Angiotensin-converting enzyme 2 (ACE2)-angiotensin (1-7) [Ang (1-7)]-Mas constitutes the vasoprotective axis and is demon-strated to antagonize the vascular pathophysiological effects of the classical renin -angiotensin system .We hypothesize that upregulation of ACE2-Ang (1-7) signaling protects endothelial function through reducing oxidative stress , thus resulting in beneficial outcome in di-abetes.Ex vivo treatment with Ang (1-7) augmented endothelium-dependent relaxation (EDR) in renal arteries from diabetic patients . Both Ang (1-7) infusion via osmotic pump (500 ng? kg -1? min-1 ) for 2 weeks and exogenous ACE 2 overexpression mediated by ad-enoviral ACE2 via tail vein injection rescued the impaired EDR and flow-mediated dilatation ( FMD) in db/db mice.Diminazene acetu-rate treatment (15 mg? kg-1? d-1 ) activated ACE2, increased the circulating Ang (1-7) level, and augmented EDR and FMD in db/db mouse arteries.In addition, activation of the ACE2-Ang (1-7) axis reduced reactive oxygen species (ROS) overproduction de-termined by dihydroethidium staining , CM-H2DCFDA fluorescence imaging , and chemiluminescence assay in db/db mouse aortas and also in high-glucose-treated endothelial cells .Pharmacological benefits of ACE 2-Ang ( 1-7 ) upregulation on endothelial function were confirmed in ACE2 knockout mice both ex vivo and in vitro.We elucidate that the ACE2-Ang (1-7)-Mas axis serves as an important signal pathway in endothelial cell protection in diabetic mice , especially in diabetic human arteries .In summary, endogenous ACE2-Ang (1-7) activation or ACE2 overexpression preserves endothelial function in diabetic mice through increasing nitric oxide bioavail -ability and inhibiting oxidative stress , suggesting the therapeutic potential of ACE 2-Ang(1-7) axis activation against diabetic vasculop-athy.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and there are no standard treatment options for ENKTL. For localized patients, radiotherapy alone or radiotherapy combined with chemotherapy could be took into consideration. Systemic combination chemotherapy remains the primary treatment for patients with advanced ENKTL. The efficacy of anthracycline based conventional chemotherapy in ENKTL is unfavorable. This paper reviews the treatment progress of ENKTL in recent years.

Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Objective To investigate the effects of compound Danshen injection on stress-induced gastric mucosal damage and its mechanism.Methods Sprague Dawley rats were used to establish immersion restraint cold stress model.50 SD rats were randomly divided into five groups(n=10 per group):① the normal control group; ② the stress model group; ③ the group treated with low dose of compound Danshen injection(50 mg/kg) ; ④ the group treated with medial dose of compound Danshen injection(100 mg/kg) ; ⑤the group treated with high dose of compound Danshen injection (200 mg/kg).The gastric mucosal ulcer index (UI),the level of malondialdehyde (MDA) in gastric mucosa,the activity of superoxide dismutase (SOD),and plasma intedeukin-1beta (IL-1β)content were detected.Results Compared with the normal control group [(0.7± 0.4) mm,(0.25 ± 0.03)nmol/mg,and (246.5 ± 45.4)Nu/mg],the stress model group exhibited a markedly increase in gastric mucosal UI[(28.4±4.5)mm](P＜0.01) and MDA level [(0.60±0.08)nmol/mg](P＜0.01) and a decrease in the activity of gastric mucosal SOD [(122.5 ±14.2) Nu/mg] (P＜0.01).In addition,an elevated level of plasma IL-1β[(31.6±8.4) pg/ml vs (8.5±3.1) pg/ml] (P＜0.01) was observed in the stress model group.Pretreatment with compound Danshen injection dose-dependently attenuated the gastric mucosal damage,characterized by a markedly decrease in gastric mucosal UI [(22.8 ± 3.7)mm、(12.2 ±3.5)mm,(6.2 ± 1.6)mm] and MDA level [(0.52 ± 0.07)nmol/mg,(0.32 ± 0.06)nmol/mg,(0.28 ±0.03)nmol/mg] and an increase in the activity of gastric mucosal SOD[(135.2± 13.6)Nu/mg,(220.7±33.5)Nu/mg,(251.2±23.7)Nu/mg] (P＜0.01).Meanwhile,compound Danshen injection reduced the content of plasma IL-1β[(27.2±7.5)pg/ml,(13.5±5.3)pg/ml,(9.3±4.4)pg/ml] (P＜0.01).Conclusion Compound Danshen injection exhibits preventive protection on the stress-induced gastric mucosal damage by water immersion restraint cold stress in SD rats,the mechanism of which might be linked to its inhibition of gastric mucosal oxidation stress and the reduced release of inflammatory mediator IL-1β.

Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

Gliomas harbor a small population of cells termed glioma stem-like cells (GSC),which have the ability to undergo self-renewal and initiate tumorigenesis.GSCs are resistant to a wide variety of chemotherapeutic agents and possess a remarkable ability to recover from cytotoxic therapy.Furthermore,GSCs play a crucial role in RT failure,as tumors surviving RT are enriched in GSCs.Therefore,an alternative strategy involving selective targeting of this functionally distinct chemo-and radiation resistant small group of GSCs rather than the bulk of the tumor may be more successful in treating this deadly disease.GSC exhibit various alterations to signaling pathway activity,which are associated with self-renewal and neoplastic proliferation.These altered pathways may represent possible targets for GSC.

Objective To observe the effect of self mading Tongfengxiao decoction in treatment of acute gouty arthritis. Methods 69 patients were randomly divided into two groups. In the control group,33 patients were given diclofenac sodium sustained-release capsules and allopurinol treatment;In treatment group ,36 patients were given to the self mading Tongfengxiao decoction in addition to the western medicine received by the control group. The two groups were all treated for 14 days. Results The total effective rate was 94.4% for treatment group and 87.8% for control group respectively. Therefore, the difference of treatment effect between twp groups was significant ( P ＜0. 05 ) ;Also, the treatment group performed better than control group in term of reducing serum uric acid( P ＜ 0. 05).Conclusion The treatment of Tongfengxiao decoction combined western medicine for acute gouty arthritis had a good synergistic effect, and could reduce serum uric acid and improve clinical symptoms.

Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.

Objective To evaluate the effect of octreotide on the survival of patients with advanced hepatocellular carcinoma(HCC).Methods Electronic databases searches were conducted.Meta-analysis of all randomized controlled trials (RCTs) comparing octreotide versus placebo or no treatment was performed.Results Five RCTs including 579 patients with HCC wers assessed.Meta-analysis of the five studies showed that octreotide had no significant effect on the 6,12 and 24 months survival rates of the patients(6months:OR=1.69,95%CI 0.89-3.21,P=0.11;12 months:OR=2.41,95%CI 0.83-6.93,P=0.10;24months:OR=0.58,95%CI 0.28-1.17,P=0.13).To perform the sensitivity analysis,the blank study,the trial detecting somatostatin receptor expression,the study with short survival or the two trials with short follow-up intervals were excluded,and the results also showed that the octreotide treatment had no significant effect on the 6 and 12 months survival rates.A sensitivity analysis based on two trials indicated that the 24months survival rate of the octreotide group was even lower than that of the control group(OR=0.51,95% CI0.27-0.98,P=0.04).Conclusions This Meta-analysis demonstrates that octreotide could not improve the survival of patients with advanced HCC.The administration of octreotide should not be recommended for the treatment of advaneed HCC.