AIM:To investigate the relationship of autophagy and reactive oxygen species ( ROS) in multiple myeloma cell line RPMI-8226 stimulated with doxorubicin.METHODS:The RPMI-8226 cells were stimulated with doxo-rubicin at different doses, and untreated cells were used as control.The protein expression of beclin 1 and LC3 was detec-ted by Western blot.ROS production was analyzed by DCFH-DA fluorescence staining.After treated with or without 3-methyladenine (3-MA), the ROS production and apoptosis in RPMI-8226 cells were determined by DCFH-DA and flow cy-tometry, respectively.After treated with or without antioxidants tempol and N-acetyl-L-cysteine ( NAC) , the expression of beclin 1 and LC3 in RPMI-8226 cells was determined by Western blot.RESULTS:The protein levels of beclin 1 and LC3Ⅱ/LC3Ⅰwere increased in the RPMI-8226 cells stimulated with doxorubicin compared with untreated group.The ROS production was increased in the RPMI-8226 cells stimulated with 2 mg/L doxorubicin compared with untreated group.After treated with 3-MA, the ROS production and apoptosis in the RPMI-8226 cells stimulated with doxorubicin were increased compared with doxorubicin group.After treated with antioxidant NAC or tempol, the expression of beclin 1 and LC3 II/I in the RPMI-8226 cells stimulated with doxorubicin was decreased compared with doxorubicin group.CONCLUSION:The autophagy and ROS levels are increased in RPMI-8226 cells stimulated with doxorubicin.Inhibition of autophagy increases the ROS production and apoptosis of RPMI-8226 cells stimulated with doxorubicin.Inhibition of ROS production reduces doxorubicin-induced autophagy in multiple myeloma cells.

AIM: To observe the effects of carvedilol on murine viral myocarditis model. METHODS: A total of 188 inbred male BALB/c mice of 4-6 weeks were divided into 4 groups: myocarditis group (group C, n=60), metoprolol treatment group (group M, n=60), carvedilol treatment group (group K, n=60), control group (group B, n=8). Myocardial histopathololgic changes were observed. The concentrations of cardiac troponin I (cTn-I) were detected by chemiluminescence immunoassay (CLIA). Western blotting was performed to analyze the contents of phosphorylated p38MAPK in myocardium. RESULTS: Metropolol and carvedilol lightened myocardial histopathololgic changes at acute stage, decreased cTn-I concentrations and myocardial phosphorylated p38MAPK value compared with myocarditis group. Treatment with carvedilol was more effective than treated with metropolol on those indexes. CONCLUSION: Carvedilol protects against viral myocarditis by inhibition of p38MAPK signal transduction pathway through blockade of β_1 and β_2 adrenergic receptors.

AIM: To explore the effect of pyrrolidine dithiocarbamate (PDTC), an NF-κB inhibitor, on the proliferation and apoptosis of human multiple myeloma U266 cells and its mechanisms.METHODS: The U266 cells were treated with PDTC at different concentrations (0, 25, 50, 100 and 200 μmol/L) in vitro.The growth inhibitory rate of the U266 cells was detected by CCK-8 assay and cell counting.The cell cycle of the U266 cells was determined by flow cyto-metry, and the apoptosis was examined by flow cytometry with Annexin V-FITC/PI staining.The effect of PDTC on the expression of DNA methyltransferase 1 (DNMT1) at mRNA and protein levels was measured by RT-qPCR and Western blot, respectively.The effects of PDTC on the protein levels of NF-κB (P65), DNMT1, Bcl-2, cyclin D1, cleaved caspase-3 and cleaved caspase-8 were determined by Western blot.RESULTS: The protein level of NF-κB (P65) was decreased after treatment with PDTC for 48 h or 72 h.PDTC inhibited the proliferation of U266 cells in both dose-and time-dependent manners.After treatment with PDTC for 48 h, the percentage of U266 cells in G2 phase increased compared with control group (P<0.05).PDTC induced the apoptosis of U266 cells in a dose-dependent manner.The expression of DNMT1 at mRNA and protein levels decreased (P<0.05).The results of Western blot showed that the expression of Bcl-2 in PDTC groups decreased, while the protein levels of cyclin D1, cleaved caspase-3 and cleaved caspase-8 were higher than those in control group (P<0.05).CONCLUSION: The NF-κB inhibitor PDTC inhibits the proliferation of U266 cells by inducing cell apoptosis.It may be related to the down-regulated expression of DNMT1, cell cycle arrest and activation of the apoptotic pathways.

