Objective To investigate the specific humoral immunity and the therapeutic effect of nasal tolerance with a dual analogue (Lys262-Ala207) in the patients with myasthenia gravis (MG). Methods The levels of serum anti-AChR IgG and anti-AChR IgG isotype were determined with ABC-ELISA in 39 MG patients before and after treatment with Lys262-Ala207 and also in controls. cAMP was measured at the same time. The clinical severity and prognosis of MG were evaluated with Xu′s clinical scoring system. Results There was different in total IgG content among all groups. However the IgG 2 content was lower after the treatment and that of control (P

Betatrophin,discovered in 2013,is a protein secreted by liver,white adipose tissues,and brown adipose tissues.Betatrophin can improve glucose tolerance in mice by promoting islet β cell proliferation and increasing the number of β cells significantly and specifically.At the same time,Betatrophin is involved in lipid metabolism.Betatrophin may work as the new target for treatment of diabetes and disorders of lipid metabolism.

Vaspin,a serine protease inhibitor derived from visceral adipose tissue,has been identified as an adipokine with insulin-sensitizing effects in a rat model of type 2 diabetes.Recent studies showed that the administration of recombinant human vaspin significantly improved insulin sensitivity and glucose tolerance,and reversed the expression of genes that may promote insulin resistance in diet-induced obese mice.However,the regulation of serum vaspin concentration in individuals with insulin resistance,and the association of vaspin with obesity,type 2 diabetes,and insulin resistance related disorders remain unclear.

Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .

In order to investigate the effects of aconitine on [Ca2+] oscillation patterns in cultured myocytes of neonatal rats, fluorescent Ca2+ indicator Fluo-4 NW and laser scanning confocal microscope (LSCM) were used to detect the real-time changes of [Ca2+] oscillation patterns in the cultured myocytes before and after aconitine (1.0 micromol/L) incubation or antiarrhythmic peptide (AAP) and aconitine co-incubation. The results showed under control conditions, [Ca2+] oscillations were irregular but relatively stable, occasionally accompanied by small calcium sparks. After incubation of the cultures with aconitine, high frequency [Ca2+] oscillations emerged in both nuclear and cytoplasmic regions, whereas typical calcium sparks disappeared and the average [Ca2+] in the cytoplasm of the cardiomyocyte did not change significantly. In AAP-treated cultures, intracellular [Ca2+] oscillation also changed, with periodic frequency, increased amplitudes and prolonged duration of calcium sparks. These patterns were not altered significantly by subsequent aconitine incubation. The basal value of [Ca2+] in nuclear region was higher than that in the cytoplasmic region. In the presence or absence of drugs, the [Ca2+] oscillated synchronously in both the nuclear and cytoplasmic regions of the same cardiomyocyte. It was concluded that although oscillating strenuously at high frequency, the average [Ca2+] in the cytoplasm of cardiomyocyte did not change significantly after aconitine incubation, compared to the controls. The observations indicate that aconitine induces the changes in [Ca2+] oscillation frequency other than the Ca2+ overload.
Aconitine/*pharmacology ; Animals, Newborn ; Calcium Signaling/*drug effects ; Cells, Cultured ; Myocytes, Cardiac/cytology ; Myocytes, Cardiac/*metabolism ; Rats, Sprague-Dawley

Aconltium plants are a group of important poisonous plants in the Ranunculaeeae family of Angiosperm subphylum.and one of the earliest recorded poisonous plants in China as well.In their tubers(root)have hypertoxic Aconitium alkaloids,which belong to the group of diesterditerpene alkaloids.It is repeatedly reported in China that aconitine poisoning,and even death from aconitine poisoning,caused by the individual differences in pharmaceutical tolerance of aconitine,taking the wrong medicine or inadequate dosage,or put in the poison by homicide.At present,the research on aconitine is mainly limited to clinical treatment,but lack of research on toxicity mechanism of aeonitine.This paper reviews some progress relating to the toxicological mechanisms of this kind of alkaloid.

Objective To summary the experience in surgical treatment of differentiated thyroid carcinoma (DTC).Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analyzed.Results 110 patients received operation and TSH suppress therapy.Histologic examination after operation revealed that papillary thyroid carcinoma(PTC) 88 cases(80%) ,follicular thyroid carcinoma 22 cases(20%) ,cervical lymph node metastasis were found in 22 cases(20%).The operation procedure consists of excision of the suffered lobe,isthmus and greater partial of the opposite lobe 59 cases(along with functional cervical dissection 12 cases) ;excision cf the sufferedlobe,isthmus 29 cases(along with functional cervical dissection 7 cases) ;excision of the suffered lobe,isthmus greater partial of the opposite lobe 18 cases(along with functional cervical dissection 5 cases) ;total thyroidectomy and bilateral cervical dissection 2 cases;total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy,1 cases with metastasis to lung.98 cases 10-year survival rate was 91.8%.Conclusion Differentiated thyroid carcinoma has a good prognosis,a proper surgical procedure is the key point to get a good outcome.

