OBJECTIVETo observe the effect of Modified Yiqi Chutan Recipe (MYCR) on blood flow perfusion in treating mid-late stage non-small cell lung cancer (NSCLC) patients by using multislice CT perfusion (CTP) , and to assess the relationship between each CTP parameter and the prognosis as well.

METHODSTotally 87 mid-late stage NSCLC patients were randomly assigned to the treatment group (44 cases, Shenyi Capsule + MYCR +chemotherapy) and the control group (43 cases, chemotherapy alone) in the ratio of 1:1. And 21 days consisted of 1 therapeutic course, 4 courses in total. All of them underwent CTP of primary tumor and routine thoracic CT examination (plain CT and enhancement CT) 3 times (before therapy, after 2 and 4 cycles). CT findings were analyzed for tumor size and perfusion parameters [blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT), and time to peak (TP) before and after treatment, and relationship between perfusion parameters and prognosis was also assessed.

RESULTSIn 87 cases, 7 dropped out and 80 cases were available, 40 in the treatment group and 40 in the control group. (1) The relief rate was 47.5% (19/40) and the total stable rate was 77.5% (31/40) in the treatment group, and they were 40.0% (16/40) and 65.0% (26/40) in the control group, with no statistical difference between the two groups (χ² = 0.672, 1.227; P > 0.05). (2) Compared with before treatment group in the same group, BF and PS decreased, and MTT increased in the two groups after 2 and 4 courses (P < 0.05); BE and PS decreased, and MTT increased in the control group after 2 courses (P < 0.05). Compared with the control group after 4 courses, BE decreased more significantly in the treatment group (P < 0.05). (3) After 4 courses, all patients were assigned to the remission group (35 cases) and the non-remission group (45 cases) according to the RECIST standard. Compared with before treatment in the same group, BF, BF, and PS all decreased, and MTT increased in the remission group after treatment (all P < 0.05); BF increased in the non-remission group after treatment (P < 0.05). (4) All patients were assigned to the BE increase group (34 cases) and the BE decrease group (46 cases) according to changed BE values after treatment. Results showed the mean survival rate was 246 days in the BF increase group (the 1-year accumulative survival rate being 13.0%) and 387 days in the BE decrease group (the 1-year accumulative survival rate being 53.1%). The life span was prolonged and the 1-year accumulative survival rate was elevated in the BE increase group, with statistical difference as compared with the BE decrease group (χ² = 19.057, P < 0.01).

CONCLUSIONSShenyi Capsule plus MYCR could reduce BE in mid-late stage NSCLC patients , improve vascular permeability, showing better synergistic effect with chemotherapy. CTP could not only reflect the change of tumor size, but also reflect vascular function of the tumor. Meanwhile, changes of CTP parameters were closely associated with prognosis. Patients with post-treatment decreased BE value had better prognosis and longer life span.

Capillary Permeability ; drug effects ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Tomography, X-Ray Computed

Objective To explore the effect of gene NDRG2 (N-myc downstream regulated gene 2) transfection on the proliferation and apoptosis of breast cancer cell. Methods Bcap37 cell line expressing low level product encoded by NDRG2 gene is transfected with recombinating adenovirus expressing high level NDRG2 gene product to improve NDRG2 gene expression level. NDRG2 expression was detected by Western blot and the proliferation activity of the cell lines was detected by MTT and flow cytometry. Results High level expression of NDRG2 inhibits cells growth and results in G_1 phase arrest in Bcap37 cell line. Compared with non-transfected Bcap37 cells and Bcap37 cells transfected by empty vector, apoptosis cells obviously increase in Bcap37 cell line transfected by recombinating adenovirus expressing high level NDRG2 gene, 12% after 48 hours and 21. 5% after 72 hours. Conclusion Overexpres-sion of NDRG2 in Bcap37 cells effectively inhibites cell proliferation and induces cell cycle arrest and apoptosis.

Objective To explore the effect of gene NDRG2(N-myc downstream regulated gene 2) transfection on the proliferation and apoptosis of breast cancer cell.Methods Bcap37 cell line expressing low level product encoded by NDRG2 gene is transfected with recombinating adenovirus expressing high level NDRG2 gene product to improve NDRG2 gene expression level. NDRG2 expression was detected by Western blot and the proliferation activity of the cell lines was detected by MTT and flow cytometry. Results High level expression of NDRG2 inhibits cells growth and results in G1 phase arrest in Bcap37 cell line. Compared with non-transfected Bcap37 cells and Bcap37 cells transfected by empty vector,apoptosis cells obviously increase in Bcap37 cell line transfected by recombinating adenovirus expressing high level NDRG2 gene,12% after 48 hours and 21.5% after 72 hours. Conclusion Overexpression of NDRG2 in Bcap37 cells effectively inhibites cell proliferation and induces cell cycle arrest and apoptosis.

