Objective To observe the effect of different concentration netrin-1 on retinal vascular permeability in diabetes mellitus (DM) rats.Methods Eighty adult Sprague-Dawley rats were randomly divided into 8 groups,10 rats in each group,including normal control group (group A),normal+balanced salt solution (BSS) group (group B),normal+netrin-1 (500 μg/ml) group (group C) and DM group (50 rats in 5 subgroups).DM rats were induced by intraperitoneal injection of streptozocin.Three months after intraperitoneal injection,10 DM rats in the control group were injected with BSS (group D).Forty DM rats were injected with 5 μl of different concentrate netrin-1,and were divided into DM+netrin-1 10 μg/ml group (group E),DM+netrin-1 50 μg/ml group (group F),DM+netrin-1 100 μg/ml group (group G),DM+netrin-1 500 μg/ml group (group H)according to the different concentration.Non-DM rats in group C were injected with netrin-1 500 μg/ml.The expression of occludin was determined by immunohistochemistry for protein,and by real-time fluorescence quantitative reverse transcription polymerase chain reaction for mRNA level.Retinal vascular permeability was measured by Evans blue infusion.Results The expression of occludin protein and mRNA in group D were less than group A (t=27.71,8.59;P=0.00,0.00).However,the retinal vascular permeability increased in group D (t=-42.72,P=0.00).The expression of occluding protein,occludin mRNA and retinal vascular permeability showed significant differences between group D,E,F,G and H (F=146.31,16.54,67.77;P=0.00,0.00,0.00).Compared the group B with group C,there was no significant differences between the expression of occludin protein,occludin mRNA and the retinal vascular permeability (t=-1.13,0.93,1.04;P=0.27,0.36,0.31).The concentrate of netrin-1 showed a significant positive correlation to the expression level of occludin and occludin mRNA (r=0.73,0.81;P=0.00,0.00),but negative correlation to the vascular permeability (r=-0.61,P=0.00).Conclusion Netrin-1 can reduce the DM rats' retinal vascular permeability,which depended on the concentration of netrin-1.

Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) and hemoglobinto-white blood cell ratio (HWR) prior to treatment in prognosis of non-operative esophageal squamous cell carcinoma (ESCC) patients.Methods From October 2009 to November 2014,a total of 362 non-operative ESCC patients were enrolled in this prospective study.x2 test was used to analyze the relationship between NLR,HWR and general clinical features;Univariate and multivariate Cox regression analysis was performed to evaluate the association between variables and prognosis of non-operative ESCC patients.Results The optimal cutoff level of 1.23 for NLR and 24.92 for HWR were identified by X-title software.x2 test indicated NLR was significantly associated with gender,tumor length,T stage,TNM stage and fasting blood glucose level.Moreover,univariate and multivariate analyses showed that high NLR and high HWR were all associated with a poor prognosis in non-operative ESCC.However,when patients were specifically stratified by treatment modus,subset analysis showed that NLR was only predictive of prognosis in the concurrent chemoradiotherapy group (HR =4.080,95％ CI:1.074-15.497,P =0.039),whereas the influence of HWR on prognosis was just existed in the sequential chemoradiotherapy group (HR =2.625,95％ CI:1.311-5.254,P =0.006).Conclusions In this investigation,we found that high NLR and high HWR were associated with poor prognosis in non-operative ESCC.

