Objective To investigate the role of hexosamine biosynthesis pathway (HBP) in the functionalalterationofmesangialcellstransinfectedwith glucose transporter 1 (GLUT1) gene. Methods Rat mesangial cells were transinfected with the human GLUT1 gene (MCGT1) by retrovirus vector. Mesangial cells transinfected with bacterial ?-galactosidase (MCLacZ) were used as control. Glucose uptake was detected with 2-deoxy-〔 3H〕-D-glucose (2-DG). Cell size, RNA/DNA ratio, protein/DNA ratio and the synthesis of fibronectin were evaluated by flow cytometry. The activity of glutamine: fructose-6-P aminotransferase (GFAT), which is the key enzyme of HBP, was assayed by spectrophotometry. The expression of GFAT gene was analyzed by RT-PCR. Results MCGT1 demonstrated higher 2-DG uptake than MCLacZ 〔(741.0?60.5)dpm/?g protein vs (92.2?9.0)dpm/?g protein,P

Objective To investigate the effects of Astragalus polysaccarides (APS) on 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis in rats. Methods Forty male Sprague-Dawley rats were randomly divided into five groups (n = 8 ): control group, TNBS group, low-dose APS group, high-dose APS group, and prednisone group. Experimental colitis was induced in rats by enema administration of TNBS. Rats in APS and sions and histological damages were determined, and the activity of myeloperoxidase (MPO) was measured in the excised colonic tissues. Cytokine levels including interleukin (IL)-4 and IL-10 were determined by enzyme-linked immunosorbent assay. Results Both macroscopic lesions and histological colonic damages induced by TNBS were reduced by low-dose APS treatment. These were accompanied by significantly attenuated colonic MPO activity (P = 0. 03) and the increase of IL-4 and IL-10 levels. The macroscopic lesions and MPO activities of high-dose APS group were higher than TNBS group, histological damage and level of IL-4 were lower, and level of IL-10 was higher, but all without statistical significance. Levels of IL-4 and IL-10 were lower than those of TNBS group, but there was no significant difference between prednisone group and TNBS group. Levels of IL-4 and IL-10 were significantly lower in prednisone group than in control group ( P = 0. 049, P = 0. 001 ). Conclusions Different doses of APS have different effects on TNBS-induced colitis. Lower dose of APS has the therapeutic potential inexperimental colitis, while higher dose of APS may aggravate the disease.

Objective To investigate the effect of rhein on endothelial plasminogen activator inhibitor-1 (PAI-1) mRNA expression and protein synthesis induced by transforming growth factor ?1 (TGF-?1), and explore the protective mechanism of rhein on human endothelial cells. Methods A human umbilical endothelium derived cell line (ECV-304) from ATCC was used in this study. The endothelial PAI-1 mRNA expression and protein synthesis were detected by Northern blot and flowcytometry analysis respectively. The activity of phospho-p44/p42 MAPK induced by TGF-?1 was determined by immunoprecipitation analysis and Western blot. Results TGF-?1 (2?g/L) could increase rapidly endothelial PAI-1 mRNA expression and persist for 24 hours. The PAI-1 mRNA expression induced by TGF-?1 in endothelial cells was inhibited by incubating with rhein. Rhein could also inhibit the endothelial PAI-1 protein synthesis. Further study revealed rhein showed a significantly inhibitory effect on the activity of phospho-p44/p42 MAPK induced by TGF-?1 in human endothelial cells. Conclusions Rhein shows a protective action on endothelial cells by inhibiting PAI-1 overexpression, and this may provide beneficial effects on the treatment of diabetes mellitus and its complications.

Objective To observe the effect of general anesthesia induction assisted dexme-detomidine on blood pressure responses to ephedrine.Methods Forty-four patients scheduled for lap-aroscopic cholecystectomy were randomly divided into normal saline(group N)and dexmedetomidine (group D)group.Group D was treated 15 minutes by micro pump injecting the dose of 0.8 μg/kg dexmedetomidine before anesthesia induction.Then the rate was changed to 0.4 μg·kg-1 ·h-1 and maintained.Meanwhile patients were given anesthesia induction and trachea intubation.0.1 mg/kg ephedrine was injected 5 minutes after trachea intubation.Likewise group N was treated 15 minutes by micro pump injecting physiological saline before anesthesia induction.The other treatments were same.SBP,DBP and HR were recorded before micro pump injecting dexmedetomidine or physiologi-cal saline(T0 ),before anesthesia induction(T1 ),during trachea intubation(T2 ),2 min after trachea intubation(T3 ),during ephedrine injection(T4 ),2 min,5 min,10 min and 15 min after ephedrine (T5 ,T6 ,T7 ,T8 ).Results Compared with T0 ,SBP and DBP of group N was lower at T1 ,T3-T8 but SBP,DBP and HR was higher at T2 (P<0.05 or P<0.01).HR of group N was lower at T4 ,T7 and T8 (P<0.05 or P<0.01).SBP at T1-T8 ,DBP at T1-T4 and T8 ,HR at T1 and T3 ,T4 was lower in group D(P<0.05 or P<0.01).Compared with T2 ,SBP,DBP and HR of group N was lower at T3 and T4 (P<0.01).SBP of group D was lower at T4 (P<0.01).Compared with T4 ,SBP of group N was only higher at T5 and T6 (P<0.05 or P<0.01).SBP,DBP and HR of group D were higher at T5-T7 and SBP was kept higher until T8 (P <0.01).Compared with group N,HR of group D was lower at T1-T3 (P<0.05 or P<0.01),SBP,DBP was lower at T2 (P <0.01)and was kept higher from T5 to T8 (P<0.05 or P<0.01).Conclusion Intubation stress response will be relieved during anesthesia induction with dexmedetomidine,which can amplified ephedrine effect.

