Objective To clarify the role of claudin-4 in endometrial tumorigenesis and explore claudin-4 be as potentially useful agent in the treatment of endometrial carcinoma.Methods The expression of claudin-4 in 62 endonetrioid endometrial carcinoma (EEC),30 atypical hyperplasia endometrial tissue and 60 human normal endometrium was determined using immunohistochemistry and realtime PCR.Ninety female BALB/c mice were transplanted with Ishikawa endometrial cancer cells,which were divided into three groups with different intraperitoneal treatments with cisplatin,paclitaxel and saline solution.After the observation period,the tumors were extracted and stained with monoclonal antibody against claudin-4.The messenger RNA expression of claudin-4 was also detected using real-time PCR.Results Among the EEC samples,34％ (21/62) showed medium staining for claudin-4 and 66％ (41/62) showed intense staining.In atypical hyperplasia group,27％ (8/30) showed weak staining,53％ (16/30) showed medium staining and 20％ (6/30) showed intense staining for claudin-4.Of the normal endometrial tissue,47％ (28/60) showed weak staining and 53％ (32/60) showed no staining for claudin-4.According to real-time PCR,the relative quantity of claudin-4 was 170 ± 12 in EEC group,89 ± 15 in atypical hyperplasia group and 18 ± 3 in normal endometrium.Compared with those in atypical hyperplasia group and normal endometrium group,the protein and mRNA expression of claudin-4 were significantly increased in the group of EEC (all P ＜ 0.05).In the study of Ishikawa xenografts,no significant changes in tumor volume and claudin-4 expression were shown in paclitaxel group compared with that in the control group.Nevertheless,a significant reduction of the tumor growth and a significant decrease in claudin-4 expression were observed in cisplatin group.After cisplatin treatment,the tumor volume was significantly decreased [(0.51 ±0.21) versus (0.73 ±0.12) cm3],and the mRNA expression of claudin-4 was also significantly decreased (153 ± 35 versus 273 ± 27).Conclusion These results demonstrate that claudin-4 is strongly expressed in EEC,which may be a useful biomarker to monitor the effects of chemotherapy in patients with endometrial carcinoma.

The inclusion compound of amylose and salicylic acid (SA) was prepared by a sealed temperature control method, and the formation of the inclusion compound was confirmed by IR spectrum and powder X-ray diffraction. The kinetic parameters of dissociation of amylose/SA compound were studied by the nonisothermal method which was defined as a relationship between the dissociation ratio and time. The values of activation energy (Ea) and frequency factors (InA) were calculated by a nonlinear least-square method. In this study, the formation of the inclusion compound of amylose/SA was confirmed by IR spectrum powder X-ray diffraction. SA existed in a molecule form in the spiral stouction of amylose. The dissociation of amylose/SA compound was attributed to first order reaction. The values of Ea calculated by the nor-isothermal method were 21.71 and 22.41 kJ x mol(-1) at heating rate 5 and 10 degrees C x h(-1), respectively. The corresponding isothermal method value of Ea was 22.17 kJ x mol(-1); the calculated InA values were 9.32 and 10.08 at heating rate 5 and 10 degrees C x h(-1), respectively. The corresponding isothermal method lnA value was 9.26. The results were in good agreement with Ea values and lnA values by isothermal method. These results indicated that the non-isothermal method described in this study could be adequately used for the stability study of inclusion compound and was a rapid and accurate method for the determination of kinetic parameters.

Game relationship of mutual restriction and mutual connection exist among various segments of Chinese medicine decoction pieces supply chain. Any problems in any segments will affect quality and safety of the whole supply chain, and ultimately affect the safety of consumers. Based on the theory of supply chain, this article established a linear supply chain and static game model, including planting farmers, production and marketing society, processors of Chinese medicine decoction pieces, terminal consumers and middle sales section whichis made up of whole sale and retail markets and manufacturing enterprises of Chinese patent medicine. This article also proposed the suggestions about quality safety of Chinese medicine decoction pieces through quantitative methods in game theory.

OBJECTIVETo compare therapeutic effects between surgical and conservative treatment for postoperative lumbar discitis.

METHODSFrom January 2004 to January 2009, 41 patients (17 males and 24 females ranging the age from 37 to 68 years with an average of 53.6 years) with postoperative lumbar discitis were retrospectively studied and divided into two groups. There were 19 patients in operation group, 22 patients in conservative group. Clinical data and features,image data, laboratory examinations, antibiotics utilization, hospital stays and sequelae were recorded and analyzed. Visual analogue scales system (VAS) and Oswestry disability index (ODI) were applied to evaluate therapeutic effects.

RESULTSAll patients were followed up over 2 years. Imaging revealed good bone fusion and no occurrence of discitis. VAS score and ODI at 1 month, 1 year and 2 years were significantly improved after treatment (P < 0.01). While VAS and ODI in operation group at 1 month were improved more than that of conservative group (P < 0.01), and there was no significant difference between two groups at 1 year and 2 years (P > 0.01).

CONCLUSIONSurgical and conservative treatment for postoperative lumbar discitis is effective. Surgical treatment is superior to conservative treatment in a short time, while conservative treatment can achieve long-term satisfactory curative effects.

