In recent years the interaction between host and gut microbiota has attracted increasing attention. However, intestinal flora dysbiosis may lead to many diseases, and there is increasing evidence that the intestinal microbiota in patients with chronic kidney disease (CKD) is associated with the pathophysiological status of the host. "Gut-kidney axis" provides a better explanation of the two-way communication between intestinal flora and CKD. Impaired kidney function leads to dysbiosis of intestinal flora and an altered intestinal flora can damage the intestinal mucosal barrier and facilitate the entry into the bloodstream of harmful bacteria, which can induce chronic inflammation and thus accelerate renal injury. In addition, the accumulation of nephrotoxic metabolites from an altered intestinal flora can aggravate CKD in the "gut-kidney axis". Among them, p-cresol sulfate, indoxyl sulfate and trimethylamine oxide are the most widely studied metabolites of nephrotoxicity, and their renal toxicity has been widely confirmed in basic research and clinical studies. Current studies show that the intestinal microbiota-metabolite network is closely related to the occurrence and development of chronic kidney disease. Thus, intervention in the intestinal microbiota may provide a new approach to the prevention and treatment of chronic kidney disease.

Objective：This study was designed to investigate the effect of brain irradiation on blood-brain barrier (BBB) quantitatively by measuring cis-diamminedichloroplatinum (DDP) concentration in cerebrospinal fluid (CSF). Methods：Twenty-two patients with brain metastases from non-small cell lung cancer (NSCLC) received brain irradiation (BI). During BI, DDP (20mg/m2) was given before radiotherapy and after cumulative doses of 10gray, 20gray, 30gray， and 40gray separately 3h prior to CSF collection and blood collection. Ten NSCLC patients without brain metastases were given the same dose DDP and the CSF and blood samples were collected. Samples were assayed for DDP levels by using flameless atomic absorption spectrophotometry. Results：There were 20 patients with and 10 without brain metastases assessable. The average DDP level in CSF was 1.02mg/L for patients with brain metastases before BI, which was significantly higher than the average level of 0.33mg/L for patients without brain metastases. The DDP level in CSF increased with the dose of BI and reached the highest level after 30gray irradiation(2.36mg/L). Conclusion：The BBB of patients with brain metastases is impaired in a certain degree and DDP could reach its therapeutic level in the CSF. The BBB would gradually open following BI, and DDP would reach the highest level after a dose of 30gray whole brain irradiation. In the CSF of patients with normal BBB, the DDP concentration is much lower than the therapeutic level.

Adenocarcinoma/surgery* ; Esophageal Neoplasms/surgery* ; Esophagogastric Junction/surgery* ; Gastrectomy ; Humans ; Margins of Excision ; Neoadjuvant Therapy ; Retrospective Studies ; Stomach Neoplasms/surgery*

The study was purposed to detect BAFF/APRIL gene expression changes in bone marrow mononuclear cells (BMMNC) and myeloma cell line U266 after interference with glucocorticoid and bortezomib. After separation of BMMNC from 7 patients with multiple myeloma, BAFF/APRIL mRNA expression in BMMNC and U266 cell line was detected by real-time PCR after treated with dexamethasone 100, 200 µg/ml, methylprednisolone 100, 200 µg/ml, bortezomib 0.1 µg/ml alone and dexamethasone or methylprednisolone combined with bortezomib respectively for 48 hours. The results showed that U266 cells and BMMNC of untreated MM patients highly expressed BAFF/APRIL genes. When dexamethasone, methylprednisolone or bortezomib was added to U266 cells or BMMNC alone, BAFF/APRIL gene expression decreased as compared with the blank control (p < 0.01). The inhibiting effect of bortezomib to BAFF/APRIL expression was obviously strong(p < 0.05). When dexamethasone or methylprednisolone combined with bortezomib, the BAFF/APRIL gene expression further decreased compared with dexamethasone or methylprednisolone alone (p < 0.01). As compared with the group of methylprednisolone combined with bortezomib, BAFF/APRIL gene expression decreased in dexamethasone combined with bortezomib with a statistically significant difference (p < 0.05). It is concluded that the expression of BAFF/APRIL gene is down-regulated after bing treated with glucocorticoids and bortezomib, which suggests that besides the glucocorticoid receptor and proteasomes targets, BAFF/APRIL and their receptor sites may be new targets of glucocorticoids and bortezomib.
B-Cell Activating Factor ; genetics ; metabolism ; Boronic Acids ; pharmacology ; Bortezomib ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; drug effects ; Glucocorticoids ; pharmacology ; Humans ; Multiple Myeloma ; metabolism ; Pyrazines ; pharmacology ; RNA, Messenger ; genetics ; Tumor Necrosis Factor Ligand Superfamily Member 13 ; genetics ; metabolism

