Metabolic rearrangement is a typical hallmark of cancer cells ,especially the disorders in glucose metabolism. Normal cells rely on the steps of oxidative phosphorylation within the mitochondria to metabolize glucose and yield energy upon enough oxygen ,yet turning to glycolysis in the absence of oxygen . Nevertheless ,tumor cells exhibit high levels of glycolytic flux in different environments ,due to the requirement of malignant proliferation. This phenomenon was named as the Warburg effect ,the initiation of which is driven by multiple mechanisms ,including the influence of tumor microenvironment ,the activa?tion of tumor-promoting signaling pathways ,and the aberrant levels of metabolic enzymes. Moreover ,our recent findings sug?gest that inhibition of gluconeogenesis ,the general reversal of glycolysis ,would further promote the Warburg effect and tumor progression.

OBJECTIVE:To study the persistence of the effects of nucleoside (acid) analogues in the treatment of chronic hepatitis B (CHB) after drug withdrawal. METHODS:150 cases of CHB were selected and received nucleoside (acid) ana-logues for one year at least. They were divided into the standard group(n=56)and non standard group(n=87)according to the drug withdrawal standard stated in Guidelines for Prevention and Treatment of CHB,and followed up for one year except 7 cas-es of drug withdrawal who were followed up less than one year. HBV serum markers HBVM and HBV-DNA were detected quan-titatively in 2 groups. CHB recurrence,HBsAg disappearance and the change of HBV in serum were observed in 2 groups after drug withdrawal. RESULTS:The recurrence rate of CHB patients with HBeAg (+) in standard group and non standard group were lower than those with HBeAg(-),with statistical significance(P<0.01 or P<0.05);that of CHB patients with HBeAg (+) in standard group was lowe than those with HBeAg (+) in non standard group,with statistical significance (P<0.05);there was no statistical significance in recurrence rate of CHB patients with HBeAg(-)between standard group and non stan-dard group(P>0.05);the total recurrence rate of standard group was lower than that of non standard group,with statistical sig-nificance(P<0.05). There was no statistical significance in recurrence rate between 2 groups after drug withdrawal following 4 kinds of nucleoside (acid) analogue monotherapy (P>0.05). Among sustained responders,HBsAg of 3 patients disappeared in standard group,including 2 cases of HBsAg seroconversion,1 case of no HBsAg seroconversion. Among patients with recurrent CHB,2 patients suffered from HBeAg(+)again in standard group,and 1 patient with HBeAg(-)developed liver cancer;5 patients suffered from HBeAg(+)again in non standard group,including 1 patient died and 1 patient with HBeAg(-)devel-oped liver cancer. CONCLUSIONS:Taking Guidelines for Prevention and Treatment of CHB as drug withdrawal standard,there still is a high recurrence rate after stopping nucleoside(acid)analogues;the recurrence rate of patients with HBeAg(-)is high-er than those with HBeAg(+),and that of patients in non standard group is higher than in standard group. The types of nucleo-side(acid)analogues do not influence recurrence rate after drug withdrawal.

BACKGROUND:Decidua tissue is one of the most important sources of endometrial stem cel s, from which stromal stem cel s can differentiate into various kinds of cel s under contain inductions. OBJECTIVE:To observe the differentiation of endometrial stromal stem cel s isolated from early-pregnancy decidua into endometrial epithelial cel s. METHODS:Endometrial stromal stem cel s from early-pregnancy decidua were cultured, identified and directional y induced. Then induced cel s were randomized into test group cultured in conditioned medium and control group cultured in normal culture medium containing fetal bovine serum. Expression of keratin was detected by immunofluorescence assay and western bolt assay in the two groups. RESULTS AND CONCLUSION:The endometrial stromal stem cel s from early-pregnancy decidua were successful y isolated and cultured, and presented with a S-shaped curve. Within 1-48 hours after inoculation, cultured cel s were in the adaptation phase;then, the cel s proliferated rapidly and began to grow logarithmical y at 48 hours after culture;after 60 hours of culture, the cel growth rate decreased, with a steady rise in the cel curve. Results from the flow cytometry detection showed that the endometrial stromal stem cel s could express CD73 and CD90, but not express CD34, CD45 and cytokeratin. Immunofluorescence findings showed the expression of keratin negative in the control group, and mostly positive in the test group. Besides, the relative expression of keratin in the test group was significantly higher than that in the control group (P<0.05). These results suggest that the endometrial stromal stem cel s can be isolated from the human decidua in early pregnancy, and differentiate into endometrial epithelial cel s by directional induction.