Objective: To evaluate the medium and long term outcomes of tension-free mid-urethral sling in the treatment of female patients with mixed urinary incontinence (MUI).Methods: Twenty-six patients who underwent the tension-free mid-urethral sling procedure for MUI from April, 2010 to September, 2016, were followed up.Four of the 26 patients underwent retropubic tension free mid-urethral sling (TVT), and 22 of them underwent transurethral middle obturator sling (TOT).Scales were used in the follow-up, such as urinary incontinence severity score (UISS), detrusor instability score (DIS), incontinence quality of life scale evaluation (I-QOL), Urogenital Distress Inventory short form (UDI-6), and the outcomes before and after the procedure were compared.Results: The mean age was 62 years, with a range of 42-80 years.The mean body mass index (BMI) was 26.82 kg/m2, with a range of 21.48-31.14 kg/m2.The mean follow-up time was 26 months, with a range of 8-69 months.Twelve patients never took M-blockers and the rest 14 patients took M-blockers within two weeks.None of the pa-tients had complications, including dysuria, injury of bladder, urethra, obturator vessel or nerve during the surgery.After pulling out the catheter, no one suffered moderate or severe pain or difficulty of urination.The overall cure rate for stress urinary incontinence (SUI) was 96.15% with 25 patients cured, and for urge urinary incontinence (UUI) was 76.92% with 20 patients cured.The patients'' life quality also improved significantly (P<0.05).Conclusion: Ten of the 26 patients showed an overactive bladder according to urodynamic study, from whom all of the six failed patient were.And 16 patients didn''t show an overactive bladder, which may due to two reasons.One is that their sense of urge is not so serious, the other one is that their sense of urge is from urethra.Proximal urethra is full of nerve, which plays a role in sense and urine control.The sense of urge may come from urethra instead of bladder.Tension-free mid-urethral sling procedure is an effective treatment for women with mixed urinary incontinence.Even without taking the M-blockers, the cure rate for urge incontinence reached 76.92%.The efficacy of surgery remained stable in medium and long term, and the patients'' quality of life improved significantly.

Objective To investigate the effect of cell proliferation and apoptosis induced by Pingyangmycin (PYM)and dexamethasone (DEX) on human umbilical vein endothelial cells (HUVEC)in vitro, so as to provide therotical evidence for treatment of aneurysm with PYMand DEX. Methods Control, PYM, DEX and PYM group were established after HUVEC were cultured for 24 hours. Cell morphology was observed by inverted microscope.The effect of cell proliferation and apoptosis were detected with CCK-8reagents and flow Cytometry. The apoptotic protein expression of caspase-3 was testedthrough Western blot. Results Descend of adherent cell density and the ascend of floating cells could be observed after treated with PYM and DEX for 24 hours. HUVEC could be inhibited effectively with concentration-dependent on PYM and DEX. The significant statistical difference of cell apoptosis rate between the group used for PYM alone and the group combined low-concentration PYM with DEX through Flow Cytometrywas found. There was significant statistical difference of apoptotic protein expression of caspase-3 through Western blot compared with the group used for PYM alone and the group combined low-concentration PYM with DEX. Conclusion PYM and DEXcould inhibitthe proliferation of HUVEC alone. The better effects could be observed combination low-concentration PYM with DEX , the mechanism of which might beapoptosis with low-concentration PYM and necrosis with high-concentration PYM.

OBJECTIVE To explore the expression of Maspin in invasive fungal rhinosinusitis (IFRS) and the value of Maspin in the diagnosis of IFRS. METHODS Forty two cases of fungal rhinosinusitis (FRS) were set as the experimental group, which included 12 cases of IFRS and 30 cases of noninvasive fungal rhino-sinusitis (NIFRS). At the same time, 30 cases of chronic rhino-sinusitis were set as control group. Immunohistochemistry (IHC) was used to detect the expression of Maspin. RESULTS Compared with the control group, the expression of Maspin in FRS group decreased statistically (t=-3.367, P<0.05). The IFRS group, compared with other two groups, had the lowest expression of Maspin (t=-3.390, P<0.05; t=-4.143, P<0.05). By using Maspin score of 5.70 as the cut-off point, the sensitivity and specificity for the diagnosis of IFRS was 91.7% and 88.3% respectively. CONCLUSION The expression of Maspin is very low in IFRS group. Down-regulation of Maspin expression may be a potential indicator for diagnosis of IFRS.

