Objective To compare the efficacy and toxicity of late-course concurrent radiochemotherapy and sequential chemoradiotherapy for advanced esophageal carcinoma. Methods Eighty-two patients with advanced esophageal carcinoma were randomized into two groups: 41 cases in late-course concurrent radiochemotherapy (LCRC) group were received two cycles chemotherapy and then underwent concurrent radiochemotherapy;41 cases in sequential chemoradiotherapy (SCR) group were received four cycles chemotherapy and then underwent radiotherapy. The regimen of chemotherapy in all cases:cisplatin 25mg/m2, 1-3 d;calcium folinate (CF) 150 mg/m2, 1-5 d;fluorouracil 375 mg/m2, 1-5 d, 21 d was one cycle. All patients were received the three-dimensional conformal radiation therapy, the total dose of radiation was same as 64 Gy. Results The short-term response rate was 85.4%(35/41) in LCRC group and 65.9%(27/41) in SCR group, they had significant difference ( P<0.05). The rates of acute radiation esophagitis that need treatment was 90.2%(37/41) in LCRC group and 87.8%(36/41) in SCR group, there had no significant difference (P>0.05). The l year, 2 years, 3 years survival rate were 68.3%(28/41) and 65.9%(27/41), 56.1%(23/41) and 51.2%(21/41), 46.3%(19/41) and 36.6%(15/41) respectively,the median survival time were 30.0 months and 26.0 months, there had no significant difference ( P>0.05). Conclusion The short-term efficacy of advanced esophageal carcinoma could be improved by the late-course concurrent radiochemotherapy.

Objective To explore the feasibility of evaluation of mice hind limb ischemia-mediated angiogenesis with ultrasound molecular imaging using molecular probes targeted to angiogenesis endothelial marker VEGFR-2.Methods A mice model of unilateral hind-limb ischemia was induced by femoral artery excision in 12 experimental mice.Ultrasound molecular imaging of the ischemia and contralateral non-ischemia hind-limbs was performed in all mice on day 7 after surgery at 8 minutes after intravenous injection of either VEGFR-2 targeting microbubbles or isotype control microbubbles in random with 30 min interval,and the video intensity (VI) was measured.Following ultrasound imaging,the hind-limb was harvested for immunohistochemical analysis.Results As expected,VI in the ischemia hind-limb was significantly higher (P ＜0.05) for MBvEGFR-2 [(25.6 ± 4.3)U] as compared with MBIso[(6.7 ± 1.6)U].However,the ultrasound signal in the non-ischemia hind-limb was low for both MBvEGFR-2 [4.4 ± 1.5)U] and MBIso [(4.6 ± 1.6)U].A marked endothelial VEGFR-2 expression in ischemia hind-limb was confirmed by immunohistochemistry.Conclusions Ultrasound molecular imaging using molecular probes targeted to angiogenesis endothelial VEGFR-2 can effectively evaluate ischemia-mediated angiogenesis.

Purpose To discuss the clinical,histopathological characteristics,diagnosis,differential diagnosis and prognosis of malignant intraductal papillary lesions of the breast.Methods 28 cases of malignant intraductal papillary lesions of the breast were analyzed by histology and immunobistochemistry.Clinical and follow-up information was obtained.The published relevant literatures were reviewed.Results All the patients were females with a mean age of 55.7 years.The clinical features were a palpable mass or nipple discharge.28 cases were diagnosed including 22 cases of intraductal papaillary carcinoma,2 cases of encapsulated papillary carcinoma and 4 cases of solid papillary carcinoma.Microscopically,the tumor showed solid and papillary area inside the capsule wall with fine delicate fibrovascular septa.The tumor cells usually displayed low-grade nuclear features.Immunohistochemistry,the tumor cells revealed diffusely strong positive ER and PR in almost all cases and HER-2,CK5/6 were negative positive.All cases were negatiive for CK5/6,p63 and SMA in the celluar nodules.CD56,Syn and CgA were found positively in some solid papillary carcinoma cases.The average positive rate of Ki-67 in tumor cells was 5.3 ％.27 patients were available for follow-up examination from 10 to 79 months and all the patients were alive.Conclusion Malignant intraductal papillary lesions of the breast most occurs in postmenopausal women.The diagnosis should be based on the clinical information,histopathological features and immunohistoehemistry stain due to its diverse histology.The main differential diagnosis is intraductal papilloma.This kind of lesion is a low grade malignant tumor with favorable prognosis.

