Adult ; Carbamazepine ; adverse effects ; therapeutic use ; Drug Eruptions ; etiology ; Female ; Humans ; Tinnitus ; drug therapy

Objective To analyze the characteristics and hepatotropism of this negative element HBVnt453-250 sequence.Methods pHBv453-250,pHBV250-453.plucHBV453-250 and plucHBV250-453 were constructed,with luciferase and enhanced green fluorecence protein(EGFP)gene as the reporter gene,respectively.After transfection of HepG2 cells with these plasmids,luciferase assays,real-time PCR and western blot assays were used to detect the gene transcription and expression level.The SV40 promoter of pGL3 control and pHBV453-250 were replaced by the cytomegalovirus early promoter,resulting in plasmids pCMVcontrol(luc)and pCMV453-250(luc).Results Compared with pHBV453-250,the mutant plasmids.with the inhibitory element inserted in difierent site or inverted orientation.exerted similar downregulation of Juciferase gene transcription and expression.Western blot analysis demonstrated the similar repression when EGFP was used as the reporter gene.By transfeeted to HepG2 cell line,the plasmid pCMV453-250(1UC)could reduce lneiferase activity(36.56%)compared with pCMLcontrol(luc).When the plasmids plueHBV453-250 and plucHBV250-453 were transfected to non-liver cell lines(A549,HeLa),luciferase gene was expressed weakly,compared with that of pGL3control(P＜0.05).Conclusion The inhibitory effect of HBVnt453-250 sequence acted in both orientation-and position-independent manners,and had no promoter selectivity and funotioned in hepatocyte-independent manner.

Objective To examine the incidence and risk factors associated with atrial fibrillation in elderly coronary heart disease patients who underwent off-pump coronary artery bypass surgery.Methods From Jun.2008 to Jun.2009,one hundred and eleven patients received OPCAB in our hospital.Clinical data including coronary angiography,diseased vessels,number of bypass grafts,postoperative electrolyte,postoperative hemodynamic measurements,anti-arrhythmic drugs used and other risk factors for atrial fibrillation was collected and reviewed individually.The mean age of patients was(73.19±2.79)years(range from 70 to 82 years).Seventy-nine patients were male and 32 were female.The mean left ventricular ejection fraction(LVEF)was 0.57±0.12,NYHA Ⅰ-Ⅳ.All patients received OPCAB.Saphenous vein(SV)and left internal mammary artery(LIMA)were harvested and used as grafts.LIMA was routinely anastomosed to the left anterior descending artery (LAD),and SV was anastomosed to the other target vessels.The average number of grafts.was(2.79±0.54)per case.The mean operation time was(3.70±0.88)hours and the duration of ICU-staying was(1.32±0.94)days.The patients were divided into 2 groups:atrial fibrillation group and non-atrial fibrillation group.Results Four deaths occurred perioperatively.The mortality was 3.42%.Major postoperative complications included low cardiac output,respiratory dysfunction and acute kidney injury.Twenty seven out of 111 patients who underwent off-pump coronary artery bypass surgery had atrial fibrillation postoperatively.The incidence was 24.3%.Single factor analysis revealed that CVP,serum levels of potassium,magnesium,and SPO2 were lower significantly in atrial fibrillation group than those in the non-atrial fibrillation group,P<0.05.Conclusion Changes of perioperative electrolytes and circulating blood volume,decline in the oxygen saturation,and the occurrence of perioperative myocardial infarction after coronary artery bypass surgery were the risk factors associated with atrial fibrillation.

