Objective To study the effects of Alprosladil and Glutathione therapy on patients with drug-induced acute renal damage. Methods 108 patients with drug-induced acute renal damage were divided into three groups at random. The patients in gruoup A (n=36) received 10?g Alprosladil injection once a day, the patients in group B (n=42) received both 10?g alprosladi and 1200mg glutathione injection once a day additionally, and the patients in group C (n=30) received 10mg dpamine injection once a day. The course of treatment of the three groups was 2～4 weeks. Results The effective rates for acute renal failure in groups A, B and C were 85 7%, 96% and 61% respectively. The effective rates for proteinuria, hematuria, N-acetyl-?-glucosaminidase(NAG)and retinol-binding protein(RBP) in urine were 70%, 78%, 76% and 80% in group A, 85%, 90%, 90% and 90% in group B, and 50%, 50%, 42% and 58% in group C respectively, which had significant difference among the three groups (P

Objective To investigate the clinical significance of plasma presepsin levels in patients with sepsis. Methods 92 patients who were admitted to the ICU of the affiliated hospital of Jiangsu University from October 2011 to March 2013 and 30 age-matched healthy controls were enrolled in this study. The patients were divided into three groups: sepsis, SIRS, and control. Plasma presepsin and serum procalcitonin (PCT) were measured, APACHEⅡscore were calculated at enrollment, and ROC curve was used to analyze the performance index for the diagnosis of sepsis. Results Serum levels of presepsin, PCT and APACHEⅡscore were significantly higher in the death group than in the SIRS group and the control group (P<0.01). Serum levels of presepsin and PCT were higher in the sepsis group than in the SIRS group and the control group (P<0.05). There was no significant statistical difference between the SIRS group and the sepsis group in the APACHEⅡ score (detailed in table 1). Level of plasma presepsin was significantly correlated with serum PCT (r = 0.82); plasma presepsin level was related with the APACHEⅡ score (r = 0.69). The area under the curve (AUC) of presepsin was 0.908 (95%CI 0.848~0.967), greater than the AUC of PCT 0.862 (95%CI 0.787~0.937). The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 629 pg/mL, of which the clinical sensitivity and specificity were 68.6% and 90%, respectively; when the cutoff value of PCT was 1.98 ng/mL, the clinical sensitivity and specificity were 92%and 65%. Conclusions Level of presepsin increases in patients with sepsis, and an elevated presepsin may suggest the severity of sepsis.

Adenolymphoma ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Keratins ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Metaplasia ; pathology ; Middle Aged ; Parotid Neoplasms ; metabolism ; pathology ; surgery

Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome.Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI,n=72),unstable angina pectoris group(UAP,n=76),and stable angina pectoris group(SAP,n=64).The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded.Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group,(154.42±16.50)ng/L in UAP group,and(143.87±9.80) ng/L in SAP group,with statistically significant differences (F =99.818,P =0.000).Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474,P =0.000;r=0.350,P=0.049).Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome (OR =1.049,P =0.022).The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887 ± 0.028 (P =0.000),with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L,sensitivity of 0.635,specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events[(168.57±7.24)ng/L vs.(156.92± 6.53) ng/L],with statistically significant difference (t =16.100,P =0.000).Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21,as an independent and effective marker,can predict acute coronary syndrome.

BACKGROUND:Tumor stem cels are found to be involved in the recurrence, metastasis and drug resistance of the tumor.
OBJECTIVE:To explore the relationship between cel activity and multidrug resistance of CD44+CD24-/low breast cancer stem cels.
METHODS:CD44+CD24-/low breast cancer stem cels sorted from multidrug resistant breast cancer cel line MCF-7/ADR were detected as percentage using flow cytometry. P-gp fluorescence intensity of the cel membrane and MDR mRNA expression in sorted cels and MCF-7/ADR were detected using flow cytometry and RT-PCR, respectively.
RESULTS AND CONCLUSION: After sorting by flow cytometry, the proportion of CD44+CD24-/low breast cancer stem cels was more than 90%, indicating that the sorted cels could meet the needs of the subsequent experiment. CD44+CD24-/low cel subsets exhibited stronger ability to form microspheres than non- CD44+CD24-/low cel subsets. The P-gp fluorescence intensity and MDR mRNA expression of CD44+CD24-/low cels were significantly higher than those of MFC-7/ADR cel line (P < 0.05). These experimental findings suggest that CD44+CD24-/low breast cancer stem cels sorted from MCF-7/ADR cel lines have a strong ability to form cel microspheresin vitro, and significantly raise the level of P-gp protein and MDR mRNA expression, which may be one of the causes of multidrug resistance.

