Refractory ulcer is a commonly seen disease clinically. We believe the therapeutic strategies for refractory ulcer should include changing life style, standardizing medication, tracing observation, and rechecking in regularity. Traditional Chinese medicine combined with western medicine can be used for the treatment. When the therapeutic effect is not good, diagnosis and therapeutic methods need to be re-judged.Local therapy and operation can be performed if necessary.

Objective: To investigate the impact of anemia on prognosis for acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Methods: A total of 220 ACS patients with successful PCI were studied. According to WHO standard, anemia was deifned by HB<130 g/L in male, HB<120 g/L in female, the patients were divided into 2 groups: Anemia group,n=56 and Non-anemia group, n=164, clinical condition was followed-up for 1 year to record the incidence of major adverse cardiac events ( MACE); based on MACE incidence, the patients were divided into another 2 groups: MACE group,n=61, Non-MACE group,n=159, clinical condition with relevant risk factors were analyzed and compared between 2 groups. Results: The patients’ mean age was at (62.39 ± 10.17) years, the ratio of anemia was 26.8% (56/220). Compared with Non-anemia group, the patients in Anemia group had more female gender and 3-vessel disease, higher Gensini score and MACE incidence; while decreased eGFR, lower levels of TC, TG and lower ratios of hypertension and smoking, allP<0.05. Compared with Non-MACE group, the patients in MACE group had the elder age, higher occurrence rates of anemia, diabetes, left ventricular dysfunction (LVEF<50%) and decreased eGFR, allP<0.05-0.001. Logistic analysis indicated that anemia (OR=2.507, 95% CI 1.012-6.208,P=0.047) was the independent risk factors for MACE occurrence in ACS patients at 1 year after PCI. Conclusion: ACS patients combining anemia had the higher incidence of MACE, anemia was the independent risk factor for poor prognosis in ACS patients after PCI.

Objective To investigate the effect of maternal limb ischemic preconditioning on the expression of caspase-3 in neurons in brain tissues after reoxygenation in the fetal rats with intrauterine distress.Methods Forty Sprague-Dawley rats at 19 days of gestation were randomly divided into 4 groups (n=10 each) using a random number table:sham operation group (group S),limb ischemic preconditioning group (group LIP),fetal rat distress group (group FD),and limb ischemic preconditioning + fetal rat distress group (group LIP+FD).Distress/reoxygenation model was established by clamping the uterine and ovarian arteries and veins with a micro-artery clamp for 15 min followed by removal of the clamp to permit reperfusion.Limb ischemic preconditioning was induced by 3 cycles of occlusion of the lower limb blood flow at the site of the right groin for 5 min with a tourniquet followed by 5 min unclamping.In group LIP+ FD,the uterine and ovarian arteries and veins were clamped,and limb ischemic preconditioning was performed at the same time.Cesarean section was performed on 2 days after the end of treatments in each group,and the fetal rat mortality rate was calculated.The fetal rats alive were sacrificed,and the hippocampi were isolated for determination of neuronal apoptosis (by TUNEL) and expression of caspase-3 protein and mRNA (by Western blot and real-time reverse transcriptase polymerase chain reaction,respectively) in hippocampal CA1 region.Apoptosis index was calculated.Results Compared with group S,the fetal rat mortality rate and apoptosis index were significantly increased,and the expression of caspase-3 protein and mRNA in hippocampal CA1 region was significantly up-regulated in FD and LIP+FD groups (P＜0.05 or 0.0l),and no significant change was found in the parameters mentioned above in group LIP (P＞0.05).Compared with group FD,the fetal rat mortality rate and apoptosis index were significantly decreascd,and the expression of caspase-3 protein and mRNA iu hippocampal CA1 region was significantly down-regulated in group LIP+FD (P＜0.05 or 0.01).Conclusion The mechanism by which maternal limb ischemic preconditioning inhibits apoptosis in neurons after reoxygenation is related to down-regulation of the expression of caspase-3 in the fetal rats with intrauterine distress.

