Objective To investigate the effects of antioxidant on the gene expression of ?1-adrenergic receptors (AR) during endotoxic shock. Methods Forty male SD rats weighing 200-250 g were anesthetized with intraperitoneal (i.p.) pentobarbital. The animals kept spontaneous breathing. Femoral artery and vein were cannulated for BP monitoring and drug administration. The animals were randomly divided into 5 groups ( n = 8 each) : (1) control group; (2) LPS group received IPS 15 mg?kg-1 i.v. ; (3) LPS + propofol group received at 1h after LPS a bolus of propofol 10mg?kg-1 i.v. followed by continuous infusion of propofol at 10 mg?kg-1?h-1; (4) LPS + uric acid (UA) group received uric acid 200 mg i.p. 1 h after LPS and (5) LPS + melatonin (MLT) group received MLT 10 mg?kg-1 i.p. 1h after LPS. The animals were killed at 6 h after LPS. Total RNA was extracted from the heart, aorta, vein, lung, liver and kidney. ?1A-,?1B-,?1D- AR mRNA and ?-actin mRNA were measured using reverse transcription polymerase chain reaction (RT-PCR) .Results The expression of ?1A-AR and ?1B-AR mRNA in all the organs and the ?1D-AR mRNA expression in aorta, liver, lung and kidney were strongly down-regulated in LPS group. In group 3 (LPS + propofol) the expression of ?1A-AR mRNA in the lung and kidney, the ?1B-AR mRNA expression in all of the organs and ?1D-AR mRNA expression in aorta, liver, lung and kidney were significantly increased as compared with LPS group. There was no significant difference in ?1-AR mRNA expression between LPS group and LPS + MLT group. The expression of ?1A-AR mRNA in kidney, the ?1B-AR mRNA expression in all of the organs except the lung and the ?1D-AR mRNA expression in aorta, liver, lung and kidney were significantly higher in LPS + UA group than in LPS group. Conclusion Circulatory failure induced by endotoxic shock is related to the down-regulation of ?1-AR gene expression. The therapeutic effects of antioxidant on the endotoxic shock is partly due to up-regulation of ?1-AR gene expression.

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction (AMI) patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group (group1, n=40 cases) and the later onset group (group2, n=48 cases) according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 (P<0.05). The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 (P < 0.05). Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.

ObjectiveTo investigate the effect on improving immune function by hemofiltration combined with hemoabsorption in septic patients with low human leukocyte antigen DR (HLA-DR) expression.Methods A prospective randomized controlled trial was conducted. Sixty sepsis patients aged over 18 years, with HLA-DR expression lower than 30% were enrolled, and they were randomly divided into experimental group and control group, n = 30 in each group. The patients were treated with standard operating procedure for sepsis, and hemofiltration combined with hemoabsorption were added in addition in the experimental group within 1-3 days. The continuous veno-venous hemofiltration (CVVH) mode was performed, with former dilution volume 4 L/h, and the hemofilter HF2000 was carried out with blood absorber HA-330H. The expression of HLA-DR in peripheral blood mononuclear cells was determined before the treatment and 3, 5, 7 days after treatment. Acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, duration of mechanical ventilation, length of intensive care unit (ICU) stay, and 28-day survival rate were evaluated in both groups.Results The HLA-DR expression before treatment in experimental group and control group was both lower than 30%, and there was no statistical difference [(25.9±7.3)% vs. (26.4±6.7)%,P>0.05]. The HLA-DR expression at 3, 5, 7 days after treatment in experimental group was gradually increased, and it was significantly higher than that of the control group [3 days: (38.9±8.6)% vs. (29.3±7.1)%, 5 days: (42.7±9.2)%vs. (31.4±6.5)%, 7 days: (40.9±8.5)% vs. (29.4±6.7)%, allP< 0.05]. There was no significant difference in APACHEⅡ score before treatment between experimental group and control group (22.4±5.3 vs. 21.7±6.2,P>0.05). APACHEⅡ score at 3, 5, and 7 days after treatment was gradually decreased in experimental group, and it was obviously lower than that of the control group (3 days: 18.6±3.6 vs. 20.5±4.3, 5 days: 15.8±3.9 vs. 21.1±4.4, 7 days: 14.9±4.2 vs. 19.8±3.7, allP< 0.05). Compared with the control group, the duration of mechanical ventilation (days: 13.3±3.4 vs. 19.8±3.7,t = 6.432,P = 0.003) and length of ICU stay (days: 20.7±3.9 vs. 26.8±4.7,t = 5.452, P = 0.006) in experimental group were significantly shortened, and the 28-day survival rate was significantly elevated (83.3% vs. 73.3%,χ2 = 3.121,P = 0.016).Conclusion Hemofiltration combined with hemoabsorption can improve the expression of HLA-DR in sepsis patients with low expression of HLA-DR, and it can improve immune function and prognosis of sepsis patients in certain degree.

