OBJECTIVETo observe the inhibitory effect of Tongxinluo (TXL) on coronary vaso spasm in small swine in vivo, and to investigate its possible acting mechanism.

METHODSThe model of coronary atherosclerosis in 16 male small swines was established by left thoracotomy after anesthesia, isolated the sections of left anterio-descending branch and proximal end of rotator branch with similar outer diameter, and encapsulated them with paper-towel holding 2.5 microg interleukin-1beta. Two weeks later, the condition of coronary vasospasm induced by catheter intra-coronary injection of 5-hydroxytryptamine (5-HT, 10 microg/kg) was observed through coronary artery contrast examination. The 12 swines with successfully formed coronary vaso spasm were randomly divided into 2 groups, the TXL group and the control group. They were fed with special diet, but TXL 1 g/(kg d) was administered additionally to the TXL group for 4 weeks. The observation on coronary vasospasm was repeated 1 week after discontinuation of TXL treatment, then the animals were sacrificed, their vascular sections enclosed with IL-1beta was taken to conduct the pathologic examination and to detect the expressions of Rho kinase mRNA and its substrate myosin- binding subunit phosphorylation (MBS-P) by RT-PCR and Western blot method.

RESULTSCoronary artery contrast showed that local coronary stenosis occurred in the 12 model swines to different extents (20% - 30%, and vascular spasm on them could be induced by 5-HT. At the time of repeating examination, 11 vascular sections in the control group still maintain their positive spasm reaction to 5-HT, but only 2 in the TXL group did so, the reaction turned to negative in 1 and 10 in the two groups respectively. Pathological examination showed that different degrees of macrophage aggregation could be found in both groups. The degree of lumen stricture and endometrial hyperplasia in the TXL group was obviously attenuated than those in the control group. The expressions of Rho kinase mRNA and MBS-P in the control group were up-regulated obviously. As compared with those in the control group, they were inhibited significantly in the TXL group, as (71.5 +/- 2.4) vs (98.2 +/- 7.7)% and 16,633 +/- 1,390 vs 25,818 +/- 4,745, respectively (all P < 0.05).

CONCLUSIONTXL could obviously inhibit the coronary intimal hyperplasia mediated by IL-1beta and coronary vasospasm induced by 5-HT, one of its mechanisms is possibly the inhibition on the intracellular Rho kinase mRNA expression in the IL-1beta enclosed vascular section to decrease the level of MBS-P.

Animals ; Coronary Vasospasm ; chemically induced ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Gene Expression ; drug effects ; Humans ; Interleukin-1beta ; genetics ; metabolism ; Male ; Random Allocation ; Serotonin ; adverse effects ; Swine ; rho-Associated Kinases ; genetics ; metabolism

[Objective]To review and summarize the academic experience of Professor LAO Changhui in the treatment of postinfective cough.[Methods]By clinical shadowing,recording medical cases and reviewing literature,the clinical experience of Professor LAO in the treatment of postinfective cough was summarized from three aspects:etiology and pathogenesis,clinical treatment,feeding and nursing.Two medical records were attached to support it.[Results]Professor LAO believes that the postinfective cough belongs to the category of cough in traditional Chinese medicine and the key of differentiation lies in external and internal injury.The treatment should be carried out according to the physiological characteristics of lung"preferring moist,hating dryness and not resistant to cold",and prescription should be based on pathological products and functions of Zang-Fu organs.Xuanfei Huatan Decoction and Shegan Mahuang Decoction were the main prescriptions for patients whose postinfective cough was caused by external factors;while Liujunzi Decoction was the main prescription for patients whose postinfective cough caused by internal injury.This article also discussed dietary therapy for cough after infection.In the first case cited,Professor LAO identified it as phlegmatic hygrosis syndrome,and used Shegan Mahuang Decoction.By warming the lung and evaporating fluid,the lung can restore the function of dispersiveness.In the second case,Professor LAO identified it as liver depression and Qi stagnation,and used Banxia Xiexin Decoction.By soothing the liver and regulating Qi,balancing cold and heat,making the Qi movement normal,all symptoms were relieved.[Conclusion]Professor LAO focuses on the differentiation of external and internal injuries in the treatment of postinfective cough,emphasizes the combination of disease and syndrome differentiation,adds or subtracts drugs according to the pathological products of patients and the function of Zang-Fu organs,pays attention to diet care,and has achieved stable clinical efficacy,which is convenient for clinical application and promotion.

Asian Continental Ancestry Group ; Bartter Syndrome ; genetics ; Child ; Chloride Channels ; genetics ; Humans ; Male ; Mutation

OBJECTIVETo retrospectively investigate the difference in survival of pancreatic adenocarcinoma patients treated by radical surgery with or without adjuvant radiation therapy.

