Objective To analysis the effect of high dose metformin on serum HE4, LPA and regulatory T cells in patients with ovarian cancer.Methods 80 cases of unilateral ovarian cancer patients were given surgery and conventional chemotherapy ,were divided into four groups according to single metformin dose: (group A:0.25g each time, B group:0.25g each time, group C:0.25g each time; group D: conventional treatment only) and three times a day oral administration of metformin and two weeks in a row , before and after the treatment of detection each serum HE4, LPA, transformation growth factor beta 1 (TGF -beta 1), interleukin -10 (IL-10) content, and CD4 +CD25 +CD127 regulating T cell percentage.ResuIts Compared with B, C, and D group, the efficacy of patients in group A was better, as follows: Serum HE4 content decreased significantly ( P<0.05 ); serum LPA content decreased significantly ( P<0.05 ); blood CD4 +CD25 +CD127 regulatory T cell percentage decreased significantly ( P<0.05 ); serum TGF beta 1, IL-10 content decreased significantly ( P<0.05 ) .The results were statistically significant .ConcIusion High dose of metformin can reduce serum HE4 , LPA content, reduce the adjusting the percentage of T cells and related cytokines in patients with ovarian cancer , and play a positive role in inhibit cancer cell proliferation and invasion .

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Male ; Musculoskeletal Manipulations ; Osteitis ; pathology ; therapy ; Sacroiliac Joint ; pathology ; Sclerosis ; therapy ; Young Adult

Animals ; Biological Availability ; Drug Carriers ; chemistry ; Drug Delivery Systems ; Humans ; Lactic Acid ; chemistry ; pharmacokinetics ; Nanoparticles ; Polyesters ; Polyethylene Glycols ; chemistry ; pharmacokinetics ; Polyglactin 910 ; chemistry ; pharmacokinetics ; Polyglycolic Acid ; chemistry ; pharmacokinetics ; Polymers ; chemistry ; pharmacokinetics

Objective To investigate the prevalence of adult epileptic patients with interictal depression symptoms(IDs) and identify early predictors of IDs. Methods Adult patients with epilepsy were recruited ( n =110,45 females and 65 males) ,age between 16 and 67 years ( median 24 years). The sociodemographic and clinical factors of patients were recorded. Hamilton Depression Scale ( HAMD ) were applied to evaluate interictal symptoms of depression ( at least 72 hours after the last epileptic seizure). According to HAMD score,the epileptic patients were divided into IDs ( ≥8 ) and non-IDs(＜8) groups. The sociodemographic and clinical factors were compared between the two groups to identify the prevalence and early predictors of IDs in adult epileptic patients.Results The prevalence of IDs in adult patients with epilepsy was 38.2% ,49.0% in active epilepsy and 12.1 %in seizure freedom. 30.0% ,5.5% ,and 2.7% were experiencing mild-to-moderate (HAMD score≥8),moderateto-severe ( ≥ 18 ) and severe ( ≥25 ) depression. 42 patients who met the HAMD score≥8 were classified as IDs group,and the remaining 68 patients were classified as non-IDs group. With multiple stepwise backward logistic regreasion, independent predictors of IDs were epileptic seizures ( OR = 8. 845, P = 0. 003 ); symptomatic or cryprogenic epilepsy ( OR = 3.132, P = 0. 045 ); prolonged duration of illness ( OR = 1. 106, P = 0.004 ) and employment status (OR =0. 154, P=0.001 ). There were no relationship between seizure frequency and severity of IDs ( Kruskal-Wallis test, x2 = 4.5, P = 0. 104). Conclusion IDs is a frequent psychiatric comorbidity in adult patients with epilepsy. The prevalence of IDs is higher in those with active epilepsy compared with those in seizure freedom and most of them are mild-to-moderate. Epileptic seizure, symptomatic or cryprogenic epilepsy, prolonged duration of illness and employment status are independent predictors of IDs, but seizure frequency has nothing to do with the IDs severity of patients.

Objective To assess the neuropsychological characteristics in active epileptic patients and investigate itsrisk factors. Methods Ninety adult epileptic patients included 60 active epileptic patients (two or more unprovoked seizures within 12 months) and 30 age-, sex-, education-, course of disease- and seizure type-matched seizure-free subjects (without epileptic seizure for at least 1 year) . The neuropsychological tests including trail making test,digit symbol test, verbal fluency test,digit span test and hamilton depression scale( HAMD) ,were used to detect mental and motor speed, attention, language, working memory and depression symptoms respectively. The neuropsychological tests were compared between active and seizure-free epileptic patients and identified the risk factors of neuropsychological deficits in active epileptic patients. Results Compared to seizure-free subjects, active epileptic patients had significantly worse scores in digit symbol test, verbal fluency test, digit span test ((47.45 ±18. 812) vs(56.40 ±13. 631), (25. 25 ±8. 163) vs(30.40 ±8. 414), (10. 39 ±2. 228) vs( 11. 80 ± 2.074) respectively) ; more time to accomplish the trail making test A and B((64. 35 ±31.710) vs( 45. 47 ± 16. 309) , ( 133. 18 ± 47. 331 ) vs ( 98. 00 ± 35. 003 ) respectively) ; and higher scores in depressive symptoms ((9.12 ±6.219)vs(3.77 ±3.997) ,all P<0.05). Within active epileptic group,significant predictors of neuropsychological deficits were identified in a stepwise linear regression analysis: advancing age was significantly negatively correlated with digit symbol test(β = -0. 468, P = 0. 000) , digit span test (β = -0. 439, P = 0. 000), trail making test A (β =0.365, P = 0.003) and B(β = 0.346, P=0.002) ; higher scores on depressive symptoms was significantly negatively correlated with digit symbol test (β = -0.244, P = 0.015) ; mental work,high-education level and monotherapy were positively correlated with some of the cognitive function subscales. Conclusion This study suggests that active epilepsy can have a direct adverse effect on cognition and depression symptoms. Multi-drug therapy, severity of depression symptoms, advancing age, low-education level and non-mental work are the predictors of neuropsychological impairment in active epilepsy. In addition, good seizure control even after 1 year can have a beneficial impact on cognitive and depression prognosis.

