Objective To evaluate the efficacy of nuvastatin on the high level of serum lipoprotein(a) [Lp(a)] and itsclinical significance in patients with type 2 diabetic nephropathy. Methods In this study, 104 patients with microalbu-winuric type 2 diebetic h?phropathy) were divided into two groups randomly: the flu vastatin. group (zomg per day P.O. )and the control group. The efficacy at 6 weeks' beatment was evaluated. The serum Lp(a) concentration and the activityof tissue-type plasminogen activator(tPA ) and plasminogen activator inhibitor(PAI) were measured by enzyme-linkedimmunosorbent assay and chromogenic substances assay respechtively in all of the patients. Results At the beginning. ser-um Lp(a ) level and PAI activity along with a low tPA activity were abnormally high in every patient. In addition, the levelof Ccr was unconventionally high. After 6 weeks,the level of serum Lp(a) and the activity of PAI and tPA were cowectedsignilicanily in the teated group compared with the other group(P

w-3 polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA) , are essential components for the development of human brain. A fish oil product enriched with DHA (51. 65%) was used to conduct a preliminary memory study with rats employing the active avoidance test. Three doses of DHA, 1. 0 g/kg, 200 mg/kg and 40 mg/kg, were administered orally to the rats twice daily for 20 days. The results showed that there was a positive correlation between the effects on memory ability and DHA adiministration, and the effects were dose responsive. The results also showed that DHA, at 200 mg/kg, could antagonize dysmnesia caused by scopolamine and had hypermnesia effect.

AIM To study effects of desulfated and poly sulfated heparin derivatives on rat mast cell (MC) degranulation. METHODS Different methods were used to prepare different sulfated heparin derivatives: 2 O desulfated heparin (2DeSH),N desulfated reacetylated heparin (NDeSAcH),6 O desulfated heparin (6DeSH),poly sulfated heparin (PSH). Passive MC degranulation induced by ovalbumin in rats to was employed observe the effects of different sulfated derivatives on rats MC degranulation. RESULTS All the sample groups were found of obvious inhibition of MC degranulation( P

Objective To investigate the effect of benazepril on intergrin-linked kinase (ILK) and α-smooth muscle actin (α-SMA) expression in glomerular mesangial cells induced by high-glucose.Methods The mesangial cells from SD rat (HBZY-1) were cultured conventionally and randomly divided into four groups:normal glucose (D-glucose 5.5 mmol/L,group NG),mannitol-treated group (mannitol 20 mmol/L,group MG),high glucose (D-glucose 30 mmol/L,group HG),Benazepril-treated high glucose group (D-glucose 30 mmol/L + Benazepril 10 μmol/L,group ACEI).Cells from NG,MG,HG,ACEI gronps were harvested after 3,6,12,24,48 and 72 hours of treatment respectively.The mRNA expressions of ILK and α-SMA were detected by RT-PCR.The protein levels of ILK and α-SMA were detected by Western blotting and immunofluorescence.Results The expressions of ILK mRNA and protein in HG group were significantly increased compared with those in NG group (all P ＜ 0.05).The increased expressions of ILK and α-SMA in HG group were time-dependent and the expression reached the peak at 48 h (ILK,P ＜ 0.05) or 72 h (α-SMA,P ＜ 0.01).The expressions of ILK and α-SMA in ACEI group were lower than those in HG group (all P ＜ 0.01),but failed to rescue to the same level as those in NG.There was no significant differences of ILK expressions between MG group and NG group at the same time point (P ＞ 0.05).The expressions of α-SMA mRNA and protein in MG were higher than that in NG (P ＜ 0.05),which suggest that high osmotic pressure could cause the increasing of α-SMA.Conclusions Benazepril can decrease the expressions of ILK and α-SMA to inhibit the process of fibrosis in DN and mediate the phenotypic transformation of glomerular mesangial cells.The phenotypic transformation of glomerular mesangial cells in glucose may also depend on high osmotic pressure in DN.

