Objective To investigate the effect of hyperuricemia(HUA) on inflammation and endothelin-1 (ET-1) production and treatment of Benzbnomanone in hypertensive patients.Methods 90 initial hypertensive patients were enrolled from the inpatient division and clinic of our hospital,60 patients of them were identified HUA,and 30 patients were normal in uric acid as control.All these hypertensive patients with HUA were treated with basic anti-hypertensive drugs,of them 30 patients were additionally treated with Benzbromarone table 50mg for 8 weeks.The levels of inflammation indices and ET-1 were compared between these hypertensive patients with HUA and hypertensive patients with normal serum uric acid,also hypertensive patients with HUA treated with or without Benzbromarone for 8 weeks.Results Compared with the hypertensive patients with normal serum uric acid,levels of ET-1,interleukin-1 (IL-1) and high-sensitive C reactive protein (hsCRP) were higher in the hypertensive patients with HUA.Also,the levels of these indices were positively correlated with the level of serum uric acid [(86.6 ± 4.8) pg/ml vs (82.4 ±6.9)pg/ml; (47.6 ±6.2)mg/L vs (19.1 ±4.1) mg/L; (3.4 ±0.8)mg/L vs (2.9 ± 1.1)mg/L,r =0.81,0.74,0.83,all P ＜ 0.05].Benzbromarone could effectively decrease the levels of ET-1,IL-1and hsCRP in the hypertensive patients with HUA [(49.8 ± 5.0) pg/ml vs (87.5 ± 5.9) pg/ml ; (17.6 ±8.8) mg/L vs (48.2 ± 7.0) mg/L; (1.7 ± 0.7) mg/L vs (3.5 ± 0.9) mg/L,all P ＜ 0.05].Conclusions HUA could increase the levels of inflammation and ET-1,while Benzbromarone effectivelv decreased these changes.Decreasing the level of serum uric acid would retard the process of atherosclerosis in the hypertensive patients with HUA.

Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix.Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only (IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group),with 50 cases in each.Both groups were treated with external intensity modulated radiotherapy,with the total dose of 50 Gy,2 Gy/fraetion,25 fractions in total,and 5 times/week.Two weeks later,internal radiotherapy followed,with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction.When the internal radiotherapy began,the external radiotherapy stopped immediately.The combination group was treated concurrently with cisplatin given by intravenous drip once a week,at the dose of 30-40 mg/m2 body surface area for 4-5 weeks,and with total cisplatin dosage of 50-65 mg.Follow-up was conducted for 18 months(3-60 months).The 1-,3-,and 5-year survival rates,local control rate,distant metastasis rate,and disease-free survival rate,blood test,rectum,and bladder were observed.Results The 1-year survival rate,local control rate,distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups,however,the 3-and 5-year survival rates,local control rates,distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (x2 =3.843,4.336,4.336,4.960,P ＜ 0.05 ; x2 =3.934,4.454,4.000,4.244,P ＜0.05).The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (x2 =4.110,4.320,P ＜ 0.05),whereas the incidence rates of cystitis,anemia,and thrombocytopenia were not significantly different between these 2 groups.No serious grade 3-4 proctitis and cystitis were observed in these 2 groups.Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group.

BACKGROUNDThe promyelocytic leukaemia (PML) protein has been implicated in control of key tumor-suppressive pathways. However, its role in pathogenesis of lung cancer is still unclear. The objective of this study is to assess expression and clinical significance of PML, P53 and P16INK4A in lung cancer, as well as the relation of these factors.

METHODSThe tissue microarrays were created with samples from lung cancers (n=148), pulmonary benign lung tumors (n=5) and normal lung tissues (n=7), and protein expression was analyzed by immunohistochemical staining. The association between protein expression and clinical parameters was evaluated by using Crosstabs method. The Kaplan-Meier method was used to estimate survival. Cox proportional hazards model was used for univariate and multivariate analysis.

