Curcumin is a principal polyphenolic curcuminoid extracted from turmeric rhizome, which has been used for treating inflammation of joints, ulcers, jaundice and other disorders in Asian traditional medicine. In recent years, many studies have indicated that curcumin plays important roles in treatment of liver diseases. Curcumin attenuates liver injury and non-alcoholic fatty liver disease by lowering the release of inflammation cytokines, minimizing oxidative stress, enhancing the sensitivity of insulin and altering lipid metabolism. Curcumin shows potent anti-fibrosis activity, contributing to inhibit the activation of hepatic stellate cells and reduce the deposition of extracellular matrix by its regulation of PPAR-γ, NF-ΚB and TGF-β signaling pathways. Moreover, curcumin exhibits anti-cancer effect by inducing G2/M phase cell cycle arrest and apoptosis in several hepatoma cell lines. However, poor water solubility and low bioavailability of curcumin limit its clinical applications. To overcome its limited systemic bioavailability, many new approaches have been explored to deliver curcumin effectively. This article focuses on advances in the effects of curcumin and its derivatives for treatment of liver injury, non-alcoholic fatty liver disease, liver fibrosis and hepatocarcinoma.
Apoptosis ; Cell Cycle Checkpoints ; drug effects ; Cell Line, Tumor ; Curcumin ; pharmacology ; Hepatic Stellate Cells ; drug effects ; Humans ; Inflammation ; drug therapy ; Liver Diseases ; drug therapy ; NF-kappa B ; metabolism ; Oxidative Stress ; drug effects ; PPAR gamma ; metabolism ; Signal Transduction ; Transforming Growth Factor beta ; metabolism

Objective To study the effect of interventional treatment on the expression of PgP and GST ? in different histopathological types of primary lung carcinoma. Methods One hundred and eighteen cases of histopathologically verified primary lung carcinoma were studied. SCLC was found in 26 cases and NSCLC in 92 cases. The non chemotherapy group had 50 cases, and the interventional treatment group had 68 cases. PgP and GST ? were examined in all specimens with 2 step immunohistochemistry. Results The positive expression rates of PgP and GST ? were 32.0% and 34.0% in non chemotherapy group, respectively, 75.0% and 78.6% in interventional treatment with non embolization group, respectively, and 50.0% and 52.5% in interventional treatment with embolization group, respectively. The positive expression rates of PgP and GST ? had significant difference between non chemotherapy group and interventional treatment with non embolization group( P 0.05). There was a tendency of positive correlation between differentiated degree of carcinoma and the expression of PgP and GST ? in NSCLC. Condusion To detect PgP and GST ? in carcinoma tissue is important and has the instructive significance for chemotherapy of lung carcinoma. The positive rate of multidrug resistant gene is obviously increased in the primary lung carcinoma with bronchial arterial chemotherapy. The inducement to multidrug resistance gene in bronchial arterial embolization with the emulsifying agent of oil anticarcinogen was lower.

Objective To investigate the role of human estrogen receptor-related receptor(ERR) ?,a submember of orphan receptors,in the tumorigenesis of endometrial cancer.Methods Plasmid of pSG-ERR? was transfected into endometrial cancer cell lines HEC-1A,HEC-1B,and Ishikawa.Real-time quantitative RT-PCR and western blot were used to analyze the mRNA and protein expression of ERR? in endometrial cancer cell.Flow cytometry was used to analyze the cellular growth.Results Expressions of the ERR? were significantly increased in the endometrial cancer cells transfected with pSG-ERR? plasmid; expression of the ERR? mRNA in HEC-1A cell was 9644.4 copies/ng,HEC-1B:9835.3 copies/ng,and Ishikawa:8008.6 copies/ng(P

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.

Objective To find out a treatment with high remission rate,long living period,and a good quality of life for elderly patients with multiple myeloma.Methods All patients were recruited into a treatment group(treated with traditional Chinese medicine,routine chemotherapy,and thalidomide)and a comparison group(treated with traditional Chinese medicine and routine chemotherapy).Results The total effective rate of the treatment group was 71.4%,higher than the comparison group(38.5%),but showing 110 statistical difference(P=0.128＞0.05).Median survive time of two groups were 21.8 months and 12 months respectively,(P=0.001＜0.01).The survival rate of 3 years and 5 years were 28.6%,15.4%and 7.1%,0 in the two groups respectively,without significant difference(0.317,1.000,both P＞0.05).Conclusion The treatment group showed higher results in both complete remission rate(CR)and very good partial remission rate(VGPR)than the comparison group,demonstrating a better results in improving the patient's quality of life.The treatment group also had a higher value of the median survive time and the median progression-free surial time than the comparison group.The combined therapy of traditional Chinese medicine,routine chemotherapy and thalidomide is an ideal choice for both aged Patients or young MM patients who had no transplant conditions.

