Objective To investigate the effects of pioglitazone on serum adipocytokines (leptin, resistin and adiponectin) in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods Thirty-five PCOS patients with IR were treated with pioglitazone 15mg/d for 12 weeks. The results of ovulation induction were observed. The changes of fasting plasma glucose (FPG), fasting serum insulin (FINS), serum levels of leptin, resistin and adiponectin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), and blood fat were examined at the baseline and after the therapy by enzyme-linked immunosorbentassay (ELISA) and radioimmunoassay (RIA). Results After 12 weeks' treatment, menstruation and rate of ovulation per cycle were improved in 35 (88.5%) PCOS patients with IR. Waist/hip ratio and F-G score were significantly decreased (P<0.05), and BMI declined with no significant difference (P>0.05). The levels of LH, T, FINS, HOMA-IR, total cholesterol, triglyceride and low density lipoprotein-cholesterol were significantly decreased (P<0.01, P<0.05) after treatment; high density lipoprotein-cholesterol level was significantly increased (P<0.01) after treatment. However, there were no significant differences in FSH and FPG (P>0.05). The levels of serum leptin and resistin were decrease than before (P<0.05), and the level of serum adiponectin was increased (P<0.05). Conclusion Pioglitazone can effectively improve clinical syndromes, insulin sensitivity, glucose and lipid metabolism of PCOS patients with IR. Adipocytokines (leptin, adiponectin and resistin) as regulators of insulin metabolism are involved in the pathogenesis of insulin resistance in PCOS. Pioglitazone treatment can decrease plasma glucose level and improve insulin sensitivity at least partly through improving the profiles of adipocytokines.

OBJECTIVE To investigate the effects and mechanism of PCB118 on cell-matrix and cel-cel adhesion in human hepatocel ular carcinoma cel s. METHODS Human hepatocel ular carcinoma cel s BEL-7402 were treated with PCB118 0.1,1.0 and 10.0 nmol · L-1 for 4 or 6 d,respectively. Then the cell-matrix adhesion assay and cell aggregation experiments were conducted to study the effect of PCB118 on cell-matrix adhesion and cell-cell adhesion in BEL-7402 cells. Quantitative real-time PCR and Western blotting methods were employed to assess the expression of key cytokines CD29,N-cadherin and E-cadherin. RESULTS The results showed that the cell-matrix adhesion ability of human hepato?cellular carcinoma cells BEL-7402 were significantly increased(P<0.05)after treatment with PCB118 0.1,1.0 and 10.0 nmol·L-1 for 6 d,whereas the cell-cell adhesion ability was significantly reduced(P<0.05). Exposure to PCB118(0.1,1.0 and 10.0 nmol·L-1)for 6 d induced significant upregulation of the mRNA expression levels of CD29 and N-cadherin along with the downregulation of E-cadherin(P<0.05). Western blotting analysis revealed that PCB118 exposure significantly increased protein expressions of CD29 and N-cadherin but reduced E-cadherin protein level(P<0.01). CONCLUSION PCB118 exposure affects the expression of CD29,N-cadherin and E-cadherin, which may be involved in PCB118-induced alteration of cell adhesion of hepatocellular carcinoma cell line BEL-7402.

Objective To examine the expression and clinical significance of E26 transformation specific-1 in premature rupture of fetal membranes. Methods Fetal membranes from 75 women in the following categories were analyzed for Ets-1 expression: preterm and term premature rupture of fetal membranes; 70 women (control group) with term cesarean sections and without complications. Ets-1 protein was localized with the use of immunohistochemical S-P method. Results Ets-1 protein was expressed in both the nucleus and cytoplasm of trophoblast of human fetal membranes, with more obvious expression in the nucleus. Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with premature rupture, which differed significantly from the control group (P<0.05). Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with preterm premature rupture, which did not differ significantly from the control group (P>0.05). Conclusion Ets-1 is expressed in human fetal membranes and its expression is up-regulated with premature rupture of fetal membranes, suggesting a role for Ets-1 in extracellular matrix remodeling of the membranes. This study provides an evidence to predict premature rupture of fetal membrances.

