Objective To evaluate the efficacy and safety of combined intrapleural therapy with bevacizumab and cisplatin in controlling malignant pleural effusion(MPE)caused by non?small cell lung cancer(NSCLC). Methods A total of 63 NSCLC study subjects with MPE were randomly assigned to one of two groups(A and B). Group A(bevacizumab,n=32)received intrapleural bevacizumab(5 mg/kg)with cisplatin(40 mg/m2) therapy once a week for a total of three cycles. Group B(cisplatin,n=31)received intrapleural cisplatin therapy alone with the same dose and cycle. Pleural fluid was collected from both groups prior to and after treatment. The levels of VEGF in the pleural fluid were determined by ELISA. The cura?tive effect and adverse reaction were observed and follow?up was conducted. Results In 63 evaluable study subjects,the curative efficacy in the be?vacizumab group was significantly higher than that found in the cisplatin group(84.3%vs 61.3%,respectively,P<0.05). But the overall survival (OS)of the two groups showed no statistically significant difference(13.0 months vs 12.0 months,P>0.05). After treatment,The VEGF levels in the MPE were significantly decreased in both groups. In the bevacizumab group,the levels of VEGF in the pleural fluid were significantly lower com?pared to those of the cisplatin group after treatment,showing greater efficacy(P<0.05). The VEGF levels of the two groups whose treatment was in?valid had no statistically significant difference(P=0.079). There was no significant difference in gradeⅢ/Ⅳadverse events between the two groups. All procedures were well tolerated by the patients. Conclusion Combined intrapleural therapy with bevacizumab and cisplatin was effective and safe in managing NSCLC?mediated MPE. The patients showed high tolerance to the therapy. For prediction of local treatment efficacy of bevaci?zumab using the VEGF expression levels in MPE,further research was needed.

Objective To analyze the safety and clinical efficacy of three types stents of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of cirrhosis with portal hypertension.Methods Totally 1 086 patients with cirrhotic portal hypertension underwent TIPS for the first time.All patients were divided into bare stent group (group A),covered stent-group (group B) and combined stents group (group C).The rates of symptom improvement,shunt insufficiency,re bleeding,survival and major complications in 2 years after TIPS were analyzed and compared.Results Totally 1 690 stents were placed in 1 086 patients.The overall technical success rate was 100％;2.53％ (10/396) emergency patients dead due to uncontrolled gastrointestinal bleeding,and 2.78％ (11/396) emergency patients,0.84％ (5/593) bleeding stopped patients dead with acute liver funtional failure.In 2-year following-up,the overall survival rate of group A,group B,group C were 83.78％ (186/222),88.36％ (281/318),96.34％ (526/546),and the difference was statistical significant (x2=4.15,P=0.04).The shunt insufficiency rates of group A,group B,group C were 39.64％ (88/222),22.33％ (71/ 318),11.17％ (61/546),and the difference was statistical significant (x2 =4.15,P=0.04),The rates of rebleeding of group A,group B,group C were 31.53％ (70/222),16.89％ (54/318),7.14％ (39/546),and the difference was statis tical significant (x2 =9.91,P=0.01).The rates of hepatic encephalopathy of group A,group B,group C were 21.62％ (48/222),22.96％ (73/318),19.23％ (105/546),and the difference had no statistical significant (x2 =1.00,P=0.06).Conclusion TIPS is an effective way to relieve portal hypertension and complications in patients with cirrhosis.The safety and clinical efficacy can be improved by 8 mm shunt with double stent technique.

