Objective To evaluate the proteetive effect of Valerian oil on lipid-induced nephropathy in Hypercholosterolemic rats and study its possible mechanisms.Methods SD rats were randomly divided into control group,hyperlipidemia group,low-dose[12.5mg/(kg·d)]valerian oil group,middle-dose[25mg/(kg·d)]valerian oil group,high-dose[(50me/(kg·d)]valerian 0il group and simvastatin group[5ms/(kg·d)for lavage].Dietary-induced hyperlipidemia were by given 4％cholosteml and 1％cholic acid diet for 16 weeks.Changes of serum lipid,urinary albumin,renal function and renal pathobiology index were assessed.The expression of integrin α3β1in glomeruli was detected by immunohistochemical stain,the expression of integrin ot3～l and TGF-β1 mRNA were detected by RT-PCR at the same time.Results The serum levels of total cholesterol,low density lipopmtein and seruln creatinine in Valerian group and simvastatin group were decreased more than that in hypedipidemia group.Urinary albumin excretion Was significantly reduced。in Valerian group after treatment for 8 weeks,and significantly reduced in simvaatatin group after 16 weeks.The morphological analysis revealed that the pathobiology index in Valerian group were significantly decreased than that in simvastatin group after 16 weeks.At the sanle time,the expression of integrin α3β1 mRNA and protein in Valerian group were significantly increased than that in hyperlipidemia group and simvastatin group,and the expression of TGF-β1mRNA were markedly decreased in Valerian group.The treatment effect in Valerian group Wag better than that insimvaatatin group.Conclusion Valerian oil has the protective effects on lipid-induced nephropathy by decreasing serum lipid,increasing the expression of integrin α3β1 and inhibiting the expression of TGF-β1.The protective effects of Valerian oil ale better than simvastatin.

Objective To explore the expression and significance of nestin in renal tubular epithelial cells in hypercholesterolemic rats. Methods Dietary-induced hyperlipidemia were induced in female SD rats by given 4% cholesterol and 1% cholic acid diet for 16 weeks. Changes of serum lipid, urinary albumin, serum creatinine and renal interstitial pathological changes were assessed. The expression of nestin and a-smooth muscle actin (α-SMA) were detected by immunohistochemical stain. Results The serum levels of total cholesterol, low density lipoprotein, urinary albumin and serum creatinine were significantly increased in hyperlipidemia group, accompanied with renal interstitial injury and fibrosis. As time extended, the expression of nestin and a-SMA in renal tubular epithelial cells were increased significantly. There was positive correlation among the expression of nestin and total cholesterol, low density lipoprotein, urinary albumin and serum creatinine( r =0.963,0.830,0.944,0.706, P <0.01). Nestin also had a positive correlation with tubular-interstitial index ( r = 0. 974, P < 0. 01) and α-SMA ( r = 0. 804, P < 0. 01). Conclusion The increased expression of nestin may be associated with renal tubular-interstitial fibrosis and tubular epithelial myofibroblast transdifferentiation in hypercholesterolemic rats.

The original meaning of Portfolio is briefcase, generally translated as study archives in our country, with learners as the center, through the process of goal setting, feedback learning, self-reflection, steps, to show yourself and target revision form of process evaluation with learners as the center, to continuously promote the personal comprehensive ability through reflective learning progress. Portfolio, introduced in clinical admissions bilingual teaching, through six aspects such as individual learning, classroom display, clinical teaching, practice process and result display and target changes, and through the learning process assessment (fuzzy comprehensive evaluation method) and professional knowledge assessment (mini) method evaluating the clinical practice, evaluates Portfolio, in order to improve the medical students' clinical thinking and their comprehensive ability of lifelong learning,and promote the medical students' all-round development.

The clinical data and routine biochemical parameters of 64 maintenance hemodialysis (MHD)patients and 20 controls were analyzed in the study.Serum cystatin C levels were detected by latex particle enhalice inununo-turbidimetry:and the cardial structure and function were assessed by echocardiography.As MHD time extended,the levels of semm cystatin C increased gradually,accompanied with high incidence of left ventricular hypertrophy(LVH).The LVH-positive patients had higher systolic blood pressure and left veHtricular mass index,and had higher serum cystatin C than tllose in LVH-negative patients.The serum cystatin C levels were positively correlated with left yentricular mass index(r=0.633,P<0.01)and systolic blood pressure(r:0.397,P<0.01).The results suggest that serum cystatin levels may be an influencing factor for long-term cardiacvascular complication in MHD patients.

