BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective.
OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis.
METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software.
RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.

Objective To investigate the mechanism of preventing islet β-cell apoptosis in NOD mice with pioglitazone.Methods Female NOD mice at 4 weeks of age were divided into pioglitazone group ( n =21,0.02％pioglitazone was added into the feed ) and control group ( n =21,fed with regular diet).The accumulative incidence of diabetes was followed-up to 52 weeks of age in each group of NOD mice.Pancreas was removed from NOD mice at 12 weeks of age in each group ( n =15 ) to score severity of insulitis by routine H-E staining.The apoptotic β-cells in islets were observed with double-labeling technique of TUNEL in situ combined with standard sensitive avidin-biotin complex (sABC) immunohistochemical method.The spleens were taken for cell culture; IL-4 and IFN-γ levels in sera and supernatants of cultured splenocyte,the activity of PPARγ and NF-κB nuclear proteins in cultured splenocyte were measured by ELISA.Results (1)At 30 and 52 weeks of age,the respective incidences of diabetes were 57.1％ and 76.2％ in pioglitazone group,and 76.2％ and 90.5％ in control group ( all P＞0.05 ).At 15 weeks of age,the incidence became 4.8％ in pioglitazone group,and 33.3 ％ in control group ( P =0.045 ).( 2 ) At 12 weeks of age,the percentages of non infiltrated islet and peri-insulitis islet in pioglitazone group were higher than those in control group ( 14.73％ vs 5.69％,P＜0.01 ; and 26.02％ vs 15.72％,P＜0.01 ),and that of intraislet insulitis was lower than that in control group ( 59.25％ vs 78.59％,P＜0.01 ).The percentage of apoptotic β-cell in pioglitazone group was lower than that in control group( 6.17％ ±3.62％ vs 10.62％ ±4.43％,P=0.008 ).(3) In sera,IFN-γ level in pioglitazone group was lower than that in control group [( 561.05±78.61 ) vs ( 666.43 ± 28.42 ) pg/ml,P =0.045].In cultured splenocyte supernatant,the level of IFN-γ in pioglitazone group was lower than that in control group[(605.84+65.60) vs (692.20+44.98) pg/ml,P=0.041].(4) In cultured splenocyte,PPARγ nuclear protein activity in pioglitazone group was higher than that in control group ( 0.06 ± 0.01 vs 0.03 ± 0.01,P =0.013 ),and NF-κB nuclear protein activity was lower than that in control group ( 0.03 ± 0.01 vs 0.08± 0.01,P =0.001 ).Conclusions Pioglitazone activates PPARγ nuclear protein,inhibits activity of NF-κB nuclear protein,downregulates IFN-γ,diminishes differeutiation of Th cells to Th1,and subsequently prevents insulitis and β-cell apoptosis in NOD mice.

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 .

Abstract?AlM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip.?METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. lt was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. lntraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system.?RESULTS:Only 13 cases (9. 8%) need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15. 1± 6. 2min. ln early postoperative, there were 107 cases ( 81. 1%) appeared lower intraocular pressure (<11mmHg) and 2 cases appeared choroid detachment in 132 cases patients. Most of the patients recovered to normal but 2 case ( 1. 5%) high myopia macular hole retinal detachment occurred recurrent retinal detachment 1wk after operation. Silicone oil was removed cleanly in the most patients, only 4 cases (3. 0%) with a little silicone oil residue.?CONCLUSlON:The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self - made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.

Objective To investigate the susceptibility of amphotericin B,itroconazol and voriconazole against filamentous fungi.Methods Etest was used to determine the MIC of amphotericin B, itroconazol and voriconazole against filamentous fungi including Aspergillus,Penicillium,Alternaria alternate,Mucor and Rhizopus species.Results The average MIC of voriconazol,amphotericin B and itroconazol against Aspergillus fumiagtus is O.29 ?g/ml,1.16 ?g/ml and 5.88 ?g/ml;the average MIC of amphotericin B and voriconazol to Aspergillus flavus is 6.39 ?g/ml and 0.22 ?g/ml;the average MIC of voriconazol,amphotericin B and itroconazol against Aspergillus niger is 0.69,2.31,and 19.75 ?g/ ml.Most of Penicillium are susceptable to amphotericin B,but 3 strains showed very high MIC to voriconazol and itroconazol.Both of the testing strains of Mucor and Rhizopus were resistant to all of the three antifungal agents.Conclusion Amphotericin B,itroconazol and voriconazole possessed different susceptibility on different types of filamentous fungi.It is important for clinical laboratories to identify the filamentous fungi to the level of genus and species to help physicians choose antifungal agents correctly.

Immunohistochemical technique was an essential tool of conventional diagnosis,therefore,the application of immunohisto- chemistry in reformation of pathology laboratory teaching would boost pathological experimental teaching standards to a higher level.

