Objective To investigate therapeutic effect of the Banxia-Baizhu-Tianma decoction combined with simvastatin for phlegm and blood stasis obstructing hyperlipidemia. Methods A total of 120 patients with phlegm and blood stasis obstructing hyperlipidemia from Dalian central hospital from June 2010 to December 2013 were divided into 2 groups according to random digits table:60 patients in a control group treated with simvastatin 20 mg/d,and 60 patients in a treatment group treated with Banxia-Baizhu-Tianma decoction on the basis of the control group. After 6 weeks treatments, the clinical efficacy, serum levels of total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), high sensitive C reactive protein(hs-CRP),high mobility group protein B1(HMGB1), alanine aminotransferase(ALT), γ-glutamyl transpeptidase(γ-GT), interleukin 8(IL-8)and superoxide dismutase(SOD) were evaluated in both groups. Results The total effective rate was 91.7%(55/60) and 73.3%(44/60) in the treatment group and the control group, respectively, with significant difference (χ2=5.772, P<0.05). After treatment, the serum levels of TC, TG, HDL-C, hs-CRP, HMGB1 in both groups were significantly lower than those before the treatment (in the treatment group t value were 12.355, 5.984, 32.825, 13.806, 14.661 and in the control group t value were 7.553, 2.177, 3.064, 10.281, 9.019, P<0.05 or P<0.01), LDL-C concentration significantly increased (t in the treatment group=3.382, P<0.01;t in the control group =2.388, P<0.05). After the treatment, the serum levels of TC, TG, HDL-C, hs-CRP, and HMGB1 in the treatment group were lower than those in the control group (t value were 7.173, 3.418, 2.377, 3.967, 8.352, P<0.05 or P<0.01);there was no significant difference in LDL-C concentration between the two groups (t=1.630, P=0.106);the levels of ALT, GT, IL-8 and SOD in the treatment group showed significant difference compared with those before the the treatment (t value were 19.053, 9.592, 12.909, 10.377, P<0.01), while in the control group, exceptγ-GT, other parameters showed significant difference after the treatment compared with before the treatment (t value were 2.253, 5.876, 3.266, P<0.05). Compared with the control group, these parameters in the treatment group were significantly different after the treatment(t value were 27.872, 10.244, 6.954, 6.145, P<0.01). Conclusions Banxia-Baizhu-Tianma decoction combined with simvastatin has good lipid-lowering effect. It may significantly lower inflammatory factor levels, reduce inflammation, and enhance antioxidant capacity.

Objective To assess the clinical efficacy ofMaxing-Shigan decoction in patients with severe pneumonia due to phlegm-heat obstructing the lung.Methods Sixty patients with severe pneumonia in the TCM Department of Dalian Municipal Central Hospital from January to December 2013 were randomly divided into a control group and a treatment group by random number table method, 30 in each group. The control group was treated with anti-infection, fluid infusion and mechanical ventilation. On the basis of treatment in the control group, the treatment group was also givenMaxing-Shigan decoction through nasogastric gavage. The mean arterial pressure (MAP), lactic acid (Lac) and PaO2/FiO2 were compared before and after the treatment in both groups. The scores of the Clinical Pulmonary Infection Score (CPIS) and the Acute Physiology and Chronic Health Evaluation II (APACHEⅡ) were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in the control group (80.0%vs.73.3%;χ2=4.800,P=0.029). In both groups, MAP (treatment group: 102.4 ± 11.9 mmHgvs. 70.4 ± 6.4 mmHg, t=12.972,P=0.000; control group: 101.2 ± 12.5 mmHgvs. 69.8 ± 6.6 mmHg,t=12.1672,P=0.000), PaO2/FiO2 (treatment group: 265.4 ± 19.7 mmHgvs. 78.6 ± 10.5 mmHg,t=45.833,P=0.000; control group: 124.8 ± 13.4 mmHg vs. 79.1 ± 11.1 mmHg;t=14.385,P=0.000) after the treatment were significantly higher than before the treatment, and the Lac level were significantly lower (treatment group: 1.04 ± 0.42 mmol/Lvs. 6.37 ± 2.27 mmol/L,t=12.65, P=0.000; control group: 3.88 ± 1.45 mmol/Lvs. 6.39 ± 2.32 mmol/L,t=5.025,P=0.000). The improvements in Lac (t=10.304,P=0.000) and PaO2/FiO2 (t=32.323,P=0.000) in the treatment group were superior to the control group. The scores of the CPIS (treatment group: 2.2 ± 1.5vs. 6.7 ± 1.7,t=10.872,P=0.000; control group: 4.5 ± 2.7 vs. 6.8 ± 1.8,t=3.882,P=0.000) and APACHEⅡ(treatment group: 5.3 ± 2.1vs. 13.8 ± 3.8,t=10.723,P=0.000; control group: 9.3±3.5vs. 13.7 ± 3.5,t=4.869,P=0.000) after the treatment were significantly lower than before the treatment in both groups, and the changes of CPIS (t=4.079,P=0.000) and APACHEⅡ(t=5.368,P=0.000) in the treatment group were greater than those in the control group.ConclusionsMaxing-Shigan decoction has definite therapeutic effects for severe pneumonia due to phlegm-heat obstructing the lung..

