Objective To observe the effect of fluvastatin on the activity of extracellular signal-regulated kinase(ERK)1/2,expression of connective tissue growth factor(CTGF) in glomerular mesangial cells stimulated by high glucose,and explore the pathogenic mechanism of diabetic nephropathy(DN) and its early prevention and treatment.Methods The study consisted of two parts,the first part was to repeat the existing experienment of stimulatory effect of high glucose on mesangial cells,and validated that high glucose could up-regulated the expression of CTGF through stimulating ERK,and the change was unrelated with hypertonic conditions.There were five groups:①normal control group(NG);②high glucose group(HG);③mannitol group(MN);④NG+ERK inhibitor PD98059 group(NG+PD);⑤HG+ ERK inhibitor PD98059 group(HG+PD).The second part was to observe the changes of the expressions of CTGF protein and mRNA in mesangial cells at high glucose concentration before and after fluvastatin intervention.There were also five groups:①normal control group(NG);②high glucose group(HG);③normal glucose and fluvastatin group(NG+F);④high glucose + fluvastatin(HG+F);⑤high glucose + fluvastatin and mevalonic acid group(HG+F+M).The activity of ERK1/2 and the expressions of CTGF protein and mRNA in cultured glomerular mesangial cells stimulated by high glucose were detected with Western blotting and RT-PCR.The amount of fibronectin(FN) in the supernatant of cells was analyzed by ELISA.Intracellular total protein level was measured by Coomassie brilliant blue method.Results The first part showed that the activity of ERK1/2 and the expression of CTGF protein in HG were more higher than those in NG(P

Objective To investigate the expression pattern of growth arrest-specific transcript 5 ( GAS5 ) in hepatocellular carcinoma and assess its pre-operation and post-operation levels.Methods Totally 243 patients were collected in Zhongnan Hospital in 2015, and were divided into 4 groups: pre-operation (117 cases), 1 weeks after operation (39 cases), patients with hepatitis B (55 cases) and cirrhosis ( 71 cases ) .Meanwhile, 129 controls were collected.The expression of GAS5 in plasma was detected by real-time quantitative PCR. The levels of GAS5 in subgroups were compared by Oneway ANOVA.The relationship between GAS5 and the clinical pathologic features, and its pre-operation and post-operation expression were analyzed by Student′s t test.Results GAS5 was downregulated in HCC plasma and the levels of GAS5 were associated with tumor differentiation ( R2 =0.219,P=0.011) and TNM stage (R2 =0.036,P=0.044).Compared with the levels in pre-operation group (3.958 ±0.282), GAS5 were upregulated after surgery (3.843 ±0.223),t=2.283, P=0.028.In addition, GAS5 expression in well and moderately differentiated HCC was higher than poorly differentiated ones before operation[(3.873 ±0.191) and(4.151 ±0.365),t=2.271,P=0.035], but there was no significant difference after operation[(3.880 ±0.154) and (3.879 ±0.246),t=0.032, P=0.975].The ROC curves indicated that GAS5 had a good sensitivity to differentiate HCC from the healthy ( 88%, 88/100 ) and the cirrhosis ( 90%, 90/100 ) . Conclusion GAS5 might be used to assess the treatment of HCC.

Objective To investigate clinical significance of Homer expression in peripheral blood leukocytes of patients with ischemic stroke (IS).Methods It was a retrospecive study.The gene expression levels of Homer were measured by RT-qPCR.266 patientscollected in Zhongnan Hospital from September 2015 to June 2016were divided into 5 groups:large-artery atherosclerosis (LAA,100 cases),cardioembolism (CE,42 cases),small vessel occlusion (SVO,68 cases),stroke of other demonstrated etiology (SOE,23 cases) and stroke of undemonstrated etiology (SUE,33 cases).Meanwhile,age and sex matched 126 healthy controls were also collected.IS diagnostic criteria for cerebral infarctionwas in accordance with the guideline for acute ischemic stroke in China in 2010.The levels of Homers in subgroups were compared by Oneway ANOVA.The area under curve (AUC) and 95％ confidence interval (CI) were calculated using ROC analyses.The odds ratio (OR) and 95％ CI were calculated using the multivariate logistic regression analyses.Results The levels of Homer1 [2.01 ± 0.15] and Homer2 [1.81 ± 0.31] in LAA patients were significantly higher than othergroups [Homer1 CE:2.40 ± 0.34;SVO:2.38 ± 0.35;SOE:2.36 + 0.33;SUE:2.40 ± 0.30;control group:2.35 ± 0.28;Homer2 CE:2.09 ± 0.38;SVO:2.08 ± 0.30;SOE:2.09 ± 0.41;SUE:2.10 ± 0.34;control group:2.12 ± 0.31] (Homer1 CE:t =9.353,P＜0.001;SVO:t =9.258,P＜0.001;SOE:t =5.396,P＜0.001;SUE:t=9.644,P＜0.001;control group:t =11.882,P＜0.001;Homer2 CE:t =4.725,P＜0.001;SVO:t =5.545,P＜0.001;SOE:t=3.640,P ＜ 0.001;SUE:t =4.669,P ＜ 0.001);There was no significant difference in the expression of Homer1 (F =0.940,P =0.441) and Homer2 (F =0.336,P =0.854) between non-LAA groupsand healthy controls.There was no significant difference in the expression of Homer3among the groups (F =0.641,P =0.669).Multinomial logistic regression analyses revealed that,higher Homerl (adjusted OR =8.62,95％ CI:4.13-18.00,P＜0.001) and Homer2 (adjusted OR=2.42,95％ CI:1.75-3.36,P ＜ 0.001) levels showed significant associations with increased odds of having LAA stroke,compared with the controls.ROC curves showed that the AUC of the combination of Homer1 and Homer2 for differentiating LAA and controls was 0.896 (95％ CI:0.862-0.929,P ＜0.001) and the AUCfor differentiating LAAand non-LAA was 0.847 (95％ CI:0.800-0.894,P ＜ 0.001).Conclusion The expression of Homer1 and Homer2 in peripheral blood leukocytes could be used as novel biomarkers for LAA stroke.