Objective To evaluate the value of high-frequency echocardiography in assessing Bax gene transfer influence on survival of heterotopic cardiac allograft in rats.Methods Thirty rat models of heterotopic heart transplantation were established.Group A received heart transplantation only; Group B received cyclosporin (CsA) after operatiom Group C received ultrasound targeted microbubble destruction (UTMD) combined with Bax-shRNA.All rats were tested by high-frequency echocardiography at day 1,3,6 after transplantation.The ultrasound parameters included left ventricular internal dimension diastole (LVIDd),left ventricular internal dimension systole(LVIDs),left ventricular ejection fraction(LVEF),left ventricular thickness (LVT),left ventricular thickening (LVTR) and so on.The pathologic examinations were carried out on five rats at day 6 after echocardiography exam.The other rats in each group were observed for the survival time of cardiac allograft.Results ①The left ventricular long axis view and the apical four chamber view could be displayed clearly by high-frequency echocardiography.②The survival time of allografts in group C was (16.21 ± 5.01)d,which was longer than that in group B [(11.14 ± 1.72)d,P ＜ 0.05] and group A [(7.26 ± 1.50)d,P ＜0.01].③LVT index got higher after transfection.At day 6,LVEF of group A was lower than group B and C markedly(P ＜0.05) while no significant difference was found between group B and C(P ＞0.05).At day 3 and 6,LVT of group A and B were higher than group C (P ＜0.05) while LVTR was lower(P ＜0.05).Conclusions The Bax gene transfer influence on survival of heterotopic cardiac allograft in rats could be evaluated accurately by high-frequency echocardiography which could assess cardiac structure and function.LVT and LVTR can be considered as early evaluation indexes for its high sensitivity over LVEF.

Objective To explore the feasibility of a novel incisionless laparoscopic technique in the treatment of colorectal tumor, and evaluate the preliminary clinical result of this technique. Methods The clinical data of 12 consecutive resected specimens of high located rectal or sigmoid tumor removed by traditional laparoscopic surgery were analyzed to probe the indication of this technique and the first 2 cases received incisionless laparoscopic anterior resection. Postoperative follow up was made to evaluate the clinical feasibilities. Results Among 12 explanted fresh specimens there were 1 adenoma and 3 adenocarcinoma cases in which the key steps of the new technique were successfully demonstrated. In two cases, the bowel above the tumor was cut and the distal end was inverted and pulled through the anus laparoscopically, the tumor along with the bowel resected, the stump pushed hack, and intralumen sigmoidproctostomy fashioned. In these two patients, one of sigmoid cancer and one of large rectal adenoma with focal canceration, the mean operation time was 200 min, mean blood lose was 50 ml, mean bowel function recovery time was 1.5 days. After 13 and 15 respective months fullow up there was no complications nor tumor recurrence. Conclusions Ineisionless laparoscopic surgery, while in line with tumor free principles, has the advantage of safety, cost-effectiveness and being cosmetic in selected cases.

Adolescent ; Adult ; Aged ; Female ; Humans ; Immunophenotyping ; Leukocyte Common Antigens ; immunology ; Male ; Middle Aged ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; Young Adult

Objective To introduce the standard procedure of Cattell Braasch maneuver and evaluate the complication and clinical value of this maneuver as a important exploration method in the surgery of pancreatic tumors. Method The clinical data of 13 cases of pancreatic tumors explored by Cattell Braanch maneuver before undergoing tumor resection were analyzed. Results Among these 13 cases there were 6 cases of tumors of the head (the pancreatic adeuocarcinoma in 4 cases, solid pseudo-papillary tumor and endocrine tumor in one each cases) and 7 cases of tumor of the body and tail of the pancreas (adenocarcinoma in 4 cases, solid pseudo-papillary tumor in 1 case, endocrine tumor in 2 cases) Pancreaticoduodenectomy was performed in 6 cases, including segmental resection of the tumor invading the superior mesenteric vein( SMV )with length varying from 3 to 7 cm and direct end-to-end reanastomosis in 3 cases. Distal pancreatectomy plus spleuectomy was performed in the other 7 cases, including the case in which extended tumor resection demanded left nephrectomy. Operations lasted from 2. 5 hrs to 11 hrs, in which only 10 ～ 15 mins were needed for Cattell Braasch maneuver . The blood lose was from 300 ml to 1000 ml. There were neither mortality nor severe complications in these series. Conclusion Cattell Braasch maneuver facilitates the exploration and tumor resection in patients suffering from pancreatic neoplasms especially malignances with better view of the operation field,it helps to avoid incidental iatrogenic injury, and also to the nongraft PV/SMV end-to-end anastomosis after the resection of tumor invaded segment.

