Objective To investigate the effect of dexmedetomidine on the expression of hypoxia-inducible factor-1α (HIF-1α) during hypoxia/reoxygenation (H/R) in human renal tubular epithelial cells.Methods Human renal tubular epithelial cells (HK-2 cells) cultured in vitro were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C),dexmedetomidine group (group DEX),H/R group and H/R+ dexmedetomidine group (group H/R + DEX).In group C,the cells were incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group DEX,dexmedetomidine 0.1 nmol/L (final concentration) was added to the culture medium and the cells were incubated for 2 h,and then incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group H/R,the cells were incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.In group H/R + DEX,the cells were incubated for 2 h in the culture medium containing dexmedetomidine 0.1 nmol/L (final concentration),incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.After treatment in each group,the cell viability was measured by MTT assay,cell apoptosis was measured using flow cytometry,the expression of HIF-1α mRNA was detected using RT-PCR,the expression of HIF-1α and activated caspase-3 protein was detected by Western blot,and the cell growth was observed.The apoptosis rate was calculated.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of HIF-1α mRNA and protein and activated caspase-3 protein was up-regulated in H/.R and H/R + DEX groups,and no significant change was found in group DEX.Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,the expression of HIF-1α mRNA and protein was up-regulated,the expression of activated caspase-3 protein was down-regulated,and the cell status was significantly improved in group H/R + DEX.Conclusion The mechanism by which dexmedetomidine attenuates H/ R-induced damage to human renal tubular epithelial cells may be related to up-regulated expression of HIF-1 α and inhibited cell apoptosis.

Objective To explore the effect and adverse reaction of priming regimen CAG in treatment of acute myeloid leukemia in elderly.Methods 32 elderly patients with acute myelogenous leukemia were treated with CAG regimen and 25 cases with standard chemotherapy regimen( DA regimen). The effect and adverse reaction were compared between the two groups. Results There was no significant difference of the complete remission rate and effective rate between the two groups. The recovery time of bone marrow and death rate of CAG the regimen group were superior to those of the DA group. Conclusion CAG regimen was effctive and safe for elderly patients with acute myeloid leukemia.

Objective:To evaluate the role of nuclear factor erythroid 2-related factor/ heme oxygenase-1 (Nrf2/HO-1) signaling pathway in dexmedetomidine-induced reduction of oxygen-glucose deprivation and restoration (OGD/R) injury to microglia.Methods:BV-2 microglia were cultured in high-glucose DMEM culture medium supplemented with 10% fetal bovine serum in an normal culture incubator at 37 ℃ (5%CO 2-21%O 2-74 %N 2). The cells were seeded in 96-well plates at a density of 1.5×10 4 cells/ml (200 μl/well) or 6-well plates at a density of 2×10 5 cells/ml (2 ml/well) and divided into 5 groups ( n=30 each) using a random number table method: control group (group C), dexmedetomidine group (group D), group OGD/R, OGD/R+ dexmedetomidine group (group OGD/R+ D) and OGD/R+ dexmedetomidine+ ML385 group (group OGD/R+ D+ ML). The cells in group C were continuously cultured in a normal culture incubator for 26 h. In group D, dexmedetomidine at the final concentration of 10 μmol/L was added, cells were incubated for 2 h, and then were continuously incubated in a normal culture incubator for 26 h. In OGD/R, OGD/R+ D and OGD/R+ D+ ML groups, the culture medium was replaced with glucose-free DMEM culture medium, cells were cultured for 2 h in an incubator at 37 ℃ (5%CO 2-1%O 2-94 %N 2), the culture medium was replaced with high-glucose DMEM culture medium containing 10% fetal bovine serum and then the cells were cultured for 24 h in a normal incubator.Dexmedetomidine at the final concentration of 10 μmol/L was added at 2 h before OGD in OGD/R+ D and OGD/R+ D+ ML groups.Nrf-2 inhibitor ML385 at the final concentration of 4 μmol/L was added at 30 min before dexmedetomidine was added in group OGD/R+ D+ ML.Cells in 6 wells in each group were selected randomly for assessment of cell viability (by methyl thiazolyl tetrazolium assay) and apoptosis (using flow cytometry), and for determination of the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 in the supernatant (using enzyme-linked immunosorbent assay), the expression of Nrf2 in nucleus, Nrf2 and HO-1(by Western blot ) and the expression of HO-1 mRNA (by real-time polymerase chain reaction). Results:Compared with group C, the cell viability was significantly decreased, cell apoptosis rate and concentrations of TNF-α, IL-6 and IL-10 in the supernatant were increased, and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was up-regulated in OGD/R and OGD/R+ D groups ( P<0.05), and no significant change was found in each parameter mentioned above in group D ( P>0.05). Compared with group OGD/R, the cell viability and IL-10 in the supernatant concentration were significantly increased, cell apoptosis rate and concentrations of TNF-α and IL-6 in the supernatant were decreased and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was up-regulated in group OGD/R+ D ( P<0.05), and no significant changes were found in the parameters mentioned above in group OGD/R+ D+ ML ( P>0.05). Compared with group OGD/R+ D, the cell viability and concentration of IL-10 in the supernatant were significantly decreased, cell apoptosis rate and concentrations of TNF-α and IL-6 in the supernatant were increased and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was down-regulated in group OGD/R+ D+ ML ( P<0.05). Conclusion:The mechanism by which dexmedetomidine alleviates OGD/R injury to microglia may be related to promoting the activation of Nrf2/HO-1 signaling pathway and inhibition of inflammatory responses.

