Objective To study pathological feature of sacroiliitis of spondyloarthropathies (SpA) in different stages,and improve the threshold of early diagnosis of SpA.Method Samples of sacroiliac joints (SIJ) of 8 patients with ankylosing spondylitis (AS) and 5 patients with undifferential spondyloarthropathies (uSpA) were taken when SIJ steroid injection was performed.The pathological feature was studied.Results Synovitis,including lining cell hyperplasia and inflammatory cell infiltration in looseconnective tissue,local cartilage degeneration,fibrosis and inflammatory cell infiltration in subchondral bony plate and marrow cave were found in 6 (86%,6/7) samples in patients with normal/suspectable SIJ CT scan.In the CT Ⅱ and Ⅲ degree sacroiliitis,marked degeneration and fibrosis of cartilage,inflammatory cell infiltration,pannus formation and subchondral bony plate destruction were increasingly prominent.In the advanced sacroiliitis (CT Ⅳ degree),destruction and calcification of cartilage and subchondral bony plate were the major feature.Eosinopil (EO) was increased in the infiltration cells of synovium and subchrodral bony plate in 3 samples.Conclusion Synovitis,including hyperplasia of lining cell and the infiltration of inflammatory cell in loose connective tissue,and local cartilage degeneration and inflammatory cell infiltration,and destruction of subchondral bony plate are the early changes identified in sacroiliitis.Pathological examination can improve the threshold of early diagnosis of sacroiliitis in case it cannot be confirmed with CT scan.

Objective To investigate the influence of injection color regents concentration on completed resection rate, operation time and injection volume of patients with intestinal tumor by ESD.Methods 90 elderly patients with intestinal tumor by ESD were chosen from June 2013 to June 2016. They were randomly divided into 3 groups including A group (30 patients) with glycerin fructose used alone, B group (30 patients) with glycerin fructose combined with 2% mythylene blue on the basis of glycerin fructose and C group (30 patients) with glycerin fructose combined with 4% mythylene blue on the basis of glycerin fructose; and the completed resection rate of tumor, operation time, injection volume and complication incidence in the peri-operative period of 3 groups were compared.Results There was no signiifcant difference in the completed resection rate of tumor among the 3 groups (P < 0.05). The operation time and injection volume of C group were signiifcant better than A group and B group (P< 0.05). There was no signiifcant difference in operation time and injection volume between A group and B group (P < 0.05). There was no signiifcant difference in the complication incidence in the peri-operative period among the 3 groups (P < 0.05).Conclusion Compared with glycerin fructose used alone and glycerin fructose combined with 1% mythylene blue for 2 mg, glycerin fructose combined with 1% mythylene blue for 4 mg by intestinal submucosal injection on patients with intestinal tumor by ESD can efifciently shorten the operation time and reduce the injection volume.

Objective: To investigate the relationship of nm23 and VEGF expression with hilar lymph node micrometastasis and the prognosis of stage Ⅰ non-small cell lung cancer (NSCLC). Methods: Immunohisto-chemistry was used to detect nm23 and VEGF protein expression in primary cancer tissue and cytokeratins in 86 hilar lymph nodes from 40 patients with stage Ⅰ NSCLC. Kaplan-meier method and Log rank test were used to analyze the 5-year survival. Results: The rate of positive hilar lymph node micrometastasis was 12.5% for stage Ⅰ NSCLC. Lymph node micrometastasis was not statistically correlated with gender, age, histologic type, differentiation, primary tumor size or VEGF protein expression (P>0.05). But it was reversely associated with nm23 protein expression in primary cancer tissue of NSCLC (P<0.05). The 5-year overall survival of pa-tients with well-differentiated NSCLC, positive nm23 expression and negative lymph node micrometastasis was better than those with moderately and poorly differentiated NSCLC, negative nm23 expression and posi-tive lymph node micrometastasis (P<0.05). Lymph node micrometastasis and nm23 protein expression were identified as two independent prognostic factors for stage Ⅰ NSCLC by univariate Cox regression analysis.Conclusion: nm23 protein expression in pdmary cancer tissue of stage Ⅰ NSCLC is closely associated with hi-lar lymph node micrometastasis, nm23 protein and hilar lymph node micrometastasis are two independent prognostic factors for stage Ⅰ NSCLC. Patients with nm23 protein deletion and positive lymph node microme-tastasis have a poor prognosis.

