Objective To analyze the association of the morbidity,the management of blood glucose,and the prognosis of patients with hyperglycemia in the medical intensive care units(ICU).Methods Medical records of ICU patients of Renji Hospital from 2002 to 2009 were reviewed using Medical Record Inquiry System,and the data were retrospectively analyzed.Results(1)2631 subjects were included in the present study,blood glucose was determined at least once during hospitalization in 2168 of them.The incidence of hyperglycemia was 26.3%,in which 12.9% presented a known history of diabetes and 13.4% without.In the patients with diabetes history,93.2% of them received anti-diabetic treatment during hospitalization.mainly with oral anti-hyperglyeemic agents (53.0%)or subcutaneous insulin injection(24.9%).However,in the patients without diabetes history,84.4% were not treated against hyperglycemia.The mortality was increased in the latter group(30.4% vs13.9%,P<0.01).(2)In the patients with diabetes history,the mortality in patients whose blood glucose>10 mmol/L was higher than those with blood glucose≤7.0 mmol/L(20.5% vs 9.9%,P<0.05):while in the patients without diabetes history,the mortality began to rise as blood glucose>7.0 mmol/L(P<0.01).(3)Multiple stepwise regression analysis revealed that the average blood glucose level was an independent risk factor for death(OR=1.26).Conclusions The ICU patients showed a high prevalence of hyperglycemia,the management of hyperglycemia should be emphasized.Hyperglycemia in critically ill patients might be an independent risk factor of increased mortality.

Objective To observe the changes of esophageal motility in patients with achalasia (AC) before and after peroral endoscopic myotomy (POEM ) and to evaluate the effects of POEM on esophageal motility in AC .Methods A total of 35 patients with AC received POEM .The esophageal motility in response to different food swallows (5 mL liquid and 2 cm × 2 cm × 2 cm solid food) was evaluated by high-resolution manometry (HRM) system before operation and one month after operation .The changes of parameters of esophageal body and lower esophageal sphincter (LES) were analyzed and compared before and after operation .The t-test ,non-parametric test or single factor analysis of variance was performed for statistical analysis .Results Before POEM operation ,lower esophageal sphincter pressure (LESP) of 35 patients in response to liquid swallows and solid swallows was (28 .94 ± 18 .70) mmHg (1 mmHg=0 .133 kPa) and (26 .41 ± 11 .57) mmHg ,respectively ;after operation it was (16 .02 ± 5 .46) mmHg and (15 .82 ± 5 .04) mmHg ,respectively ;and the differences were statistically significant (t= 4 .338 and 4 .726 ,both P<0 .01) .Before operation ,4 s integrated relax pressure (4 s IRP) during liquid swallows and solid swallows was (27 .18 ± 14 .63) mmHg and (28 .46 ± 11 .15) mmHg ,respectively ;after operation it was (12 .22 ± 6 .75) mmHg and (14 .54 ± 7 .83) mmHg ,respectively ;and the differences were statistically significant (t= 5 .902 and 5 .436 ,both P< 0 .01) .And after operation intra boluspressure (IBP) of liquid swallows and solid swallows also decreased compared to that before operation (t=5 .075 and 2 .944 ,both P< 0 .01) .Lower esophageal sphincter relaxation rate (LESRR) during liquid swallows and solid swallows increased compared to that before operation (t= -2 .990 , P< 0 .01 ;t=-0 .340 ,P>0 .05) .There was no difference in the distal contractile integral (DCI) and distal esophageal peristaltic amplitude in subtype Ⅰ and Ⅲ patients before and after operation (all P>0 .05 ) .All those parameters decreased in subtype Ⅱ patients (Z= -2 .704 and -2 .489 ,P< 0 .05 ;Z= -1 .929 and-0 .747 , P> 0 .05 ) . Proximal esophageal peristalsis was observed in two patients after operation , however there was no integrated esophageal body peristalsis .Clinical symptoms quickly relieved in all patients after POEM operation and clinical score significantly decreased compared to that before operation (0 .86 ± 1 .19 vs 8 .16 ± 1 .84 ,t=20 .605 , P<0 .05) .Conclusions POEM can effectively relieve LES relaxation disorder in AC patients and improve esophageal body peristalsis to a certain degree .The efficacy is regardless of AC types ,and further studies are need to shed light on the long-term efficacy .The long-term efficacy still need further follow-up study .

