Objective The purpose of this study was to investigate the efficacy and safety of bortezomib +doxorubicin + dexamethasone (PAD) regimen in the treatment of patients with multiple myeloma (MM) . Methods Thirty-eight patients with MM in our hospital were selected and randomly divided into observation group and control group with 19 cases in each. The observation group was treated with PAD regimen and the control group was treated with VAD regimen (vincristine+doxorubicin+dexamethasone) . Clinical efficacy and adverse reaction were compared between the two groups. Results The effective rate and total effective rate of the observation group were 52.63%and 78.95%respectively, which were significantly higher than those of the control group ( <0.05 and <0.05) . There was no statistical difference in the incidence of adverse events between the two groups ( >0.05) . Conclusion PAD regimen could improve the clinical effect of treating patients with MM, and the adverse reactions can be tolerated. It is safe and worthy of clinical application.

Objective To investigate the FH/Wjd rat model of alcoholic liver disease.Methods Thirty-six 16-18 week old SPF grade FH/Wjd rats (male:female=1:1) were used in this study.The rats were divided into two groups randomly by body weight:water intake group and alcohol intake group.The rats took water or alcohol freely.16 weeks lat-er, ALT, AST, TBIL, TG, CHO in the serum and TG, GSH in the liver homogenate were detected.The expression of PPARαprotein in the liver tissue was detected by Western blot.The apoptosis rate of liver cells was assessed by flow cy-tometry.The pathological changes of liver tissue were examined using HE staining.Results Compared with the water in-take group, the serum TBIL and TG were significantly increased in rats of both sexes of the alcohol intake group, moreover, ALT and CHO of the female rats in the alcohol intake group were significantly decreased.TG in the liver homogenate in-creased obviously, while GSH in the liver homogenate showed a decreasing tendency.Hepatocyte apoptosis in rats of both sexes in the alcohol intake group showed an increasing tendency.The PPARαprotein expression was up-regulated obvious-ly, and the main pathological change in the liver tissue was microvesicular fatty degeneration.Conclusion Spontaneous long-term alcohol intake can induce liver injuries in FH/Wjd rats.

Objective:To investigate the Foxp3 expression in murine model of type 1 diabetes mellitus and the effects of Foxp3 in the pathogenic mechanism of type 1 diabetes mellitus.Methods:Type 1 diabetes mellitus of mouse was induced by STZ.The Foxp3 expression in the spleen cells was detected at the mRNA level by RT-PCR and at protein level by Western blot.The percentage of CD4+CD25+ Treg cells in the spleens were detected by Flow cytometry.Results:The expressing levels of Foxp3 mRNA and scurfin in the model group was higher than those of control group within the first week after induction,but the expressing level of Foxp3 mRNA and Scurfin began to decrease on day 7 and were lower than those of control group on day 30.The percentage of CD4+CD25+ Treg cells in model group was similar with that of control group within the first week after induction,but after day 7,the percentage of CD4+CD25+ Treg cells in model group began to get lower than contol group.Conclusion:The expressing level of Foxp3 is decreased,then the proportion of CD4+CD25+ Treg cells is decreased accordingly,which may contribute to the pathogenic mechanism in type 1 diabetes mellitus.

OBJECTIVE:To study the time-effect and dose-effect of paeonol on the apoptosis of knee osteoarthritis(OA)artic-ular chondrocyte in rabbits and the mRNA expression of its related protein Bcl-2 and Bax. METHODS:60 big-ear rabbits were ran-domly divided into normal (normal saline) group,model (normal saline) group,paeonol high-dose,medium-dose and low-dose groups and triamcinolone acetonide(positive drug)group,with 10 rabbits in each group. Except for normal group,OA model was induced by right knee anterior cruciate ligament (ACLT) and the medial meniscus 1/3 resection in those groups. After modeling, different doses of paeonol(0.8,0.4,0.2 mg/kg),triamcinolone acetonide 0.2 mg/kg were injected into right articular cavity twice a week. 4 weeks and 8 weeks after administration,articular cartilage specimens were collected. Ultrapathological structure changes of articular chondrocytes were observed by electron microscope. Apoptosis of cartilage cell was observed by TUNEL and apoptotic index was calculated. mRNA expression of apoptosis related genes of Bcl-2 and Bax in articular cartilage tissue of rabbits were de-tected by in situ hybridization technique. RESULTS:Compared with normal group,articular chondrocyte of model group showed early and middle stage apoptosis morphology change after 4 and 8 weeks,and apoptosis index increased significantly and the mRNA expression of Bcl-2 and Bax was up-regulated (P<0.01);4 and 8 weeks later after administration,compared with model group,apoptosis index decreased and mRNA expression of Bax was down-regulated in paeonol groups,while mRNA expression of Bcl-2 was up-regulated(P<0.05 or P<0.01). Electron microscopy ultrastructural observation showed articular chondrocyte of pae-onol high-dose and middle-dose groups were in early stage of apoptosis.CONCLUSIONS:Paeonol can slow down articular chondro-cyte degeneration and destroy in OA model rabbits in time and dose dependently. Its mechanism may be associated with expression up-regulation of Bcl-2 and expression down-regulation of Bax.