Objective To analyze artifacts of gross tumor volume (GTV) and correlated factors in each phase images of four dimensional CT (4DCT) for peripheral lung cancer based on three dimensional CT (3DCT) assisted with active breathing control.Methods Nineteen patients with peripheral lung cancer underwent 3DCT (CTFB) and 4DCT simulation scans during free breathing and then underwent 3DCT simulation scans in end inspiration hold (CTEIH) and end expiration hold (CTEEH) assisted with active breathing control.The relative deviations (Devref) between the reference GTV (GTVref) and the GTVsdelineated based on CTFB (GTVFB) and all phases of 4DCT were calculated respectively.Correlations between GTVref and Devmax and between the tumor motion in the cranio-caudal (CC) direction and Devref were analyzed.Results The maximum median Devref of GTV was GTVFB with 17.83％,and the maximum median Devref of the GTV in all phases of 4DCT was GTV30 with 17.20％.A significant negative correlation was found between GTVEIH and Devmax (r =-0.691,P =0.001).The Devref was crrnelated with the tumor motion amplitude in the CC direction (r =0.323-0.617,P =0.005-0.150).The partial regression coefficient of influence of GTVref size and motion amplitude in the CC direction to the tumor Devmax were -0.500 and 0.583,P =0.002 and 0.001,respectively.Conclusions The GTV artifacts in different phase of 4DCT for the peripheral lung cancer were different to each other,and the influence of target displacement to artifacts was larger than that of target volume,so artifacts could be reduced by controlling breathing to reduce target displacement.

Objective To compare the position,volume and matching index (MI) of esophagus between quiet end-inspiration and end-expiration in three dimensional CT (3D-CT) assisted with active breathing control (ABC) and the corresponding phases in four dimensional CT (4D-CT).Methods Eleven patients with peripheral lung cancer underwent 4D-CT simulation scan and 3D-CT simulation scans in end-inspiratory hold (CTEIH) and end-expiratory hold (CTEEH) in succession.The 0％ phase was defined as end-inspiratory phase (CT0),while the 50％ phase was defined as end-expiratory phase (CT50).The proximal,mid-,and distal thoracic esophagus were delineated separately on CT0,CT50,CTEIH and CTEEH images.The position,volume and MI of each segment esophagus between CT0 and CTEIH,CT50 and CTEEH were compared.Results In the left-right (x) direction,the position differences in the proximal,mid-,and distal thoracic esophagus between CT0and CTEIH were (-0.02 ±0.16)cm,(0.06 ± 0.26)cm and (0.10 ± 0.33) cm respectively,and in the anterior-posterior (y) direction,the position differences were (0.04 ±0.24)cm,(0.04 ±0.12) cm and (0.08 ±0.15) cm respectively,and the position differences in the same direction were not statistically significant.In the x direction,the position differences of the proximal,mid-,or distal thoracic esophagus between CT50 and CTEEH were (-0.02 ±0.24) cm,(0.12 ± 0.37) cm and (0.26 ± 0.33) cm respectively,and in the y direction,the position differences were (0.03 ±0.21)cm,(0.04 ±0.17)cm and (0.14 ±0.18)cm respectively,and the position differences in x and y directions of proximal and mid-thoracic esophagus between CT50 and CTEEH were not statistically significant,while the position differences in x and y directions of distal thoracic esophagus between CT50and CTEEH were both statistically significant (t =0.025,0.024,P ＜ 0.05).The volumes of the proximal,mid-and distal thoracic esophagus were all larger in CT0and CT50 than those in CTEIHand CTEEH,but without statistical differences.The MIs of the volumes of the proximal,mid-and distal thoracic esophagus between CT0 and CTEIH were (0.50 ± 0.17),(0.50 ± 0.19) and (0.56 ± 0.08),respectively,and those between CT50and CTEEH were (0.50 ±0.16),(0.47 ±0.14) and (0.51 ±0.15),respectively.The MI of each segment esophagus between CT0and CTEIHwas larger than that between CT50 and CTEEH,but without statistical differences.Conclusions The influence of breathing modes on the centroid positions of the proximal,mid-thoracic normal esophagus were not significant and there were spatial mismatches for any segment esophagus between 3D-CT assisted with ABC and 4D-CT.

