Objective To investigate the effects of benazepril on plasma copeptin and N terminal brain natriuretic peptide (NT-proBNP) in the patients with chronic heart failure (CHF) in order to explore the mechanism of benazepril on ventricular remodeling.Methods Two hundred and thirty-eight patients with CHF were randomized into control group (n =118) and therapy group (n =120).Patients in control group were received regular treatment including medicine of treating cardiotonic diuretic and vasodilator for 6 months,while in therapy group were given benazepril beside regular treatment.The levels of copeptin,NT-proBNP were measured before and after treatment.The left ventricular ejection fraction (LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end diastole diameter(LVEDD) were recorded and compared before and after treatment.Results In treatment group,the levels of copeptin and NT-pro BNP,LVEF,LVEDD,LVESD were (4.9 ± 1.3) pmol/L and (327.8 ± 226.8) ng/L,(33.5 ± 6.2) ％,(47.6 ± 8.9) mm,(60.2 ± 7.1) mm before treatment,different from that after treatment ((17.8 ± 7.9) pmol/L,t =7.331,P =0.008 ; (1 779.6±838.3) pg/mL,t =10.236,P =0.002; (50.5 ±5.2)％,t =3.336,P=0.009;(32.9 ±5.7) mm,t =2.767,P =0.010 ; (43.2 ± 5.6) rmm,t =2.882,P =0.009).After treatment the levels of copeptin,NT-proBNP,LVEF,LVESD and LVEDD in treatment were lower than that of control group(control group:copeptin:(10.5 ± 2.4) nmol/L; NT-proBNP:(1076.6 ± 486.6) pg/L; LVEF:(36.6 ± 5.6) ％ ; LVESD:(45.9 ± 6.8)mm; LVEDD:(57.5 ± 5.4) mm),and there was significant difference between groups (P =0.049,0.010,0.035,0.038,0.048 respectively).Conclusion Benazepril treatment could decrease the level of plasma copeptin and NT-proBNP in CHF patients,inhibit neuroendocrine and the ventricular remodeling,and then improve the heart function.

ObjectiveTo explore the inhibitory effects of r-k4k5 on retinal neovascularization.MethodsEighty-eight one-week-old C57BL/6J mice were put into the environment with 75% oxygen for 5 days to establish models of vascular proliferation retinopathy. One eye of each mouse received an intravitreal injection of 500 ng of r-k4k5 (large-dosage group) and of 250 ng of r-k4k5(small-dosage group), and the same volume of BSS was injected into the other eye of the mice both in these two groups as a control. The ADPase histochemical staining was used for retinal flatmount to observe changes of retinal vessels. The inhibitory effects of r-k4k5 on retinal neovascularization were evaluated by counting the endotheliocyte nuclei of new vessels extending from retina to vitreous in the tissue-slice.ResultsRegular distributions and reduced density of retinal blood vessels in eyes in the treatment group were found in retinal flatmount. The number of the endotheliocyte nuclei of new vessels extending from retina to vitreous was less in the eyes in the treatment group than which in control group (P

Objective To explore the relationship between improved exercise endurance and inspiratory muscle strength,dyspnea and lower limb fatigue in chronic obstructive pulmonary disease(COPD)patients. Methods Twelve moderate-to-severe COPD patients were given lower limb exercise training for 12 weeks.Routine tests of pulmonary ventilation function,diffusion function,lung volume,maximal inspiratory pressure(MIP),expiratory flow limitation(EFL),cycle ergometer exercise capacity and constant work rate capacity were administered before and after the training program.Borg's scale(BS)was used to assess dyspnea and lower limb fatigue was measured during the exercise tests.Results After training,the average peak work rate(W Rpeak)and average MIP both had increased significantly,but no significant change was observed in routine pulmonary ventilation function,diffusion function or lung volume.The 5-point EFL score showed no significant change.hut Borg's scale dyspnea scores and lower limb fatigue decreased significantly.The changes in W Rpeak were positively correlated with the MIP changes,Borg scale scores and changes in Borg scores.All of these relationships were statistically significant. Conclusion The improved exercise endurance of moderate-to-severe COPD patients after lower limb exercise training is due to increased inspiratory muscle strength and decreases in the sensation of dyspnea and lower limb fatigue.