Objective To investigate the role of TLR9 in the glomerulonephritis through observing the changes of Toll-like receptor 9 in the glomerulo nephritis kidney tissue with or without CpG-ODN stimulation .Methods Wistar male rats were randomly divided into normal group(N),nephritis model group(M),CpG-ODN group(CpG) and GpC-ODN group(GpC).The urine samples were collected at 2,4,6 and 8 weeks after treatment,respectively.Blood samples were collected at the end of the last urine sample was collected,and the kidney tissue was collected,then the rats were killed.24 h urine protein was measured by Coomassie light blue technique.Serum album and renal function were determined by serological method.The pathologic changes of kidney were observed by light microscope and NF-?B p65 expression was detected using immunohistochemystry,RT-PCR was performed to detect the expressions of TLR9,INF-? and IL-6 mRNA.Results The expression of TLR9 was lighter in group M,and significantly increased after CpG-ODN stimulation compared with group M.Furthermore,24 h urine protein excretion was markedly increased,serum album was markedly decreased.The histopathologic changes of kidney were more severe.The mesangial cells(MCs) proliferated diffusifully in midrange and wide range,some of the glomeruli formatted cellularity crescent,micrangium loop was limitted,mononuclear macrophile cells were seen in the mesangial region.Conclusion Inflammatory factors mediated by TLR9 can deteriorate the biochemical and histopathologic changes.The immunologic reaction mediated by TLR9 is one of the mechanisms for the glomerulonephtitis' progression.

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

AlM:To compare the efficacy and safety of latanoprost and brimonidine in the treatment of open angle glaucoma, and provide reference for rational drug use.METHODS:A total of 121 cases ( 136 eyes ) who were diagnosed as primary open angle glaucoma were selected in this study, and they were randomly divided into experimental group (62 cases, 70 eyes) and control group ( 59 cases, 66 eyes) according to different drug treatment. Patients in the control group received brimonidine eye drops twice a day, while patients in the experimental group received latanoprost eye drops once a day. The intraocular pressure, visual acuity and adverse reactions were checked of the two groups in the following 3mo.RESULTS:The intraocular pressure of patients in the control group was 18. 1 ± 1. 3mmHg, while the experimental group was 17. 0 ± 0. 9mmHg after 12wk of treatment, which were both lower than before (P<0. 05). The fluctuation of intraocular pressure in the experimental group was significantly lower than that of the control group. There was no significant difference in the LogMAR visual acuity between before and after treatment in the control group, while the LogMAR visual acuity of the experimental group was significantly improved. The control group had hyperemia, burning sensation, tearing, eyelid edema and other adverse side effects, and the experimental group had little adverse reactions. CONCLUSlON: Latanoprost can significantly reduce intraocular pressure in glaucoma patients with in the follow- up time, and reduce the impact of elevated intraocular pressure in the vision of glaucoma patients, with little adverse reaction, worthy of clinical application.

