Adolescent ; Adult ; Anti-Inflammatory Agents ; therapeutic use ; Diagnosis, Differential ; Dipyridamole ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lupus Erythematosus, Systemic ; drug therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Prednisone ; therapeutic use ; Tripterygium ; chemistry

AIM: To investigate the role of epigenetic modification in Pdx-1 gene transcription and expression, and to compare the differences between epigenetic modifications of Pdx-1 gene promoter in various cell types of mice. METHODS: The promoter DNA methylation and histone modification status of Pdx-1 and MLH1 genes in NIT-1 cells, NIH3T3 cells and mouse embryonic stem cells were measured by chromatin immunoprecipitation-real time PCR method. The expression levels of these genes in the three cell lines were measured by real time RT-PCR. The relation between epigenetic modifications and gene expression was analyzed. RESULTS: (1) Compared to mES cells, there was lower DNA methylation and higher H3K4m3 modification levels in the promoter of Pdx-1 gene in NIT-1 cells (P<0.05). DNA methylation, H3 acetylation, H3K4m3 and H3K9m3 modification levels in the promoter of Pdx-1 gene in NIH3T3 cells were distinctly increased (P<0.05). (2) Pdx-1 gene transcription expressed only in NIT-1 cells. The Spearman's rho between Pdx-1 gene expression and DNA methylation (r=-0.802,P<0.01) was observed. The Pearson correlation between Pdx-1 gene expression and H3K4m3 modification (r=0.997,P<0.01) was also found. The Spearman's rho between Pdx-1 gene expression and H3K9m3 modification (r=-0.879,P<0.01) was observed. (3) No correlation between housekeeper MLH1 gene expression and epigenetic modification was found. CONCLUSION: DNA methylation, H3K4m3 and H3K9m3 modification coordinated participate to regulate and control the expression of Pdx-1 gene. It is of great significance to the differentiation of β cells from ES cells.

Objective To observe the clinical effect of percutaneous transluminal angioplasty (PTA)combined with autologous peripheral blood stem cells(PBSC)transplantation in the treatment of lower extremity ischemic disorders.Methods Fourty-two cases of lower extremity ischemic disorders in the treatment group were treated with PTA and autologous peripheral blood stem cells injection and 40 cases in control group were treated with PTA exclusively.Results All the procedures were successful.In treatment group,ABI improved from 0.32 ±0.11 to(at the 3rd month)and 0.49 ±0.13(at the 6th month)(t=-6.765,-6.040,P＜0.05)while TcPO_2 improved from(26.1 ± 2.3)mm Hg to(32.7 ±4.2)mm Hg(at the 3rd month)and(34.5 ±2.7)mm Hg(at the 6th month)(t=-8.901,-14.250,P＜0.05).In control group,ABI improved from 0.30 ±0.12 to 0.47 ±0.15 and 0.47 ±0.130=-5.631,-5.873,P＜0.05)while TcPO_2 increased from(25.9 ±2.4)mm Hg to(28.9 ±2.9)mm Hg(at the 3rd month)and(28.9 ± 2.1)mm Hg(at the 6th month)(t=-5.090,-5.389,P＜0.05).There was significant difference in TcPO_2 on follow-up between the two groups after the treatment(P＜0.05).Conclusion Autologous PBSC transplantation in combination of PTA was effective for the treatment of lower extremity ischemic disorders.PBSC injection helps to increase TcPO_2.

Objective To investigate the feasibility and clinical effects of suture anchors technique for acute distal avulsion fracture of patella. Methods From January 2007 to July 2009, 33 patients(18males and 15 females, ranging from 28 to 72 years, with an average of 49.3 years) were treated with the suture anchors technique. The average time from injury to surgery was 3.5 days(2 to 7 d). Injury reason: traffic accident in 12 cases, injured in daily life in 11 cases, sports injury 9 cases, no clear trauma history in one case. The Bostman evaluation system, follow-up X-ray, and knee mobility were used to analyze the clinical effects of suture anchors technique. Results All patients obtained the follow-up and the average time was 16.5 months(12 to 23 months ). One patient suffered foreign body reaction, and his wound healing was good after operation. The remaining patient wound healing was good. No complications were found in all patients,such as popliteal fossa artery, tibial nerves or peroneal nerve complication. Bostman patella fracture functional score 27.3±2.3 points at the sixth months follow up, 28 cases were rated as excellent, 5 cases were good, and the excellent and good rate was 100%. Six months later, X-ray showed bone healing, knee activity recovered well. The Range of Motion was extension for -2.5°±2.1° and flexion for 122°±5.3°. Conclusion Suture anchors fixation in treatment of acute distal avulsion fracture of patella has a good efficacy, safety and reliability advantages, and without the second operation. This technique provides an alternative in lower pole patella fracture.

