Objective To investigate the effect of parecoxib on cardiac function after acute myocardial infarction (AMI) in rats. Methods Twenty-four adult male SD rats, weighing 230-250 g, were randomly divided into 3 groups ( n = 8 each): group Ⅰ sham operation (group S), group Ⅱ AMI and group Ⅲ parecoxib (group P). Myocardial infarction was induced by ligation of left anterior descending branch (LAD) of coronary artery in group Ⅱ and Ⅲ . In group S, LAD and cervical sympathetic trunk were exposed but not ligated and transected.Group P received intrperitoneal parecoxib 8 mg/kg once a day for 3 days 24 h after ligation of LAD, while group AMI received normal saline instead. At 4th day after ligation LAD, the left ventricular systolic pressure ( LVSP),left ventricular end-diastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded. Blood samples were taken from common carotid artery to determine the plasma concentrations of TXA2 and PGI2 and PGI2/TXA2 was calculated. Then the animals were sacrificed and hearts removed. Myocardial infarct size of left venicle was calculated. Results Compared with group S, LVSP, ± dp/dtmax, plasma concentrations of PGI2 and PGI2/TXA2 were significantly decreased, while LVEDP and plasma concentrations of TXA2 increased in group AMI and P( P ＜0.05). Compared with group AMI, LVSP, ± dp/dtmax, plasma concentrations of PGI2 and PGI2/TXA2 were significantly decreased, while LVEDP and plasma concentrations of TXA2 increased in group P ( P ＜ 0.05). There was no significant difference in myocardial infarct size between group AMI and P (P ＞ 0.05). Conclusion Parecoxib can improve cardiac function after AMI in rats and the mechanism is related to regulation of the balance of PGI2/TXA2.

Objective To investigate the relationship between the expression of trannsient receptor potential vanilloid 1 (TRPV1) and the severity of airway remodeling in elderly patients with chronic obstructive pulmonary disease(COPD).Methods According to airflow obstruction severity,totally 100 cases of elderly patients with COPD were divided into chronic obstructive pulmonary disease Global Initiative(gold) grade 1 in 23 cases,24 cases of grade GOLD2,GOLD3 27 cases,GOLD4 26 cases,respectively.The TRPV1 concentrations in induced sputum supernatant and serum from each level of elderly patients with COPD as well as in 50 cases of healthy old people were analyzed.Results TRPV1 concentrations in serum and induced sputum in the COPD group was significantly increased compared with the healthy elderly group[(9.94±2.91)μg/L vs.(3.68±0.46)μg/L,(3.29± 1.32)μg/L vs.(0.70 ± 0.30)μg/L] (P ＜ 0.01).The serum and induced sputum TRPV1 concentrations in the mutual pairwise comparison between the elderly COPD patients with all levels had statistical difference (P ＜ 0.01).Conclusion The expression of TRPV1 protein become increased with the severity of airway remodeling in elderly patients with chronic obstructive pulmonary disease.

ObjectiveTo demonstrate the project scope of the afferent nerves of the lumbar intervertebral disc,on which basis to explore the mechanism of the symptoms of discgenic low back pain.MethodsThirty Wistar rats were divided randomly into three groups of 10 rats each:the L4-5,L5-6,and L6 S1 group.Each group was further divided randomly into two subgroups,the experimental group and the control group,5 rats for each group.Intervertebral disc was exposed through the posterior approach under peritoneal cavity anesthesia,after the nerve roots were pull away,2 μl of 30％ cholera toxin-horseradish peroxidase (CT-HRP) was injected into the inner layer of the intervertebral disc in the experimental group,while 2 μl of 0.9％ Nacl was used in the control group.Forty-eight hours after the surgery,all rats were perfused and bilateral dorsal root ganglions(DRGs) of T10-L3 were resected and fixxied.Each DRG was sectioned at 30 μm thickness and processed by DAB method.The sections of DRGs were coverslipped and observed by optical microscopy for the neurons or axons labelled by CT-HRP.It was judged as positive that brownish-black particles were in the neurons or axons.ResultsNot in a single dorsal root ganglions,but in a scope of dorsal root ganglions axons labled by CT-HRP could be seen in the rats in the experimental groups.No CT-HRP labled neurons or axons were seen in dorsal root ganglions in the contral groups.ConclusionAfferent nerves of the lumbar intervertebral disc project to a scope of dorsal root ganglions,which is the anatomic basis of the mechanism of the symptoms of discgenic low back pain.