Objective To observe the clinical effect on cervicogenic headache (CEH) of pulsed radiofrequency stimulation (PRF) applied to the C2 dorsal root ganglion combined with nerve block.Methods A total of 78 cases diagnosed as CEH were randomly divided into a combined treatment group,a PRF treatment group and a nerve block group.The combined treatment group was given both PRF applied to the C2 dorsal root ganglion and blocking therapy.The other two groups were given only one treatment or the other.All the treatments were once weekly for 3 weeks.Before treatment and 1,3 and 6 months after treatment,all of the patients' headaches were evaluated using a visual analogue scale (VAS).Results At 1,3 and 6 months after treatment,the average VAS scores of all three groups had decreased significantly.The VAS ratings dropped the most in the combined treatment group,followed by the PRF group and then the nerve block group.All the intergroup differences were statistically significant.The combined treatment group's cure rate (88％) was significantly better than that of the PRF group (81％),which was significantly better than that of the nerve block group (54％).Conclusion Combining PRF applied to the C2dorsal root ganglion with nerve block therapy has a synergistic effect on CEH.The curative effect of the combined treatment was better than either PRF or blocking alone.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective To investigate the effects of emodin on the triglyceride metabolism and oxidative stress in steatosis in HepG2 cells and possible underlying mechanisms.Methods The appropriate concentration of emodin on HepG2 cells were detected by methyl thiazolyl tetrazolium (MTT) assay.HepG2 cells were induced to fat overaccumulation by 1 mmol/L free fatty acids (FFA) (oleate∶ palmitate =2∶1).The model group exposed to 10 μmol/L,20 μmol/L,40 μmol/L emodin.The intracellular lipid accumulation was documented by Oil Red O staining and the content of triglyceride and total cholesterol was observed.Reactive oxygen species (ROS) was determined by flow cytometry.Western blotting was performed to analyze the protein levels of adenosine monophosphate-activated protein kinase (AMPK),phosphorylated AMPK,and sterol regulatory element-binding protein 1 (SREBP-1).Results Emodin reduced lipid accumulation and triglycerides (TG) content (P ＜ 0.05).At the same time,it significantly reduced ROS production (P ＜ 0.05).Moreover,the levels of AMPK and p-AMPK protein were significantly upregulated,and SREBP-1 protein was significantly downregulated with the treatment of emodin (P ＜ 0.01).Conclusions This study has demonstrated that emodin can reduce fatty degeneration induced by FFAs in hepatocytes,and this effect may be partially mediated by the AMPK/SREBP-1 pathway.

Objective To retrospectively analyze the diagnosis and treatment of multicentric Castleman's disease (MCD) ,and review related literatures. Methods A total of six patients were first-ever diagnosed as MCD and treated with combination chemotherapy and/or interferon α. The clinical manifestation, laboratory findings and therapeutic strategies were recorded in detail. Results In the six HIV-negative patients, histologically, four of them were diagnosed with plasma cell type of Castleman's disease, two with mixed type. All the six patients showed multiple lymphadenopathy, polyclonal hypergammaglobulinemia and hypoalbuminemia. One of the two patients treated with interferon α achieved complete remission, and the other,who showed no effects with hormone and combination chemotherapy ,achieved sustained partial remission after treatment with interferon α for 3 months. Of the four patients treated with combination chemotherapy, three achieved partial remission, and one died of no effects. Conclusions Interferon α and combination chemotherapy might be the most effective and convenient therapeutic methods for MCD. Serum albumin level may be used as a diagnostic and monitoring index for MCD.

Objective To study the changes in miRNAs expression in the exosomes of human umbilical vein endothelial cells(HUVECs) after 60 Co γ-rays expose using microRNA(miRNA) chips and bioinformatics techniques so as to provide new clues to the mechanism of radiation-induced vascular tissue injury and its bystander effects.Methods HUVECs exosomes were collected in the control and 4 Gy irradiated cells by ultra-high-speed centrifugation,and further confirmed using transmission electron microscopy (TEM) and Western blotting of exosomes biomarkers.miRNA microarray was used to analyze miRNA expression profiles of exosomes and cells.Also,real-time quantitative PCR(qRT-PCR) was used to verify differentially expressed miRNAs,and the miRDB and TargetScan were performed to predict the target genes of the differentially expressed miRNAs.Bioinformatics analysis was performed using DAVID,KEGG and other online tools.Results Compared with the control exosomes from non-irradiated HUVECs,miRNA microarray analysis revealed that 5 up-regulated,and 13 down-regulated miRNAs were identified in the exosomes from HUVECs at 0.5 h after 4 Gy-irradiation,and 16 up-regulated and 5 down-regulated miRNAs at 2 h after 4 Gy-irradiation.Moreover,38 and 85 miRNAs were differentially expressed respectively in the HUVECs at 0.5 h and 2 h after radiation.The difference was statistically significant(P<0.01).The results of bioinformatics showed that these miRNAs might exert the radiation-induced bystander effect (RIBE) by regulating MAPK signal pathways,RAS and PI3K-Akt signal pathways.Conclusion The ionizing radiation injury significantly alters the components and expression levels of exosomal miRNAs,which play important roles in regulating the signal pathways in response to radiation.

