Objective To explore the effects oflosartan on brain natriuretic peptide(BNP)and C-reactive protein(CLRP)in diabetic cardiomyopathy patients. Methods Sixty diabetics were divided into diabetic control group(30 cases)and diabetic cardiomyopathy group(30 cases), and the levels of BNP and CRP in plasma were determined. Then, diabetic cardiomyopathy group were divided into conventional treatment group(15 cases)and losartan treatment group(15 cases)by random digits table to take corresponding treatment for 12 weeks. The changes of cardiac function, the levels of BNP and CRP in plasma were detected and compared. Results The levels of BNP and CRP in diabetic cardiomyopathy group [(331.27 ±65.64)ng/L,(26.10±10.13)mg/L]were significantly higher than those in diabetic control group[(76.09±39.14)ng/L,(7.03±2.71)mg/L](P＜0.01). After treatment 12 weeks, the levels of BNP and CRP were significantly lower, left ventricular ejection fraction was significantly higher and left ventricular end-diastolic diameter was significantly lower in losartan treatment group than those in conventional treatment group(P＜0.05).Conclusions The increasing levels of BNP and CRP can reflect clinical severity of diabetic cardiomyopathy.Losartan can decrease the levels of BNP and CRP, and improve heart function, and it has better effective on diabetic cardiomyopathy.

Objective:To study the expression of caspase-3 and free radical injury in hypoxic-ischemic brain damage ( HIBD) of neonatal rats.Methods:All seven-day-old Wistar rats were randomly divided into HIBD group and sham operation group.Brains was obtained at time of 6 h,12 h,24 h,48 h,72 h,96 h after HIBD.Neuronal cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling ( TUNEL).The expression level of caspase-3 protein was detected by immunohisto-chemistry.The level of malondialdehyde ( MDA) and supemxide dismutase ( SOD) were measured by thiobarbitic acid colorimetry and xanthin oxidase,respectively.Results:The number of neuronal cell apoptosis and the expression of caspase-3 protein began to increase at 6 h and reached the peak at 48 h in HIBD group,they were both significantly higher than those in the sham operation group at each time point (P<0.05).The level of MDA began to increase at 6 h and reached the peak at 24 h in HIBD group,it was significantly higher than the sham operation group at each time point (P<0.05).The level of SOD began to decrease at 6 h and reached the lowest level at 24 h in HIBD group,it was significantly lower than the sham operation group at each time point ( P<0.05 ) .The number of neuronal cell apoptosis and the expression of caspase-3 protein were positively correlated with the level of MDA, but they were negatively correlated with the level of SOD.Conclusion: Free radical injury promotes the expression of caspase-3 and neuronal cell apoptosis in HIBD.

Purpose:To evaluate the efficacy and toxicity of vindercine(VDS)in the interven- tional treatment of hepatic and pulmonary carcinomas.Materials and Methods:30 cases of mid-ad- vanced hepatic and pulmonary carcinomas,among them,13 eases of primary hepatic carcinomas,7 cases of matastic hepatic carinomas and 10 cases of primary pulmonary carcinomas,were treated by selective arterial infusion chemotherapy.The combination chemotherapeutic regimens conpored of VDS together with 5-Fu,MMC,carboplatin or Vp16.Results:The response rate for all cases was 60%,for primary hepatic carcinomas 61.5%,for metastic hepatic carcinoma 42.9% and for primary pulmonary carcinoma 70%.Myelosuppession was the main toxicity and 70% patients had the gastrointertional reac- tions as nusea,vomiting etc.Conclusion:VSD is a more effective drug for pulmonary carcinoma,but for hepatic carcinoma,the efficacy of VDS was unmarkable from other drugs.

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.

Objective To evaluate the cardiopulmonary allograft function and to analyze key factors for long-term survival of heart-lung transplantation in a patient survived more than 5 years. Methods On December 17th, 2003 at Zhongshan Hospital of Fudan University, a homologous heart-lung transplantation was performed on a female who diagnosed with cardiopulmonary failure secondary to congenital atrial septal defect with severe pulmonary hypertension. Heart-lung allograft was preserved with 1 000 mL UW solution and 4 000 mL HTK solution.Postoperative immunosuppressive therapies were managed with Zenapax, cyclosporine A (or tacrolimus), mycophenolate mofetil and corticosteroids. Cyclosporine A maintained with serum trough levels of 100-200 μg/L and tacrolimus with serum trough levels of 8-20 μg/L. Cardiopulmonary allograft functions were evaluated by echocardiogram, pulmonary function test and thoracic CT periodically. Results The patient survived operation and experienced normal daily life with NYHA cardiac function of class Ⅰ-Ⅱ during the follow-up of 5 years and 6 months. Echocardiogram showed left ventricular ejection fraction of 65% to 86%. Pulmonary function test exhibited with nearly normal oxygen exchange, meanwhile, small airway obstruction was detected from one year after operation and keeping stable from then on. Two episodes of severe pneumonia were complicated and treated with antibiotics and fhconazob, no severe acute allograft rejection episode was experienced. Conclusions Heart-lung transplantation proves to be a reliable therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation, accurate balance of the risk between acute allograft rejection and infection, and strict preventive measures against infection are key factors for long-term survival of heart-lung transplantation.