Objective To explore the effect of treadmill training on inspiratory function and its association with improvement of exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Methods The 12 moderate to severe COPD patients were allocated to lower-limb exercise training for 12weeks. The routine tests of pulmonary ventilation function, diffusion function,lung volume, peak inspiratory flow (PIF), maximal inspiratory pressure (MIP), symptom-limited progressive cycle ergometer exercise tests and constant work rate exercise tests were administered before and after the training program. During the constant work rate exercise tests, tidal breathing flow volume (TBFV) curves were recorded every 1 mir. Results After treadmill training, the exercise duration (T) (t=7. 357, P＜0. 001), peak work rate (WRpeak) (t=3. 614, P＜0.05), MIP (t=4.754, P＜0. 001) and PIF (t=2. 440, P＜0. 05) increased significantly. The tidal PIF (t=- 2.747, P＜0.05) and peak expiratory flow (PEF) (t = - 4.487, P＜ 0.05 ) decreased significantly at isotime. Maxium inspiratory flow reserve (△FLOWinsp) (t = 2. 755, P ＜ 0. 05 ) increased significantly at isotime, and maxium expiratory flow reserve (△FLOWexp) (t = 1. 326, P ＞ 0.05)showed no significant changes; The△T were positively correlated with △MIP (r=0. 613, P＜0. 05),△PIF (r=0.497, P＜0.05) and △FLOWinsp (r=0.592, P＜0.05). Conclusions Lower limb exercise training improves inspiratory function of COPD patients. The improvement of exercise endurance in moderate to severe COPD patients after lower limb exercise training is due to increases of inspiratory muscle strength, maxium PIF and inspiratory flow reserve.

Objective To explore the clinical significance of serum vascular endothelial growth factor (VEGF) level in nasopharyngeal carcinoma patients. Methods Serum VEGF level of 55 nasopharyngeal carcinoma patients were measured by sandwich enzyme?- linked immunosorbent assay (ELISA). 40 normal healthy volunteers served as control. Results Serum VEGF level of nasopharyngeal carcinoma patients was significantly higher than that of control group (P =0.000); Serum VEGF level was significantly higher in advanced nasopharyngeal carcinoma stage (stage Ⅲ ~Ⅳ) than that in early stage(stageⅠ ~Ⅱ) (P =0.003); Serum VEGF level with nasopharyngeal carcinoma patients with lymphnode metastasis was significantly higher than that of patients without lymphnode metastasis. There was no significant relationship compared serum VEGF level in nasopharyngeal carcinoma patient's gender, age and pathological types. Conclusions Serum VEGF can be used as a marker of nasopharyngeal carcinoma for diagnosis and monitoring the progress and the prognosis of the disease.

Objective To report clinical features,diagnosis and treatment in a case of adult onset Still's disease (AOSD) accompanied by demyelinating encephalopathy.Methods We reported a case of Stills disease with signs of encephalopathy.We also reviewed and discussed the literature on the neurological manifestations in AOSD.Results The 35-year-old patient had recurrent fever and arthralgias for 3 years,headache for 1 month and transient loss of consciousness.Laboratory tests showed non-specific immunological activity.MRI showed tumor-like lesions at left parietal and occipital lobes surrounded by sleeve-like edema.The lesion had significant occupation effect.Biopsy proved the presence of demyelinating changes.The patient recovered favorably after administration of corticosteroids and immunoglobulin.The lesions had almost disappeared on follow-up MRI 4 months later.Conclusions Demyelinating encephalopathy may develop in patient with AOSD.MRI may show tumor-like damage,which is rarely reported in the literature.Diagnosis depends on history,clinical manifestation and neuroimaging.Biopsy provides important information in making diagnosis.Treatment with corticosteroids and intravenous immunoglobulin was found to achieve good recovery.

