The B-cell lymphoma gene 2 (Bcl-2) is considered as the most important inhibiting cell apoptosis control gene,and its expression is up-regulated in asthma.Drug intervention against Bcl-2 affects signal pathways,down-regulates the Bcl-2 expression,and induces programmed cell death.It may become the target of asthma treatment.This article reviews the structure characteristics of the Bcl-2,the mechanism of regulating apoptosis,and its role in asthma.

Objective To investigate the consistent long-term clinical efficacy of the procedure for prolapsed hemorrhoids (PPH) treatment for hemorrhoids.Methods Data of 87 patients with third-and fourth-degree hemorrhoids treated by surgical procedure for prolapsed hemorrhoids were collected.In all cases,third-degree hemorrhoids in 65 cases,fourth-degree hemorrhoids in 22 cases,median followed up after PPH was (3.8 ± 0.5) years.The long-term efficacy and the occurrence of complications were followed up to assess the effect of surgical procedure for prolapsed hemorrhoids.Results In patients with third-degree hemorrhoids,bleeding recurred in 2 cases (3.1％) for again bleeding,for anal bulge in 4 cases (6.2％).In patients with fourth-degree hemorrhoids,prolapse recurred in 2 cases (9.1％) for bleeding in 5 cases (22.7％).anal bulge 3 patients (13.6％),defecation difficult in one case (4.5％),one-degree of fecal incontinence in 1 case (4.5％),no other complications found,such as anal pain,anal stenosis,foreign body discomfort and fecal urgency.The chi-square test for comparison analysis suggested that:third-degree hemorrhoids postoperative prolapse and bleeding recurrence rate was significantly lower than fourth-degree hemorrhoids.Conclusions Procedure for prolapsed hemorrhoids treatment for hemorrhoids is safe and feasible,has small trauma,little pain,and definite efficacy,fewer complications,shorter hospital stay,lower reoperation rate,etc.But the long-term efficacy for third-degree hemorrhoids is superior to the fourth-degree hemorrhoids.

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

leptin-induced VSMCs proliferation as well as expression of PCNA and OB-R at both mRNA and protein levels. The maximum effect was at 100 μmol/L(P<0.01).

Objective To observe the effects of intrabepatic injection with bepatocyte growth factor and dexamethason on stereological quantitative changes of hepatic sinusoidal tissues and expression of IV-collagen on hepatic sinusoidal walls of patients with hepatic cirrhosis.Methods Under the guide of hypersound,98 cases of hepatic cirrhosis were intrahepatic injected with 80mg hepatocyte growth factor and 1mg dexamethason at one time,twice a week,12 times a course,pathological changes of hepatic sinusoidal tissues and the expression of IV-coliagen on hepatic sinusoidal walls were detected by liver biopsy after one course.Results Pathological changes of hepatic sinusoidal tissues were improved obviously(P＜0.01 ) and the expression of IV-collagen was alleviated significantly(P＜0.01 ) on 98cases of hepatic cirrhosis after one course.Conclusion Pathological changes of hepatic sinusoidal tissues and the expression of IV-collagen on hepatic sinusoidal wails can be improved obviously on patients with hepatic cirrhosis who had been intrahepatic injected with hepatocyte growth factor and dexamethason under the guide of hypersound.

Objective To study the effects of melatonin (MT) on hepatic tissue of autoimmune hepatitis (AIH). Methods AIH model rats were divided randomly as model group, MT group and pig hepacyte growth factor (pHGF) group, to observe the pathological changes of hepatic tissue of the three groups. Results Hepatic tissue inflammation and accrementition graded of elastic fibers, reticular fibre, collagenous fibrils of MT group [(0.97±0.16),(1.09±0.17),(1.31±0.17)] were much lighter than model group [(1.55±0.18),(2.00±0.14),(3.00±0.14)](all P<0.01). The expression of VEGF was weaker in MT group than in pHGF group. There was no distinct difference between MT group and pHGF group. Conclusion MT can obviously improve the pathological changes of hepatic tissue of rats with AIH.

