To explore the effects of exercise and Danzhi Jiangtang Capsule (DJC), a compound traditional herbal medicine, on the JNK signaling pathway in pancreatic tissues of diabetic rats and to investigate the possible mechanisms of exercise and DJC in treating diabetes.

Objective To investigate the high-risk factors leading to a poor prognosis of small renal cell carcinoma, and provide theoretical basis for the individualized treatment regimen. Methods This retrospective study analyzed the clini?cal and histological data of 18 patients with small renal cell carcinoma treated in the Department of Urology of the Second Hospital of Tianjin Medical University from January 2004 to July 2015. All the patients underwent ultrasound, plain and en?hanced CT examinations, also, received the surgeries. The tumor diameters, pathological types, pathological stages, Fuhrman grading of tumors and the prognosis of patients were analyzed. Results Preoperative CT examination revealed that 18 pa?tients with the average tumor diameter of (3.1 ± 0.6) cm (ranged 2.0 to 4.0 cm). Five patients were diagnosed as T1aN0M0, 4 patients with T1aN0M1 (3 cases with lung metastasis, 1 case with brain metastasis), 3 patients with T1aN1M0 (CT examina?tion showed a lymph node metastasis), 6 patients with T3aN0M0 (renal vein invasion or renal vein tumor thrombus). Patholog?ical examination after surgery showed that 12 patients were Fuhrman gradeⅡ, 5 were gradeⅢand 1 was gradeⅣ;15 cases were clear cell carcinomas, 1 case was papillary carcinoma, 1 was hybrid cellular tumor (malignant rhabdoid tumor with sar?comatoid differentiation) and the last case was sarcomatoid carcinoma renal cell carcinoma (Fuhrman grade V). 4 patients (T3a, Fuhrman grade Ⅱ) underwent retroperitoneal laparoscopic partial nephrectomy and the remaining underwent laparo?scopic radical nephrectomy. The median follow-up time was 22.5 months (ranged 6 to 48 months). Four cases died (2 cases with tumor diameters of 3.8 cm and 4.0 cm at preliminary diagnosis,2 cases with sarcomatoid renal carcinoma and 1 with brain metastasis), 1 case was lost. Other patients were found no tumor recurrence and metastasis. Conclusion The small re?nal cell tumor with diameter≥3.0 cm, FuhrmanⅢ/Ⅳgrade,sarcomatoid cancer or metastasis should be considered as high-risk factors of small renal cell carcinoma. The high-risk small renal cell carcinoma is heterogeneous in its biological behav?ior, which is expressed as aggressive growth and early invasion of renal tissue and even metastasis. The individualized treat? ment should be made based on preoperative imaging findings and postoperative pathology.

Objective: To explore the risk factors for heart failure (HF) occurrence in patients with inferior or combining right ventricular myocardial infarction (MI).
Methods: A total of 143 patients with inferior or combining right ventricular myocardial infarction (MI) in our hospital from 2013-01 to 2015-06 were studied. Based on HF occurrence, the patients were divided into 2 groups:HF group, n=81 and Non-HF group, n=62. The risk factors related to HF occurrence as age, gender and hypertension were retrospectively studied and compared between 2 groups.
Results: Compared with Non-HF group, HF group had more patients with hypertension, female gender, higher blood levels of Hs-CRP and creatinine, more volume of lfuid input on the 3rd day of admission and the higher ratio of V4-6 ST segment depression in ECG; while obviously lower diastolic blood pressure (DBP) at admission. Multivariate Logistic regression analysis indicated that hypertension (OR=3.275, 95% CI 1.220-8.793), female gender (OR=13.236, 95% CI 3.476-50.405), Hs-CRP (OR=1.029, 95%CI 1.005-1.070), low DBP at admission (OR=0.945, 95%CI 0.911-0.979), serum creatinine (OR=1.053, 95%CI 1.029-1.078) and V4-6 ST segment depression in ECG (OR=4.118, 95%CI 1.395-12.154) were positively related to HF occurrence in relevant patients.
Conclusion: The incidence of HF has been relatively high in patients with inferior or combining right ventricular MI;hypertension, female gender, low DBP at admission, blood level of Hs-CRP, serum creatinine, V4-6 ST segment depression in ECG were the independent risk factor for HR occurrence.

