Objective To systematically review the efficacy and safety of mycophenolate mofetil versus cyclophosphamide in adults with refractory nephrotic syndrome. Methods The randomized controlled trials of mycophenolate mofetil and cyclophosphamide treatment for refractory nephrotic syndrome were searched from Cochrane library, PubMed, Embase, Wanfang, VIP and CNKI till March 2014. The relevant studies were screened according to inclusion criteria and exclusion criteria. The quality of the included studies was evaluated. Meta-analyses were performed by using RevMan 5.2 software. The indexes were analyzed including the complete remission rate, efficiency, serum albumin, and adverse reaction after completing the treatment for adults with refractory nephrotic syndrome. Results There were 9 RCTs, a total of 467 patients were enrolled. The result of the meta-analysis showed that mycophenolate mofetil could significantly increase complete remission rate (RR=1.45, 95%CI=1.17～1.81, P=0.000 7) and efficiency rate (RR=1.23, 95%CI=1.11～1.36, P＜0.000 1). It can also enhance the level of serum albumin (WMD=2.73, 95%CI=1.42～4.04, P＜0.000 1) and decrease 24-hour urinary protein (SMD=-0.63, 95%CI=-1.16～-0.10, P=0.02) compared with cyclophosphamide in the treatment of refractory nephrotic syndrome. There was no significant difference in the serum level of cholesterol between mycophenolate mofetil group and cyclophosphamide group (SMD=0.31, 95%CI=-0.23～0.84, P=0.26 ). The incidence rates of liver dysfunction (RR=0.13,95%CI=0.06～0.28, P＜0.000 01), leukopenia (RR=0.10, 95%CI=0.04～0.23, P＜0.000 01), gastrointestinal reaction (RR=0.21, 95%CI=0.11～0.39, P＜0.000 01) and alopecia (RR=0.08, 95%CI=0.02～0.29, P＜0.000 01) were significantly lower in mycophenolate mofetil group than those of cyclophosphamide group. There were no significant differences in respiratory tract infection rate (RR=0.68, 95%CI=0.41～1.14, P=0.14) and lung infection rate (RR=0.58, 95%CI=0.31～1.08, P=0.09) between the two groups. Conclusion The safety and efficacy are better in the treatment of refractory nephrotic syndrome using mycophenolate mofetil than that of cyclophosphamide.

Objective To evaluate the expression of GPR30 and Ki-67 in Non-small cell lung cancer(NSCLC) and the relationship between them.The clinicopathological features of GPR30 in NSCLC were also analyzed.The molecular mechanism that estrogen mediated the proliferation of H1299 by activating GPR30 was further studied.Methods The expression of GPR30 and Ki-67 in 80 cases of specimens of NSCLC after surgery was examined using immunohistochemistry method.After 17-β-estradiol(E2) or G-1 added,H1299 cells were counted and the cell cycle distribution was analyzed by flow cytometry.Finally,the activated ERK1/2 and the expression of cyclin D1 and p16 after G-1 treatment in H1299 cells were examined through western blotting.Results Expressions of GPR30 was more in stage Ⅲ or low differentiation tissues or adenocarcinoma (P＜0.05).A positive correlation between GPR30 and Ki-67 was further disclosed (r=0.502,P=0.000).The proliferation of H1299 cells was promoted and more cells entered S-p hase after E2 or G-1 treatment for 3 days,which could be inhibited after G-15 or U0126 pre-treatment for 2 hours.We further discovered that the activated ERK1/2 and cyclin D1 expression increased after G-1 treatment,which was blocked after G-15 or U0126 pre-treatment for 2 hours.The change of p16 was on the opposite.Conclusion A positive correlation existed between GPR30 and Ki-67.GPR30-EGFR-MAPKs signaling transduction pathway was involved in the estrogen-induced proliferation of NSCLC cells.Blocking GPR30 signaling pathway may be a promising new strategy for NSCLC treatments.