ObjectiveTo summarize the clinical features of ulcerative eolitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment. MethodsSix cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed,and related literature was searched and reviewed.ResultsThe incidence of the toxic megacolon in the patients with UC in our center was 0.7％ (6/824),which was lower than those reported in the literature.There were always risk factors triggering the disease.The prognosis of the patients was poor,even after medical care and surgery intervention.Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. ConclusionIt's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

Objective To investigate the therapeutic effect of immunodepressant on Crohn's disease (CD).Methods 105 patients with CD were collected from 1983 to 2006 in Peking Union Medical College Hospital.All of their clinical manifestations and therapeutic results were analyzed retrospectively.Results (1)The application of immunedepressant was significantly increased after the year of 2000 (34.7% vs 3.0%,P=0.000).(2)The application of immunodepressant and the clinical features of these patients were as fouows：①The number of patients with modcrate to severe CD were more than that with mild CD in those using immunodepressant (28.9% vs 0).②The use of immunodepressant was not related with the diseased site of CD.because there were no difference among the groups with lesion in small intestine (20.0%),colon(27.3%)and ileocolon(27.1%),P=0.726.③The serum albumin level of CD patients using immunodepressant was significantly lower than that of those not using(31.9 g/L vs 35.1 g/L,P=0.047).④The use of immunodepressant did not decrease the incidenee of operative treatment(38.5% vs 50.0%,P=0.320).(3)The rate of remission in 19 CD patients using azathioprine is 68.4%(13/19)and the percentage of neutrophil in the group with relief was lower than that without relief(0.76 vs 0.65,P=0.032).Conclusions Immunodepressant is playing more important role in the treatment of CD.The patients with moderate and severe CD with as well as lower serum albumin should be treated with immunodepressant as early as possible.Whether immunedepressant is necessary or not is not decided by the diseased site.CD patients with higher percentage of neutrophil have less therapeutic effect than those with lower.

Objective To assess the nutritional risk of patients with inflammatory bowel disease (IBD).Methods The nutritional status of 112 IBD patients from PUMC Hospital were evaluated by Nutritional Risk Screening 2002 (NRS 2002).Using Chinese standard,a body mass index (BMI) that was lowered than 18.5 kg/m~2 according to clinical material was regarded as malnutrition,and the score was recorded as 3.The se-verity of ulcerative colitis (UC) was evaluated using True-Love criteria as mild,moderate,and severe.Crohn's disease (CD) was evaluated using Harvey-Bradshaw Index as in remission stage (≤4),moderately active stage (4-8),and severely actively stage (≥9).Results All these 112 patients,including 70 UC cases and 42 CD cases,were evaluated by NRS2002.Forty-five patients (40.2%) were judged as at the risk of malnutrition.The incidence of malnutrition was significantly higher in CD patients than in UC patients (52.4% vs.32.9%,P<0.05).It was also significantly correlated with the severity of disease.In patients with severe IBD,the rate of mal-nutrition evaluated by BMI according to clinical material was significantly lower than the rate of nutritional risk.Con-clusions The risk of malnutrition is high in IBD patients.NRS 2002 can be used for nutritional risk screening.

Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.

Objective To characterize the feasibility of low-dose CT angingraphy on 16-slice multislice computed tomography (16-MSCT), and its relationship to the noise in the pre-contrast image and enhancement value.Methods Forty-three consecutive patients (male 21, female 22, mean age 59 years, median age 56 years) underwent abdominal 16-MSCT (Toshiba Aquilion 16) with constant scanning parameters including 120 kVp, a 0.5-second gantry rotation time, a pitch of 0.938: 1, and 16×1-mm detector collimation.The mA was set at 200 in the pre-contrast scan and 160 in the contrast-enhanced scan.The arterial phase images were retrospectively reconstructed with 1-mm slice thickness, 0.8 mm interval.The pre-contrast noise was defined as the standard deviation (SD) of the aorta at the level of right posterior crura of diaphragm.The enhancement of aorta was also measured at level of celiac artery.The volume rendering of CT angiography was made and classified into three grades (excellent, good, bad).Receiver operating characteristic curve (ROC) was used to evaluate the relationship between the image quality of CT angiography and noise in the pre-contrast image and enhancement value.Results Twenty-five cases had the aorta enhancement between 300.0--400.0 HU.The sensitivity and specificity of excellent CTA image was 75% and 62%, respectively when the SD was 12.00.Eighteen cases had the aorta enhancement more than 400.0 HU.The sensitivity and specificity of excellent CTA image was all 100% when the SD was 12.25, and 100% and 75%, respectively when the SD was 13.35.The area under curve of CTA image quality and enhancement in receiver-operated characteristic analysis was O.907.The enhancement was more than 356.7 HU when the sensitivity and specificity of excellent CTA image was 100% and 60%, respectively, and 389.8 HU when 78% and 80%.When the enhancement was more than 442.4 HU, the specificity of excellent CTA image was 100%.Conclusions MSCT angiography with low radiation dose is feasible.Good CT angiography demands great enhancement, and then, the needed mAs is lower when the SD is smaller.

'Three-acupoint and Five-needle Method' is a summary of Prof. Shao Jing-ming's clinical experience in the treatment of asthma for years. It is used to alleviate asthma during seizure and to improve the pulmonary functions, strengthen the body constitution and prevent recurrence in the remission stage. This article introduces the theoretic source and basic principle, and concrete operating method, i.e. puncturing bilateral Feishu (BL 13), Dazhui (GV 14) and bilateral Fengmen (BL 12), and adding acupoints based upon pattern identification, in combination of moxibustion and cupping therapy for promoting the clinical application of this method.