Objective To investigate the clinical features of nonresponsive Kawasaki disease by intravenous immunoglobulin. Methods The clinical data of 163 hospitalized patients of Kawasaki disease from June 2008 to February 2013 were analyzed retrospectively based on the response to high intravenous immunoglobulin (IVIG) therapy. All patients were divided into responsive group and nonresponsive group. The clinical characteristics and biochemical index were compared in two groups. Results The nonresponsive group had more frequently experienced in coronary artery lesion, cervical lymph node enlargement, sterile pyuria and higher levels of neutrophils, CRP, AST, ALT, TBIL and lower levels of albumin, high density lipoprotein, serum sodium concentration than the responsive group (P < 0.05). No differences was found in the age, sex, duration of fever at initial treatment, clinical manifestations complete or incomplete and WBC, CK-MB, PLT, ESR between the two groups (P > 0.05). Conclusion It might be useful in predicting nonresponse to IVIG therapy in children with Kawasaki disease in more frequently experienced coronary artery lesion , cervical lymph node enlargement, sterile pyuria and higher levels of neutrophils, CRP, AST, ALT, LDH, TBIL and lower levels of albumin, high density lipoprotein, serum sodium concentration.

AIM: Hematopoietic stem cell transplantation is the only method to cure hematologic disease. This article analyzes risky factors as to suffering and development of diabetes after hematopoietic stem cell transplantation for malignant hemopathy. METHODS: ①Sixteen patients who received hematopoietic stem cell transplantation were enrolled at the Wuhan Central Hospital from January 2003 to February 2007. They were divided into diabetic (n=6) and non-diabetic (n=11) groups with an average age of 45.2 years. ②The interrelationship between occurrences of diabetes after hematopoietic stem cell transplantation and patients' age, symptom before operations (times of chemotherapy, times of large amount of dosage for intensifying treatment, status of blood pressure, sugar tolerance), immunosuppressant, dosage and time of cortex incretion as well as effect of diabetes on patients. RESULTS: Sixteen patients were included in the final analysis ①5 cases of diabetes occurred after surgery; patients with abnormal sugar tolerance before surgery possessed a higher rates of occurrence of diabetes than those with normal sugar tolerance; ②Those patients of older than 40 years and who had taken in sugar-containing cortex incretion during chemotherapy also possessed a comparatively higher rates of occurrence of diabetes; Patients whose intake of cortex incretion have being cancelled after half a year of transplantation possessed an obviously lower rates of occurrence of diabetes than those intake of cortex incretion had being cancelled within half a year of transplanting operation. ③ Application of immunosuppressant and plasma drug concentration had no affect on occurrence of diabetes in both groups. ④No evident effect of infection rate of cytomegalovirus was detected in the diabetic group. CONCLUSION: Those patients that are older than 40 years and who have taken in sugar-containing cortex incretion during chemotherapy and with abnormal sugar tolerance as well as taking in sugar-containing cortex incretion to prevent occurrence of graft-versus-host-disease (GVHD) possess relatively higher rates of occurrence of diabetes.

