Objective To analyze the inducement,clinical manifestations,diagnosis and treatment of diabetes patients with multiple organ failure(MOF).Methods A retrospective analysis of 64 diabetes patients with multiple organ failure was executed,the clinical data were statistically analyzed.Results Heart failure was the most common in 64 cases with a incidence of 100.0％,the rest common failure organ were kidney(92.2％ ),brain( 32.8％ ),lung ( 14.1％ ),gastrointestinal tract (3.1％ ),and liver( 1.6％ ).Cases with the glucose level over 33.5mmol/L illustrated a significantly higher incidence than other groups ( P ＜ 0.05 ),glucose level between 22.5 and 33.4mmol/L group was significantly higher than the 12.2 ～ 22.4mmol/L group( P ＜ 0.05 ) The inducement of MOF were infection (76.6％ ) medication terminate ( 9.4％ ),ketoacidosis ( 7.8％ ),cardiovascular and cerebrovascular accidents (6.3％ ).Conclusion Positive control of blood glucose in the early stage of diabetes,prevent complications,eliminate the incentive could reduce the incidence of MOF,eventually reduce the mortality rate.

Objective: To study the inhibitory effects of andrographolide (Andro) on the proliferation, migration and clone formation ability of renal cell carcinoma (RCC) cells and the induction on the apoptosis, and to clarify their related mechanisms. Methods: The RCC cells were treated with different concentrations (5, 10, 20, 40 and 80 μmol · L-1) of Andro as experimental groups, and 0 μmol · L-1 Andro group was used as blank control group, MTS assay was used to detect the proliferation rates of RCC cells in various groups. The RCC cells were treated with different concentrations (0. 50, 1. 25 and 2. 50 μmol · L -1) of Andro as experimental groups, and 0 jumol · L-1 Andro group was used as blank control group. Clonogenic assays was used to detect the colony formation ability of RCC cells in various groups. The RCC cells were treated with different concentrations (10, 20 and 40 μmol · L-1) of Andro as experimental groups, and 0 μmol · L-1 Andro group was used as blank control group. Wound healing assay was used to detect the migration ability of RCC cells in various groups. Flow cytometry was used to detect the apoptotic rates of RCC cells in various groups. Western blotting was performed to detect the expression levels of apoptosis related proteins in RCC cells in various groups. Results: Compared with blank control group, the proliferation rates of RCC cells in 10, 20, 40 and 80 μmol · L-1 Andro groups were markedly decreased (P<0.05 or P<0.01). Compared with blank control group, the colony formation rates of RCC cells in 0. 50 and 1. 25 jumol · L-1 Andro groups were markedly decreased (P<0. 05 or P<0. 01). Compared with blank control group, the scratch healing rates of RCC cells in 10, 20 and 40 μmol · L-1 Andro groups were markedly decreased (P<0. 01), and the apoptotic rates of RCC cells in 20 and 40 μmol · L-1 Andro groups were markedly increased (P<0. 01). Compared with blank control group, the expression level of γ-H2AX protein in 40 jumol · L-1 Andro group was markedly increased (P<0. 01), the expression level of Caspase-8 protein was decreased (P<0. 05), and the expression level of cleaved Caspase-8 protein was markedly increased (P<0. 01). Conclusion: Andro can effectively suppress the proliferation, migration and colony formation ability of RCC cells and induce the apoptosis of RCC cells. The mechanism of apoptosis might be related to inducing the DNA damage and the apoptotic pathways induced by JNK/H2AX and Caspase-8.

Objective To investigate the effects of brain ischemic preconditioning (BIP) on peripheral blood EPCs and neovascularization in ischemic brain tissue in rats with cerebral ischemia reperfusion injury (IRI). Methods One hundred and eight male SD rats were randomly divided into three groups:SO group (n=36), MCAO group (n=36) and BIP group (n=36). Neurological function assessment was conducted at 0 h before MCAO-reperfusion, 3 h, 24 h and 3 d, 5 d as well as 7 d after MCAO-reperfusion (n=6 for each group in each time point). Flow cytometry was used to calculate the number of EPCs. Immunohistochemical staining was used to detect the capillary density. Results ①Although neurologi?cal deficit scores were significantly decreased in both BIP and MCAO groups after 3 h following MCAO-reperfusion, the scores were much lower in BIP group than in MCAO group(5 d:1.00±0.63;7 d:1.00±0.63, P<0.05).②The numbers of EPCs were decreased in MCAO group while was increased in BIP group at 3 h after MCAO-reperfusion. The numbers of EPCs were significantly higher in BIP group than in MCAO group(24 h:0.58±0.07;3 d:0.80±0.10;5 d:0.68±0.05;7 d:0.52 ± 0.03, P<0.01). ③ The new blood vessels could be detected at 3 d in BIP group and 5 d in MCAO group after MCAO-reperfusion. The numbers of new blood vessels were significantly higher in BIP group than MCAO group(5 d:14.53 ± 3.44; 7 d: 41.40 ± 5.62, P<0.01). ④ Pearson analysis showed a positive correlation between EPCs and capillary density (5 d: r=0.855, P<0.01; 7 d: r=0.946, P<0.01). Conclusion BIP can improve EPCs mobilization and function, which may contribute to neovascularization in the ischemic brain tissue.