Objective To evaluate the outcome of radiotherapy for locally advanced pancreatic cancer. Methods From January 2000 to December 2007,41 patients with inoperable locally advanced (stage Ⅲ) pancreatic cancer were treated with three-dimensional conformal radiation therapy(3DCRT) or intensity-modulated radiation therapy (IMRT). Among these patients, 30 received concurrent radio-chemo-therapy. Results The median survival time(MST) and 1-year overall survival were 9.2 months and 23%. Patients with pretreatment KPS≥80 ,no regional lymph nodes metastasis, and CR/PR after radiotherapy had better prognosis. The corresponding MSTs were 11.1 months vs 5.8 months (χ2 = 7.50, P = 0.006), 10. 8months vs 6.5 months (χ2 = 5.67, P = 0.017), and 19.5 months vs 9.1 months (χ2= 7.28, P = 0. 007), re-spectively. Concurrent radio-chemotherapy tended to improve the overall survival (χ2 = 3.25, P = 0. 072). After radiotherapy, 18 patients had clinical benefit response, mainly being abdominal pain relief. Neither grade 4 hematologic nor grade 3 non-hematologic toxicities were observed. Conclusions For patients with locally advanced pancreatic cancer, both 3DCRT and IMRT are effective in alleviation of disease-related symptoms. Patients with better porformance status before treatment, no regional lymph nodes metastasis, and better response to radiotherapy may have better prognosis. Concurrent radio-chemotherapy trend to improve overall survival when compared with radiotherapy alone.

Objective To analyze the electroencephalograph (EEG) features of 43 patients with clinically possible or probable Creutzfeldt-Jakob disease (CJD) and its correlation with megnetic resonance imaging (MRI) imaging and clinical manifestations.Methods All patients diagnosed with suspected CJD who were hospitalized in Xuanwu Hospital from January 2013 to December 2015 were collected.The clinical data, EEG and MRI imaging features were analyzed retrospectively.Based on the periodic sharp wave complexes (PSWC) appearance in EEG results, the patients were divided into typically changed group (TCG), atypically changed group (ACG) and unchanged group (UCG).Age, disease duration, clinical manifestations and MRI features among three groups were analyzed and the correlations between patient′s EEG features and age, disease duration, clinical manifestations or MRI features were explored using spearman method.Results Among the 43 patients with possible or probable CJD disease, 26 were male and 17 were female with an average disease duration of 4 months.The age of onset ranged from 31 to 80 with an average of (58.0±9.8) years old, and 86.0% of patients were 51 years old or above.Clinical characteristics of CJD patients according to occurrence rate were as follows: 35 cases (81.4%) with cognitive impairment, 29 cases (67.4%) with mental and behavior disorder, 28 cases (65.1%) with pyramidal tract damage, 24 cases (55.8%) with cerebellar symptoms, 23 cases (53.5%) with extrapyramidal symptoms,17 cases (39.5%) with myoclonic, 13 cases (30.2%) with dyssomnia, 13 cases (30.2%) with visual disorder and 2 cases (4.7%) with akinetic mutism.Regarding EEG features, 39.53% (17/43) of patients showed typical periodic sharp wave complexes (PSWC) (TCG group), 51.2% (22/43) had irregular rhythm and different forms of slow wave (ACG group) and only 9.3% (4/43) had no EEG change (UCG group).The occurrence rate of ribbon sign in MRI was 82.4% (14/17) in TCG group, 77.3% (17/22) in ACG group and none in UCG group.The rates were significantly higher in TCG and ACG group than that in UCG group (both P<0.05).Spearman correlation analysis revealed that EEG features was correlated with disease duration (r=0.351, P=0.021) and visual impairment (r=-0.377, P=0.013) for all CJD patients.There was no correlation between EEG and MRI or other clinical manifestations such as myoclonic, age and so on (all P>0.05).Conclusions EEG showed typical changes associated with disease duration in different stages of disease.EEG and MRI are two different means to evaluate different aspects of patients with CJD disease, and combination of two means could achieve better evaluation results.