Objective To compare the influence of postoperative pelvic floor function after different surgical procedures of hysterectomy. Methods A total of 260 patients who underwent hysterectomy in Renmin hospital of Wuhan University from January 2012 to January 2014 were enrolled in the study, and divided into 5 groups by different surgical procedures, which were total abdominal hysterectomy (A-TH;46 cases), total laparoscopic hysterectomy (L-TH;59 cases), total vaginal hysterectomy (V-TH;42 cases), abdominal intrafascial hysterectomy (A-CISH;78 cases), laparoscopic intrafascial hysterectomy (L-CISH;35 cases). Pelvic examination, pelvic organ prolapse quantitation (POP-Q), test of pelvic muscle strength, pelvic floor distress inventory-short form 20 (PFDI-20) and the female sexual function index (FSFI) questionnaire were measured after 6 months and 12 months. Results The differences of pelvic organ prolapse incidence after 6 months, A-TH and A-CISH [7%(3/46) versus 3%(2/78)], A-TH and L-CISH [7%(3/46) versus 3% (1/35)] were statistically significance (all P＜0.05).POP-Q grade after 6 months between A-TH and A-CISH was statistically different in degree (P＜0.05). The differences of incidence of abnormal pelvic floor muscle fatigue after 6 months of A-TH and A-CISH [59% (27/46) versus 29% (23/78)], A-TH and L-CISH [59%(27/46) versus 26%(9/35)] were statistically significant (all P＜0.05), after 12 months the difference of L-TH and A-CISH [61% (36/59) versus 29%(23/78)] was statistically different (P＜0.05). The differences of incidence of abnormal pelvic floor muscle strength after 6 months of L-TH and A-CISH [53%(31/59) verus 24%(19/78)], V-TH and A-CISH [60%(25/42) verus 24%(19/78)], V-TH and L-CISH [60%(25/42) verus 23%(8/35)] were statistically significant (all P＜0.05);after 12 months the difference of V-TH and A-CISH [57% (24/42) versus 26% (20/78)] was statistically significant (P＜0.05). Stress urinary incontinence, abnormal bowel movements after 6 months and 12 months were no significant difference between groups (all P＞0.05), PFDI-20 total score was not statistically significant (P＞0.05). FSFI total score after 6 months and 12 months in A-TH and A-CISH, L-TH and A-CISH, A-CISH and L-CISH were statistically significant (all P＜0.05). Conclusion The influences of different surgical procedures to pelvic floor function are no statistical difference; as to the surgical resection of hysterectomy, intrafascia hysterectomy compared with extrafascia hysterectomy, the former is more helpful to the protection of the structure and function of the pelvic floor.

PURPOSE: Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). MATERIALS AND METHODS: Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. RESULTS: The subjects' serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher serum cathepsin K levels compared to the controls (130.8+/-25.5 ng/mL vs. 86.9+/-25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1+/-26.9 ng/mL vs. 102.6+/-12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). CONCLUSION: These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
Aged ; Biological Markers/blood ; C-Reactive Protein/metabolism ; Cathepsin K/*blood ; Coronary Artery Disease/*blood/metabolism ; Female ; Humans ; Male ; Middle Aged

PURPOSE: Cathepsin K is a potent collagenase implicated in human and animal atherosclerosis-based vascular remodeling. This study examined the hypothesis that serum CatK is associated with the prevalence of coronary artery disease (CAD). MATERIALS AND METHODS: Between January 2011 and December 2012, 256 consecutive subjects were enrolled from among patients who underwent coronary angiography and percutaneous coronary intervention treatment. A total of 129 age-matched subjects served as controls. RESULTS: The subjects' serum cathepsin K and high sensitive C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol were measured. The patients with CAD had significantly higher serum cathepsin K levels compared to the controls (130.8+/-25.5 ng/mL vs. 86.9+/-25.5 ng/mL, p<0.001), and the patients with acute coronary syndrome had significantly higher serum cathepsin K levels compared to those with stable angina pectoris (137.1+/-26.9 ng/mL vs. 102.6+/-12.9 ng/mL, p<0.001). A linear regression analysis showed that overall, the cathepsin K levels were inversely correlated with the high-density lipoprotein levels (r=-0.29, p<0.01) and positively with hs-CRP levels (r=0.32, p<0.01). Multiple logistic regression analyses shows that cathepsin K levels were independent predictors of CAD (odds ratio, 1.76; 95% confidence interval, 1.12 to 1.56; p<0.01). CONCLUSION: These data indicated that elevated levels of cathepsin K are closely associated with the presence of CAD and that circulating cathepsin K serves a useful biomarker for CAD.
Aged ; Biological Markers/blood ; C-Reactive Protein/metabolism ; Cathepsin K/*blood ; Coronary Artery Disease/*blood/metabolism ; Female ; Humans ; Male ; Middle Aged

PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
Angioplasty, Balloon, Coronary/*methods ; Coronary Stenosis/*therapy ; Diabetes Mellitus ; *Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective:To investigate the influence of COX-2 expression in hepatocellular carcinoma (HCC) on the infiltration and immune response of conventional type 1 dendritic cells (cDC1).Methods:Clinicopathological data from 111 HCC patients undergoing radical hepatectomy at Peking University People's Hospital from Jan 2016 to Jun 2017 were retrospectively analyzed. Immunofluorescence staining was employed to evaluate the cDC1 infiltration and COX-2 expression in tumor tissues. Patients were divided into two groups based on cDC1 infiltration: cDC1 enrichment and cDC1 depletion, and the correlation between COX-2 expression and cDC1 infiltration was analyzed. Single-cell sequencing of HCC tumor tissues was used to further investigate the correlation between PTGS2, the encoding gene of COX-2, and cDC1 infiltration. Hematopoietic stem cells (HSC) were utilized for in vitro generation of cDC1. HSC-derived cDC1s were sorted by FACS and cocultured with HCC cell line SNU423. Celecoxib, a selective COX-2 inhibitor, was used to suppress the COX-2 expression in HCC cell line SNU423. The functions of cDC1 were explored by FITC-dextran uptake assay, flow cytometry, and Luminex multiplex cytokine assay. Results:COX-2 expression was significantly higher in the cDC1 depletion group ( n=73) compared to the cDC1 enrichment group ( n=38) ( P=0.004 2). Patients with higher PTGS2 expression had significantly lower proportion of cDC1. Increased cDC1 infiltration in the HCC tumor microenvironment correlated with improved patient overall survival rates ( P=0.037) and disease-free survival rates ( P=0.048). Results from FITC-dextran uptake assay, flow cytometry, and Luminex assay indicated that cDC1 co-cultured with HCC showed significantly reduced antigen uptake function, co-stimulatory molecule expression, and cytokine secretion, but partially abrogated with celecoxib treatment. Conclusions:The intratumoral infiltration of cDC1 is positively correlated with favorable prognosis in HCC patients. Elevated COX-2 expression in HCC impedes the intratumoral accumulation of cDC1 and compromises their immune response capabilities. COX-2 inhibitors hold promise for enhancing cDC1 function in HCC.

Objective To explore the age-related biological properties of bone-derived mesenchymal stem cells(BMSCs)from mice of different age groups and their osteogenic differentiation induced by bone morphogenetic protein 2(BMP2).Methods Eight C57BL/6J mice were divided into a young group(4 weeks old,weighing 10～15 g,n=4)and an old group(12 months old,weighing 20～25 g,n=4),with half male and half female.MSCs were extracted from the whole bones of the 2 groups of mice.After the obtained cells were identified with flow cytometry for the surface markers,β-galactosidase staining was employed to compare the senescence level of BMSCs,MTT and EdU incorporation assays were conducted to compare the proliferation and self-renewal abilities of between the 2 groups.Western blotting was employed to analyze the expression of CyclinD1 and P21 in BMSCs.Then ALP staining,Alizarin Red staining and RT-qPCR were used to evaluate the osteogenic differentiation ability of the cells.RNA sequencing was performed to compare the differential gene expression in BMP2-induced BMSCs.Lastly,the sequencing results were re-confirmed by using flow cytometry.Results Flow cytometry showed that the sorted and cultured mouse BMSCs met the criteria for MSCs.The results of β-galactosidase staining indicated that the senescence level of BMSCs in the old group was significantly higher than that in the young group(P＜0.05).MTT and EdU doping experiments revealed that the cell viability and proliferation ability of BMSCs were significantly lower in the old group than the young group(P＜0.05).Western blotting displayed that the expression level of cell cycle protein CyclinD1 was lower,whereas that of cell cycle inhibitory factor P21 was significantly higher in the BMSCs from the old group than the cells from the young group(P＜0.05).ALP/Alizarin Red staining and RT-qPCR demonstrated that the BMSCs from the young group had stronger osteogenic differentiation capacity after BMP2 treatment when compared the cells of the old group(P＜0.05).RNA sequencing results displayed that the changing profile of CD51 expression was in opposite trends in the young and old BMSCs after BMP2 treatment.Finally,flow cytometry revealed that the percentage of CD51+cells within the CD45-cells was significantly higher in the young group than the old group.Conclusion The decrease in the percentage of CD51+cells among CD45-cells in aged BMSCs is closely associated with their decreased responsiveness to BMP2-induced osteogenic differentiation.