BACKGROUND:Iron overload as a new etiological factor participate in the pathogenesis of senile osteoporosis, but its mechanism remains unclear. But the mechanism of iron overload cause senile osteoporosis pathogenesis remains unclear. Osteogenic/adipogenic differentiation homeostasis of bone marrow mesenchymal stem cel s (BMSCs) plays an important role in the maintenance of normal human bone mass, and its imbalance can lead to senile osteoporosis. Iron effects on the osteogenic/adipogenic differentiation of BMSCs remain unclear. Therefore, we clarify the role of iron overload in the pathogenesis of senile osteoporosis by studying the effect of iron overload on BMSCs osteogenic/adipogenic differentiation. OBJECTIVE:To explore the effect of iron overload on the osteogenesis and adipogenesis of human BMSCs (hBMSCs) in vitro and to explicit the role of iron overload in the pathogenesis of senile osteoporosis. METHODS:hBMSCs were isolated by using density gradient centrifugation method. Isolated cel s were treated with normal saline as normal control group, treated with 10, 20, 30μmol/L ferrous citrate to mimic iron overload conditions, or treated with 30μmol/L ferrous citrate fol owed by 0.5 mmol/L N-acetylcysteine as an antioxidant. RESULTS AND CONCLUSION:Iron overload did not remarkably inhibit the proliferation of hBMSCs, but it could promote the generation of reactive oxygen in hBMSCs. After treatment with ferrous citrate, the expression of c-Maf and Runx2 decreased, and the expression of peroxisome proliferator-activated receptorγincreased;moreover, formation of calcium nodules decreased, but lipid droplets were produced. N-acetylcysteine could inhibit the production of reactive oxygen and increase the expression of c-Maf induced by iron overload. These findings indicate that iron overload inhibits osteogenesis and promotes adipogenesis in hBMSCs through the generation of reactive oxygen. Meanwhile, c-Maf plays an essential role in the iron-overload induced differetiation imbalance.

Objective: To investigate the principles of rational drug use for the patients suffering from heart failure complicated with diuretic-induced gouty arthritis.Methods: The clinical pharmacist participated in the diagnosis, treatment and drug adjustment of one patient suffering from heart failure complicated with furosemide-induced gouty arthritis.Taking the disease symptoms and potential gouty-inducing drugs into full consideration, clinical pharmacist suggested the withdrawal of related-drugs and the adjustment of treatment plan.Results: Considering the characteristics of the patient, clinical pharmacist adjusted the rational drug treatment.After the adoption of the suggestions, the gouty symptoms were relieved, heart failure was controlled and the condition was improved.Conclusion: Loop diuretics can easily trigger an acute attack of gout, especially for the patients with heart failure and gout history.Clinical pharmacist can make full use of professional advantages to optimize the treatment plan in order to reduce adverse reactions and promote the rational drug use by participating in clinical practice.

Objective To investigate the changes of renal medulla aquaporin 2 expression and morphological changes of epithelia of collecting tube after bile duct recanalizaiton operation.Methods Thirty rats were divided into two groups randomly.Common bile duct ligation was performed on 20 experimental rats with silicon tubes 2 mm in extre-diameter,and sham operation on the other 10 rats.Seven days later,bile duct recanalizaiton was performed on obstructive jaundice group and sham operation on contrast group.Experimental rats were divided into two subgroups randomly.Half of them were killed immediately and the others would be killed 24 hours later.Serum of each rat was collected to detect hepatic function and renal function.Renal medulla was fixed for microscopic examination and was kept in the-80 ℃ refrigerator for aquaporin 2 expression measurement by Western blot technique.ResultsAll of the animals accomplished the experiment smoothly.Golden ascites were found in the rats of obstructive jaundice group.Twenty-four hours after recanalization,serum bilirubin levels decreased 〔(45.95?8.39)?mol/L〕,P