Objective:To observe the effects of microRNA-21 (miR-21) on cell invasion, migration and apoptosis of pancreatic cancer PANC1 cells, and explore the potential molecular mechanism.Methods:Recombinant plasmids carrying miR-21 or small interfering RNA targeting miR-21 were constructed. Using blank plasmid as the control, the recombinant plasmids were transfected with human pancreatic cancer PANC1 cells by liposome method, respectively to establish blank group, miR-21 overexpression group (overexpression group) and miR-21 silence group (silence group) PANC1 cell lines. Cell proliferation, apoptosis, invasion and metastasis were detected by MTT method, flow cytometry, transwell chamber and wound scratch test, respectively. ELISA and Western blot were used to measure the protein expression of programmed cell death factor 4(PDCD4), gene of phosphate and tension homology deleted on chromsome ten (PTEN), vascular endothelial growth factor (VEGF), survivin, matrix metalloproteinase 2 (MMP-2) and MMP-9.Results:After 24 h cell culture, the cell proliferation rate of blank group, overexpression group and silence group was (20.72±5.62)%, (28.46±6.12)% and (14.05±3.36 )%; cell apoptosis rate was (5.89±0.26)%, (4.62±0.19)% and (8.66±2.55)%; the number of transmembrane cells was (212.4±32.5), (508.8±50.7) and (50.9±10.6) per 200 times visual field; the area covered by migrated cells was (75.6±12.1), (118.8±20.2) and (48.8±9.5)mm 2 per 200 times visual field; the expression of PDCD4 was 0.85±0.22, 0.72±0.10 and 1.36±0.41; the expression of PTEN was 0.85±0.21, 0.28±0.09 and 1.36±0.45; the expression of VEGF was 0.79±0.24, 1.15±0.31 and 0.46±0.10; the expression of survivin was 1.02±0.33, 1.51±0.42 and 0.52±0.12; the expression of MMP-2 was 1.12±0.22, 1.86±0.52 and 0.56±0.18; the expression of MMP-9 was 1.06±0.15, 1.78±0.48 and 0.49±0.12. All the differences among the three groups were statistically significant (all P<0.05). Compared with blank group, the cell apoptosis rate, PDCD4 and PTEN expression were increased, while cell proliferation, invasion and migration, and the protein expression of VEGF, survivin, MMP-2 and MMP-9 were all decreased; the changes in silence group was totally contrary to those in overexpression group. All the differences among the three groups were statistically significant (all P<0.05). Conclusions:miR-21 silencing can inhibit the proliferation, migration and invasion of PANC1 cells and promote apoptosis, and the mechanism was possibly associated with the upregulation of PDCD4 and PTEN protein expression.

Objective To evaluate the toxicities and long-term survival of a pilot study of radical surgery followed by concurrent capecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients.Methods From March 1,2005 to December 31,2007,131 pathologically proved stage Ⅱ and Ⅲ rectal cancer patients received radical surgery followed by chemoradiotherapy and adjuvant chemotherapy.Capecitabine was delivered daily in twice,for 2 weeks followed by a 2nd cycle after a rest of 7 days during radiotherapy,with the dosage of 1600 mg/m2/d.Three-dimensional conformal radiotherapy was encouraged to the dose of 50 Gy in 25 fractions,and Oxaliplatin/5-fluorouracil or leucovorin based adjuvant chemotherapy was recommended.Results Grade 3 +4 toxicities during concurrent chemoradiotherapy were observed in 28.2％ of patients.The follow-up rate was 93.9％.The 3-year overall survival (OS),locoregional-free survival and distant metastasis-free survival rates were 85.1％,96.7％ and 79.5％,respectively.Among the 31 patients with relapse,5 had loco-regional recurrence and 28 had distant metastasis.Univariate analysis indicated that patients with low and moderate-low differentiated adenocarcinoma,no adjuvant chemotherapy,stage ⅢC disease or positive lymph node ratio (LNR) more than 30％ had lower OS ( x2 =15.49,15.85,8.80 and 9.76,P ＝ 0.000,0.000,0.011 and 0.002 ).Patients with N2 disease had more loco-regional recurrence.Patients with stage ⅢC,without adjuvant chemotherapy,or LNR more than 30％ were at higher risk of distant metastasis ( x2 =6.51,11.57 and 9.70,P =0.034,0.001 and 0.002 ).However,patients who didn ' t receive adjuvant chemotherapy were likely to have low differentiated adenocarcinoma and T4 stage disease ( x2 =7.20,6.48,P =0.027,0.039).Conclusions After radical surgery and concurrent eapecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients,loco-regional recurrence rate is pretty low.Distant metastasis is the main treatment failure.

