Objective:To investigate the distribution of precancerous conditions and lesions of high-risk population in the high-in-cidence area of esophageal cancer in Ci County, Hebei Province. Methods:Esophageal cancer was detected early in 40 to 69 year old patients in Ci Xian through endoscopic screening data and endoscopic screening using iodine staining and indicative biopsy. The pa-tients were classified according to gender, age group, statistical esophageal precancerous condition, and lesion detection rate. Results:The analysis included 11 423 cases by screening queue, and the esophageal biopsy rate was 66.90%. The detection rates of squamous epithelium with mild, moderate, and severe dysplasia were 11.84%, 2.66%, and 1.04%, respectively. DCIS detection rate was 0.40%in patients with squamous cell carcinoma. The detection rate of the patients had been infiltrated by the squamous cell carcinoma was 0.04%.The rate of the squamous cell carcinoma within the mucosa was 0.37%.The rate of the infiltration squamous cell carcinoma was 0.17%. The detection rate of the hyperplasia above average severe dysplasia and cancer was 2.01%. Conclusion: High incidence of esophageal precancerous lesions was found in the Ci County aged 40 to 69. A large number of asymptomatic patients with cancer were detected. Age and sex are closely related to detection rate.

AIM: To investigate the effects of advanced glycation end products (AGEs) on protein and mRNA expression of macrophage inflammatory protein-1? (MIP-1?) in cultured human umbilical vein endothelial cells(HUVECs). METHODS: HUVECs were cultured with AGEs at different concentrations for 24 h and at a concentration of 400 mg/L for different time.The levels of mRNA and protein expression of MIP-1? in cultured HUVEC were detected by in situ hybridization and Western blot, respectively. RESULTS: In situ hybridization showed that after exposure of HUVECs to AGEs at different concentrations (100 mg/L, 200 mg/L, 400 mg/L) for 24 h, the average integrated optical density values (18.76?3.17, 26.58?1.61, 34.23?2.25) of MIP-1? mRNA expression in HUVECs were higher than that in control group (13.83?1.24, P

Objective To establish the HPLC-DAD-ELSD fingerprint of Radix astragali,provide new methods for science quality control of the medicinal materials.Methods Application of HPLC-DAD-ELSD techniques were connected in series.The mobile phase A: 10% acetonitrile,B: 90% acetonitrile,detecting wavelength: 265 nm,flow rate: 1 mL/min,column temperature: 35 ℃,sample size: 20 ?L,gain: 20,tube: 55 ℃,neb: 65%,air pressure: 2.068 5?105 Pa.The mutual mode was established depending on ten Astragalus samples from different growing areas in Gansu.The software "Similarity Evaluation System for Chromatographic Fingerfrint of Chinese Materia Medica" was applied to analyzing.ResultsThe established method is good for the separation of saponins,flavonoids from Radix Astragali,and simultaneous determination of the two different components in one sample injection.The similarity of different batches of medicinal materials is fit for the requirement.Conclusion The method is workable to simultaneously determine saponins and flavonoids fingerprint from Radix Astragali,and to control its quality.

It has been known that the renal microvasular lesions could aggravate the progress of glomerular sclerosis and tubulo-interstitial fibrosis in chronic kidney diseases. Modern pharmacological studies indicated that the two traditional Chinese herbs, Astragalus membranaceus and Angelica sinensis, could improve micorvascular lesions through multiple mechanisms, including increasing local renal blood flow to lessen the hypoxic renal injury, promoting the recovery of renal blood flow and glomerular filtration rate after ischemia-reperfusion, modulating the imbalance of vaso-activators such as nitric oxide and angiotensin, increasing the expression of vascular epithelial growth factor and inhibiting the release of the intracellular calcium ion and promoting DNA synthesis in endothelial cells to improve the function of endothelial cells. These evidences suggest that Astragalus membranaceus and Angelica sinensis may retard the progress of renal diseases through the above-mentioned mechanisms.
Angelica sinensis ; chemistry ; Animals ; Astragalus membranaceus ; chemistry ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Kidney ; blood supply ; drug effects ; Kidney Diseases ; drug therapy ; physiopathology ; Microvessels ; drug effects

