Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta?minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic?contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had hyperpigmentation, 75 hypopigmentation, 93 palmoplantar keratoderma, 27 skin cancer, and 8 multiple skin cancer. Five patients were complicated by tuberculosis, 15 by hypertension, 2 by rheumatoid arthritis, 4 by cerebral infarction, 7 by coronary heart diseases, 3 by internal malignancy, 6 by hepatic cirrhosis and 2 by anemia. Logistic regression analysis revealed a significant correlation between hyperpigmentation and arsenic concentrations in water(OR=0.32, 95%CI=0.10-0.98;ORadjusted=0.27, 95%CI=0.08-0.90), between occurrence of hepatic cirrhosis and arsenic concentrations in water (OR=24.67, 95%CI=2.69-226.57;ORadjusted=22.51, 95%CI=2.38-213.11), and between occurrence of coronary heart diseases and duration of arsenic exposure(OR=6.41, 95%CI=1.09-37.88;ORadjusted=8.55, 95%CI=1.21-60.41). Conclusions There is a high incidence of aberrant pigment metabolism, palmoplantar keratoderma and skin cancer in patients with chronic arsenicosis due to contaminated drinking water. Different arsenic concentrations in water and duration of arsenic exposure seem to have different influences on the human body.

PurposeThe bone flare phenomena has been well described on bone scintigraphy for efficacy monitoring up to now, but our knowledge has been rarely described on MSCT, the phenomena may be erroneously classiifed as disease progression. This article intends to evaluate the existence and CT features of bone flare phenomena of metastatic bone disease in lung cancer patients treated with ibandronate, to raise awareness of this phenomenon.Materials and Methods The clinical and image data of 45 patients with bone metastases of lung cancer were retrospectively analyzed prior to treatment and 3, 6 months after treatment, the change of CT value and CT features 3 months after treatment between bone flare phenomena group, progressive disease group 1 and progressive disease group 2 were compared.Results The incidence of bone flare phenomena was 6.7% (3/45). 3 months after treatment, CT value of the bone flare phenomena group and progressive disease group 1 changed when compared with before treatment, the differences were statistically signiifcant (t=-5.787 and-2.788,P<0.05) and there was no statistically signiifcant difference (t=1.691,P>0.05) of CT value in the progressive disease group 2 after 3 months' treatment. After 3 months' treatment, the bone flare phenomena group mostly appeared as osteogenic sclerosis of osteolytic lesions, while the cases of progressive disease group mostly appeared as new periosteal reaction of the lesion, or osteogenic/mixed lesion combined with osteolytic damages, the difference between the two groups was statistically signiifcant (χ2=10.139, 8.041 and 4.154,P<0.01,P<0.05). There was no statistically signiifcant difference in increase of density in osteosclerotic lesions (χ2=0.059, P>0.05).Conclusion In patients treated with ibandronate, when there is therapeutic effect evaluation standard of bone metastases (disease progression) and clinical comprehensive curative effect evaluation standard (effective) discordance at 3 months after treatment, it can be interpreted as bone flare phenomena, and the change of CT features contributes to the differential diagnosis of bone flare phenomena with progressive disease.

Objective To investigate the effects of subchronic arsenic exposure on caspase-3 expression in Leydig cells and serum testosterone level in rats. Methods Forty SD rats were divided into four groups based on body mass (160-220 g) by random number table, 10 in each group and treated with As2O3 through drinking water at the doses of 0.0 (distilled water), 2.0, 12.0 and 60.0 mg/L for 14 weeks. Blood sample from heart was collected, serum testosterone was measured by enzyme linked immunosorbent assay (ELISA); the testicular tissue of rats was taken, the expression of caspase-3 was assayed by immunohistochemical staining, and its average gray value was analyzed with image analysis software (Biomias). Results There were statistically significant differences of the serum testosterone levels between groups (F= 37.99, all P< 0.05). Compared with the control group [(3.082 3 ± 0.653 0) ng/L], serum testosterone levels in middle-dose and high-dose groups [(1.694 6 ± 0.255 4), (1.350 5 ± 0.281 9)ng/L] were significantly lower (all P< 0.05). The numbers of positive cells of caspase-3 were 8.10 ± 1.91, 9.80 ± 2.15,10.00 ± 1.83 and 10.90 ± 2.38 in each vision in the 4 groups, there were statistically significant differences between groups (F=3.17, all P<0.05), compared with the control group , the middle-dose and high-dose groups were significantly higher (all P<0.05);the average gray values of caspase-3 were 135.10 ± 6.89, 130.00 ± 3.30, 117.10 ± 4.28, and 113.10 ± 5.38, there were statistically significant differences between groups (F = 41.09, P < 0.05), compared with the control group, the middle-and high-dose groups were decreased (all P<0.05). Conclusions One possible mechanism of As2O3 on male germ cell toxicity may be through up-regulation of the expression of caspase-3 in Leydig cells of SD rats and initiating the pathway of the apoptosis signal, which can lead to increased apoptosis of Leydig cells, decreased concentrations of testosterone, and damaged reproductive function in rats.

