Akt is the downstream target protein of phosphatidylinositol 3-kinase(PI3K),and PI3K/Akt signaling pathway is involved in cell proliferation,differentiation,apoptosis and metabolism.The activities of Akt in the central nervous system is also regulated by the neurotransmitter dopamine(DA),therefore Akt mediates multiple drug addiction process.This article reviews the structural characteristics and activity regulation of Akt,as well as the related research in drug addiction of this signal molecule.

Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) is a type-Ⅱ membrane protein belonging to the C-type lectin family molecules, which acts as a cell surface endocytosis receptor for atherogenic oxidized LDL (Ox-LDL). LOX-1 supports the binding internalization and proteolytic degradation of oxidized LDL, but not of significant amounts of acetylated LDL. LOX-1 is initially synthesized as a 40 kD precursor protein with N-linked high mannose-type carbohydrate, which is further glycosylated and processed into a 48-kD mature form. In vivo, endothelial cells that cover early therosclerotic lesions, intimal macrophages and smooth muscle cells in advanced atherosclerotic plaques express LOX-1. LOX-1 is cleaved at membrane proximal extracellular domain and released from the cell surface. Measurement of soluble LOX-1 in vivo may provide novel diagnostic strategy for the evaluation and prediction of atherosclerosis and vascular diseases.

Total 280 non-medical undergraduates (174 males and 106 females) were enrolled in the study from September 2015 to January 2016.Among all participants,132 received comprehensive cardio-pulmonary resuscitation (CPR) training,including knowledge teaching,video playing and simulation practice (study group),and 148 received knowledge teaching and simulation practice only (control group).Changes of CPR knowledge,skills and willingness were evaluated before and after training,and compared between two groups.The theory scores were increased after the training in both groups (study group: 87.7±5.6 vs.47.9±4.7,P<0.001;control group: 71.6±5.2 vs.48.4±4.9,P<0.001);there was no significantly difference between two groups before the training (P>0.05),however,there was significant difference after the training (P<0.001).The qualified rates of CPR skills were increased after the training in both groups (study group 81.8% vs.26.5%,P<0.001;control group: 68.2% vs.26.4%,P<0.001);there was no significant difference in qualified rates before the training between two groups (P>0.05),however,there was significant difference after the training (P<0.01).The willingness rates of performing CPR were increased after the training in both groups (study group: 64.4% vs.13.6%,P<0.001;control group: 46.6% vs.14.2%,P<0.001);there was no significant difference in willingness level before the training between two groups (P>0.05),however,there was significantly difference after the training (P<0.01).The study shows that comprehensive training can enhance CPR knowledge,skills and willingness for non-medical undergraduates,indicating that it may also be effective for other social groups.

Objective To investigate whether uninduced autologous bone-marrow mononuclear cell (ABM-MNC) could survive and differentiate into myocardial cells and endothelial cells in the infarcted heart. Methods 40 male big-ear Japanese rabbits were divided into two groups randomly: the transplanted group (n=20) and the control group (n=20). The model of acute myocardial infarction was made by left anterior descending artery ligation, which was confirmed by ECG. The cardiac function was evaluated by the echocardiography. 7 days later, BrdU labeled ABM-MNCs were injected into infarcted and marginal area myocardium in the transplanted group, while the control rabbits were injected with saline. 6 weeks later, the hearts were harvested for histology and immunohistochemistry evaluation. Results In the transplanted group, viable cells labeled with BrdU could be identified in the infarcted area, and myocytes and endothelial cells labeled with BrdU can also be found in the border area, these cells demonstrate myogenic differentiation with the expression of α-Actin by immunostaining. Moreover, the vessel density of the transplanted group in the borders of the infarction was higher than the control group (P＜0. 05), but there was no difference in the infarcted areas between two groups (P＞0.05). At the 6 weeks after experiment, the cardiac function was improved in both groups, but the transplanted group improved more than that in the control group (P＜0.05). Conclusion Autologous bone-marrow mononuclear cells injected into the infarcted myocardium could survive in both the infarcted and the border areas, differentiated into endothelial cells and other cells which have obtained the characters of myocytes, and increase the vessel density in border area, improved the cardiac function.

