Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

Objectives To explore the relationship of orthostatic hypotension in elderly hypertensive patients with left ventricular structure and function.Methods 101 cases of elderly patients with hypertension were selected from July 2013 to June 2015.After blood pressure measurement in vertical and decubitus position,all patients were divided into non-orthostatic hypotension and orthostatic hypotension groups,received the echocardiography and the accurate calculation of left ventricular mass index.Results Compared with non-orthostatic hypotension,orthostatic hypotension in patients with left ventricular diastolic diameter,left ventricular posterior wall thinckness and interventricular septum thickness.Left ventricular mass index significantly increased(48.13±5.54)mm vs.(52.45 ± 1.48)mm in left ventricular diastolic diameter,(10.08± 1.87)mm vs.(11.29± 1.98)mm in left ventricular posterior wall thickness,(10.18± 1.88)mm vs.(11.61±1.66) mm in interventricular septum thickness,and (114.59 ± 22.72) g/m2 vs.(131.98 ± 23.43)g/m2 [t=4.386、2.985、4.397、8.672,in left ventricular mass index(BMI),all P＜0.05].Left heart ventricular ejection fraction and mitral peak early/late diastolic blood flow decreased [(60.81 ± 4.73)vs.(53.60±2.58)and(0.93±0.23)vs(0.76±0.26)t=4.298、3.654,all P＜0.05].Conclusions There is relationship of orthostatic hypotension with left ventricular structure and function in elderly hypertension patients,and it is essential not only to control blood pressure effectively,but also to focus on controlling orthostatic hypotension.

Objective To evaluate the diagnostic procedures and treatment choice of primary malignant tumor of the duodenum.Methods The clinical data of 54 cases with primary malignant tumor of the duodenum at Peking University People's Hospital from 1995 to 2005 were analyzed retrospectively.Resuits Tumors located in the first,second,third and fourth parts in 6 cases(10%),44 cases(82%),2 cases(4%),and 2 cases(4%)respectively,and among them,tumors within papillary area accounted for 86%(38 cases)of all cases.Fifty cases(92%)were of adenocarcinoma,2 cases(4%)of mucinous adenoearcinoma carcinoid and undifferentiated carcinoma for 1 case each(2%)respectively.The main clinical presentations included jaundice,upper abdominal pain,weight loss,abdominal distention,nausea and vomiting.gastrointestinal obstruction and abdominal mass.The accuracy rate of duodenoscopy and ERCP in preoperative diagnosis was 94%,and 78%respectively.Preoperative associated cholecystopathy accounted for 37%.Panceaticoduodenectomy was performed in 38 cases,duodenectonmy in 1 ease,palliative resection of tumor in 9 cases,and tumor was inoperable in 6 cases.Resection rate was 89%,and radical resection rate was 72%.The postoperative 3-and 5-year survival rate was 41%and 22%respectively.Patients after palliative resection died from 3 months to 24 months and all patients who did not undergo a surgery died within 6 months.Conclusions Tumors located in papillary region account for the majority of primary malignant tumors of the duodenum and are mainly of adenocarcinoma.Specific signs on abdominal examination are few.The symptoms of advanced stage are complicated,associated cholecystopathy is relatively frequent.Endoscopy and ERCP examination are the main diagnostic tools.the pancreatoduodenectomy is the first choice of therapy for patients with primary duodenal carcinoma.

Objective To provide experimental evidences for developing a safe and effective re- combinant fowlpox virus which can prevent the infection of HIV-2.Methods A fowlpox virus(FPV) transferring vector was constructed by inserting HIV-2 gag gene to the downstream of a synthetic complex promoter ATI-p7.5?20 of vector pUTA2.Transfection was then carried out,and recombi- nant FPV(rFPV)was screened by 5'-bromo-deoxyuridine(BrdU),genome PCR and western blot detection.Balb/c mice were immunized with rFPV by muscular injection.Anti-HIV-2 antibody, CD4~+ and CD8~+ T-cell count and specific target-killing activity of spleen CTL in immunized mice were analyzed by ELISA,FACS and LDH release assay,respectively.Results A transferring vector pA- gag was constructed and confirmed by amplifying a fragment of 766 bp from the rFPV genome.Mean- while,HIV-2 multi-antibody-specific protein blot(55 000)was detected from the recombinant virus and the HIV-2 specific antibody was detected from the immunized Balb/c mice.HIV-2 specific target- killing activity of spleen CTL was observed in immunized mice.Conclusion A recombinant fowlpox virus expressing HIV-2 structural protein Gag has been obtained,and it can stimulate HIV-2-specific eelluar and humoral immune reactions in mice.