Objective To evaluate the clinical efficacy and toxicity of rituximab combined with CHOP (R-CHOP) in the treatment of relapsed or refractory diffuse large B cell lymphoma (DLBCL).Methods 30 patients were enrolled.All patients,pathologically confirmed to be CD20 positive DLBCL (all in stages Ⅲ-Ⅳ ), were relapsed or refractory after received 2-6 cycles of chemotherapy. Then all of them received R-CHOP schedule for 4 to 6 cycles, each cycle was 21 days. Clinical data before and after R-CHOP were collected.A retrospective analysis of the R-CHOP therapy,either compared to the literature or self-control was performed to evaluate the efficacy and toxicity. Results All the 30 patients were evaluable, induding 15 cases were complete remission (CR), 10 cases were partial remission (PR), 3 cases were stable disease (SD),and 2 cases were progressed disease (PD).The CR rate was 50.0 ％ (15/30),the total response rate (RR) was 83.3 ％ (25/30).All patients were well tolerated to the therapy.Only 3 cases were Ⅱ degree neutropenia,1 case was Ⅰ degree thrombocytopenia, and 2 cases suffered nausea and other mild gastrointestinal discomfort. Conclusions R-CHOP regimen could also achieve good response for relapsed or refractory DLBCL significantly.The common adverse effects of rituximab were mild.All the patients were well tolerated.

Objective To explore the correlation and clinical diagnostic significance between EGF ,PAF‐AH on henoch‐schonlein purpura (HSP) renal damage in children ,in order to provide a new way of thinking for early diagnosis and clinical prog ‐nosis for HSP nephritis(HSPN) .Methods Totally 86 cases of children with HSP from September 2013 to January 2014 in hospital were collected .According to the presence of renal damage ,the patients were divided into non‐HSPN group and HSPN group ,50 ca‐ses of healthy children as control group ,and 30 casea were diagnosied as bronchial pneumonia .Using PCR technique to detect the change of blood EGF and PAF‐AH ,and using ELISA to detect the change of blood EGF ,PAF‐AH and urine EGF .Results Detec‐tion of blood PAF‐AH mRNA ,EGF mRNA in case group obviously higher than control group ,and detection of blood PAF‐AH mRNA in HSPN group were also hgher than non‐HSPN group(P< 0 .05) .Detection of blood EGF mRNA in HSPN group higher were than non‐HSPN group ,but there was no statistically significant difference (P> 0 .05) .Detection of serum PAF‐AH ,EGF and urine EGF in case group obviously higher than control group and the case group significantly lower recovery than acute stage (P<0 .05) .Conclusion Blood EGF ,PAF‐AH and urine EGF process involved in the pathogenesis of HSP ,and is related to renal dam‐age .

Prednisolone-induced zebrafish osteoporosis model was used to explore the bone-strengthening effect of Jie-Gu-Tang (JGT). Zebrafish larvae of 5 days post fertilization (d.p.f.) were co-exposed with 25 μmol·L-1 pred-nisolone and a series of JGT solutions with a range of concentrations (0.025, 0.25, 2.5, 25 and 100 mg crude herb per liter). The 25 μmol·L-1 prednisolone was selected as the model group. Etidronate disodium (15 and 30 mg·mL-1) with 25 μmol·L-1 prednisolone was used as the positive group. And 0.5% DMSO was used as the vehicle control group. All groups were incubated in 24-well plates (28.5℃) until 10 d.p.f. Zebrafish skeleton at 10 d.p.f. was anes-thetized and fixed for staining with alizarin red. Quantitative analysis of the stained area was performed by microscop-ic inspection and digital imaging methods to reflect the amount of zebrafish head skeleton mineralization. The results showed that prednisolone group at 25 μmol·L-1 concentration can obviously decrease the staining area and the stain-ing optical density values when compared with the vehicle control group (0.5% DMSO). Compared with the model group, both etidronate disodium (15 and 30 mg·mL-1) and JGT (2.5, 25 and 100 mg crude herb per liter) can in-crease the mineralized matrix and integrated optical density (IOD) of zebrafish head skeleton significantly with dose-effect relationship. It was concluded that zebrafish osteoporosis model was successfully used in the evaluation on bone loss prevention and bone formation promotion of JGT, which provided basis for the reliability and reasonability of zebrafish model.