Objective To investigate the histopathologic characteristics of bladder tumor and provide theoretical basis for the reasonable selection of treatment modality.Methods This retrospective study collected the pathological data of 4 200 bladder tumor from May 2001 to October 2014.There were 3 443 male and 757 female, and the average diameter of these tumors was (1.8 ± 0.6) cm (ranged 0.2 to 6.5 cm).Among all cases, 3 214 (76.5％) cases were solitary tumor while 986 (23.5％) were multiple tumors.The histologic subtype, pathological grade and stage, the existence of vascular and lymphovascular invasion, tumor in situ, abnormal variants and rare subtypes were recorded and analyzed.Results 162 cases (3.9％)were benign tumors and 4 038 cases (96.1％)were malignant tumors including 4 008 cases of urothelial cancer (UC), 18 cases of primary adenocarcinoma and 12 cases of primary bladder squamous carcinoma.Furthermore, 2 460 (61.4％)cases were high grade UC while 1 548(38.6％)cases were low grade.320 cases were found intravascular tumor embolus or lymphovascular tumor thrombus and 391 (9.3％)cases were found metaplasia of squamous epithelium.Moreover, there were 230 cases of squamous differentiation, 120 cases of glandular differentiation, 110 cases of both squamous and glandular differentiation, and 39 cases (0.9％)of other rare subtypes or variations.On pathological stage, 112 (2.8 ％) cases were carcinoma in situ, 548 (13.7％)cases were Ta, 2 599(65.1％)cases were T1, 480(12％)cases were T2, 92 cases(2.3％)were T3 and 23 cases(0.6％)were T4 stage, with the rest cases being unable to be accurate staging.Multiple Logistic regression analysis revealed that lymphovascular invasion was related to tumor grade , pathological stage and abnormal differentiation (P ＜ 0.02).Moreover, UC with squamous and glandular differentiation were related with tumor recurrence and progression (P =0.02).Conclusions Most bladder tumors were high grade and low stage urothelial cancer with various forms of differentiation.Squamous and glandular differentiation were most common variation which should be avoided to diagnosed as hybrid carcinoma.Lymphovascular tumor thrombus and abnormal differentiation were correlated with tumor stage and grade.

Objective To investigate the clinical feature , pathologic characteristics and prognosis of urothelial carcinoma of bladder with squamous differentiation . Methods From Jan.2010 to Jun.2013, the pathological and clinical data of 96 cases of urothelial carcinoma of bladder with or without squamous dif-ferentiation were compared .Of the group with squamous differentiation , there were 39 males and 9 females with a median age of 70 (29 to 87) years.44 cases presented with painless gross hematuria .4 cases presen-ted with finding of bladder tumors in annual physical examination .TURBT, partial cystectomy and radical cystectomy were performed in 25, 8 and 13 cases, respectively.In addition, one case was only underwent bi-lateral ureteral skin gastrostomy .The last one only performed cystoscopy .In accordance with sex , age, path-ological stage and classification and surgical approach , 48 controls were selected .For the other group , there were 40 males and 8 females with a median age of 68 (39 to 86) years.45 cases presented with painless gross hematuria.3 cases presented with finding bladder tumors by annual physical examination .TURBT, par-tial cystectomy and radical cystectomy were performed in 28, 7 and 13 cases, respectively.All patients with retaining bladder had postoperative intravesical instillation for one year .Some patients with or without bladder performed 3-6 cycles chemotherapy with the GC protocol . Results In squamous differentiation group , there were 1 (2.1%) pTa, 25 (52.1%) pT1, 17 (35.4%) pT2, 4 (8.3%) pT3 and 1 (2.1%) pT4 tumors. Whereas, 1 (2.1%) pTa, 28 (58.3%) pT1, 16 (33.3%) pT2, 2 (4.2%) pT3 and 1 (2.1%)pT4 tumors were selected in the control group .There were 2 (4.2%) cases with low grade and 46 (95.8%) cases with high grade carcinomain in both groups .Patients were followed up with a mean duration of 16 and 12 months in squamous differentiation and control group , respectively .In squamous differentiation group , eight recur-rences were recorded with a mean follow-up of 12 months.Of the 3 died patients, only one died from bladder cancer.In control group, seven recurrences were recorded with a mean follow-up of 22 months, and no pa-tient died.For patients with TURBT, 3 year recurrence rate of patients with squamous differentiation was 49.5%, while the control was 34.8%.The difference was statistically significant (P<0.05). Conclusions Urothelial carcinoma of bladder with squamous differentiation is at a high level of malignant and recurrence . The rate of myometrial invasion with squamous differentiation is higher than pure urothelial bladder cancer . Patients with squamous differentiation should be closely followed up .