Objective:To investigate the change of expression of AQP 2 in renal of obstructive jaundice rats , and the relationship between AQP 2 and the changing of Cr and BUN.Methods: Legated the common bile duct of rats to form the obstructive jaundice group.Scarified the rats on the 3th,5th,7th,10th,14th day,took blood samples and the kidney of the rats.Test direct bilirubin BUN and Cr in serum,the renal histopathological changes were observed by optical microscopy .The expression of AQP2 in renal of rats was tested by using radio immunological method.Results: Light microscopic examination of kidney showed that swelling epithelium arranged irregularly in 3rd day ,bleb in the 5th day.The expression of AQP2 in renal of rats with obstructive jaundice were greatly less than sham operation.Mesenchyma inflammatory cells infiltrate in 7th day.Local epithelial necrosis and lots of inflammatory cells infiltrate in the mesenchyma in 10th day and 14th day.The expression of AQP2 in renal collective tubule was decreased on the 5th day compared with sham operation ,and the decrease was more as time gone by.The renal function injury can be confirmed though the renal collective tubule change.Cr and BUN in serum began to increase on the 10th day and 14th day.Conclusion: Decrease of AQP2 is earlier than the increase of Cr and BUN ,and it can be the early sign of renal function injury.

Objective To investigate the prognostic factors of low-and undifferentiated gastric cancer with negative metastasis of lymph nodes.Methods The clinicopathological data of 270 patients with low-and undifferentiated gastric cancer and negative metastasis of lymph nodes who were admitted to the Tianjin Cancer Hospital from January 2002 to December 2007 were retrospectively analyzed.All the patients received radical gastrectomy.One hundred and sixty-one patients had the number of lymph nodes dissected under 15,53 patients had 15-20 lymph nodes dissected,33 had 21-30 lymph nodes dissected and 23 patients with the number of lymph nodes dissected more than 30.Patients were followed up via out-patient examination,phone call and mail till October 2013.The prognosis analysis was done by COX step-wise regression.The survival curve was drawn by KaplanMeier method,and the survival was analyzed using the Log-rank test.Results All the patients were followed up for a median time of 63 months (range,2-103 months).The median survival time was 63 months (range,2-103 months),and the 1-,3-,5-year overall survival rates were 93.0％,69.5％ and 58.5％,respectively.The median survival time of the 161 patients with the number of lymph nodes dissected under 15 was 58 months (range,2-103 months),and the 1-,3-,5-year survival rates were 91.4％,59.3％ and 48.8％,respectively.The median survival time of the 53 patients with the number of lymph nodes dissected between 15 and 20 was 68 months (range,4-95 months),and the 1-,3-,5-year survival rates were 94.3％,84.9％ and 71.7％,respectively.The median survival time of the 33 patients with the number of lymph nodes dissected between 21 and 30 was 68 months (range,34-94 months),and the 1-,3-,5-year survival rates were 100.0％,97.0％ and 87.9％,respectively.The median survival time of the 23 patients with the number of lymph nodes dissected more than 30 was 60 months (range,2-84 months),and the 1-,3-,5-year survival rates were 87.5％,62.5％ and 54.2％,respectively.There was significant difference in the prognosis between the 4 groups (x2 =25.077,P ＜ 0.05).There was significant difference in the prognosis between patients who had 21-30 lymph nodes resected and those had 15-20 lymph nodes resected (x2=3.924,P ＜0.05).Significant difference was also observed in the prognosis between patients who had 15-20 lymph nodes resected and those had more than 30 lymph nodes resected (x2=4.454,P ＜ 0.05),while no significant difference was observed in the prognosis between patients who had lymph nodes resected more than 30 and those had lymph nodes resected less than 15 (x2=0.450,P ＞0.05).The results of univariate analysis showed that gender,age,location and diameter of the tumor,serosal invasion,Borrmann classification,range of gastric resection and the number of lymph nodes dissected were factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (x2 =4.143,12.607,23.665,11.549,26.350,8.059,5.222,25.077,P ＜0.05).The results of multivariate analysis showed that the tumor diameter longer than 5 cm and serosal invasion were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (HR =1.842,3.084,95％ confidence interval:1.286-2.638,1.956-4.861,P ＜ 0.05).Lymph nodes dissected for 21-30 was the protective factor of prognosis (HR =1.533,95％ confidence interval:1.229-2.248,P ＜ 0.05).Conclusions Lymph nodes dissected for 21-30 during radical gastrectomy may improve the long-term survival of patients.The tumor diameter longer than 5 cm,serosal invasion and the number of lymph nodes dissected (less than 15,15-20 and more than 30) were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes.