Objective To explore the correlation of serum high -sensitivity C -reactive protein and ische-mic stroke in elderly people.Methods 120 patients with acute cerebral infarction were selected as the cerebral infarction group,100 healthy people taken examination at the same period were selected as the control group.The lev-els of serum high -sensitivity C -reactive protein in the two groups were detected,and the serum high -sensitivity C -reactive protein levels in patients with different cerebral areas and different neurological function scores were analyzed.Results Serum high -sensitivity C -reactive protein level in the cerebral infarction group was (10.17 ± 3.13)mg/L,which was significantly higher than that of the control group[(0.81 ±0.24)mg/L],the difference was statistically significant(t =29.82,P <0.05).And the serum high -sensitivity C -reactive protein level was gradually increased with cerebral infarct volume increased and the deepening of neurological deficits(P =0.01).Conclusion The serum high -sensitivity C -reactive protein level in elderly patients with ischemic stroke was higher than healthy people,the larger the infarct volume and the more severe neurological deficits,the higher sensitivity C -reactive protein levels,it is worthy of reference.

OBJECTIVE:To observe the efficacy and safety of Xingnaojing injection in the treatment of ischemic stroke. METH-ODS:110 patients with ischemic stroke were randomly divided into control group and observation group. 2 groups were given regu-lation of blood pressure and blood glucose,lipid lowering,aspirin,citicoline and edaravone,mannitol depending on severity and other conventional treatment. Based on it,control group was intravenously infused 250 ml 0.9% Sodium chloride injection,once a day;observation group was additionally intravenously infused 20 ml Xingnaojing injection,adding into 250 ml 0.9% Sodium chlo-ride injection,once a day. The efficacy was judged after 14 d. US National Institutes of Health Stroke Scale(NIHSS),Glasgow coma score(GCS),nitric oxide(NO),nitric oxide synthase(NOS),inducible nitric oxide(iNOS)content in 2 groups were ob-served,and in the incidence of adverse reactions was recorded. RESULTS:The total effective rat in observation group was signifi-cantly higher than control group,the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in the NIHSS,NO,NOS and iNOS contents between 2 groups(P>0.05);after treatment,GCS in 2 groups were sig-nificantly higher than before,and observation group was higher than control group,NIHSS,NO,NOS and iNOS contents were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLU-SIONS:Based on conventional treatment,Xingnaojing injection has significant efficacy in the treatment of ischemic stroke,with good safety,which may be related that it can reduce NO and GCS.

The acute respiratory distress syndrome,a common severe case,can cause life-threaten multiple organ failure.Statins has been clinically applied in prevention of cardiovascular diseases and cerebrovascular disease.Previous studies indicate that statins can modulate inflammatory responses.In this paper,we discussed the mechanisms of statins,mechanisms and application of statins in acute lung injury and acute respiratory distress syndrome,and the effectiveness and safety of statins.

[ABSTRACT]AIM:Toexploretheeffectsofchrysinoninsulinresistance(IRe)inamousemodel.METHODS:Male C57 mice were randomly divided into control group , IRe group, low-dose chrysin group ( IRe+chrysin-low) and high-dose chrysin group (IRe+chrysin-high).After 24 weeks, the body weight, liver index and fat mass in all mice were detected.The blood glucose , insulin level and HOMA-IR were measured to determine the changes of the insulin resistance in the animals.The oxidative stress (SOD, GSH-Px and MDA) was also measured.The mRNA expression of insulin sig-naling pathway molecules (IR, IRS1, IRS2, Glut2 and Glut4) and inflammatory factors (TNF-α, IL-1β, IL-6 and NF-κB) was analyzed by real-time PCR.The protein levels of IRS1 and p65, and their phosphorylation were detected by West-ern blot.RESULTS:After 24-week intervention , the indicators in IRe group were higher than those in control group , in-cluding body fat deposition, serum glucose, serum insulin, HOMA-IR and liver oxidative stress (P<0.01), indicating that the model of insulin resistance was successfully established .Low dose and high dose of chrysin decreased the body weight, serum glucose, serum insulin and HOMA-IR in the IRe mice (P<0.05).The liver oxidative stress was also re-duced in both groups (P<0.05).However, no statistical difference of the indexes between IRe +chrysin-low group and IRe+chrysin-high group was observed.Chrysin upregulated the mRNA expression of IR , IRS1, IRS2, Glut2 and Glut4 (P<0.05), and down-regulated the mRNA expression of various inflammatory factors .The inhibitory effect of chrysin on the mRNA expression of NF-κB was observed (P<0.05), especially in high dose group (P<0.05).It was confirmed that the effect of chrysin on liver IRe was related with the increase in the p-IRS1 levels and decrease in the p-p65 levels by Western blot .CONCLUSION:Chrysin inhibits obesity , hyperglycemia and hyperinsulinemia , and relieves insulin resist-ance and oxidative stress , which might be closely related to the regulation of insulin signaling pathway and the inhibition of inflammatory factor expression .