OBJECTIVETo discuss the effect of continuous positive airway pressure (CPAP) treatment for functional cardiac arrhythmias combined with obstructive sleep apnea hypopnea syndrome.

METHODSFifty-six OSAHS patients combined functional cardiac arrhythmia were randomized divided into two groups. The 28 patients in the control group were treated with metoprolol according to cardiac guidelines, the other 28 cases in the experimental group were treated with CPAP therapy combined with metoprolol. AHI and the lowest oxygen saturation (LSaO2) were tested before and after treatment.

RESULTSThe efficiency rates were 57.1% and 17.9% in experimental and control group respectively, with statistical difference (χ2 = 7.62, P < 0.01). Total effective rates were 85.7% and 53.6% respectively, with statistical difference (χ2 = 5.41, P < 0.05). In the experimental group, there were three treatment subgroups. After treatment, AHI and the lowest oxygen saturation were significantly different (P < 0.05).

CONCLUSIONCPAP treatment can effectively eliminate respiratory disturbance index, improve the symptoms of hypooxygen at night, and effectively improve the therapeutic effect of functional cardiac arrhythmias in OSAHS patients combined with functional arrhythmia.

Arrhythmias, Cardiac ; therapy ; Brugada Syndrome ; Cardiac Conduction System Disease ; Continuous Positive Airway Pressure ; Heart Conduction System ; abnormalities ; Humans ; Sleep Apnea, Obstructive ; therapy

Objective To investigate the effects of resveratrol on inhibiting proliferation and inducing apoptosis of U251 cells. Methods The proliferation activity was detected by MTT assay, and apoptosis of early and late period by method of Annexin V-FITC apoptosis assay, and the cell morphological changes were observed by microscopy after U251 cells being treated with resveratrol. Results Resveratrol could significantly inhibite the proliferation and induce the apoptosis of early and late period of U251 cell in a time-and does-dependent manner. Conclusion Resveratrol can significantly inhibite the proliferation and induce the apoptosis of early and late period of U251 cell.

Objective:To investigate the effectiveness of abdominal compression in tumor motion and the target volume, and analyze the suitable margins of planning target volume (PTV) for patients treated with lung-SBRT based on 4DCT.Methods:Patients diagnosed with peripheral pulmonary tumor were enrolled. The patients were divided into the whole group, upper-middle-lobe group (group A) and the lower-lobe group (group B). Each patient underwent 3DCT, 4DCT with abdominal compression (4DCT com) and 4DCT with free breath (4DCT free) scans. The GTVs were delineated and IGTVs on these images. PTV MIP 5 mm, PTV MIP 4 mm, PTV MIP 3 mm were constructed with a 5, 4, 3 mm margin in left-right (LR), anterior-posterior (AP) directions and cranial-caudal (CC) directions. Results:The median motion vector with compression reduced by 30.92% in whole group, increased by 3.42% in group A and reduced by 18.80% in group B, respectively. And there were no significant differences of TMA LR, TMA AP, TMA CC and motion vector by the Wilcoxon test ( P>0.05). The median sizes of IGTV MIP com , IGTV MIP free and IGTV10 com, IGTV10 free were 4.01, 5.36 cm 3and 6.59, 7.65 cm 3, with statistically significant difference ( Z=-3.45, -3.14, P<0.01). The median ratio of DI of IGTV CBCT com in PTV MIP 5 mm, PTV MIP 4 mm and PTV MIP 3 mm≥95% was 100%, 100% and 83.33%, respectively. Conclusions:The patients′ respiratory pattern changed with abdominal compression and abdominal compression is useful in reducing the size of IGTV MIP and IGTV10, which could reduce the target volume and protect the normal tissue. Adding a 4 mm margin to IGTV MIP com based on 4DCT account for respiration in SBRT is a tendency for precise radiotherapy.