Objective To evaluate the effects of chronic arsenic poisoning on serum inhibin-B (INH-B) and testosterone of male rats.Methods Forty Sprague-Dawley rats in cleanliness grad were randomly divided into four groups according to body weight:high-dose,middle-dose,low-dose arsenic exposure groups and control group,10 animals in each group.Rats in high-dose,middle-dose,and low-dose groups were administered with arsenic in concentrations of 10.0,5.0,2.5,0.0 mg/kg in distilled water,respectively.Rats in control group were fed with distilled water freely.After 9 months,serum INH-B and testosterone were tested using an ELISA Kit.Results Serum INH-B and testosterone levels in the above mentioned four groups,respectively,were (66.31 ± 37.21),(75.13 ± 29.88),(119.02 ± 36.10),(133.04 ± 38.67)ng/L and (1.292 ± 0.715),(1.757 ± 0.649),(2.359 ± 0.675),(2.817 ± 0.890)μg/L,and the differences between different groups were statistically significant (F=84.88,8.214,all P ＜ 0.05).Serum INH-B and testosterone levels in high-dose and middle-dose groups were significantly lower than that of control group(all P＜ 0.05),whereas no significant difference was found between low-dose group and control group (all P ＞ 0.05).Conclusion Chronic arsenic poisoning has led to decreased concentration of serum INH-B and testosterone in male rats.

Objective To investigate the effects of sub-chronic arsenic poisoning on hyaluronidase activity of rat sperm.Methods Forty Sprague-Dawley (SD) rats in cleanliness grade,weighing 100-200 g,were randomly divided into four groups:control group,low-dose,middle-dose and high-dose arsenic exposure groups,10 in each group,and allotted to cages.Rats of arsenic groups were exposed to arsenic through drinking water (As2O3 was dissolved in distilled water).The concentrations of As2O3 in low-dose,middle-dose and high-dose groups were 25,50,and 100 mg/L,respectively.Body weight of each rat was weighed once a week.The rats in control group drank distilled water freely.All rats were fed for three months.After the experiment,all rats were killed and their sperms were collected.The positive rates and hyaluronidase activity intensities of the sperms in different groups were examined by the mature improved fixed-substrate film method.Results The positive rate of sperm hyaluronidase in control,low-dose,middle-dose and high-dose groups were (90.8 ± 13.2)％,(79.1 ± 15.6)％,(59.7 ± 20.3)％ and (33.8 ± 14.5)％,respectively.Compared with the control group,the positive rates of the middledose and the high-dose groups were significantly reduced(all P ＜ 0.05).The activity intensities of hyaluronidase in the sperms in control,low-dose,middle-dose and high-dose groups were (45.1 ± 24.0),(31.1 ± 21.3),(19.4 ± 15.3) and (9.8 ± 3.1)μm,respectively.Compared with the control group,the activity intensities of hyaluronidase of the middle-dose and the high-dose groups were significantly reduced(all P ＜ 0.05).Conclusion Sub-chronic arsenic poisoning reduces the activity intensities and positive rates of sperm hyaluronidase of rat,resulting in reduced sperm fertilizing capacity.

AIM: To provide the applied ground of the formulation of Rhizoma Phragmitis by setting up a fingerprint of Rhizoma Phragmitis. METHODS:We gained the extracts of Rhizoma phrapmitis by acetone extraction and assayed its extracts by means of HPLC, with a mobile phase of water (1% acetic acid)-water(5% acetonitrile) on inertsil ODS-3 column. an ultraviolet detector was at 250 nm. RESULTS:Fingerprint was established on the basis of the relative retention value and the relative peak area. CONCLUSION: The method is of high sensitivity and good reproducibility.

