OBJECTIVE To investigate the forms of carbamazepine and its metabolites in the gastric juice,blood and urine samples from a poisoned patient and its metabolic pathways. METHODS The gastric juice,blood and urine samples were obtained from a patient who was rushed to the Hospital of Prevention and Treatment for Occupational Diseases to be treated for an overdose of carbamazepine for about six hours. The samples were analyzed by gas chromatography-mass spectrometry. The metabolites were identified from their mass spectra by comparison with spectra in NIST 98 libraries. The metabolic pathways were inferred by fragmentation regularities of mass spectra and the published data. RESULTS The results showed that only M1 was found in the gastric juice sample. Four metabo?lites,such as iminostilbene(M1),9-methyl-acridine(M2),9-propyl-acridan(M4)and M3,were found in the blood sample and thirteen metabolites,including M1,M2,M4,acridine(M5),acridone(M6), 9,10-dihydro Acridine (M7), 1a,10b-dihydro-6H-dibenz[b,f]oxireno[d]azepine-6-carboxamide (M8),9-acridinemethanol (M9),10,11-dihydrodiol-carbamazepine (M10),2-methyl-acridone (M12),4-methyl-acridone(M13),undetermined M3 and M11,were found in the urine from the poi?soned patient. The forms of carbamazepine metabolites in the gastric juice ,blood and urine were different. Little carbamazepine was found in the urine after metabolism. CONCLUSION Based on the analysis by gas chromatography-mass spectrometry and identification of NIST 98 libraries,the metabolites could be identified accurately,which can help analyze the metabolic mechanism and pathways of carbam?azepine.

Objective To investigate the molecular and cell signal transduction mechanisms by Lactobacillus cell wall extract(LCWE)inducing human-β-defensin-2(hBD-2)expression in human vaginal epithelial cells.Methods The induction of hBD-2 in human vaginal epithelial cells(WZV-1)by LCWE was observed using real-time PCR and Western blot.After stimulating WZV-1.the activation of NF-κB and p38MAPK signaling pathways were determined by Western blot.The induction of hBD-2 in WZV-1 cells by LCWE was observed with signaling pathways inhibitors of NF-κB and p38MAPK using real-time PCR and Western blot.Results The results showed that LCWE significantly upregulated hBD-2 expression in the time and dose-dependent manner.The maximal stimulatory effect of LCWE on the expression of hBD-2mRNA in WZV-1 cells were observed at the concentration of 50μg/ml after treatment for 8 h.After stimulation by 50μg/ml LCWE,Western blot analysis demonstrated that the phosphorylation of p38MAPK increased at 0.5 h significantly,peaked at 1 h,moreover the concentration of NF-κB in nucleus increased at 0.5 h significantly(P<0.05),peaked at 2 h.Blocking with inhibitor of NF-κB and(or)p38MAPK pathways results in decreased levels of HBD-2 expression.Conclusion These findings suggest that p38MAPK and NF-κB pathways play the important roles in induction of hBD-2 expression by LCWE in human vagihal epithelial cells.

Background and Purpose:In recent years,along with marked rise in the incidence of lung cancer,the incidence of brain metastasis from lung cancer has increased year by year.The main treatment strategy of lung cancer with brain metastasis is irradiation,while so far there are only few researches concerning chemotherapy combined with radiotherapy for these patients.The aim of this study is to evaluate the therapeutic effect,survival rate and toxicity of chemotherapy with VM_(26)+DDP regimen given concurrently with whole-brain radiotherapy in lung cancer with brain metastasis.Methods:From Sep.2000 to Oct.2001,forty-one patients with lung cancer with brain metastasis were divided randomly into two groups: 20 patients(14 male,6 female) received concurrent chemoradiotherapy(chemoradiotherapy group),the other 21 patients(14 male,7 female) received only radiotherapy(radiotherapy group).In the chemoradiotherapy group,the average age was 50 years with range 40 to 70 years,16 patients were non-small-cell lung cancer,4 patients were small-cell lung cancer.In the radiotherapy group,the average age was 52 years with range 40 to 73 years and 19 patients were non-small-cell lung cancer,2 patients were small-cell lung cancer.For both groups,the same radiation technique was given with conventional fraction.Radiotherapy was delivered by 6MV.Fractionations of 3Gy/fraction/day was delivered 10Gy/5 factions/week.The total dose was 30Gy/10Fr/2W.For chemoradiotherapy group,the patients were also given concurrent chemotherapy(VM_(26) 60mg/m~(2)/ day iv on days 1-3,cisplatin 60 mg/m~(2) iv on the 1~(st)day).Results:The response rate and complete response in the chemoradiotherapy group was significantly higher than that in the radiotherapy group(75% ?? 38.10%,P

0.05).Conclusions:Concurrent chemoradiotherapy can be well tolerated even though the acute side-effects less than grade 2 were higher in concurrent chemoradiotherapy than other group.Immediate response was very encouraging in the concurrent group.There was no advantage in terms of survival rate in the concurrent group compared to the sequential group.