Aim To investigate the effect of salvianolic acid B (Sal B)on c-Jun N-terminal kinase (JNK)ac-tivation and apoptosis of INS-1 cells induced by inter-mittent high glucose.Methods INS-1 cells were pre-incubated with Sal B for 24 h,followed by exposure to intermittent high glucose (IHG,11.1 mmol·L-1 12 h,33. 3 mmol·L-1 12 h)for 72 h.Cell viability was assessed by MTT assay and cell apoptosis was evalua-ted by flow cytometry.Glucose induced insulin secre-tion capacity and intracellular reactive oxygen species (ROS)contents were measured by enzyme linked im-munosorbent assay (ELISA)and a fluorescent probe DCFH-DA,respectively.Levels of JNK activation and PDX-1 protein expression were determined by Western blot analysis.Results Sal B significantly alleviated IHG-induced cell injury and apoptosis,with glucose induced insulin secretion capacity improved evidently (P<0.05 or P<0.01).Preincubation with Sal B no-tably decreased intracellular ROS and JNK activation in INS-1 cells,while the level of PDX-1 protein was in-creased markedly (P<0.05 or P<0.01 ).Conclu-sion Sal B is capable of ameliorating IHG-induced cell injury and apoptosis in INS-1 cells,which might be derived from suppression of JNK activation and up-regulation of PDX-1 protein expression.

OBJECTIVETo establish a blood glucose fluctuation model in diabetic rats.

METHODSMale SD rats were randomly divided into 2 groups, namely normal group and diabetes group. Rat model of diabetes was established by single intraperitoneal injection of streptozotocin (STZ) and then divided into sustained high blood glucose group and blood glucose fluctuation group. Rat model of blood glucose fluctuation was established by subcutaneous injection with regular insulin or gavaging of glucose twice daily in diabetic rats. The general condition, body weight, daily blood glucose levels of 5 different times, daily average blood glucose (MBG), standard deviation of daily average blood glucose (SDBG), the maximum amplitude of glycemic excursions (LAGE), fasting serum insulin (FINS) and pancreatic tissue pathology were observed.

RESULTSRats in blood glucose fluctuation group and sustained high blood glucose group developed symptoms of polyphagia, polyuria and polydipsia. Though significant differences in body weight were observed at different time (P<0.01), no significant differences were found among the three groups (P>0.05). After 6 weeks of blood glucose fluctuation, MBG, SDBG and LAGE in blood glucose fluctuation group and sustained high blood glucose group were increased significantly than those in normal group (P<0.01), the level of FINS decreased markedly (P<0.05). SDBG and LAGE in blood glucose fluctuation group were higher than those in sustained high blood glucose group (P<0.01). Islet of diabetic rat became atrophy, irregular shape, sparse distribution, and decreased in number, and the changes were more obvious in blood glucose fluctuation group.

CONCLUSIONRat model of blood glucose fluctuation can be successfully established by subcutaneous injection of regular insulin of gavage of glucose twice daily in diabetic rats.

Animals ; Blood Glucose ; analysis ; Body Weight ; Diabetes Mellitus, Experimental ; Fasting ; Glucose ; administration & dosage ; Insulin ; administration & dosage ; Male ; Rats ; Rats, Sprague-Dawley ; Streptozocin

Objective To establish a blood glucose fluctuation model in diabetic rats. Methods Male SD rats were randomly divided into 2 groups, namely normal group and diabetes group. Rat model of diabetes was established by single intraperitoneal injection of streptozotocin (STZ) and then divided into sustained high blood glucose group and blood glucose fluctuation group. Rat model of blood glucose fluctuation was established by subcutaneous injection with regular insulin or gavaging of glucose twice daily in diabetic rats. The general condition, body weight, daily blood glucose levels of 5 different times, daily average blood glucose (MBG), standard deviation of daily average blood glucose (SDBG), the maximum amplitude of glycemic excursions (LAGE), fasting serum insulin (FINS) and pancreatic tissue pathology were observed. Results Rats in blood glucose fluctuation group and sustained high blood glucose group developed symptoms of polyphagia, polyuria and polydipsia. Though significant differences in body weight were observed at different time (P<0.01), no significant differences were found among the three groups (P>0.05). After 6 weeks of blood glucose fluctuation, MBG, SDBG and LAGE in blood glucose fluctuation group and sustained high blood glucose group were increased significantly than those in normal group (P<0.01), the level of FINS decreased markedly(P<0.05). SDBG and LAGE in blood glucose fluctuation group were higher than those in sustained high blood glucose group (P<0.01). Islet of diabetic rat became atrophy, irregular shape, sparse distribution, and decreased in number, and the changes were more obvious in blood glucose fluctuation group. Conclusion Rat model of blood glucose fluctuation can be successfully established by subcutaneous injection of regular insulin of gavage of glucose twice daily in diabetic rats.

