0.05),including seven with spinal kyphosis,seven with thoracic deformity,five with pleural effusion,five with emphysema diagnosed by chest X-ray film,three with spontaneous pneumothorax,two with diaphragmatic hernia,and one developed severe respiratory failure and the other developed cot pulmonale.Conclusions The thorax,lungs and diaphragm were more easily involved in the patients with Marfan syndrome,and pulmonary specialists should keep an eye on them.

Objective To investigate the changes in angiopoietin 2 and endoplasmic reticulum stress,and the prognosis of acute phase of coronary syndrome (ACS) in type 2 diabetic patients with glycemic fluctuations.Methods Seventy-eight cases of consecutive diabetic patients with ACS within 7 days were enrolled.Another 78 cases of non-diabetic patients with ACS were selected as control.Risk assessment with global acute coronary events (GRACE) score in patients with ACS,dynamic blood glucose monitoring system (CGMS) for three days,realtime PCR analysis of angiopoietin-2,within the reticulum stress-related heavy chain binding protein (Bip),inositol kinase demand Ⅰ (IREI),endoplasmic reticulum class should PKR kinase (PERK),oxygen-regulated protein 150 (ORP150),activating transcription factor 6 (ATF6),X-box binding protein 1 (XBP1)mRNA expression change,phosphorylation of eukaryotic translation initiation factor 2oα (p-eIF2α) by western blotting angiopoietin-2,parameters were compared between the two groups.Correlation analysis with GRACE score ; while angiopoietin-2 parameters and glycemic fluctuation,endoplasmic reticulum stress-related genes correlation analysis were made.Results (1) ACS group average daily blood glucose fluctuations(MAGE),mean absolute difference daytime blood glucose (MODD),and postprandial blood glucose fluctuation (MPPGE) and the maximum amplitude of glycemic excursions (LAGE) were significantly higher [MAGE(5.13 ± 1.19) vs (3.19 ± 0.55) mmol/L,MODD (2.59 ± 0.72) vs (1.72 ± 0.63) mmol/L; MPPGE (3.51 ± 1.01) vs (2.58 ± 0.55) mmol/L and LAGE (7.75 ± 2.39) vs (4.34 ± 0.85) mmol/L,all P＜0.05].(2)In ACS group angiopoietin-2,endoplasmic reticulum associated genes Bip,IREI,PERK,ORP150,ATF6,XBP1,and monocyte chemoattractant protein 1 (MCP-1) mRNA expression levels as compared with the control group were statistically significant(all P＜0.05) ; Angiopoietin-2,protein p-eIF2α were higher(P＜0.05).(3) In the ACS group with pearson correlation analysis,angiopoietin-2 and MAGE,LAGE,MPPGE correlation (r =0.432,0.279,0.386,all P＜0.05),Bip and MAGE,LAGE,MPPGE correlation(r =0.783,0.589,0.887,all P＜ 0.05) ; IREI and MAGE,LAGE,MPPGE,MODD correlation (r =0.567,0.783,0.569,0.823,all P＜0.05) ; PERK and MAGE,MPPGE,MODD correlation(r =0.687,0.902,0.709,all P＜0.05) ; ORP150 and MAGE,LAGE,MPPGE,MODD correlation(r=0.779,0.871,0.775,0.689,all P＜0.05) ; ATF6 and MAGE,LAGE,MPPGE,MODD correlation(r =0.873,0.675,0.893,0.884,all P＜0.05),while XBP1 with no correlation with glycemic fluctuations (P＞0.05).(4) The endoplasmic reticulum stress gene was related to MCP-1 and blood glucose fluctuation parameters.(5) Multiple Logistic regression analysis revealed that LAGE,MPPGE,Bip,IREI,PERK,ORP150,ATF6 were risk factors affecting angiopoietin-2,and angiopoietin-2,ages,MAGE,homeostasis model assessment for insulin resistance,Bip,ATF6 were risk factors affecting GRACE.(6) The ejection fractions of the ACS patients showed negative correlation with MAGE and LAGE,multiple linear regression analysis showed that age,HOMA-IR,Ang-2,and MAGE,Bip,ATF6 established the linear regression relation with ejection fraction.Conclusion Glycemic fluctuations cause angiopoietin-2 to rise and lead to increased endoplasmic reticulum stress and affect the prognosis of diabetic patients with ACS.