Objective:To evaluate the role of nuclear receptor subfamily 1, group D, member 1/brain and muscle Arnt-like 1(Rev-erbα/Bmal1) signaling pathway in myocardial ischemia-reperfusion (I/R) injury in diabetic rats and its relationship with autophagy.Methods:SPF-grade adult male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-220 g, were used in this study.Type I diabetes mellitus was induced by intraperitoneal streptozotocin 60 mg/kg.The rats were continuously fed for 8 weeks after successful establishment of the model.Thirty rats with type 1 diabetes mellitus were divided into 3 groups by a random number table method: diabetic sham operation group (DS group, n=6), diabetic myocardial I/R group (DI/R group, n=12) and diabetic myocardial I/R plus Rev-erbα antagonist SR-8278 group (DI/R+ SR group, n=12). Eighteen non-diabetic rats were divided into 2 groups by a random number table method: non-diabetic sham operation group (NS group, n=6) and non-diabetic myocardial I/R group (NI/R group, n=12). The myocardial I/R model was established by ligation of the left anterior descending coronary artery for 30 min followed by 120-min reperfusion in anesthetized rats.SR-8278 2 mg/kg was intravenously injected via the femoral vein at 1 h before ischemia in group DI/R+ SR.Blood samples were collected from the carotid artery immediately after the end of reperfusion for determination of serum troponin I (cTnI), creatine kinase-MB (CK-MB) and lactic dehydrogenase (LDH) levels (by enzyme-linked immunosorbent assay). Then the rats were sacrificed, and myocardial tissues were obtained for determination of myocardial infarct size (by TTC method), expression of Rev-erbα and Bmal1 mRNA (by real-time polymerase chain reaction) and expression of Rev-erbα, Bmal1, microtubule-associated protein 1 light chain (LC3) Ⅱ and LC3Ⅰ (by Western blot) and for calculation of the ratio of LC3 Ⅱ/LC3Ⅰand the number of autophagosomes (with a transmission electron microscope). Results:Compared with group NS, the percentage of myocardial infarct size, serum levels of cTnI, CK-MB and LDH and the number of autophagosomes were significantly increased, the expression of Rev-erbα and its mRNA in myocardial tissues was up-regulated, the expression of Bmall and its mRNA was down-regulated, and the ratio of LC3 Ⅱ/LC3Ⅰwas increased in group NI/R, and serum levels of cTnI, CK-MB and LDH were increased, the number of autophagosomes was decreased, the expression of Rev-erbα and its mRNA in myocardial tissues was up-regulated, the expression of Bmall and its mRNA was down-regulated and the ratio of LC3 Ⅱ/LC3Ⅰwas decreased in group DS ( P<0.05). Compared with group NI/R, the percentage of myocardial infarct size and serum levels of cTnI, CK-MB and LDH were significantly increased, the number of autophagosomes was decreased, the expression of Rev-erbα and its mRNA in myocardial tissues was up-regulated, the expression of Bmall and its mRNA was down-regulated, and the ratio of LC3 Ⅱ/LC3Ⅰwas decreased in group DI/R ( P<0.05). Compared with group DS, the percentage of myocardial infarct size, serum levels of cTnI, CK-MB and LDH and the number of autophagosomes were were significantly increased, the expression of Rev-erbα and its mRNA in myocardial tissues was up-regulated, the expression of Bmall and its mRNA was down-regulated, and the ratio of LC3 Ⅱ/LC3Ⅰwas increased in group DI/R ( P<0.05). Compared with group DI/R, the percentage of myocardial infarct size, serum levels of cTnI, CK-MB and LDH and the number of autophagosomes were significantly decreased, the expression of Rev-erbα and its mRNA in myocardial tissues was down-regulated, the expression of Bmall and its mRNA was up-regulated, and the ratio of LC3 Ⅱ/LC3Ⅰwas increased in group DI/R+ SR ( P<0.05). Conclusion:Rev-erbα/BMAL1 signaling pathway is involved in the process of myocardial I/R injury by regulating cell autophagy in diabetic rats.