RESULTSThere was at least triplicate 0.6-mm cores per sample, 4 cases of lung cancer were excluded for lacking of enough tissue. PML was found in the cytoplasm of 14.0% cases of NSCLC and of 39.1% SCLC (P=0.010), and in the nuclei of 31.4% NSCLC and 8.7% SCLC respectively (P=0.026). PML protein was present in 9 patients with SCLC and absent in 14 cases, 5-year cumulative survival rate of the patients was 50% and 23% respectively (Log-rank test, P=0.047). Lacking of PML protein and senior pathologic T-stage were two hazardous factors that influenced prognosis of SCLC. P53 expression was found in 33.3% lung cancer, and absent in benign tumors and normal tissues of the lung (P=0.038). P16INK4A expression was abolished in normal lung tissue, however, increased in lung cancer (28.5%), and especially in lung cancer with non- or poor differentiation (36.5%) and in SCLC (69.6%). There was inverse correlation between PML expression in the nuclei and P16INK4A expression, positive correlation between P53 and P16INK4A expressions in lung cancers. PML was negatively correlated with P53 in squamous cell carcinoma.

CONCLUSIONSAs an important suppressor of tumor, PML is related with P53 mutation in squamous cell carcinoma. Increased P16INK4A protein in lung cancer may be the results of gene mutation, and be related with mutant P53 protein.

Objective:To observe the effect of emotional stimulation on the formation process of atherosclerosis ( AS) ,and explain the role of hydrogen sulfide ( H2 S) in atherosclerotic lesions. Methods:Twenty-four Sprague-Dawley rats were randomly divided into AS group, qi-stagnation and blood-stasis AS group and the control group. The AS group was fed with special diets, the qi-stagnation and blood-stasis AS group was fed with special diets and emotional stimulation, and the control group was fed with normal diets. During the experiment, the indicators including the characterization score, H2 S content, four items of the natural bleeding and blood coagula-tion, tissue blood flow and blood lipid were respectively detected in the 4 th, 8 th and 12 th week. Results:Compared with those in the AS group, since the 4 th week, the rats in qi-stagnation and blood-stasis AS group were with significantly decreased activity, slow re-sponse, lackluster fur and dark purple tongue (P<0. 01);the level of plasma lipid increased significantly, and increased further with time extension(P<0. 05 or P<0. 01);since the 8 th week, APTT and FIB changed significantly (P<0. 05),the blood flow to skin, liver and kidney decreased significantly (P<0. 05);the content of H2S was significantly higher in the 12 th week (P<0. 01). Con-clusion:Emotional stimulation promotes the formation of AS model,and the gas molecule system of H2 S plays a regulatory role in the qi-stagnation and blood-stasis AS animal model.