Objective To investigate whether uninduced autologous bone-marrow mononuclear cell (ABM-MNC) could survive and differentiate into myocardial cells and endothelial cells in the infarcted heart. Methods 40 male big-ear Japanese rabbits were divided into two groups randomly: the transplanted group (n=20) and the control group (n=20). The model of acute myocardial infarction was made by left anterior descending artery ligation, which was confirmed by ECG. The cardiac function was evaluated by the echocardiography. 7 days later, BrdU labeled ABM-MNCs were injected into infarcted and marginal area myocardium in the transplanted group, while the control rabbits were injected with saline. 6 weeks later, the hearts were harvested for histology and immunohistochemistry evaluation. Results In the transplanted group, viable cells labeled with BrdU could be identified in the infarcted area, and myocytes and endothelial cells labeled with BrdU can also be found in the border area, these cells demonstrate myogenic differentiation with the expression of α-Actin by immunostaining. Moreover, the vessel density of the transplanted group in the borders of the infarction was higher than the control group (P<0.05), but there was no difference in the infarcted areas between two groups (P>0.05). At the 6 weeks after experiment, the cardiac function was improved in both groups, but the transplanted group improved more than that in the control group (P<0.05). Conclusion Autologous bone-marrow mononuclear cells injected into the infarcted myocardium could survive in both the infarcted and the border areas, differentiated into endothelial cells and other cells which have obtained the characters of myocytes, and increase the vessel density in border area, improved the cardiac function.

Pancreatic necrosis (IPN) is a serious complication of acute pancreatitis (AP), with a mortality reported to be as great as 32.0%. At present, it is considered that patients with proven or suspected infected necrotizing pancreatitis, invasive intervention (i.e. percutaneous catheter drainage, endoscopic transluminal drainage/ necrosectomy, minimally invasive or open necrosectomy) should be delayed where possible until at least 4 weeks after initial presentation to allow the collection to become 'walled-off'. With the development of endoscopic technology, endoscopic transmural (stomach or duodenum) drainage and necrosectomy has been recommended as one of the preferred methods for walled-off necrosis. This article introduces the diagnosis and evaluation of the walled-off necrosis ; the indications, operation procedures, postoperative evaluation and management of postoperative complications of endoscopic transmural drainage and necrosectomy. At last, the research progress of endoscopic drainage and debridement in recent years was introduced.

Objective To compare the body composition of diabetic and healthy subjects and to investigate the correlation between obesity and type 2 diabetes mellitus.Methods Body composition was analyzed in 80 type 2 diabetic patients (diabetes group) and 80 healthy subjects (control group) selected at random.They were measured for body fat mass,visceral fat area,sketedtal muscle mass,waist-hip ratio,the content of protein and mineral,etc.The blood glucose,blood fat,insulin resistance index (Homa-IR) and glycosylated hemoglobin(HbA1c) were also measured.Results The means of body fat mass((19.68 ± 6.78)kg),percent body fat ((29.87 ± 8.04) ％),obesity degree ((115.93 ± 15.94) ％),visceral fat area ((104.48 ± 36.19) cm2),Body mass index(BMI) ((24.85 ± 3.51) kg/m2),chest circumference ((94.06 ±7.86) cm),waist circumference ((85.18 ± 9.50) cm) and waist-hip ratio (0.90 ± 0.05) were significantly higher than the means of healthy subjects'weight control ((-4.08 ± 6.79) kg),body fat mass ((17.31 ± 5.55)kg),percent body fat ((27.38 ± 6.47)％),obesity degree((108.88 ± 13.80)％),visceral fat area ((85.44 ±44.04) cm2),BMI ((23.43 ± 3.10) kg/m2),chest circumference ((91.11 ± 7.52) cm),waist circumference ((80.79±8.17) cm) and waist-hip ratio (0.86 ± 0.05) (t=2.55,2.30,3.12,2.86,2.73,2.28,3.12 and 4.76 respectively;P ＜0.05),body mass control ((-7.01 ± 7.49) kg),obesity control ((-8.53 ± 6.66)kg),muscles control((1.52 ± 1.43) kg) were lower than control group:the body mass control((-4.08 ±6.79) kg),obesity control ((-6.39 ± 5.78) kg),muscles control ((2.31 ± 2.09) kg).The uric acid was negatively related to weight control and obesity control (r =-0.43,-0.42 ; P ＜ 0.01),and were positively related to visceral fat area,percent body fat,waist-hip ratio,BMI,obesity degree,chest circumference,waist circumference and body fat mass (r =0.32,0.31,0.40,0.36,0.36,0.31,0.42,0.42 ; P ＜ 0.05).The triglyceride was negatively related to weight control and obesity control (r =-0.44,-0.41 ;P ＜ 0.01),and were positive related to percent body fat,waist-hip ratio,BMI,obesity degree,chest circumference,waist circumference and body fat mass(r =0.27,0.35,0.46,0.46,0.35,0.42,0.42 ;P ＜ 0.05).Conclusion The body fat and fat distribution are significantly different between diabetic and healthy subjects.There may be some relationship between central obesity and diabetes.