OBJECTIVE To explore the effect of Lianhuaqingwen capsules ( LHQW ) on junction protein expression in mouse lung tissue of lipopolysaccharide (LPS)-induced acute lung injury ( ALl). METHODS 120 male mice were randomly divided into six groups: normal control, model, model+dexa-methasone 5 mg.kg-1 , model +LHQW 2, 4 and 8 g.kg-1 groups. Dexamethasone and LHQW were administered orally, once daily, for 7 d. 24 h after the last administration, LPS solution was instilled into the tracheas of mice except the normal control group to prepare the mouse model of ALl. 24 h after the establishment of the ALl model, the mice were sacrificed and the pathological changes in the mouse lung tissue were observed by optical microscopy and ultrastructure of alveolar epithelium was observed by transmission electron microscopy. The cell percentage of positive expression of tumor necrosis factor-α(TNF-α) in the peripheral blood T lymphocytes was detected by flow cytometry. The expressions of con-nexin 43 ( Cx43), occludin and zonula occludens protein-1 ( ZO-1) in lung tissues were detected by immunohistochemistry. RESULTS Under the light microscope, the mouse lung of model group showed a large amount of inflammatory cell infiltration and alveolar wall thickening. Compared with model group, inflammatory cell infiltration was reduced in model+dexamethasone, model+LHQW 2,4 and 8 mg.kg-1 groups. Under the electron microscope, the mouse alveolar epithelial cells of model group showed injury. Compared with model group, the damage was reduced in model+dexamethasone, and model+LHQW 2, 4 and 8 mg.kg-1 groups. The cell percentage of TNF-α positive expression in peripheral blood T lympho-cytes in normal control, model, model+dexamethasone, model+LHQW 2,4 and 8 mg.kg-1 groups was (3.6±0.9)%, (6.4±0.8)%, (2.8±0.7)%, (4.7±1.6)%, (4.0±1.5)% and (3.6±1.2)%, respectively. The percentage in model group was obviously higher than that in normal control group( P<0.01), but was lower in the four drug treatment groups than in model group(P<0.05, P<0.01). The expression of Cx43, occludin and ZO-1 in lung tissue of model group was lower than that of normal control group(P<0.01), but higher in model+dexamethasone, model + LHQW 4 and 8 mg.kg-1 groups than in model group(P<0.05). CONCLUSION LHQW may alleviate ALl induced by LPS and play a protective role by inhibiting inflammatory cell infiltration and improving protein connection expression in alveolar epithelial cells and pulmonary vascular endothelial cells.

