BACKGROUNDCathepsin S and its endogenous inhibitor cystatin C are implicated in the pathogenesis of atherosclerosis, especially in the plaque destabilization and rupture leading to acute coronary syndrome. However, whether circulating cathepsin S and cystatin C also change in association with coronary plaque morphology is unknown yet.

METHODSWe recruited 98 patients with unstable angina (UA, n = 6) or stable angina (SA, n = 2) who had a segmental stenosis resulting in > 20% and < 70% diameter reduction in one major coronary artery on coronary angiography. Thirty-one healthy subjects served as controls. Intravascular ultrasound (IVUS) was used to evaluate plaque morphology. Plasma cathepsin S and cystatin C were measured as well.

RESULTSAt the culprit lesion site, plaque area ((7.85 +/- 2.83) mm(2) vs (6.53 +/- 2.92) mm(2), P = 0.027), plaque burden ((60.92 +/- 11.04)% vs (53.87 +/- 17.52)%, P = 0.025), remodeling index (0.93 +/- 0.16 vs 0.86 +/- 0.10, P = 0.004) and eccentricity index (0.74 +/- 0.17 vs 0.66 +/- 0.21, P = 0.038) were bigger in UA group than in SA group. Plasma cathepsin S and cystatin C were significantly higher in patients than in controls (P < 0.01). Plasma cathepsin S was higher in UA group ((0.411 +/- 0.121) nmol/L) than in SA group ((0.355 +/- 0.099) nmol/L, P = 0.007), so did the plasma cystatin C ((0.95 +/- 0.23) mg/L in UA group, (0.84 +/- 0.22) mg/L in SA group; P = 0.009). Plasma cathepsin S positively correlated with remodeling index (r = 0.402, P = 0.002) and eccentricity index (r = 0.441, P = 0.001), and plasma cystatin C positively correlated with plaque area (r = 0.467, P < 0.001) and plaque burden (r = 0.395, P = 0.003) in UA group but not in SA group.

CONCLUSIONSPlasma cathepsin S and cystatin C increased significantly in UA patients. In angina patients, higher plasma cathepsin S may suggest the presence of vulnerable plaque, and higher plasma cystatin C may be a clue for larger atherosclerotic coronary plaque.

Adult ; Aged ; Aged, 80 and over ; Cathepsins ; blood ; Coronary Artery Disease ; blood ; diagnostic imaging ; pathology ; Cystatin C ; blood ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; methods

The aim of this study was to explore the synergistic effect of arsenic trioxide and bortezomib on apoptosis of Raji cell line. The cells were treated with arsenic trioxide, bortezomib, low-dose arsenic trioxide combined with bortezomib, respectively. The cell viability and proliferative curve were estimated by trypan blue dye exclusion. The cell apoptosis and cell cycle status were analyzed by flow cytometry. The apoptosis related elements such as caspase-3, BCL-2, BAX, JNK2 and IkappaB-alpha, were measured with Western blot. The results showed that compared with cells treated with mentioned above drugs alone, the proliferative potential of cells in combination group was significantly inhibited (p < 0.01), and apoptosis rate markedly increased (p = 0.001), while obvious cell cycle arrest was not observed. On the protein level, the expression of Caspase-3, BAX and IkappaB-alpha increased, while the expression of BCL-2, and JNK2 decreased. It is concluded that low-dose arsenic trioxide combined with bortezomib synergistically induced apoptosis in Raji cell line which may be mediated by inhibiting NK-kappaB and JNK2 signaling.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; Boronic Acids ; pharmacology ; Bortezomib ; Burkitt Lymphoma ; pathology ; Cell Line, Tumor ; Drug Synergism ; Humans ; Oxides ; pharmacology ; Protease Inhibitors ; pharmacology ; Pyrazines ; pharmacology

OBJECTIVETo describe the changes of health related behavior and influencing factor during and after the prevalence of severe acute respiratory syndrome (SARS), as to providing evidence for inducing public health related behavior to cope with the emergent infectious public health hazards.

METHODSAccording to the epidemic strength of SARS, Guangzhou, Taiyuan, Hangzhou were selected to be the research areas, and convenience sampling was used to identify 200 city residents, 200 country residents and 400 occupational populations from each area. The uniform and self-made questionnaire was carried out by about 2400 residents.