Objective To review the clinical data of reduction mammoplasty by central pedicle technique,and to summarize all kinds of the complications to modify the technique for improvement of long term aesthetic effects.Methods The postoperative complications were analyzd and then an approach was used to investigate the pattern of the blood supply and the nerve distribution of breast.Based on the anatomical study,a modified double-circle reduction mammoplasty technique was designed to treat patients with hypertrophical breasts. Results With a follow-up for 3 months to 3 years,the patients who underwent this modified central pedicle technique,had an invisible scar,good projection,the better shape of breast and preserved their sensation of nipple-areola complex.Conclusions Modified central pedicle technique is a safe and reliable technique,especially ideal for Chinese women.The blood supply is rich and the sensation of nipple-areola complex is preserved.The fixation of the gland tissue is more important than the dermal-bra.

Objective To explore the effects of H.pylori and crude extracted proteins secreted by H.pylori(broth culture filtrate protein,BCF-P)on acid secretion from isolated rabbit parietal cells.Methods Parietal cells from rabbit gastric mucosa were isolated and enriched with digestion and elutriation.H.pylori(NCTC 11637,CagA+ VacA+)were grown in liquid broth culture and BCF-P was precipitated with ammonium sulfate.The vacuolation activity of BCF-P was evaluated with neutral red dye uptake test in HeLa cell.Isolated parietal cells were incubated with H.pylori(bacteria/cell=100∶1)for 2 h and 16 h,or BCF-P(100μg/ml)for 1 h and 12 h.Acid secretion from parietal cells was studied using 14C-aminopyrine(14C-AP)accumulation indirectly and H+-K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results (1)BCF-P containing vacuolating cytotoxin(VacA)with vacuolation activity on HeLa cells had positive result on neutral red uptake test.(2)The basal expression of H+-K+ ATPase α subunit mRNA could be detected in isolated parietal cells and 14C-AP accumulation was significantly increased in response to the stimulation of histamine with different concentrations for 30 min(P＜0.05).These results indicated that the isolated parietal cells retain relative intact acid secretion function.(3)The histamine(1.0×104 mol/L)stimulated acid secretion was inhibited sustainedly in response to H.pylori by 81% at 2 h and by 94% at 16 h(P＜0.05).However,H+-K+ ATPase α subunit mRNA expression was up-regulated in tlle acute period(2 h)and was down-regulated in the chronic period (16 h)by H.pylori(P＜0.05).(4)BCF-P significantly inhibited the histamine-stimulated acid secretion by 24% at 1 h and by 58% at 12 h(P＜0.05),and this inhibition was accompanied by the down-regulated expression of H+-K+ATPase α subunit mRNA.Conclusions Intact H.pylori and VacA secreted by H.pylori could directly inhibit histamine-stimulated acid secretion from parietal cells and this inhibition may be mediated by the down-regulated H+-K+ ATPase expression.

Objective To investigate the causes, clinical features, treatment and prognosis of gastrointestinal bleeding (GIB) patients in emergency department.Methods To analyze prospectively the clinical data of 168 GIB patients admitted to the emergency department of Peking Union Medical College Hospital during 2006.1-2006.12.Results (1) General data; male: female = 1.75:1 ( 107: 61) , mean age 13-87(56.5 ±17.8) years with a peak in 60-69 years.The percentage of old patients was significantly higher than that of young and middle age ( 52.4% vs 19.6% and 28.0% , P = 0.000 ).( 2 ) The incidence of acute gastric mucosal lesion in patients taking non-steroidal antiinflammatory drugs ( NSAIDs) ( 18.5% ) was significantly higher than that in patients not taking( 0.7% , P = 0.000 ).( 3 ) 86.9% ( 146/168 ) of the patients had anemia.(4) More patients who took emergency gastroscopy could be diagnosed than those patients who did not (89.4% vs 58.5% , P =0.000), while no significant difference could be seen between patients who took emergency enteroscopy and patients who had non-emergency gastroscopy (20.0% vs 57.9% , P =0.315).(5)The hemostatic ratio in GIB patients due to peptic ulcer was obviously higher than that in GIB patients due to other causes (86.0% vs 40.7% ,P =0.000).The rate of emergency operation for GIB patients was 1.8%.Conclusions Most of the GIB patients admitted to tertiary general hospitals are elderly males.NSAIDs administration is one of the most important causes of upper GIB.Upper GIB patients should have gastroscopy as soon as possible, while emergency coloscopy is of little significance in cases with lower gastrointestinal hemorrhage.