Objective Posterior reversible encephalopathy syndrome (PRES) is a rapidly evolving neurologic syndrome with characteristic clinical and radiographic features. To define the clinical characteristics of PRES in patients with eoneomitant systemic lupus erythematosus (SLE) by analyzing their clinical manif-estations and reviewing the literature. Methods The details of 4 cases and a review of the literature relevant to the development of PRES in association with SLE are presented. We described the clinical and imaging characteristics and associated risk factors of posterior roversible PRES in patients with SLE. Results Inclu-ding our cases, we reviewed a total of 48 patients with SLE and PRES. Hypertension was observed in 42 cases (88%), renal failure in 30 cases (63%), 39 recent onset cases were treated with immunosuppressive drugs and/or steroids recently (81%). Headache was observed in 46 cases (96%), Corffusion/coma in 20 cases (42%), seizures in 43 cases (90%), visual disturbances in 28 cases (58%). Neuroimaging demonstrated posterior white matter edema involving the parietal-occipital, temporal, frontal lobes, and cerebellum. The hypertension and other worsening factors should be treated. Conclusion PRES is a central nervous system syndrome that is observed in SLE patients. It is associated mainly to acute hypertension, renal failure, and immunosuppressive drugs. Although reversibility is common, residual neurological damage may be observed. Complete clinical and radiographic recovery oeeurrs with prompt antihypertensive treatment and supportive care.

Objective:To investigate the expressions of krüppel-like factor 4 (KLF4) in human glioma tissues and its effect on the activity of tumor cells.Methods:The glioma tissues specimens of 74 patients with primary malignant gliomas who were admitted to Nanyang Second General Hospital of Henan Province from March 2018 to May 2019 were collected. During the same period, 50 cases of benign meningioma tissues and 31 cases of normal brain tissues receiving surgery because of head injury were also collected. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the expression of KLF4 mRNA in tissues. Glioma U-87MG cells were selected and the glioma cell models with low-expression of KLF4 were constructed and were divided into the blank control group, KLF4-NC group and KLF4-siRNA group. The proliferation ability of cells was detected by using MTS cell proliferation detection kit, and the expression levels of E-cadherin, vimentin and zonula occludens protein 1 (ZO-1) were detected by using Western blot.Results:The relative expression level of KLF4 mRNA in low-grade glioma, benign meningioma, and normal brain tissues was 0.26±0.04, 0.13±0.02, 0.11±0.02, respectively, which were lower than that in high-grade glioma(0.34±0.06), and the difference was statistically significant ( t = 8.381, 15.720, 15.984, all P<0.05). The relative expression level of KLF4 mRNA in benign meningiomas and normal brain tissues was lower than that in low-grade gliomas, and the difference was statistically significant ( t = 13.771, 14.239, all P<0.05). At each time point of cell culture, the proliferation ability of U-87MG cells in KLF4-siRNA group was lower than that of the blank control group and KLF4-NC group, and the difference was statistically significant (all P < 0.05). There was no significant difference in U-87MG cell proliferation ability between the blank control group and KLF4-NC group ( P > 0.05). The relative expression level of E-cadherin and ZO-1 protein in KLF4-siRNA group was 0.82±0.10, 0.79±0.11, respectively, which were higher than that in the blank control group (0.24±0.08, 0.39±0.05) and KLF4-NC group (0.26±0.05, 0.42±0.09), and the difference was statistically significant (all P < 0.01); and the relative expression level of vimentin in KLF4-siRNA group (0.31±0.08) was lower than that in the blank control group (0.90±0.08) and KLF4-NC group (0.92±0.05), and the difference was statistically significant (all P < 0.01). There was no statistically significant difference in the expression level of E-cadherin, vimentin and ZO-1 between the blank control group and KLF4-NC group (all P > 0.05). Conclusion:The expression level of KLF4 is increased in human glioma tissues, especially in high-grade glioma. Down-regulating the expression of KLF4 may inhibit glioma cell proliferation and epithelial-mesenchymal transition, and reduce cell activity.

