BACKGROUND: The morbility of rheumatoid arthritis is closely associated with cell apoptosis process. Hyperplasia of synoviocyte lies in the relatively insufficiency of synoviocyte apoptosis. Therefore, induction of synoviocyte apoptosis has clinical significance in the treatment of rheumatoid arthritis. Arteannuin and its derivatives can induce the apoptosis of various cells. OBJECTIVE: To observe the effect of artesunate on the expression of Fas/FasL and Bcl-2/Bax, which are correlated with apoptosis in synoviocyte of adjuvant arthritis. DESIGN: Randomized and controlled observation. SETTING: First College of Clinical Medical Science, Three Gorges UniversityMATERIALS: The experiment was conducted in the laboratories of Immunology and Morphology, Three Gorges University from September 2005 to November 2005. Fifty 8-week-old male Wistar rats of clean grade and (150±21) g were provided by the Animal Experimental Center of Tongji Medical College, Huazhong University of Science and Technology; Complete Freud adjuvant by SIGMA, U.S., and artesunate solution by Guilin Pharmaceutical Corporation.rabbit anti-mouse Fas (SC-716), rabbit anti-mouse FasL and Technology (No. SCXK 2004-2007).Complete Freud adjuvant (SIGMA, U.S. No. 093K8932); artesunate solution (Guilin Pharmaceutical Cor); rabbit anti-mouse Fas (SC-716), rabbit anti-mouse FasL multi-antibody (SC-834), goat anti-mouse IgG-HRP multimer, rabbit anti-mouse P53 (M3566) multi-antibody, Bcl-2 (sc-7382) multi-antibody, rabbit anti-mouse Bax (sc-7480) multi-antibody, ABC compound reagent kit and DAB coloring reagent all acquired from Santa Cruz biotechnology (Santa Cruz, USA); methotrexate (MTX) purchased from Shanghai Hualian Pharmaceutical Co., Ltd.; microscope and image analysis system obtained from Leica (Leica,Germany); microtome (Leica, Germany).METHODS: Fifty rats were randomly divided into six groups: normal group (n =8), model group (n =8), high dose artesunate group (n =8), low dose artesunate group (n =8), artesunate plus methotrexate (MTX) group (n =8), and MTX group (n =8). ①Model construction was referred to literature: Except the normal group with 0.1 mL normal saline, all rats were injected with 0.1 mL complete Freund's adjuvant into the right voix pedis to establish the models of adjuvant arthritis. Since the 13th day after modeling, high and low dose artesunate groups were intraperitoneally injected with 40 and 20 mg/kg artesunate, respectively everyday; artesunate plus MTX group was intraperitoneally injected with 20 mg/kg artesunate everyday and 0.4 mg/kg MTX every three days; MTX group with 0.4 mg/kg MTX solution every three days;model group with 1 mL normal group everyday. ②The arthrosis index (Al) of each group was evaluated before and 13 days after administration; the expressions of Fas/FasL, Bcl-2, and Bax in synovial membrane tissue were examined by immunohistochemistry.MAIN OUTCOME MEASURES : Al and the expression of Fas/FasL, Bcl-2, and Bax in synovial membrane tissue of each group.RESULTS: Fifty rats were involved in the result analysis. ①Thirteen days after administration, the Al of each experiment group (including model control) was remarkably lower than that before treating (P ＜ 0.01). The Al of eachexperiment group was significantly lower than that in model control group (P ＜ 0.01). ②The expression of Fas/FasL in high and low dose artesunate groups and artesunate plus MTX group was up-regulated significantly compared with that in model group (P ＜ 0.01). There was no statistically significant difference in the expression between MTX group and model group (P ＞ 0.05); the expression of Bcl-2 was significantly down-regulated but Bax up-regulated in two artesunate groups,artesunate plus MTX group and MTX group compared with that in model group (P ＜ 0.05).CONCLUSION: The findings suggest that artesunate could alleviate adjuvant arthritis, up-regulate the expression of Fas/FasL and Bax, but down-regulate that of Bcl-2, in which the induction of synoviocyte apoptosis may be one of the mechanisms.