Objective To investigate the value of transvaginal color Doppler sonography (TVCDS) and magnetic resonance imaging (MRI) in diagnosis for myometrial invasion of eudometrial cancer before surgical operation, in comparison with pathological examinations. Methods TVCDS and MRI were undergone before surgical operation in 34 patients with endometrial cancer confirmed by biopsy to evaluate depth of its myometrial invasion, as compared to those with postoperative pathological examinations. Results Predictive accuracy for myometrial invasion by TVCDS was 85%, with sensitivity, specificity, positive predictive value and negative predictive value of 80%, 9/9, 100% and 9/14, respectively, and predictive accuracy by MRI was 68%, with sensitivity, specificity, positive predictive value and negative predictive value of 60%, 8/9, 15/16 and 8/18, respectively. Resistance index (RI) averaged 0.51 for flow signal to detect superfical myometrial invasion by color Doppler flow imaging (CDFI) and 0.43 for deep myometrial invasion. Conclusions TVCDS and MRI can be used before surgical operation to judge the depth of myometrial invasion for patients with endometrial cancer, particularly more suitable for its screening, which will be helpful to judge the depth of myometrial invasion incorporated with resistance index by color Doppler flow signal.

Objective To investigate the effect of water-immersion restraint stress(WRS) on nitric oxide(NO) production and its mechanism in rat platelets.Methods Male SD rats underwent WIR stress for 2,4 and 8 hours.Ulcer index(UI) of stomach was chedsed by Guth method,nitrite production was measured by Greiss assay,nitric oxide synthase(NOS) activities and L-arginine transport rate were determined by isotope tracer method.ResultsAfter 2 h WRS,the NO production,the NOS activity and L-arginine transport rate in rat platelets obviously increased and then gradually decreased.After 8 h of WRS,these parameters were decreased as compared with the control group.The gastric ulcer appeared and got more serious after 4 h WIR stress.Conclusion Short-term WRS up-regulates L-arginine /NO pathway and increases nitric oxide production in the platelets but long-term WIR stress has the reversed effect.

3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.

Objective To investigate the alternation of left ventricular systolic function in patients underwent transcatheter aortic valve implantation operation(TAVI) by three-dimensional speckle tracking technology (3D-STI).Methods Totally 20 patients with severe aortic stenosis were enrolled.All the subjects underwent successful TAVI operation.The real-time 3D full volume datasets on apical four-chamber view were acquired on before,7 days and 1 month after TAVI.Left ventricular global longitudinal strain(GLS),regional peak systolic longitudinal strain(LS),regional peak systolic circumferential strain(CS) and regional peak systolic radial strain(RS),were analysed using off-line TomTec software,the differences among the three groups were compared.Results Compared with the preoperation,aortic valve blood flow velocity (AV),mean aortic valve pressure gradient(mPAG) of 7 days after operation decreased significantly.Threedimensional left ventricular ejecation fraction(3D-LVEF) among the patients whose 3D-LVEF under 50％had a remarkable increase and whose 3D-LVEF exceed 50％ before operation had no significant change,while 1 month after operation the 3D-LVEF had a significant improvement compared with the preoperational data regardless of 3D-LVEF under 50％ or not.The GLS and LS of all segments of 7 days after TAVI were higher than pre-operation(all P ＜0.05),and it had a further improvement 1 month after TAVI.Conclusions LV systolic function had improvement early after TAVI.3D-STI is a new,convenient way to detect the global and regional left ventricular systolic function of TAVI patients.

Objective To understand the current status of Toxoplasma gondii(TOX)infection among pregnant women and to explore the risk factors in some areas of Lhasa City,Tibet. Methods From 2015 to 2016,3 districts(counties)of Lhasa City were chosen as the investigation sites,and 200 pregnant women in each district(county)were selected as the investigation objectives. Meanwhile,450 pregnant women from Xuzhou,Yangzhou,Wuxi cities in Jiangsu Province were chosen as the con?trol. Then the blood samples of the pregnant women both in Lhasa and Jiangsu were detected by ELISA for TOX antibodies IgG , IgM,and the detection results were analyzed and compared. In addition,the individual information of the pregnant women in Lhasa City was surveyed by questionnaires,and the related risk factors of TOX infection were analyzed. Results Among 600 pregnant women investigated in Lhasa City,there were 99 pregnant women with positive TOX antibodies,and the positive rate was 16.50%,which was significantly higher than that(5.11%)of the pregnant women in Jiangsu Province(P<0.05). There was no statistically significant difference among the 3 districts(counties)of Lhasa City in the positive rates of pregnant women (P>0.05). The positive rates of the women who preferred raw meat or had the intimate contact with animal were high. Conclu?sions Compared with Jiangsu Province,the infection rate of TOX among pregnant women in Lhasa City is high. Therefore,the comprehensive measures including health education,early examination and treatment should be taken actively,so as to prevent and control TOX infection in this area.