Objective To observe the clinical effectiveness and prognostic factors of autologous hemopoietie stem cell transplantation on diabetic peripheral angiopathy patients under different degrees of vascular lesions. Methods Thirty-six patients with diabetic were divided into mild vascular stenosis group (group A: 20 lower extremities, vascular stenosis less than 50% ), moderate vascular stenosis group(group B :26 lower extremities, vascular stenosis of 50%-70% ) and severe vascular stenosis group (group C: 25 lower extremities, vascular stenosis greater than 70% ) according to the degree of vascular lesions. All patients were given the stem cell mobilization for 5 days, then peripheral hemopoietic stem cells were gathered on the last day and transplanted to ischemic limb by using monoeyte stem cell suspend liquid with 3 cm × 3 cm intervals.Each index of three groups was regularly observed ( 1th,12th and 18th month respectively after the operation)and comprehensive evaluated. Meanwhile,the transplantation prognostic factors (age, disease duration, post-prandial 2 hours blood glucose, glycated hemoglobin, blood pressure, triglycerides) were analyzed by multiple regression. Results Twelve months after transplantation, the ankle brachial index (ABI) and percutaneous oxygen pressure (TcPO2) of all three groups increased compared with that before the transplantation (P<0.05). In the 18th month after transplantation, the ABI still increased in group A and B (P< 0.05), and no significant changes were found in group C compared with that in the 12th month. Eighteenth month after transplantation, lower extremities of 8 patients (40%) in group A, 8 patients (31%) in group B and 6 patients (24%) in group C were examined to have neovascularizatian. Age, disease duration, blood pressure, post-prandial 2 hours blood glucose, glycated hemoglobin and triglycerides were all the important factors that affected diabetic peripheral angiopathy recurrence after transplantation. Conclusions The long-term effica-cy of stem cell transplantation on diabetic peripheral angiopathy patients at a mild to moderate degree is superior to that with severe vascular lesions. Close monitoring of blood glucose, blood pressure and triglycerides in the operation perinatal stage is required.They are the important prognostic indicators.

Objective To evaluate the effect of lipoic acid on endothelial microparticles (EMP) in diabetic patients with peripheral artery disease (PAD) of the lower limbs. Methods Forty eight diabetic patients with PAD of the lower limbs were randomly divided into two groups: the therapeutic group and control group (each group has 24 cases). Patients of control group only received internal comprehensive medicine therapies for 3 weeks. Patients of therapeutic group were treated with both lipoic acid (600 mg lipoic acid injection in normal saline solution for intravenous drip, once daily for 3 weeks) and internal comprehensive medicine therapies at the same time. The levels of EMP in venous blood and Ankle-brachial index (ABI) were estimated before and after treatment by flow cytometry. Results Compared to the control group after treatment [(1 179. 8± 120. 1) per μL], EMP value showed a significant reduction in therapeutic group [(1 032. 4±117. 2) per μL] (P<0. 01). The levels of ABI of therapeutic group (0. 68 ±0. 10) was increased obviously as compared that before lipoic acid treatment (P<0. 01). Patients treated with lipoic acid showed the higher levels of ABI than the control group after treatment (0. 58±0. 11) (P<0. 01). Conclusion Lipoic acid injection significantly decreased the level of EMP in diabetic patients with PAD of lower limbs. Lipoic acid might be an effective drug for diabetic patients with PAD.

Objective To observe the infiuence of recombinant human thyroid stimulating hormone(rhTSH)-aided 131I treatment for patients with differentiated thyroid carcinoma (DTC)and its efficacy on thyroid hormone level.Methods 20 cases with DTC admitted from Nov.2010 to Jun.2014 were divided into 2 groups.11 cases received rhTSH-aided 131I treatment (rhTSH-aided group)and the other 9 cases received 131I treatment after thyroid hormone withdrawal (THs withdrawal group).The influence of the 2 treatment methods on the serum TSH,FT3,FT4,Tg was evaluated,and the therapeutic effects were assessed according to 131I whole body scintigraphy (WBS)and Tg-negative rate.Results The serum TSH was significantly higher in rhTSH-aided group than that before treatment(t=27.70,P＜ 0.001)and in THs withdrawal group (t=7.18,P＜0.001).TSH levels of all patients were＞30 mU/L.WBS displayed that the thyroid remnant clearance rate was 72.73％(8 cases)nd 66.67％(6 cases)respectively in rhTSH-aided group and THs with-drawal group and there was no statistical difference between the 2 groups(x2=0.178,0.673).Conclusion The rhTsH treatment can help to accomplish the preparation of 131I treatment for DTC and acquire satisfactory ablation efficacy.