Objective To observe the effect of netrin-1 on retinal Müller cells in diabetes mellitus (DM) rats. Methods Fifty Sprague-Dawley rats were randomly divided into the normal control group (group A), normal + balanced salt solution (BSS) group (group B), normal+netrin-1 group (group C), DM+BSS group (group D) and DM+netrin-1 group (group E), with 10 rats in each group. DM rats were induced by intraperitoneal injection of Streptozotocin (60 mg/kg). The expression level of glial fibrillary acidic protein (GFAP) on retinal Müller cells was determined by immunohistochemistry, the level of GFAP mRNA was analyzed by real-time fluorescence quantitative reverse transcription polymerase chain reaction. Results Immunohistochemistry showed that GFAP was distributed in retinal ganglion cells and retinal nerve fiber layer in group A, B and C. Compared to group B, GFAP staining was brighter in the group D. There were significant differences in the expression of GFAP protein and mRNA among groups A-E (F=203.43, 72.91; P=0.00, 0.00), they were higher in group D than group A (t=-26.01, 22.26; P=0.00, 0.00), and group E (t=-10.78, 3.93; P=0.00, 0.00). They were higher in group E than group A (t=7.00, -9.82; P=0.00,0.00). There were no significant differences in between group A and group C (t=-0.29, 0.50; P=0.77, 0.62). Conclusion The expression of GFAP in Müller cells of DM rats could be decreased by injecting netrin-1 into vitreous.

This study was aimed to compare the effect of insulin plus rosiglitazone with that of insulin plus metformin on the level of serum N-terminal pro-brain natriuretic peptide (NT-BNP) in patients with type 2 diabetes mellitus, and to find out whether serum NT-BNP can be used as an index for predicting heart failure induced by rosiglitazone in the cases of type 2 diabetes mellitus. Sixty type 2 diabetic patients were recruited and were randomly divided into two groups: group A (n = 30) received insulin plus rosiglitazone (4 mg/d) and group B (n = 30) received insulin plus metformin. The observations covered an 8-weeks' course of treatment. Serum NT-BNP was measured at the beginning and at the end of 8 weeks. The Before-After study revealed that the level of serum NT-BNP did not change apparently in the two groups (P >0.05). There was no remarkable difference in the level of serum NT-BNP between the two groups (P>0.05). There were 3 cases with edema in the group of insulin plus rosiglitazone, but none with heart failure; in these three cases, the mean serum NT-BNP level at the end of the treatment exhibited an increase of 108.99 fmol/ml when compared with that at the beginning. Neither insulin plus rosiglitazone nor insulin plus metformin had apparent effect on the level of serum NT-BNP in the patients with type 2 diabetes mellitus. The question of whether serum NT-BNP is a predictive index of heart failure awaits answers given by more observation on type 2 diabetes mellitus patients using rosiglitazone.
Aged ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Drug Therapy, Combination ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Insulin ; therapeutic use ; Male ; Metformin ; therapeutic use ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Thiazolidinediones ; therapeutic use