Objective To understand the status of knowledge,attitude and behavior on malaria of residents in endemic areas of Yunnan Province.so as to provide evidences for implementation of Global Fund MaIaIia Control Program.Methods The subjects were selected by the method of multi-level sampling in 47 countries and were investigated by questionnaire.Results A toatl of 40 940 households in 883 natural villages were investigated.39 234 questionnaires were effective with an effective rate of 95.83%.A total of 60.32%interviewees knew malaria symptom and signs,22.41%of them knew the route of transmission,17.65% knew the preventive measures.57.61% had the willing to use insecticide-treated bed nets(ITNs),and 8.68%of the households owned ITNs.Conclusion Health edueion and promotion regarding critical malria interventions should be strengthened in the following implementation.

AIM: To study the expression and the role of neurokinin-1 receptor(NK-1R) and neurokinin-2 receptor (NK-2R) in distal ileum during acute necrotizing pancreatitis(ANP).METHODS: 130 adult Sprague-Dawley rats were divided into 2 groups: the rats in ANP group( n=80 ) were induced by the retrograde intraductal infusion of 5% sodium taurocholate. The rats in sham operation control group ( n=50 ) received laparotomy only. Reverse transcription polymerase chain reaction (RT-PCR) was used to determine the mRNA expression of NK-1R and NK-2R, Western blot was used to investigate expression level of NK-1R.RESULTS: NK-1R and NK-2R mRNA levels were enhanced in the distal ileum of ANP rats compared with controls. Western blot revealed stronger NK-1R immunoreactivity exited in intestinal mucosa in ANP rats. The overexpression of NK-1R was associated with mucosal pathological score( r=0.77,P

AIM: To investigate the expression of neurok inin-2 receptor (NK-2R) in normal pancreas and chronic pancreatitis (CP) tissues. The relation of expres sion of NK-2R with pain in CP was also evaluated. METHODS: CP tis sues were ob tained from 18 men and 7 women undergoing pancreatic head resection as a result of CP. Normal human pancreatic tissues were obtained from 20 patients (11 males/ 9 females). Real-time quantitative reverse transcription polymerase chain reacti on was used to determine the mRNA expression of NK-2R, Western blot analysis was used to determine its protein expression level, and immunohistochemistry was us ed to localize expression site of NK-2R protein. NK-2R mRNA level and pain were also analysed whether correlation exists. RESULTS: NK-2R mRNA and p rotein level were enhanced expressed in CP tissue samples compared with normal pancreas. Ove rexpression of NK-2R was related to the intensity ( r=0 59, P

