Objective:To observe the curative effect of transfer factor oral solutions as the adjunctive therapy in ederly patients with recurrent respiratory tract infection ( RRTI) . Methods:Totally 74 ederly patients with RRTI were selected and divided into the observation group and the control group randomly. The patients in the two groups were given anti-infection and symptomatic treatment during the acute stage of attack. The patients in the observation group were additionally given transfer factor oral solutions 10ml, po, tid for 3 months. The changes in serum immunoglobulin IgG, IgA and IgM levels in the two groups before and after the medical treat-ment were compared, and the clinical curative effect and adverse drug reactions ( ADR) were observed as well. Results: After the medical treatment, the serum IgG, IgA and IgM levels in the observation group were obviously increased than before (P<0.05), while those in the control group showed no obvious changes (P>0. 05). The total clinical efficiency in the observation group was much higher than that in the control group (P<0. 01). The ADR between the two groups with light symptoms showed no statistical differ-ences (P>0. 05). Conclusion:Transfer factor oral solutions as the adjunctive therapy in ederly patients with RRTI has the favorable clinical curative effect and safety, and the underlying mechanisms may be concerned with the effect of enhancing serum immunoglobulin IgG, IgA and IgM levels, as well as humoral immune function.

Objective To explore the clinical effects and prognostic factors of postoperative radiotherapy for malignant gliomas. Methods From June 1998 to October 2007, seventy-eight cases of malignant gliomas patients were treated with radiotherapy after surgery, including -28 cases received whole brain radiotherapy, 34 cases local field irradiation and 16 cases three-dimensional conformal radiotherapy. Thirty-one cases received chemotherapy which included semustine, semustine plus teniposide and temozolomide. Kaplan-Meier survival analysis and COX regression analysis were used to analyze the prognostic factors. Results The median survival time and 1-, 3-, 5-year survival rate were 16 months, 65.4 %, 32.8 % and 17.9 % for all patients, respectively; 24 months, 72.7 %, 41.5 % and 22.8% for grade 1 patients; 11 months, 47.8 %, 10.9 % and 5.4 % for grade IV patients. Univariate analysis showed the age, Karnofsky, pathologic grade, surgical approach and the time from surgery to radiotherapy were significantly correlated with the survival time (P <0.05). Karnofsky (P =0.000), pathologic grade (P =0.004) and age (P =0.011) were independent prognostic factors in the multivariate analysis. Conclusion Prognosis of the patients with Karnofsky ≥70, age < 50 years and grade Ⅲ is better in malignant gliomas. Postoperative radiotherapy combined with chemotherapy may prolong the survival time.

Objective To investigate the effects of trichostatin A (TSA) on Th1 and Th17 cells in the mice model of collagen induced arthritis (CIA).Methods Mice model of rheumatoid arthritis (RA) was induced in DBA/1 mice with type Ⅱ collagen.Paws were scored for histological severity of arthritis.The severity of inflammation of mice joints was evaluated by histological examination.Real time polymerase chain reaction (PCR) was used to determine mRNA of cytokines and transcriptional factors.Serum cytokine production was measured by enzyme linked immunosorbent assay (ELISA).T cell proliferation was examined by MTT method.One-way ANOVA and Student-Newman-Keuls were conducted in this study.Results The expressions of IFN-γand IL-17 mRNA of the CIA group were higher than that of the control group (8.27±0.64 vs 2.97±0.25,5.80±0.23 vs 0.70±0.26,all P＜0.01),but were inhibited significantly by TSA introduced at the onset of arthritis(6.60±0.52,2.50±0.41,all P＜0.01).Collagen specific T cell proliferation was significantly suppressed by the introduction of TSA.Increased level of IL-4 was observed in TSA treated group compared to that of CIA group(2.10±0.17 vs 1.01±0.08,P＜0.01).Conclusion Th1 and Th17 cells play crucial roles in the lesions of RA.TSA can suppress the progress of CIA by decreasing the percentage of Th1 and Th17.