With the development of techniques and methods of medical researches, the ethic review of clinical research has become essential for healthy development of medical research. This article analyseds the practice of ethic reviews of research projects involving human subjects in our hospital and the difficulties in the process are discussed.

Objective To investigate the relationship between the effect of unmethylated cytosine phosphate-guanine oligodeoxynucleotide ( CpG ODN ) 7909 on X-ray-induced G2/M phase arrest and apoptosis and the phosphorylation of ATM kinase.Methods Human lung adenocarcinoma A549 cells were randomly classified into five groups,control,CpG group,irradiation group,CpG + irradiation group and ATM siRNA + CpG + irradiation group.Cell survival fraction was evaluated by clonogenic assay.Cell cycle and apoptosis were analyzed by flow cytometry.The expressions of ATM,checkpoint kinase-2(Chk2) and p53 were detected with Western blot.Results Compared to the situation under X-ray irradiation alone,decreased cell clonogenic survival,prolonged G2/M arrest,and increased cell apoptosis were observed after the combination treatment with CpG ODN7909 and X-rays ( t =13.41,17.32 and 7.71,P ＜ 0.05).Moreover,the phosphorylations on ATM,Chk2,and p53 were increased in the irradiated A549 cells that had been pre-treated with CpG ODN7909.After ATM siRNA interfering,abrogation of G2/M arrest,reduction of apoptosis,and decrease of Chk2 and p53 phosphorylation were found in A549 cells treated with CpG ODN7909 and X-rays ( t =26.84,2.98,47.24 and 67.47,P ＜0.05).Conclusions CpG ODN7909 can enhance the X-ray-induced phosphorylation of ATM kinase in human lung adenocarcinoma cells in vitro,which might be involved in regulating G2/M phase arrest and apoptosis.

Objective To compare clinical and laboratory characteristics between systemic lupus erythematosus (SLE) patients with and without cutaneous vasculitis,and to investigate the correlation of cutaneous vasculitis with severe visceral involvement and laboratory biomarkers.Methods A total of 152 SLE patients with various skin manifestations were enrolled from Department of Dermatology of Huashan Hospital affiliated to Fudan University from July 2011 to October 2014.The clinical and laboratory data were collected and retrospectively analyzed.SLE patients with cutaneous vasculitis were divided into upper/lower extremity vasculitis group and livedo reticularis group.A logistic regression model was used to analyze the correlation between cutaneous vasculitis and various clinical and laboratory variables.Results Of 152 SLE patients,62 (41％) presented with cutaneous vasculitis,including 55 with upper/lower extremity vasculitis and 7 with livedo reticularis,and 90 (59％) did not have cutaneous vasculitis.Patients with upper/lower extremity vasculitis showed significantly younger age (30.54 ± 12.67 years vs.37.77 ± 12.17 years),and lower prevalence of aberrantly elevated 24-hour protein excretion (39.39％ vs.64.00％) and serum urea level (2.08％ vs.16.43％),but significantly higher percentage of females (98.18％ vs.84.44％),higher proportions of patients with abnormal brain MRI (37.5％ vs.12.19％),anemia (87.03％ vs.70.93％) and positive antiribosomal P protein antibodies (77.77％ vs.53.65％),and higher SLE disease activity index (SLEDAI) (14.71 ± 7.75 vs.10.68 ± 5.61) than those without vasculitis (all P ＜ 0.05).The proportion of patients with decreased C3 level did not differ between patients with upper/lower extremity vasculitis and those without cutaneous vasculitis (P =0.362),but was significantly lower in the patients with livedo reticularis than in those without cutaneous vasculitis (28.57％ vs.79.76％,P =0.008).However,no significant differences in the other variables were observed between patients with livedo reticularis and those without cutaneous vasculitis (all P ＞ 0.05).Additionally,body mass index (BMI),abnormal lung function and other laboratory variables all did not differ among patients with upper/lower extremity vasculitis,patients with livedo reticularis and patients without cutaneous vasculitis (all P ＞ 0.05).Logistic regression analysis revealed that after exclusion of potential effects of age and gender,cutaneous vasculitis was significantly positively correlated with abnormal brain MRI (OR =4.24,95％ CI:1.17-16.13,P =0.028),and positive anti-ribosomal P protein antibodies (OR =3.97,95％ CI:1.86-8.47,P =0.0004),but negatively correlated with abnormally elevated 24-hour protein excretion (OR =0.25,95％ CI:0.09-0.69,P =0.009).Furthermore,cutaneous vasculitis showed no significant associations with abnormal serum urea level (OR =0.12,95％ CI:0.01-1.06),decreased C3 level (OR =0.93,95％ CI:0.38-2.28),anemia (OR =1.38,95％ CI:0.56-3.40) or SLEDAI (OR =1.05,95％ CI:0.98-1.14).Conclusions Cutaneous vasculitis is closely associated with central nervous system damage and emergence of anti-ribosomal P protein antibodies,so SLE patients with cutaneous vasculitis should be closely monitored for central nervous system damage.SLE patients without cutaneous vasculitis are more liable to kidney injury,so they also need to be closely monitored.