Objective To evaluate long-term outcome of simultaneous kissing sirolimus-eluting stent (SKS) technique versus single sirolimus-eluting stent (SSS) technique for percutaneous treatment of true coronary bifurcation lesions in large-size vessels.Methods This randomized study assigned 190 patients with a coronary bifurcation lesion to simultaneous kissing stenting (SKS) in both main and side branches and 190 patients to main vessel stenting only (SSS).The endpoints included restenosis,death,non-fatal myocardial infarction,target-lesion revascularization (TLR),stent thrombosis,success rate of percutaneous coronary intervention (PCI) and the operation duration.Results During 1-year follow-up,the SKS group and the SSS group had similar incidences of overall re stenosis [30 ( 15.8 ％ ) vs.24 ( 15.2 ％ ),x2=0.000,P＜0.05],mainbranch restenosis [20 ( 10.5％ ) vs.16 ( 10.1％ ),x2=0.003,P ＞ 0.05];side-branch restenosis [13 ( 6.8％ )vs.23 ( 14.6％ );x2=4.73,P＜0.05];death [2 ( 1.1％ ) vs.1 ( 0.6％ ),x2=0.026,P ＞ 0.05],non-fatal myocardial infarction [4 (2.1％ ) vs.2 ( 1.3％ ),x2=0.034,P ＞ 0.05],TLR [23 ( 12.1％ ) vs.20 ( 12.7％ ),x2=0.000,P ＞ 0.05] and stent thrombosis [4 (2.1％ ) vs.2 ( 1.3 ％ ),x2=0.034,P ＞ 0.05] and a shorter operation duration[(20 ± 8) min vs.(45 ± 9) min,t=1.98,P＜0.05] than the SSS group.Conclusion For true coronary bifurcation lesions in large-size vessels,SKS and SSS have similar long-term outcomes.The SKS group has a higher success rate of PCI and shorter operation duration.

Insulin is the most common medicine used for diabetic patients, unfortunately, its effective time is short, even the long-acting insulin cannot obtain a satisfactory effect. Fibroblast growth factor (FGF)-21 is a recently discovered glucose mediator and expected to be a potential anti-diabetic drug that does not rely on insulin. In this study, db/db mice were used as the type 2 diabetic model to examine whether mFGF-21 has the long-term blood lowering effect on the animal model. The results showed that mFGF-21 could stably maintain the blood glucose at normal level for a long-term in a dose-dependent manner. Administration of mFGF-21 once a day with three doses (0.125, 0.25 and 0.5 mg x kg(-1)) could maintain blood glucose of the model animals at normal level for at least 24 h. Administration of mFGF-21 every two days with the same doses could maintain blood glucose of the model animals at normal level for at least 48 h, although it took longer time for blood glucose to reach to normal level depending on doses used (twenty injections for 0.125 mg x kg(-1) and 0.25 mg x kg(-1) doses, ten injections for 0.5 mg x kg(-1) dose). Surprisingly, the blood glucose of the treated model animals still maintained at normal level for 24 h after the experiment terminated. Glycosylated hemoglobin level of the animals treated with mFGF-21, which represented long-term glucose status, decreased significantly compared to the control group and the insulin group. The results suggest that FGF-21 has potential to become a long-acting and potent anti-diabetic drug.

Fibroblast growth factor-21 (FGF-21) is an important metabolism regulator, however, whether FGF-21 has effects on cardiovascular remains unclear. In this study, H2O2-induced injury in H9c2 cells was used as a cell model, the anti-apoptosis potential and mechanism of FGF-21 against oxidative injury were evaluated by MTT assay, flow cytometry assay and real-time PCR. The results showed that FGF-21 could increase the cell survival of H2O2-induced injury in H9c2 cells and prevent H9c2 cells from oxidative stress-induced apoptosis. Furthermore, FGF-21 can elevate SOD activity and regulate Bcl-2/Bax expression in H9c2 cells. The results suggest that FGF-21 have protective effect against the H2O2-induced apoptosis in H9c2 cells.

Insulin resistance in insulin sensitive organ results in metabolic disorder such as hyperglycemia, hyperinsulinemia and hyper triglyceridemia which are common features of type 2 diabetes.Insulin resistance in liver cells mainly causes impaired glycogen synthesis, failed to suppress glucose production which is the major contribution to hyperglycemia.FGF-21 as a new metabolic regulator can control fasting blood glucose.The mechanism of FGF-21 effects on regulating plasma glucose has little to known.In order to establish an in vitro insulin resistant model of liver cells and evaluate the effects and mechanism of FGF-21 on glucose metabolism in the cell model, HepG2 cells were incubated with 10-7 mol/L insulin for 24 h to build insulin-resistant cell model.To evaluate the cells for insulin resistance, the cells were stimulated with fresh insulin for 24 h and the glucose uptake by these cells was carried out.The insulin-resistant cells were treated with different concentrations of FGF-21 for 24 h and insulin-treated cells were used as a control.The glucose uptake by the cells was detected by the method of glucose oxidizes/peroxides(GOD-POD);the synergy between insulin and FGF-21 was evaluated.The mRNA expression of GLUT1 in the insulin-resistant cells was detected by the real-time PCR.Glycogen synthesis of the cells was examined by the anthrone method.The results showed that HepG2 cells treated with 10-7 mol/L insulin for 24 h became resistant to insulin and the insulin resistance status was maintained for 48 h without change of cell morphology.FGF-21 could stimulate glucose consumption of the insulin-resistant model in a dose-dependent manner.The glucose consumption and glycogen synthesis of the insulin-resistant model were significantly improved by FGF-21 treatment.FGF-21 showed strong synergy with insulin in glucose uptake and glycogen synthesis of the model cells.While the cells became resistant to insulin, FGF-21 could increase the mRNA expression of GLUT1.Thus, It is concluded that FGF-21 stimulates glucose uptake in insulin resistant HepG2 cells through GLUT1 expression, stimulates glycogen synthesis and improves the glucose metabolism in the insulin resistant liver cell model.