Objective To discuss the changes of correlative ultrasonic parameter index of normal hips and abnormal hips with developmental dislocation of the hip (DDH) in infants of different months in order to provide objective information for the diagnosis. Methods Three-hundred and seventy-eight normal hips and 244 hips with DDH among 622 hips of 311 infants were detected by ultrasonography(US). The morphology and structure information of hips were observed, and the values of ultrasonic parameter index,including angle α,angle 3, acetabular index( AI), femoral head percentage of cover(FHC) of normal hips and abnormal hips were measured. The values of each parameter index were collected by being divided into different groups (3 months a group) ,then the correlation was analyzed. Results Morphology and structure,position relation between femoral head and acetabulum of the hips were demonstrated by US. Normal or abnormal hips,the degrees of abnormal hips and the types of hips could be judged according to the findingsof US. Analysis of values of parameter index of normal hips:①There was significantly statistical significance in the values of ultrasonic parameter index, such as angle α, angle β, AI, FHC of normal hip between the groups of different age (P＜0.01). ②There was correlation between the age and the values of each parameter index, among which angle α, FHC had positive correlations with age ( r = 0. 537, 0. 554,respectively ) while angle β and Al negative correlations ( r = -0. 465, -0.424, respectively ). ③There was correlation between the values of different parameter index. Both angle β and AI had negative correlation with angle α,among which the latter correlation was closely ( r = - 0. 794). No statistical significance was found between the ultrasonic values of each group under different ages of different type abnormal hips( P ＞0.05) ,but closely negative correlations still existed between angle α and AI. ConclusionsUS can be viewed as an early definite and a screening method of diagnosing DDH.For older infants (above 6 months) it will be more accurate to analyze the ultrasonic parameter index together with the age of infants.

Objective To investigate the clinical applications of sandwich technique according to area calculation in endovascular aneurysm repair of patients with aorta and iliac artery lesions.Methods Six patients with aortoiliac artery disease confirmed by CT were treated using sandwich technique according to area calculation.The diameter of the main stent and two branches stents were chosen according to the area calculation.Technical success rate,patency of the stent graft and complications were observed.Results Technical success rate was 100％ (6/6),and no complications occurred in all the 6 patients.The clinical symptoms were significantly improved.Gutter endoleak was found in 1 patient 2 months after the procedure,and was managed by coil embolization successfully.No endoleak occurred in other patients during follow-up of 6-31 months.Conclusion For patients with special anatomy of aorta and iliac artery lesions,the application of area calculation in the sandwich technique provides a feasible approach in choosing the matching size of the main body stent and two side branches stents.

Objective To investigate the expression of Oct4 in liver cancer, and the interrelation of the Oct4 and Wnt/β-catenin genes in hepatocellular carcinoma( HCC) cell line HepG2. Methods RTPCR technique was used to detect the expression of Oct4 and β-Catenin in HCC specimens; RNAi was used to knock-down the expression of Oct4 in HepG2, and the change of Wnt/β-catenin related genes were detected by Real time-PCR. Results In HCC specimens, the expression of Oct4 and β-Catenin in tumor and cirrhotic liver tissues were stronger than normal liver tissues. In SiRNA Oct4 HepG2 cells, the expression of Oct4 was downregulated, and β-catenin as well as Wnt10b were in a positive correlation with Oct4, TCF3 was in negative correlation with Oct4. Clone formation and move ability of the HepG2 were downregulated. Conclusions The expression of Oct4 was higher in tumor tissues than in normal liver tissues. Silencing Oct4 by SiRNA-0ct4 in HepG2 resulted in decreased ability of clone formation and cell movement.