Objective To analyze the clinical characteristics of patients with acute pancreatitis (AP) in Jiangxi Province.Methods From 2007 to 2012,the data of 2 625 hospitalized patients diagnosed as AP were retrospectively analyzed.The changes of composition in gender,age and etiology during 2007-2009 time period and 2010-2012 time period were compared.Mann Whitney U test was performed for non-normal distribution measurement data analysis and x2 test was for count data analysis.Results Among the 2 625 patients with AP,from 2007 to 2009 there were 1 028 cases and 1 597 cases in the period 2010 to 2012.The ages of the patients in these two period were 50(38,61) and 50 (40,63) years old,respectively.There was statistically significant difference in the age distribution between these two period (U=783 635.5,P＜0.05).Biliary factor was the most common cause of AP in the two time period 2007 to 2009 and 2010 to 2012,which accounted for 55.9％ (575/1 028) and 62.9％ (1 005/1 597),respectively,and the difference was statistically significant (x2=12.778,P＜ 0.01).Alcoholic AP accounted for 1.9％ (19/1 028) and 7.3％ (117/1 597),respectively,hyperlipidemic AP were 14.0％ (144/1 028) and 17.7％ (283/1 597),and idiopathic AP were 22.0％ (226/1 028) and 5.9％ (94/1 597),all the differences were statistically significant (x2 =38.204,6.330 and 151.416,all P＜0.05).In male patients,biliary AP accounted for 52.4％ (732/1 398),which was lower than that of female patients (69.1％,848/1 227),and the difference was statistically significant (x2 ＝76.524,P＜0.01).Alcoholic AP and hyperlipidemic AP accounted for 9.0％ (126/1 398) and 21.4％ (299/1 398) in male patients,which were significantly higher than those of female patients (0.8％,10/1 227; 10.4％,128/1 227),and the differences were statistically significant (x2 89.396 and 57.585,both P＜0.01).Biliary AP accounted for 79.9％ (631/790) in elderly group,which was higher than that of non elderly group (51.7％,949/1 835),and the difference was statistically significant (x2＝182.720,P＜0.01).In elderly group hyperlipidemic AP and alcoholic AP accounted for 2.5％ (20/790) and 1.3％ (10/790),which were significantly lower than those of non-elderly group (22.2％,407/1 835; 6.9％,126/1 835),and the differences were statistically significant (x2 =156.524 and 35.262,both P＜0.01).Conclusions The middle-aged and elderly people are the vulnerable population of AP.Biliary factor is the most common cause of AP,especially in the female and elderly.The proportions of hyperlipidemic AP and alcoholic AP both significantly increase,in the male higher than that of the female and in the non-elderly higher than that of the elderly.The proportion of idiopathic AP significantly decreases.

OBJECTIVE:To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemo-therapy alone for non-small lung cancer(NSCLC),and to provide reference for drug payment and clinical treatment. METHODS:By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with che-motherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS:5 dimensions FACT-L score:the patients of Shenqi fuzheng injection combined with chemo-therapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score:the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group (1 632.44 vs. 11 145.30),and incremental cost-effectiveness ratio was 448.69. ZPS score:Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone(-17 398.77 vs. 384 513.00). Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs(1 313 326 yuan vs. 13 374 365 yuan). CONCLUSIONS:Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemo-therapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.

AIM: To determine the role of LOX-1/PPAR pathway in regulating expression of adhesion molecules elicited by oxidizing low density lipoprotein(Ox-LDL) through Lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) in human umbilical vein endothelial cells(HUVECs).METHODS: HUVECs were incubated with Ox-LDL,poly(I),carrageenan or 15-deoxy-△12,14-prostaglanding J2(15d-PGJ2).PPAR mRNA and protein were examined by real time RT-PCR and Western blotting.ICAM-1 and E-selectin were detected by RT-PCR and Western blotting respectively.RESULTS: Ox-LDL increased PPAR expression in HUVECs,which was inhibited by pretreatment of HUVECs with LOX-1 blockers.Preincubation of HUVECs with 15d-PGJ2 attenuated the expression of intercellular adhesion molecule-1(ICAM-1) and E-selectin in response to Ox-LDL.Upregulation of ICAM-1 and E-selectin mediated by Ox-LDL were suppressed more significantly by the combination of 15d-PGJ2 and polyinosonic acid as compared to either 15d-PGJ2 or polyinosonic acid alone.CONCLUSION: The results indicate that Ox-LDL exerts a biphasic effects on inflammatory response.It evokes harmful effects by inflammatory injury on one side and protective effects by triggering the LOX-1/ PPAR signaling pathway on the other hand.