The purpose of this research is to investigate the effects and mechanisms of paeonol (PL), a phenolic compound found in many traditional Chinese formulations, on reversing drug resistance in the ovarian cancer resistant SKOV3/DDP cells. The results showed that PL had significant drug-resistant reversal effect on SKOV3/DDP cells. Flow cytometry showed that PL could inhibit P-glycoprotein (P-gp) function in a concentration-dependent manner. Fluorescent quantitative PCR and cell immunofluorescence techniques were used to detect mechanisms of action. Results revealed that both the inhibitory effect on MDR1/P-gp and metadherin (MTDH) expression and the induction effect on phosphatase and tensin homolog (PTEN), by 15, 30, and 60 μmol·L^-1 PL, were increased with increased concentrations of PL (P < 0.01, P < 0.05). The inhibitory effect on MTDH mRNA and the induction effect on PTEN mRNA, by PI3K inhibitor LY294002, were stronger or equivalent to that of the 60 μmol·L^-1 PL treated group; however, the inhibition or induction effect on MTDH or PTEN protein were only comparable to the 15 μmol·L^-1 PL treated group. The present study shows that the effect of PL on SKOV3/DDP cells may be related to the inhibition of P-gp function and expression, the inhibition of MDR1, MTDH expression, and the induction of PTEN expression, all which can provide a theoretical foundation for PL as a drug resistance reversal agent on the treatment of ovarian cancer chemotherapy resistance.

Objective To investigate the efficiency of Trichostatin A (TSA) in inducing cell apoptosis and altering the Notch pathway genes expression in PANC-1 cells line.Methods The survival rate and apoptosis of PANC-1 cells were measured by MTT assay and Hoechst 33258 staining,respectively.mRNA expression levels of the genes,numb,gcn512,dll3,hes6,eaf2,cytohesins,in PANC-1 cells were assessed by real-time quantitive PCR.Western blot was used to measure the expression of bcl-2,bax,actived caspase-3 and NICD protein which was the biologically active form of Notch-1.Results After culturing with 0.1,0.2,and 0.4 μmol/L TSA for 24 hours,the cellular survival rate of PANC-1 cells significantly decreased to 72％,58％ and 39％,respectively.The survival rate of PANC-1 was negatively correlated to time length of culture with TSA.Increased apoptosis of PANC-1 cells after 12,24 and 36 h culture with TSA was detected by Hoechst 33258 staining.Western blotting showed that the expression of bax,actived caspase-3 and NICD protein increased while the bcl-2 protein decreased after culture with TSA.In real time quantitive PCR assessment,the mRNA expression of numb and hes6 in PANC-1 cells were upregulated by TSA (P ＜ 0.05),while the mRNA expression of gcn512 and dll3 were down-regulated by TSA (P ＜ 0.05).While mRNA expressions of eaf2 and cytohesin1,2,3,4 were not affected by TSA.Conclusions TSA induces apoptosis of pancreatic cancer cell line PANC-1.The Notch signal pathway may be involved in inducing cellular apoptosis of PANC-1 when cultured with TSA.

