From the perspective of philosophy,centering on the background,the realistic problems and the fu-ture trend of medicine,this paper analyzed the nature-understanding of medicine and the meaning of integration,and put forward that integration meantto reshape the view of life,health,and knowledge.

Objective To investigate the histogenesis,clinicopathological features and biological behavior of goblet cell carcinoid (GCC) of the appendix. Methods 3 cases of GCC of the appendix were studied by light microscopy and immunohistochemistry. Results 3 cases all occured in men. Microscopically: the tumor was composed of goblet cells containing mucin-filled with basal round to crescentic nuclei without atypia.These tumor cells were arranged in single forms,nests or acinus with no central lumen. 1 case was composed of simple goblet cells and typical carcinoid cells were seen in other 2 cases arranged in trabeculae and tubule.There was transition between goblet cells with tubelar and crypt epithelium.Immunohistochemical staining revealed that goblet cells were positively reacted with CgA, Syn, CEA, CK and p53 in 1 case. Conclusions Goblet cell carcinoid of the appendix arise from a pluripotent cell with divergent neuroendocrine and mucinous differentiation .It is a subtype of carcinoids of the appendix.The diagnosis mainly bases on its morphologic changes and immunohistochemical findings. The unpredictable behavior of this tumor is probably related to its component and the degree of infiltration.

Aim To explore the effects of the inhibition of cell adhesion , invasion and migration in non-small cell lung cancer ( NSCLC ) H460 and A549 cells in-duced by platycodin-D ( PD ) and its mechanism. Methods Cell adhesion assay, wound-healing assay and Transwell chamber migration assay were used to detect the ability of cell adhesion, migration and inva-sion. Regulation of MMP-2 and MMP-9 mRNA was de-termined by RT-PCR. Meanwhile, Western blot was performed to determine the expression levels of MMP-2/9 , its upstream related proteins of ERK signaling pathway and p-Akt. Results PD effectively inhibited the ability of cell adhesion, invasion and migration in H460 and A549 cells in a dose-dependent manner ( P<0. 05 ) . PD reduced the expression of MMP-2 and MMP-9 mRNA in H460 and A549 cells ( P<0. 01 );meanwhile, PD down-regulated the expression levels of MMP-2/9 , and inhibited the expression of its upstream proteins Ras, p-c-Raf, p-ERK 1/2 and p-Akt in a time- and dose-dependent manner. Conclusions PD inhibits cell adhesion, invasion and migration in NSCLC cells, and these effects are related to the down-regulation of the expression of MMP-2 and MMP-9 mR-NA and protein, and inhibition of its upstream expres-sion of ERK signaling pathway and p-Akt.

Aim To explore the inhibitory effects of ophiopogonin-B (OP-B ) on cell adhesion,invasion and migration in non-small cell lung cancer (NSCLC) A549 cells in vitro and its possible mechanism.Meth-ods Cell adhesion assay and transwell chamber assay were used to detect the ability of cell adhesion,migra-tion and invasion.qRT-PCR was used to detect the mRNA levels of MMP-2 and 9 .Meanwhile ,Western blot assay was performed to determine the protein levels of MMP-2/9 and p-Akt.Results OP-B significantly inhibited the ability of cell adhesion,invasion and mi-gration in A549 cells at the concentration of 10 μmol· L-1 (P<0.01 ).Meanwhile,it inhibited the mRNA and protein levels of MMP-2 and MMP-9 and down-regulated the phosphorylation of Akt (P <0.0 1 ). Conclusion OP-B inhibits cell adhesion,invasion and migration in A549 cells through down-regulation of the mRNA and protein expression of MMP-2/9 ,and the inhibitory effect on the expression of p-Akt.

Objective: To study the effect of HaikunShenxi on expression of connective tissue growth factor(CTGF) in renal tubules of STZ-induced diabetic nephropathy rats.Methods: SD rats were randomly divided into two groups: normal control and diabetic nephropathy.Diabetes was induced by intraperitoneal injection of STZ.The diabetic models were affirmed upon blood glucose ≥16.5 mmol/L,urinary glucose ≥ ++++ 72h after the injection.And the diabetic rats were randomly divided into four groups: model group,irbesartan treatment group,low and high dose HaikunShenxi treatment group.24-hour urine volume,24-hour urinary protein excretion were examined at week 4,8,and 12 respectively.All the rats were sacrificed at week 12;body weight,kidney weight,and serum excretion,serum creatinine,blood urea nitroge were detected.Kidney were taken for pathological examination(HE,Mallory stain),The expressions of CTGF in rat renal were detected respectively by immunohistochemistry and in situ hybridization.Result: 24-hour urine volume,24-hour urinary protein excretion were examined at week 4,8,and 12 respectively.All the rats were sacrificed at week 12;body weight,kidney weight,and serum excretion,serum creatinine,blood urea nitroge was improved by HaikunShenxi preparation.Haikunshenxi can alleviate severe pathological changes of kidney structure in rats with DN,The expression of CTGF in the HaikunShenxi treatment group was depressed greatly.Conclusions: The overexpression of CTGF in renal tissue of diabetic rats may be one of the mechanisms of diabetic nephropathy,haikunshenxi had certainly protective effects on it.