METHODSForty-four patients with pancreatic cancer underwent surgical resection with a curative intent, and were divided into two groups: surgery alone (n = 24) or surgery combined with postoperative external beam radiotherapy (EBRT) (n = 20). Survival as an endpoint was analyzed between the two groups.

RESULTSAll 44 patients completed their scheduled treatment. The median survival time of the patients treated with radical resection alone was 379 days versus 665 days for those treated with combined therapy. The 1-, 3-, 5-year survival rates of the patients treated with radical resection alone were 46.3%, 8.3%, 4.2% versus 65.2%, 20.2%, 14.1% for the patients treated with combined therapy, respectively, with a significant difference between the two groups (P = 0.017). The failures in local-regional relapse were significantly lower in the postoperative EBRT group than that in the surgery alone group (P < 0.05), while the additional postoperative radiation therapy did not increase the complication rate (P > 0.05).

CONCLUSIONPostoperative external beam radiation therapy can improve the survival in patients with pancreatic adenocarcinoma.

Adenocarcinoma ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; pathology ; radiotherapy ; surgery ; Postoperative Period ; Radiotherapy, Adjuvant ; Radiotherapy, High-Energy ; Retrospective Studies ; Survival Rate

With the mutual communication and penetration of traditional Chinese medicine and modem medicine,the combination of traditional Chinese and western medicine is common in clinical practice.However,since western-style doctor is usually lack of traditional Chinese medicine theory knowledge,many problems exist in the combination of Chinese and western medicine.The problem that Chinese medicine containing ephedra alkaloids in combination with western medicine in pediatric medicine is especially serious.Because of the complexity of the children's drugs,improper use of the ephedra alkaloids is prone to adverse reactions.A comprehensive analysis of drugs containing ephedra alkaloids existing in the pediatric clinical application is performed,and in order to provide guidance for clinical rational drug use.

OBJECTIVETo investigate the magnetic resonance imaging (MRI) manifestations of sellar region of children and adolescents with pituitary stalk interruption syndrome (PSIS).

METHODSThirty-one PSIS cases were selected from February 2001 to August 2010 in Peking Union Medical College Hospital. MRI images were collected to calculate the volume and coronary area of the pituitary based on its measured height, width, and anteroposterior diameter. The results of the measurement were retrospectively analyzed together with clinical data.

RESULTSThe patients in this study included 28 males and 3 females, aged 16.5∓3.8 years (range, 6~25 years). MRI images showed pituitary stalk rupture associated with ectopic posterior pituitary in 16 cases, significantly thinner or unclear pituitary stalk in 15 cases, in which 7 cases were found with vacuole turcica. All the 31 patients presented with reduced pituitary volume and dysfunction of anterior pituitary.

CONCLUSIONPSIS may show pituitary stalk interruption with ectopic posterior, thinning or unclear of pituitary stalk, and with a variety of anterior pituitary hormone deficiency.

Adolescent ; Adult ; Child ; Female ; Humans ; Hypopituitarism ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Male ; Pituitary Gland ; pathology ; Retrospective Studies ; Sella Turcica ; pathology ; Young Adult

OBJECTIVETo explore the efficacy and prognosis of first-line autologous hematopoietic stem cell transplantation (ASCT) for newly diagnosed patients with multiple myeloma(MM).

METHODSFrom January 2005 to December 31, 2012, 60 patients with MM were enrolled. All patients received thalidomide or/and bortezomib-based induction therapy, then received high-dose melphalan (200 mg/m²) and autologous stem cell support to get a ≥ partial response (PR), and followed by thalidomide-dexamethasone (TD) ±bortezomib as consolidation or maintenance treatment. With the follow up to December 31, 2012, the overall survival (OS), progression free survival (PFS) and the prognostic factors, including ISS stage, response and fluorescent in situ hybridization (FISH) data of cytogenetics were analyzed.

RESULTSWith a median follow up of 36.8 (12.0-102.5) months, the median OS and PFS estimate were not reached and 86.5 months, respectively. After transplantation, all (100%) patients received very good partial response (VGPR), and 34 (56.7%) patients achieved complete response (CR) after consolidation or maintenance treatment. The patients that achieved CR resulted in long term PFS (P=0.030), with no difference in OS (P=0.942). The univariate analysis showed that the abnormalities, including 13q14 deletion, 1q21 gain, IgH location and p53 deletion had the prognostic impacts. If the t(4;14) or p53 deletion was excluded, there would be no correlation between 13q14 deletion or 1q21 gain with PFS and OS. The patients with p53 deletion had a worst survival.

CONCLUSIONThere has been significant improvement in the outcome for young MM patients by using ASCT and novel drugs. Cytogenetic abnormalities and response to therapy are the main factors affecting the survival of patients.

Adult ; Aged ; Chromosome Aberrations ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics ; therapy ; Prognosis ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo investigate the expression of microRNA-155 and microRNA-146a in the CD19(+) B cells of chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), splenic marginal zone lymphoma (SMZL), and to analyze its clinical significance.