Objective To observe the efficacy of Wuteng Ercao decoction in treating active rheumatoid arthritis (RA) and its effects on the levels of cytokine interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α).Methods Sixty-five patients with active RA were randomly divided into treatment group (33 cases) and control group (32 cases). Patients in the control group were administered with methotrexate tablets 10 mg, oral taking, once a week;hydroxychloroquine sulfate tablets 200 mg, oral taking, twice a day;diclofenac sodium sustained release tablets 75 mg, oral taking, twice a day. Patients in the treatment group were administered with Wuteng Ercao decoction additionally, oral taking, three times a day. The treatment lasted for 12 weeks. The changes and untoward effects of various clinical and laboratory indicators were observed before and after treatment.Results After treatment, the tender joint count, swollen joint count, patient’s global assessment, and physician’s global assessment were improved (P<0.05), with statistical significance between the two groups (P<0.05). The levels of ESR, CRP, IL-6 and TNF-α decreased significantly after treatment (P<0.05), but those were more significantly in treatment group (P<0.05). There were 2 cases with untoward effects in the treatment group and 1 case in the control group (P>0.05).Conclusion Wuteng Ercao decoction is effective in patients with active RA and it can reduce the levels of IL-6 and TNF-α.

Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio (NLR) in patients with gastrointestinal stromal tumors (GIST).Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013.According to the exclusion criteria,79 cases were enrolled.Preoperative neutrophil and lymphocyte count was collected and NLR was calculated.According to the receiver operating characteristic (ROC) curve of NLR,GIST patients were divided into low NLR group (NLR ＜ 2.30) and high NLR group (NLR ≥ 2.30).Clinic-pathological features and five year disease free survival (DFS) were compared between the two groups.Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group (respectively,x2 =9.517,12.411,all P ＜ 0.05).Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78％ and 32％ (x2 =18.749,P =0.000).By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs (RR:3.516,95％CI:1.453-8.506,P=0.005).Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.

Obturator hernia is an extremely rare pelvic hernia which occurs mostly in elderly, thin, multiparous women. Clinical manifestations are abdominal pain and/or unexplained intestinal obstruction, and obturator neuralgia due to compressed obturator nerve. As the lack of specific symptoms and external masses likes other abdominal wall hernias, its diagnosis may be arduous and difficult; hence, an accurate preoperative diagnosis or surgical treatment is often delayed, such a delay often leads to gangrenous bowel in a large proportion of cases and results in unacceptably high morbidity and mortality. preoperative detection of the obturator hernia due to clinical alert and in-time computed tomography of the pelvis. Early diagnosis and prompt initiation of surgical intervention are essential for this rare entity. This explanatory review emphasizes and illuminates its various facets under the significant events, anatomy, epidemiology and rationale of its diagnosis and management to familiarize surgeons with the condition that seldom thought of and hence seldom sought.

Objective To evaluate the clinical feature of adult acute myeloid leukemia with nucleophosmin (NPM1) cytoplastic positive (NPMc+AML), and to investigate the significance of the NPM1 gene mutations regularly in detecting the early relapse. Methods The NPM1 gene mutations was screened by the PCR-capillary electrophoresis in 95 newly diagnosed adult AML patients. 5 complete remission AML patients were selected to detecte the NPM1 gene mutations regularly. Results In 95 cases of adult AML patients, the incidence of the NPM1 mutations was 9.5 % (28/95). The incidence of the NPM1 mutations in patients (≥40-year-old) was higher clearly than it' s in pazients (40-year-old) (λ 2= 6.963, P = 0.012). That in the AML patients with normal karyotype (51.1%) was higher than that in the patients with abnormal karyotype (8.3 %) (λ2= 20.860, P= 0.0000). NPM1 mutations occured with a considerate percentage in AML patients with M5/M2 subtype. In AML with recurrent genetic abnormalities the NPM1 mutations wasn' t found.The white blood cell count, platelet count, lactate dehydrogenase in the NPMc+AML patients were clearly higher than that in the NPMc-AML patients (t were individually 4.132, 4.603, 4.069, P ＜0.05). The rate of complete remission, relapse-free survival and overall survival in the NPMc+AML patients were also higher than that in the N PMc-AML patients (λ 2 were individually 10.448, 4.146, 4.384, P ＜0.05). In cases detected regularly NPM1 mutations preceded the hematological relapse about 1.5-2 months. Conclusion NPM1 gene mutations has a higher incidence in adult AML, particularly in normal karyotype AML. The clinical manifestations are older, and higher in white blood cell count, platelet count, and lactate dehydrogenase. The NPM1 mutations in adult AML is a good factor for prognosis. The regular detection of NPM1 mutation could find relapse early.