Objective To study clinical and immunological features of renal tubular acidosis (RTA) patients complicated with autoimmunity disease. Methods Data of 60 patients of RTA complicated with autoimmune disease and 40 without it during 1999 and 2009 were reviewed, including clinical features,immunological examinations and renal tubular function. Results Among 60 patients of RTA, 59 were type Ⅰ, one type Ⅱ, and 55 complicated with Sjogen's syndrome (92%), one with systemic lupus erythematosus, nine with autoimmune thyroid disease, and one with rheumatoid arthritis. Flaccid paralysis was manifested in 50 (83%) RTA patients complicated with autoimmune disease, polyuria in 28 (47%),polydipsia in 28 (47%) , bone disorder in 24 (40%) and arthralgia in 28 (47%) cases, but of those without autoimmune disease, bone disease only in eight (20%) and arthralgia in nine (22%) cases, with statistically significant difference ( P ＜0. 01 ). Serum level of parathyroid hormone increased noticeably, with prevalence of positive antinuclear antibody, anti-SSA antibody and anti-SSB antibody of 88 % (49/56),84% (47/56) and 43% (24/56), respectively in RTA patients with autoimmune disease, all significantly higher than those in the patients without it ( P ＜ 0. 05 ). Conclusions Sjogen' s syndrome is the most common and prevalence of bone disorder and arthralgia are significantly higher in patients of RTA complicated with autoimmune disease, which should be examined as early as possible for timely diagnosis and treatment.

OBJECTIVETo evaluate the outcome of endodontic microsurgery in 54 cases with persistent apical periodontitis.

METHODSAll surgical procedures were performed under a dental operating microscope after root canal treatment. Surgical procedures included periapical curettage, root-end resection, retropreparation with ultrasonic microtips, and root-end filling with mineral trioxide aggregate (MTA). Healing was monitored clinically and radiographically.

RESULTSOne year later, 31 (57.41%) cases were cured, 19 (35.19%) cases were improved, 4 (7.41%) cases were failure. There were no statistical difference between sex, age, tooth location, size of the lesion and pathological features (P>0.05).

CONCLUSIONThe outcome of the present study indicates that endodontic microsurgery may result in a predictable treatment outcome in teeth with persistent periradicular lesions.

Aluminum Compounds ; Apicoectomy ; Calcium Compounds ; Drug Combinations ; Humans ; Microsurgery ; Oxides ; Periapical Periodontitis ; Root Canal Filling Materials ; Root Canal Obturation ; Root Canal Therapy ; Silicates ; Treatment Outcome

Objective:To investigate the efficacy and prognosis of hypofractionated intensity-modulated radiation therapy combined with hormonal therapy in the treatment of pelvic lymph node metastatic prostate cancer.Methods:Clinical data of 42 IV A prostate cancer patients who received hypofractionated intensity-modulated radiation therapy combined with hormonal therapy in Cancer Hospital of Chinese Academy of Medical Sciences between 2006 and 2018 were retrospectively analyzed. The total irradiation doses to the prostate and seminal vesicles were 67.5 Gy/25f, 2.7 Gy/f. The prophylactic irradiation doses to the pelvic lymph nodes were 45-50 Gy with a daily fraction dose of 1.8-2.0 Gy. Thirty-three patients with residual lymph nodes were boosted to 60.0-67.5 Gy for the residual area, 2.4-2.7 Gy/f. Androgen deprivation therapy included surgical castration or luteinizing hormone-releasing hormone agonists combined with antiandrogens. Survival rate was calculated using Kaplan- Meier method. The differences between two groups were analyzed by log-rank test. Prognostic factors were identified by univariate and multivariate analyses. Results:The median follow-up was 65.5 months (range, 5 to 150 months). The 5-year and 10-year failure-free survival (FFS) rates in the whole group were 67% and 45%, respectively. No clinical recurrence was observed in the irradiation field. The 5-year and 10-year prostate cancer-specific survival/overall survival (PCSS/OS) rates were 85% and 60%, respectively. Gleason score (≥8 and<8) and duration of hormonal therapy impacted the FFS (both P<0.05). The duration of hormonal therapy was an independent prognostic factor for PCSS/OS ( P=0.003). Conclusions:Hypofractionated intensity-modulated radiotherapy combined with hormonal therapy yields optimistic clinical efficacy in the treatment of pelvic lymph node metastatic prostate cancer. Gleason score (≥8 and <8) and duration of hormonal therapy are critical prognostic factors.