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.

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.

OBJECTIVEVasoconstriction and vascular hypersensitivity to serotonin were previously shown in animal models of adventitia injury. We investigated the contribution of angiotensin II (AngII)/AngII receptors and oxidative stress to vascular contractility and reactivity in this model.

METHODSWistar Kyoto rats were divided into 3 groups: normal (n = 6, no any intervention, only for measuring the serum AngII concentration), vehicle (n = 12, collared), and valsartan (n = 12, collared + valsartan 30 mg×kg(-1)×d(-1)). After one week of treatment, adventitia injury was induced by positioning a silicone collar around the right carotid artery for one week. Blood flow and vascular reactivity to serotonin were determined one week after injury, the blood from left ventricle was taken to measure the serum AngII concentration by ELISA, and carotids were harvested for morphometry and Western blot analysis.

RESULTSAdventitia injury induced lumen cross-sectional area reduction (-44% vs. -5%), media diameter increase (62% vs. 10%), blood flow reduction [(2.79 ± 0.22) vs. (4.33 ± 0.84) ml/min] were significantly attenuated by valsartan. The increased vascular reactivity sensitivity to serotonin in vehicle group was also significantly reduced in valsartan group. Serum AngII concentration was significantly increased in vehicle group [(45.21 ± 4.52) pg/ml vs. (19.83 ± 0.5) pg/ml in normal rats, P = 0.0148] and the expression of AngII type 1 (AT(1)) receptor, AngII type 2 (AT(2)) receptor, as well as p22(phox) in collared arteries were significantly upregulated. Valsartan did not affect the AT(1) receptor expression but further increased serum AngII concentration [(89.73 ± 20.44) pg/ml vs. (45.21 ± 4.52) pg/ml, P = 0.001], and AT(2) receptor expression, while downregulated p22(phox) expressions.

CONCLUSIONSCollar-induced adventitia injury resulted in chronic vasoconstriction and vascular hypersensitivity to serotonin via increased serum AngII level, upregulated AngII receptors expression in the vascular well, and activated local oxidative stress. These changes could be blocked by valsartan suggesting a crucial role of AngII/AngII receptors on vascular contractility and reactivity changes in this model.

Angiotensin II ; metabolism ; Animals ; Carotid Arteries ; drug effects ; metabolism ; pathology ; Connective Tissue ; pathology ; Male ; Oxidative Stress ; Rats ; Rats, Inbred WKY ; Receptors, Angiotensin ; metabolism ; Tetrazoles ; pharmacology ; Valine ; analogs & derivatives ; pharmacology ; Valsartan ; Vasoconstriction ; drug effects

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

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 study the clinical features, treatment and prognosis of malignant minor salivary gland tumors of the larynx.

METHODSTreatment and outcome were retrospectively analyzed in a consecutive series of 15 patients with malignant minor salivary gland tumors of the larynx treated in this hospital from 1959 to 2005. Ten patients (66.7%) had adenoid cystic carcinoma and 2 (13.3%) had adenocarcinoma. The other three patients had mucoepidermoid carcinomas, polymorphic adenocarcinoma and base cell carcinoma respectively. Eleven (73.3%) were located in the supraglottis and 4 (26.7%) in the subglottis. Fourteen had surgery (7 with adjuvant radiotherapy) and one was treated with radiotherapy plus chemotherapy. Five patients were found to have recurrent disease, 4 of whom underwent salvage surgery, 1 of whom had palliation radiotherapy.

RESULTSWith a median follow-up of 8 years (ranging from 2 to 16 years), 7 patients are alive. Five patients have no evidence of disease, 1 of whom had surgery alone, 4 of whom were treated with surgery plus radiotherapy. Four patients died of distant metastases in a range of 2 to 10 years. The other 4 patients were lost to follow-up after treatment (ranging from 2 years to 16 years). Seven patients developed recurrent disease, 1 of whom had local recurrence alone, 1 had regional recurrence alone, 2 had distant metastases alone, and 3 had local and distant metastases.

CONCLUSIONSMinor salivary gland carcinomas of the larynx are rare and they are prone to the local recurrence and the distant metastasis in advanced stage. Distant metastases remain the principal cause of treatment failure. Surgery is the primary treatment modality used in most cases and the radiotherapy combining surgery has better local and regional control rate.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Lost to Follow-Up ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Salivary Gland Neoplasms ; diagnosis ; therapy ; Salivary Glands, Minor ; pathology

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

Objective To investigate the role of c-Jun NH2-terminal kinase (c-JNK) signaling pathway on voltage-gated potassium channel (Kv) remodeling in left ventricular myocytes of diabetic rats,and explore the intrinsic regulatory mechanism.Methods Forty-five SD rats were randomly divided into DM group (n=25,modeling with streptozotocin induction) and control group (n=20,fed with normal diet).Transient outward potassium current (Ito) of rats' ventricular myocytes in DM group and control group was recorded by whole-cell patch-clamp method.The c-Jun activity was detected using a non-radioactive JNK kinase assay kit (Cell Signaling Technology).JNK inhibitor SP600125 was used to incubate the cardiomyocytes of diabetes rats in vitro,and then the changes of I,o in cardiomyocytes were observed.Thioredoxin reductase (TrxR) inhibitor--auranofin (AF) was used to treat the rats' cardiomyocytes incubated with SP600125,and then the changes of Ito in cardiomyocytes were observed.The content of Kv4.2 was tested using anti-Kv4.2 antibody,and the results were analyzed using a UVP bioimaging system.Results The JNK activity in DM group rose more than 1 times compared with control group,while the density of Ito decreased significantly (Control:30.2 ± 3.3pA/pF,n=16;DM:15.3 ± 2.1pA/pF,n=17;P＜0.05).The ventricular myocytes of DM rats were treated with SP600125 (10μmol/Lol/L) for 4 hours,then the Ito density increased to control group level (DM+SP600125:32.3 ± 3.7pA/pF,n=18;Control:30.2 ± 3.3pA/pF,n=16;P＜0.05).There was no significant difference in the maximum Ito density between the treated with SP600125 (Control+SP600125:31.6 ± 3.4pA/pF,n=18) and untreated control groups.The Ito density in DM myocardial cells significantly increased after treatment with the membrane permeable protein inhibitor JNKI-1 (10μmol/L),and no changes were found in control group after the same treatment.The augmentation effect of SP600125 on Ito current in DM myocytes was significantly inhibited by TrxR inhibitor auranofin (lμmol/L) (DM+SP600125+AF:15.7 ± 3.3pA/pF,n=15),while AF did not change the Ito density in control group.The expression of Kv4.2 protein was significantly increased in DM rats after administration of SP600125,which was consistent with the changes of Ito current observed in the myocardium of DM rats,although not fully restored to the level of control group myocardium.JNK inhibitor did not markedly alter the expression of Kv4.2 protein in control group myocardium.Conclusions Kv channel remodeling in DM rat's myocardium is redox-regulated,and the Ito remodeling might be assisted with the persistent activation of c-JNK signaling pathway.It has showed that c-JNK activity is significantly increased in DM rat heart and the current density of Kv channels is reduced.The inhibition of JNK signaling pathway can markedly improve Kv channel reconstruction and the process may be regulated by thioredoxin system.