Angiotensin-converting enzyme 2 (ACE2)-angiotensin (1-7) [Ang (1-7)]-Mas constitutes the vasoprotective axis and is demon-strated to antagonize the vascular pathophysiological effects of the classical renin -angiotensin system .We hypothesize that upregulation of ACE2-Ang (1-7) signaling protects endothelial function through reducing oxidative stress , thus resulting in beneficial outcome in di-abetes.Ex vivo treatment with Ang (1-7) augmented endothelium-dependent relaxation (EDR) in renal arteries from diabetic patients . Both Ang (1-7) infusion via osmotic pump (500 ng? kg -1? min-1 ) for 2 weeks and exogenous ACE 2 overexpression mediated by ad-enoviral ACE2 via tail vein injection rescued the impaired EDR and flow-mediated dilatation ( FMD) in db/db mice.Diminazene acetu-rate treatment (15 mg? kg-1? d-1 ) activated ACE2, increased the circulating Ang (1-7) level, and augmented EDR and FMD in db/db mouse arteries.In addition, activation of the ACE2-Ang (1-7) axis reduced reactive oxygen species (ROS) overproduction de-termined by dihydroethidium staining , CM-H2DCFDA fluorescence imaging , and chemiluminescence assay in db/db mouse aortas and also in high-glucose-treated endothelial cells .Pharmacological benefits of ACE 2-Ang ( 1-7 ) upregulation on endothelial function were confirmed in ACE2 knockout mice both ex vivo and in vitro.We elucidate that the ACE2-Ang (1-7)-Mas axis serves as an important signal pathway in endothelial cell protection in diabetic mice , especially in diabetic human arteries .In summary, endogenous ACE2-Ang (1-7) activation or ACE2 overexpression preserves endothelial function in diabetic mice through increasing nitric oxide bioavail -ability and inhibiting oxidative stress , suggesting the therapeutic potential of ACE 2-Ang(1-7) axis activation against diabetic vasculop-athy.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and there are no standard treatment options for ENKTL. For localized patients, radiotherapy alone or radiotherapy combined with chemotherapy could be took into consideration. Systemic combination chemotherapy remains the primary treatment for patients with advanced ENKTL. The efficacy of anthracycline based conventional chemotherapy in ENKTL is unfavorable. This paper reviews the treatment progress of ENKTL in recent years.

Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Insulin-like growth factor receptor type 1 (IGF-1 R) is the receptor cascade effect molecules of IGF signaling pathways in the hypothalamus-pituitary-growth hormone axis.In recent years,IGF-1R gene mutation of short stature case reports increased year by year,now the progress of IGF-1R gene defects in short stature for clinicians was summarized.

In the treatment of 169 cases of the patients sick with intervertebral disc hemiation by integrated application of acupuncture therapy,Chinese massage therapy and herbal fumigation method.the results showed cure in 129 cases.improvement in 33 cases and failure in 7 cases,and the total effective rate was 95.9%.

Multiple myeloma (MM) is a unique cancer paradigm for investigating the mechanisms involved in the transformation from a premalignant condition (unknown monoclonal gamma globulin,MGUS) into a malignant disease (MM).In its pathogenesis,genotype characteristics of tumor clones which are highly complex and heterogeneous,as well as the dialogue between plasma cells and their microenvironment are equally important and both play a key role in the outcome of the disease.MM will soon no longer be considered as a single disease.A large number of new drug emergence and applications will increase the need for monitoring minimal residual disease (MRD) in prognosis and treatment of MM.New drugs and high-dose chemotherapy with autologous stem cell transplantation applications have been significantly improving the prognosis of MM in the past 20 years.Re-examining the early MM diagnostic criteria and the possibility of early intervention will open up a new therapeutic approach.It is important to find a balance of efficacy,toxicity and cost in order to achieve a cure for this disease.