Objective To investigate the clinical features and risk factors of adult nephrotic syndrome with pulmonary thromboembolism (PTE). Methods Sixty patients diagnosed with nephrotic syndrome and clinically suspected with PTE were enrolled in this retrospective study. Patients were divided into PTE group (n=32) and no-PTE group (n=28) according to the results of computed tomographic pulmonary angiography (CTPA). The single factor analysis and Logistic repres?sion analysis were used to analyse risk factors including age, gender, onset time, clinical symptoms, laboratory examination and pathological types. According to the independent risk factors, the receiver-operating characteristic curve (ROC curve) was used to determine PTE threshold value based on the evaluation index in nephrotic syndrome. Results Single factor analysis showed that there were significant differences in disease duration, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein cholesterol, D-dimer and physical examination in P2 hyperthyroidism between two groups (P <0.05). Logistic regression analysis showed that D-dimer was independent risk factor of PTE. The analysis of ROC curve indi?cated that D-dimer optimal threshold was 1 015.50μg/L. Conclusion D-dimer is an independent risk factor of PTE in pa?tients with nephrotic syndrome. When D-dimer is greater than 1 015.50μg/L, should pay attention to the occurrence of PTE.

Objective To investigate the feasibility of labeling mice spleen lymphocytes with superparamagnetic iron oxide(SPIO)and in vitro MR imaging of the labeled cells.Methods Spleen lymphocytes of 5 mice were isolated and then labeled with SPIO of 100,50,25,15,10,5 μg/ml,which was previously prepared with PLL.Prussian blue staining was performed to show the intracellular iron.Cell viability was compared among fresh,labeled and unlabeled cells.Different concentrations of mice spleen lymphocytes were screened using 3.0 T MR on T2WI,T2 * WI and SWI sequences in vitro.Cell viability was compared using independent-sample t test between groups.The MRI values among different groups were compared using one-way ANOVA.Results SPIO prepared with PLL could successfully label mice spleen lymphocytes,the optimum concentration of SPIO was 5 μg/ml.The Prussian blue staining showed intracellular blue spots and a labeling efficiency of(93.6 ± 2.1)％.Three groups of fresh,labeled and unlabeled cells showed a Trypan blue staining result of(94.8 ± 3.1)％,(88.7 ± 2.7)％,and(88.9 ±3.2)％,respectively; no statistically significant difference was found in cell viability between labeled and unlabeled lymphocytes(t =0.281,P ＞ 0.05); however,the cell viability of fresh cells were statistically significant higher than the labeled and unlabeled lymphocytes(t =8.125 and 7.253 respectively,P ＜0.05for all).Among the T2 WI,T2 * WI and SWI sequences under the same concentrations of cells,the SWI sequence was the most sensitive.Conclusions The mice spleen lymphocytes can be effectively labeled with SPIO with no impact on cell viability,and MR can be used to track these labeled cells in vitro.The SWI sequence is the most sensitive.

Objective To investigate the relationship between EphA2, EphrinAl and E-cadherin expressions and tumor stage and prognosis in pancreatic cancer. Method EphA2, EphrinAl and Ecadherin expressions were detected by immunohistochemistry in the tumor tissue and normal tissue specimens from 48 patients with primary pancreatic cancer. Results The expressions of EphA2 and EphrinAl were higher in the pancreatic carcinoma tissues than in the normal pancreatic tissues (P<0. 05). The E-cadherin expression was lower in the pancreatic cancer tissues than in the normal pancreatic tissues (P<0. 05). With decreasing histological differentiation, the expressions of EphA2 and EphrinAl in carcinoma tissues increased significantly (P<0. 05), while the E-cadherin expression decreased significantly (P<0. 05). The positive expressions of EphA2 and EphrinAl in the primary tumor significantly increased in stageⅢ and Ⅳ than in stage Ⅰ and Ⅱ (47. 9%vs 6. 25% , P<0. 05;47. 9% vs 8. 3%, P<0. 05), while the negative expression of E-cadherin was reversely correlated with these tumor stages (14. 6% vs 64. 6%, P<0. 05). Cox multivariate analysis showed that the clinical stage, EphA2 positive expression and E-cadherin negative expression were significantly associated with survival. Conclusion Abnormal expressions of EphA2, EphrinAl and E-cadherin were involved in the progression of pancreatic cancer and they were useful in predicting prognosis.