objective To observe the effects of megsin gene transfection on glomerular mesangial cells(GMCs)and the expression of platelet-derived growth factor-BB(PDGF-BB),phosphorylated extracellular signal-regulated protein kinase(pERK1/2),transforming growth factor β1 (TGF-β1)and type Ⅳ collagen under high concentration of glucose,and to investigate the impact of megsin gene transfection on the extracellular signal-regulated protein kinase (ERK)siginal pathway. Methods Cultured mesangial cells were divided into seven groups:low glucose group (group A,5.5 mmol/L),high glucose group(group B,30 mmol/L),high glucose plus empty vector group (group C), high glucose plus megsin expression plasmid group (group D), high glucose plus megsin expression plasmids plus U0126 group (group E), high glucose plus megsin siRNA expression plasmids group (group F) and low glucose plus mannitol (24.5 mmol/L,group G). The expressions of megsin, PDGF-BB, pERK1/2, TGF-β1, as well as type Ⅳ collagen in GMCs of each group were detected by Western blotting, after being cultured for 12, 24 and 48 hours respectively. The concentration of type Ⅳ collagen in cell supernatant was measured by radioimmunochemistry. Results Compared with group A, the expression of megsin was increased in GMCs under high glucose medium, with an increase of PDGF-BB, pERK1/2, TGF-β1 in GMCs and type Ⅳ collagen in the supernatants (P＜0.05, respectively). The expression of above indices was in time-dependant manner. The over expression of megsin in exposure to high up-regulated the expression of PDGF-BB, pERK1/2, TGF-β1 and type Ⅳ collagen(P＜0.05, respectively). Compared with group D, the application of U0126 (pERK1/2 inhibitor) had no significant effect on the expression of megsin and PDGF-BB(P＞0.05, respectively). However, the expression of pERK 1/2,TGF-β1 and type Ⅳ collagen were obviously decreased (P＜0.05, respectively). Dowa-regulated expression of megsin by siRNA transfection decreased the expression of PDGF-BB, pERK1/2, TGFβ1 and type Ⅳ collagen(all P＜0.05). Conclusions The expression of megsin and PDGF-BB in GMCs with transfected megsin gene in high glucose medium is increased, possibly in a way of activating ERK signal pathway to some extent that boosts both the expression of TGF-β1 and the production of type Ⅳ collagen. The transfection of megsin siRNA inhibits the expression of obove indices, which probably contributes to the development of diabetic nephropathy.

Objective To observe the effects of uric acid (UA) on mitochondrial oxidative damage and apoptosis in renal tubular epithelial cells (HK-2),and investigate the possible mechanism.Methods HK-2 cells were exposed to UA (480 μmol/L,720 μmol/L) for different time (0 h,24 h,48 h)in vitro.The mitochondrial ROS production was detected by MitoSOX staining.The mitochondrial membrane potential was measured by JC-1 staining.The expressions of prohibitin and AIF were examined by Western blotting and irnmunofluorescence cytochemistry.The cell apoptosis was measured by Annexin V-FITC/PI staining.Results The mitochondrial ROS production in HK-2 cells exposed to 480 μ mol/L UA was increased than that of control group at 24 h (P ＜ 0.05),and increased gradually with UA concentration and incubation time increasing,while the mitochondrial membrane potential was reduced at the same time.There were no significant changes in AIF expression and apoptosis rate of HK -2 cells exposed to 480 μmol/L UA for 24 h compared with that of control group (P ＞ 0.05),while both of them were up-regulated when HK-2 cells were exposed to 480 μmol/L UA for 48 h and 720 μmol/L JA for 24 h and 48 h (P ＜ 0.05).The prohibitin expression in HK-2 cells exposed to 480 μmol/L UA was reduced than that of control group at 24 h (P ＜ 0.05),and down-regulated gradually with UA concentration and incubation time increasing.Conclusion Uric acid can induce the mitochondrial ROS production increased,the mitochondrial membrane potential reduced,the prohibitin expression down-regulated and the mitochondrial apoptosis pathway activated in HK-2 cells.

Resident standardization training is an essential way in cultivating medical professionals. It is important for subject development and talent reserve. For cultivating high-quality resident physicians with comprehensive theory, independent clinical thinking, great practical ability, and innovative scientific idea, it recourses to both optimizing training scheme and evaluation system with highly specialization and comprehensive quality. In this study, the authors proposed incorporate training patterns includingoptimiz-ing design, innovating training, and standardized assessment based on their recent experience on resident standardization training.

Objective:To compare the prediction efficiency of traditional linear regression model and four machine learning models on the learning behavior of clinical medical postgraduates, and to explore the pros and cons and applicability of different prediction models.Methods:A total of 6,922 clinical medical postgraduates were surveyed, their comprehensive learning behavior scores were obtained through the learning behavior scale. In the training set, Lasso linear regression and artificial neural network, decision tree, Bootstrap random forest, and lifting tree were used to build prediction models respectively. The above models were used to predict the validation set data and compare the prediction efficiency.Results:The comprehensive learning behavior score of clinical medical postgraduates was (3.31±0.54) points, and the overall compliance rate was 74.02%. In the linear regression model, the influence of age, school level, degree type, learning interest, pressure and satisfaction on learning behavior were statistically significant. In the prediction of validation set, the sensitivity, specificity, and accuracy of the linear regression model were 0.484, 0.914, and 0.801, respectively. The indexes of the four machine learning models were higher than those of the traditional linear regression model, and the Bootstrap random forest had the highest elevation.Conclusion:The linear regression model has a good prediction effect on learning behavior, and machine learning is superior to linear regression model in terms of accuracy of prediction. However, traditional linear regression models are superior to machine learning models in computational efficiency and interpretability.

