Plastic bronchitis(PB) is an uncommon respiratory disease characterized by formation of casts in tracheobronchial tree.It can lead to airway obstruction, difficulty of breathing and even respiratory failure.PB in children is commonly associated with lower airway infection, cyanotic congenital heart disease and asthma or atopic diseases.It can also be found in children with sickle cell anemia, thalassemia and cystic fibrosis and so no.There are three main mechanisms for the formation of casts: airway inflammation results in mucus hypersecretion; inflammatory insults lead to necrosis and abscission of the airway epithelium, mucosal edema, and finally cause airway clearance impairment; leakage of chyle from lung lymphatic circulation into airway.But the etiology of this disease is various, pathogenesis is complex.Further research is required to elucidate the pathogenesis.

Objective A considerable percentage of gallbladder cancers are accompanied by su-perficial cancer spread adjacent to the main tumor. Therefore, cholecystectomy for early gallbladder cancer must be performed carefully to avoid leaving cancer cells at the surgical margins. Methods Thirty-six patients with gallbladder cancer invading no more than perimuscular connective tissue un-derwent surgical resection at our medical center. After operation, the resected specimens were investi-gated macroscopically and microscopically to clarify the clinicopathological features and the risk factors of superficial cancer spread. Results Seventy percent of all cases (25 cases) had superficial cancer spread. Comparison between the cases having superficial cancer spread and the cases without it re-vealed that the macroscopic morphology of the primary tumor and the depth of cancer invasion in the gallbladder wall were significantly different between the two groups. Furthermore, multivariate analy-sis indicated that 'superficial raised type' in macroscopic morphology was an independent predictive factor for having superficial cancer spread. Superficial cancer spread from the main tumor located in the neck of the gallbladder grew predominantly in the direction of the fundus. More advanced gallbladder cases were accompanied by more extensive superficial spread. Conclusion Superficial cancer spread is frequently observed adjacent to the gallbladder cancer, especially in the superficial raised type. A negative margin should be confirmed by intraoperative frozen section while performing cholecystectomy.

OBJECTIVENaringenin has been reported to attenuate Mucin (MUC) 5AC secretion in many pathological models. Many stimuli activate MUC5AC expression through JNK/AP-1 signaling pathways. We hypothesized that naringenin may have inhibitory effects on mucous hypersecretion by modulating MUC5AC production and inhibiting JNK/AP-1 signaling pathways.

METHODThe cell model of mucous hypersecretion was made by human lung adenocarcinoma epithelial (A549) cells stimulated by RSV. A549 cells were subcultured and then randomly divided into 7 groups, which were designated as group C (cell control group), groups R1-3 (cells were infected with RSV at the multiplication of infection (MOI) of 0. 5, 1. 0, 5. 0), groups N1-2 (cells infected with viruses in presence of Nar 30 - 100 mol/L), groups N3-4 (uninfected cells treated with Nar 30 - 100 µmol/L), group D (DMSO), group S (cells infected with viruses in presence of SP600125). After incubating for 24 hrs, the expression of MUC5AC at mRNA and protein level in the groups were determined by real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA). The protein expression changes of JNK, p-JNK and AP-1 were measured by Western blotting.