Objective To explore the effect of microsurgery for refractory temporal lobe epilepsy . Methods A retrospective analysis was made in 102 patients with refractory temporal lobe epilepsy from January 2005 to December 2011.The patients received comprehensive preoperative localization , intraoperative frontotemporal pterional incision , and microsurgical resection of epileptogenic focus .The efficacy was evaluated according to the Engel standards .Indications such as self-care ability, learning ability, and working ability were used to evaluate the quality of life , which were recorded and compared before and after operation . Results Follow-up was accomplished in all the 102 cases for a duration of 1 year and 9 months to 7 years.There were no mortality and serious complications .The effects evaluations at 1 year after operation showed complete disappearance of symptoms ( levelⅠ) in 61 cases (59.8%), almost disappearance (level Ⅱ) in 17 cases (16.7%), symptoms improvement more than 75% (level Ⅲ) in 13 cases (12.7%),and ineffective (level Ⅳ) in 11 cases (10.8%), bearing an effective rate of 89.2% (91/102) and a good-and-excellent rate of 76.5%(78/102).At one year and nine months postoperatively , 6 patients could not take care of themselves , 32 patients obtained partial self-care, and 64 patients had complete self-care,as compared with which there were 21 patients, 67 patients, and 14 patients preoperatively, respectively, having significant differences before and after surgery (Z =-7.001, P =0.000). Statistical significances were obtained before and after operation in 67 cases of children and adolescents with learning ability ( Z=-3.747, P =0.000) and in 35 adult cases with working ability ( Z =-2.564, P =0.010). Conclusions Microsurgical treatment is an effective method for refractory temporal lobe epilepsy .Patients ’ quality of life can get significant improvement after surgery.

Objective To evaluate the effect of indomethacin in the prevention of post ERCP pancreatitis (PEP) .Methods The literatures and corresponding references of randomized controlled trials (RCT ) on indomethacin in the prevention of PEP were searched from Cochrane Library (Jan 1970 to June 2013) ,Pubmed(Jan 1966 to June 2013) ,EMBASE(Jan 1966 to June 2013)and China Biology Medicine disc(Jan 1978 to June 2013) .Literature screening ,data extraction and methodological quality assessment were individually performed by two researchers .The software RevMan 5 .2 of Cochrane Collaboration was used for statistical analy‐sis .Results A total of 7 trails ,2170 patients were included in this study .Meta analysis results showed:indomethacin could effec‐tively prevent from PEP (RR=0 .45 ,95% CI:0 .33-0 .60 ,P<0 .05) and Hyperamylasemia (RR=0 .51 ,95% CI:0 .37-0 .70 ,P<0 .05) compared with placebo ,and could effectively alleviate the severity of pancreatitis after ERCP (RR=0 .43 ,95% CI:0 .23 -0 .78 ,P<0 .05) .Conclusion Indomethacin could effectively prevent from PEP and Hyperamylasemia ,and could effectively alleviate the severity of PEP .

Objective To investigate the relationship between sarcoplasmic reticulum Ca2+modulation proteins and postresuscitation myocardial dysfunction. Methods Thirty-eight SPF male Sprague-Dawley (SD) rats were randomly divided into control group(n=12)and cardiac arrest(CA)group(n=26). CA was induced by intravenous bolus of potassium chloride(40μg/g),and cardiopulmonary resuscitation(CPR)was conducted 8 minutes later. No CA was induced in control group except catheter placement for monitoring cardiopulmonary parameters after anesthesia. Invasive hemodynamic parameters were monitored for 1 hour after CPR. Echocardiogram was performed to evaluate cardiac function. Myocardial samples were harvested 5 minutes and 1 hour after restoration of spontaneous circulation (ROSC),and sarcoplasmic reticulum Ca2+ ATPase (SERCA2a),phosphorylated phospholamban (p-PLB) and rynodine receptor(RyR)were determined by Western Blot. Results ROSC rate of CA group was 92.3%(24/26),and mean recovery time was (68 ±39)seconds. Cardiac function was significantly impaired in CA group at 1 hour after resuscitation, and ejection fraction, fraction shortening (FS), the maximal rate of left ventricular pressure increase/decline (±dp/dt max)were significantly decreased compared with those in control group 〔ejection fraction:0.548±0.060 vs. 0.809±0.043,F=71.692,P=0.000;FS:(34.4±4.4)%vs. (46.0±3.5)%,F=55.443,P=0.000;+dp/dt max(mmHg/s):4 718±743 vs. 7 098±394,P<0.01;-dp/dt max(mmHg/s):-3 824±612 vs.-6 187±473,P<0.01〕. Compared with control group,the expression levels of p-PLB (gray value)was significantly decreased at 5 minutes and 60 minutes(5 minutes:0.64±0.15 vs. 1.29±0.13,P<0.01;60 minutes:0.95±0.08 vs. 1.30±0.09,P<0.05)after resuscitation in CA group,while the level of sarcoplasmic SERCA2a(gray value)and RyR (gray value)showed no significant differences(SERCA2a 5 minutes:1.01±0.18 vs. 1.24±0.07,60 minutes:1.03± 0.14 vs. 1.25 ±0.06;RyR 5 minutes:0.96 ±0.13 vs. 0.97 ±0.13,60 minutes:0.88 ±0.14 vs. 0.99 ±0.11,all P>0.05). Conclusions The impairment of the p-PLB is closely related to postresuscitation myocardial dysfunction.

Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.