Objective To study the effect of body weight management on community residents with over-weight or obesity.Methods Chronic Disease Management Information System was used to establish personal health profile for 10 560 individuals with over-weight or obesity(4660 men and 5900 women,average age 58±12 years).Guide for individualized food intake,physical activity were given to these participants for an average of 9±6 months (range,1 to 32 months) with a following up.The change of body weight before and after the intervention was nalyzed.Statistical software(SPSS 12.0) wag used for the data analysis,the frequencies,rate and trend were analysised by the chi-square test,the means in quatitaitve data was analyzed by the paired t-test.P valuse for statistiacal significance is set for 0.05.Results A total of 9848 participants showed no change in body weight,although weight decrease or increase was seen in 499 and 213,respectively.Before and after the intervention,the proportion of weight remained,decrease or increase among over-weisht + central obesity individuals was 92.3%(6290/6817),5.9%(403/6817) and 1.8% (124/6817);95.5%(2888/3024),2.8%(84/3024) and 1.7%(52/3024) among the simple overweight or obesity group;and 93.2%(670/719),1.7%(12/719)and 5.1%(37/719) among the simple central obesity group,separately.Conclusions Body-weight management among central obesity individuals with over weight in communities is a more effective way of in terms of individule intervention than those individuals only with single over-weight,obesity or central obesity status.

Objective To investigate the expression and distribution of Cdc42-interacting protein 4 (CIP4) in renal fibrotic tissue,and the interaction between CIP4 and β-catenin in transforming growth factor β1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) model of HK-2 cell line.Methods In vivo,the model of renal fibrosis was induced by 5/6 subtotal nephrectomy in rat.Masson staining was used to evaluate the level of renal tissue fibrosis.The expression and distribution of CIP4 was detected by immunohistochemistry.In vitro,the EMT model of HK-2 cell line was induced by TGF-β1 (10 μg/L) for 72 h.Western blotting was used to observe the expression of E-cadherin,β-catenin,CIP4 and α-SMA.Colocalization and interaction of CIP4 and β-catenin were detected by immunofluorescence and immunoprecipitation respectively.Results Compared to sham group,CIP4 expression was increased in group of 5/6 subtotal nephrectomy,CIP4 was mainly distributed in basolateral side of renal tubular epithelia.In vitro,expressions of α-SMA and CIP4 were increased in HK-2 cells stimulated by TGF-β1 for 72 h (2.5and 1.8 folds,respectively) (all P＜0.05),expression of E-cadherin was decreased(P＜0.05).Partial colocalization between CIP4 and β-catenin was detected by immunofluorescence.In control group,CIP4 and β-catenin partially colocalized at the cell membrane.Mter the stimulation of TGF-β1,translocation to nucleus of CIP4 and β-catenin were increased,and partially colocalized in nucleus.The interaction between CIP4 and β-catenin was observed by immunoprecipitation in both control and TGF-β1 stimulated groups.Conclusions Expression of CIP4 in renal fibrotic tissue is increased,which is mainly distributed in basolateral side of renal tubular epithelia.CIP4 and βcatenin partially colocalize and interact with each other.CIP4 may play a role in EMT process through the interaction with β-catenin.

Objective To investigate the expression of Erbin in renal interstitial fibrosis (RIF) and the effect of over-expression of Erbin on transforming growth factor β1 (TGF-(β1)-induced epithelial-mesenchymal transition (EMT) in NRK52E cells. Methods In vivo, the model of renal fibrosis was induced by 5/6 subtotal nephrectomy in rat. Scr and BUN was detected and Masson staining was used to evaluate the level of renal tissue fibrosis. The location and expression of Erbin in renal tissue were detected by immunohistochemistry and Western blotting. In vitro, after NRK52E cells were treated by TGF-β1 (10 μg/L) for 72 h, immunofluorescence and Western blotting were used to obverse the expression and distribution of E-cadherin and α-SMA. The expression of Erbin mRNA and protein were detected by RT-PCR and Western blotting respectively. NRK52E cells were transiently transfected with Prk5-myc-Erbin plasmid via lipofectamine 2000, then the expressions of Erbin, E-cadherin and α-SMA were detected by Western blotting. Results (l)Compared to sham group with Scr (33.96±7.28) μmol/L and BUN (8.11±2.55) mmol/L, rats in 5/6 nephrectomy model with Scr (140.52±61.11) μmol/L and BUN (34.23±7.66) mmol/L revealed renal dysfunction. Masson staining indicated kidney interstitial fibrosis, and the expression of Erbin was significantly increased in renal tissue(2.9 folds), especially in tubular epithelia. (2)In vitro, the expressions of Erbin and α-SMA were markedly increased (2.3 folds and 2.1 folds, P<0.05, respectively) and the expression of E-cadherin was dramatically decreased in NRK52E cells stimulated by TGF-β1, which were consistent with immunofluorescence results. TGF-β1-induced E-cadherin suppression and a-SMA induction could be efficiently blocked by over-expression of Erbin (all P <0.05). Conclusions Erbin is up-regulated in renal interstitial fibrosis, and over-expression of Erbin can partly inhibit renal EMT induced by TGF-β1, which indicates Erbin playing an protective role in renal fibrosis.