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

This study was aimed to investigate the expression characteristics of HSP70 protein/mRNA, pim-1 mRNA in bone marrow mononuclear cells from leukemia patients, and to clarify whether these changes are related to leukemia type, tumor burden of leukemia, therapeutic reaction and prognosis. HSP70 mRNA and pim-1 mRNA in BMMNCs were detected with semi-quantitative RT-PCR in 40 leukemia patients and 10 controls. HSP70 protein in BMMNCs was assayed with Western blot in 34 leukemia patients and 10 controls. Relation of HSP70 and pim-1 expression with leukemia classification, the degree of tumor burden and therapeutic reaction were analyzed. The results showed that the BMMNCs from both leukemia patients and controls expressed HSP70 protein/mRNA. The mean ODR value of HSP70 mRNA in BMMNCs from leukemia patients was significantly higher than that of the controls; the mean ODR value of HSP70 protein/mRNA in acute myeloid leukemia and chronic myeloid leukemia patients both were significantly higher than that of acute lymphocytic leukemia patients; the mean ODR value of HSP70 protein/mRNA in acute leukemia patients with high-degree tumor burden was higher than that of the patients with low-degree tumor burden; the mean ODR value of HSP70 protein/mRNA in the patients after chemotherapy was significantly higher than that of the patients before chemotherapy; the BMMNCs from both leukemia patients and controls expressed pim-1 mRNA. The mean ODR value of pim-1 mRNA in BMMNCs from leukemia patients was significantly higher than that of the controls; the mean ODR value of pim-1 mRNA in BMMNCs for Acute lymphocytic leukemia patients was significantly higher than that of the patients suffered from acute myeloid leukemia and chronic granulocytic leukemia; there was a positive relationship between pim-1 mRNA and HSP70 mRNA expressions in leukemia patients (p < 0.05). It is concluded that there are high expressions of HSP70 and pim-1 in leukemia and their positive correlation is shown. The over-expressions of HSP70 and pim-1 protein/mRNA are related to tumor burden in leukemia patients.
Adolescent ; Adult ; Aged ; Bone Marrow Cells ; cytology ; Female ; HSP70 Heat-Shock Proteins ; genetics ; metabolism ; Humans ; Leukemia ; genetics ; metabolism ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Prognosis ; Proto-Oncogene Proteins c-pim-1 ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Young Adult

OBJECTIVETo evaluate the effect of high intensity focused ultrasound (HIFU) for liver cancer.

METHODSHIFU treatment was performed in 44 liver cancer patients under general anesthesia and ultrasound positioning. Before and after HIFU treatment, the clinical symptoms, liver functional tests, AFP and MRI were evaluated.

RESULTSAfter HIFU treatment, the remission rate of clinical symptoms was 87.5% (28/32), with the scanty ascites in 3 patients disappeared. ALT (79.73 +/- 12.31 U/L) and AST (103.47 +/- 24.55 U/L) before HIFU were reduced to normal in 84.6% (22/26) and 73.5% (25/34) patients. AFP in 64.3% (18/28) patients decreased > or = 50% of the original value. After HIFU, MRI showed coagulative necrosis and blood supply reduction or disappearance of tumor in the target region.

CONCLUSIONHIFU treatment pocesses good effect on liver cancer, which will offer a considerable weight in noninvasive local treatment of hepatic tumor.