Betel Shi-San-Wei Ingredients Pill(BSSWIP) was first recorded in the 19th century writings Meng-Yi Jin-Gui with the name of Gao-Y ou-13. The name of BSSWIP was first recorded in the book of the 1977 edition of the Drug Standard of the Jilin Province, which was formerly known as Tai De Hu Ran Gu Lu Ge Qi Nai Ran Ta, Se Me Ji De Ji De, and etc. Although in the book of Tong-Wa-Ga-Ji-De, Se Me Ji De Ji De was documented, it was the same name of different compositions. It had no original relation with BSSWIP. In different periods, the BSSWIP was consisted of 13, 14 or 15 kinds of herbs. There were at least five different types of herbs appeared in the Gao-Y ou-13. The evolution of prescription was mainly from the 19th century to the first half of the 20th century. There was no major change on prescription composition and proportion since 1971. Among them, 10 kinds of herbs, which were Bing-Lang, Guang-Zao, Mu-Xiang, Ding-Xiang, Rou-Dou-Kou, Zi-Nao-Sha, Gan-Jiang, Bi-Ba, Hu-Jiao, and Chen-Xiang were fixed. The ratio of single herbal medicine changed the most was Zhi-Cao-W u, which was followed by Mu-Xiang, Ding-Xiang and Chen-Xiang. There were no marked sources of BSSWIP in the recording of the Drug Standard of the Jilin Province and the Mongolian Medicine V olume·Ministry of Health of the People's Republic of China. The composition and proportion were considered to be from the book Meng-Y i Jin-Gui according to notes of Standards on Mongolian Patent Medicine in Inner Mongolia. Recordings of three standards are in consistence with the Meng-Y i Jin-Gui on Gao-Y ou-13 except for Y e-Mao-Niu Xin and the different ratio of Zhi-Cao-W u. In the appendix of the Standards on Mongolian Patent Medicine in Inner Mongolia, it marked the differences from the original prescription. Therefore, the other two criteria should also mark the similarities and differences compared with the original prescription properly.

Epithelial-to-mesenchymal transition (EMT) plays a critical role in cancer metastasis,and is relevant to the inflammatory microenvironment.Lipopolysaccharide (LPS),a cell wall constituent of gram-negative bacteria,has been reported to induce EMT of cancer cells through TLR4 signal.We previously reported that LPS promoted metastasis of mesenchymallike breast cancer cells with high expression of cyclin D 1 b.However,the role of cyclin D1b in LPS-induced EMT has not been fully elucidated.In the present study,we described that cyclin D1b augmented EMT induced by LPS in MCF-7 breast cancer cells.Cyclin D1b markedly amplified integrin αvβ3 expression,which was further up-regulated under LPS stimulation.Our results showed ectopic expression of cyclin D1b promoted invasiveness of epithelial-like MCF-7 cells under LPS stimulation.Additionally,LPS-induced metastasis and EMT in MCF-7-D1b cells might depend on αvβ3 expression.Further exploration indicated that cyclin D1b cooperated with HoxD3,a transcription factor promoting αvβ3 expression,to promote LPS-induced EMT.Knockout of HoxD3 repressed LPS-induced EMT and αvβ3 over-expression in MCF-7 cells with high expression of cyclin D1b.Specifically,all these effects were in a cyclin D1a independent manner.Taken all together,LPS up-regulated integrin αvβ3 expression in MCF-7 cells with high expression of cyclin D 1b and induced EMT in breast cancer cells,which highlights that cyclin D1b may act as an endogenous pathway participating in exogenous signal inducing EMT in breast cancer cells.