Adult ; Aged ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Discitis ; drug therapy ; surgery ; Female ; Humans ; Lumbar Vertebrae ; drug effects ; surgery ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; surgery ; Retrospective Studies ; Treatment Outcome

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

Objective To explore the role of heme oxygenase-1 (HO-1) gene expression on murine experimental abdominal aortic aneurysm (AAA).Methods Wistar rats were divided into hemin (experimental group) and saline (control group) group randomly, and experimental AAA model was established by elastase perfusion. The specimen was obtained at postoperative day 7, and the dilatation rate was calculated. In situ hybridization was applied to detect the expression of HO-1 mRNA in aortic wall, while immunohistochemical staining was used to detect the protein expression of ICAM-1 and HO-1. Results In experimental group, the aorta dilation was inhibited and aneurysm was not observed. In experimental group, HO-1 mRNA and protein expression was strengthened (P

OBJECTIVETo observe the clinical effect and safety of blood activating stasis removing method (BASRM) on intracerebral hemorrhage patients.

METHODSA multi-center, prospective, randomized, open, controlled and blinded endpoint design was adopted. Totally 228 intracerebral hemorrhage patients were assigned to the treatment group and the control group, 114 in each group by center randomized method. All patients received basic treatment of Western internal medicine. Patients in the treatment group received intravenous infusion with Xingnaojing Injection (XI) from the 1st day of grouping, 20 mL per day for 14 days. Then they took or were nasally fed with Chinese medical granules (by syndrome typing as complicated with wind syndrome, fire syndrome, and phlegm syndrome) for 21 days. Finally they took Naoxueshu Oral Liquid (NOL), 10 mL each time, 3 times per day till the 3rd month of incidence. Patients' disability degree, activities of daily living, neurological impairment, the effective rate, physiologic functions, mental status, social relationship, and degree of treatment satisfaction were assessed using Modified Rankin Scale (MRS), Barthel index (BI), National Institute of Health Stroke Scale (NIHSS), and patient reported outcome (PRO). Head CT was performed to evaluate the absorption of hematoma at the 1st and 7th day of grouping. The safety was also assessed.

RESULTSTotally 108 patients in the treatment group and 112 patients in the control group completed the trial. There was no statistical difference in the total effective rate between the two groups after 3 months of treatment (P>0.05). The MRS score was obviously lower in the treatment group than in the control group (P<0.01) at month 3 after attack (P<0.01). There was statistical difference in the difference between pre-post hematoma volume between the two groups after 7-day treatment (P<0.05). The NIHSS score of two groups at the 7th, 14th, 21st day, and 3rd month decreased significantly (P<0.05). Compared with the control group, the decremenit of NIHSS score decreased more obviously in the treatment group at day 7, 21, and 3rd month (P<0.05). Compared with the control group, the BI increased (P<0.01); physiologic fupctions, social relationship, treatment satisfaction and total score in PRO scale were all lower in the treatment group than in the control group (P<0.05, P<0.01). The incidence of adverse events occurred in 7 cases (6.14%) in the treatment group and 5 cases (4.39%) in the control group, with no statistical difference (P>0.05).

CONCLUSIONBASRM could lower the deformity rate of intracerebral hemorrhage patients at month 3, effectively promote hematoma absorption within 7 days, improve neurologic impairment, and elevate living abilities at month 3 of onset.

Activities of Daily Living ; Cerebral Hemorrhage ; therapy ; Hematoma ; Humans ; Medicine, Chinese Traditional ; Prognosis ; Prospective Studies ; Syndrome

Objective To construct the risk model for healthcare-associated infection (HAI)with multidrug-re-sistant organisms(MDROs)in intensive care unit (ICU).Methods 836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively,logistic regression model of HAI was constructed,the model was conducted goodness of fit tests and the area under ROC curve analysis. Results Among 836 patients,incidence of HAI with MDROs was 14.23%(n=119).15 variables that were statis-tically significant in univariate analysis were included in logistic multivariate analysis,the results showed that the following variables entered into logistic regression equation:length of ICU stay (OR,2.493 [95%CI ,1 .816 -3.494]),underlying diseases (OR,1 .536 [95%CI ,1 .243 - 1 .898 ]),hypoproteinemia (OR,87.211 [95%CI , 36.165-210.304]),ventilator days (OR,1 .723 [95%CI ,1 .399-2.121 ]),fever(OR,20.639 [95%CI ,3.462 -123.043]),and primary pulmonary infection (OR,0.295 [95%CI ,0.133 -0.664]).Evaluation of model effect:sensitivity 95%,specificity 87.9%,the area under ROC curve 0.973.Conclusion Logistic regression model has a high goodness of fit in predicting HAI among ICU patients.

Dihydroorotate dehydrogenase (DHODH) is a flavin-dependent metabolic enzyme that oxidizes dihydroorotate acid to orotic acid in the de novo synthesis pathway of pyrimidine metabolism. DHODH is located in mitochondria, closely related to cellular oxidative phosphorylation, and an important suppressor of the ferroptosis pathway. This study investigates the influence of DHODH on the progression of malignant tumors, including its important role in the de novo synthesis of pyrimidine, oxidative phosphorylation, and ferroptosis. The objective is to present evidence that DHODH is a potential target for the clinical treatment of tumors.