Objective To assess the feasibility of evaluation of coronary flow reserve (CFR) for left anterior descending (LAD),left circumflex (LCx),and right coronary posterior descending artery(PDA) as well as diagnostic accuracy for patency of each branches by transthoracic Doppler echocardiography (TTDE). Methods CFR of main coronary artery branches at the distal sites were studied by TTDE with adenosine infusion (140 μg · kg-1 · min-1) in 439 consecutive patients with suspected coronary heart disease. The relations between CFR and stenosis rates of coronary bifurcations were analyzed. Results Twenty-eight of LAD,12 of LCx and 21 of PDA were occluded in 439 patients. The success rate of CFR assessment of LAD, LCx and PDA were 96.8% (395/411), 74.9% (320/427), 83.0% (347/418)respectively. Then CFR≤2.0 and CFR≤1.7 were chosen as the criteria of coronary stenosis (≥50 %) and severe stenosis(≥75%). The sensitivity and specificity of detection of LAD,LCx and PDA stenosis were 81% and 87% ,64% and 82%, 79% and 85%, respectively. The sensitivity and specificity of diagnosis of LAD, LCx and PDA severe stenosis were 86% and 81%, 70% and 85%, 81% and 82%, respectively.Conclusions CFR evaluation of main coronary artery branches has high feasibility and can provide valuable information for relevant vessel patency.

Objective To study the effects of extracellular-signal regulated kinase mitogenactivated protein kinase (ERK-MAPK) signaling pathway inhibition on histone phosphorylation and the related gene expression in human colorectal cancer cells.Methods Two human colorectal cancer cell lines (SW1116 and HCT116) were cultured and treated with gradient(0,20,40/μmol/L) doses of ERK-MAPK signaling pathway inhibitor U0126.Cell viability was determined by cell counting kit 8 (CCK-8) assay.Cell cycle distribution was assessed by flow cytometry.The expression levels of histone H3 kinases including ribosomal S6 serine-threonine kinase (RSK-2) and mitogen-and stressactivated protein kinase 1 and 2 (MSK1 and MSK2),and the levels of histone H3 (Ser10) phosphorylation and c-Fos protein were detected using Western blotting.Results Treatment of these two human colorectal cancer cell lines with ERK-MAPK inhibitor resulted in a time and dose-dependent inhibition of cell proliferation significantly. Proliferation rate of HCT116 was reduced to 47% at 72 hours after 40/μmol/L U0126 treatment. Cell cycle analysis showed that the percentage of phase G0/G1 cells significantly increased (P<0. 01) and the percentage of phase S cells decreased (P<0.01) after treatment with ERK-MAPK inhibitor. The expression of MSK1 and RSK2 reduced obviously in both of human colorectal cancer cell lines treated with U0126, which resulted in a 28% and 40% reduction of levels of MSK1 and RSK2 as compared with control HCT116 cells respectively,while no detectable change in the expression of MSK2 was found. Consistent with this, the expression level of histone H3 (ser10) phosphorylation was markedly down-regulated by ERK-MAPK inhibitor, and the related protein c-Fos expression decreased accordantly. Conclusions Decreased ERK-MAPK signaling pathway may reduce histone H3 (Ser10) phosphorylation via suppression of the activity of histone H3 kinase including MSK1 and RSK2, but not MSK2, consequently decrease the expression of c-Fos protein, which results in the inhibition of colorectal cancer cells proliferation.

Objective To discuss causes and treatment outcomes of radial nerve injury related to hinged external fixators applied to the elbow,enhance understanding of the injury and thereby reduce its clinical incidence.Methods The study involved five cases who experienced radial nerve injury in the wake of application of unilateral hinged external fixators to the elbow.Exploration and neurolysis was perfomed at 3-12 weeks after injury since no signs of nerve recovery.Afterwards,follow-up was made for all cases.Results Causes of radial nerve injury were as follows:proximal humerus Schanz screws stretched and compressed radial nerve by tethering soft tissues into cicatricial bands in two cases; distal humerus Schanz screws compressed radial nerve by tethering soft tissues adjacent to radial nerve to cicatricial bands in one case; distal humerus Schanz screws compressed radial nerve in motion of the elbow by tethering thickened intermuscular septa and further forcing the enlargement of muscle force in two cases.Forces of muscles supplied by radius nerve reached fourth or fifth rank at postoperative one-year follow-up.Conclusions Radial nerve is vulnerable in the application of unilateral hinged external fixators to the elbow due to its special path and relative stability.Accordingly,injury to radial nerve can be reduced and even avoided by knowing its anatomy features and standardizing the operation in use of external fixators.Exploration and treatment immediately after the confirmation of radial nerve injury can achieve good prognosis.