Objective To study the effect of bromocriptine(BRC) on the activation of T lymphocyte stimulated by phytohemagglutinin(PHA).Methods After CD4+ T cell line Jurkat E6-1 cells were stimulated by PHA,prolactin(PRL) and BRC,respectively,the expression of linker for activation of T cells(LAT) and zeta-chain T cell receptor associated protein kinase 70 000(ZAP-70) mRNA of T lymphocytes were checked by RT-PCR.The expression of PRL mRNA of T lymphocytes was detected by Real time PCR.The expression of CD25(cluster of differentiation) as a marker of early activation on the surface of T lymphocytes was detected by flow cytometry,and the activation of nuclear factor-?B(NF-?B) was detected by luciferase reporter system.Results 1.BRC inhibited the expression of ZAP-70 as the common signal molecules both in the T lymphocyte activation pathway and PRL-prolactin-prolactin receptor(PRLR) signal transduction pathway,and decreased the expression of PRL mRNA produced by activation T lymphocytes.2.BRC enhanced the expression of LAT mRNA as another important signal molecular on the T lymphocytes and CD25 on the surface of the T lymphocytes.3.The activation of NF-?B of T lymphocytes was decreased.Conclusions BRC might inhibit the activation of T lymphocytes by inhibiting the expression of ZAP-70,the common signal molecules between T lymphocytes activation and PRL-PRL pathway,and PRL mRNA,the like-T lymphocyte growth factor.

Objective To determine the fluoride contents in dried chilies in Southwest China to provide the basis for the prevention of the fluoride contamination in chili.Methods The dried chili samples collected from the markets and farmers in 76 counties of 9 regions in Southwest China.Their dehydration methods and storage time were investigated.These dried chilies were classified by Bailey'Criteria.The total fhorine content in chili were determined with ion wlective electrodes,fluoride forms with acid-soluble ultrasonic and water-soluble ultrasonic methods,Based on the differences of chili variety,edible part,dehydration method,storage time and fluoride form, a systemic statistics of the fluoride content in dried chili Was established.Results Theere were 296 dried chili samples collected from 76 counties of 9 regions.The geometric mean of fluoride content in dried chili was 19.6 mg/kg;The dried chili samples were classified into 4 types:cherry chili,corn chili,long chili and cluster chili; their ranges of fluoride content in cherry chili,corn chili,long chili and cluster chili Were 1.7～233.4,3.4～ 367.3,2.0～380.3,3.9～104.0 mg/kg,respectively,and the high to low sequence of fluoride content was cherry chili(25.9 mg/kg),long chili(20.3 mg/kg),corn chili(19.5 mg/kg) and cluster chili(15.3 mg/kg).The waler- soluble fluoride content in dried chili about 27.9 mg/kg occupies 77.5%(15.2/19.6)of total fluoride content and the acid-soluble fluoride content about 33.5 mg/kg reached as high as 93.0%(1 8.2/19.6).The high to low sequence of fluoride content in dried chili Was the sun-dried stored less than 1 year(10.9 mg/kg),the sun-dried stored more than 1 year(13.7 mg/kg),the fumace-dried stored less than 1 year(21.4 mg/kg),the fumace-dried stored more than 1 year(53.9 rag/ks).Conclusions The research shows that inappropriate dehydration method and storage time are the two main reasons leading to fluoride contamination in chili.

Objective To analyze the change of chromosome test level after participating in the inter‐laboratory proficiency test(PT) program of the College of American Pathologists (CAP) .Methods The results for participating in CAP PT during 2011-2014 were analyzed ,the accuracy of the cytogenetic chromosome quality control test in this laboratory was obtained accord‐ing to the CAP evaluation results ,and the effect of CAP external quality assessment item on increasing the chromosome detection level in this laboratory was evaluated by analyzing the chromosome band levels before and after participating in CAP .Results This laboratory participated in CAP PT test for 10 times during 2011-2014 ,a total of 59 cases were analyzed ,the accuracy rate for jud‐ging chromosome karyotype was 100% ,the karyotype description accuracy rate was 95 .1% .The chromosome test results of clinical cases in this laboratory displayed that peripheral blood chromosome abnormal detection rate was 18 .9% and bone marrow chromo‐some abnormal detection rate was 25 .9% ,the abnormal rate of newly diagnosed leukemia was 66 .8% ;the detection failure rates of peripheral blood chromosome and bone marrow chromosome were 0 .5% and 5 .0% respectively ;the detection failure rates of pe‐ripheral blood chromosome and bone marrow chromosome after participating in CAP were decreased ,the chromosome band average level was improved ,showing statistical difference compared with those before participating in CAP (P<0 .01) .Conclusion Partici‐pating in high quality external laboratory assessment item can increase the clinical analytic level of cytogenetic chromosome test .

OBJECTIVETo observe the effects of Mongolian pharmaceutical Betel shisanwei ingredients pill on AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depressive rats.