Objective To investigate the influence of spleen aminopeptidase lyophilized powder on serum levels of transforming growth factor -β1 (TGF -β1),monocyte chemoattractant protein -1 (MCP -1),stromal cell derived factor 1 (SDF -1 )in pediatric asthma.Methods 128 patients with asthma were randomly divided into observation group(64 cases)and control group (64 cases).Two groups of children were given symptomatic treat-ment.The control group was orally administered montelukast,the observation group was treated with montelukast and splenic ammonia lyophilized powder for 3 months.The levels of TGF -β1,MCP -1,SDF -1 of the two groups were compared before and after treatment.Results After treatment,the asthma control test table (ACT)score,expiratoryvolume in one second (FEV1 )and peak expiratory flow rate (PEF)in the observation group were (24.25 ± 3.98)points (80.25 ±4.25)%,(7.25 ±0.69)L/min,which were significantly higher than those in the control group [(20.12 ±4.02)points,(75.02 ±3.96)%,(5.82 ±0.70)L/min,t =7.203,6.757,14.459,26.677,P <0.01].After treatment,the serum levels of TGF -β1,MCP -1,SDF -1 of the observation group were (42.23 ± 6.02)ng/mL,(48.56 ±3.96)pg/mL,(252.36 ±32.22)ng/L,which were significantly lower than those in the con-trol group [(42.23 ±6.02)ng/mL,(59.02 ±4.22)pg/mL,(425.25 ±40.62)ng/L,t =6.757,14.459,26.677,all P <0.01].Conclusion Montelukast combined with splenic aminopeptidase lyophilized powder for asthma can effec-tively reduce serum TGF -β1,MCP -1,SDF -1 levels and improve clinical symptoms and lung function,improve the treatment of children.

For better implementation of outstanding physician education program,Chongqing Medical University carried out the centering on the organ system curriculum reform.In motor system disease teaching,we integrated motor system curriculums,reduced the classroom theory teaching time,strengthened the discussion and practice teaching,proceeded teacher training and teaching demonstration before class and adopted the model of problem-based learning (PBL) teaching,carried out clinical skills teaching,established formative assessment system to comprehensively evaluate students' learning effects and accept motor system disease teaching certification and other measures,which improved the students' knowledge system,enhanced the students' ability of analysis and solve problems.

BACKGROUND:There are many internal fixation methods for tibial plateau fractures with their own merit and demerit. Knee joint internal fixation for Schatzker type V and VI bicondylar tibial plateau fractures has better outcomes, but it is unclear about the specific difference in the repair of these two kinds of fractures.
OBJECTIVE: To observe the repair effects of metal implants insertedviaanterolateral and posteromedial knee joint approach on Schatzker type V and VI bicondylar tibial plateau fractures.
METHODS: From January 2009 to December 2012, 67 patients with Schatzker type V and VI bicondylar tibial plateau fractures were admitted at the Department of Orthopedics, Beijing Changping Hospital, China, including 38 cases of Schatzker type V and 29 cases of Schatzker type VI. Al these patients underwent internal fixation with metal implantsvia the anterolateral and posteromedial knee joint approaches. During the folow-up, differences in fracture healing and functional recovery between the two groups were observed.
RESULTS AND CONCLUSION: The wounds of al patients after active treatment were healed. By the last folow-up, Schatzker VI patients had better outcomes than Schatzker V patients in the aspects of varus-valgus scores, Rasmussen radiology scores, flexion and extension scores, joint range of motion, joint stability scores and good rate of knee joint function (P < 0.05). In addition, there were insignificant differences in colapse, condyle widening scores, ability to walk, knee pain scores, fracture healing time, and incidence of complications between the two groups (P > 0.05). Schatzker V patients showed better recovery of the articular surface and reliable internal fixation. These findings indicate that the internal fixation viathe anterolateral and posteromedial knee joint approaches has better clinical efficacy in the treatment of Schatzker type V bicondylar tibial plateau fractures than Schatzker type VI bicondylar tibial plateau fractures.