Objective To introduce a urodynamic classification of female patients with symptoms of overactive bladder(OAB) and discuss its clinical significance.Methods From January 2015 to January 2017,62 female patients from Peking University People's Hospital who diagnosed clinically with OAB and underwent preoperative urodynamic test were involved in this study.Female OAB patients can be stratified into four groups based on the chief complaints and the urodynamic test,including type Ⅰ-no evidence of detrusor overactivity(DO) on urodynamic test,patients can feel urgency and have no urinary incontinence,type Ⅱ-involuntary detrusor contraction present,patients aware and able to abort them and have no urinary incontinence,type Ⅲ-involuntary detrusor contraction present,patients aware and able to contract the sphincter but can not abort contractions and have urinary incontinence and type Ⅳ-contractions present,and patients unaware and unable to contract the sphincter or abort contractions and have urinary incontinence.According to the classification,the amount of the four types of OAB patients were 8,22,25 and 7,respectively.The data of height,age,weight showed no statistical significance (P ＞ 0.05).The amount of the concomitant diseases of the type Ⅰ,Ⅱ and Ⅲ showed no obviously difference (P ＞ 0.05),but the type Ⅳ was higher than the other three types(P ＜ 0.05).The preoperative OABSS(6.38 ± 1.51 vs.6.41 ± 1.76,P ＞ 0.05) and AUASS scores (16.38 ± 5.26 vs.16.59 ± 5.11,P ＞ 0.05) of the type Ⅰ and Ⅱ have shown no obviously difference.The preoperative OABSS(9.00 ± 2.35 vs.9.71 ± 3.04,P ＞ 0.05) and AUASS(20.59 ± 3.95 vs.22.00 ± 4.97,P ＞ 0.05) scores of the type Ⅲ and Ⅳ have shown no obviously difference.The preoperative scores of the OABSS scores and AUASS scores of the type Ⅲ and the type ⅣV were obviously higher than that of the type Ⅰ and the type Ⅱ (P ＜ 0.05).In this study,16 of the 62 patients were treated with tolterodine,46 patients were treated with solifenacin,with the average duration of drug therapy of 3.4 months (0.5-20.0 months).The postoperative scores of the OABSS and AUASS were followed up.The treatment outcomes among different OAB types were compared.Results The 62 patients were followed up from 6 to 20 months,with an average of 11.2 months.The improvement of the OABSS scores of the type Ⅰ and Ⅱ(3.63 ± 0.74 vs.3.86 ± 0.89,P ＞ 0.05) have shown no obviously difference.The improvement of the OABSS scores of the type Ⅲ (6.40 ± 1.17) were obviously higher than the type Ⅰ,Ⅱ and Ⅳ (1.71 ± 1.38) (P ＜ 0.05).The improvement of the OABSS scores of the type Ⅳ were obviously inferior to the type Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).The improvement of the AUASS scores of the type Ⅰ and Ⅱ (11.75 ± 4.33 vs.12.30 ±5.34,P ＞0.05)have shown no obviously difference.The improvement of the AUASS scores of the type Ⅲ (15.28 ± 4.32)were obviously higher than the type Ⅰ,Ⅱ and ⅣV (8.14 ± 4.34) (P ＜ 0.05).The improvement of the AUASS scores of the type ⅣV were obviously inferior to the type Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).Conclusions The type Ⅳ OAB presented with the worst outcome and the type Ⅲ OAB presented with the best among the four types of OAB.The classification system will have a suggestive significance to predict the prognosis and the therapeutic effect of the patients with OAB.

Objective To observe the influence of human umbilical cord mesenchymal stem cells (hUCMSC) transplanted into the tail vein of diabetic rats on apoptosis of retinal neurons and the retinal expression level of glial fibrillary acidic protein (GFAP).Methods Seventy clean male Sprague-Dawley rats were randomly divided into the normal control group (group A),diabetes mellitus (DM) only group (group B),DM + balanced salt solution (BSS) group (group C),DM + hUCMSC group (group D),with 10 rats in each group.DM rats were induced by intraperitoneal injection of streptozotocin.Apoptosis of retinal cells was assayed by dUTP nick end labeling.Immunohistochemistry and Western blot was performed to detect the retinal expressions of GFAP in rats.Results Compared with group A,large numbers of apoptotic cells could be found in the retinal ganglion cell layer (GCL) and inner nuclear layer (INL) of group B and group C,however the apoptotic cells in group D were significantly reduced than group B and C.The expression of GFAP was mainly located in the retinal GCL and retinal nerve fibre layer (RNFL) in group A,throughout the inner plexiform layer (IPL) in group B and C,only distributed in RNFL and GCL in group D.It was obvious that the expression of GFAP in group B and C was higher than group A.Compared with group B and C,the expression of GFAP in group D was significantly reduced.The difference of GFAP expression among the 4 groups was significant (F=79.635,P＜0.05).Conclusion hUCMSC could inhibit the apoptosis of retinal cells and activation of glial cells in early DM rats.