Objective To find out a reference range of epidermal nerve fiber density in normal humans and compare the concordance between clinical features, electrophysiology and the results of skin biopsy. Methods Fifty-one patients with peripheral neuropathy and 10 normal controls were studied. Skin biopsies were obtained from distal leg and/or proximal leg and nerves identified using immunohistochemistry with antibody against protein gene product (PGP) 9. 5. Forty-one in 51 performed routine nerve conduction vdocity and electromyography, 21 in 51 performed sympathetic skin response(SSR). The concordance of the consequences was compared. Results Intraepidermal nerve fiber density (IENFD) was (21.4 + 2. 7) /mm in thigh and (15.4±2. 2) /mm in the distal part of the leg in normal controls. IENFD was (15.0± 6. 3)/mm and (8. 1±5.9) /mm in patients. The intraepidermal nerve fiber density was significantly lower in the patients than in the normal controls both in proximal (t = 2. 976, P = 0.004) and distal legs (t= 3.191, P=0.002). Forty-eight out of 51 patients showed abnormalities in skin biopsy, among which 33 patients had length-dependent neuropathy. In the group of abnormal skin biopsy, 41 received routine electrophysiology, among which 21 (51.2%) were abnormal and they were performed SSR, turning out that 17 (81.0%) were abnormal. In 29 patients who had only small fiber neuropathy, 27(93. 1%) showed abnormalities in skin biopsy, out of whom 20 were performed routine electromyography, and it identified that 6 (30. 0%) were abnormaL In 14 receiving SSR, 11 were abnormal. Conclusion Skin biopsy is safe and tolerable, which has a higher sensitivity especially in small fiber neuropathy.

Objective To investigate the value of the immunohistochemistry and Western blot in the diagnosis of the benign muscular dystrophy with abnormal dystrophin expression.Methods The medical histories and clinical manifestations of 4 patients were collected.In addition to routine histological and histochemical studies,expression of dystrophin in muscle fibets was observed by immunohistochemical reaction(dys-N,dys-R and dys-C)and Western blot to anti-dystrophin antibody.Results Two patients had muscular weakness while another 2 patients had only muscular pain and elevated creatine kinase blood levels without muscular weakness.Histochemical stains showed atrophy,hypertrophy and fiber splitting in 2 patients,while only variation in fiber size was presented in anothor 2 patients.One patient had no reaction for dys-N,but had immunostains for dys-C and dys-R in the sarcolemma of muscle fibers.Western blot confirmed that the band of dys-C and dys-R was partly deficient,and the band of dys-N was absent compared with control.Three patients had no reaction for dys-R,but had immunostains for dys-C and dys-N.Compared with control,Western blot confirmed that the band of dys-R was absent,and the band of dys-C and dys-N were truncated.Conclusion The immunohistochemistry is stained with three anti-dystrophin antibodies to avoid diagnostic errors.Western blot is essential to further determine the type of dystrophin protein.