Objective To investigate the mechanism of pioglitazone preventing diabetes and the role of nuclear factor of actived T cells (NFAT) on non-obese diabetic(NOD) mice .Methods (1)Female NOD mice at 4 weeks of age were randomly divided into pioglitazone group(n=21) and control group(n=21) .The accumulative diabetes incidence was followed-up to 30 weeks of age in each group of NOD mice .(2)Pancreas were removed from NOD mice at 12 weeks of age in each group(n=15) to score insulitis se-verity by routine HE staining .IL-4 ,IFN-γand peroxisome proliferator-activated receptor γ(PPARγ) mRNA levels in spleens were tested by RT-PCR .IL-4 and IFN-γlevels in sera ,the activity of PPARγand NFATc1 nuclear protein in spleens were measured by enzyme linked immunosorbent assay (ELISA) .Results (1) At 15 weeks of age ,the diabetes incidence was 4 .76% in pioglitazone group ,and 33 .33% in control group(P<0 .05) .At 30 weeks of age ,the diabetes incidence was 57 .14% in pioglitazone group ,and 76 .19% in control group(P>0 .05) .(2) At 12 weeks of age ,the insulitis score in pioglitazone group was lower than that in control group[(1 .79 ± 0 .75) vs .(2 .38 ± 0 .66) ,P<0 .05] .(3) IFN-γ mRNA level in pioglitazone group was lower than that in control group[(0 .16 ± 0 .07) vs .(0 .53 ± 0 .26) ,P<0 .05] ,and PPARγmRNA level in pioglitazone group was higher than that in control group(0 .91 vs .0 .25 ,P<0 .05) .(4)IFN-γ level in pioglitazone group was lower than that in control group [(561 .05 ± 78 .61)pg/mL vs .(666 .43 ± 28 .42)pg/mL ,P<0 .05] .(5)At 12 weeks of age ,the spleen PPARγnuclear protein activity in pioglitazone group was higher than that in control group [(0 .05 ± 0 .01) vs .(0 .02 ± 0 .01) ,P<0 .05)] ,and NFATc1 nuclear protein activity was low-er than that in control group[(0 .23 ± 0 .04) vs .(0 .33 ± 0 .04) ,P<0 .05] .Conclusion Pioglitazone could activate PPARγ nuclear protein ,inhibit activity of NFATc1 nuclear protein ,downregulate IFN-γ,diminish Th cells deviating to Th1 ,and sequently prevents insulitis and diabetes onset in NOD mice .

BACKGROUND:A large number of biomechanical studies and clinical application research showed that unilateral pedicle screw fixation with a single cage can not only make the spine to obtain immediate stability, and also reduces the fixed segment stiffness. However, there is not related research on the change of adjacent segment disc nucleus pulposus volume with unilateral pedicle screw. OBJECTIVE:To evaluate the effects of unilateral pedicle screw fixation with a single cage on adjacent segment degeneration for treating lumbar degenerative disease with MRI measurement of lumbar nucleus pulposus volume. METHODS:A total of 34 patients with lumbar disc herniation were treated by posterior lumbar interbody fusion with unilateral pedicle screw fixation with a single cage insertion. There were L4-5 segment in 16 patients (9 males and 7 females) and L5-S1segment in 18 patients (10 males and 8 females). The fixator was taken out at 18 months after surgery. They were folowed up for 24 to 36 months. With MRI, the transverse diameter and sagittal diameter of the nucleus pulposus were measured by using T2-weighted images at 6, 12, 18, 30 months after treatment, while the nucleus pulposus height was measured by middle sagittal position. Cephalic intervertebral height was measured with angular bisector method on X-ray films. Effects of unilateral pedicle screw fixation on cephalic intervertebral disc degeneration were evaluated according to nucleus pulposus volume and the intervertebral space height. RESULTS AND CONCLUSION:(1) Nucleus pulposus volume at cephalic L3-4 on the fixed L4-5segment was reduced in male patients after 30 months of treatment compared with pre-treatment (P=0.139), but increased in female patients (P=0.143). (2) Nucleus pulposus volume at L4-5 near to fixed L5-S1 segment was slightly reduced in male patients after 30 months of treatment (P=0.096); nucleus pulposus volume was slightly increased in female patients after 6, 12, 18 and 30 months of treatment (P > 0.05). (3) Disc space height at cephalic L3-4 near to L4-5 segment was diminished in male and female patients at 30 months of treatment (P > 0.05). (4) Disc space height at cephalic L4-5 near to L5-S1 segment was slightly reduced in male and female patients compared with pre-treatment (P > 0.05). (5) Unilateral pedicle screw with a single cage could effectively prevent adjacent segment degeneration in treatment of partial lumbar intervertebral degenerative disease.