Objective To compare the pharmacological actions of Liandai Tablet(LT) and its main active components on apoptosis of gastric cancer cells and DNA damage. Methods Effects of Liandai Tablet(LT) and its main active components,berberine and indirubin,on growth and apoptosis of gastric cancer cell strain MGC_803 were explored and their effects on DNA damage were also studied. Results LT serum in high and low dosages and berberine could inhibit the growth of MGC_803 as compared with the control group,and typical morphological features of apoptosis were found in the MGC_803 by methyl green pyronin stain assay.But indirubin at various concentrations showed no obvious inhibitory effects. Agarose gel electrophoresis assay revealed that the MGC_803 cell DNA was split into large fragments when treated with berberine. Conclusion LT serum exerts a similar inhibitory effect on the growth and apoptosis of gastric cancer cells as compared with berberine.The effects of LT at various serum concentrations on MGC_803 DNA was less than that of berberine,and indirubin at the given concentration had no this effect.

The aim of this study was to determine the raising anticancer effects of resveratrol (Res) on paclitaxel (PA) in non-small cell lung cancer (NSCLC) cell line A549. The 10 µg/ml of Res had no effect on human fetal lung fibroblast MRC-5 cells or on A549 cancer cells and the 5 or 10 µg/ml of PA also had no effect on MRC-5 normal cells. PA-L (5 µg/ml) and PA-H (10 µg/ml) had the growth inhibitory effects in NSCLC cell line A549, and Res increased these growth inhibitory effects. By flow cytometry experiment, after Res (5 µg/ml)+PA-H (10 µg/ml) treatment, the A549 cells showed the most apoptosic cells compared to other group treatments, and after additional treatment with Res, the apoptosic cells of both two PA concentrations were raised. Res+PA could reduce the mRNA and protein expressions of COX-2, and Res+PA could reduce the COX-2 related genes of VEGF, MMP-1, MMP-2, MMP-9, NF-κB, Bcl-2, Bcl-xL, procollagen I, collagen I, collagen III and CTGF, TNF-α, IL-1β, iNOS and raise the TIMP-1, TIMP-2, TIMP-3, IκB-α, p53, p21, caspase-3, caspase-8, caspase-9, Bax genes compared to the control cells and the PA treated cells. From these results, it can be suggested that Res could raise the anticancer effects of PA in A549 cells, thus Res might be used as a good sensitizing agent for PA.
Carcinoma, Non-Small-Cell Lung ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Cell Line* ; Collagen ; Fibroblasts ; Flow Cytometry ; Humans ; In Vitro Techniques* ; Lung ; Paclitaxel* ; Procollagen ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Tissue Inhibitor of Metalloproteinase-3 ; Vascular Endothelial Growth Factor A