Objective To study the protective mechanism of astragaloside on skin photoaging. Methods BALB/c mice were randomly divided into four groups: model group irradiated with ultraviolet rays (UV), model plus matrix group pretreated with the matrix before UV irradiation, model plus astragaloside group pretreated with astragaloside 0.08% cream before UV irradiation, normal control group received no irradiation or pretreatment. After 4-week irradiation, the mice were sacrificed, and skin tissues were resected from the back of these mice. Then, reverse transeription PCR (RT-PCR) and immunohistochemistry were performed to detect the mRNA and protein expression of TGF-βR Ⅱ and Smad 7, respectively. Gray scale ratio was used to represent the mRNA levels of TGF-βR Ⅱ and Smad 7. Results There was a significant difference in the mRNA level (F = 80.98, 736.80, respectively, both P < 0.01) and protein positivity rate (F = 45.36,132.25, respectively,both P < 0.01) of TGF-βR Ⅱ and Smad 7 among the 4 groups. The mRNA level and protein positivity rate of TGF-βR Ⅱwere 0.2588±0.0283 and (28.20 ± 5.24)% respectively in the model group, significantly lower than those in the normal control group[0.5688 ± 0.0439, (53.00 ± 4.72)%, both P < 0.01] and model plus astragaloside group [0.3767 ± 0.0374, (41.64 ± 2.59)%, both P< 0.01]; on the contrary, the mRNA level and protein positivity rate of Smad 7 in the model group [0.8637 ± 0.0514, (82.06 ± 2.18)%] were significantly higher than those in the normal control group [0.5900 ± 0.0585, (47.50±3.81)%, both P < 0.01] and model plus astragaloside group [0.7131 ± 0.0410, (64.36 ± 2.62)%, both P< 0.01]. In the model plus astragaloside group, the mRNA level and protein positivity rate of TGF-βR Ⅱ were significantly higher than in the model plus matrix group [0.2653 ± 0.0456, (28.74 ± 2.28)%, both P < 0.01], while those of Smad 7 were statistically lower than in the model plus matrix group [0.8553 ± 0.0575, (82.62 ± 4.02)%, both P < 0.01]. However,no significant difference was observed in the mRNA level or protein positivity rate of TGF-βR Ⅱ or Smad 7 between the model group and model plus matrix group (all P > 0.01). Conclusion Astragaloside can prevent skin photoaging by the alteration of TGF-β pathway via up-regulating TGF-βR Ⅱ expression and down-regulating Smad 7 expression.

Purpose: This study investigates the alterations in A549 human non-small-cell lung cancer (NSCLC) cells exposed to Citrus junos extract (CJE). We further examine the antiproliferative and apoptotic effects of CJE on NSCLC cells. Methods: Inhibition of proliferation was examined by applying the 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) colorimetric assay on CJE-treated A549 NSCLC cells. The lactate dehydrogenase (LDH) assay was performed to measure the degree of toxicity of CJE on NSCLC cells. The effect on migratory proliferation was confirmed using the scratch wound healing assay. The antiproliferative effect of the CJE on human lung cancer cells was verified through morphological observation, fluorescence microscopy, and caspase-3 colorimetry. Results: Exposure of NSCLC cells to CJE resulted in a dose- and time-dependent decrease in cell activity and increased toxicity to the cells. In addition, microscopic observation revealed a reduced ability of the cancer cells to migrate and proliferate after exposure to the CJE, with simultaneous morphological apoptotic changes. Fluorescence staining and microscopic examination revealed that this death was a process of self-programmed cell death of NSCLC cells. Compared to unexposed NSCLC cells, the expression of caspase-3 was significantly increased in cells exposed to CJE. Conclusion Exposure of A549 human NSCLC cells to CJE inhibits the proliferation, increases the cytotoxicity, and decreases the ability of cells to migrate and grow. Moreover, the expression of caspase-3 increases after CJE treatment, suggesting that the apoptosis of NSCLC cells is induced by a chain reaction initiated by caspase-3. These results indicate that Citrus junos is a potential therapeutic agent for human non-small-cell lung cancer.