Objective To explore the computed tomography (CT) features of gastric cancer invasion to the pancreas and significance in the assessment of resectability of primary lesions.Methods The retrospective cohort study was conducted.The clinical data of 31 gastric cancer patients who were admitted to the Peking University Cancer Hospital between February 2011 and August 2016 were collected.Of 31 patients receiving CT examinations,11 who were diagnosed with suspected pancreas invasion by preoperative CT examinations but operation confirmed no invasion were allocated into the pancreas negative (PN) group,11 who were confirmed as pancreas invasion and under vent radical gastrectomy of gastric cancer combined with pancreas resection were allocated into the pancreas invasion (PI) group,and 9 who were confirmed as pancreas invasion and had unresectable primary lesions were allocated into the pancreas invasion non-resected (PI-NR) group.Observation indicators:(1) morphologic type of contact surface between gastric cancer and pancreas;(2) comparison of CT findings among the 3 groups:primary lesion location,tunor thickness,Borrmann type,serosa pattern of gastric cancer,judging obvious region invaded by gastric cancer,contact or invasion site with pancreas,contact length between gastric cancer and pancreas,pattern,clarity and CT values of contact surface or peripancreas invaded and normal peripancreas;(3) treatment or follow-up situations.All the patients underwent radical resection and palliative resection for gastric cancer or non-operation according to results of exploration.Telephone interview was performed to detect the survival of patients up to February 2017.Measurement data with skewed distribution were described as M (Qn),and comparisons among groups were done by the Kruskal-Wallis test.Comparison of count data were done by the Fisher exact probability.Results (1) Morphologic type of contact surface between gastric cancer and pancreas:there were 4 types according to results of CT examination.Type Ⅰ.pancreas contacted with gastric cancer and there was no change in the morphology and radian of contact surface.Type Ⅱ:pancreas contacted with gastric cancer and radian of contact surface became flattened or shallow depression.Type Ⅲ:contact surface showed a inserted sign or obvious depression.Type Ⅳ:pancreas didn't contact with gastric cancer and there was increased density in fat space between pancreas and gastric cancer,with a smudge sign or strip-and sheet-like opacity.Of 31 patients,type Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 5,10,4 and 12 patients,respectively.(2) Comparison of CT findings among the 3 groups:nodular protrusion,spiculation and strip shape,clounding patch opacity of serosa panern of gastric cancer were detected in 1,6,4 patients in the PN group and 5,4,2 patients in the PⅠ group and 0,2,7 patients in the PI-NR group,respectively,with a statistically significant difference (X2=10.054,P＜0.05).Two,8 and 8 patients in the PN,PI and PI-NR groups had obvious tumor invasion located at a adjacent region between stomach and pancreas,with a statistically significant difference (X2 =11.259,P＜0.05).Contact or invasion site with pancreas located at head,body and tail of pancreas was detected in 6,5,0 patients in the PN group and 1,7,3 patients in the PI group and 5,4,0 patients in the PI-NR group,respectively,with a statistically significant difference (X2=8.390,P＜0.05).Type Ⅰ,Ⅱ,Ⅲ and Ⅳ of contact surface between gastric cancer and pancreas were detected in 5,6,0,0 patients in the PN group and 0,4,4,3 patients in the PI group and 0,0,0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2=29.291,P＜0.05).Number of patients with clear and ambiguous contact surface was 10,1 patients in the PN group and 0,11 patients in the PI group and 0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2 =26.227,P＜ 0.05).CT values of contact surface or peripancreas invaded were-46 HU (-57 HU,-20 HU) in the PN group and-34 HU (-41 HU,-25 HU) in the PI group and-10 HU (-15 HU,-10 HU) in the PI-NR group,respectively,with a statistically significant difference (Z=15.306,P＜0.05).CT values of normal peripancreas were-87 HU (-96 HU,-76 HU) in the PN group and-88HU (-70 HU,-1 HU) in the PI group and-83 HU (-98 HU,-74 HU) in the PI-NR group,respectively,with statistically significant differences in CT values between contact surface or peripancreas invaded and normal peripancreas among the 3 groups (Z=12.581,13.780,7.793,P＜0.05).(3) Treatment or followup situations:of 31 patients,22 underwent radical gastrectomy and 9 underwent simplex exploration or short surgery.All the 31 patients were followed up for 6.0-71.0 months,with a median time of 13.5 months.Postoperative 1-and 2-year survival rates were 82.6％ and 77.1％.Conclusions There are significant differences in pancreatic invasion and resectability between CT features of contact surface of gastric cancer and pancreas and tumor classification.CT features include that pancreas contacts with gastric cancer in the PN group,radian of contact surface becomes flattened and with a inserted sign in the PI group,and there are increased density in fat space between pancreas and gastric cancer and a smudge sign or strip-and sheet-like opacity in the PI-NR group.