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy (PD).Methods The clinical data of 186 patients who received PD at the Second Affiliated Hospital of Kunming Medical College from May 2000 to May 2010 were retrospectively analyzed.All patients were divided into pancreatic fistula group (39 patients) and non-pancreatic fistula group ( 147 patients).Risk factors of pancreatic fistula after PD were screened out from 20 factors by univariate and multivariate analysis.The univariate analysis was carried out by chi-square test or Fisher exact test,and the muhivariate analysis was done by Logistic regression.Results Thirty-nine patients were complicated with pancreatic fistula,including 26 in grade A,10 in grade B and 3 in grade C.The results of univariate analysis showed that duration of preoperative jaundicc,loss of body weight at 6 months before operation,preoperative total bilirubin level,preoperative albumin level,postoperative albumin level,length of pancreas dissected,pancreatic tube diameter,pancreatic texture and time of abdominal drainage tube pull out were high risk factors of pancreatic fistula ( x2 =34.990,20.480,8.212,10.890,13.561,11.505,13.820,4.539,36.590,P ＜ 0.05).The results of multivariate analysis showed that duration of preoperative jaundice ＞ 8 weeks,loss of body weight at 6 months before operation ≥ 10％,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture and time of abdominal drainage tube pull out ＞ 5 days were the independent risk factors of pancreatic fistula ( OR =2.229,3.383,1.437,1.273,11.939,P ＜ 0.05).Conclusion Duration of preoperative jaundice ＞ 8 weeks,unconscious loss of body weight ≥ 10％ within 6 months before operation,pancreatic tube diameter ＜ 3 mm,soft pancreatic texture,time of abdominal drainage tube pull out ＞ 5 days would increase the risk of pancreatic fistula after PD.

Objective To assess the relationship of serum prealbumin level with the severity of acute ischemic stroke (AIS).Methods The clinical data of 2522 AIS patients who were admitted in Peking Union Medical College Hospital from 2000 to 2008 were retrospectively analyzed.The serum prealbumin and hypersensitive C-reactive protein (hs-CRP) levels were evaluated by immunoturbidimetric assay within 24 hours after admission.The AIS severity was evaluated at admission using modified Rankin Scale (mRS).Patients were divided into mild AIS group (mRS score ≤ 3 ) and severe AIS group (mRS score ＞ 3 ).The levels of serum prealbumin and hs-CRP were compared between these two groups,and the relationship between praalbumin and hs-CRP was also analyzed.Results There were 1697 patients in the mild group (average mRS score:1.67) and 825 patients in the severe group ( average mRS score:4.53 ).The severe group had significantly lower prealbumin level [ ( 191.20,82.00)versus (219.18,72.00) mg/L,P =0.000] and higher hs-CRP level [ (6.01,8.22) versus (4.15,6.93) mg/L,P =0.000 ] than the mild group,respectively.Partial regression analysis showed that the stroke severity was negatively correlated with serum prealbumin level (r =-0.115,P =0.000) and positively correlated with hs-CRP level (r =0.098,P =0.000).Serum prealbumin level was inversely correlated with hs-CRP level ( r =- 0.396,P =0.000).Conclusion The prealbumin level is relevant with the severity of AIS and inflammation.