BACKGROUND: Diabetes causes abnormal insulin like growth factor-1 (IGF-1) gene expression, which contributes to initiation and development of peripheral neuropathy.OBJECTIVE: To investigate the efficacy of a single dose of methylcabalamin on prevention of experimental diabetic neuropathy and the possible molecular mechanism of its involvement in IGF-1 gene expression.DESIGN: Completely randomized and controlled experiment.SETTING: Endocrinology Department of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The study was carried out in an Animal Center of Nanjing Medical University. Totally 80 male Sprague Dawley rats (sanitary degree)were randomly selected.METHODS: ① Totally 64 rats were chosen to be induced diabetic. They were injected intravenously with alloxan dissolved in saline solutions, at the dose of 240 mg/kg. ② Of 16 rats were chosen as normal control group who were injected intravenously with equivalent volume of saline solution. ③ Of 64 established diabetic rats were treated with daily subcutaneous injection of pork regular insulin in combination of protamine zinc insulin (2:1) then further divided into 2 groups as insulin-treatment diabetic control groups based on different blood glucose levels: group 1 with relatively better control of diabetes, group 2 with relatively worse control of diabetes, with 32 rats in each group. Totally 16 rats of each group were treated with methylcobalamin injection intramuscularly with 500 μg/kg body weight, thus correspondingly divided into insulin +methylcobalamin group 1 and insulin+methylcobalamin group 2. The remaining 16 rats of each group as respective insulin-treatment diabetic control groups were treated with equivalent volume of saline. ④ Initiate weight and end weight were measured at beginning of the experiment and after diabetic model was established. Glucose oxidase was used to detect glucose level. 1-deoxy-1-malin was used to detect fructose level. ⑤ Parameters were measured as follows: Sensory/motor nerve conduction velocity (SNCV, MNCV) and evoked potential amplitude (EPA) of sciatic nerves detected by evoked electromyogram; IGF-I mRNA by reverse-transcriptase polymerase chain reaction (RT-PCR); IGF-1 peptide by enzyme-linked immunosorbent assay (ELISA). ⑥ One-way analysis of variance was used to analyze the Significance of differences among groups.MAIN OUTCOME MEASURES: ① Tissue IGF-1 mRNA/ IGF-1 peptide, electrophysiological data of individual groups at different points of the experiment. ② Comparison between individual groups in glucose metabolic parameters and body weights at different points of the experiment.RESULTS: Three rats died for diabetic infection or other acute complications and only 77 rats were included in the final statistical analysis.① Body weight and glucose metabolic parameter changes: After diabetic model, glucose, fructose level and body weight change between methylcobalamin+insulin treated groups and insulin treated groups were not significant. ② IGF-1 mRNA/peptide changes: Tissue IGF-1 mRNA increased significantly in methylcobalamin + insulin treated groups than that in insulin treated groups, respectively (P ＜ 0.05-0.01). Two weeks after diabetic model was established, the sciatic tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 1 than that in insulin treated group 1 (P ＜ 0.05), but not significantly different from that in NC group; Similarly, tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 2 than that in insulin treated group 2 (P ＜ 0.05), but lower than that in NC group (P ＜ 0.01); Month 2, tissue IGF-1 contents in methylcobalamin+ insulin treated groups were lower signiiicantly than NC groups, but higher than insulin treated groups (P ＜ 0.05-0.01). By month 3, IGF-1 mRNA level in methylcobalamin+ insulin treated group 2 was not significantly different from that in insulin treated group 2. The IGF-1 peptide levels in nerve tissue changed approximately parallel to IGF-1 mRNA level over time course. ③ Nerve electrophysiological data changes: Month 2 and 3, SNCV, MNCV and EPA were significantly higher in methylcobal-amin+ insulin treated group 1 than in insulin treated group 1 (P ＜ 0.05);Month 2, SNCV and EPA were higher in methylcobalamin+ insulin treated group 2 than in insulin treated group 2 (P ＜ 0.05); Month 3, SNCV, MNCV and EPA were significantly lower in methylcobalamin + insulin treated group 2 than in control group (P ＜ 0.05-0.01), whereas no difference was observed between methylcobalamin + insulin treated group 2 and insulin treated group 2.CONCLUSION: ① Methylcobal has not effect on blood glucose. ②Methylcobal could prevent occurrence of experimental neuropathy through its effect on nerve IGF-1 gene expression of diabetic rats. ③ A better efficacy could be achieved by Methylcobal with a good control of blood glucose level in prevention of diabetic peripheral neuropathy.