Objective To investigate the dyslipidemia in patients with psoriasis,and the characteristics of the serum lipids in pa-tients with different types of psoriasis.Methods 332 psoriatic patients were devided into pustular psoriatic,psoriasis vulgaris and erythrodermic psoriasis based on clinical manifestations.Serum lipids of the three groups were analyzed including TC,TG,HDL-C, LDL-C,ApoA1,ApoB and Lp(a).Results The serum concentrations of TC,HDL-C,ApoA1 in patients with psoriasis were signifi-cantly lower than those in control group(P <0.05),while the concentration of Lp(a)was significantly higher in psoriasis patients compared with those in control group(P <0.05).The serum level of TC,HDL-C,LDL-C and ApoA1 in pustular psoriasis group were significantly lower than those in the other two groups(P <0.05).Conclusion The patients with psoriasis have dyslipidemia, and the serious disorder situation could be associated with psoriasis types.

Objective To observe changes of cognitive function and the expression of tumor necrosis factor alpha(TNF-α),interleukin 10(IL-10) in hippocampus of diabetic rats,and assess the role of inflammation in the possible pathogenesis of diabetic encephalopathy (DE).Methods 30 male SD rats were randomly divided into control group and diabetes mellitus group.After 4 weeks of feeding high fat diet,diabetes mellitus group according to 30mg/kg injected with streptozotocin to establish type 2 diabetic rat model.At the end of the experiment,cognition were evaluated using water maze test.The concentration of beta-amyloid(Aβ) in hippocampus of diabetic rats were detected through enzyme linked immunosorbent assay,and the expression of TNF-α,IL-10 were detected by Western blotting.The expression of Aβ,TNF-α,IL-10 were observed through immunohistochemistry.Results Time spent in the target quadrant in diabetes mellitus group was shorter than that in control group ((38.21± 3.68)s vs (42.10±2.62)s,t=3.105,P＜0.01).The frequency of crossing original platform site was less than that in control group((2.62±0.77) vs(3.69±0.95),t=3.184,P＜0.01).Compared with control group the expression of Aβ,TNF-α were higher(BothP＜0.01),and IL-10 were lower(P＜0.01)in diabetes mellitus group.The positive expression of Aβ,TNF-α were obviously and IL-10 were less obviously observed in diabetes mellitus group according to immunohistochemistry.Conclusion The cognitive decline in diabetic rats is possibly related to inflammatory cytokines expressing out of balance.

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

Objective To observe the analgesic and sedative effects of dezocine injection on the medical thoracoscopy check -up.Methods 98 cases of patients with unexplained pleural effusion were randomly divided into sedation group(dezocine group,49 cases)and anesthesia group(local anesthesia by lidocaine,49 cases)by adopting digital expression method.Sedation group was intravenously injected with 5mg dezocine before the operation,and another 5mg dezocine was mixed with 100mL of 0.9% sodium chloride for intravenous drip,with 10mL of 2%lidocaine for local anesthesia during the operation;anesthesia group was only administered with 10mL of 2% lidocaine for local anesthesia.Verbal rating scales(VRS)results and visual analogue scales(VAS)results of the two group patients,as well as their hemodynamics and pleural reaction were recorded.Results The VAS scores of the sedation group and anesthesia group were (4.3 ±2.2)points and (2.1 ±1.9)points,respectively,VRS scores were (3.5 ± 1.1)points and (1.4 ±1.1 )points,there were statistically significant differences(t =0.415,P =0.019 and t =0.293,P =0.006,respectively).The two groups had basically similar operation duration,but the sedation group had more stable hemodynamic indexes such as maximum heart rate,systolic pressure,diastolic pressure and pleural reaction,including cough,dizziness,chest tightness,sweating,etc.Conclusion Dezocine injection can be used in medical thoracoscopy check -up and treatment,with significant analgesic effect and less adverse reaction,effectively alleviating the discomfort of thoracoscopy check -up,and improving patients′compliance and comfort,so as to enhance the success rate of thoracoscopy check -up.