OBJECTIVETo study the effect of aqueous extract of Taxus chinensis var. mairei (AETC) combined Erlotnib on the growth of A549 xenograft in nude mice and its mechanism.

METHODSThe xenograft model in nude mice was established by inoculating A549 cells subcutaneously. BALB/c nude mice bearing A549 xenograft were randomly divided into six groups, i.e., the low dose Erlotinib group (A) , the standard dose Erlotnib group (B) , the low dose Erlotinib combined AETC group (C), the standard dose Erlotnib combined AETC group (D), the AETC group (E), the control group (F), 12 in each group. Different medication was performed for 7 successive weeks after 24 h. One mL blood was withdrawn and tumor tissues taken. The tumor inhibition rate was calculated. The combined effect was analyzed by Jin's Formula [Q = Ea + b/(Ea + Eb-Ea x Eb) ]. mRNA and protein expression levels of epidermal growth factor receptor (EGFR), cyclooxygenase-2 (COX-2), and B cell lymphoma-2 (Bcl-2) in xenografts were detected using real-time RT-PCR and ELISA.

RESULTSCompared with Group F, the xenograft weight was obviously lowered in Group B-E (P < 0.05, P < 0.01). The q value was 0.92 in Group C and 0.96 in Group D, which was obtained by simple adding of the two drugs. Compared with Group F, EG- FR mRNA expression in Group D and E, COX-2 mRNA expression in Group A-E; Bcl-2 mRNA expression in Group B-D; COX-2 protein expression in Group B-E; Bcl-2 protein expression in Group C and D were obviously lowered with statistical difference (P < 0.05, P < 0.01).

CONCLUSIONSAETC combined low dose and standard dose Erlotinib had synergistic effect on tumor inhibition. Its mechanism might be associated with down-regulating mRNA and protein expression levels of COX-2 and Bcl-2.

Animals ; Antineoplastic Agents ; pharmacology ; Antineoplastic Combined Chemotherapy Protocols ; pharmacology ; Cell Line, Tumor ; Cyclooxygenase 2 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Enzyme Inhibitors ; pharmacology ; Erlotinib Hydrochloride ; pharmacology ; Heterografts ; Lung Neoplasms ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Receptor, Epidermal Growth Factor ; metabolism ; Taxus ; Transplantation, Heterologous

Animals ; Brain ; metabolism ; Female ; Ginkgolides ; pharmacology ; Hypoxia ; metabolism ; Lactic Acid ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase ; metabolism

Objective:To explore the characteristics of human melanoma-specific antigen peptides by HLA-A2 restricted tumor-infiltrating lymphocytes.Methods:The HLA-A2 protein and polypeptides molecules were purified from the three tumor cell lines(624-Mel, Chap-Mel and JY) by immunoaffinity chromatography, after the peptides bound to HLA-A2 protein solution were acidified with acetic acid and boiled by high temperature, and centrifuged through an Ultra-CL filter, then the peptides extracts were fractionated by revered phase high pressure liquid chromatography(RP-HPLC). Individual fractions were assessed for their ability to reconstitute melanoma-specific epitopes by adding to the HLA-A2 Ag-procceing mutant cell, T2. The biological feature of one of three active peptides from RT-HPLC samples was performed by mass spectrometric analysis. The synthetic peptides identical to active peptide sequences were determined in the reconstitute test.Results:Three prominent peaks(P19, P25 and P31) of the fraction from 624-Mel were observed in the reconstitute test, TIL killing rate was 67% for (P31) peptide fraction. The mass spectrometric analysis of one of active peptides (P31) showed that at mass-to-charge ratio(m/z) 948 has been usually nine residues. The sequence is H+ Ala Lue Trp Lue Phe Phe Gly Val Lue OH-. The peptide synthesized comprising epitopes were verified.Conclusion:These results showed the peptides derived from active fractions were related to human melanoma-specific tumor antigen peptides recognized by HLA-A2-restriced TIL. These peptides could develop novel peptide-based an anti-tumor vaccine for immunotherapy of CTL.