RESULTSAll 2424 subjects completed the questionnaire. The correlation coefficient of scores of health related behavior during and after SARS was 0.782 (P < 0.01). And 39.3% subjects were considered as under the health risked stress by CPSS. Multiple linear regression indicated that the scores of health related behavior were significantly related to the perceived stress, demographic characteristics and recognition of SARS.

CONCLUSIONSThe public health related behavior should be developing in the SARS, and part of health related behavior had been kept after SARS and part been decreased. Behavior change should depends on the prevalence of the disease, cultural heritage and behavior variability. More attention should be paid to induce the public psychology and behavior and enhance the degree of recognition on related knowledge through health education as to relieving the stress in populations when we conduct to cope with the emergent public health hazards.

Adult ; Female ; Health Behavior ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Risk ; Rural Population ; Sampling Studies ; Severe Acute Respiratory Syndrome ; epidemiology ; Surveys and Questionnaires ; Urban Population

OBJECTIVETo evaluate the prognostic value of surgical operation-related factors in patients with hepatocellular carcinoma (HCC).

METHODSThe clinical data of 234 patients after hepatic resection (214 men and 20 women) were retrospectively studied. Univariate and multivariate COX regression analyses were performed for surgical operation-related prognostic factors including age, gender, intraoperative blood loss, iatrogenic tumour rupture, transfusion, operation duration, hepatectomy extent, Pringle manoeuvre, with or without devarscularization, and complications (e.g. postoperative ascites, biliary leakage, incision infection, and pleural effusion). Kaplan-Meier and log-rank tests were used to compare survival rates. Kendall's tau bivariate analyses were used to examine the correlations of these surgical operation-related factors.

RESULTSUnivariate COX regression analysis revealed that iatrogenic blood loss (chi2 = 19.721, P < 0.001), transfusion (chi2 = 7.769, P = 0.005), tumour rupture (chi2 = 6.401, P = 0.011), operation duration (chi2 = 4.793, P = 0.029), and postoperative ascites (chi2 = 4.452, P = 0.035) were statistically significant predictors in patients with HCC after hepatic resection. Multivariate COX regression analysis revealed that pathological factors, such as blood loss (RR: 2.138, 95% CI: 1.556-2.939), tumour rupture (RR: 2.260, 95% CI: 1.182-4.321), and postoperative ascites (RR: 1.648, 95% CI: 1.088-2.469), independently influenced the HCC prognosis. Blood loss correlated with transfusion (Kendall's tau = 0.416, P < 0.001). There was no correlation between hepatectomy extent and blood loss (Kendall's tau = 0.057, P = 0.383), while transfusion closely correlated with the hepatectomy extent (Kendall's tau = 0.185, P = 0.004). The postoperative ascites closely correlated with Child classification (Kendall's tau = 0.151, P = 0.024).

CONCLUSIONSThe long-term survival of patients with HCC after hepatectomy may be improved by avoiding blood loss and iatrogenic tumour rupture. The indications of blood transfusion may not be strictly obeyed in some severe cases. Child class B and C cirrhotic patients may experience postoperative ascites and a worse prognosis, and therefore may be candidates for liver transplantation.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; mortality ; pathology ; surgery ; Child ; Female ; Hepatectomy ; adverse effects ; Humans ; Intraoperative Complications ; Liver Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult

This study was aimed to establish the real-time fluorescent quantitative PCR (RT-qPCR) with erythrocyte Kidd blood group gene for detecting the hematopoietic chimera and to investigate the feasibility of this method. The TaqMan MGB probes and special primers were designed on basis of difference of erythrocyte Kidd blood group alleles, the hematopoietic chimerism was detected by RT-qPCR, the DNA chimerism was simulated by means of dilution of multiple proportions, and the sensitivity analysis was performed. The results showed that the RT-qPCR with erythrocyte Kidd blood group gene could effectively distinguish JK*A and JK*B alleles. There was no significant difference between the theoretic value and the practical measured value by this method (P > 0.05). As 156 donor's cells could be discriminated from 10(4) chimeric cells, this method may effectively detect donor's cells with correlation coefficient 0.998. It is concluded that the established RT-qPCR with erythrocyte Kidd blood group gene shows the feasibility for quantitative detection of hematopoietic chimera, and may be used to quantitatively detect chimera in a certain range.
Chimera ; Erythrocytes ; Humans ; Kidd Blood-Group System ; genetics ; Real-Time Polymerase Chain Reaction

OBJECTIVETo analyze the risk factors related to in-hospital bleeding for patients with acute coronary syndrome (ACS).