METHODSixty male Wistar rats were randomly divided into six groups according to the sugar consumption test (10 rats in each group), normal control group,model group,fluoxetine group (3.3 mg x kg(-1)) and low dose, medium dose and high dose group (0.25, 0.5, 1 g x kg(-1)) of Betel shisanwei ingredients pill. Except the normal control,the other groups were treated with the chronic unpredictable mild stress stimulation combined with lonely raising for 28 days. 10 mL x kg(-1) of drugs were given to each rat once daily,continuously for 28 days. The AC activity of the hippocampus and prefrontal cortex were determined by radiation immunity analysis (RIA), while cAMP and PKA quantity were determinated by Enzyme-linked immunosorbent (ELISA).

RESULTThe AC activity, cAMP and PKA quantity of hippocampus and prefrontal of mouse model of Chronic stress depression decreased significantly than those of control group (P < 0.05 or P < 0.01). However, the AC activity, cAMP and PKA quantity of rat hippocampus and prefrontal cortex in the fluoxetine group and the Mongolian pharmaceutical Betel shisanwei ingredients pill group indecreased significantly than those of model group (P < 0.01 or P < 0.05). Especially for the high dose group of Mongolian pharmaceutical Betel shisanwei ingredients pill.

CONCLUSIONThe AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depression model of rats is down-regulated, whereas Mongolian pharmaceutical Betel shisanwei ingredients pill could up-regulated it to resist depression.

Adenylyl Cyclases ; genetics ; metabolism ; Animals ; Cyclic AMP ; metabolism ; Cyclic AMP-Dependent Protein Kinases ; genetics ; metabolism ; Depression ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Hippocampus ; drug effects ; metabolism ; Humans ; Male ; Mice ; Prefrontal Cortex ; drug effects ; metabolism ; Rats ; Rats, Wistar ; Signal Transduction ; drug effects

AIMTo explore the effects of M3 receptor on myocyte apoptosis induced by acute myocardial infarction in rats.

METHODSRat model was induced by ligation of the anterior branch of the left coronary artery. All animals were divided into four groups: sham-operated group, occlusion group, choline group (10 mg x kg(-1), iv), and 4DAMP (4-diphenylacetoxy-N-methylpiperidine-methiodide) group (0.12 mg x kg(-1), iv). The serum malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were determined. The infarct size areas on the myocardium were identified by TTC staining. The apoptosis in cardiomyocyte was detected by TUNEL assay and apoptosis-related proteins in Bcl-2 and Fas expression were measured by immunohistochemistry assay.

RESULTSM3 receptor agonist choline reduced serum MDA content and increased SOD activity. The myocardial expression of Bcl-2 was increased, whereas the expression of Fas was decreased by choline. However, blockade of M3 receptor by 4DAMP completely inhibited these effects of choline on cardiac myocytes.

CONCLUSIONActivation of M3 receptor has protective effect on myocyte apoptosis induced by acute myocardial infarction in rat, and this effect might be related to modulating the expression of some immediateearly genes including Bcl-2 and Fas.

Animals ; Apoptosis ; Choline ; pharmacology ; Male ; Malondialdehyde ; blood ; Myocardial Infarction ; metabolism ; pathology ; Myocardium ; pathology ; Myocytes, Cardiac ; metabolism ; pathology ; Piperidines ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Wistar ; Receptor, Muscarinic M3 ; agonists ; antagonists & inhibitors ; Receptors, Tumor Necrosis Factor ; metabolism ; Superoxide Dismutase ; blood ; fas Receptor

Objective To investigate the distribution of fluoride content in fresh chili in southwestern China and provide the fluoride background content for the confirming fluoride contamination discrimination value for fresh chili.Methods The method of analyzing fluoride in food as stipulated in GB/T 5009.18-2003 was adopted to determinate fluoride content in chilies.175 fresh chili samples were collected from 76 counties in southwestern China.Based on the origin and types of the chilies,we systemically analyzed the fluoride content in fresh chilies.Results In fresh chilies directly sampled from farms,the averaging content was up to 8.9 mg/kg(dry weight)and the fluoride content in more than 95.54% of fresh chili samples was less than 24.7 mg/kg(dry weight).Conclusions The current fluoride content standard for vegetables as stipulated in GB 2762-2005(≤1.0 mg/kg)is unsuitable for chili,therefore it is essential to draw a new value for discriminating fluoride contamination in fresh chili.