Objective To investigate the differences of EUS images between stromal tumors and leiomyoma in esophagus and cardia. Methods EUS image of 13 cases of stromal tumors and 11 cases of leiomyoma diagnozed immunohistochemically were collected. Information of gray scale including mean value and dissociation of lesions and submucosal layer were analyzed. Gray scale values of lesions were calibrated according to that of the submucosal layer. Results The mean value of corrected gray scale of stromal tumors was 0. 285, which was significantly different from that of leiomyoma (0. 185, P ＜ 0. 05). Dissociation of gray scale of stromal tumors was 8. 14, which was also significantly different from that of leiomyomia (4. 59,P ＜0. 05). Conclusion In esophagus and cardia, stromal tumors exhibits higher and more inhomogeneous ultrasound echo than leiomyoma.

Objective To investigate the clinical effects of autologous tumor immune cells (DC-CIK)assisted interventional therapy in the treatment of advanced primary liver cancer.Methods Totally 76 patients with advanced primary liver cancer were divided into 2 groups with 38 cases in each group by random number table method.The control group were merely treated with interventional therapy while the ob-servation group were treated with autologous DC-CIK cell assisted interventional therapy.The short-term curative effect,adverse reactions,liver function indexes before and after treatment,alpha fetal protein (AFP)and changes of immune function were compared between the 2 groups. Results There was no statistically significant difference in short-term curative effect and incidence of adverse reactions between the 2 groups (P >0.05).After treatment,the levels of AST,ALT and AFP in the observation group [(30.4 ±6.0)u/L,(45.2 ±3.8)u/L,(168.5 ± 49.3)mg/L]were significantly lower than those in the control group [(65.1 ±6.3)u/L,(61.8 ±5.3)u/L,(315.2 ±39.5)mg/L],and the differences were statistically significant (P <0.05).After treatment,CD3 +,CD4 + and CD4 +/CD8 + in the observation group were significantly higher than those in the control group (P <0.05).Conclusion Autologous DC-CIK cell assisted interventional therapy can sig-nificantly improve the liver function of patients with advanced primary liver cancer,and it can reduce the level of tumor marker AFP and sig-nificantly improve the immune function of patients.

Objective To evaluate the value of volumetric modulated arc therapy ( VMAT) in postopera-tive radiotherapy for cervical cancer .Methods Eighty four cases of cervical cancer patients were retrospectively analyzed after surgery .Thirty-nine patients received volumetric modulated arc therapy , while the other forty -five patients received three -dimensional conformal radiation therapy (3DCRT).The images were collected both before and after treatment.We recorded the setup errors including x (lift-right),y(ventral-dorsal),and z(an-terior-posterior)axes in thirty -nine patients with cone beam CT (CBCT).These images were compared with correponding planning images to calculate the position errors .We also analyzed the radiation dosimetry parameters and adverse reactions .Results The setup errors before and after radiation therapy in x ,y,and z axes were (1.07 ±0.91)cm,(0.76 ±1.07)cm,(0.74 ±0.81)cm and(0.11 ±0.04)cm,(0.11 ±0.09)cm,(0.08 ±0.20) cm,respectively.These data showed that the application of CBCT reduced the setup errors of treatment significant -ly.We analyzed the illuminated volume of bladder and rectum with dose volume histogram (DVH),and found there was no difference between VMAT and 3DCRT groups when 20 Gy irradiation dose was adopted .When the ir-radiation dose increased to 30 Gy and 40 Gy, the corresponding illuminated volume of bladder and rectum in VMAT group were 69.45 ±1.13,41.78 ±2.8 and 75.66 ±3.34,30.12 ±9.59,respctively.In the 3DCRT group,the corresponding illuminated volume of bladder and rectum were 93.37 ±6.59,88.32 ±12.13 and 95.26 ±8.95,90.32 ±6.98,respectively.VMAT can obviously decrease the illuminated volume of bladder and rectum when compared to 3DCRT.Conclusion VMAT can not only decrease the setup errors to improve the accuracy of radiotherapy ,but also reduce the reaction of normal tissues effectively in the cervical cancer patients who accepted postoperative radiotherapy .Therefore,the VMAT technology can improve both patients′treatment compliance and their quality of life .