treated with human blood plus stachyose perfusion).After perfusion for 1h,the heart xenografts were examined for deposit of lgG and IgM by immunohistochemistry and pathological analy sis.Results The mean survival time of perfusion hearts in groups A and B was(9.5?2.5)min and (46.8?8.1)min respectively(P

Occupational Medicine ; education

Objective To compare the clinical data of patients with chronic hepatitis B virus (HBV) carriers and chronic hepatitis B so that to provide pathological evidence for management of chronic HBV carriers with different alanine aminotransferase (ALT) levels.MethodsLiver biopsies were performed in totally of 292 cases of chronic HBV infection.The subjects were divided into HBV carrier group (G0-G1 and S0-S1) and hepatitis group (G＞ 1 and/or S＞ 1) according to the pathological diagnosis. The relationships between different age subgroups, different ALT level subgroups and pathological diagnosis were analyzed. Meanwhile,other clinical,biochemical,and iconographic indexes which were possibly related to the pathology diagnosis were compared. The multivariate analysis was done by Logistic regression equation (withdrawal method, maximum likelihood method) to definite the independent influencing factors of pathologically diagnosed with chronic HBV carrier.ResultsAmong the 292 patients,140 (47.9％) were pathologically diagnosed with chronic HBV carries and 152 (52.1％)were chronic hepatitis B. There were statistical differences between ≤35 years group and 36-40 years,＞40 years group (x2 =3.936 and 8.534,respectively; P =0.047 and 0.003,respectively). There were statistical difference among patients with ALT＜0.5×upper limit normal (ULN),(0.5-1.0) ×ULN,(1.1-1.5) ×ULN,(1.6-2.0) ×ULN and ＞2.0 × ULN (x2 =55.314,P＜0.01),while there was no significant difference between (1.1-1.5) × ULN and ＞2.0 × ULN (x2 =3.810,P=0.051). Multivariate analysis indicated that course of disease,alcohol consumption,ALT,HBV DNA level and the surface of liver (smooth or not smooth)detected by ultrasonography were independent influencing factors of pathological diagnosis of chronic HBV carriers (OR =0.995,0.224,0.516,1.308 and 0.270,respectively; P=0.005,0.007,0.000,0.025 and 0.001,respectively).ConclusionLiver biopsy is much meaningful in patients with age ＞35 years old and ALT (1-2)× ULN.

OBJECTIVE: To observe the effect of active component in Cichorii (N3) on lipid metabolism of rat with hypertriglyceridemia complicated by hyperuricemia and hyperglycemia. METHODS: Hypertriglyceridemia complicated by hyperuricemia and hyperglycemia was induced in rats by feeding a kind of feedstuff containing high fructose for 21 days. Then three different doses of N3 were administered continuously to the rats for 35 days. The effects of N3 on lipid metabolism were observed by determining the levels of serum triglyceride (TG), uric acid (UA), glucose (GLU) and free fatty acids (FFA) and the activities of fatty acid synthetase (FAS) and hepatic lipase (HL) from the liver and lipoprotein lipase (LPL) from the heart. RESULTS: Twenty-one days after feeding a high-fructose diet, the levels of serum UA, TG and GLU in the untreated group were significantly higher than those of the normal control group. Thirty-five days after administering N3, there was no statistical difference in serum TG and heart LPL activity between the untreated group and the normal control group, while liver FAS activity, serum FFA level and liver HL activity in the untreated group were significantly higher than those in the normal control group. Different doses of N3 treated rats all showed a decrease of TG, UA and GLU levels. N3 could decrease FAS activity and FFA level, and increase LPL and HL activities significantly. CONCLUSION: N3 in Cichorii may regulate the lipid metabolism of the rats with hypertriglyceridemia complicated by hyperuricemia and hyperglycemia by decreasing FAS activity and FFA level, and increasing LPL and HL activities.