Background and purpose: AMP-activated protein kinase (AMPK) plays an important role in the regulation of cell metabolism and energy balance and is associated with cell proliferation, survival and multiple signaling pathways. Recent reports found that AMPK is involved in tumor suppression and drug resistance. The aim of this study was to explore the effect of AMPK on the anti-tumor effect of adriamycin and underlying mechanism in breast cancer MCF-7/adr cells. Methods:The anti-proliferative effects of adriamycin was detected by methyl thiazolyl tetrazolium (MTT) assay in MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKαcells. The cell morphology in each group was stained with the lfuorescent dye Hoechst 33528, and the effects on apoptosis induction were examined by lfow cytometry (FCM). The intracellular concentration of adriamycin was detected by lfuorescence assay. The resis-tance-and apoptosis-related proteins were analyzed by Western blot. Results:The growth of breast cancer MCF-7/adr cells was inhibited by adriamycin in a dose-and time-dependent manner. The IC50 values at 24 and 48 h were (36.8±2.1) and (28.8±1.3) μg/mL, respectively. AMPKαover-expression enhanced the cytotoxic effect of adriamycin in MCF-7/adr-AMPKαcells in a dose-and time-dependent manner. Its IC50 values at 24 and 48 h were (16.0±0.7) and (4.2±0.2) μg/mL, respectively. Fluorescent morphological assay showed that AMPKαoverexpression contributed to adriamycin induced apoptosis in MCF-7/adr-AMPKαcells. After treatment with 1.0 μg/mL adriamycin for 48 h, the apoptosis rates of MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKα cells were (12.0±1.4)%, (12.7±1.6)% and (32.0±4.2)%, respectively, indicating that overexpression of AMPKα enhanced the adriamycin-induced apoptosis in MCF-7/adr cells. Fluorescence microplate assay showed that over expression of AMPKαsigniifcantly increased the intracellular accumulation of adriamycin, in a concentration dependent manner. Western blot analysis showed that, compared with MCF-7/adr and MCF-7/adr-vector cells, the expressions of Bax, caspase-3 and cleaved PARP proteins were increased. Meanwhile, Bcl-2 and P-gp protein expressions were decreased in MCF-7/adr-AMPKαcells. Furthermore, the release of cytochrome c from mitochondria into the cytosol was also observed in MCF-7/adr-AMPKαcells. Conclusion:AMP-Kαoverexpression can enhance the chemosensitivity of breast cancer MCF-7/adr cells to adriamycin through inhibiting the drug effux transporter and regulating the expression of apoptosis-related proteins.