Objective To explore the effects of miRNA-204 targeted LC3B expression on Ang Ⅱ induced cardiomyocytes hypertrophy.Methods The primary neonatal rat cardiomyocytes served as the research objects and divided into the control group,AngⅡ group,combination-treated group 1 (cardiomyocytes were given Ang Ⅱ stimulation,meanwhile infected by negative control lentivirus vector),combination-treated group 2 (cardiomyocytes were given Ang Ⅱ stimulation,meanwhile infected by lentivirus carrying miRNA-204 overexpression vector) according to different treatments.About 48 h to 72 h after intervention treatment,the cardiomyocyte hypertrophy change was detected by confocal microscopy,the expression of miRNA-204 was analyzed by real time PCR,the protein expression of LC3B was measured by Western blot and targeted gene of miRNA-204 was demonstrated by dual-luciferase reporter assay system.Results Compared with the control group,the cardiomyocyte relative surface area in the Ang Ⅱ group was significantly enlarged,the protein expression of LC3B was significantly increased,the expression of miRNA-204 was upregulated,the differences were statistically significant (P＜0.05).Whereas comparing the combination-treated group 1 with combination-treated group 2,the protein expression of LC3B in the latter was down-regulated and the cell area was reduced (P＜0.05).The further luciferase activity report gene experiment results suggested that miRNA-204 was able to bind to LC3B 3'-UTR and decreased the luciferase activities (P＜0.05),but not to bind its mutated fragment for inactivating luciferase activity(P＞0.05).Conclusion miRNA-204 is able to inhibit Ang Ⅱ induced cardiomyocytes hypertrophy,its action is realized by targeting the expression of LC3B.

Objective To explore the effect and mechanism of renal denervation combined with Losartan on cardiac hypertrophy in spontaneous hypertensive rats. Methods Spontaneous hypertensive rats with cardiac hypertrophy underwent renal denervation combined with following 4 weeks drug treatments. Transthoracic two-dimensional guided M-mode echocardiography was performed. The expression of hypertrophy-related gene was detected. Left ventricularmass index was calculated and histological sectionsstained with hematoxylin and eosin (HE). Results The characteristics of cardiac hypertrophy was observed in left ventricular tissues with HE staining in12 weeks old spontaneous hypertensive rats.The thickness was increased in those ventricular (IVSs, IVSd, LVPWs and LVPWd). After4 weeks after treatment, histological improvements were observed in both RDN and R+L groups compared with sham group. The improvement was more obvious in R+L group. Similar results were observed in histological sections, ventricular thicknesses (IVSs, IVSd, LVPWs and LVPWd), related-hypertrophy genes (ANP and β-MHC) expression, left ventricular mass idex (LVMI) and the protein expression of inflammatory cytokines (TNF-α and IL-6). Conculsion Renal denervation therapy can improve hypertensive-induced cardiac hypertrophy in spontaneous hypertensive rats. The effect was more significant when combined with Losartan. The mechanism might be involved in inhibiting inflammatory cytokines.

