OBJECTIVETo study the pathologic features of pulmonary carcinomas with spindle and/or giant cells.

METHODSTwenty cases of pulmonary carcinomas with spindle and/or giant cells were studied by using lightmicroscopy and immunohistochemical staining.

RESULTSOf 20 cases, 15 cases were pleomorphic carcinoma (10 cases with adenocarcinoma, 3 cases with large cell carcinoma, 1 case with squamous cell carcinoma and 1 case with giant cell carcinoma) , 4 cases were spindle cell carcinoma, and 1 case was giant cell carcinoma. Immunohistochemical results showed AE1/AE3 was positive in the spindle and/or giant cell component of 19 cases, Vimentin was positive in the spindle and/or giant cell component of 20 cases, P53 was positive in 10 cases and thyoid transcription factor-1 (TTF-1) was negtive in all cases.

CONCLUSIONSPulmonary carcinomas with spindle and/or giant cells is definded as a group of poorly differentiated non-small cell carcinoma that contains a component of spindle and/or giant cells. The diagnosis is based on histopathology and immunohistochemical staining of AE1/AE3 and Vimentin.

Adenocarcinoma ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Giant Cells ; pathology ; Humans ; Lung ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged

Objective To investigate the effect of intermittent high glucose on proliferation, apoptosis, and cell cycle progression of INS-1 cells, and the possible intracellular pathways activated by intermittent high glucose. Methods Cell viability was evaluated by cell counting kit, the cell cycle was determined by flow cytometry,Annexin-V/PI double-labeled cell apoptosis detection kit was used to monitor cell apoptosis. Cell cycle related protein Skp2 and p27 expressions were detected by Western blot. Results ( 1 ) Both intermittent and constant high glucose significantly inhibited the growth of INS-1 cells, and the former effect was more significant. ( 2 ) Intermittent and constant high glucose levels significantly increased apoptosis in INS-1 cells, and the former effect was more significant. (3) Intermittent and constant high glucose levels significantly inhibited the cell process, the G0/G1 cell cycle arrest also was induced by intermittent high glucose, resulting in lowered proportion of the G2/M phase and S phase of INS-1 cells. (4) Intermittent and constant high glucose significantly decreased the level of protein Skp2 and increased the level of cell cycle related protein p27. Conclusion Intermittent high glucose levels affect INS-1 cell growth and proliferation, as well as induce cell apoptosis, probably by decreasing the level of protein Skp2 and increasing the level of p27 in the cells, resulting in arrest of progression through the G1 phase to the S phase of INS1 cells, and thus impairment of cell proliferation.

Objective To investigate the meaning of expression of apoptosis related molecules NFKBp65 and p53 and GPX1-mRNA in patients with Keshan disease(KSD).Methods Sixteen chronic Keshan Disease patients were enrolled in KSD group according to electrocardiogram,chest X ray film and clinical examinations on 15,September in 2009,and 23 healthy people were included in control group from physical examination taken in The Second Affiliated Hospital of Xi'an Jiaotong University.Fresh blood(5 ml)was collected from antecubital vein of all subjects in the fasting state.Total mRNA and protein of blood sample were isolated using Trizol.GPX Assay Kit was used to detect GPX enzyme activity,and GPX1-mRNA expression was determined by SYBR Real-Time PCR.Meanwhile,expression of apoptosis related molecules NFKBp65 and p53 were determined by Western blot.Results GPX enzyme activity decreased significantly in KSD group[(108.61±14.10)U]compared with control group[(122.78±11.89)U,t=2.874,P<0.05],GPX1-mRNA level of KSD group(0.553±0.299)notably KSD group(0.802±0.057)compared with control group[(1.065±0.355),t=6.829,P<0.01].p53 increased in KSD group(1.604±0.191)compared with control group[(1.137±0.186),t=3.033,P<0.05].Conclusiom Decreased GPX1-mRNA expression may result in lower GPX enzyme activity of patients with KSD.Thus oxidative damage increases and cadioeyte apoptosis is activated by activating apoptosis signal pathway.