Background:The prevalence rate of diabetes mellitus ( DM ) associated with gastroesophageal reflux disease ( GERD)is increasing recently,and the relationship between DM and GERD has become a research hotspot. Aims:To study clinical features and influential factors of therapeutic efficacy of reflux esophagitis( RE)in elderly patients with type 2 DM(T2DM). Methods:Two hundred elderly patients with RE diagnosed by gastroscopy from March 2011 to October 2013 were enrolled,and divided into T2DM associated with RE( T2DM)group and RE group. The clinical features, endoscopic findings and therapeutic efficacy of the two groups were analyzed,and the influences of DM course and control of blood glucose on efficacy of RE were also analyzed. Results:The main manifestations of RE were extraesophageal symptoms,typical esophageal symptoms were less common. The overall efficacy rate decreased with the increase of endoscopic grade of RE,however,extraesophageal symptoms improved significantly. With the prolonging of DM course,the endoscopic grade of RE was increased,and the control of blood glucose was worse. The overall therapeutic efficacy was significantly reduced with the prolonging of DM course in patients with well controlled blood glucose. Conclusions:Extraesophageal symptoms are common,endoscopic grade of RE is worse and blood glucose is difficult to control in elderly T2DM patients associated with RE. DM course and status of blood glucose control have influences on the therapeutic efficacy of RE.

Objective Toinvestigatetheeffectsofpyrrolidinedithiocarbamate(PDTC)onexpressionofNF-κB,MMP-2andleft ventricular collagen remodeling following acute myocardial infarction in rats .Methods The myocardial infarction model in rat was induced by ligation of left anterior descending coronary artery .12 adult Sprague-Dawley rats survived 24 for h after acute myocardial infarction were randomly divided into the myocardial infarction (MI) group and the PDTC-treated(PD) group .Six rats were desig-nated as sham-operated group(SH group) .The PD group was intraperitoneally injected with PDTC (80 mg · kg -1 · d-1 ) for 28 d , the MI group and SH group were given normal saline as control .On 28 d ,the cardiac function of left ventricle was measured by ech-ocardiography .The infarct size was evaluated .The total collgen ,typeⅠcollgen ,typeⅢcollgen ,and Ⅰ /Ⅲ collgen ratio were quanti-fied histomorphometry .The mRNA and protein levels of NF-kappaBp65 and MMP-2 were determined by reverse transcription-poly-merase chain reaction(RT-PCR) and by Western blot ,respectively .Results Compared with the SH group ,the values of the total collgen ,typeⅠcollgen ,typeⅢcollgen ,and Ⅰ /Ⅲ collgen ratio in the MI group and the PD group were significantly increased ,the differen had statistical significance (P<0 .01) .The values of the total collgen ,typeⅠcollgen ,typeⅢcollgen ,and Ⅰ /Ⅲ collgen ratio in the PD group were notably decreased than those in the MI group(P<0 .01) .Moreover ,the mRNA and protein levels of NF-kap-paBp65 and MMP-2 in the PD group were lower than those in the MI group ,the difference had statistical significance(P<0 .01) . Conclusion Left ventricular collagen remodeling following acute myocardial infarction could be improved by PDTC to some extent , which mechanism could be related with inhibiting NF-kappaB activation and down -regulating the expression of MMP-2 in rats .

Objective To explore the effects and mechanism of bexarotene in combination with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on apoptosis of leukemic cell line KG1a. Methods KG1a cells at logarithmic growth phase were obtained, and were divided into TRAIL group, bexarotene group, 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group. Cell apoptosis rate was detected in each group by flow cytometry. Flow cytometry was also employed to determine the apoptosis rates of KG1a cells after treatment with bexarotene and TRAIL in different sequences. The expression of Fas associated death domain-like IL-1 beta converting enzyme inhibitory protein (c-FLIP) was detected by Western blotting. Results There was no significant difference in cell apoptosis rates between TRAIL group and bexarotene group of each concentration (except for bexarotene 2.0 μmol/L) (P > 0.05). The cell apoptosis rates of 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group were significantly higher than those in TRAIL group and bexarotene group of each corresponding concentration (P <0.01). Sequential analysis revealed that bexarotene could reverse the resistance of KG1a cells to TRAIL (P < 0.001). Compared with single use of 2.0 μmol/L bexarotene or 300 ng/mL TRAIL, combination use could significantly down-regulated the expression of c-FLIP (P < 0.05). Conclusion Bexarotene can significantly enhance the apoptosis of KG1a cells induced by TRAIL, which may be attributed to the down-regulation of c-FLIP expression.