Objective To observe the effect of Delta-like ligand 4 (Dll-4) on the pathological structure of retina in early diabetic rats (DM) and its relationship with vascular endothelial growth receptor-2 (VEGFR-2).Methods A total of 70 male Sprague-Dawley rats were randomly divided into normal group and DM group,with 10 and 60 rats in each group,respectively.The rats of DM group was induced by intraperitoneal injection of streptozotocin to established DM model.The rats with blood glucose recovery and death were excluded,and the final 60 rats were included in the statistics.Rats in the normal group were injected with an equal volume of citric acid-sodium citrate buffer.Rats in the DM group were divided into DM 1 month (DM lm) group,DM 2 months (DM 2m) group,DM 3 months (DM 3m) group and DM 3m + Anti group,DM 3m + phosphate buffer solution (PBS) group by random number table method,and 10 rats in each group.In the DM 3m+Anti group,4 μl ofantiDll-4 polyclonal antibody was injected into the vitreous cavity,and the antibody concentration was 0.25 mg/ml.The DM 3m+PBS group was intravitreally injected with an equal volume of PBS.Five days after the injection,the rats were sacrificed.Rats in the DM 3m group and the normal group were not treated,and were sacrificed 3 months after the model was established.The structure and microvascular changes of the retina were observed by hematoxylin-eosin staining,and the total thickness of the retina was measured.The expression of Dll-4 and VEGFR-2 in the retina was detected by immunohistochemistry and fluorescence quantitative polymerase chain reaction (PCR).One-way analysis of variance was used to compare the expression of Dll-4 and VEGFR-2 in the retina of each group.The least significant difference t test was used to compare the two groups.Results Light microscopy showed that the retinal ganglion cells layer in the DM 3m group were obviously edematous,the inner and outer nuclear layers were thinner,the number of cells was reduced,the arrangement was disordered,the edema of outer plexiform layer was obvious,and the microvessels were abnormally dilated.In the DM 3m+Anti group,the edema of outer plexiform layer was lessened than that of the DM 3m group,and the other layers were not significantly different from the DM 3m group.Compared with the normal group,the total retinal thickness of the DM 3m group,the DM 3m+Anti group and the DM 3m+PBS group increased (t=5.596,3.290,4.286;P=0.000,0.008,0.002).Immunohistochemical staining showed that a small amount of Dl14 was positively expressed in the retinal ganglion cell layer of the normal group;a small amount of VEGFR-2 was positively expressed in the ganglion cell layer and the inner and outer nuclear layers.The positive expression of Dll-4 and VEGFR-2 in retinal vascular endothelial cells of DM 3m group increased significantly.The expression of Dll-4 was significantly decreased in the retinal layers and vascular endothelial cells ofDM 3m+Anti group,while the expression of VEGFR-2 was significantly increased.There was no significant difference between the positive expression of Dll4 and VEGFR-2 in the DM 3m+PBS group and the DM 3m group.The results of real-time PCR showed that the relative expression of Dll-4 and VEGFR-2 mRNA in the DM 3m group was significantly higher than that in the normal group (t=6.705,20.871;P＜0.05).Compared with DM 3m group,the relative expression of Dll-4 mRNA in DM 3m+Anti group decreased,and the relative expression of VEGFR-2 mRNA increased (t=2.681,3.639;P＜0.05).The relative expressions of Dll-4 and VEGFR-2 mRNA in the DM 3m+PBS group and DM 3m group were not statistically significant (t=0.513,0.657;P＜0.05).Conclusions The expression of Dll-4 in retinal vascular endothelial cells is gradually increased during the early retinopathy of DM rats.The expression of Dll-4 is inhibited,the expression of VEGFR-2 is up-regulated,and the plexus edema is alleviated.