Objective To evaluate the role of c-AMP-protein kinase A (cAMP-PKA) on the up-regulation of heme oxygenase-1 (HO-1) expression during lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 180-220 g,aged 2.5-3.0 months,were randomly divided into 4 groups (n =12 each)∶ normal control group (group C),ALI group (group ALI),H89 +ALI group (group H + ALI) and H89 group (group H).In group C,normal saline (solvent for LPS) 0.5 ml was injected via the femoral vein and normal saline (solvent for H89) 0.5 ml was injected subcutaneously 2 h later.In group ALI,10 mg/kg LPS 0.5 ml was injected via the femoral vein and normal saline 0.5 ml was injected subcutaneously 2 h later.In group H +ALI,10 mg/kg LPS 0.5 ml was injected via the femoral vein and 5 mg/kg H89 0.5ml was injected subcutaneously 2 h later.In group H,normal saline 0.5 ml was injected via the femoral vein and 5 mg/kg H89 0.5 ml was injected subcutaneously 2 h later.The rats were then sacrificed at 6 h after iv injection of LPS and the lungs were removed for microscopic examination and lung water content.The pathological changes of the lung were scored.The expression of HO-1 and PKA (by Western blot) and HO-1 mRNA (by RT-PCR) was detected.Results Compared with group C,the pathological score and lung water content were significantly increased,and the expression of HO-1,PKA and HO-1 mRNA was up-regulated in groups ALI and H +ALI (P ＜0.05),and no significant change was found in the parameters mentioned above in group H (P ＞ 0.05).The pathological score and lung water content were significantly higher,and the expression of HO-1,AP-1 and HO-1 mRNA was significantly lower in group H + ALI than in group ALI (P ＜ 0.05).Conclusion Activation of signaling pathway c-AMP-PKA is involved in the up-regulation of HO-1 expression during LPS-induced ALI in rats.

ObjectiveTo explore the clinical value of three-dimensional (3D) skeletal ultrasound mode imaging, 3D helical computer tomography (3D-HCT) and MRI in diagnosing lower limb skeletal malformations of fetal sirenomelia.MethodsSeven fetuses were suspected of sirenomelia with routine prenatal ultrasonography examination. Three-dimensional skeletal ultrasound mode imaging and MRI were used to conifrm the diagnosis, and the results were compared to those of pathology, 3D spiral CT or X-ray after termination. Five of them underwent chromosome examination including chorionic villus or umbilical cord biopsy.ResultsSix fetuses were singletons and one fetus was a conjoined twin. Three fetuses were male, while four fetuses were female. All fetuses with sirenomelia showed varying degrees of skeletal abnormalities: 1 case of typeⅢ, 2 cases of typeⅣ, 3 cases of typeⅤ and 1 case of typeⅥ. No foot was detected in one case and only single foot was detected in other 6 cases. In 7 cases, 3D skeletal ultrasound mode imaging could demonstrate all the lower limb skeletal malformations, including abnormal femur and tibioifbula, single foot or no feet. Prenatal MRI could demonstrate abnormal femur in 4 cases, abnormal tibioifbula in 1case, and no foot malformation. The results of 3D spiral CT after termination were consistent with X-ray and pathological examination results.ConclusionsAs a new imaging technology for detecting fetal skeletal malformations, prenatal 3D skeletal ultrasound mode imaging and postnatal 3D spiral CT both can display fetal bone clearly. They both have important clinical value in diagnosing lower limb skeletal malformations.

Objective To construct an eukaryotic expression vector of retinoblastoma gene (pIRES-Rb94), and investigate the radiosensitising effect of Rb94 on lung adenocarcinoma cell line A549 and the mechanism. Methods Recombinant expression plasmid pIRES-Rb94 was constructed and then transfected into A549 cells using lipofectamine 2000. Steadily transfected cells were obtained using G418 se-lecting system. Cell counting method was used to produce the growth curve and the population doubling time was then calculated. The radiosensitivity of A549 cells was assessed by clonogenic assay. The expression of bTERT and Bcl-2 mRNA was detected by real-time RT-PCR. Cell cycle distribution was measured by flow cytometry. Results Steadily transfected cell line pIRES-Rb94-A549 was aquired. Compared with A549 cells, the population doubling time of pIRES-Rb94-A549 cells was increased from 31.5 h to 39.5 h (t=5.15, P<0.01). The expression of hTERT and Bcl-2 mRNA was both down-regulated (0.02:1.00, t= 18.99,P<0.01,0.01:1.00,t=13.73,P<0.01). The number of cells was increased in G2/M phases (35.91%:4.53%, t =36.78,P=0.00), whereas decreased in G0/G1 and S phases (47.02%:74.07%, t =11.71,P=0.00;17.07%:22.32%, t =2.30,P<0.05). The sensitizing enhancement ratio was 1.30. Conclusions Rb94 has marked radiosensitizing effect on A549 cells by G2/M phase blockage and down-regulation of hTERT and Bcl-2 mRNA expression. Rb94 may also inhibit the ability of cell proliferation by regulating cell cycle distribution.