METHODSClinical and therapeutic data of 3807 patients who were registered with acute coronary syndrome in SINO-GRACE in China from March 2001 to December 2007 were reviewed. A total of 57 patients were grouped to bleeding group and 234 out of the remaining 3750 patients without bleeding were randomly chosen and served as non-bleeding group. Hemorrhage-related factors were screened and compared between the two groups. Unitary logistic regression analysis was performed to detect the possible factors related to hemorrhage. Factors with P < 0.1 were further analyzed by stepwise regression method and multivariate conditional logistic regression analyses.

RESULTS(1) Age, history of coronary artery bypass graft (CABG), previous hemorrhage, renal failure and heart failure as well incidence of acute coronary syndrome were significantly higher in bleeding group than in non-bleeding group (all P ≤ 0.05). Patients were more often treated with clopidogrel and glycoprotein (GP) IIb/IIIa receptor antagonist in bleeding group than in non-bleeding group. (2) Single factor logistic regression analysis showed that age > 70 years, history of previous bleeding, renal failure, heart failure, clopidogrel and GP IIb/IIIa receptor antagonists use, non-ST-segment elevation myocardial infarction, inferior wall, lateral myocardial infarction, CABG were risk factors for bleeding (all P < 0.05). (3) Multivariate logistic regression analysis showed that history of renal failure (OR = 19.77, 95%CI 4.38 - 89.18, P < 0.01) and clopidogrel (OR = 19.77, 95%CI 4.38 - 89.18, P < 0.01) and GPIIb/IIIa receptor antagonist (OR = 343.57, 95%CI 40.39 - 999.99, P < 0.01) use were the independent risk factors for bleeding.

CONCLUSIONOur results show that renal failure history and clopidogrel and GPIIb/IIIa receptor antagonist use are independent risk factors for in-hospital bleeding in patients with acute coronary syndrome.

Acute Coronary Syndrome ; complications ; pathology ; Age of Onset ; Aged ; Female ; Hemorrhage ; etiology ; Hospitalization ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Platelet Glycoprotein GPIIb-IIIa Complex ; antagonists & inhibitors ; Renal Insufficiency ; Risk Factors ; Ticlopidine ; analogs & derivatives ; therapeutic use

OBJECTIVETo find out the perceived stress in general public during prevalence of severe acute respiratory syndrome (SARS) and its impact on health behavior.

METHODSA retrospective survey was conducted in Guangzhou, Hangzhou, and Taiyuan according to the epidemic situations of SARS, and 2532 subjects were randomly selected from constructive industry, school, and commercial business and residents in urban and rural areas. The perceive stress was measured by Chinese perceived stress scale (CPSS), and health related behavior during SARS was tested by uniform and self-made questionnaire. EpiData 2.0 was used for data management and CPSS value was calculated according to answer to 14 questions contained in the scale. Health risk stress among different population group and health related behavior among low, medium and high stress state were analyzed by SPSS 11.5.

RESULTS2424 subjects were involved in the survey. The CPSS value was measured from 0 - 49 (22.7 +/- 6.8), M = 24.0. 39.3% (953/2379) subjects were under the health risk stress. The health related behaviors such as washing hands, opening the window for air, keeping away from others when cough and sneeze, doing exercises etc were reduced with the stress increased. Logistic regression indicated that compared with the persons with the thoughts of nothing serious of SARS, without any dread of SARS, and knowing nothing about prevention of SARS, the perceived stress was significantly related with perceiving of the thread to certain extent (beta = 0.41, Wald chi(2) = 4.84, P = 0.03), worrying little about the epidemic (beta = 0.50, Wald chi(2) = 6.69, P = 0.01), worrying about it to certain extent (beta = 1.39, Wald chi(2) = 48.59, P = 0.00) and scared so much (beta = 1.77, Wald chi(2) = 53.59, P = 0.00), and knowing little about the prevention (beta = 0.74, Wald chi(2) = 4.48, P = 0.03), knowing something about prevention (beta = -0.98, Wald chi(2) = 8.29, P = 0.00) and knowing the prevention very well (beta = -1.18, Wald chi(2) = 10.66, P = 0.00).

CONCLUSIONThe adoption of health related behaviors declined with increase of perceived stress. Opening connection to authority and government, enhancing the awareness of outburst affairs among general public and providing positive social support may be effective ways to reduce the population perceived stress.