Objective To evaluate the effect of curcumin on spinal inflammatory factor in rats with diabetic neuropathy. Methods Diabetic neuropathy was induced by intraperitoneal injection with 1% STZ (60 mg/kg) in sprague-dawley rats. These diabetic rats were randomly allocated to diabetic group (D group, n=10) and curcumin group ( C group , n = 10 ) . Another 10 age-matched normal rats served as controlled group ( N group , n = 10 ) . 28 days after STZ injection, the rats in C group received daily intragastric administration of curcumin (200 mg/kg) whereas those in D group received the same volume of normal saline for 2 weeks. Caudal vein blood glucose levels at T1( before STZ injection)and at T2-T8(2、7、14、21、28、35、42 days after STZ injection)from all rats were detected. Responses to the mechanical stimulus were measured with von Frey filament, and paw withdraw threshold (PWT) was recorded at T1 and at T3 to T8. At T8,the rats were killed and lumbar segments of spinal cord were removed to detect TNF-αand IL-6 content. Results Compared to N group, rats in both C and D group showed hyperglycemia at T2 to T8 (P<0.05) and lower PWT at T4~ 8 (P < 0.01). Compared to D group, C group showed higher PWT at T7,8(P<0.05). Both D and C group showed higher levels of blood sugar at T2 ~ 8 than that at T1 (P < 0.05). C group showed higher PWT at T7,8 than that at T6(P<0.05). Compared to N group,spinal TNF-αand IL-6 content increased in both D and C groups (P<0.05). Compared to D group, C group had reduction of TNF-αand IL-6 concentration (P < 0.05). Conclusion Curcumin can attenuate diabetic neuropathic pain on rats probably by reducing inflammatory factor in spinal cord.

Objective To study the expression of tansforming growth factor(TGF)-?1 and mRNA in the renal tubules of Streptozotocin(STZ)-induced diabetic nephropathy rats.Methods SD rats were randomly divided into two groups: normal control and diabetic nephropathy.Diabetes was induced by intraperitoneal injection of STZ.And the diabetic rats were randomly divided into four groups: model group,irbesartan treatment group,Haikunshenxi low and high dose group.Twenty-four-hour urine volume and urinary protein excretion were examined at week 4,8,and 12 respectively.All the rats were sacrificed at week 12,and body weight,kidney weight,and serum excretion,serum creatinine,blood urea nitrogen were examined.The expression of TGF-?1and mRNA in rat renal tissue were detected respectively by immunohistochemistry and in situ hybridization.The graphic analysis system and SPSS 11.5 statistics software were used to treat the results.Results The expression of TGF-?1and mRNA in the Haikunshenxi group was depressed greatly(P

Platycodin-D (PD) is the major monomer of triterpene saponins in the root of Platycodon grandiflorum. Recent studies have demonstrated that PD has a wide range of anti-tumor effect and its efficacy is satisfying. This article reviewed anti-tumor mechanisms of PD from the aspects of proliferation, apoptosis, invasion and metastasis, immune and anti-inflammation, etc., with a purpose to provide a theoretical basis and reference for the further development and better utilization of PD and taking its anti-tumor advantage.

OBJECTIVE: To investigate the changes of connective tissue growth factor (CTGF) protein and CTGF mRNA in kidney tissue of rats with adriamycin (ADR)-induced nephropathy and to study the effects of compound Biejia Ruangan tablet (CBJRGT), a traditional Chinese herbal medicine for treatment of liver fibrosis. METHODS: A rat model of ADR-induced nephropathy after one-sided nephrectomy was established. Forty-five Wistar rats were randomly divided into 5 groups: normal control group, sham-operated group, untreated group, lotensin-treated group and CBJRGT-treated group. Pathological changes of the kidney tissue were observed by microscopy after 10-week drug administration. The expressions of CTGF protein and CTGF mRNA in the kidney tissue were measured by the methods of immunohistochemistry and in situ hybridization. RESULTS: The expressions of CTGF protein and CTGF mRNA in the normal and sham-operated groups were decreased in the intracytoplasm of glomerular mesangial cells, renal tubular epithelial cells and interstitial cells. Compared with the sham-operated group, the expressions of CTGF protein and CTGF mRNA in the untreated group were markedly increased and the development of renal fibrosis in the untreated group could be observed. CBJRGT could significantly decrease the expressions of CTGF protein and CTGF mRNA, and there was no significant difference between CBJRGT-treated group and lotensin-treated group. CONCLUSION: CBJRGT may suppress the development of fibrosis through down-regulating the expressions of CTGF protein and CTGF mRNA.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.