Adult ; Aged ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Ultrasonic Therapy ; Ultrasound, High-Intensity Focused, Transrectal

Chronic spinal cord lesions (CSCL) which result in irreversible neurologic deficits remain one of the most devastating clinical problems. Its pathophysiological mechanism has not been fully clarified. As a crucial factor in the outcomes following traumatic spinal cord injury (SCI), the blood-spinal cord barrier (BSCB) disruption is considered as an important pathogenic factor contributing to the neurologic impairment in SCI. Vascular endothelial growth factor (VEGF) is a multirole element in the spinal cord vascular event. On one hand, VEGF administrations can result in rise of BSCB permeability in acute or sub-acute periods and even last for chronic process. On the other hand, VEGF is regarded to be correlated with angiogenesis, neurogenesis and improvement of locomotor ability. Hypoxia inducible factor-1 (HIF-1) is a primary regulator of VEGF during hypoxic conditions. Therefore, hypoxia-mediated up-regulation of VEGF may play multiple roles in the BSCB disruption and react on functional restoration of CSCL. The purpose of this article is to further explore the relationship among HIF-1, hypoxia-mediated VEGF and BSCB dysfunction, and investigate the roles of these elements on CSCL.
Animals ; Chronic Disease ; Humans ; Hypoxia-Inducible Factor 1 ; physiology ; Neovascularization, Physiologic ; Neurogenesis ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; physiopathology ; Vascular Endothelial Growth Factor A ; physiology

Objective: This study compared the outcomes of single blastocyst transfer cycles, using day- 5 poor-quality blastocysts and day-6 high-quality blastocysts. Methods: We analyzed 462 frozen-thawed embryo transfer (FET) cycles performed at our center from January 2014 to December 2019. The cycles were divided into two groups: a day-5 poor-quality blastocyst transfer group (group A) and a day-6 high-quality blastocyst transfer group (group B). The clinical outcomes were tested. Results: In groups A and B, respectively, the clinical pregnancy rate (CPR; 61.65% vs. 67.17%, p=0.258), implantation rate (IR; 61.65% vs. 67.17%, p=0.258), and live birth rate (LBR; 69.51% vs. 77.83%, p=0.134) showed no significant differences. Moreover, when day-3 embryo quality was considered, the CPR, IR, and LBR were also similar in group A and group B (p>0.05). Conclusion The clinical outcomes of day-5 poor-quality blastocysts and day-6 high-quality blastocysts were similar, suggesting that the developmental speed of the embryo might be more important than embryo quality for the clinical outcomes of single blastocyst transfer in FET cycles.

OBJECTIVETo assess the association between leptin gene promoter methylation and serum leptin concentrations in patients with impaired glucose regulation (IGR) and type 2 diabetes mellitus (T2DM).

METHODSMethylation status of leptin gene promoter was determined with methylation-specific polymerase chain reaction. Serum leptin concentrations were determined using enzyme-linked immunosorbent assay.

RESULTSAmong three groups of individuals with different levels of glucose, the methylation rates of leptin gene in IGR and T2DM groups were 43.6 % and 31.5 %, respectively, which were significantly lower than that of healthy subjects (59.2%; Chi-square=22.499 and 5.109, respectively, P<0.05). A lower methylation rate was also observed in T2DM group compared with IGR group (Chi-square=3.962, P<0.05). Leptin levels in both T2DM and IGR groups were elevated compared with normoglycemic subjects, but only T2DM group was significantly higher (q=6.81, P<0.01). Linear regression analysis indicated that serum leptin concentrations has increased along with declining of DNA methylation rate (r=-0.95, P<0.01).

CONCLUSIONLower levels of leptin gene promoter DNA methylation and serum leptin concentrations are associated with the development of diabetes. Measurement of the methylation status of leptin gene promoter and expression can facilitate early intervention of the disease.

DNA Methylation ; Diabetes Mellitus, Type 2 ; genetics ; metabolism ; Female ; Genetic Predisposition to Disease ; Glucose ; genetics ; metabolism ; Humans ; Leptin ; blood ; genetics ; metabolism ; Male ; Middle Aged ; Promoter Regions, Genetic