Objective To evaluate the effect of keeping atrial septal fenestration in correction of total anomalous pulmonary venous connection (TAPVC) with left ventricular hypoplasia.Methods We reviewed 44 TAPVC patients between June,2006 and June,2013 in Shanghai Xinhua Hospital.According to whether keeping atrial septal fenestration during operation,patients were divided into group A(keeping fenestration,25 cases) and group B(no fenestration,19 cases).Retrospective statistical analysis was carried on the in-patient data and follow-up outcomes.Results No statistically significant differences between the two group on age,weight,left ventricular volume and crossclamp time (P ＞ 0.05).While cardiopulmonary bypass time,ventilation time,dosage of positive inotropic drugs,and ICU stay time of group A were shorter compares with group B (P ＜ 0.05).4 patients in group A (16.00％) suffered from low cardiac output syndrome (LCOS) postoperatively,and 6 in group B(31.58％).Pulmonary edema occurred in 3 patients,1 in group A(4.00％),and 2 in group B(10.53％).Total post-operative mortality was 6.82％ (3/44).2 cases died of serious LCOS(1 from group A,and the other from group B),1 cases died of infection and multiple organ dysfunction syndrome(group B).No significant difference of mortality was observed between two groups.Follow-up data showed some fenestrations can close naturally.Conclusion Keeping atrial septal fenestration can be done as a feasibility tactic in correction of TAPVC with left ventricular hypoplasia.

Objective To extract principal components from valuable indicators on conventional ultrasoundand contrast-enhanced ultrasound (CEUS) in the differential diagnosis of thyroid benign and malignant lesions and to discuss the diagnostic value of each indicator.Methods One hundred and three patients with 125 thyroid lesions (65 malignant lesions and 60 benign lesions) underwent preoperative grayscale ultrasound (GSUS),color Doppler ultrasound (CDUS) and CEUS examinations.Eighteen indicators were chosen to evaluate every lesion and principal components were extracted by principal component and valuable indicators were ordered by importance.Results There were significant differences on GSUS and CEUS indicators between benign and malignant lesions.The first principal component was the representation of contrast enhanced ultrasound and was valuable in the differential diagnosis of thyroid benign and malignant lesions.The rank of valuable CEUS indicators were homogeneity of enhancement,filling defect,relative arrival time of periphery,peak interior echogenicity,relative arrival time of interior,peak peripheral echogenicity and ring enhancement.Conclusions GSUS and CEUS are valuable in the differential diagnosis of thyroid benign and malignant lesions.

Objectives To report the ifrst Chinese case of early onset argininosuccinic aciduria. Methods A girl aged three days was admitted because of vomiting and lethargy from the second day of life. General laboratory examination, blood amino acids analysis, urine organic acids tests and gene studies were performed for the diagnosis. Results Severe hyperam-monemia, liver dysfunction, metabolic acidosis, hypokalemia and hypocalcemia were found. Bood citrulline was extremely elevated (1098.12μmol/L vs normal range 5 to 25μmol/L), while blood arginine was decreased. Urine orotic acid, uracil and argininosuccinic acid were signiifcantly elevated. Two known heterozygosis mutations on ASL gene, c.544C>T (p.R182X) and c.706C>T (p.R236W), conifrmed the diagnosis of argininosuccinic aciduria. Unfortunately, protein-restricted diet with L-arginine supplement showed no effect. The patient died at the 23th day of life. Conclusions Argininosuccinic aciduria is a severe inherit-ed metabolic disorder. Clinical diagnosis is dififcult. It is characterized biochemically by severe citrullinemia. Urine organic acids analysis and ASL gene analysis are important for the differential diagnosis. In this study, a case of neonate death due to early-on-set argininosuccinic aciduria was diagnosed by post-mortem investigation. ASL gene study is helpful for the genetic counseling and prenatal diagnosis of the disease.

The relationship between visfatin.endothelin, and insulin resistance in the pathogenesis of type 2 diabetes mellitus was explored. Endothelin, visfatin, and other markers were compared. Plasma visfatin was reduced after therapy. Endothelin was positively correlated with fasting insulin, HOMA-IR, HOMA-p, and visfatin. Visfatin was positively correlated with endothelin, HbA1C , fasting insulin, and HOMA-IR. HOMA-IR was an independent related factor in influencing visfatin. The visfatin is related to endothelin and insulin resistance, which may contribute to the pathogenesis of insulin resistance and type 2 diabetes mellitus.