Liver transplantation is the most effective way to treat end-stage liver disease, but biliary stenosis after liver transplantation, and tumor recurrence after liver transplantation impairs patients’ life quality and long-term survival. This article discussed the current status of treatment of biliary stenosis after liver transplantation and tumor recurrence after liver transplantation which based on the latest domestic and international researches and the authors’ clinical experience.

Objective To observe the expression and localization of CIP4 (Cdc42 interacting protein-4) in the renal fibrosis and the effect of CIP4 on the expression of E-cadherin,vimentin and β-catenin tyrosine phosphorylation. Methods In vitro, the human tubular epithelial cells (HK-2 cell line) were cultured with 10 μg / L TGF-β1 for 72 h. The protein expressions of CIP4, E-cadherin, vimentin and β-catenin tyrosine phosphorylation were measured by Western blotting; the expression of CIP4 mRNA was detected by RT-PCR. The intracellular distribution of CIP4 was observe by confocal microscope. In vivo, Masson staining was used to evaluate the level of renal fibrosis; the expression and distribution of CIP4 in renal tissue were detected by immunohistochemistry. HK-2 cells were transfected with pcDNA3. 1-CIP via lipofectamine 2000. The expressions of E-cadherin, vimentin and β-catenin tyrosine phosphorylation level in the transfected cells were detected by Western blotting. Results The expressions of CIP4 mRNA and protein were up-regulated in renal tubular EMT cells. Most of CIP4 protein localized in cell membrane, and some was in cytoplasm. After stimulation by TGF-β1, the expression of CIP4 protein both in cytoplasm and nucleus was greatly increased (P ＜0.05),especially in cytoplasm. In vivo, CIP4 was expressed in renal tubular epithelia, but little expressed in glomeruli. In renal from 5/6 nephrectomized rats, CIP4 expression was significantly increased. In the CIP4 transfectants, the expression of CIP4, vimentin and β-catenin tyrosine phosphorylation level were up-regulated (P ＜0.05), but E-cadherin expression was suppressed (P ＜0.05).Conclusion The overexpression of CIP4 is likely to take part in the epithelial-to-mesenchymal transition process, thereby promoting the renal fibrosis.

Objective To observe the effect of CIP4(Cdc42 interacting protein 4)on human renal tubular epithelial to mesenchymal transition(EMT)induced by transforming growth factor β1(TGF-β1)and to study the associated mechanism. Methods Human proximal tubular epithelial cells (HK-2 cell line) were cultured with TGF-β1 (10μg/L) for 72 hours. The protein expressions of E-cadherin and α-SMA were measured by Western blotting. One set of siRNA oligos specific for CIP4 and CIP4 construction of the entire coding sequence were designed based on the full CIP4 sequence in GenBank. Then HK-2 cells were transfected with CIP4-siRNA or pcDNA3.1-hCIP4 via lipofactamine 2000. The protein expressions of CIP4, E-cadherin and α-SMA were evaluated respectively in control cells, TGF-β1 treated cells, siRNA transfected cells, pcDNA3.1-hCIP4-transfected cells by Western blotting. The distribution of E-cadherin and α-SMA was observed by confocal microscope. After TGF-β1-treated HK-2 cells were interferenced with specific inhibitor of PI3K-Akt (wortmannin) 1μmol/L for 48 hours, Western blotting was used to detect the CIP4 protein in control cells and interferenced cells. Results With TGF-β1 stimulation, the expression of E-cadherin protein was decreased markedly (P＜0.05), and in contract, the expression of α-SMA were increased notably (P＜0.05), which revealed that TGF-β1 could induce EMT. After transfected with CIP4-siRNA, the protein expression of E-cadherin was increased (P＜0.05), and the protein expression of α-SMA was decreased (P＜0.05). The EMT induced by TGF-β1 was effectively reversed. After transfected with pcDNA3.1-hCIP4, the expression of E-cadherin protein was down-regnlated (P＜0.05), and the expression of α-SMA protein was up-regulated compared with control group (P＜0.05), leading to EMT. After HK-2 cells were interferenced with wortmannin for 48 hours, the expression of CIP4 was decreased (P＜0.05). Conclusion TGF-β1 upregulates the expression of CIP4 via PI3K-Akt pathway, and CIP4 may participate in EMT induced by TGF-β1.