BackgroundThe immunotherapy for retinoblastoma(RB) is gradually concerned recent year.To seek relative immune-associated antigen is a basis of immunotherapy.NY-ESO-1 and NY-SAR-35 are two kinds of genes of cancer testis antigen( CTA ).To understand their expressions in RB tissue can offer index for relative study.ObjectiveThis study was to investigate the expressions of two CTA NY-ESO-1 and NY-SAR-35 in RB and explore the possibility of them as potentially promising targets for antigen-specific immunotherapy of RB.Methods The samples were obtained from 15 RB eyes,12 non-tumor retinopathy eyes and 22 normal eyes with other benign eye diseases.Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expressions of NY-ESO-1 mRNA and NY-SAR-35 mRNA in the samples.Genes of positive PCR results were sequenced randomly.The relevance of the expression of the two cancer-testis antigen genes with the clinical characteristics such as tumor stage,tumor size and clinical stage were analyzed.This study was approved by Ethic Committee of Guangxi Medical University.Written informed consent was obtained from each patient before operation. Results NY-ESO-1 mRNA was positively expressed in 6 RB samples and NY-SAR-35 mRNA was expressed in 9 RB samples.In the non-tumor retinopathy samples and normal eye tissues,NY-ESO-1 mRNA and NY-SAR-35 mRNA were absent.No significant relevances were found between the expressions of the NY-ESO-1 mRNA and NY-SAR-35 mRNA with clinical characteristics such as age ( P =0.426,0.822 ),gender ( P =0.180,0.464 ),pathological classification ( P =0.744,0.582 ),tumor size ( P =0.760,0.790),and clinical stage ( P =0.868,0.707 ).Conclusions NY-ESO-1 and NY-SAR-35 have high expressing frequencies in RB tissue and their expressions in RB have specificity.These results offer a clue for the identification of targets antigen of RB.

BACKGROUNDThe prevalence of obstructive sleep apnea (OSA) increases after menopause in women, but remains under diagnosed because of social or lifestyle factors. It is important to evaluate the hazards of OSA on cardiovascular disease in menopausal women. We tested the hypothesis that chronic intermittent hypoxia (CIH) may aggravate cardiomyocyte apoptosis in ovariectomized (OVX) Sprague Dawley (SD) rats; the changes of anti-oxidation ability in cardiac muscles may be one of the reasons for cardiomyocyte apoptosis.

METHODSForty-eight 60-day old female SD rats were randomly divided into a CIH group, OVX group, OVX+CIH (OC) group, and handled control (HC) group, and the rats were exposed either to CIH (nadir O2 6%) or handled normoxic controls. The changes of body weight and whole heart weight were measured. Super oxide dismutase (SOD) and malonaldehyde (MDA) were used to evaluate the level of oxidative stress. TdT-mediated dUTP nick end labeling (TUNEL) was used to measure apoptosis in each rat. Western blotting was used to measure apoptosis associated proteins in cardiac muscle samples from each rat.

RESULTSWhen compared with the HC and CIH groups, the levels of oxidative stress in the OC and OVX groups were significantly higher. The levels of SOD in the HC, CIH, OC, and OVX groups were (47.99 ± 4.89), (53.60 ± 4.47), (20.99 ± 2.72), and (30.64 ± 3.79) mmol/mg protein; significantly increased in the CIH group (P < 0.05) and significantly decreased in the OC (P < 0.01) and OVX (P < 0.05) groups. The levels of MDA in the HC, CIH, OVX, and OC groups were (1.63 ± 0.20), (1.93 ± 0.77), (3.30 ± 0.39), and (1.95 ± 0.20) mmol/mg protein; it significantly increased in the CIH (P < 0.05), OC (P < 0.01), and OVX (P < 0.05) groups compared with the HC group. Bax protein expression was significantly increased and bcl-2 protein expression was significantly reduced after CIH compared with HC rats (P < 0.05). The protein expression of bax and bcl-2 in the OC group was not significantly different from the CIH group, but the ratio of bax/bcl-2 was significantly increased in the OC group (P < 0.05); this was associated with severe cardiomycyte apoptosis in the OC group. TUNEL confirmed this observation.