Objective To explore the therapeutic effects of nimodipine and magnesium sulfate on severe pregnancy induced hypertension (PIH) as well as the effect on plasma endotheline (ET) and serum nitric oxide (NO), in order to provide theoretical foundation for clinical treatment. Methods Forty two patients with severe PIH, being divided into 2 groups at random, were treated with nimodipine or magnesium sulfate. The changes of blood pressure, arteriole of eyeground, urine protein, ET, NO and clinical symptoms were observed respectively before and after the treatment, and the pregnancy outcomes were compared. Results (1) After the treatment of nimodipine, the serum NO of patients increased significantly from (51.72?14.64)?mol/L to (67.56?14.77)?mol/L ( P 0.05). (2) The nimodipine group took shorter time (0.5 h) to lower the blood pressure notably than the magnesium sulfate group (2 h).(3) As for the disappearing of subjective symptoms , nimodipine group (1.7? 1.3) h was quicker than magnesium sulfate group (3.4?1.7) h. Conclusions Compared with magnesium sulfate, nimodipine was better in improving and protecting the function of endotheline cells, dilating cerebral blood vessels, depressing blood pressure strongly and persistently, reducing subjective symptoms of patients and had no other side effects except increasing heart rate.

Objective To explore the effect of the mutant and expression level of N-ras on chronic myelogenous leukemia. Method We investigated the mutant by direct sequencing in a K562 human chronic myelogenous leukemia cell line, with determination of the expression level of N-ras mRNA in K562 by RT-PCR. Result No single point mutation was detected in K562 cell line, furthermore, the expression level of N-ras gene is abnormaly high in contrast to normal human. Conclusion Our results indicated that the expression level of N-ras gene was obviously high in K562 cell line, and the underlying mechanism was not only mutation, so that further investigation is called for.

Objective To observe the effects of pioglitazone on secretion of E2 and expressions of P450 aromatase (P450arom), insulin-receptor substrate-1 (IRS-1), and insulin-receptor substrate-2 (IRS-2) mRNA in polycystic ovary syndrome (PCOS) ovarian granulosa cells.Methods In this study, granulosa cells that were fertilization-embryo transferred from 27 PCOS patients were primary cultured in vitro with different concentrations of pioglitazone (0, 10, 102, 103 and 104nmol/L) (Group A), different concentrations of pioglitazone+FSH (50ng/L, Group B) and different concentrations of pioglitazone+insulin-like growth factor I (IGF-I, 50ng/L, Group C).Estradiol concentrations in the culture supernatant were detected by radioimmunoassay;P450arom, IRS-1 and IRS-2 mRNA expressions on granulosa cells were detected by Real-time PCR.Results The levels of E2 secreted by granulosa cells and the expression of P450arom mRNA on granulosa cells of PCOS for 48 hours were different among Groups A, B and C (P<0.05).With increase in pioglitazone concentration, the level of E2 and the expression of P450arom mRNA declined, some of which correlated negatively with the concentration of pioglitazone.Among these groups, the level of E2 secretion and the expression of P450arom mRNA were higher in Group C than in Group B (P<0.01) and Group A (P<0.01) at the same concentration of pioglitazone.The level of E2 secretion and the expression of P450arom mRNA were higher in Group B than in Group A (P<0.05) at the same concentration of pioglitazone.The expressions of IRS-1 and IRS-2 mRNA on granulosa cells of PCOS under pioglitazone stimulation for 48 hour were different among the groups of different pioglitazone concentrations (P<0.05).With increase inpioglitazone concentration, the expression of IRS-1 mRNA on granulosa cells of PCOS was decreased, but the expression of IRS-2 mRNA on granulosa cells of PCOS was increased.Conclusion Pioglitazone may decrease estrogen production by inhibiting p450 aromatase and adjusting the expressions of IRS-1 and IRS-2 on granulosa cells of PCOS to play a role in ovulation induction and ameliorate insulin resistance in ovary of PCOS.Pioglitazone can inhibit IGF-I and FSH in inducing E2 secretion by ovarian granulosa cells.

Objective To investigate the effects of pioglitazone on serum leptin and adiponectin in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods Thirty-five PCOS patients with IR were treated with pioglitazone 15mg/d for 12 weeks. The results of ovulation induction were observed. The changes of fasting plasma glucose (FPG), fasting serum insulin (FINS), serum levels of leptin, adiponectin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and blood fat were examined at the baseline and after the therapy by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA). Results After the treatment, the rate of ovulation per cycle was improved in 31 (88.5%) out of the 35 patients. After treatment, the level of serum leptin was decreased (P<0.05) while the level of serum adiponectin was increased (P<0.05). After 12 weeks'treatment, waist-to-hip ratio and F-G score were significantly decreased (P<0.05), BMI declined but without significant difference (P>0.05). The levels of LH, T, FINS, Homa-IR, total cholesterol, triglyceride and low density lipoprotein-cholesterol were significantly decreased (P<0.01, P<0.05), whereas the level of high density lipoprotein-cholesterol was significantly increased (P<0.01). No significant difference was seen in FSH and FPG following treatment (P>0.05). Conclusion Pioglitazone treatment can effectively improve PCOS with IR patients'clinical syndromes, insulin sensitivity, glucose and lipid metabolism at least partly through improving the profiles of leptin and adiponectin.