Objective: To evaluate the effect of lifestyle intervention among high risk group of chronic diseases in Shenzhen Futian district. Methods: 12 out of 115 communities were randomly selected in Futian district of Shenzhen city from October to November, 2013, and 1 923 cases were screened by multiple ways as high risk groups of chronic diseases. High risk groups of chronic diseases were divided into intervention group (1 338 cases, from five residential communities and three villages within city) and control group (585 cases, from four residential communities). The intervention group received group based health education activities as well as lifestyle intervention. The intervention group was provided with health management which was mainly lifestyle intervention. No intervention was implemented in the control group. All participants were followed up over two years. 1 563 participants (1 002 in intervention group and 561 in control group) were followed up from October to November, 2015. The changes of lifestyle related outcome indicators were analyzed to examine the effect of intervention. Results: In the intervention group, 21.8% (219 persons) in high risk groups of chronic diseases became healthy individuals and 15.2% (152 persons) became patients with chronic diseases. In the control group, 9.6% (54 persons) in high risk groups of chronic diseases became healthy individuals and 20.5% (115 persons) became patients with chronic diseases. The outcome of the intervention group was better than that of the control group and the difference was statistically significant (χ²=-5.67, P<0.001). The proportion of people who knew how to correctly use of oil control pot in the intervention group increased from 61.00% (61/100) to 80.00% (280/350). The proportion of people who took oil control measures in the intervention group increased from 36.43% (365/1 002) to 56.99%(571/1 002). The changes in the intervention group were statistically different (P<0.001), but there was no statistical difference in the control group over the years (P>0.05). The proportion of people who knew how to correctly use of the salt restriction spoon increased from 81.95% (109/133) to 97.99% (342/349). The proportion of people who took salt control measures increased from 45.61% (457/1 002) to 62.67% (628/1 002) in the intervention group. The changes in the intervention group were statistically different (P<0.001). There was no statistical difference in the control group over the years (P>0.05). Conclusion The proportion of people who adopted healthy lifestyles has increased after 2 years intervention and the lifestyle intervention demonstrated good effect.

Objective To improve the rational use of angiotensin-converting enzyme inhibitors (ACEI).Methods Clinical pharmacists reviewed ACEI use for the patients admitted into coronary heart disease care unit (CCU) during May 2012 to May 2013 to analyze the rational use of ACEI according to the expert consensus standards, guidelines and drug instructions of ACEI without any interventions.Clinical pharmacists intervened the irrational use of ACEI based on the same standard from June 2013 to May 2015.Results By comparing the data before and after intervention, it was found that the percentage of ACEI use increased from 80.1％ to 98.9％.The percentage of initial ACEI overdose was dropped from 21.4％ to 0.9％, and the percentage of under dose was decreased from 4.7％ to 0.5％, which was statistically significant.Conclusion Clinical pharmacists can play a leading role in promoting the rational use of ACEI.

In recent years, chimeric antigen receptor-modified T-cell (CAR-T) immunotherapy, as a new idea of tumor immunotherapy, has been proved to be effective in hematological diseases. More and more studies have been focusing on this field. At present, some progress have been made in the treatment of hepatocellular carcinoma with CAR-T, but some problems such as solid tumor inherent barrier, tumor microenvironment, immune escape and specific tumor associated antigens still need to be further figure out. Nevertheless, CAR-T immunotherapy will provide a more cutting-edge treatment for hepatocellular carcinoma immunotherapy. In addition, the combination of CAR-T and other methods may also be the direction to be explored in the next step.

Objective:To study the occurrence and disappearance of gallbladder polyps in patients who underwent multiple ultrasonographic examinations, and to determine the risk factors of formation of gallbladder polyps.Methods:From January 2014 to December 2017, relevant data on patients who underwent follow-up abdominal ultrasound examinations at the Health Screening Center of Xuanwu Hospital was retrospectively analyzed, and the dynamic changes of gallbladder polyps were assessed. A comparative analysis was then conducted between those who had gallbladder polyps (the gallbladder polyps group, n=1 149) and those who had no gallbladder polyps (the control group, n=18 243). The occurrence, changes and disappearance of gallbladder polyps shown on multiple untrasonographic examinations were compared. Results:The patterns of changes of gallbladder polyps showed that the proportions of patients with gallbladder polyps which were stable in size ( n=1 149, 52.1%) were greater than those who had new appearance of gallbladder polyps ( n=797, 36.2%), and these 2 groups of patients were having higher proportions than those who had disappearance of gallbladder polyps ( n=258, 11.7%). The largest proportion of gallbladder polyps were found in middle-aged people, and new polyps were mainly found in the age group of 30.0-59.0 years. The peak of gallbladder polyps incidence was after age 60. There were significant differences in age, male, blood glucose, total cholesterol, low density lipoprotein (LDL), and diastolic blood pressure between the study and the control groups (all P<0.05). Multivariate analysis showed that age ( OR=1.152), male ( OR=1.407) and LDL ( OR=1.656) were independent risk factors of gallbladder polyp formation. Conclusions:The annual incidence of gallbladder polyps was 9.7‰. Gallbladder polyps were more commonly found in middle age, and the incidence of gallbladder polyps was increasing. Gallbladder polyps could disappear. However, with increase in initial diameter of gallbladder polyps, the probability of disappearance decreased. Age, male gender and elevated LDL were independent risk factors of gallbladder polyps formation.