Objective To explore the clinical features and surgical management of aged patients with acute cholecystitis,and try to command the opportunity and procedure of laparoseopic cholecystectomy(LC)better.Meth- ods Clinical data of 52 aged cases with acute cholecystits undergone LC were analyzed retrospectively.Results All of the patients(within 48h of the acute attack)were successfully recovered without serious operative complications. Conclusion Aged acute cholecystitis progressed rapidly and its operative difficulty and risk were higher;only if more attention was paid to perioperative managements and operative time and technical skill were mastered,early LC for the patients was safe and feasible.Therefore.it should be recommended in the great majority of cases except the des- perate patients whose general condition was too poor to operate.

Objective To observe the roles of nuclear factor-κB (NF-κB) and hypoxia-inducible factor-1 o (HIF-1 α) in hippocampal neurodegeneration of status epilepticus (SE) rats, and explore whether HIF-1α activation is regulated by NF-κB.Methods A total of 110 male Sprague-Dawley rats were randomly divided into seven groups : (1) Control group treated with saline (control, n =15), (2) sham group implanted cannula into lateral ventricle and treated with saline (sham, n =15), (3) SE group treated with pilocarpine (SE, n =20), (4) NF-κB activity inhibitor pyrrolidine dithiocarbamate (PDTC) group treated only with PDTC (PDTC, n =15), (5) SE + PDTC group treated with pilocarpine plus PDTC (SE + PDTC, n =15), (6) SE + HIF-1o siRNA group implanted cannula into lateral ventricle and treated with pilocarpine plus HIF-1 α siRNA (SE + HIF-1α siRNA, n =15), (7) SE + control siRNA group implanted cannula into lateral ventricle and treated pilocarpine plus control siRNA (n =15).SE was induced by injecting lithium chloride and pilocarpine.The seizure of rats was observed.The protein expressions of NF-κB and HIF-1 α in hippocampus of rats were examined by Western blotting.The degenerating neurons in hippocampus were detected by Fluoro-Jade C (FJC) staining.Results Twenty-four hours after termination of SE, the nuclear protein expressions of NF-κB and HIF-1α in hippocampus of rats were increased in SE group (0.57 × 0.06, 0.47 ± 0.07) compared with those in control group (0.23 ± 0.03, 0.20 ± 0.03;P ＜0.05);and compared with SE group PDTC significantly decreased the nuclear protein expressions of NF-κB and HIF-1 α in SE + PDTC group (0.23 ± 0.03, 0.14 ± 0.03;P ＜ 0.05);in SE + PDTC group the numbers of FJC positive cells in CA1 area (28.33 ±5.03) were decreased compared with that in SE group (76.67 ± 13.32);HIF-1 o siRNA injected into lateral ventricle of rats significantly decreased the expression of HIF-1α in hippocampus (0.22 ±0.03) and the number of FJC positive cell in CA1 area (27.34 ±7.02) in SE + HIF-1α siRNA group compared with those in SE group (0.39 ±0.06, 76.67 ± 13.32;P ＜0.05).Conclusions These data suggest that SE can result in activation of NF-κB/HIF-1o pathway in brain.Inhibition of the pathway can attenuate hippocampal neurodegeneration caused by SE, which has the brain protective effect.