Objective To investigate the role of PI3K/Akt signaling in the regulation of epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells (PMCs) in peritoneal dialysis in vitro and in vivo.Methods The level of Phosphorylated serine/threonine kinase Akt and the expression of EMT associated gene and protein,including ZO-1,Vimentin and FN,were measured in mice EMT model.In vitro study,phosphorylation level and nuclear translocation of Akt,ZO-1 and Vimentin expression induced by TGF-β1 in human peritoneal mesothelial cells (HPMCs) were also observed.Moreover,HPMCs were pre-treated by one of PI3K/Akt inhibitor,LY294002,or transfected with dominant-negative Akt plasmid to inhibit PI3K/Akt signaling,then analyzed its effect on Zo-1 and Vimentin expression induced by TGF-β1.Results Compared with the control,thickened parietal peritoneum and remarkable decrease in mRNA and protein of the epithelial marker ZO-1,and notable increased in the expression of mesenchymal markers Vimentin and FN were observed in PD mice (all P ＜ 0.01).Moreover,the phosphorylation of Akt also significantly increased under above condition (P ＜ 0.01).In vitro study,with the stimulation of TGF-β1,the expression of Zo-l was down-regulated,while the expression of Vimentin increased (all P ＜ 0.01).In addition,TGF-β1 remarkably increased pAkt in HPMCs (all P ＜ 0.01) in dose-dependent.However,LY294002 and DN-Akt dramatically inhibited the vimentin expression in HPMCs induced by TGF-β1 after inhibition of pAkt.On the other hand,the expression of ZO-1 also was restored (P ＜ 0.01).Conclusion PI3K/Akt signaling is involved in EMT of peritoneal mesothelial cells in peritoneal dialysis,and may be a new target for the prevention and treatment of peritoneal fibrosis during PD.

Objective To study the indications for extubation of percutaneous transhepatic gallbladder drainage(PTGD).Methods Between January 2009 and December 2013,PTGD were performed on 104 patients with acute cholecystitis.The clinical data were analyzed retrospectively.Results PTGD were performed on all 104 patients successfully.In all the patients,after drainage the abdominal pain was relieved within 0.5 to 8 hours and mean time was(2.3 ± 1.9) h.The temperature decreased to normal in 1 days after drainage.The time of drainage was from 7 to 49 days,(22.4 ± 10.3) days on average.Thirteen patients'tubes were accidentally off during 3 to 12 days,5 patients were performed PTGD again,and 8 patients were given anti-infection,fluid infusion and other symptomatic treatments and all these patients were back to normal in time.Re-intubation rate was 4.8％.In 78 patients laparoscopic cholecystectomy (LC) were performed 1 to 2 months after PTGD.Operation time was between 35 to 95 min and mean time was(52.7 ± 15.0) min.There were 6 patients done open operation and the conservation rate was 7.7％.A mount of blood during LC was 30 to 150 mL,(61.7 ± 31.0) mL on average.No operative deaths occurred during therapeutic session.Conclusions Patients who formed PTGD obey the indications can extubate in time and reduce retrograde infection and skin irritation,also shorten the time during hospital's,which will have a positive impact about LC.

Objective To examine the recurrent ischemic stroke(RIS)in hospitalized patients predicted by Essen Stroke Risk Score(ESRS)and investigate the effect of intensive antiplatelet therapy in patients with high risk of RIS. Methods Retrospective analysis of patients with acute noncardioembolic ischemic stroke consecutively admitted to Peking Union Medical College Hospital(PUMCH)during 2001-2008. All 1008 patients were included in this study, 377 hospitalized in 2001-2002, 315 in 2005 and 316 in 2008. High risk of RIS was defined as ESRS ≥3. The average ESRS score in three groups and percentage of patients with high risk of RIS in each group were calculated. Risk of RIS was evaluated by comparing the average ESRS score in these three groups. Patients with high risk and taking clopidogrel treatment were also evaluated. Results Average ESRS score was 2. 67 ± 1.47,3.55 ± 1.40 and 3.93 ± 1.48(F= 150. 85,P=0.000)in groups of patients hospitalized in 2001-2002, 2005 and 2008 respectively. A significant difference was shown in percentage of high risk patients with ESRS ≥3 in three groups: as 51.64% in 2001-2002,77. 19% in 2005 and 85. 45% in 2008(X2=98.30,P=0. 000),showing a trend of increasing risk of RIS. Except for patients age, rates of having the risk factors in patients increased significantly, including hypertension, diabetes, myocardial infarction, myocardial diseases, smoking,vascular disease and stroke history. Clopidogrel usage has been increasing to 25.63% in 2008, but was far behind high ratio of high risk RIS patients(85.45%). Conclusions This retrospective study showd an increasing trend in RIS risk during 2001-2008. Identifying high risk patients and applying intensified antiplatelet therapy might play an important role in reducing the risk of RIS.