RESULTThe expressions of MUC5AC protein and mRNA in all RSV infected groups were significantly higher than that in group C in a dose-dependent manner (all P <0. 05). Nar of 30 and 100 µmol/L significantly and dose-dependently decreased RSV-induced secretion of MUC5AC protein in cell supernatant and expression of MUC5AC mRNA (P <0. 05). The relative content of p-JNK, AP-l in R2 groups were 3. 31 ± 0. 34 and 1. 94 ± 0. 05. Theyfrweremtgnificanty increased as compared with group C (both 1. 00 ± 0. 00) (all P <0. 05). The levels of p-JNK in N2 and S groups were 2. 10 ± 0. 20. 27 and 1.±97 ± 0. 16. The levels of AP-1 in N2 and S groups were 1. 40 ± 0. 03, 1. 36 ± 0. 05. Nar and SP600125 led to a largest decrease in levels of p-JNK and AP-1 when compared with group R2 (P <0. 05). The MUC5AC protein in group R2 was (48. 19 ± 0. 47) µg/L. The protein expression of MUC5AC in group R2 was significantly higher than that in group C [(36. 67 ± 1. 50) g/L] with a statistically significant difference (P <0. 05). The protein expression of MUC5AC in groups N2 and S were(43. 17 ± 1. 06) µg/L, (44.±02 ± 0. 99) µg/L, Nar and SP600125 remarkably inhibited RSV-induced secretion of MUC5AC in supernatant of A549 cells (P < 0. 05).

CONCLUSIONSNaringenin might be able to block RSV-induced mucous

Adenocarcinoma ; Blotting, Western ; Cell Line, Tumor ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Flavanones ; pharmacology ; Humans ; Lung Neoplasms ; Mucin 5AC ; secretion ; Mucus ; secretion ; Random Allocation ; Signal Transduction ; Transcription Factor AP-1 ; drug effects

Objective To evaluate the impact of laparoscopic cholecystectomy(LC) on the prognosis of unsuspectedgallbladder cancer(GC).Methods A retrospective clinicopathologic study was performed on 21 patients with unsuapective GC,but diagnosed gallbladder cancer postoperatively by pathology.Of which,11patients underwent LC and 10 patients underwent open cholecystectomy(OC),The correlation was evaluatedbetween cumulative survival rates and the following 5 prognostic factors:histopathological grade,pathologic stage,occurrence of bile spillage,type of cholecystectomy(LC or OC),and additional surgical treatments.Results Eight patients(73%) after LC and 7 patients(70%) after OC had cancer recurrence,and the difference was of no statistical significance(P=0.86).There were no recurrences of cancer in the abdominal wall after either LC or OC.Survival rate was statistically correlated to tumor stage(P=0.006),and to the occurrence of bile spillage(P=0.003).Survival rate did not differ according to whether the operation was carried out using LC or OC(P=0.74).Conclusions LC does not worsen the prognosis of unsuspected gallbladder cancer.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

Objective To explore the effect of chest circumference index adjusting tube voltage techniquey on image quality and radiation dose at coronary CTA. Methods One hundred and twenty consecutive patients [body mass index(BMI)<25 kg/m2] with suspected coronary heart disease (CHD) undergoing coronary CT angiography were prospectively selected and divided into 2 groups at random:conventional group and low dose group. Low dose group was divided into the following three subgroups according to different chest circumferences:A group(<80 cm, n=16), B group(80 to 90 cm, n=44) and C group (>90 cm, n=20). All patients were examined by coronary CTA. The patients in conventional group were performed using retrospective ECG-gating technology and reconstructed by filtered back projection algorithm. The tube voltage/tube current was 120 kV/1 000 mAs. Prospective ECG?gating technology and iterative algorithm reconstruction were used in low dose group. The tube voltages/currents were 80 kV/150 mAs, 100 kV/150 mAs, 120 kV/150 mAs in A, B, C group, respectively. Image quality was assessed by subjective evaluation (image quality score) and objective evaluation (signal?to?noise ratio).The effective radiation dose was calculated. Analyses of the differences between groups were compared with image quality, radiation dose by single factor variance and Wilcoxon signed ranks test.Results The image quality scores and signal?to?noise ratio of aorta were respectively (3.47 ± 0.38), (3.48 ± 0.27), (3.45 ± 0.32), (3.46±0.29) and (15.5±3.6), (15.8±3.6), (15.8±4.1), (16.2±3.9) in conventional, A, B and C groups, there was no statistical difference between the four groups (P=0.24, 0.43). The effective radiation dose of four groups were respectively (17.15 ± 3.25), (0.88 ± 0.02), (1.38 ± 0.05), (2.32 ± 0.04) mSv, the difference was statistically significant (P=0.02). The effective radiation dose of A, B, C group was significantly lower than that in the conventional group. Conclusion Chest circumference index adjusting tube voltages technology at coronary CT angiography can effectively reduce the effective radiation without compromise of image quality.