Adolescent ; Adult ; Aged ; Culture ; Female ; Health Behavior ; Humans ; Middle Aged ; Occupations ; Retrospective Studies ; Rural Population ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; psychology ; Social Perception ; Surveys and Questionnaires ; Urban Population ; Young Adult

OBJECTIVETo analyze the reason of coronary artery aneurysmal dilations in patients after sirolimus-eluting stent implantation.

METHODSLate localized aneurysmal dilations post PCI were evidenced in 4 patients (age 69.5 +/- 3.5 years, 3 males) during follow-up (24.8 +/- 1.8 months). Nine stents were implanted into 7 diseased vessels: 5 Cypher select stents in LAD; 2 Firebird stents and 1 Pixel stent in LCX; 1 Cypher select stent in RCA. Clopidogrel (75 mg/d) was used for one year.

RESULTSAll stents were implanted successfully after predilation. No acute or subacute in-stent thrombosis and MACE was recorded. Follow-up angiogram imaging at 12 months after stenting was normal in all patients. Chest pain reoccurred in these 4 patients at 16, 18, and 22 months post stent implantation and patients were rehospitalized and treated with clopidogrel, asprine, and intravenous nitroglycerin. Angiography showed aneurysmal segment at the stented site of LAD in 3 patients, and at RCA in 1 patient. The symptom disappeared after 3 days intravenous tirofiban treatments and discharged without in-hospital complications. Patients remained symptom-free 3 - 6 months post discharge.

CONCLUSIONLate localized aneurysmal dilations after sirolimus-eluting stents are related to reoccurred angina pectoris post PCI.

Aged ; Coronary Artery Disease ; therapy ; Coronary Restenosis ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Sirolimus ; administration & dosage

Xi'an Jiaotong University has proposed the concept of "less teaching and more learning, interaction between guiding and learning" in medical education, based on its sedimentary deposits, and carried out reform for all clinical medical students since 2001. After more than ten years of educational reform, we have built brand new management framework, and established integrated organ system-based curriculum and PBL teaching pattern. This pattern involves eight aspects of comprehensive reform, including training program, curriculum model, textbook, teaching method, learning style, assessment and evaluation, teaching organization, teaching conditions and guarantee. It will provide paradigm for the integrated curriculum reform in peer colleges, and will be a milestone in the history of medical education in China.

OBJECTIVETo study the possible role of JNK1, Raf-1 and Livin in the carcinogenesis of sporadic colorectal tubular adenoma.

METHODSImmunohistochemical staining was used to detect the expression of JNK1, Raf-1 and Livin proteins in 65 sporadic colorectal tubular adenomas with dysplasia of varying degrees and 22 colorectal tubular adenoma with cancerous area.

RESULTSIn normal colorectal mucosa, colorectal tubular adenoma with dysplasia and colorectal tubular adenoma with cancerous area, the positive rate of JNK1, Raf-1 and Livin expression was increased gradually. The positive expression of JNK1, Raf-1 and Livin was all significantly higher in the cases of colorectal tubular adenoma with dysplasia or with cancerous area than that in normal colorectal mucosa (P < 0.05), and the positive expression of JNK1, Raf-1 and Livin was significantly higher in colorectal tubular adenoma with cancerous area than that in colorectal tubular adenoma with dysplasia of different degrees (P < 0.05). In the cases of colorectal tubular adenoma with dysplasia of varying degrees, the positive expression of Raf-1 was increased along with the increasing dysplasia degree of colorectal tubular adenoma (P < 0.05). Coexpression of JNK1, Raf-1 and Livin increased gradually in the carcinogenesis of sporadic colorectal tubular adenoma, while positive correlation was found among the expressions of JNK1, Raf-1 and Livin.

CONCLUSIONJNK1, Raf-1 and Livin may be involved in the carcinogenesis of sporadic colorectal tubular adenoma.

Adaptor Proteins, Signal Transducing ; metabolism ; Adenoma ; metabolism ; pathology ; Adult ; Carcinoma ; metabolism ; pathology ; Cell Transformation, Neoplastic ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Intestinal Mucosa ; metabolism ; pathology ; Male ; Mitogen-Activated Protein Kinase 8 ; metabolism ; Neoplasm Proteins ; metabolism ; Precancerous Conditions ; metabolism ; pathology ; Proto-Oncogene Proteins c-raf ; metabolism