Objective To improve the awareness,diagnosis and treatment of pneumocystis carinii pneumonia (PCP) after renal transplantation.Methods A retrospective review was performed in 28 patients who underwent renal transplantation and developed PCP afterwards.The main clinical manifestations were fever(28 cases),nonproductive cough(28 cases),chest distress (12 cases).Occurrences of PCP were described 1.5 to 7 months after the renal transplantation.There were 10 patients treated with tacrolimus (FK506 2-6 rag/d,FK506 concentration 4-10 ng/ml) and 18 patients treated with cyclosporine (CsA 200-500 mg/d,CsA trough level:150-250 ng/ml) based immunosuppressive regimen.Anti-CD_(25)~+ monoclonal antibody (anti-CDCD_(25)~+mAb) was used in 10 cases for immune induction before operation while single steroid in 18 cases.Creatinine of patients with PCP was 70 to 106 μmol/L.CD_4~+ lymphocyte counts of the peripheral blood were 245±32/μl before PCP treatment and 536±25/μl after recovery.The most abnormal chest radiological findings were bilateral patchy ground-glass opacity.All the patients were diagnosed with PCP by bronchoalveolar lavage.Treatment was performed by reducing immunosuppressive agents and giving SMZco.Nineteen patients who had a PaP2 less than 70 mm Hg were given intravenous small-dose steroid.Results All the patients recovered from PCP 2 to 3 weeks after treatment.One patient experienced recurrence half year later.Five patients with higher creatinine after treatment recovered to normal levels after stopping the treatment of SMZco.No significant differences were seen in PCP patients treated with CsA and FK506,P＞0.05.The similar results were observed in use of anti-CDCD_(25)~+ mAb and single steroid,P＞0.05.Significant differences were observed in PCP patient peripheral blood CD_4~+ lymphocyte counts before and after treatment (P=0.001).Conclusions Patients who have fever,cough and hypoxia,chest imaging showing bilateral lung interstitial inflammation,might be PCP patients in the early post-renal transplantation period.Effective treatment should be performed by reducing immunosuppressive agents and giving SMZco.

Objective To explore the technique of allocation and rebuilt of vessels of donor pancreas during pancreas-kidney transplantation.Methods Multiple abdominal organs were successfully retrieved from 40 donors.Results Excision of donor abdominal organs was successful in all the 40 cases.The average warm ischemic time was no 3.2 min,ranging from 2 min to 5 min.No injury occurred in any of the donor organs or vessels.After transplantation,2 patients lost the transplant,one because of abdominal infection,and the other because of venous thrombosis.Conclusion A good trim or rebuilt of donor pancreas vessels is one of the key points for successful combined pancreas-kidney transplantation.

Objective Investigate the clinical features of the neurological disorders in patients after pulmonary thromboendarterectomy (PTE) for chronic pulmonary thromboembolism , analyze the factorial. Methods A retrospective study was made of 26 patients who underwent PTE between 2002 and 2010 in Beijing Chao-Yang hospital. The symptom of neurological system disorders occurred in the survivors were been investigate. The preoperative conditions and the perioperative conditions of all survivors were investigated. Compared the differences between the groups with neurological system disorders and the groups without. Results There were 22 patients of 26 survived after the surgery. Cardiac function of the survivors improved, and the quality of life improved significantly. 5 cases of the 22 survivors had symptoms of neurological system disorders. 3 patients showed lethargy, delirium, memory disorders, brain CT found no abnormal, symptoms recovered within 2 weeks. The fourth patient showed ataxia, unsteady gait, dance-like movements symmetry, in addition to the above symptoms, brain CT no abnormal showed,brain MRI showed bilateral abnormal signal in the midbrain, basal ganglia, symptoms improved and discharged after 8 weeks, the symptoms completely disappeared 6 months, and the abnormal signals in brain in MRI disappeared. The fifth patient with similar symptoms to the fourth, brain CT no abnormal found, be discharged 10 weeks after the operation, recovery is poor, living part of themselves. The postoperative neurological disorders occurred in the patients of Jamieson surgery type Ⅲ type, Ⅳ type of larger proportion, (P = 0.024), longer circulatory arrest surgery (P = 0.034). Conclusion The neurological disorders postoperative PTE often showed diffuse symmetric cerebral cortex and basal ganglia nerve dysfunction, brain MRI showed abnormal signal corresponding region, the majority of symptoms disappeared in 2 - 8 weeks, abnormal signal in brain MRI could disappeared after 6 months. Neurological dysfunction occurs in patients with more difficult surgical procedure, longer circulatory arrest, suggesting that with the surgery cerebral ischemia and hypoxia related.