OBJECTIVETo observe the effect of Buyang Huanwu Decoction (BYHWD), a representative formula of qi benefiting blood activating method on aorta Rho associated coiled-coil forming protein serine/threonine kinase (Rhokinase, ROCK) and nuclear transcription factor kappa B (NF-κB) p65 mRNA expressions and levels of blood lipids in atherosclerosis (AS) model rats.

METHODSThe AS rat model was prepared by vitamin D3 and high fat diet. Totally 60 rats were randomly divided into 6 groups, i.e., the normal control group, the model group, the low dose BYHWD group (10 g/kg), the high dose BYHWD group (20 g/kg), the Simvastatin control group (0.6 mg/kg), and the BYHWD prevention group (10 g/kg), 10 in each group. After successful modeling all medication was intervened for 28 days. Expression levels oxidized low density lipoprotein (ox-LDL) were detected by ELISA. Levels of TG, TC, LDL-C, HDL-C were determined by enzyme method. Pathological changes of aortic tissue were observed under light microscope. mRNA expressions of Rho kinase and NF-κB p65 in aorta were detected by real time (RT) PCR.

RESULTSHigh fat diet and peritoneal injection of vitamin D3 could induce AS rat model. Typical atheromatous plaque formed in aorta of AS model rats. Compared with the normal control group, levels of TC, TG, LDL-C, and ox-LDL significantly increased in the model group, but the HDL-C level decreased (P < 0.01). Compared with the model group, levels of TC, TG, LDL-C, and ox-LDL all decreased, but HDL-C increased in low and high dose BYHWD groups, the Simvastatin control group, and the BYHWD prevention group (P < 0.05, P < 0.01). Compared with the low dose BYHWD group, above-mentioned indices were more obviously lowered in the high dose BYHWD group, the Simvastatin control group, and the BYHWD prevention group (P < 0.05). Compared with the normal control group, mRNA expression levels of Rho kinase and NF-κB p65 significantly increased in the model group (P < 0.01). Compared with the model group, mRNA expressions of Rho kinase and NF-κB p65 obviously decreased in low and high dose BYHWD groups, the Simvastatin control group, and the BYHWD prevention group (P < 0.01). Compared with the low dose BYHWD group, the two indicators were more obviously lowered in the high dose BYHWD group, the Simvastatin control group, and the BYHWD prevention group (P < 0.05). But there was no statistical difference in blood lipids levels, mRNA expression levels of Rho kinase or NF-κB p65 among the high dose BYHWD group, the Simvastatin control group, and the BYHWD prevention group (P >0. 05).

CONCLUSIONSBYHWD could down-regulate mRNA expression levels of Rho kinase and NF-κB p65, lower levels of blood lipids, and fight against AS. Suppressing Rho kinase pathway might be one of its mechanisms.

Animals ; Aorta ; Atherosclerosis ; genetics ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Gene Expression ; drug effects ; Lipids ; Lipoproteins, LDL ; NF-kappa B ; metabolism ; RNA, Messenger ; metabolism ; Rats ; Simvastatin ; Transcription Factor RelA ; metabolism ; rho-Associated Kinases ; metabolism

OBJECTIVETo study the clinicopathologic and immunohistochemical features of adult type pulmonary blastoma (PB).

METHODFour cases of adult type PB were studied with light microscopy and immunohistochemical staining.

RESULTSThree cases of PB were biphasic type and were composed of primitive epithelial component and primitive stromal component; one case of PB was epithelial type and was shown as branching glands with clustered and well-differentiated structure. Immunohistochemical studies showed that AE1/AE3 was positive in the epithelial component in four cases, Vimentin was positive in the stromal component in three cases, thyroid transricption factor-1 was positive in two cases, CD117 was positive in one case, Ki-67 was 2% positive in one case, while P53 was negative in all cases.

CONCLUSIONSThe adult type PB is a rarely seen biphasic tumor. It contains a primitive epithelial component and a primitive mesenchymal stroma, which looks like well-differentiated fetal adenocarcinoma. As highly invasive intrathoracic neoplasm, it is mainly found in adult with an unfavorable outcome.