Aim To investigate the effect of Jinlida on cholesterol-related genes in skeletal muscle in fat-in-duced insulin resistance ApoE-/ - mice. Methods Ten male C57 BL/6 J mice were selected as normal group ( NF );50 male ApoE-/ - mice with a high-fat feeding after 16 weeks ( HF) were divided into model group, rosiglitazone ( LGLT ) , Jinlida low dose group ( JLDL, 0. 95 g · kg-1 · d-1 ) , Jinlida medium dose group ( JLDM, 1. 9 g·kg-1 ·d-1 ) , Jinlida high dose group (JLDH, 3. 8 g·kg-1·d-1), which were per-formed intragastric administration for 8 weeks. Oil red O staining of mouse skeletal muscle was used for fat ac-cumulation. Insulin receptor ( INSR) , insulin receptor body substrate-1 ( IRS-1 ) , low-density lipoprotein re-ceptor ( LDLR ) , cholesterol sensor ( SCAP ) mRNA and protein expression in mouse skeletal muscle were measured by quantitative reverse transcription PCR ( RT-PCR ) and Western blot. Results Compared with NF group, fasting blood glucose ( FBG) , choles-terol ( TC ) , triglyceride ( TG ) and low density lipo-protein cholesterol ( LDL-C ) of HF mice were signifi-cantly elevated, while high-density lipoprotein ( HDL-C ) significantly decreased ( P < 0. 05 ) . Compared with HF group, Jinlida group could reduce to varying degrees FBG, TC, TG and LDL-C in mice, and in-crease HDL-C ( P <0. 05 ) . Jinlida could downgrade fasting serum insulin ( FINS ) level, and improve the insulin sensitive index ( ISI ) ( P < 0. 05 ) . Jinlida could obviously improve skeletal muscle fat accumula-tion of mice. Compared with NF group, skeletal mus-cle INSR, IRS-1, LDLR mRNA and protein levels of HF group were significantly decreased ( P <0. 05 ) , while SCAP mRNA and protein level increased signifi-cantly (P<0. 05). Compared with HF group, Jinlida could increase to varying degrees INSR, IRS-1, LDLR mRNA and protein levels ( P < 0. 05 ) , and lower SCAP mRNA and protein levels ( P<0. 05 ) . Conclu-sion Jinlida can alleviate fat-induced insulin resist-ance in ApoE-/ - mice through regulation of cholester-ol-related gene expression.

Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P < 0.01 or 0.05). In control group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.87 ± 0.45), 0.00 (0.00, 0.25), (2.64 ± 0.27) points before the intervention, 6 months after the intervention were (0.89 ± 0.43), 0.00 (0.00, 0.38), (2.73 ± 0.27) points, there was no significant difference between drug knowledge and medication compliance (t=0.44, Z=1.83, P > 0.05), there were statistically significant differences in self-management behavior (t=6.23, P<0.01);there was no difference between the statistical significance between the 2 groups before intervention (t=1.02, Z=1.46, t=1.32, P > 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P<0.01). Patients in the experimental group with the systolic and diastolic blood pressure were (147.11 ± 14.31), (90.16 ± 13.02) mmHg (1 mmHg=0.133 kPa) respectively, before the intervention; 6 months after the intervention were (139.39 ± 17.05), (83.76 ± 12.52) mmHg respectively, the difference was statistically significant (t=3.59, 2.92, P<0.01). The control group before intervention were (149.56 ± 18.11), (93.56 ± 15.09) mmHg respectively, 6 months after the intervention were (145.14±20.50), (88.14±10.88) mmHg respectively, the difference was statistically significant (t=2.02, 2.72, P<0.05 or 0.01);there was no significant difference between the two groups before intervention (t=1.09, 1.82, P>0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.

Objective To analyze the correlative differences in the cardiac surgery for patients with end-stage renal disease (ESRD) and non-nephropathy disease, and explore the cardiac perioperative nursing for patients with ESRD. Methods A single-center retrospective comparative analysis was conducted in patients with ESRD (ESRD group, 26 cases) and non-nephropathy disease (control group, 26 cases) treated with cardiac surgery from January 2004 to December 2016 in Peking University First Hospital. Postoperative laboratory indexes, the changes of indexes in the monitoring room and the blood transfusion were compared between two groups. Results At 0, 1 and 2 d after the surgery, hemoglobin levels of patients in ESRD group were significantly lower than those in the control group; creatinine and urea nitrogen levels in ESRD group were significantly higher than those in the control group (P< 0.01). Postoperative serum potassium levels in ESRD group were significantly higher than those in the control group (P<0.01). The amount of erythrocyte and platelet transfusion in ESRD group were higher than those of control group (P<0.01). There was no statistically significant difference between the ESRD group and the control group in the ventilator time, 24-hour pleural drainage and total thoracic drainage (P> 0.05). The duration of stay in ICU and postoperative hospital stay were (101.62±49.10) h and (28.23±20.44) d in the ESRD group, which were significantly longer than those in the control group [(71.35±33.10) h, (16.58±8.43) d]. Conclusions ESRD patients have a higher risk in the cardiac surgery when compared with patients with non-nephropathy disease. Therefore, nurses should pay attention to the perioperative electrolyte balance and infusion of blood products, as well as the prevention of postoperative complications and psychological nursing, to help patients with better prognosis.