Objective To observe the effects of mesenchymal stem cells (MSCs) surface CXC chemokine receptor 4 over-expression on the repair of kidney after ischemia reperfusion (I/R) injury.Methods The MSCs were co-cultured with I/R injured renal cell homogenate supernatant.The MSCs surface CXCR4 and stromal cells derived factor-1 (SDF-1α) protein levels were detected by Western blot, chemotactic ability of MSCs to SDF-1 was investigated by transwell test.The I/R injured renal model was made and pathological changes were observed in control group, I/R group, MSCs injection group and CXCR4 neutralize antibody group.Renal CXCR4 protein expression was measured by immunofluorescence histochemistry, SDF-1α、 CXCR4、 hepatocyte growth factor (HGF) and epidermal growth factor (EGF) mRNA were detected by Real-time quantitative polymerase chain reaction (RT-PCR).Comparisons among multiple groups were performed using One-way analysis of variance, and comparisons between groups were carried out using independent-sample t-test.Results In vitro, the SDF-1α protein expression markedly increased in I/R injured renal tissue homogenate, but the difference was not significant between I/R group and CXCR4 antibody group (t =0.862, P =0.403).MSCs surface CXCR4 protein expression increased significantly after co-cultured with I/R injured renal tissue homogenate (F =95.957, t =10.166, P ＜ 0.01), and the chemotactic ability of MSCs to SDF-1 increased at the same time (F =82.459, t =6.826, P ＜ 0.01), the CXCR4 protein expression (t =13.657, P ＜ 0.01) and the chemotactic ability (t =12.662, P ＜0.01) could be decreased by CXCR4 neutralize antibody.In vivo, renal tubular structure was destroyed in I/R group.After MSCs injection, the renal pathological injury improved rapidly, but the improvement could be inhibited by CXCR4 antibody.The expression of SDF-1α mRNA and level of SDF-1a protein increased in I/R group, but there was no significant difference among different groups (F =1.909,P =0.173).MSCs injection markedly up-regulated the CXCR4 protein and mRNA expression (F =6.663, P =0.006).Following the increase in CXCR4 expression, the expressions of HGF mRNA (F =11.898,P ＜ 0.01) and EGF mRNA (F =5.309, P ＜ 0.05) increased gradually which could be restrained by CXCR4 antibody (t =5.312, t =4.310, P ＜ 0.01).Conclusions I/R injured renal microenvironment markedly increased the mesenchymal stem cells surface CXCR4 expression, and increased CXCR4 expression can induce MSCs chemotaxis and stimulate the secretion of renal protective growth factors paracrine promoting the repair of the kidney.

Objective To evaluate the safety and efficacy of icotinib as first-line therapy in Chinese non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) sensitive mutations.Methods Patients with stage ⅢB/Ⅳ NSCLC who had EGFR sensitive mutation and had no previous treatment were enrolled into this study.The response rates , progress free survival ( PFS) , overall survival ( OS ) , and the safety were analyzed.Results Ninety advanced adenocarcinoma patients were enrolled in this study , 44 patients had partial response ( PR ) , 42 patients had stable disease ( SD ) , 4 patients had progressive disease (PD), with an overall response rate (ORR) of 48.9%, and a disease control rate (DCR) of 95.6%.The median PFS was 14.9 months (95%CI 13.5-16.3) and the OS was 37.0 weeks ( 95%CI 27.9 -46.1 ).Patients with brain metastases showed higher ORR ( P =0.049 ).Patients with stage ⅢB had longer PFS than those with stage Ⅳ( P=0.007 ).The most common adverse events were grade 1 -2 skin rash (38 patients, 40.9%).Other adverse events included dry skin , oral mucositis, diarrhea and liver function injury.Three patients withdrew because of severe liver injury or skin rash.No treatment related mortality occurred .Conclusions Icotinib is effective and safe as first-line treatment for Chinese advanced NSCLC patients with EGFR sensitive mutation.