Adult ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; Male ; Pulmonary Blastoma ; metabolism ; pathology ; Retrospective Studies ; Vimentin ; metabolism

Systems-based integrated course is the core and hot spot in current advanced medical education reform.An integrated organ-system oriented curriculum system of endocrinology and metabolism was applied in eight year clinical medicine and five year excellent doctor education.The teaching contents of endocrinology and metabolism from traditional Basic Medicine,Internal Medicine and Surgery were integrated and optimized to compile the integrated syllabus and teaching cases.Curriculum integration oriented PBL teaching and comprehensive morphology experimental teaching were implemented into the integrated endocrinology and metabolism system curriculum.This endocrinology and metabolism course integration based on organ-system based learning is conducive to establishing the organic connection between Basic Medicine and Clinical Medicine,and cultivating high-quality medical talents.

[Summary] Drug naive, newly diagnosed type 2 diabetic subjects were randomized to Saxagliptin/Metformin / Rosiglitazone(Triple Therapy, n=23) or insulin 70 30 mix group(Intensive Insulin Therapy) (n=21) for 24 weeks. How did the 2 therapies influence fasting blood glucose, fasting insulin, C-peptide, and glucagon levels and the change of body weight were compared. This study was aimed to explore the comparative glycemic efficacy and impact on α/ β-cell function of two different antidiabetic therapies, triple combination therapy using saxagliptin/metformin/ rosiglitazone and intensive insulin therapy, for newly diagnosed type 2 diabetes mellitus. The results indicated that fasting blood glucose, HbA1C , insulin resistance index 2(HOMA 2-IR), glucagon and body mass index level were significantly decreased, and insulin secretion index 2 ( HOMA 2-% β) was increased significantly( P <0. 05) in triple therapy group, and the decreasing extent of HOMA 2-IR, glucagon, and body mass index were significantly greater than that in the intensive insulin group(P<0. 05). Triple therapy group has a stronger effect of reducing insulin resistance, as well as on inhibiting glucagon and promoting weight loss.

Teaching rounds is an important part of clinical teaching but it is difficult to implement in place for a variety of reasons. To endocrine and metabolic section as an example, Lack of enthusiasm, inadequate preparation and other issues result that teaching rounds is difficult to achieve the desired effect in the teaching rounds, especially in the English teaching rounds. In view of the above situation, based on the concept of PBL to carry out teaching rounds in English is not only an important method to cultivate the clinical thinking of medical students, but also an important measure to improve teachers' and students' English proficiency, as well as to cultivate medical students' clinical thinking. The last but not the least, carrying out teaching rounds in English is an important measure for medical education reform and improve-ment. Facts have proved that carrying out teaching rounds in English has a high practicality and feasibility in clinical practice.

Objective To investigate the effects of AGEs-RAGE on the apoptosis of GLUTag cells and explore the possiblc mechanism.Methods GLUTag cells treated with 0、100、200、300μg/ml of AGEs for 24h were examined for gene and protein expression of RAGE using RT-PCR and western blotting,respectively.GLUTag cells were randomly divided into four groups:control,200μg/ml AGEs,AGEs+siRNA-RAGE and AGEs+apocynin.The protein expression of p22phox、p47phox 、Bcl-2、Bax in the cells were detected with western blotting.The reactive oxygen species (ROS) levels were examined using 2'7'-dichlorodihydroflur-rescein diacetate (DCFH-DA) and the apoptosis of L cells were tested by AnnexinV-FITC/PI.Results AGEs increased thc cxpression of RAGE in a dose dependent manner.Treatment with AGEs induced a significant increase in the expression of p22phox,p47phoxand the activity of ROS,caused up-regulation of Bax and down-regulation of Bcl-2,which enhanced the apoptosis of GLUTag cells.Apocynin,the inhibitor of NADPH oxidase,prevented those responses and the effects caused by AGEs were abolished by inhibition of RAGE activity with siRNA.Conclusion AGEs positively regulate the exprcssion of NADPH oxidase-derived ROS and its down-steam signaling pathway p53/Bax by targeting RAGE,leading to the apoptosis of GLUTag cells.

Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.