Objective To evaluate the efficacy and safety of magnesium sulfate in the treatment of acute stroke.Methods The patients were randomly divided into treatment group and control group.Each group was treated with citicoline(CDPC)as a primary treatment.Magnesium sulfate was added to the treatment group for fifteen days.Results The therapeutic effect of the treatment group was significantly better than that of control group,with mild adverse effects.Conclusion Magnesium sulfate is effective and safe in the treatment of acute stroke.

ObjectiveTo assess right ventricular diastolic function in patients with essential hypertension using tricuspid valve flow spectrum and tricuspid annulars motion dectected by echocardiography. MethodsAccording to Ganau′s categories, 124 patients with essential hypertension were enrolled,which were divided into four groups:normal left ventricular configurational group (group Ⅰ, n =32 ), centripetal reconstruction group (group Ⅱ, n =30), centripetal hypertrophy group ( group Ⅲ, n =32), eccentric hypertrophy group ( group Ⅳ, n =30 ). Control group consisted of 35 normal subjects pulsed wave Doppler(PW) data and tissue Doppler imaging(TDI) data were acquired from tricuspid and its' annulus respectively on apical four chamber view. ResultsEPA ＞ 1 was observed in control group as well as group Ⅰ and Ⅱ ,while E/A ＜ 1 in group Ⅲ and group Ⅳ ,there were significant differences between them. Em/Am ＜ 1 was observed in all of patients with hypertension,there were significant differences among them( P ＜ 0.05 ) .ConclusionTissue Doppler imaging was more sensitive than pulse Doppler in evaluating decreased right ventricular diastolic function in patients with essential hypertension, and the decrement of the function was different in degree based on variant left ventricular configurations.

The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.

AIM: To investigate whether celecoxib,a cyclooxygenase-2(COX-2) inhibitor,potentiates the anti-leukemia activity of STI571 in K562 cells.METHODS: K562 cells were treated with STI571,celecoxib or combination of both at different concentrations in suspension culture.Cell proliferation was documented by MTT assay,and cell apoptosis was determined by flow cytometry and morphology.Meanwhile,RT-PCR was applied to analyze the probable mechanism underlying the effects of the drugs.RESULTS: The combination of STI571 and celecoxib dramatically suppressed the proliferation of K562 cells,in which 0.25 ?mol/L STI571 and 40.0 ?mol/L celecoxib enhanced the inhibiting rate to 76.1%?1.6%.Furthermore,the combining administration of drugs significantly promoted the apoptosis induced by STI571,which showed characteristic changes of morphologic features and increase in sub-G_1 cells.By using RT-PCR technique,the expression of COX-2 had no decline by single administration of celecoxib or STI571.However,a progressive down-regulation was caused by coadministration of two drugs.In contrast with COX-2,the expression of VEGF had no changes at any time.CONCLUSION: The administration of celecoxib alone only inhibits the proliferation of K562 cells.Combination treatment with STI571 and celecoxib promotes the apoptosis induced by STI571.

Objective:To evaluate the prognostic value of the ratio of androgen receptor splice variant 7 (AR-V7) and androgen receptor (AR) in prostate cancer.Methods:One hundred and five prostate cancer patients treated by castration therapy were selected in this study in People′s Hospital of Gaozhou City, Guangdong Province from March 2013 to March 2018. The expression of AR and AR-V7 in biopsy specimens was detected by immunohistochemistry. The relationship between AR, AR-V7, AR-V7/AR and prognosis of patients was analyzed. Cox regression was used to analyze the related factors affecting prognosis of prostate cancer.Results:The positive rate of AR expression was 59.0% (62/105), and the positive rate of AR-V7 expression was 19.0% (20/105). The patients were followed up for 15 to 61 (44.8 ± 10.1) months. The progression free survival (PFS) and overall survival (OS) in AR-V7 positive patients were significantly shorter than those in AR-V7 negative patients: (10.8 ± 2.2) months vs. (25.0 ± 3.4) months and (20.3 ± 5.1) months vs. (42.8 ± 7.4) months, and there were statistical differences ( P<0.01). The PFS and OS in high AR-V7/AR expression patients were significantly shorter than those in low AR-V7/AR expression patients: (12.5 ± 3.2) months vs. (24.9 ± 5.5) months and (22.5 ± 4.6) months vs. (42.1 ± 8.3) months, and there were statistical differences ( P<0.01). In multivariate Cox regression analyses, T4 stage (HR = 2.618, 95% CI 1.362 to 4.986, P<0.01) and high AR-V7/AR ( HR = 5.799, 95% CI 2.541 to 13.253, P<0.01) could effectively and independently predict the prognosis of hormonal therapy. Conclusions:AR-V7 positive and high AR-V7/AR prostate cancer patients treated by castration therapy may have shorter PFS and OS, compared with AR-V7 negative and low AR-V7/AR patients. High AR-V7/AR is the independent predictor of the prognosis of prostate cancer.