Objective:To observe therapeutic effect and safety of six‐month atrovastatin sequential treatment on pa‐tients with acute coronary syndrome (ACS) undergoing PCI .Methods :A total of 280 ACS patients were consecu‐tively enrolled ,randomly and equally divided into sequential treatment group (received atorvastatin 80mg 2d before PCI operation ,then 40mg/d after operation ,20mg/d a month later ) and routine treatment group (no taking atorv‐astatin before PCI operation ,then 20mg/d after operation and as a maintenance dose ) .Both groups were observed for six months ,therapeutic effect and safety were compared between two groups .Results:Compared with before PCI ,there were significant rise in levels of creatine kinase isoenzyme (CK‐MB) and cardiac troponin I (cTnI) after PCI 18h~24h in two groups ,and those of sequential treatment group were significantly lower than those in routine treatment group [CK‐MB:(2.72 ± 0.52) μg/L vs .(6.04 ± 0.51) μg/L ,cTnI : (0.28 ± 0.13) μg/L vs .(0.42 ± 0.16) μg/L , P < 0.01 both ];Compared with routine treatment group , the high sensitive C reactive protein (hsCRP) level significantly reduced in sequential treatment group after PCI 2d ,and continued until post‐operation six months [ (2.34 ± 0.51) mg/L vs .(1.49 ± 0.78) mg/L ,P=0.001];the blood lipids levels (except level of high density lipoprotein cholesterol significantly rose ) in sequential treatment group were significant lower than those of routine treatment group , P<0.01 all;there were no significant difference in percentage of transaminase level high‐er than normal three times and incidence rates of major adverse cardiovascular events (MACE) between two groups , P>0.05 all .Conclusion:Preoperative 80mg atrovastatin combined postoperative 40mg atrovastatin treatment can significantly reduce inflammatory reaction ,improve blood lipids ;compared with routine dose ,it doesn't significant‐ly increase adverse drug reactions ,so it's safe and effective .

Animals ; Cell Line, Tumor ; Colonic Neoplasms ; genetics ; metabolism ; pathology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-18 ; biosynthesis ; genetics ; Mice ; Mice, Nude ; Neoplasm Transplantation ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Analysis ; Time Factors ; Transfection ; Transplantation, Heterologous

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

Objective To compare effectiveness,performance,onset time and complications between ultrasound-guided cervical transverse process block and interscalene brachial plexus block in patients undergoing proximal humeral surgeries.Methods Sixty patients,27 males and 33 females, aged 18-70 years,scheduled for proximal humeral surgeries were randomly divided into two groups. They were given either cervical transverse process block (group T,n =30)or ultrasound-guided in-terscalene brachial plexus block (group I,n =30).All patients received a total of 8 ml of 0.5% ropiv-acaine.The performance, anesthetic onset time, the side effects and block success rate were evaluated.Results Block procedure was quicker in group T than in group I [(8.73 ±3.1 7)min vs. (14.40±8.21)min,P <0.01].The severity of diaphragmatic paralysis in group T was significantly lower than in group I (P <0.01).The ultrasound-guided cervical transverse process block was more effective than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries (100% vs.80%,P <0.05).Conclusion The ultrasound-guided cervical transverse process block has a higher success rate and fewer incidence of diaphragmatic paralysis than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries.