Objective To review the clinical characteristics of adult-onset Still's disease (AOSD) patients with special pulmonary complications.Methods Medical records of 506 AOSD inpatients,who were admitted in Peking Union Medical Hospital from October 1997 through March 2015,were retrospectively reviewed.The clinical features,biochemical parameters,radiology,pulmonary function tests,ultrasound,treatments and prognosis of AOSD patients with special pulmonary complications were analyzed.Results The incidence of special pulmonary complications in AOSD inpatients was 2.2％ (11/ 506),including 3 cases of interstitial lung disease and 8 cases of pulmonary artery hypertension.All 11 patients had common manifestations of AOSD,including fever (11/11),arthralgia/arthritis (11/11),rash (9/11),lymphadenopathy and/or splenomegaly (8/11),serositis (10/11),abnormal liver function (9/ 11),neutrophilia (11/11),and hyperferritinemia (11/11).The patients with interstitial lung disease had no or mild symptom,and were diagnosed by HRCT and pulmonary function test.The patients with pulmonary artery hypertension had various symptoms including dyspnea of exertion (8/8),cough (4/8),chest suppression (2/8),and chest pain (2/8).Four patients died from severe infection,including 3 cases of pulmonary artery hypertension and 1 case of interstitial lung disease.Conclusions Interstitial lung disease and pulmonary artery hypertension are life-threatening complications of AOSD patients.Earlier recognition and prompt treatment should be made to improve patient outcomes.

AIM: To investigate the influence of Astragalus Injection on morphology,cell cycle and oxidative stress of rat's glomerular mesangial cells(GMC) cultured with advanced glycation end products(AGEs). METHODS: GMC were incubated in culture medium containing AGEs in the presence of Astragalus Injection and aminoguanidin for 48 h.At the same time,the normal and control groups were established.Then the cultured GMC was stained by mixed fluorescence liquid and observed under fluorescence microscope.Cell cycle of GMC was analyzed using flowcytometry.The activity of SOD、MDA and GSH-PX in GMC supernatant were measured by test kit.The level of ROS was detected by flowcytometry. RESULTS: Morphology analysis showed that the morphology and structure of normal GMC were normal.The structure of most cells in AGEs was unclear,cell counts increased markedly and they grew intensively.Cell cycle analysis showed that cell percentage of S phase increased and G_0/G_1 reduced.The level of ROS,MDA remarkably increased,and SOD,GSHPX activity reduced.Whereas Astragalus Injection was added,cell morphology tended to be basically normal and cell counts decreased,the percentage of S phase also decreased.The level of ROS,MDA and the SOD,GSH-PX activity restored in comparison with the control groups. CONCLUSION: Astragalus Injection can prevent GMC from lesion caused by AGEs.Astragalus Injection may protect GMC from retarding the progression of diabetic nepropathy by partially inhibiting the occurrence of oxidative stress.

Aging ; Health ; Humans ; Longevity

OBJECTIVETo observe the effect of Jianpi Yangzheng Xiaozheng Recipe (JYXR) on the tumor inhibition rate of subcutaneous transplanted tumor gastric cancer cell line MGC-803 in BALB/c nude mice, and to study its molecular mechanism of apoptosis and autophagy.

METHODSGastric cancer cell line MGC-803 was subcutaneously inoculated to nude mice for preparing transplanted gastric cancer models. Totally 32 BALB/c nude mice were randomly divided into 4 groups according to random digit table, i.e., the negative control group, the positive control group, the high dose JYXR group, the low dose JYXR group, 8 in each group. Normal saline was administered to mice in the negative control group by gastrogavage. 5-fluorouracil (5-Fu) at 2. 5 mg/kg was administered to mice in the positive control group by gastrogavage. JYXR at 85 and 43 g/kg was administered to mice in the high dose JYXR group and the low dose JYXR group by gastrogavage, once per day for 10 successive days. The effect of JYXR on the tumor inhibition rate of subcutaneous transplanted tumor was observed. Effects of JYXR on gene expression levels of Bax, Bcl-2, Fas, Cyclin D1, Cyclin D2, and Cyclin D3 in transplanted tumor were observed by real-time PCR. Effects of JYXR on protein expression levels of Procaspase-3, Procaspase-8, Procaspase-9, cleaved-PARP, Beclin-1, and LC3B were detected using Western blot.