Primary mediastinal choriocarcinoma in male is not a very common disease,with nonspecific clinical manifestations.Gynecomastia and testicular atrophy are present in some cases.The levels of serum human chorionic gonadotropin are often significantly increased.Giant lump in the mediastinum and bilateral lungs multiple metastases can be seen on the computed tomography for lung.The diagnosis for it depends on pathological biopsy.Current treatment method is a comprehensive,consisting of chemotherapy,radiotherapy and surgery.This paper reported a case of primary mediastinal choriocarcinoma in male,who were diagnosed and treated in the Second Xiangya Hospital of Central South University.He was admitted for cough and hemoptysis,and finally diagnosed by biopsy.The prognosis is very poor.Therefore,it is important to take physical examination regularly because it can be detected and diagnosed early.

A 61-year-old woman with pulmonary alternariosis and aspergillosis was reported.The patient presented with recurrent hemoptysis and cough for 3 years.Alternaria was identified by fungal culture.Biopsy specimen showed pulmonary aspergillosis.The patient had been treated with voriconazole at 400 mg/d through intravenous guttae for 7 days,and then switched amphotericin B at 25 mg/d through intravenous guttae for 11 days.The patient was treated with voriconazole at 400 mg through oral when she was discharged from hospital.After the treatment,the clinical symptoms ofhemoptysis and cough were recovered,and the lung CT examinations showed normal.

Objective:To observe and explore the clinical therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns.Methods:A prospective randomized controlled study was conducted. One hundred cases of superficial burn (sunburn) patients who met the inclusion criteria were admitted to Department of Dermatology of Chongqing Hospital of Traditional Chinese Medicine from October 2016 to June 2018, the course of sunburn was less than 15 days. According to the of random number table, the patients were divided into new dressing (ND) group (30 males and 20 females, aged (55±14) years) and conventional dressing (CD) group (28 males and 22 females, aged (59±12) years). Patients in ND group were treated with a self-developed new low-temperature boric acid wet dressing, and patients in CD group were treated with normal temperature boric acid solution wet dressing, 3 times a day. The Eczema area and severity index (EASI) score and Visual Analogue Scale (VAS) score of patients before and 14 days after treatment (patients discharged from hospital within 14 days were recorded on the day of discharge), the number of cured patients at 6, 8, 10, and 11 to 14 days after treatment, and the efficacy were compared between the patients in 2 groups. The nurse operators were investigated by self-made convenience questionnaire, and the time and convenience required of 2 dressings were compared. Data were statistically analyzed with independent sample t test or Mann-Whitey U test. Results:Before the treatment, the EASI and VAS score in those two groups showed no significantly difference ( t=1.576, 1.492, P>0.05). At 14 days after treatment, the EASI score (2.4±0.4) points in ND Group was significantly lower than (4.6±0.7) points in CD Group ( t=3.552, P<0.01); the VAS score (0.51±0.12) points in ND Group was significantly lower than (0.98±0.19) points in CD Group ( t=3.496, P<0.01). At 14 days after treatment, the cured time of sunburns in ND Group was significantly shorter than that in CD Group ( Z=-6.690, P<0.01); the treatment effects of ND Group showed better than that in CD Group ( Z=3.387, P<0.01). The time for nurses operating ND was significantly shorter than that in CD ( Z=-5.575, P<0.01); the nurses also believed the operation of ND was more convenient than CD ( Z=-4.304, P<0.01). Conclusions:Compared with that of CD, the application of ND can shorten the recovery time and improve the treatment efficiency. At the same time, the application of ND can significantly reduce the time of nursing operations, and the material is easy to use. This new material is worthy of clinical promotion for the treatment of superficial burns.

PURPOSE: G-protein coupled estrogen receptor 1 (GPER) probably play important roles in the progression of breast cancer including endocrine therapeutic resistance. We evaluated GPER in primary breast cancers. METHODS: Immunohistochemistry was used to detect GPER in paraffin-embedded tissues of primary breast cancers from 423 patients and GPER expression was correlated with clinicopathological factors. RESULTS: GPER was expressed in 63.8% of specimens, coexpressed with estrogen receptor alpha (ERalpha) in 36.6% of tumors and was positive in 62.5% of the ERalpha-negative tumors. The expression of GPER had no relationship with the status of ERalpha, progesterone receptor and HER2. Although the expression of GPER was significantly inversely related with nodal status (p=0.045), no correlation between GPER expression and other clinicopathological variables (age, menstruation status, tumor size, stage, histologic grade, Nottingham Prognostic Index or pathological type) was found. CONCLUSION: GPER and ERalpha exhibited independent expression pattern of distribution in primary breast cancers. A long-term follow-up and a more definite molecular phenotype for ER are necessary in confirming studies.
Breast ; Breast Neoplasms ; Estrogen Receptor alpha ; Estrogens ; Female ; Follow-Up Studies ; GTP-Binding Proteins ; Humans ; Immunohistochemistry ; Menstruation ; Phenotype ; Receptors, Progesterone