Objective To investigate the relationship between body mass index (BMI) and long-term survival in patients with chronic obstructive pulmonary disease (COPD).Methods A retrospective cohort study was conducted in 1124 patients with completed data among 1528 hospitalized patients with COPD.Vital status was ascertained at death registry and civil affairs department.Clinical characteristics were acquired from medical record.Patients were divided into 4 groups according to the quartile of BMI:BMI＜18.9 kg/m2 (group A),BMI from 18.9 kg/m2to 22.7 kg/m2 (group B),BMI from 22.8 kg/m2 to 26.2 kg/m2 (group C),BMI＞26.2 kg/m2 (group D).The differences in survival curves were compared between groups by using log-rank test.The relationship between all-cause mortality and BMI was evaluated by Cox proportional hazards regression model.Results The median BMI of 1124 patients was 22.7 kg/m2 [(18.9-26.2) kg/m2].270 patients (24.0％) had BMI＜18.5 kg/m2.162 patients (14.4％) died during follow-up.There was significant difference in the survival curves in the four groups (x2 =7.97,P＜0.05).Survival rate was highest in group C and lowest in group A.After adjustment for other factors,BMI was an independent risk factor for predicting long-term survival.The survival rate was respectively decreased by 41 ％ and 35 ％ in group C and D as compared with group A.Conclusions Weight loss is comman in COPD patients.BMI is an independent risk factor for predicting long-term survival.BMI is easily acquired and stable,which is especially suitable to evaluate the prognosis of patients with acute exacerbation.

Objective To study the changes in mRNA and protein expression of ubiquitin and to explore the relationship of apoptosis in the skeletal muscle of mouse with emphysema.Methods Emphysema model was established by passive cigarette smoking in mouse.Apoptosis was detected with TUNEL staining.The reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical assay were used to determine the mRNA and protein level of ubiquitin.Results Apoptotic cells were increased in skeletal muscle of mouse with emphysema.The mRNA and protein level of ubiquitin were significantly higher in mouses with emphysema (0.48±0.02 and 0.23+0.05,respectively) than in control group (0.17±0.01 and 0.14+0.01,t=6.223、4.093,both P ＜0.05).Conclusions The increase of apoptosis in skeletal muscle of mouses with emphysema may be associated with high expression of ubiquitin.

Objective To observe the preventive and therapeutic effects of L-carnitine on the metabolic disorder and cardiac remodeling in alcoholic cardiomyopathy. Methods Experimental animals were divided into three groups: alcohol-fed group(A), an alcohol/L-carnitine fed group(B) and a control group(C). Free fatty acid(FFA) and earnitine were detected in the blood serum at different time. mRNA and protein expressions of peroxisome proliferator-activated receptors (PPARα and PPARγ), retinoic acid receptor retinoid X receptor alpha (RXRα), earnitine palmitoyl transferase isoform and medium-chain acyl-CoA dehydrogenase (MCAD) were observed with RT-PCR and Western blotting methods. Results (1) When group A and B were compared with group C, FFA was increased and carnitine was decreased;mRNA and protein expressions of PPARα, RXRα, CPT-Ⅰ and MCAD were decreased with the development of alcoholic cardiomyopathy (ACM), being more significantly in group A than group B (P < 0.05). (2) mRNA and protein expressions of PPARγ had no statistical significance between these three groups at the end of 2 and 4 months(P>0.05), but after 6 months, they were increased in group B and decreased in group A (A vs. C,P<0.01;B vs. C,P<0.05). Conclusion Metabolic disorder and cardiac remodeling occur in the development process of ACM; they are partly prevented by L-carnitine through downregulating mRNA and protein expressions of PPARct, RXRα, CPT-Ⅰ, MCAD and PPARγ.

Objective To investigate the association between inflammatory biomarkers and survival in patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 1038 patients with stable COPD from January 2008 to December 2009 were included in a prospective cohort study.Clinical characteristics,pulmonary function tests,6 min walk test and a modified British Medical Research Council dyspnea scale (MMRC) were completed.Fasting blood was obtained to detect inflammatory biomarkers including neutrophils,C-reactive protein(CRP),fibrinogen,TNF-a,IL-6 and IL-8.Participants were evaluated every 3 months,all-cause mortality was used as the end event.Results 120 patients (9.2％) died in the period of follow-up.Kaplan-Meier analysis showed that 1 year,2-year-and 3-year survival rates were 94.4％,88.3％ and 84.0％,respectively.Compared with survivors,those who died had a higher level of inflammatory biomarkers.Cox multivariate regression analysis demonstrated that the independent risk factors for death were neutrophils (HR:1.262,95％CI:1.143-1.512,P=0.035),CRP (HR:1.234,95％CI:1.097-1.624,P=0.029),fibrinogen (HR:1.327,95％CI:1.141-1.619,P=0.026),TNF-α (HR:1.124,95％CI:1.043-1.659,P=0.045),IL-6 (HR:1,429,95％CI:1.237-1.816,P=0.014) and IL-8 (HR:1.188,95％CI:1.024-1.383,P=0.042).C statistical analysis showed that no single biomarker significantly improved the C statistic value on the base of clinical model,but it was further improved by the addition of all biomarkers (C =0.764,P =0.010).Conclusions The level of inflammatory biomarkers in the death with stable COPD is significantly increased.Age.BODE index,neutrophils,CRP,fibrinogen,TNF-α,IL-6 and IL-8 are independent risk factor for the prediction of mortality in patients with COPD.