Objective To prepare rat models of liver stagnation syndrome constipation-type irritable bowel syndrome(IBS-C)using single and multi-factor modeling method with different indicators,to provide ideal experimental animal models of IBS-C.Methods Forty-two SD rats were divided randomly into blank(Normal),cold-water gavage(Cold),restraint(Restrain),tail-clamping(Tail),cold-water gavage + restraint(C + R),and cold-water gavage + tail-clamping groups(C + T).Body weight,food intake,water intake,and survival status,as well as open-field behavior,fecal Bristol score,visceral sensitivity,and small intestine propulsion were observed in each group during the modeling period.Pathological changes in the rat colon were observed by hematoxylin and eosin staining,and the serum and colon contents of 5-hydroxytryptamine(5-HT)and vasoactive intestinal peptide(VIP)were determined by enzyme-linked immunosorbent assay.Results The body weight in each group decreased after modeling(P<0.05,P<0.01),the food and water intakes decreased,and serum 5-HT levels increased.The number of fecal particles and Bristol score decreased while the colon 5-HT content increased in the Cold group(P<0.05,P<0.01);the total distance and average speed of the restraint group in the open field decreased(P<0.01);the preference for sugar water in the Tail group decreased(P<0.01);the preference for sugar water,total open-field distance,small intestine propulsion rate,defecation particles,and Bristol score all decreased,while the colon 5-HT content increased and the VIP content decreased in the C + T group(P<0.05,P<0.01);and the total distance,average speed,and VIP content in the colon decreased in the C + R group(P<0.05).Except for the Tail group,all the model groups showed visceral hypersensitivity(P<0.05,P<0.01)compared to the blank group at various pressure values on days 7 and 14 of modeling.Pathological observations showed no significant inflammatory cell infiltration or pathological changes in any of the model groups.Conclusions The combination of ice-water gastric lavage and tail clamping can be used to establish a rat model of liver depression syndrome in IBS-C.This may be the best of the five tested method,and the resulting model may lay the foundation for further systematic and in-depth research into the mechanism of traditional Chinese medicine in preventing and treating IBS-C.

OBJECTIVE:To study the effect of Xuchangqing-ermiaosan-santeng formula on the contents of tumor necrosis fac-tor α(TNF-α)and ossification-related factor DKK-1 in serum of model mice with arthritis,and reveal its mechanism in the treat-ment of arthritis. METHODS:60 BALB/c mice were randomly divided into normal group,model group,sulfasalazine group(posi-tive control,9 mg/kg) and Xuchangqing-ermiaosan-santeng formula low-dose,medium-dose,high-dose groups (calculated by crude drug as 11.25,22.5,45 g/kg),10 in each group. Except for normal group,other 50 mice were intraperitoneallly injected complete Freund's adjuvant + proteoglycans to induce model with arthritis. After modeling,mice in each administration group were intragastrically administrated relevant medicines,mice in normal group and model group were intragastrically administrated equal volume of normal saline,once a day,for 20 d. After administration,enzyme-linked immunosorbent assay was used to detect the contents of TNF-αand DKK-1 in serum of mice in each group,and ultrastructural changes of sacroiliac joint synovial cells were ob-served by transmission electron microscopy. RESULTS:Compared with normal group,TNF-α content in serum in model group was obviously increased,DKK-1 content was obviously decreased (P<0.05);sacroiliac joint synovial cells showed hyperplasia, organellar deformation,mitochondrial swelling and other pathologic damage. Compared with model group,TNF-α contents in se-rum in each administration group were obviously decreased(P<0.05 or P<0.01);except for sulfasalazine group,the DKK-1 con-tent of mice in other administration groups were obviously increased (P<0.05). Pathologic damages of sacroiliac joint synovial cells in each administration group were reduced to varying degrees,and improvement degree in Xuchangqing-ermiaosan-santeng for-mula groups was higher than sulfasalazine group. CONCLUSIONS:Xuchangqing-ermiaosan-santeng formula may inhibit the sacroil-iac arthritis and pathological ossification of model mice with arthritis by decreasing TNF-α content and increasing DKK-1 content in serum.