Objective: Epithelial dysplasia of the esophagus and gastric cardia is precancerous lesion, including mild, moderate and severe levels. In 2000 year, WHO recommended to replace dysplasia with intraepithelial neoplasia. Mild and moderate dysplasia were classified as low-grade intraepithelial neoplasia (LIN). Cardia adenocarcinoma was suggested to be called esophageal-gastric junction adenocarcinoma. The risk of cancer development and the rule of time evolution were detected in esophagus and esophageal-gastdc junction LIN in high incidence area of esophageal cancer in Northern China, in an effort to provide scientific data for the prevention of esophageal cancer. Methods: Between October 2001 and October 2002, two townships of Cixian were chosen to carry out endoscopic iodine staining screening cohort study. The total population aged 0-85 was 22,016, of which 6,596 aged 40-69 (3257 males and 3339 females). Except for thoese with contraindications and those who refused to join the study, 3,506 cases were finally recruited in the study, and the screening rate was 53.2%. According to WHO criteria of the pathological diagnosis, the esophageal squamous epithelium with mild and moderate dysplasia and esophageal-gastric junction with mild dysplasia were classified into LIN groups (including 616 cases). The control group contained a total of 2,478 cases without precancerous lesions and free of cancer in endoscopic screening. Results: From June to September in 2008, the cohort was followed up and 174 cases were lost, with a follow-up rate of 95.0%. Follow-up was 3,970.7 person- years in the LIN group and 16,120.0 person-years in the control group.Carcinomous conversion rates were 251.7 and 68.2/per 100,000 person- years respectively in the LIN group and the control group. The median time in the two groups was 38 and 47 months, respectively. Compared with that of the normal population, the relative risk (RR) of LIN was 3.69 (95% CI=1.57-8.69, P=0.001). Conclusion: Population with LIN are at high-risk for esophageal cancer and endoscopic examination every year is absolutely necessary.

Recently , the country actively explores the pattern of an integrated healthcare which enables the as-sociation among hospitals of different levels , aimed to achieve maximum utilization of medical resources and lead a reasonable distribution of the patients .By reviewing the practices related to the integration of healthcare in Beijing , Shanghai , Zhenjiang and Wuhan city , this paper sums up in five typical mechanisms , i.e.organization and manage-ment mechanism , human resource management mechanism , interest distribution mechanism , service continuity and resources sharing mechanism .The effects of these practices were analyzed and the faced challenges were discussed . The following points were made clear during analysis and discussion:the sustainability of the collaboration mode and organization structure , human resource supports and incentive methods , health insurance guidance for hospitals and patients , two-way referral system and supporting measures , and building of information system .Then we put forward some suggestions , hoping to offer some references to the establishment of integrated healthcare in other regions .

Background The pathogenesis and development of cataract is associated with oxidative stress-induced apoptosis of human lens epithelial cells(LECs).BH3-only protein is a factor that can initiate apoptosis,and thus the apoptotic process is probably related to the activation of the c-Jun N-terminal kinase(JNK).However,the relationship between oxidative stress-induced apoptosis of human LECs and the JNK pathway remains to be illuminated.Objective This study was to investigate the effects of the JNK/c-Jun pathway and its target gene,Bim (Bcl-2 interacting mediator of cell death)and PU M A(p53 up-regulated modulator of apoptosis),on oxidative stressinduced apoptosis of human LECs.Methods The human LECs cell line(HLEC-B3)was cultured and passaged in DMEM with 10％ fetal bovine serum in vitro.Confluent cells were incubated in 24 well plates and divided into 4 groups.Hydrogen peroxide(H2O2)(50 μmol/L)was used to treat the cells for 4,8 or 12 hours,and cells without H2O2 treatment served as the control group.Apoptosis was detected using Hoechst 33258 staining and quantified by counting the number of cells with pyknotic nuclei.In addition,confluent cells were seeded in 6 well plates,and Western blot and RT-PCR were used to detect the expression of the caspase-3,c-Jun,Bim and PUMA proteins and their mRNA in HLEC-B3,respectively.The JNK/c-Jun pathway inhibitors,CEP11004 or SP600125,were added into cultured media with H2O2,and cells treated with DMSO or H2O2 only served as negative and positive control groups.The expression of the p-JNK,JNK,p-c-Jun,c-Jun,Bim,PUMA proteins was detected by Western blot and apoptosis was assayed using Hoechst 33258 staining.200 pmoL/L of Bim or PUMA small interference RNA(siBim or siPUMA)fragments were transfected into the cells for 24 hours,respectively,and H2O2 was then used to treat the cells for 8 hours.The expression of the Bim and PUMA protein and their mRNA in the cells was detected by Western blot and RT-PCR,respectively.Results After H2O2 treatment in HLEC-B3 cells for 4,8,or 12 hours,the rates of apoptosis were 4.30％±1.15％,27.08％±0.74％ and 46.59％±0.91％,showing a significant difference among them (F=1909.433,P=0.000),and those of the 4,8,12 hour groups were significantly increased in comparison to the control group(P =0.049,0.000,0.000).Compared to untreated cells,the levels of expression of the JNK,Bim,PUMA proteins and their mRNA in HLEC-B3 cells were significantly elevated.After the addition of CEP11004 or SP600125,the expression of these protein and mRNA in HLEC-B3 cells in the presence of H2O2 was significantly weaker than that in the DMSO control group(P =0.000,0.000).After the tranfection of siBim or siPUMA,the apoptosis rates of the H2O2 treated groups were significantly higher than those in the Bim-/-or PIMA-/-group (P＜0.05).Conclusions H2O2 can activate the JNK/c-Jun pathway and up-regulate the expression of its target genes Bim and PUMA in human LECs in a time-dependent manner.Inhibiting the JNK/c-Jun pathway and interfering with the expression of Bim and PUMA can protect human LECs against oxidative stress-induced apoptosis.