[Abstract ] Objective High-mobility group box-1 (HMGB1) is abundantly released in the epileptogenic brain tissue , but few reports are seen about the effect of HMGB 1 on the expression of P-glycoprotein ( P-gp) in the vascular endothelial cells of the epi-leptogenic tissue .This study is to explore whether HMGB 1 can regulate P-gp expression in the brain microvascular endothelial cells of the mouse in vitro . Methods Immortalized brain microvascular endothelial bEnd .3 cells of the mouse were cultured in vitro and al-located to different concentration groups ( treated with culture medium containing 10 , 100 , 500 , and 1000 ng/mL HMGB1 for 8 hours), treatment duration groups (treated with culture medium containing 100 ng/mL HMGB1 for 4, 8, 16, 24, and 32 hours), and a control group ( treated with culture medium without HMGB 1 ) .The mRNA expression of P-gp-encoding gene-multidrug resistance gene 1a (mdr1a) was detected by real-time qPCR, and its protein expression determined by Western blot and immunocytochemistry . Results The results of qPCR manifested that the expressions of mdr 1a mRNA were 1.646 ±0.176, 1.777 ±0.135, 1.617 ±0.043, and 1.398 ±0.182 in the 10, 100, 500, and 1000 ng/mL HMGB1 groups, respectively, significantly higher than 1.030 ±0.284 in the control group (P<0.05), and so were those in the 4, 8, 16, 24 h, and 32 h groups (2.655 ±0.112, 2.168 ±0.212, 1.823 ± 0.232, 1.418 ±0.376, and 1.445 ±0.123) than in the control (1.010 ±0.164) (P <0.05).Western blot showed a significant increase in the P-gp protein expression in all the concentration groups (P<0.05) as well as in the 8 h and 16 h treatment duration groups as compared with the control group (P<0.05).Immunocytochemis-try also revealed a higher P-gp expression in the HMGB1-treated than in the control cells (P<0.01). Conclusion HMGB1 can upregu-late the expressions of mdr1a mRNA and P-gp protein in the brain microvascular endothelial cells of the mouse , which may associated with drug resistance of central nervous system diseases , especially that of epilepsy .

Objective To explore the ursodeoxycholic acid efficacy and safety analysis of nucleoside drugs for HBeAg-positive with high viral load in patients with liver cirrhosis, and its effect on peripheral blood Th17, Treg levels.Methods 80 patients with high viral load B HBeAg-positive from November 2012 to February 2014 were selected and randomly divided into control group and observation group, 40 cases in each group.Patients in control group received conventional treatment, observation group was treated with ursodeoxycholic acid based on the control group, antiviral efficacy and adverse reactions, peripheral blood Th17, Treg levels were compared between two groups.Results After treatment, the ALT, AST, ALB, TBil levels between two groups were significantly lower compared with before treatment(P<0.01), the ALT, AST, ALB, TBil levels in observation group were significantly lower than the control group ( P<0.01 ); HBV-DNA negative rate ( 85.0%) and decrease of HBV-DNA in observation group were significantly higher (7.5%) than those in control group, the difference was statistically significant (χ2 =48.322, t =11.490, P<0.01); ALT normalization rate (52.5%), HBeAg seroconversion rate (57.5%) in observation group was significantly higher than those in control group(15.0%, 17.5%), the difference was statistically significant (χ2 =12.579,χ2 =13.653, P<0.01);complications compared with the situation observed group of death, hepatocellular carcinoma, spontaneous bacterial peritonitis, gastrointestinal bleeding compared with control group, the difference was not statistically significant (χ2 =1.01, χ2 =2.05, χ2 =3.12, χ2 =0.21, P>0.05).After treatment, the Th17 levels elevated, Treg level decreased in two groups, Th17 level in observation group was significantly higher than control group, Treg levels were significantly lower than the control group, Th17/Treg ratio was higher than the control group (P<0.05).Conclusion Ursodeoxycholic acid can significantly improve liver function of patients with HBeAg positive with high viral load, increase the rate of HBeAg seroconversion, inhibit HBV viral replication and delay progression of the disease, and less adverse reactions.It can increase the number of Th17 cells, reduce the number of Treg cells in patients, which may be one of its antiviral mechanism.

Objective To investigate precipitants of epileptic seizure, and to explore the correlation between various precipitants and relationship between precipitants and clinical features of epilepsy.Methods Data were collected from 154 patients attending a tertiary-care epilepsy clinic of Nanjing Brain Hospital between April 2015 and April 2016.The patients with epilepsy were older than 16 years, had a clinical history of one year or more, and one seizure at least a year and one seizure at least in the latest three months.An enclosed questionnaire was combined with open interview to identify and characterize seizure precipitants and clinical characteristics of patients.Patients were asked respectively whether there were some precipitants three months before and during last three months.Correlation between seizure precipitants and relationship between precipitants and clinical characteristics, such as age, gender, course, seizure frequency and so on, were calculated.Results A total of 125 (81.2%) participants reported at least one precipitant.Common precipitants (in descending order) were as follows: emotional stress (56.0%), sleep disorder (38.4%), fatigue (27.2%), missed medication (20.0%).There were one to six different precipitants for one patient, and 60.8% of patients had two or more precipitants.There was a correlation between emotional stress and sleep disorders as well as fatigue (χ2=4.665, 8.668;P<0.05).Patients with idiopathic epilepsy were more sensitive to sleep disorders.There was no relationship between total precipitants and clinical features such as age, gender, age of onset, duration, type of seizure, seizure frequency, number of drug taking and so on.Conclusions Seizure precipitants were found widespread.The most common precipitants were found to be emotional stress, sleep disorders, fatigue and missed medication.There existed a correlation between emotional stress and sleep disorders as well as fatigue.There was no connection between total precipitants and patient′s demographic characteristics as well as clinical features.However, the type of seizure precipitants was different in patients with different demographic and clinical characteristics.