Depression is a mental disorder characterized by persistent low mood and belongs to the category of "stagnation syndrome" in traditional Chinese medicine （TCM）， with the characteristics of high prevalence， high disability rate， high suicide rate， and high recurrence rate. The pathogenesis of depression is extremely complex and involves factors such as genetics， psychology， and social environment. Currently， clinical antidepressant drugs such as tricyclic and tetracyclic antidepressants， and selective serotonin reuptake inhibitors， have slow onset of action and significant adverse effects with long-term application. Furthermore， clinical statistics show that about one-third of patients do not respond to these types of medications. Enhancing the effectiveness of depression treatment has become a major challenge in the medical field. TCM， based on the holistic view and treatment based on syndrome differentiation， has unique advantages in the prevention and treatment of depression， including stable therapeutic effects， low recurrence rate， minimal side effects， and good patient compliance. As one of the heat-clearing drugs， Gardeniae Fructus has the effects of clearing heat， purging fire， cooling blood， and relieving restlessness， which makes it effective in treating patients with "stagnation syndrome". Literature studies have found that active components of Gardeniae Fructus， such as geniposide， genipin， and crocin， as well as drug pairs such as Gardeniae Fructus-Chuanxiong Rhizoma， Gardeniae Fructus-Acanthopanacis Senticosi Radix et Rhizoma Seu Caulis， and Gardeniae Fructus-Lycii Fructus， and prescriptions such as Zhizichi Tang， Yuejuwan， Zhizi Houpotang， Danzhi Xiaoyaosan， and Jieyu Anshen Granules， have shown significant antidepressant effects. The mechanism of action may be related to regulating the hypothalamic-pituitary-adrenal （HPA） axis， modulating neurotransmitters such as serotonin （5-HT） and dopamine （DA）， increasing brain-derived neurotrophic factor （BDNF） in the hippocampus， enhancing neurogenesis in the hippocampus， and regulating the nuclear factor-kappa B （NF-κB） signaling pathway to inhibit neuroinflammation. This article summarized the research progress on the active components of Gardeniae Fructus， drug pairs， and Chinse medicinal prescriptions containing Gardeniae Fructus， providing references for further promoting the clinical application of Gardeniae Fructus and its prescriptions in the treatment of depression.

The 82nd American Diabetes Association Academic Meeting was held in New Orleans, U. S.A. on June 3, 2022. The meeting had both in-person and virtual activities, encompassed the advances in diabetes study, prevention, and management, including the latest research results of Chinese researchers. This summary highlights the important research findings, including congress awards, drug research progress, management of complications/comorbidities, update of guideline/consensus, and progress of other metabolic diseases, with an aim to provide reference for diabetes management in China.

OBJECTIVE To detect the reversal effect of Guizhi Fuling Wan on cisplatin-resistant ovarian cancer SKOV3/DDP cells and its relationship with protein expression of phosphatase and tensin homolog (PTEN) and metadherin (MTDH). METHODS Guizhi Fuling Wan (GFW) concentrated solution was prepared according to the Chinese Pharmacopoeia 2015 edition, Wistar rats were given GFW viagavage at 4 g·kg-1·d-1,8 g·kg-1·d-1,16 g·kg-1·d-1,or given saline as blank control for 5 days.Blood samples were taken and the corresponding drug-containing low-dose sera, medium-dose sear, high-dose sera and blank sera were prepared.The XCELLigence RTCA S16 real-time label-free cell analyzer was used to detect the reversal effect by the sera combined with cisplatin or paclitaxel in SKOV3/DDP cells. Annexin V-FITC and PI double-staining were used to detect the apoptosis-inducing effect of the sera in the cells. RT-qPCR and western blot were used to detect the mRNA and protein expression of PTEN and MTDH after the cells treated with the sera. RESULTS The inhibition rate of low-dose sera against SKOV3/DDP cells was less than 5%.After the low-dose sera combined with cisplatin or pacli-taxel, the IC50 of SKOV3/DDP cells against cisplatin and paclitaxel decreased by 3.01 and 1.79-fold, respectively.The total apoptosis rates induced by the low-dose sera,medium-dose sear,high-dose sera and blank sera in SKOV3/DDP cells were 11.08±0.13,19.42±0.30,24.23±0.31,and 3.21±0.24,respec-tively; there was a significant difference between the groups (P<0.01). RT-qPCR results showed that, compared with the blank serum, the sera can up-regulate the expression of PTEN mRNA and down-regulate the expression of MTDH mRNA in a dose-dependent manner. Western blot results showed that the induction effect to PTEN protein and the inhibition effect to MTDH protein by the sera were gradually enhanced with thesera dose increasement. CONCLUSION The resistance reversal effect of Guizhi Fuling Wan on ovarian cancer SKOV3/DDP cells may be related to the inhibition of MTDH, up-regulation of PTEN and induction of apoptosis, providing with an experiment basis for the applica-tion of Guizhi Fuling Wan as a reversal agent for chemotherapy resistance of ovarian cancer.