Objective:To investigate the effects of continuous monitoring intracranial pressure (ICP) and brain oxygen partial pressure (PbtO 2) on the prognosis of patients with severe craniocerebral injury. Methods:A prospective randomized controlled trial was conducted. Seventy patients with severe craniocerebral injury with a Glasgow coma score (GCS) 4-8 admitted to the neurosurgical intensive care unit (NICU) of the People's Hospital of Inner Mongolia Autonomous Region from January 2017 to May 2020 were enrolled, and they were divided into ICP monitoring group and ICP+PbtO 2 monitoring group by random number table. Patients in ICP monitoring group received ICP monitoring and were given traditional treatment of controlling ICP and cerebral perfusion pressure (CPP), the therapeutic target was ICP < 20 mmHg (1 mmHg = 0.133 kPa) and CPP > 60 mmHg. Patients in ICP+PbtO 2 monitoring group were given ICP and PbtO 2 monitoring at the same time, and oxygen flow was adjusted on the basis of controlling ICP and CPP to maintain the PbtO 2 > 20 mmHg, and the therapeutic target of ICP and CPP was the same as the ICP monitoring group. ICP and PbtO 2 values were recorded during monitoring in the two groups, the results of CPP, GCS and arterial blood gas analysis were recorded, and the prognosis at 3 months and 6 months after injury was compared by Glasgow outcome scale (GOS) score between the two groups. GOS score > 3 was considered as good prognosis. Kaplan-Meier survival curve was drawn, and the 3-month and 6-month cumulative survival rates of the two groups were analyzed. Linear regression analysis was used to further evaluate the relationship between PbtO 2 and GOS score. Results:Finally, a total of 70 patients with severe craniocerebral injury were enrolled in the analysis, 34 patients received ICP combined with PbtO 2 monitoring and guided therapy, and 36 patients received ICP monitoring alone. The average ICP of ICP+PbtO 2 monitoring group was significantly lower than that of ICP monitoring group (mmHg: 13.4±3.2 vs. 18.2±8.3, P < 0.01). Although the CPP in both groups was great than 60 mmHg, the average CPP of ICP+PbtO 2 monitoring group was significantly higher than that of ICP monitoring group (mmHg: 82.1±10.5 vs. 74.5±11.6, P < 0.01). No significant difference was found in average GCS score or arterial partial pressure of carbon dioxide (PaCO 2) between the ICP+PbtO 2 monitoring group and ICP monitoring group [GCS score: 5.3±2.3 vs. 5.2±2.2, PaCO 2 (mmHg): 33.5±4.8 vs. 32.6±5.2, both P > 0.05]. The average arterial partial pressure of oxygen (PaO 2) of ICP+PbtO 2 monitoring group was obviously higher than that of ICP monitoring group (mmHg: 228.4±93.6 vs. 167.3±81.2, P < 0.01). Compared with the ICP monitoring group, the good outcome rates of 3 months and 6 months after injury in the ICP+PbtO 2 monitoring group were significantly higher (3 months: 67.6% vs. 38.9%, 6 months: 70.6% vs. 41.7%, both P < 0.05). Kaplan-Meier survival curve showed that the 3-month and 6-month cumulative survival rates of ICP+PbtO 2 monitoring group were significantly higher than those of ICP monitoring group (3 months: 85.3% vs. 61.1%, Log-Rank test: χ2 = 5.171, P = 0.023; 6 months: 79.4% vs. 55.6%, Log-Rank test: χ2 = 4.511, P = 0.034). Linear regression analysis showed that PbtO 2 was significantly correlated with GOS score at 3 months and 6 months after injury in patients with severe craniocerebral injury ( r values were 0.951 and 0.933, both P < 0.01). Conclusions:PbtO 2 compared with ICP monitoring guiding therapy is valuable in improving the prognosis of patients with severe craniocerebral injury. It can improve the prognosis at 3-6 months after injury.

OBJECTIVETo investigate the effect of luteolin on the proliferation and collagen expression of hepatic stellate cells.

METHODSThe effect of luteolin on proliferation and collagen synthesis of hepatic stellate cells isolated from the liver of Wistar rats were determined by (3)H-TdR and (3)H-Pro, and procollagen gene expression was also detected by DIG-labeled gene probe and in situ hybridization.

RESULTSThe proliferation and collagen synthesis were significantly and dose-dependently inhibited by luteolin when the concentrations reached 10 micromol/L and 20 micromol/L respectively (t=2.542, P<0.05; t=3.650, P<0.01). The type I, III procollagen mRNA expression was decreased by 25 micromol/L luteolin, in which the type I procollagen mRNA was reduced with statistical significance (x(2)=6.850, P<0.01).