Objective To explore the effects of miR-34a and the alteration of AMPK/mTOR signal pathway on angiotensin (Ang)Ⅱ-stimulated cardiomyocytes hypertrophy. Methods Neonatal rat cardiomyocytes were cultrued in vitro and were divided into 3 groups:negative control for lentivirus carrying miR-34a group (NC), AngⅡplus lentivirus carrying negative control group (AngⅡ+NC) and AngⅡplus lentivirus carrying miR-34a group (AngⅡ+miR-34a). The relative cell area was detected by confocal microscopy. The expression of miR-34a and hypertrophy-related genes (ANP and β-MHC) were analyzed by real time PCR. The AMPK/mTOR signal pathway was measured by Western blot assay. Results Compared to NC group, the relative cell area was increased in AngⅡ+NC group (P<0.05). But compared with AngⅡ+NC group, the relative cell area was decreased in AngII+miR-34a group (P<0.05). Moreover, compared with NC group, the expression of miR-34a was decreased, and the expression of hyperthophy-related genes(ANP and β-MHC) was up-regulated in AngⅡ+NC group. However, the expression of miR-34a was decreased, and the expression of hyperthophy-related genes (ANP and β-MHC) was down-regulated (P<0.05). Finally, compared to NC group, the ratio of phosphop-AMPK/AMPK was significantly induced in AngII + NC group, but the ratio of phosphop-mTOR/mTOR was significantly decreased (P<0.05). However, compared to AngⅡ+NC group, the ratio of phosphop-AMPK/AMPK was significantly decreased in AngII + miR-34a group, but the ratio of phosphop-mTOR/mTOR was significantly increased (P<0.05). Conclusion miR-34a is able to inhibit myocardial hypertrophy of neonatal rat cardiomyocytes, and its mechanism is partly carried out by the alteration of the signal pathway of AMPK/mTOR.

Objective To assess the early prognosis of 117 patients after carduopulmonary resuscitation (CPR) in ICU by using the markers of inflammation,Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Methods A total of 117 CPR patients admitted between 2010 January to 2012 December were enrolled for study.Within 24 h after admission,inflammatory markers,blood routine items,hepatorenal function,electrolytes of blood were measured.The GCS and APACHE Ⅱ scores were recorded.Arterial blood gas analyses were performed at 0,12,and 24 h after hospitalization,and the 12-h and 24-h lactate clearance rates were calculated.Seven days after treatment,according to the outcomes,the patients were divided into survival group and death group,and the clinical data of two groups were analyzed.Results (1) Of them,73 patients died and 44 survived.Factor analysis showed that age,time elapsed from resuscitation to ICU admission,D-dimer,arterial oxygenation index (FiO2),arterial blood pH,arterial blood lactate concentration upon ICU admission,GCS score and APACHE Ⅱ score were significantly different between the two groups (P ＜ 0.05or P ＜ 0.01); (2) Two classification logistic regression analysis showed that D-Dimer,GCS score and APACHE Ⅱ score significantly correlated with the mortality risk of the patients in the wake of CPR with relative odds ratios of 1.000,2.091,and 0.531,respectively (P ＜ 0.05 or P ＜ 0.01) ; (3) Receiver operating characteristic curve analysis indicated that the area under the curve of GCS (0.821) and APACHE Ⅱ (0.869) had higher predictive value than D-dimer (0.655).The highest accuracy (84.6％) in predicting patient survival was achieved when the GCS score was 6.5.Meanwhile,the highest accuracy (82.1％) in predicting patient death was achieved when the APACHE Ⅱ score was 17.5.Conclusions Both GCS score and APACHE Ⅱ score has obvious correlation with the prognosis of the critically ill patients after CPR and could be used to predict prognosis at early stage.

OBJECTIVE To investigate the infection episode and related risk factors in continuous hemodialysis patients. METHODS The relationship among infection and etiologies of infection,nutritional status,pathogens and causes of chronic renal failure(CRF) were retrospectively analyzed in 180 continuous hemodialysis patients. RESULTS Totally 113 times infections were observed among the 86 inpatients under continuous hemodialysis.The main infectious site in hemodialysis patients was lungs.Thirty eight times were positive in 50 times of etiologic detection,Gram-negative germ was the most common(60.3%).Hemoglobin and serum albumin decreased obviously in infectious patients.Diabetes and systemic lupus erythematosus patients were more susceptible to infection.The hepatitis virus infections rate in hemodialysis patients was relatively high. CONCLUSIONS There is higher infections rate in continuous hemodialysis patients.Diabetes and systemic lupus erythematosus patients are more susceptible to infection.Anemia,lower serum albumin,old age and bad compliance are the susceptible factors.