Objective To explore the relationship between syncope and risk of death in patients with cardiovascular emergencies including acute myocardial infarction(AMI), arrhythmia, acute heart failure(AHF), pulmonary thromboembolism(PTE) and aortic dissection(AD) rupture. Methods Data from 2 789 patients with cardiovascular emergency admitted from June 2010 to June 2016 in the Emergency Department, Air Force General Hospital, PLA was retrospectively analyzed. Difference in gender, age and motality were compared between patients with syncope and those without syncope. Among fi ve kinds of cardiovascular emergency events with syncope, difference in mortality were compared. Difference in mortality were also analyzed by the CHM corrected chi square test when difference of disease, gender and age were taken into consideration. Syncope, the type of cardiovascular emergency, gender and age were analyzed as potential risk/protective factors for death by the multiple logistic regression analysis. Results The mortalities of the fi ve diseases accompanied with syncope were 50%, 30.43%, 26.53%, 20% and 7.04% respectively in arterial dissection, pulmonary embolism, acute myocardial infarction, acute heart failure and arrhythmia.There was a statistically signifi cant difference in mortality among the fi ve kinds of cardiovascular emergencies accompanied with syncope(P<0.05).The mortalities of patients with syncope were significantly higher than those without syncopein AMI patients(26.53% vs.11.20%,P<0.05) and cardiac arrhythmias patients(7.04% vs.0.36%,P<0.05).The results of the CHM corrected chi square test showed that there was signifi cant difference in mortality between the syncope group and non-syncope group, when the differences in disease type, age and gender were adjusted (χ2=35.876, P<0.01). The mortality of syncope group was higher than that of non-syncope group.When age, gender and disease type were considered as covariates, the multiple logistic regression analysis showed that syncope signifi cantly increased the risk of mortality(OR=3.876,95% CI:2.362-6.359,P<0.01).Conclusion Syncope is an independent risk factor of death in patients with cardiovascular emergencies.

Objective To investigate the risk factors of death in patients with syncope. Methods Clinical data of 516 patients experienced syncope admitted from June 2010 to June 2016 were analyzed retrospectively. Factors including gender, age, history of hypertension, diabetes mellitus, hyperlipidemia, smoking history, drinking history, and etiology of syncope (cardiogenic syncope, neuroreflex syncope, orthostatic hypotension, orthostatic syncope, unexplained syncope, and syncope caused by other special diseases) were analyzed as likely risk factors of death within 30 days after syncope happened. After adding the derived variables (over 22 new factors), analyses were done to investigate independent risk factors of death for patients with syncope. Results This study included 321 male (62.2％) and 195 females (37.8％), with mean age of (62.23±19.69) years. Logistic regression analyses showed that age (OR=1.033, 95％ confidence interval (95％CI):1.008-1.058, P =0.008 8),cardiac syncope (OR=19.704,95％CI:5.894-5.875,P＜0.01) were independent risk factors of death within 30 days after syncope occurred. Multiple-variate analysis with derived variables showed that cardiac syncope (OR=11.487, 95％CI:4.938-26.721,P＜0.01),age and age derived variables (OR=1.000, 95％CI:1.000-1.000,P=0.000 8),age and cardiogenic syncope derivative variables (OR=1.033, 95％CI:1.022-1.044, P＜0.01) were independent risk factors for death within 30 days after syncope. Conclusion Age and cardiogenic syncope were independent risk factors for death within 30 days after syncope occurred. And a derivative factor of age, and interactivity between age and cardiac syncope were independent risk factors of death in patients with syncope.