Objective To investigate the potential mechanism of interleukin-1β(IL-1β)in H.pylori-related gastric carcinogenesis.Methods Human gastric cancer cell line(AGS),human gastric epithelial cell line(GES-1)and isolated parietal cells were treated with exogenous IL-1β(10 ng/ml)in the presence or absence of H.pylori(NCTC 11637).Cell proliferation and apoptosis were determined by MTT assay and flow cytometry,respectively. Expressions of cyclooxygenase-2(COX-2)mRNA and protein were examined using RT-PCR and flow cytometry,respectively.Acid secretion by parietal cells was tested using 14C-aminopyrine(14 C-AP) accumulation indirectly.H+/K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results The cell proliferation and H.pylori-related apoptosis in both GES-1 and AGS celL lines were stimulated and inhibited by IL-1β.IL-1β induced expression and upregulation of COX-2 mRNA in GES-1 and AGS cell lines,respectively.In addition,IL-1β continuously inhibited the ability of histamine-stimulated 14C-AP accumulation of isolated parietal cells accompanied by down-regulation of H+/K+ ATPase mRNA expression.Conclusions It suggests that IL-1β play an important role in H.pylori-related gastric carcinogenesis through two pathways:①to interfere gastric epithelial cell growth by up-regulating COX-2 expression,②to inhibit acid secretion from parietal cell by down-regulating H+/K+ ATPase expression.

OBJECTIVETo explore the feasibility of the transdiferentiation of human breast adipose-derived stem cells (hbASCs) into mammary epithelial-like cells after co-culturing in Transwell in vitro.

METHODSThe third passage hbASC and the HBL-100 cell line were co-cultured in a Transwell culture system for 15 days. The hbASCs were observed and identified by inverted phase contrast microscope and transmission electron microscopy, and immunocytochemistry staining in the induced and control groups.

RESULTSBoth the third passage hbASCs and the HBL-100 cell line cells could adhere and grow rapidly after co-culture in the Transwell system. After co-culture for 15 days, the morphology of some induced hbASCs changed into epithelial-like cells. Some induced hbASCs showed positive expression of CK18, CK19 by immunocytochemistry staining, and typical epithelium cells with microvilli, desmosomes and tonofilaments observed under TEM. The positive rate of CK18 and CK19 was (24.4 +/- 12.0)% and (21.6 +/- 16.4)% in experimental group, and (1.8 +/- 1.7)% and (1.1 +/- 0.6)% in control group.

CONCLUSIONThe data suggests that hbASCs may have the potential to transdifferentiate into human mammary epithelial-like cells after co-culturing in Transwell in vitro.

Adipose Tissue ; cytology ; Breast ; cytology ; Cell Differentiation ; Cells, Cultured ; Coculture Techniques ; Epithelial Cells ; cytology ; Female ; Humans ; Stem Cells ; cytology

Objective To analyze and summarize the clinical characteristics and to evaluate the laboratory tests and therapeutic methods of pancreatic carcinoma,so as to improve the understanding pancreatic carcinoma.MethodsThree hundreds cases of pancreatic carcinoma were collected during 1995—2003 in PUMCH.Results ①The clinical systoms included weight loss(75.3%),abdominal pain(66.3%),anorexia(51.0%),jaundice(50.0%),abdominal distention(44.0%),back pain(18.0%),diarrhea(14.3%) and melena(7.7%).②The sensitivities of tumor markers to diagnose pancreatic cancer were 77.5% of CA19-9,66.0% of CA50,48.3% of CA242 and 29.7% of CEA.If CA19-9 combined with CA50,CA242 and CEA,its sensitivity was increased up to 86.0%.③The titer value of CA19-9 was significantly related with radical operation ratio(P