Objective To depermine oupcome of papienps wiph non-ST elevapion acupe coronart stndromes (NSTEACS) preaped wiph FFR-guided versus CAG-guided sprapegt. Methods From Jult 1. 2014 po Jult 30. 2015 in Beijing Anzhen Hospipal, papienps admipped for NSTEACS were reprospecpivelt analtsed wiph a 10-monph follow-up. 142 cases on CAG were furpher assessed wiph FFR ( phe FFR group). Papienps were mapched as 1 : 2 wiph NSTEACS who had moderape lesions shown on CAG in phe same period were enrolled (CAG group, n = 284). End poinps were deaph, nonfapal mtocardial infarcpion (MI), pargep vessel revascularizapion ( TVR), and procedure cosps. Major adverse cardiac evenps ( MACE) were defined as deaph, nonfapal MI, and TVR. Results Fifpt-pwo papienps (36. 6% ) in phe FFR group had FFR less phan 0. 80 underwenp percupaneous coronart inpervenpion (PCI) while 133 papienps (46. 8% ) in phe CAG group received PCI (P =0. 037). Papienps preaped wiph FFR-guided sprapegt had significanplt lower rape of nonfapal MI (2. 2% vs. 4. 5% , P =0. 040) and TVR (5. 9% vs. 11. 7% , P = 0. 046). No spapispical difference was observed in morpalipt (0. 7% vs. 1. 1% , P = 0. 682) and MACE (8. 8% vs. 14. 4% , P = 0. 085). Topal financial cosp was less in phe FFR group (P = 0. 033). Conclusions FFR-guided sprapegt for papienps wiph NSTEACS resulps in less rape of PCI,lower cosp and bepper clinical oupcomes when compared wiph an angio-guided sprapegt.

OBJECTIVETo investigate the angiographic feature and its diagnostic value in gastrointestinal stromal tumor (GIST).

METHODSTwelve patients with pathologically proved GIST underwent angiography using PUCK and DSA one week before operation. The origin, size, morphology and angiographic appearance of the lesion were retrospectively analyzed.

RESULTSIt was found that two tumors originated from stomach, eight from jejunum, and two from ileum. Seven cases were benign but five malignant. Obviously thickened and enlarged feeding artery was detected in eight tumors, and early-developed vein was found in three. Two types of angiographic changes of GIST were observed: 1) twisted irregular neoplastic vessels with partially coarse and indistinct margin were found in four cases, which were all malignant; 2) ball-like neoplastic vessels with homogeneous stain in tumor were found in eight cases, seven of them were benign but one was malignant.

CONCLUSIONAngiography may be helpful in localization and diagnosis as well as defining the size of GIST, and especially in patients with melena of unknown origin.

Adult ; Aged ; Angiography ; methods ; Female ; Gastrointestinal Stromal Tumors ; blood supply ; diagnostic imaging ; Humans ; Jejunal Neoplasms ; blood supply ; diagnostic imaging ; Male ; Mesenteric Arteries ; diagnostic imaging ; Middle Aged ; Stomach Neoplasms ; blood supply ; diagnostic imaging

Objective To evaluate the relationship between plasma cystatin C concentration (PcyC) and coronary artery diseases (CAD). Method A total of 126 subjects with CAD evidenced by coronary angiography admitted from April 2007 to March 2009 were divided into three groups: stable angina pectoris (SAPs, n = 34),unstable angina pectoris (UAPs, n = 56) and acute myocardial infarction (AMIs, n = 36), according to the diag-nostic criteria of CAD set by WHO. Another 34 subjects without CAD were taken as controls. There were no statis-tical differences in demographics among four groups. Serum lipids profile, uric acid (UA), PcyC and high-sensi-tive C-reactive protein (hs-CRP) were determined. And in the meantime, all patients were followed up for six months and adverse cardiovascular events were recorded. Comparisons were made between groups with a number of independent-sample t -tests. Data were processed with analysis of variance to test the differences in means among four groups, and the means were compared with chi-square test. Statistical significance was established at a P val-ue of less than 0.05. Results Cystatin C levels were significantly higher in UAPs than that in SAPs and in controls (P < 0.05), but were much lower than that in AMIs (P < 0.05). And much higher concentration of hs-CRP was found in UAPs (P < 0.05) and in AMIs (P < 0.01). Cystatin C was positively and significantly corre-lated with age, hs-CRP, WBC, creatinine and UA (r > 0, P < 0.05), whereas a significantly negative correla-tion with high-density lipoprotein cholesterol was found (r = - 0.227, P < 0.05). These coefficients were obvi-ously high for creatinine (r = + 0. 612), and WBC (r = + 0.459). During the period of six-month follow-up, 26 patients with adverse cardiovascular events were found, and had significantly higher cystatin C levels than 22 con-trols at admission (P < 0.01). Conclusions Cystatin C plays a pivotal role in the course of CAD, and the PcyC is a strong predictor for the risk of cardiovascular events.