Objective To observe the effects of Jianpi Qutan Huayu Prescription on oxidative stress and inflammatory response in mini-pigs with atherosclerosis(AS);To explore its mechanism based on the NOX5-ERK1/2 signaling pathway.Methods Twelve Bama mini-pigs were randomly divided into control group,model group,and Jianpi Qutan Huayu Prescription low-and high-dosage groups,with 3 pigs in each group.A high-fat diet was used to feed for 24 weeks to construct an AS model,and the treatment group was also supplemented with Jianpi Qutan Huayu Prescription in the feed.The general condition of mini-pigs(body length,abdominal circumference,body mass,food intake,and fecal water content)was measured at week 0,16,and 24 of administration,HE staining was used to observe the morphology of aortic tissue,while oil red O staining was used to observe lipid deposition in aortic and myocardial tissue,transmission electron microscopy was used to observe the ultrastructure of aortic tissue,and a fully automated biochemical analyzer was used to detect serum contents of TC,HDL-C,and LDL-C.ELISA was used to detect the contents of serum reactive oxygen species(ROS),interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-α,hypersensitivity-C-reactive protein(hs-CRP),vascular cell adhesion molecule-1(VCAM-1),and intercellular adhesion molecule-1(ICAM-1).Western blot was used to detect the expressions of NADPH oxidase 5(NOX5),extracellular signal regulated kinase 1/2(ERK1/2),p-ERK1/2,VCAM-1,and proliferating cell nuclear antigen(PCNA)proteins.Results Compared with the control group,the abdominal circumference,body mass,and food intake of mini-pigs in the model group increased at 16 and 24 weeks(P<0.01),there was significant thickening of the inner membrane of aorta,destruction of endothelial cells,lipid deposition,edema of smooth muscle cells,and significant swelling of mitochondria,serum TC,LDL-C contents and the contents of ROS,IL-6,IL-10,TNF-α,hs-CRP,VCAM-1,and ICAM-1 increased,while the content of HDL-C decreased(P<0.01);the expressions of NOX5,p-ERK1/2,VCAM-1,and PCNA proteins in aortic tissue increased(P<0.01).Compared with the model group,Jianpi Qutan Huayu Prescription low-and high-dosage groups showed a decrease in abdominal circumference,body mass,and food intake at 16 and 24 weeks(P<0.05,P<0.01),the plaque area and lipid deposition were reduced,and the damage to endothelial cells was alleviated,serum TC,LDL-C contents and the contents of ROS,IL-6,IL-10,TNF-α,hs-CRP,ICAM-1,and VCAM-1 decreased,and the content of HDL-C increased(P<0.01,P<0.05);the expressiond of NOX5,p-ERK1/2,VCAM-1,and PCNA proteins in aortic tissue decreased(P<0.01,P<0.05).Conclusion Jianpi Qutan Huayu Prescription can effectively alleviate AS in mini-pigs,and its mechanism may be related to inhibiting the activation of the NOX5-ERK1/2 signaling pathway and alleviating oxidative stress-induced inflammatory response.

Objective To investigate the difference in the prognosis of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) caused by hepatitis recurrence after withdrawal of nucleos(t)ide analogues (NUC) and possible causes in HBeAg-positive versus HBeAg-negative chronic hepatitis B (CHB) patients. Methods A total of 108 CHB patients with HBV-ACLF caused by withdrawal of NUC who were admitted to The First Affiliated Hospital of Nanchang University from January 2017 to December 2018 were enrolled, and according to HBeAg status, these patients were divided into HBeAg-positive group with 57 patients and HBeAg-negative group with 51 patients. The two groups were compared in terms of sex, age, clinical manifestation, signs, levels of total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, prothrombin time, activated partial thromboplastin time, prothrombin time/international normalized ratio, and HBV DNA quantification on admission, complications (including hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis), and prognosis of HBV-ACLF. In addition, 48 CHB patients with continuous NUC antiviral therapy for > 2 years and HBV DNA < 20 IU/mL were enrolled, and the serum level of HBV pgRNA was measured to investigate the possible causes of the difference in the prognosis of HBV-ACLF between the patients with different HBeAg statuses. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data. Results For the 108 patients with HBV-ACLF caused by drug withdrawal and recurrence, the HBeAg-positive group had an improvement rate of 49.1% and the HBeAg-negative group had an improvement rate of 74.5%. The HBeAg-negative group had a significantly higher improvement rate than the HBeAg-positive group ( χ 2 =2.811, P =0.006). The HBeAg-positive group had a significantly higher level of HBV DNA than the HBeAg-negative group on admission ( t =-3.138, P =0.002). For the 48 CHB patients who achieved virologic response after long-term antiviral therapy, the HBeAg-positive group had a significantly higher HBV pgRNA load than the HBeAg-negative group ( H =2.814, P =0.049). Conclusion Compared with the HBeAg-positive CHB patients, HBeAg-negative CHB patients have a significantly better improvement rate of HBV-ACLF caused by hepatitis recurrence after withdrawal of NUC antiviral therapy. The difference in baseline HBV pgRNA level may be associated with the difference in the prognosis of HBV-ACLF in patients with different HBeAg statuses.