Objective:To observe immunological indexes,the quantity of cytokine expression and clinical curative effect of umbilical cord mesenchymal stem cells between before and after the treatment of systemic lupus erythematosus patients.Methods:Selected 10 cases of SLE,on the basis of glucocorticoid and immune inhibitor treatment,intravenous injection UC-MSC of cultivating proliferation within 6 generations.Before and after treatment of UC-MSC testing the relative quantity of cytokine of CTLA-4,IL-15,IL-2,CD86,IL-17c,Foxp3,TGF-β2 which were related of immunopathogenesis of SLE.Before and after treatment to determined SLE disease activity index (SLEDAI) score and detection of blood in the urine routine,liver and kidney function,24 hours urinary protein quantitative,immunoglobulin and complement levels.Results:After treatment the relative expression value of IL-15 and IL-2 was decreased,CTLA-4 was risen.There had no significant difference with the relative expression value of CD86,IL-17c,Foxp3,TGF-β2 in before and after treatment of UC-MSC.After treatment serum complement C3 and C4 level,serum albumin,were risen.24 hour proteinuria and SLEDAI were decreased.There was no serious adverse reaction occurred,no complications related to transplantation in 10 cases.Conclusion:UC-MSC can regulate the expression of cytokines of participate in the immune response in the patients with SLE.Treatment of SLE by UC-MSC can elevate serum albumin and C3 and C4 level,reduce the 24 hours urinary protein quantity,relife kidney damage,improve clinical symptoms;UC-MSC transplantation in patients with SLE have good security;UC-MSC transplantation may be a feasible method for the treatment of SLE.

A patient suffering Madelung's disease was treated and the literatures were reviewed in this article. The cause, the clinical features and treatment were discussed. The cause of this disease is unknown, and it is characterized by symmetrical accumulation of fat around the neck,nape and armpit having a appearance of "horse collar"or "hump back". Histological analysis revealed typical fat tissue depositing around the structures. Surgery is the main means of treatment, and prognosis is good.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on hypertension induced by insulin resistance in rats and to provide mechanistic insights into its therapeutic effect. Male Sprague-Dawley (SD) rats were fed with high-fructose (10%) water to develop mild hypertensive models within 4 weeks, then randomized into 4 groups: model control, FGF21 0.25, 0.1 and 0.05 micromol x kg(-1) x d(-1) groups. Five age-matched normal SD rats administrated with saline were used as normal controls. The rats in each group were treated once a day for 4 weeks. Body weight was measured weekly, systolic blood pressure (SBP) was measured noninvasively using a tail-cuff method, insulin sensitivity was assessed using oral glucose tolerance test (OGTT) and HOMA-IR assay. At the end of the treatment, blood samples were collected, and blood glucose, serum cholesterol, serum triglyceride and serum insulin were measured. The results showed that blood pressure of the rats treated with different doses of FGF21 returned to normal levels [(122.2 +/- 3.5) mmHg, P < 0.01] after 4-week treatment, whereas, SBP of untreated (model control) rats maintained a high level [(142.5 +/- 4.5) mmHg] throughout the treatment. The observation of blood pressure in 24 h revealed that SBP of FGF21 treated-rats maintained at (130 +/- 4.5) mmHg vs. (143 +/- 5.5) mmHg for model control (P < 0.01). FGF21 treatment groups improved serum lipids obviously, total cholesterol (TC) and triglyceride (TG) levels decreased significantly to normal levels. The serum NO levels of three different doses FGF21 treatment group were significantly higher than that of the model control group [(7.32 +/- 0.11), (7.24 +/- 0.13), (6.94 +/- 0.08) vs. (6.56 +/- 0.19) micromol x L(-1), P < 0.01], and the degree of improvement showed obvious dose-dependent manner, indicating that FGF21 can significant increase serum NO in fructose-induced hypertension rat model and improve endothelial NO release function. The results of OGTT and HOMA-IR showed that insulin resistance state was significantly relieved in a dose-dependent manner. Thus, this study demonstrates that FGF21 significantly ameliorates blood pressure in fructose-induced hypertension model by relieving insulin resistance. This finding provides a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of essential hypertension.