CONCLUSIONSThis study found that CIH may induce oxidative stress in OVX rats but not in CIH rats, and cause more severe cardiomyocyte apoptosis in OVX rats compared with CIH rats. This means that OVX rats exposed to CIH suffered more severe cardiac injury compared with CIH rats due to reduced antioxidation. These findings may partly explain the reason why OSA has a worse cardiovascular impact on menopausal women, and emphasize the importance of detection and early treatment of OSA in menopausal patients.

Animals ; Apoptosis ; Body Weight ; Disease Models, Animal ; Female ; Hypoxia ; pathology ; Myocytes, Cardiac ; pathology ; Organ Size ; Ovariectomy ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Sleep Apnea, Obstructive ; pathology

OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.

OBJECTIVETo observe the effects of puerarin (Pue) on the neurocyte apoptosis and the p-Akt (Ser473) expression in the ischemic penumbra of rats with cerebral ischemia/reperfusion (I/R).

METHODSThe 48 Sprague-Dawley rats were randomly divided into four groups, i.e., the sham-operation group, the I/R group, the Pue treatment group, and the Pue + LY294002 treatment group (Pue + LY), 12 in each group. The cerebral I/R rat model was established by Longa's suture method. Pue and Pue + specific P13K kinase inhibitor, i.e., LY294002 were administered. The score of the neurological deficit was estimated 1 h followed by 24 h reperfusion. The infarct volume was measured using TTC staining. The number of apoptotic neurons were detected using Tunel method. The expressions of p-Akt (Ser473) was detected using immunohistochemical assay, and the images were analyzed.

RESULTSThe score of the neurological deficit decreased more obviously, the number of apoptosis decreased more significantly, the expressions of p-Akt (Ser473) increased more significantly in the Pue group than in the I/R group (all P < 0.05). The score of the neurological deficit increased more obviously, the number of apoptosis increased more significantly, the expression of p-Akt (Ser473) decreased more significantly in the Pue + LY group than in the Pue group (all P < 0.05).

CONCLUSIONPue reduced the apoptosis of neurocytes and had protective effects against cerebral I/R injury possibly through activating the PI3K/Akt signaling pathway.

Animals ; Apoptosis ; drug effects ; Brain Ischemia ; metabolism ; pathology ; Cerebral Cortex ; drug effects ; metabolism ; Chromones ; pharmacology ; Isoflavones ; pharmacology ; Male ; Morpholines ; pharmacology ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; pathology

Aim To design and synthesize of a new rhein derivative 1 , 8-diacetyl rhein ( 2-bromo )-ethyl ester ( rhein derivatives B ) and explore its effect on os-teosarcoma MG-63 cells and the related mechanism . Methods 1 , 8-diacetyl rhein ( 2-bromo )-ethyl ester was synthesized from rhein and its structure was identi-fied by UV, IR and NMR spectra .The purity of the synthetic product was determined by HPLC .The in vitro anti-proliferative activity of rhein and the synthetic product on osteosarcoma MG-63 cells were determined by MTT assay .Apoptosis and cell cycle distribution were detected by flow cytometry .Results The molec-ular structure of 1 , 8-diacetyl rhein ( 2-bromo )-ethyl ester was confirmed by UV , IR, 1 H NMR and 13 C NMR, and the purity was higher than 98％.The IC50 values of rhein and rhein derivatives B on osteosarcoma MG-63 cells were 110.60μmol· L-1 and 25.78μmol · L-1 , respectively .The Results of flow cytometry showed that the apoptotic rates of rhein and rhein de-rivatives B at the concentration of 80 μmol· L-1 were (6.87 ±0.53)％and (48.84 ±2.20)％, respective-ly, and the cell cycle was mainly arrested in S phase on MG-63 cells.Conclusions The anti-tumor activity of 1,8-diacetyl rhein-(2-bromo)-ethyl ester is superior to that of rhein in vitro, and the mechanisms may be associated with blocking the process of cell cycle of os-teosarcoma MG-63 cells and initiating apoptosis .