Objective To explore the diagnostic value of endoscopic retrograde cholangio-pancreatiography (ERCP),ultrasonography (US) and CT scanning on cholagio-pancreatic diseases caused by clonorchis sinensis infection.Methods The results of US,CF and ERCP examination in 65 cases of obstructive jaundice caused by clonorchiasis and confirmed by presence of imagoes or eggs in feces or bile juice were analyzed and compared retrospectively.Results US examination was the simplest and most convenient which was characterized by diffuse even dilatation,thickening of walls,strengthened echo with the shape of“equal sign”intrahepatic bile ducts.The characteristic findings of CT included saccular dilatation of bile ducts of the periphery of the liver,thickening of the walls of bile ducts.Under duodenoscopy,32.3% (21/65) of cases presented as abnormal papilla such as small opening,mucosa outward turned,trapping or stiffness.Alterations in ERCP were characterized by shm or oval filling defect,diffuse saccular dilatation of terminal intrahepatic bile ducts.The most common complications included cholangiolithiasis (40%,26/65),carcinoma of bile duct on papilla (9.8%,6/65),and pancreatitis (1.5%,1/ 65).Conclusions Three methods were all useful for diagnosis of cholangio-pancreatic diseases caused by clonorchis sinensis infection,which were identically characterized by diffuse saccular dilatation of terminal intrahepatic bile ducts.The gold standard of diagnosis was the presence of imagoes or eggs in bile juice aspirated by the route of ERCP.Endoscopic sphincterectomy with postoperative vermifugal was the first choice of the treatment.

Objective To investigate the relationship among carotid atherosclerosis,plasma homocysteine and D-dimer level in patients with acute cerebral infarction.Methods Two hundred and eightyseven cases of patients with acute cerebral infarction treated in Pudong Hospital,Shanghai from January 2011 to March 2012 were enrolled into the observation group and 287 cases of healthy people not suffering from cerebral infarction or other patients had nothing to do with cerebrovascular disease were selected into the control group.The serum levels of plasma homocysteine were determined by fluorescence polarization immunoassay (FPIA) and D-dimer level by double antibody clip method.At the same time,neck vascular artery ultrasound were performed by MycoCardR Reader Ⅱ.The relationship of carotid atherosclerosis with plasma homocysteine and D-dimer were compared between these two groups.Results There were significant differences on total cholesterol ((4.25 ± 0.92) mmol/L vs (4.98 ± 0.88) mmol/L,t =3.244,P ＜ 0.05),triacylglycerol ((1.48 ±0.82) mmol/L vs (1.78 ± 1.09) mmol/L,t =3.564,P ＜ 0.05),low density lipoprotein ((2.52-0.76) mmol/L vs (2.92 ± 0.73) mmol/L,t =2.987,P ＜ 0.05),high-density lipoprotein ((1.38 ± 0.26) mmol/L vs (1.06± 0.29) mmol/L,t =3.964,P ＜ 0.05),systolic pressure ((130.28 ± 14.78) mm Hg vs (152.98 ± 20.45) mm Hg,t =3.264,P ＜ 0.05),diastolic pressure ((78.45 ± 16.02) mm Hg vs (93.81 ± 16.88) mm Hg,t =2.785,P ＜0.05) and common carotid artery IMT(left:(0.86 ±0.41)mm vs (1.18 ±0.25)mm,t =2.164,P ＜0.05;right:(0.87 ± 0.39)mm vs (1.12 ± 0.29)mm,t =2.254,P ＜ 0.05) between observation group and control group.Homocysteine concentration and the D-dimer level of patients with carotid atherosclerosis were significant higher than that without carotid atherosclerosis (homocysteine concentration:(12.89 ± 6.56) μnol/L vs (3.17 ± 0.12) μnol/L,t =2.324,P ＜ 0.05 ; D-dimer level:(1.53 ± 0.59) mg/L vs (0.33 ± 0.23) mg/L,t =2.753,P ＜ 0.05).Conclusion The plasma homocysteine concentration and the D-dimer levels are correlated with carotid atherosclerosis in patients with acute cerebral infarction.