METHODSPeripheral blood (PB) (78 cases) and bone marrow (BM) samples (9 cases) from 53 CLL patients, 13 MCL patients, 19 SMZL patients, and 12 healthy donors were collected. Mononuclear cells were isolated and B cells were purified with a CD19(+) magnetic-bead system. Total RNA was extracted from purified CD19(+) cells and microRNAs expression were measured using the TaqMan microRNA quantitative PCR. The results combined with the clinic data of patients were analysed.

RESULTS(1) The expression of microRNA-155 in CLL (4.49 ± 0.83) was significantly higher than in MCL (3.83 ± 0.45) and SMZL (3.80 ± 0.61) (P < 0.05); (2) The level of microRNA-146a in SMZL (3.81 ± 0.59) was significantly higher than in CLL (2.58 ± 0.90) and MCL (2.27 ± 0.88) (P < 0.01); (3) The level of microRNA-155 was significantly higher in IgVH unmutated patients than in mutated patients in CLL (P = 0.012); (4) The microRNAs expression had no statistical difference between two prognostic groups in CLL.

CONCLUSION(1) The expression of microRNA-155 and microRNA-146a is different in malignant lymphoproliferative disorders (LPD); (2) Deregulation of the microRNAs expression might play a critical role in the pathogenesis and prognosis in the LPD.

B-Lymphocytes ; metabolism ; Case-Control Studies ; Chronic Disease ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; genetics ; pathology ; Lymphoproliferative Disorders ; genetics ; pathology ; MicroRNAs ; metabolism

OBJECTIVETo investigate the pathohistological characteristics of the prostate tissues in patients who receive a second TURP and to evaluate their clinical significance.

METHODSWe collected surgical specimens from 50 cases of TURP (the control group) and another 50 cases of re-TURP (the re-TURP group), detected the expressions of CD34, vascular endothelial growth factor (VEGF) and androgen receptor (AR) in the prostate tissues by immunohistochemistry (S-P), and determined microvessel density (MVD) and the expressions of VEGF and AR. We performed statistical analyses on the results obtained from the specimens of the control group as well as from those of the first and second operations of the re-TURP group.

RESULTSVEGF and AR expressed in all the specimens. The expressions of VEGF and AR and MVD were significantly higher in the re-TURP group than in the controls (P < 0.05), but showed no significant differences between the first and second operations in the re-TURP group (P > 0.05). Positive correlations were found between the expressions of AR and VEGF, VEGF and MVD, and AR and MVD (r = 0.650, 0.705 and 0.525, P < 0.05).

CONCLUSIONIncreased AR, VEGF and MVD in the prostatic tissues may be one of the important causes of recurrence of BPH after TURP, and could be considered as the risk factors for postoperative recurrence and targeted indicators for preventive measures.

Humans ; Male ; Prostatic Hyperplasia ; metabolism ; pathology ; surgery ; Receptors, Androgen ; metabolism ; Reoperation ; Transurethral Resection of Prostate ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVEPhosphorylation of myosin light chain (MLC) is one of the most important steps for vascular smooth muscle contraction and Rho-kinase is involved in this process. We investigated the role of Rho-kinase in a porcine coronary artery spasm model with interleukin-1beta.

METHODSSegments of left coronary artery adventitia were surrounded by normal saline (n = 8) or IL-1beta agarose microne (n = 8) for 2 weeks. Vasospastic responses to intracoronary serotonin or histamine then studied at the saline or IL-1beta-treated site. The Rho-kinase mRNA expression in the treated site was measured by reverse transcription-polymerase chain reaction analysis (RT-PCR). The extent of phosphorylation of myosin-binding subunit of myosin phosphates (MBS, one of the major substrates of Rho-kinase) were quantified by Western blot analysis.

RESULTSIntracoronary serotonin or histamine repeatedly induced coronary artery spasm and coronary arterial stenosis was evidenced at IL-1beta-treated site. Expression of Rho-kinase mRNA in IL-1beta-treated site was significantly increased compared to saline treated site (98.20% +/- 7.66% vs. 63.70% +/- 4.26%, P < 0.05). Western blot analysis showed that during the serotonin-induced contractions the extent of phosphorylation of MBS was also significantly increased in the spastic site (25,485 +/- 4745 vs. 6510 +/- 779, P < 0.05).

CONCLUSIONRho-kinase upregulation at the spastic site and increased phosphorylation of myosin-binding subunit of myosin phosphates are key players in inducing vascular smooth muscle hypercontraction in this porcine model.

Animals ; Coronary Vasospasm ; metabolism ; pathology ; Disease Models, Animal ; Interleukin-1beta ; adverse effects ; metabolism ; Male ; Myosin Light Chains ; metabolism ; Phosphorylation ; RNA, Messenger ; metabolism ; Swine ; rho-Associated Kinases ; metabolism