Objective To analyze the composition of urinary stones in Taizhou of Zhejiang province.Methods Clinical data of 1 022 patients with urinary stones admitted in Taizhou Hospital of Zhejiang province were retrospectively reviewed.The samples of urinary stones were collected and analyzed by infrared spectrophotometry.Results There were 722 males and 300 females with a male to female ratio of 2.4:1 and with a mean age of (53.4±13.6) years (14-88 years).Among 1 022 patients,the stones with single composition were found in 299 cases (29.3%);the most common single-component was anhydrous uric acid (15.9%),followed by calcium oxalate monohydrate (12.0%).The mixed stones were found in 723 cases (70.7%);the most common mixture was calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite mixture (316 cases,30.9%).Calcium oxalate (58.9%,602/1 022) was the most common major component and frequently seen in upper urinary tract stones,followed by uric acid (21.8%,223/1 022).Uric acid calculi was predominant component in male patients(χ2=30.97,P=0.00),while the rate of infection stones was higher in women (χ2=60.69,P=0.00).The mean age of patients with uric acid stones was 59.4 years,which was older than that with other components (t=7.62,P=0.00).The uric acid stones were more common in upper urinary tract stones(χ2=42.97,P=0.00).The mean age of patients with infection stones was 49 years,which was younger than that with other types of stones(t=4.87,P=0.00).Conclusion Mixed stones with calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite are the predominant urinary stones in Taizhou of Zhejiang province,while the most common single-component stones are anhydrous uric acid stones.Location,age and sex are associated with the types of urinary stones.

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.

This study examined the adipocytokine-vascular interactions and link between epicardial adipose tissue and coronary artery atherosclerosis. Thirty-four patients undergoing open heart surgery were chosen randomly, and divided into group I (non-coronary artery disease group) and group II (coronary artery disease group). Blood samples were taken through peripheral vein prior to surgery. Plasma levels of a panel of proteins (adiponectin, IL-10, TNF-α) were detected by using ELISA. Epicardial adipose tissue was taken near the proximal tract of the right coronary artery and subcutaneous adipose was taken from the leg before cardiopulmonary bypassing, adiponectin and CD68 + were detected by using RT-PCR and immunohistochemistry. Our results showed that plasma adiponectin level was significantly lower in the group II as compared with group I (P<0.05). There were no differences in plasma concentration (IL-10, TNF-α, tatal-chol, HDL-chol, LDL-chol) between group I and group II. The number of CD68+ cells in epicardial adipose tissue of group II was significantly higher than that in subcutaneous adipose tissue. Adiponectin mRNA expression was 6 fold higher in subcutaneous adipose tissue than in epicardial adipose tissue of group II (P<0.01). Furthermore, the level of adiponectin mRNA in the epicardial adipose tissue in group II was also significantly lower than in group I (P<0.05). We are led to conclude that inflammation that occurs locally in epicardial adipose tissue of CAD contributes to the pathogenesis of coronary artery disease.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC). Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC. This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy. The electronic databases were searched. Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib, sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included. Data were pooled to meta-analyze. A total of 7 RCTs with 3451 patients were involved. The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC. Among them, sunitinib had a higher overall response rate (ORR) than IFN (47% versus 12%, P<0.000001). Bevacizumab plus IFN produced a superior PFS [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.76-0.97; P=0.01] and ORR (RR: 2.19; 95% CI: 1.72-2.78; P<0.00001) in patients with mRCC over IFN, but it yielded an increase by 31% in the risk of serious toxic effects (RR: 1.31; 95% CI: 1.20-1.43; P<0.00001) as compared with IFN. The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months). It was concluded that compared with IFN therapy, VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC. However, the risk to benefit ratio of these agents needs to be further evaluated.