BACKGROUND: Nerve growth factor (NGF) and brain-derived neurotrophic factor(BDNF) are very important to the survival and proliferation of nerve cells. In the patients with Alzheimer disease (AD), the levels of NGF and BDNF are low.OBJECTIVE: To investigate whether acidic peptide can stimulate rat astrocytes to secrete NGF and BDNF.DESIGN: A randomized control animal experiment.MATERLALS: The experiment was finished in the First Laboratory of Institute of Biopeptide, Zhengzhou University; Cellular Culture Center,School of Basic Medical Sciences of Zhe ngzhou University from September 2003 to May 2005. Fifteen neonatal SD rats within 2 days after birth were selected.METHODS: ① The cerebral cortex of the neonatal SD rats was removed under sterile condition, the astrocytes were isolated and cultured, and then identified with the glial fibriliary acidic protein immunohistochemical staining. ② The cultured astrocytes were randomly divided into six group:blank control group, serum control group, positive control group and acidic peptide treated groups. No treatment was given in the blank control group,serum of 0.2 in volume fraction and 1 000 U/mL interferon were added in the serum control group and positive control.group, 37.5, 75 and 150 mg/L acidic peptides were added in the acidic peptide treated groups respectively. ③ The astrocytes of the 2nd generation, which covered the whole bottom of bottle, were digested to single cell suspension, and then inoculated to three 12-well plates equally at 5×105 /mL. The survival rate and the contents of NGF and BDNF in the supernatant of each group were determined at 24, 48 and 72 hours respectively.MAIN OUTCOME MEASURES: ① Cell numbers and survival rates at different culture time-points; ② Effect of acidic peptide on the proliferation of astrocytes in rats; ③ Changes of NGF and BDNF in the supernatant of astrocytes at different culture time-points.RESULTS: ① As compared with the blank control group, the cell numbers and survival rates at 24, 48 and 72 hours were obviously increased in the acidic peptide groups treated with 75 and 150 mg/L (P＜0.05, 0.01,0.001), but not obviously increased in the acidic peptide group treated with 37.5 mg/L. ② As compared with the blank control group, the rates of proliferation in the acidic peptide groups treated with 37.5, 75 and 150 mg/L were all significantly increased (17.5%, 45.5%, 72.5%, P＜0.001). ③ As compared with the blank control group, the absorbance (A) values of NGF in the supernatant at 24, 48 and 72 hours were all markedly increased in the acidic peptide groups treated with 37.5, 75 and 150 mg/L (P＜0.001),and the A values of BDGF in the supernatant at 48 and 72 hours were significantly increased (P＜0.05, 0.01).CONCLUSION: Acidic peptide can increase the secretions of NGF and BDNF of rat astrocytes to different extent.

Objective To observe the effect of Herba Hedyotis Diffusae(HHD) on expression of heat shock protein 70(HSP70) and P16 anti-oncogene protein in mice with H22 cell transplanted tumor. Methods The mice were immunized with hepatoma-lines-H22 cells which were treated by Chinese herbs firstly. According to the pretreatment of the Chinese herbs and whether the H22 cells being blocked by HSP70 monoclonal antibody,the mice were divided into 5 groups:HHD non-blocking group,HHD-blocking group,Radix Codonopsis(RC)-blocking group,RC non-blocking group,and RPMI-1640 control group. Then the treated H22 Cells were translated into the mice. The expression of HSP70 and P16 anti-oncogene protein in mice with transplanted H22 liver carcinoma was detected by immunohistochemical marking method. Results The expressions of HSP70 was up-regulated in HDD non-blocking group and RC non-blocking group,in particular in RC non-blocking group,and the difference was significant as compared with HHD-blocking group,RC-blocking group and control blank group.The expression of P16 anti-oncogene protein was up-regulated in the treatment groups,and the difference was significant in comparison with the control group. The effect on P16 anti-oncogene protein expression was stronger in HDD groups than that in RC groups,but the difference was insignificant between the blocking group and the non-blocking group of each herb. Conclusion The anti-tumor effect of HDD may be achieved by inducing HSP70 expression in transplanted H22 neoplasia and by enhancing the immunogenicity. The up-regulation of P16 anti-oncogene expression by HHD and RC has no direct relationship with the induction of HSP70,and the related mechanism needs further research.