A method for determination of PCDD/Fs, PCBs and PCNs in soil sample was developed by using accelerated solvent extraction (ASE)-silica gel column cleanup-basic alumina column separation coupled with GC-MS/MS.The sample was extracted by ASE with Hexane-methylene chloride (Hex-DCM, 50∶50, V/V) at 120℃.The basic alumina column was used to separate PCDD/Fs, PCBs and PCNs.The extracts were eluted with Hex-DCM (95∶5, V/V) to obtain PCBs and PCNs, followed by Hex-DCM (50∶50, V/V) to obtain PCDD/Fs.The limits of detection (LOD) were in the range of 0.04-0.25 μg/L, 0.10-0.20 μg/L and 0.01-0.05 μg/L for PCDD/Fs, PCBs, PCNs, respectively.The relative standard deviations (RSDs) of average relative response factors (RRF) were below 13%.The recoveries of 13C-labeled internal standards of the three classes of analytes were 50%-95%, 51%-103% and 49%-74%, respectively.Concentrations of ∑PCDD/Fs, ∑PCBs and ∑PCNs in soil samples were 16.1-1148 pg/g, 6.6-152.6 pg/g and 10.9-99.5 pg/g, respectively.The results were consistent with that of high resolution mass spectrometer.

BACKGROUNDHepatoma-derived growth factor (HDGF), a novel growth factor, has a widely expression in many normal cells and tumor cells. It plays an important role in cell proliferation, differentiation and angiogenesis. It is considered as a promising marker for predicting the invasion, matastasis and prognosis of carcinomas in clinical researches. The aim of this study is to evaluate the expression of HDGF and its clinical implication in patients who undergone complete resection for stage I non-small cell lung cancer (NSCLC).

METHODSImmunohistochemical technology was applied to detect the expression of HDGF in 118 lung cancer tissues and 30 normal lung tissues as control.

RESULTSHDGF staining was observed in nuclear as well as in cytoplasm. HDGF positively staining was seen in all patients, and remarkably higher than that in normal lung tissues (52.23±10.35 vs 156.73±70.95, P < 0.01). Expresson of HDGF was closely related to histological classification, but not to other clinicopathological factors, and the expression of HDGF in adenocarcinoma was much stronger than that in squamous cancers (P=0.001). Univariate analysis and multivariate Cox regression analysis showed that the patients with high HDGF expression had a shorter overall survival and HDGF was a significantly independent predictive factor for patients with stage I NSCLC (RR=1.011, P=0.002).

CONCLUSIONSHDGF may be a promising predictive factor for stage I NSCLC, and the assessment of HDGF may provide new insight on carcinogenesis and development of stage I NSCLC .

BACKGROUNDThe latest studies have demonstrated that postoperative adjuvant chemotherapy may improve survival in patients with stage I non-small cell lung cancer (NSCLC), so it was a challenge for clinician to choose the patients who might benefit from adjuvant chemotherapy. The aim of this study is to evaluate the prognostic implications of angiogenesis and tumor blood vessel invasion (BVI) in stage I NSCLC patients who underwent complete resection.

METHODSOne hundred and eighteen stage I NSCLC patients undergoing complete resection from 1994-2002 were retrospectively reviewed. Angiogenesis was assessed by vascular endothelial growth factor (VEGF) and microvessel density (MVD), BVI was assessed by examining the direct invasion of tumor cells marked by CD34 within vessel lumen.

RESULTSLow VEGF expression was seen in 44 patients (37.3%), high VEGF expression was in 74 patients (62.7%). The MVD of high VEGF expression cases was much higher than that of low VEGF expression ones (33.4±17.8 vs 24.7±14.8, P=0.010). There was a positive correlation between VEGF and MVD (r=0.216, P=0.019). The 5-year survival rate in patients with high VEGF expression was much lower than in those with low VEGF expression (36.48% vs 72.20%, P=0.003). The BVI was present in 32 patients (27.1%) and absent in 86 patients (72.9%). The 5-year survival rate in patients with presence of BVI was much lower than those with absence of BVI (34.38% vs 60.47%, P=0.018). Multivariate COX regression analysis showed that high VEGF expression and BVI were significantly independent predictive factors for overall survival. Finally, the presence of both risk factors, BVI and high VEGF expression was highly predictive of poor outcome (P= 0.001 ).

CONCLUSIONSTumor vessel invasion and high VEGF expression are independent prognostic factors for overall survival of postoperative stage I NSCLC. The assessment of these factors may improve prognostic stratification for adjuvant therapy or a targeted and specific treatment in stage I NSCLC.

Objective To investigate ultrahistopathological features of symmetrical acrokeratoderma.Methods Biopsy specimens were obtained from skin lesions and perilesional normalappearing skin of 6 patients with symmetrical acrokeratoderma,as well as from normal skin of 3 healthy volunteers.Then,these skin specimens were subjected to transmission electron microscopy (TEM).Results TEM showed obviously thickened stratum corneum,irregular morphology of keratinocytes and discontinuous cornified envelope.Aggregation and abnormal arrangement of keratin filaments occurred in all epidermal layers.Many vacuoles of different sizes were observed in the transitional zone between the stratum corneum and stratum granulosum.Hypogranulosis,abnormal shape and different sizes of keratohyalin granules,and reduction of membrane-coating granules were found in the stratum granulosum.Increased melanocytes with a large number of stage Ⅳ melanosomes in the cytoplasm were observed in the basal layers.Moreover,there was infiltration of a few lymphocytes in the superficial dermis.Perilesional normal-appearing skin tissues showed similar but milder ultrastructural changes.Conclusion Abnormal metabolism of keratins,epidermal differentiation complex proteins and lipids may exist in skin lesions of symmetrical acrokeratoderma,which may contribute to epidermal thickening and impairment of skin barrier function.