Purpose To study the clinicopathologic features, immunophenotype and differential diagnosis of solid papillary carcinoma (SPC) of breast.Methods 73 cases of breast SPC with or without invasive carcinoma were collected, and the clinical data and histopathologic features were analyzed with further investigation of transmission electron microscopy and immunohistochemical staining (EnVision method). Selected antibodies included cytokeratin (CK), myoepithelial markers, neuroendocrine markers, proliferation marker Ki-67 and ER,PR,c-erbB-2,etc.Results All the patients were females with mean age of 64.7 years.The presenting symptoms were either a palpable breast mass or nipple discharge.Metastasis was observed in 43 cases who had undergone axillary lymph node dissection. Histologically, the tumor displayed a solid-papillary growth pattern, with mucin production demonstrated in 25 cases. Intraductal papilloma was not uncommon at the peripheral area of the tumor. The tumor cells were polygonal, oval, spindled or signet ring-like and contained abundant eosinophilic to granular cytoplasm and mildly to moderately pleomorphic nuclei. More than 5 mitotic figures/10 HPF were observed in 51 cases. 43 cases contained foci of invasive carcinoma which showed similar cytologic features as those of in-situ component. Immunohistochemical study showed that the tumor cells were negative for basal cell cytokeratin; positivity for smooth muscle actin-alpha and p63 were demonstrated in the myoepithelial layers of fibrovascular cores, as well as around the expanded ductolobular units.Most cases also showed cytoplasmic positivity for chromogranin A (89.0%), synaptophysin (86.3%) and neuron-specific enolase (95.9%).The proliferatiing index, as highlighted by Ki-67 imnunostaining, was 9.2%.The tumor mainly expressed estrogen receptor and progesterone receptor. The staining for c-erbB-2 oncoprotein was negative in the most cases. Neuroendocrine granules were seen under transmission electron microscope in the cytoplasm.Conclusions SPC represents a subgroup of low-grade ductal carcinoma in situ.SPC predilection in older women is associated with mucinous and neuroendocrine components. Follow-up data suggest that SPC has a good prognosis.

Background and purpose:Radical nephroureterectomy can be performed in a variety of ways, and each method has its advantages and disadvantages. It still remains controversial for choosing the surgical methods. In this study, we chose six surgical methods and investigated the safety and efficacy of different methods in treating upper urinary tract carcinoma.Methods:We retrospectively analyzed 135 patients with upper urinary tract transitional cell carcinoma who underwent operations in our hospital from Jan. 2002 to Oct. 2013, and compared the data of six different operations in-cluding operating time, volume of bleeding, time of bowel function recovery and incidence of bladder carcinomas.Results:The operations were successfully completed in groups A and B. Five cases in group C were transferred into group A be-cause of failing to pull the nub of the ureter. Two cases in group D were transferred into group A because of failing to pull the nub of the ureter. Three cases in group E were transferred into group D and 1 case was transferred into group A because of adhesion or bleeding. One case in group F was transferred into group A because of bleeding. There was no statistically significant difference in survival rates among six operations.Conclusion:Six operations are all safe and effective for the treatment of upper urinary tract carcinomas. Each method has its advantages and disadvantages. We should choose differ-ent methods according to particular cases.

Objective To study the possible relationships between expression of matrix metalloproteinase(MMP)2,9 and the pathogenesis of preeclampsia in which trophoblast invasion is impaired. Methods MMP-2,9 expression were detected by immunohistochemistry streptavidin-biotin complex (SABC)method in 20 normal term placentae and 20 preeclampsia placentae,respectively.In addition, mRNAs for MMP-2,9 were analyzed by real time PCR in both groups.Results The intensities of both MMP-2 and MMP-9 immunostaining in preeclampsia placentae were significantly declined compared to those of normal term placentae(P