Primary lesion removal and lymph node dissection are the main constituents of radical gastrectomy. However, the high recurrence rate after D2 radical gastrectomy for advanced gastric cancer has not improved. Recently, studies have found that discrete tumor deposits in the mesogastrium may be an important factor affecting the prognosis of gastric cancer after surgery. With the development of laparoscopic equipment, the ever-expanding "submicroscopic vision" makes it possible to completely remove the mesogastrium. Professor Gong Jianping advocated "membrane anatomy" to optimize the concept of radical gastrectomy: D2- based complete mesenteric resection (CME), namely D2+CME procedure. To prevent the leakage of tumor cells into the surgical field, as histological barrier, the intact mesogastrium should be located. The essential difference between D2+CME and previous D2/D2+systematic mesogastrium excision (SME), en-bloc mesogastric excision (EME) is as follow: double-factor guiding (lymph nodes and discrete tumor deposits) vs. single factor guiding (lymph nodes only). After practicing dozens of radical gastrectomy (D2+CME) authors believe that its conceptual connotation (double factor guiding) and operational extension (above mesentery bed) cover D2. In D2+CME surgery, depending on the anatomical identification under the magnified field of view, the conformal space between gastric mesentery and mesenteric beds is unique operational plane with repeatability. These findings and considerations address one problem: where is the precise boundary of en bloc principle in radical gastrectomy? In author′s opinion, with laparoscopy and "sub-microsurgery" progression and detection of discrete tumor deposit metastasis, survival benefit from definition of en bloc boundary in radical gastrectomy will be widely recognized. Meanwhile, D2+CME procedure is an appropriate way for study. Although the development of the "membrane anatomy" concept for gastric cancer still requires many further clinical and basic researches, it is reasonable to foresee that D2+CME surgery will guide a concept-optimized era for gastric cancer surgery.

A sensitive, fast and comprehensive method for the quality assessment of Semen Ziziphi Spinosae (SZS) standard decoction with characterization of its chemical components was developed and validated. UPLC-Q/TOF-MS/MS system was used to identify thirty-six chemical components of SZS standard de-coction which included nucleosides, phenolic acids, alkaloids, and flavonoids. Furthermore, a UPLC-PDA method was validated to simultaneously determine adenosine, protocatechuic acid, magnoflorine, ca-techin, protocatechin, vicenin II, spinosin, kaempferol-3-rutinoside, and 6'''-feruloylspinosin which re-present four species of characteristic compounds. The qualitative method had been validated according to Chinese Pharmacopoeia (2015 edition) in terms of lineary, repeatability, recovery and stability for all analytes, with the results showing good precision, accuracy and stability. In conclusion, the method using UPLC combined with MS and PDA provided a novel way for the standardization and identification of SZS standard decoction, and also offered a basis for qualitative analysis and quality assessment of the pre-parations for SZS standard decoction.

Purpose: This study was conducted to investigate the eating behavior (EB) and nutritional status of university students in Gwangju, and to compare their nutrition quotients (NQs) and problems according to their EB types. Methods: The subjects were 219 (127 female and 92 male) undergraduate students from Gwangju. The Student’s t-test was used to compare the EB levels according to gender, and Pearson’s χ2 test was used to compare the distribution of EB types by gender. A gender-adjusted analysis of covariance (ANCOVA) was conducted to examine the difference in NQs by EB types. Results: First, there were significant differences in the EB scores and the distribution of EB types according to gender. Female students showed higher levels of emotional (Emo) and external (Ext) EBs than the male students, and Emo, Ext, and combined (Com) EB types were more evident among female rather than male students. Second, there was a difference in NQs according to the EB types. The Emo EB type subjects had a lower NQ than those of the restrained (Res) EB type and showed significant differences in diversity and dietary behavior. Specifically, the Emo EB type subjects displayed significantly lower efforts to maintain a healthy diet and subjective health status than the Com EB type and their levels of checking nutrition labels, hand washing, and water intake were significantly lower than that of the Res EB type. The Ext EB type showed significantly lower moderation of Ramyeon and sweetened drink intake than the Res and Com EB types. Conclusion The level of EBs and the distribution of EB types varied according to gender, and the NQs were different according to EB types. The results of this study are expected to contribute to the establishment of customized strategies for improvement by identifying major nutritional problems by gender and the EB types of university students.

Cardiac Catheterization ; Heart Septal Defects, Ventricular ; therapy ; Humans ; Prosthesis Implantation ; instrumentation ; Septal Occluder Device

Objective:To investigate the association between metabolically healthy obesity(MHO) and atherosclerosis risk among Chinese community population aged 40 or older.Methods:A total of 9 525 participants without cardiovascular diseases (3 621 men and 5 904 women) from Jiading community in Shanghai were enrolled to complete questionnaires, undergo extensive physical examination including brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) assessment, and laboratory screening. According to body mass index (BMI) and metabolic status, these participants were categorized into 4 groups including metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), MHO, and metabolically unhealthy obese (MUO). High baPWV was defined as baPWV>1 400 mm/s, and high pulse pressure (PP) was defined as PP above fourth quartile of the population. Multivariate logistic regression model was conducted to explore the relationship between MHO and high baPWV as well as high PP after adjusting for confounders. Results:After multivariable adjustment, such as sex, age, current smoking, current drinking, and education, logistic regression analysis showed that MHO was significantly correlated with high baPWV ( OR=1.18, 95% CI 1.02-1.37) and high PP ( OR=1.72, 95% CI 1.43-2.08) in comparison with MHNO. Otherwise, both MUNO and MUO subjects were at higher risk for suffering from high baPWV (MUNO: OR=3.02, 95% CI 2.60-3.50; MUO: OR=3.26, 95% CI 2.87-3.70) and high PP (MUNO: OR=2.56, 95% CI 2.17-3.02; MUO: OR=3.49, 95% CI 3.01-4.06). Conclusion:On the basis of Chinese community population, there was a pronounced correlation between the MHO phenotype and the increased risk of developing atherosclerosis.