Objective To explore the possibility and reliability of mutual recognition of renal indexs among 20 clinical labora-tories entitled with state key clinical laboratory,and to supply reference for future national mutual recognition of laboratory examination results.Methods Determined the concentrations of TP,ALB,TC,TG and Roche multiple calibrators and sub-mitted the results.The results were analyzed for robust Z score,percentage difference after calibration,bias at medical deci-sion level to observe the possibility and reliability.Results The bias of TG was out of the least allowable bias,thus they were not appropriate to mutual recognition.Conclusion It remains immature in the mutual recognition of lipids’determina-tions and much work needs to be done in field of internal quality control of the laboratory.

Background Excessive production,deposition and contraction of extracellular matrix (ECM) of human lens endothelial cells (LECs) is one of main causes to posterior capsular opacification (PCO).Researches indicated that Wnt3a protein was involved in production of ECM and fibrosis in epithelial cells,but its effect on LECs is still unclear.Objective This study aimed to elucidate the roles of Wnt3a in production of ECM and gel contraction of LECs.Methods Lipofectamine-mediated transient transfection technique was used to introduce cDNA of Wnt3a gene and pcDNA3-HA vector into the LEC cell line SRA01/04 to act as Wnt3a transfection group and control group respectively.After 48 h of transfection,Western blot was used to detect the expression of Wnt3a,main components of ECM Col-Ⅰ,Col-Ⅳ and integrin β1.Immunofluorescence was used to detect the expression and distrubition of α-SMA and F-actin;collagen contraction was observed by mingling SRA01/04 cells with Col-Ⅰ.Results After 48 hours of transfection using lipofectamine 2000,the expressions of wnt3a protein in SRA01/04 cells was 0.703 ±0.105 in the wnt3a transfected group,and that in the control group was 0.290 ± 0.066,showing a significant difference between the two groups (t =5.782,P＜0.01).Western blot assay showed that the expression levels of Col-Ⅰ and Integrin β1 was 0.697±0.021 and 0.875±0.055 in the Wnt3a transfected group,and which was significantly higher than 0.370±0.020 and 0.580±0.030 in the control group (t =19.600,8.156,both P＜0.01).The expression level of Col Ⅳ in the Wnt3a transfected group was higher than that of the control group (0.430±0.020 vs 0.383 ±0.031),but the difference was not significant (t =2.514,P＞0.05).Immunofluorescence assay revealed that F-actin and α-SMA were weakly expressed in the cell membrane primarily in the control group,while they were strongly expressed in the cell membrane,cytoplasma in the Wnt3a transfected group.Tewnty-four hours after addtion of Col-Ⅰ,the gel contraction area ratio appeared to be more obvious in comparison with the 8 hours (64.1％ ±2.3％ vs 98.9％ ± 1.0％),and gel contraction area ratio was lower in the Wnt3a transfected group than that in the control group (64.1％ ± 2.3％ vs 93.9％ ± 3.1％).Conclusions The overexpression of Wnt3a activates the production of ECM,and the remodeling of celluar skeleton and cellular contraction.

Purpose:To study the expression of CD44v6 protein in breast carcinoma and its prognostic significance. Methods:100 cases of formalin-fixed paraffin-embeded female breast invasive ductal carcinoma tissues were retrospectively analyzed using EnVision~(TM) immunohistochemical method with the monoclonal antibody CD44v6.Statistical analysis was based on the Log-rank test and Cox analysis.Results:Sixty-six of 100 cancer tissues expressed CD44v6.Positive staining was mainly on the cell membranes.There was significant correlation between CD44v6 immunoreactivity and lymph node me- tastasis and TNM stage.The 5-and 10-year survival rates were 82.76% and 78.37% of patients with CD44v6 low-expres- sion tumors,and 64.1% and 49.88% of those with CD44v6 high-expression tumors,respectively;the difference between the two groups of patients was significant(P

Aim To evaluate the antianginal efficacy of trimetazidine in combination with other regular anti-ischemic drugs in the treatment of stable angina. Methods Twenty-two male cases with stable,effort-induced angina and positive exercise ECG test were treated with trimetazidine for 12 weeks.Exercise ECG test was examined again in the end of the study. Results There were obviously increased in exercise tolerance,total exercise workload after treatment(P