As an important part of traditional Chinese medicine (TCM), mineral medicine plays an irreplaceable role. However, little has been reported on its species and valence state of heavy metals and deleterious elements, and also the relevance to pharmacological effect and toxicology. The present paper, in a new perspective, summarized the determination of the species and valence state of heavy metals and deleterious elements in recent years, discussed the progress of the pharmacological effect and toxicology, and prospected for future study which might provide reference for mineral medicine.
Animals ; Drug Contamination ; statistics & numerical data ; Drug Therapy ; Humans ; Medicine, Chinese Traditional ; Metals, Heavy ; analysis ; toxicity ; Minerals ; analysis ; pharmacology

The gene of mutated TNF-?D4 gene was amplified by overlap PCR and cloned into the prokaryotic expressive vector pBV220.TNF-?D4 contains two changes:substitutions of Pro8Arg,Ser9Lys,Asp10Arg,Ile157Phe,Leu29Ser,Arg31Val and a deletion of the N terminal four amino acids.The recombinant vector pBV220-TNF-?D4 was transformated into E.coli strain DH5?,and the high expression strain was obtained by screening monoclones.The level of expression was about 45% of total cell protein.After purification,the purity of fusion protein was above 90% by HPLC and relative ability was 8 ?107.TNF-?D4 was modificated by mPEG-ButyrALD。After purification,the purity of mPEG-TNF-?D4 was above 85% and relative ability was 8.6?107.The in vivo systemic toxicity of mPEG-TNF-?D4,which is indicated by LD50,is lower than that of rhTNF-?.These results strongly supported for the further study and exploitation of TNF-antitumor drug.

Obej ctive Abnormal proliferation of T cells plays an important role in the development of autoimmune diseases. The article aimed to study the inhibitory effect of small molecule compound BD691 on T cell proliferation and its mechanism. Methods Human peripheral blood T-lymphocytes were isolated and purified by the immunomagnetic microbeads,then T cells were ac-tivated with anti-CD3/CD28 mAbs or alloantigen.The inhibitory effect of BD691 on activated T cell proliferation, the cytotoxic effect BD891 on resting T cells and the expression of activated T cells marker CD25 were measured by flow cytometry.Furthermore, ELISA was used to detect the secretion of cytokines associated with T cell differentiation. Results BD691 significantly inhibited the prolif-eration of T cells being stimulated by anti-CD3/CD28 mAb or alloantigen in a dose-dependent manner, and IC50 values are (8.5 ± 1.5)μmol/L and (7.2 ±1.3)μmol/L, respectively.However, BD691 had no obvious cytotoxic effects on resting T cells and periph-eral blood mononuclear cells, even at a high concentration ( up to 100μmol/L) .In T cells which were not activated by anti-CD3/CD28 mAb, the percentage of CD25+T cells is only 1.6%of the total cells, while the number increased to 68% after activating treatment.Mean-while, in T cells which were activated by 0, 3.3, 10, 30μmol/L BD691, no obvious change of CD25 expression were observed, while immunosuppressant FK506 (0.1μmol/L) significantly decreased the expression of CD25 +T cells (14.9%).In unactivated T cells, 95.6%cells were at G0/G1 phase, while after activation, the percentage of cells at G0/G1 phase reduced to 57.7%.In addition, BD691 inhibited the secretion of IFN-γ, IL-6 and IL-17 in activated T cells, but had no effects on the secretion of IL-2, IL-4 and IL-10. Co nclusion BD691 exerts no effects on T cell activation, but it inhibits T cell proliferation by inducing T cell cycling arrest at G0/G1 phase.Moreover, BD691 inhibits the secretion of key cytokines (such as IFN-γ, IL-6, IL-17) closely related to the differ-entiation of Th1 and Th17 cells.The results suggest that BD 691 is a potential lead compound to develop a new immunosuppressant for the inhibition of abnormal proliferation and differentiation of T cells.

OBJECTIVEThe purpose of this study was to investigate how different surface roughness of opaque porcelain influence reflectance and CIE L* value of porcelain fused to metal (PFM) restorations.

METHODS48 casted Ni-Cr alloy metal specimens (12.0 mm x 1.0 mm) were fabricated with ShoFu Vintage Halo porcelain and divided into six groups, eight pieces for each group. The specimens in the first group without polishing were used as control. Other groups were polished against 200-, 400-, 600-, 800-, and 1000-grit sandpaper after sintered, respectively. Surface roughness and color parameters of the specimens were measured with a Surface Roughometer EX2154-13 and a spectrocolorimeter, respectively. Ra (arithmetical mean deviation of the profile) was the main standard value to describe the surface roughness of many kinds of meatal or porcelain materials, and here we used it to express surface roughness of opaque porcelain. The data were statistically analyzed by one-way analysis of variance (alpha = 0.05) in SPSS 13.0.

RESULTSThe reflectance value increased from 72.386 +/- 3.953 to 78.671 +/- 3.408, and CIE L* value from 90.189 +/- 1.200 to 93.496 +/- 1.070 with the increasing of surface roughness (Ra) of opaque porcelain from (0.226 +/- 0.069) microm to (0.706 +/- 0.082) microm. The same magnitude were also observed after body porcelain and enamel porcelain were sintered on with reflectance increased from 76.301 +/- 3.097 to 81.529 +/- 4.028, and CIE L* value from 80.694 +/- 1.564 to 84.604 +/- 2.964.

CONCLUSIONThe surface roughness of opaque porcelain had effects on the reflectance and value of PFM restorations. Within the limitation of this study, the recommended Ra range of opaque porcelain was 0.23-0.50 microm.