ObjectiveTo investigate the regulatory effects of traditional Chinese medicine (TCM) Shufengxuanfeijiedu formula on Janus kinase signal transducer and activators of transcription (JAK-STAT) of lung tissues in mice with influenza viral pneumonia.Methods According to random number table, 60 mice were randomly divided into six groups with 10 mice in each group: normal group (N), model group (M), Tamiflu control group (C) and low (SL), medium (SM), high dose (SH) Shufengxuanfeijiedu formula groups. The mouse model of influenza virus pneumonia was reproduced by dropping of 0.05 mL 4LD50 inflluenza virus FM1 strain which can be adapted to lung tissue into the nose; while the N received nose instillation of 0.05 mL normal saline. After successful modeling for 2 hours, distilled water was given orally (by lavage) to N and M; Duffy (oseltamivir) 2.5 g·mL-1·d-1 was administrated to C; the TCM SL, SM, SH were intragastrically administered with different doses of shufengxuanfeijiedu decoction into the corresponding groups respectively (the ingredients of prescription: chrysanthemum, mulberry leaf, almond, platycodon root, forsythia, bupleurum etc. forming granules), according to the suitable dose of granules used for human body surface, the dose used for mouse surface area was calculated, the high dose means the dose used in the medium dose group doubled, the low dose means 1/2 dose used in medium group, once a day, once 0.2 mL for consecutive 4 days. Afterwards, the lung tissues were collected, the mouse differential gene expressions related to JAK-STAT pathway were detected by gene chip technology, the standards for screening of differential gene expression were as follows: up-regulated gene was P < 0.05, and the log2ratio > 1; down-regulation gene wasP < 0.05, and log2ratio < -1. The levels in lung tissue kinase (JAK) andγinterferon (IFN-γ) mRNA expressions were determined by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-qPCR).Results Compared with those in N, the differential expression gene transcription activator, STAT5 [log2 (N/M) = 2.32], interleukin 4 receptor alpha subunit [IL4RA, log2 (N/M) = 4.77], interleukin 12 receptor [IL12R, log2 (N/M) = 1.58], JAK [log2 (N/M) = 2.41] were all obviously up-regulated, and IFN was significantly down-regulated [log2 (N/M) = -1.45] in M. Compared with those in M, C group IFN [log2 (C/M) = 1.51], various TCM dose groups [log2 (SL/M) = 1.46, log2 (SM/M) = 1.72, log2 (SH/M) = 1.40] differential expression gene IFN was significantly up-regulated, STAT5 [log2 (C/M) = -2.06, log2 (SL/M) = -1.41, log2 (SM/M) = -2.10, log2 (SH/M) = -1.89], IL4RA [log2 (C/M) = -2.52, log2 (SL/M) = -1.85, log2 (SM/M) = -2.74, log2 (SH/M) = -1.39), IL12R [log2 (C/M) = -1.48, log2 (SL/M) = -0.10, log2 (SM/M) = -1.58, log2 (SH/M) = -0.53], JAK [log2 (C/M) = -1.44, log2 (SL/M) = -0.88, log2 (SM/M) = -1.74, log2 (SH/M) = -0.53] were significantly down-regulated. In M, the JAK mRNA expression was obviously elevated (2-ΔΔCt: 3.17±0.94 vs. 1.01±0.13,P < 0.05), while the IFN-γ mRNA expression was decreased (2-ΔΔCt: 0.15±0.48 vs. 1.01±0.12,P < 0.05); compared with M, the JAK mRNA expressions in C, SM and SH groups were all obviously decreased (2-ΔΔCt: 2.02±0.63, 1.19±0.30, 1.59±0.67 vs. 3.17±0.94, allP < 0.05); while the IFN-γmRNA expressions in C, SL, SM and SH groups were elevated (2-ΔΔCt: 0.61±0.12, 0.41±0.13, 0.85±0.14, 0.78±0.20 vs. 0.15±0.48, allP < 0.05).Conclusions Shufengxuanfeijiedu formula can ameliorate the mice immune pathological injury of lung tissues induced by influenza virus by regulating JAK-STAT signal pathway and balancing Th1/2 via up-regulating the expression of IFN-γ.

Purpose: This study was aimed to evaluate the clinical significance and prognostic value of CRP/albumin ratio (CAR) in patients with gastric cancer. Methods: The data of 205 gastric cancer patients who underwent surgery was analyzed retrospectively. The association of CAR with the clinical features and prognostic value in gastric cancer was analyzed. The data of this study was combined with previous studies to further determine the prognostic value of CAR in patients with gastric cancer using a metaanalysis method. Results: Cox analysis revealed that preoperative CAR was an independent prognosis indicator in patients with gastric cancer. High expression of CAR indicated a shorter survival time than in those with lower expression. CAR has a higher prognostic value in the 1-, 3-, and 5-year overall survival in patients with gastric cancer. CAR showed significant difference regarding the gastric cancer patients’ age, M stage, and clinical stage. The discriminate value of CAR in M stage of gastric cancer was high (area under the curve, 0.809). A meta-analysis combining previous data and our data showed that preoperative CAR demonstrated a significant association with the overall survival of patients with gastric cancer. Conclusion This study demonstrated that preoperative CAR could serve as an important prognostic indicator in patients with gastric cancer.