RESULTS(1) Compared with the negative control group, the tumor weight was obviously reduced in the rest three groups (P <0. 05). The tumor weight was higher in the high dose JYXR group and the low dose JYXR group than in the positive control group (P <0. 05). (2) Results of RT-PCR indicated that, compared with the negative control group, expression levels of Bax were up-regulated, but expression levels of Bcl-2, Cyclin D1, Cyclin D2, and Cyclin D3 were down-regulated in the positive control group and JYXR groups (P <0. 05). The expression level of Fas was up-regulated in the positive control group and the high dose JYXR group (P <0. 05). Compared with the positive control group, expression levels of Fas, and Bax were all down-regulated, but expression levels of Bcl-2, Cyclin D2, and Cyclin D3 were all up-regulated in the high dose JYXR group and the low dose JYXR group (all P <0. 05). The expression level of Cyclin D1 was down-regulated in the high dose JYXR group, but it was up-regulated in the low dose JYXR group ( both P <0. 05). (3) Results of Western blot showed, compared with the negative control group, expression levels of Procaspase-3, Procaspase-8, and Procaspase-9 were down-regulated, but expression levels of cleaved-PARP, Beclin-1, and LC3B II were up-regulated in the high dose JYXR group and the low dose JYXR group (all P <0.05). Compared with the negative control group, expression levels of Procaspase-3, Procaspase-8, Procaspase-9, and LC3B II were down-regulated, but expression levels of cleaved-PARP, Beclin-1, and LC3B I were up-regulated in the positive control group (all P <0. 05).

CONCLUSIONSJYXR showed significant inhibition on subcutaneous transplanted tumor gastric cancer cell line MGC-803 in BALB/c nude mice. Its mechanism might be associated with activating apoptosis and autophagy correlated factors.

Animals ; Antineoplastic Agents ; pharmacology ; therapeutic use ; Apoptosis ; drug effects ; Autophagy ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Chemistry, Pharmaceutical ; methods ; standards ; Cyclin D1 ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Fluorouracil ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Stomach Neoplasms

Objective To study effects of early non-invasive ventilation (NIV) application in treating elderly patients with acute left ventricular failure induced respiratory failure. Method Totally 32 elderly patients with acute left ventrieular failure induced respiratory failure, admitted from August 1997 to February 2007, received NIV treatment, and were retrospectively studied. There were 22 male and 10 female, aged (81.5?8.6) yearsdd. The changes of rahs, respiration rate, heart rate, arterial blood gas, cardiac function before and after NIV application were compared. According to the application time of NIV, 32 patients were divided into two groups: group A (early NIV application group, n=17) and group B (non-early NIV application group, n= 15). The time to improve the symptoms, the application time of NIV, cure rates, tracheal intubation rates and mortality were compared between the two groups. Results Thirty of the 32 patients survived, cardiac function was improved from New York classⅣtoⅠ～Ⅱ, respiratory rate, heart rate and blood pressure significantly decreased, PaO_2 and SaO_2 significantly increased and PaCO_2 significantly decreased. The tracheal intubation was performed in 4 patients. The time needed to improve the symptoms and the application time of NIV were significantly different between group A and group B (P

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.

dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.

Objective To investigate the accuracy and applied value of measurement of pulmonary flow velocity with phase-contrast MRI(PC-MRI).Methods ①42 healthy volunteers were divided into 2 groups randomly,one group was examined by PC-MRI,another was examined by doppler ultrasound.The inner diameter,maximum velocity and mean velocity of main pulmonary artery(MPA) were measured;②The flow volume of MPA in a cardiac cycle was calculated with formulation.Results ①The inner diameters of MPA measured with PC-MRI and doppler ultrasound were(24.4?3.41) mm and(21.5?2.55) mm respectively;②The maximum velocity and mean velocity of MPA measured by PC MRI were(79.9?24.0) cm/s and(50.3?7.71) cm/s respectively;③The maximum velocity and mean velocity of MPA gained by doppler ultrasound was(88.8?8.33) cm/s and(53.7? 5.04) cm/s resepectively;④The flow volume of MPA in a cardiac cycle measured by PC MRI and doppler ultrasound was(73.5?6.60) ml and(69.0?10.6) ml respectively.The results were analyzed by group sample t-test,and the level of test was 0.05.Conclusion The blood flow velocity and volume of pulmonary artery can be measured accurately by PC-MRI,it is of certain applied value in assessing the pulmonary blood flow dynamics changes.

Objective To explore the cause,treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of 1554 patients undergoing pancreatectomy in our hospital from Aug 2003 to Aug 2013 were retrospectively analyzed.Results 16 patients suffered from DMH,including 13 patients who had undergone pancreaticoduodenectomy,and 3 patients who had had resection of pancreatic body and tail.Gastrointestinal haemorrhage occurred in 6 patients,intra-abdominal haemorrhage occurred in 10 patients,respectively.Reoperations were performed in 11 patients,transcatheter arterial embolization (TAE) undertaken in 2 patients,and endoscopic treatment in 3 patients.10 patients recovered after treatment,6 patients (6/16) died.Conclusions The mortality of DMH after pancreatic surgery is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors,intra-abdominal arterial haemorrhage is the main cause of death.