Objective: To investigate the effects of Ang II on cellular proliferation and activation of cultured rat pancreatic stellate cells (PSCs). Methods: Growth arrest was induced in the 4th-7th passage rat PSCs by culturing with serum-free DMEM for 48 h, then the PSCs were incubated for 24 h or 48 h with serum-free culture medium containing different concentrations of Ang II (0, 1, 10, and 100 nmol/L) in the presence or absence of ZD7155 and PD123319, the specific antagonists of Ang II type 1 and 2 receptors (AT1 and AT2). The DNA synthesis rate was investigated by using [3H]thymidine incorporation, collagen synthesis rate by [3H]proline incorporation, α-smooth muscle actin (α-SMA) expression by Western blot analysis, and procollagen α1 (I) mRNA expression by Northern blot analysis. Results: Treatment of cells with Ang II for 24 h resulted in a dose-dependent increase in DNA synthesis, with statistically significant increase at 10 and 100 nmol/L (both P<0.05 vs normal control). Treatment for 48 h with Ang II at concentrations of 1, 10, and 100 nmol/L dose-dependently induced collagen synthesis and procollagen α1(I) mRNA expression (both P<0.05 vs normal control). The above effects of Ang II (100 nmol/L) were inhibited by ZD7155 (P<0.01 vs Ang II alone) but not by PD123319 (P>0.05 vs Ang II alone). No significant increase in the expression of α-SMA protein was observed in response to stimulation with increasing concentrations of Ang II. Conclusion: The present study indicates that Ang II, mediated by AT1 receptor, can dose-dependently induce the proliferation and collagen production in rat PSCS, thus participating in the pancreatic fibrogenesis.

Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis, typically as chronic anterior uveitis with insidious onset. Delayed and inadequate treatment may result in loss of patients' vision and even blindness. For refractory or severe uveitis related to juvenile idiopathic arthritis, systemic immunosuppressive agents should be used as early as possible. With the advantage of controlling ocular inflammation, avoiding ocular complications and reducing the use of traditional immunosuppressant drugs and glucocorticoid, tumor necrosis factor-α inhibitors have been new therapeutic options for uveitis associated with juvenile idiopathic arthritis, although methotrexate is known as the first-line approach. However, there are no internationally unified guidelines for clinical issues regarding the timing of application, reduction and withdrawal of tumor necrosis factor-α inhibitors, and no agreement on the application of tumor necrosis factor-α inhibitors in the management of ocular complications either. An in-depth understanding of the application status and progress of tumor necrosis factor alpha inhibitors in the treatment of juvenile idiopathic arthritis-associated uveitis has important clinical significance.

ObjectiveTo compare the appearance of abnormal lipid accumulation in skeletal muscle fibers in various neuromuscular disorders by analyzing the results of Oil-Red-O staining of muscle biopsy samples. Methods523 muscle biopsies performed in 1998—2002,consisted of lipid storage myopathy, mitochondrial diseases, inflammatory myopathy, muscular dystrophy, steroid myopathy, alcoholic myopathy and neurogenic muscle atrophy,were studed. ResultsType Ⅰ fibers were selectively involved in lipid storage of muscle fibers.In all diseases, men were more frequently affected than momen in which men to women was 3∶2.Marked uniformity lipid storage in muscle fibers was found most frequently in patients with lipid storage myopathy and mitochondrien-lipid-glycogene storage diseases. Moderate uniformity lipid storage in the muscle fibers was found in patients with steroid myopathy, alcoholic myopathy and malnutrition. Moderate or marked non-uniformity lipid storage in muscle fibers was found in patients with mitochondrial cytopathy, inflammatory myopathy, muscular dystrophy. Moderate non-uniformity lipid storage in muscle fibers was found in patients with neurogenic muscle atrophy. Mild lipid storage in muscle fibers was found in numerous systemic disease and neuromuscular disorders. ConclusionNumerous neuromuscular diseases can associated with abnormal lipid metabolism in muscle fibers, in which the men are more involved than women. The appearance of lipid accumulation in the muscle fibers markedly changes in different neuromuscular diseases. The diagnostic value of lipid storage in muscle fibers should be considered under analysis clinical symptoms and other myopathological findings.

Objective　To summarize the phenotypic and genotypic characteristics of mitochondrial combined oxidative phosphorylation deficiency type 1 (COXPD1), and to improve the clinicians' awareness of this mitochondrial encephalomyopathy. Methods　The clinical characteristics, physical examination, laboratory examination and other data of a child with COXPD1 were analyzed retrospectively. The diagnosis was confirmed by clinical whole exon sequencing and high-precision mitochondrial genome full-length PLUS gene detection, and the phenotype and genotype were analyzed by reviewing relevant literature. Results　A one-year and five-month-old boy mainly presented with hyperlactacidemia and abnormal liver function. Clinical whole exon sequencing showed that the child had homozygous variation of c. 688G>A(p.G230S) in the GFM1 gene. Sanger sequencing verified that the variation was respectively inherited from the parents of the child (both were heterozygous) with the autosomal recessive inheritance pattern. The high-precision mitochondrial genome full-length PLUS detection also did not find pathogenic mutations related to clinical phenotypes. The child was diagnosed with COXPD1. After "cocktail" therapy and liver protection therapy, the patient's condition improved. Conclusions　The phenotype of COXPD1 is complicated and variable, mainly liver type and brain type. The mutation of GFM1 gene affects mitochondrial translation system function, and early gene detection is helpful for definite diagnosis.

Objective:To investigate the effects of rapamycin on allograft rejecti on and immune response in mice. Methods:The heterotopic ear-hea rt grafting or sk in grafting were done in mice. The delayed type hypersensitivity (DTH) response i nduced by dinitro-fluorobenzene (DNFB), the production of hemolysin of mouse sensitized by sheep red blo od cell (SRBC) and the neutral red phagocytosis of the peritoneal macrophage wer e also tested in mice. Results:RAPA significantly blocked allograft reject ion of heart and skin, markedly inhibited DTH response and decreased the production of hemolysin,but had no significant effect on the neutral red phagocytosis of the p eritoneal macrophage. Conclusion:RAPA potently blocked allograft rej ections in mi ce and suppressed cellular and humoral immune response, but had no significant e ffect on phagocytoses of macrophage.

Deifnitive treatment for locoregionally advanced squamous cell carcinoma of the head and neck region (HNSCC) is challenging, and usually require multidisciplinary efforts involving surgery, radiotherapy, and chemotherapy. Although surgery followed by radiation or chemoradiation therapy remains the standard treatment for resectable disease, combined chemoradiation therapy provides an effective option with organ spearing potential. In addition, combined chemoradiation therapy is the only treatment option for non-metastatic advanced HNSCC. Recently published results from TAX323 and TAX324, two important randomized clinical trials on the efficacy of induction chemotherapy using docetaxel based regimen, showed that induction chemotherapy using TPF can signiifcantly improve patients’ survival as compared to the conventional PF regimen. However, whether TP or TPF induction chemotherapy should be combined with concurrent chemoradiation and considered as part of the standard treatment regimen remains controversial, and requires support from the results of well-designed randomized clinical trial.

The therapy of removing beat and toxic,strengthening the body to cultivate the fundamental is the mainstream of treating cancer in traditional Chinese medicine up to now,and the therapy of warming yang has been rarely involved.While the pathogenesis of tumor is spleen and kidney yang deficiency in root,and phlegm,stasis,and poison entangled with each other at the secondary position; the main therapeutical principle of tumor is simultaneous application of purging-tonifying therapy while focusing on protecting yang.The author believes that the treatment of cancer should pay attention to the whole concept,especially warming yang for patients with advanced tumors.The therapy of warming yang is an effective way to get rid of phlegm and blood stasis.Patients after radiotherapy and chemotherapy should be paid more attention to warming yang.

Objective To investigate the clinical significance of the changes of hemodynamics and electrolyte during orthotopc liver transplantation.Methods We studied 9 patients undergoing elective orthotopic liver transplantation without venovenous bypass,drew out arterial blood for monitoring arterial blood gas tensions,Na~+,K~+,Ca~(2+) and observed changes in hemodynamics and electrolyte.Results In most patients,arterial pressure significantly decreased at the prophase of the anhepatic phase,and tended to normal range in other phases.The concentration of calcium maintained a low-level during the whole surgery.During the prophases of the anhepatic phase and neo-hepatic phase,there was a light hyperkalemia,and the concentration of natrium slightly increased since 30 minutes after the anhepatic phase and neohepatic phase,but insensibly exceeded normal range.With resuming of the stability of hemodynamics,these changes had followed.Conclusion We shoud give our attention to correct the occurrence of the hypocalcemia during the forepart of the anhepatic phase and neo hepatic phase,and care for the hyperkalemia 5 minutes after the block of liver blood purveyance and revascularization of liver.The lock of body capability shoud be recruit duly according to the lose of blood and hemacytometer changes.In order to prevent serious academia and maintain the stability of hemodynamics and electrolyte,vasoconstrictor shoud be used carefully during the anhepatic phase.

The lack and absence of knowledge in humanities and medical ethics among nursing staff have a negative influence on the mutual communication between nurses and patients and the implementation of humanistic nursing.The implementation of humanistic nursing can improve the general quality of nursing staff,especially their knowledge in humanities and medical ethics,and increase patients' satisfaction towards medical service.Meanwhile,it can also upgrade hospital's overall image,and increase social and economic profits of hospitals as well.

Radiotherapy is an important therapeutic method in the management of head and neck cancer.However,since the head and neck region has many important functions of the human body,radiotherapy may cause serious sequelae.Proton and heavy ion radiotherapies have better radiophysical and biological properties compared with conventional proton beam and are beneficial to tumor control and protection of normal tissue.The advantages of proton and heavy ion radiotherapies have been demonstrated in soft tissue tumors (especially skull base chordoma and chondrosarcoma),malignant melanoma,and adenoid cystic carcinoma resistant to conventional protons in the head and neck region,and the safety of proton and heavy ion radiotherapies have been confirmed in reirradiation for recurrent tumors.