CONCLUSIONSLuteolin inhibits the proliferation and collagen expression of hepatic stellate cells in vitro. It may have a preventive or therapeutic role in liver fibrosis.

Animals ; Cell Division ; drug effects ; Cells, Cultured ; Collagen ; biosynthesis ; drug effects ; Expectorants ; pharmacology ; Flavonoids ; pharmacology ; Liver ; cytology ; Luteolin ; Protein Synthesis Inhibitors ; pharmacology ; Rats ; Rats, Wistar

BACKGROUNDTissue microarray provides a convenient shortcut for immunohistochemical staining. The aim of this study is to investigate the clinicopathologic and prognostic values of survivin and cyclooxygenase-2 (COX-2) expression level in patients with non-small cell lung cancer (NSCLC).

METHODSExpression of survivin and COX-2 was detected in 88 cases of NSCLC and 5 cases of normal lung samples by immunohistochemical staining on tissue microarray sections. All cases were followed up for more than 5 years.

RESULTSCytoplasmic and nuclear expression rate of survivin in NSCLC was 94.3% and 79.5%, respectively, and positive expression rate of COX-2 was 71.6%, however, neither survivin nor COX-2 expression was observed in normal lung tissues (P < 0.005). Nuclear expression of survivin was markedly higher in smokers than that in non-smokers (P=0.002). The positive expression of COX-2 was significantly related to gender, smoking, histologic subtype and lymph node metastasis (P < 0.05). Univariate analysis showed that patients with positive expression of COX-2 had worse overall survival (P=0.014), however, survivin expression was not related to survival. Multivariate analysis showed that neither survivin nor COX-2 was independent prognostic factor for survival.

CONCLUSIONSThe results indicate that survivin highly expresses in NSCLC, so the ubiquitous expression makes it a potential novel parameter for diagnosis of NSCLC. Aberrant expression of COX-2 is related to worse overall survival, which may be useful to predict prognosis for NSCLC.

OBJECTIVETo investigate the expressions of Sonic hedgehog (Shh) and matrix metalloproteinases 2 (MMP2) in human esophageal squamous cell carcinoma (ESCC) and their association with the clinicopathological features.

METHODSImmunohistochemistry was employed to examine the expressions of Shh and MMP2 in 48 specimens of ESCC and 44 specimens of adjacent tissues.

RESULTSThe positivity rate of Shh expression in ESCC (75%) was significantly higher than that in the adjacent tissues (20.45%). Shh expression was located mainly in the cell nuclei and cytoplasm, and was closely correlated with TNM stage. Positive MMP2 expression was detected in 68.75% of the ESCC tissues as compared to 22.72% in the adjacent tissues. MMP2 expression was localized mainly in the cytoplasm, and its expression level was closely correlated with TNM stage and lymph node metastasis. A positive correlation was found between Shh and MMP2 expressions in the 48 ESCC tissues (R=0.037, P=0.019).

CONCLUSIONThe expression of Shh protein may be involved in tumor invasion and metastasis of ESCC.

Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Hedgehog Proteins ; metabolism ; Humans ; Lymphatic Metastasis ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Middle Aged ; Neoplasm Staging

The concept of "hand-foot" teaching method was first formed and applied in orthopedic teaching. In the class of bone and joint anatomy and diseases, the students can understand them more thoroughly and memorize them more easily by gestures of hands and feet. In learning the classification of lumbar disc herniation, the body is compared to the dural sac and the arms are compared to the nerve roots, which perfectly explains the types of lumbar disc herniation. The clinical manifestations of nerve injury in limbs were explained by the anatomical similarity of upper and lower limbs. We also explain the position variation of appendix by different directions of the thumb. In the same way, the "hand-foot" teaching method are used to explain the female reproductive system and so on. The "hand-foot" method has been widely applied in clinical teaching of many disciplines and achieved good effect in teaching practice.