Senna contains anthraquinones, flavonoids, polysaccharide and volatile oil and other chemical substances, which show the effect of diarrhea, antibacterial, hemostatic, regulating immune function and antioxidation. This article reviewed the Senna chemical composition, pharmacological effects, clinical application and new formulations of drug development, in order to provide reference for the research and clinical application of Senna.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

OBJECTIVETo investigate the alkaloids in the roots of Dactylicapnos scanden (D. Don) Hutch.

METHODThe compounds were isolated by various column chromatographic methods. The structures were elucidated by spectroscopic analysis.

RESULTEight compounds were isolated and identified as d-isocorydine (1), protopine (2), d-magnoflorine (3), d-isocorydine-beta-N-oxide (4), d-corydine-alpha-N-oxide (5), d-corydine-beta-N-oxide (6), 6S, 6aS-N-methyllaurotetanine-alpha-N-oxide (7), and 6R, 6aS-N-methyllaurotetanine-beta-N-oxide (8).

CONCLUSIONCompounds 4-8 were isolated from this species and the genus Dactylicapnos for the first time.

Alkaloids ; chemistry ; Fumariaceae ; chemistry ; Plant Extracts ; chemistry ; Plant Roots ; chemistry

We investigated the molecular characteristics of the full-length genome of 14 dengue serotype 1 virus (DENV-1)strains isolated in Sino-Myanmar border region in Yunnan Province,China during 2013-2015.Isolation of dengue virus was using C6/36 cell culture method.Viral RNA was extracted from virus isolates,and then the full-length genome was amplified by RT-PCR.The homology and phylogenetic analysis was made on the nucleotide and deduced amino acid sequences by bioinformatics software including ClastalX1.83 and MEGA6 etc.Results showed that fourteen strains of DENV-1 isolated from dengue fever cases,of these,9 strains from Ruili City of Dehong Prefecture,3 from Lincang Prefecture,2 from Kunming City.RT-PCR and sequencing indicated that the full-length genes (10 735 nt) of 14 DENV-1 strains were obtained,and their open reading frame (95-10 271) were coded 3 392 amino acid residues.The genotypes of DENV-1 were revealed by homology and phylogenetic analysis based on structural and non-structural proteins.Thirteen were genotype Ⅰ (G-Ⅰ) (7 from indigenous cases in Ruili and Lincang and 6 from imported case from Myanmar to Ruili,Lincang and Kunming),and 1 G-Ⅲ from imported case from India to Kunming.The phylogenic analysis indicated that the 13 isolates from Yunnan divided into 2 phylogenic subgroups,and they had a closer genetic relationship with the strains isolated from Southeast Asia.The gene sequences of the 13 G-Ⅰ strains have been acquired,the rate of their nucleotide homology and amino acid homology were 97.02 ％-100 ％ and 98.78 ％100 ％ respectively.Compared with 6 strains from Southeast Asia,nucleotide homology and amino acid homology were 96.53％-99.53％ and 97.33％-100％ respectively.Compared with prototype strain (US_Hawaii) of DENV-1,nucleotide homology and amino acid homology were 93.76％-94.45 ％ and 95.86 ％-96.91％ respectively.Compared with US_Hawaii strain,there were 44 and 150 different sites in amino acid of structural and non-structural proteins,respectively.The G-1 of DENV-1 have been popular in Sino-Myanmar border region in Yunnan,2013-2015.They have genetic diversity but multiple transmission sources were from Myanmar,and should strengthen control cross-border spread of dengue fever in this region.It is necessary to further study that change of the amino acid sites of Yunnan strains of DENV-1 is related to its antigenicity and pathogenicity.