Objective· To evaluate the safety of neoadjuvant therapy which was constituted by docetaxel based systemic chemotherapy and maximal androgen blockage for patients with locally advanced prostate cancer and to summarize the related adverse events and clinical managements.Methods· From June 2015 to February 2017,the clinical data of 55 patients undergoing neoadjuvant chemotherapy combined with complete androgen deprivation were retrospectively reviewed.The patients were given docetaxel and prednisone as DP regimen every 3 weeks and LHRH analogues with bicalutamide as maximal androgen deprivation for a total of 4 cycles.All treatment-related adverse events were observed and then recorded.Results· Two cases with liver function impairment after 2 cycles of treatment were withdrawn from the study.No severe allergic reactions occurred during neoadjuvant therapy.The most common adverse events were hematologic toxicity,while 23.6％ of patients had grade Ⅲ-Ⅳ neutropenia,and about 12.7％ had anemia.Due to a relatively short course of treatment,the skin or mucous damage,peripheral neurotoxicity and fluid retention were rare.However,hot flash,male breast development as well as erectile dysfunction were very frequently observed due to maximal androgen deprivation.The majority of these adverse events were relieved by symptomatic and supportive treatment.Conclusion · After strict selection,4 cycles of neoadjuvant chemotherapy combined with total androgen blockade could be well tolerated by the patients with high-risk locally advanced prostate cancer.Even though the adverse events were controllable,they still need to be closely monitored during treatment in order to reduce the incidence.In addition,the very low testosterone level associated endocrinal metabolic disorders caused by complete androgen deprivation were also of great concern.

Objective To investigate the efficacy and safety of docetaxel chemotherapy combined with androgen-deprivation therapy (ADT) for patients with metastatic hormone-sensitive prostate cancer.Methods One hundred and ninety-two cases of metastatic hormone-sensitive prostate cancer in Renji Hospital between January 2015 and July 2016 were analyzed retrospectively.Patients' age was 39 to 90,the median age was 71 years.The median prostate-specific antigen (PSA) at diagnosis was 90.6ng/ml (4.1-2 556.0 ng/ml).One hundred and eighty were with bone metastasis and 12 were with distant lymphatic metastasis.Sixty-one of them received docetaxel chemotherapy plus ADT for 3 weeks,131 received hormonal treatment alone.The median age of combination therapy group was 67 years (39-80 years),that of single treatment group was 75 years (50-93 years) (P ＜ 0.001).The median PSA baseline of the two groups were 91.6 ng/ml (35.5-157.5ng/ml) and 89.1 ng/ml (59.6-191.0 ng/ml) (P =0.324).Gleason score of combination therapy group showed that 3 cases (4.9％) was 6,23 cases (37.7％) 7,35 cases (57.4％) ≥8.That of single treatment group showed that 17 cases (13.0％) 6,51 cases (38.9％) 7,63 cases (48.1％) ≥8.There was no statistic difference between the two groups (P =0.122).But there was statistic difference in the rate of T3 or T4 clinical stage in primary lesion,that of combination therapy group was 50.7％ (37/61) and 34.4％ (21/61),and that of single treatment group was 60.3％ (79/131) and 21.4％ (28/131) (P =0.011).Imaging showed local lymph node metastasis in the two groups (80.3％ vs.67.9％,P =0.005).As to physical condition,the combination therapy group showed a lower ECOG score than the single treatment group (P ＜ 0.001).All the patients' survival condition,PSA response rate and adverse events were analyzed.Results One hundred and ninety-two patients were regularly followedup.The median follow-up time was 23.3 (14.4-33.4) months.Median progression free survival time of combination therapy group and single treatment group were respectively 24.4 (7.5-31.3) months vs.17.5(3.0-30.7) months (P ＜ 0.001).There were 1 and 16 cases died in the two groups due to disease progression.During the treatment,the rate of PSA level less than 0.2 ng/ml was 29.5％ (18/61) vs.13.7％ (18/131) in combination therapy group and single treatment group.Regarding the tolerance of combination therapy group,the incidence rate of grade 3-4 neutropenia was 27.9％ (17/61).Skin and mucous membrane damaged in 24.6％ (15/61) patients,transaminase rised in 13.1％ (8/61) patients,and peripheral nerve toxicity occurred in 9.8％ (6/61) patients.There was no significant difference between the 2 groups in relevant events caused by ADT,gynecomastia (14.8％ vs.16.3％) and erectile dysfunction (100％ vs.100％).Most of them could be relieved by symptomatic treatment.Conclusions For metastatic hormone-sensitive prostate cancer,docetaxel combined with hormonal treatment showed longer progression free survival than ADT alone with adverse reactions acceptable.