Objective To investigate the roles of somatostatin(SS)positive intemeurons in the development and compensation of temporal lobe epilepsy.Methods Piloearpine-induced epilepsy rat model was established.Immunohistochemistry method was used to detect number changes and axonal sprouting of SS positive intemeurons in different domains of the hippocampus at difierent time points.Degeneration of SS positive interneurons and their neurophils were detected by the double immunofluorescence staining with SS and Fluoro-Jade B(FJB)at 7 and 60 days after status epilepticus (SE).Results In the exoerimental rat group,the number of SS positive neurons decreased in each hippocampal domain,and it reached the lowest at 7 days post-SE(There were 11.1±3.3 in hilus,2.8±0.9 in CA1region and 1.8±0.7 in CA1region,t=13.519,9.644 and 8.808,all P<0.01).In chronic phase,the number of SS neurons gradually recovered,and exceeded the control group in CA1 area at 60 days post-SE(12.8±1.5 vs 8.8±1.3,t=-4.506,P<0.01),however,the number of SS neurons in the hilus(25.5±4.6)and CA1 area(4.8±0.8)remained significantly less than normal levels(t value were 4.691 and 3.953.both P<0.01).Increased SS positive fibers were found in the lacunosum-molecular (1m)layer and outer molecular layer of dentate gyrus after 30 days post-SE,and numerous SS positive fibers were seen threnghout the layers of area CA1 at 60 days post-SE.Double immunofluuorescence revealed that a few SS positive interneurons and fibers were also labeled by FJB in area CA1 at 7 days post-SE and in CA domain/hilus at 60 days post-SE.Conclusions SS intemeurons loss plays an important role in the development of temporal lobe epilepsy.The loss is partially caIlsed by the degeneration and death of neurons;SS positive neurophils increase within area CA1 in chronic phase may play a significant role in the generation and compensation of temporal lobe epilepsy.

Objective To investigate the efficacy and safety of leflunomide as induction and mainten-ance therapy for class Ⅴ lupus nephritis. Methods Sixteen patients with lupus nephritis (of which, three proven with Ⅴ +Ⅲ, six with Ⅴ+Ⅳ ), proven by renal biopsies, were included in this study. ALL patients rec-eived LEF plus prednisone treatment. For induction therapy, all patients were given an initial loading dose of LEF 60 mg daily for three days, followed by 20 mg daily for the whole induction treatment period. Prednisone was given starting from 0.8 mg per kilogram daily, then tapered four weeks later. After twenty-four weeks, the dosages of LEF and prednisone were 10 mg/d, 5～10 mg/d respectively during maintenance therapy. We asses-sed total remission rates in the end of twenty-four weeks, as well as the changes of system lupus erythematosus disease activity index (SLEDAI), urinary protein per twenty-four hours (24 h Upr), serum albumin, serum creatinine level, complement C3, complement C4, C reactive protein, serum titer of ANA and anti-dsDNA be-fore treatment, 12 weeks, 24 weeks and 48 weeks after treatment respectively. Meanwhile, seven patients received repeated renal biopsies after completing induction therapy, so we compared pathological activity index (AI) and chroniciry index (CI) between pre-therapy and post-therapy at the same time. T and t' test were selected. Results Sixteen patients were followed-up. After 24 weeks induction therapy, the total remission rate was 75.0%; SLEDAI was significantly lower than pre-therapy [(15.4±3.5) vs (6.9±1.7), P<0.05]; 24 h Upr was also significantly lower than pre-therapy [(5.8±2.2) g vs (l.3±0.5) g, P<0.01 ]. Unfortunately, all seven patients performed repeated renal biopsies with class Ⅴ lupus nephritis again histologically, of which two were transformed other cater-ofies. Comparing with that of pre-therapy, AI was improved after therapy [(2.4±0.9) vs (1.7±0.8), P<0.05]. However, CI indicated no difference. Adverse events including major infection occurred in four patients. The adverse events happened at the 12 th week after treatment. Conclusion The efficacy of LEF plus corticoster-oids as induction and maintenance therapy for class Ⅴ lupus nephritis is remarkable and the tolerance of patients is good.