Objective To establish a blood glucose fluctuation model in diabetic rats. Methods Male SD rats were randomly divided into 2 groups, namely normal group and diabetes group. Rat model of diabetes was established by single intraperitoneal injection of streptozotocin (STZ) and then divided into sustained high blood glucose group and blood glucose fluctuation group. Rat model of blood glucose fluctuation was established by subcutaneous injection with regular insulin or gavaging of glucose twice daily in diabetic rats. The general condition, body weight, daily blood glucose levels of 5 different times, daily average blood glucose (MBG), standard deviation of daily average blood glucose (SDBG), the maximum amplitude of glycemic excursions (LAGE), fasting serum insulin (FINS) and pancreatic tissue pathology were observed. Results Rats in blood glucose fluctuation group and sustained high blood glucose group developed symptoms of polyphagia, polyuria and polydipsia. Though significant differences in body weight were observed at different time (P<0.01), no significant differences were found among the three groups (P>0.05). After 6 weeks of blood glucose fluctuation, MBG, SDBG and LAGE in blood glucose fluctuation group and sustained high blood glucose group were increased significantly than those in normal group (P<0.01), the level of FINS decreased markedly(P<0.05). SDBG and LAGE in blood glucose fluctuation group were higher than those in sustained high blood glucose group (P<0.01). Islet of diabetic rat became atrophy, irregular shape, sparse distribution, and decreased in number, and the changes were more obvious in blood glucose fluctuation group. Conclusion Rat model of blood glucose fluctuation can be successfully established by subcutaneous injection of regular insulin of gavage of glucose twice daily in diabetic rats.

Objective:To investigate the value of serum programmed cell death molecule 5 (PDCD5) protein expression in early prediction of gastric cancer and its clinical significance.Methods:A total of 103 patients with gastric cancer who were treated in Yuechi County People′s Hospital in Sichuan Province from March 2014 to March 2016 and 80 healthy people who underwent physical examinations (control group) in the same period were selected as subjects. The serum level of PDCD5 protein were detected by enzyme-linked immunosorbent assay. The diagnostic performance of serum PDCD5 protein on gastric cancer was evaluated by receiver operating characteristic curve. The patients with gastric cancer were divided into low-level group (50 cases) and high-level group (53 cases) according to serum PDCD5 protein level. The relationship between serum PDCD5 protein level and clinical data in patients with gastric cancer was analyzed by χ2 test. Univariate and multivariate Cox regression models were used to analyze independent risk factors for survival and prognosis of gastric cancer. Kaplan-Meier method was used to map survival curves of gastric cancer patients with different levels of serum PDCD5 protein. Results:Serum PDCD5 protein level in gastric cancer group was significantly lower than that in control group: (0.82 ± 0.30) mg/L vs. (1.26 ± 0.39) mg/L, and there was statistical difference ( t=8.628, P<0.01). Serum PDCD5 protein level in patients with gastric cancer was related to tumor TNM stage and tumor invasion ( P<0.05), but not related to gender, age, body mass index (BMI), tumor size, lymph node metastasis, tumor type and tumor differentiation ( P<0.05). The area under curve (AUC) of serum PDCD5 protein in the diagnosis of gastric cancer was 0.810 (95% CI 0.747 to 0.873), with a sensitivity of 71.8%, and a specificity of 76.3% ( Z=9.641, P<0.01). Serum PDCD5 protein level was an independent risk factor for poor prognosis in patients with gastric cancer ( P<0.05). The 5-year survival rate in low-level group was significantly lower than that in high-level group: 32.0% vs. 62.3%, and there was statistical difference ( χ2=18.422, P<0.01). Conclusions:The serum PDCD5 protein level in patients with gastric cancer is significantly decreased. Low serum PDCD5 protein level is independent risk factors for poor prognosis of patients with gastric cancer.