BACKGROUND: Nowadays, it is reported that vessel structural abnormity is the main morphological basis of vertigo due to vertebrobasilar arterial insufficiency abroad, but the report of vascular structural abnormality in vertebrobasilar arterial insufficiency is rare at home.OBJECTIVE: To observe the manifestation and clinical significance of vessel structural abnormity tested by digital substraction angiography (DSA)in patients with vertigo induced by vertebrobasilar arterial insufficiency.DESIGN: Case analysis.SETTING: Department of Neurology, Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University and Department of Neurology, Huaihua Hospital Affiliated to Nanhua University.PARTICIPANTS: A total of 57 patients, who were diagnosed as having episodic vertigo with or without nausea or vomiting, and hospitalized in the Department of Neurology, Huaihua Hospital Affiliated to Nanhua University from August 2003 to May 2004 and Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University between October 2004 and May 2005, were enrolled.METHODS: Fifty-seven patients with vertigo induced by vertebrobasilar arterial insufficiency hospitalized in the recent two years were treated with digital subtraction radiography in aortic arch and aortocranial angiography:Applying retrograde angiography of femoral artery puncture, Optiray nonionic contrast agent with syringe pattern to perform aortic arch angiography. Digital subtraction machine displayed bilateral carotid artery, vertebral artery, ranged from carotid artery to siphon of carotid artery from multiple angles. Measurement and evaluation were conducted by 2 doctors from department of neurology.MAIN OUTCOME MEASURES: Type, distribution and proportion of vesselstructural abnormity of aortic arch, carotid artery and vertebrobasilar system.RESULTS: Of the 57 patients, 1 patient was dropped out, because the left vertebral artery (LVA) could not be entered. A large area cerebral infarction was occurred in another patients during aortic arch angiography was performed, and the operation was stopped. Totally 55 patients were involved in the result analysis. It was found that 71%(39/55) of patients had vessel structural abnormity in cervical part and intracalvarium, 11%(6/55)of patients with simple anterior circulation lesion, 60% (33/55) of patients with posterior circulation lesion, of which 9 cases (16%) with compound lesion of anterior circulation abnormity. Two or above vessels in 24 cases (24/55,44%) were involved. Vertebral artery complicated with other angiostegnosis was the most common, and there was no vessel structural abnormity in other 16 cases (16/55,29%).CONCLUSION: Various types of vessel structural abnormity are the main etiological factors of vertigo induced by vertebrobasilar arterial insufficiency. Gold standard of diagnosing vertigo due to vertebrobasilar arterial insufficiency is DSA.

Objective To determine the effects of Sodium Nitroprusside ( SNP) , superoxide dismutase ( SOD) and catalase ( CAT ) on the expression of catalytic subunit of the DNA-dependent protein kinase ( DNA-PKcs ) and Ku70/80 heterodimer in cardiomycyte H9C2, as well as their expression in the myocardial tissues of SD rats . Methods H9C2 cells were co-cultured with SNP at concentreations of 10, 20 and 40 mmol/L for 6 hours, SD rats were injected with normal saline , SNP, SNP+SOD, SNP+CAT or SNP+SOD+CAT.Western blot and immuno-histochemistry assay were used to examine DNA-PKcs and Ku70/80 protein expression respectively .Results The expression of DNA-PKcs and Ku70/80 increased in H9C2 cells co-cultured with SNP when compared with control group, but they were be decreased when treated with SOD or/and CAT.The expression of DNA-Pkcs and Ku70/80 in myocardial tissues of experimental groups were higher than the control .Conclusions Radical scavengers may play a role as a protective effect for sodium nitroprusside related injury in cardiac myocytes .

Objective:To investigate the effect of heat shock protein 60(HSP60) on the functions of dendritic cells of ApoE-/-mice (mDCs) in vitro by signal transduction of mitogen-activated protein kinase (MAPK) family mediated by Toll-like receptors (TLRs).Methods:Myeloid mDCs were extracted in vitro from ApoE-/-mouse marrow,which were incubated as atherosclerotic animal model,and divided into three groups:HSP group,LPS group and control group.The three groups of mDCs were incubated to mature with mHSP60,LPS and normal saline,respectively and then examined the expression of TLR protein and mRNA by flow cytometry and real-time RT-PCR.In addition,the expression level of CD80 was examined by flow cytometry.The expression of MAPK family proteins was determined by Western blot analysis.The levels of cytokines secreted by mDCs,such as IL-6 and TNF-?,were analyzed by ELISA.Results:The expression of TLRs and MAPK families (p38 and ERK) was increased in the samples of HSP group,when compared with control group (P0.05).Conclusion:HSP60 is involved in activation of mDCs of atherosclerotic animal model by means of the signal transduction of MAPK family mediated by TLRs.

The progressive loss of skeletal muscle protein observed in cancer cachexia may have a negative impact on both the quality of life and the survival time of patients. In recent years, accumulating evidences suggest that the ATP ubiquitin proteasome pathway may be crucial in muscle cachexia. The review is mainly about the role of the ATP ubiquitin proteasome pathway in the degration of skeletal muscle protein during cancer cachexia.

Objective: To extract the active polysaccharides from traditional Chinese herb-cuttlebone and to purify cuttlebone polysacchride salts 1(CPS-1), an active component of crude polysaccharides, so as to obtain refined natural active polysaccharides. Methods: Hot-water extraction method was optimized by orthogonal designing and was used to extract crude polysacchaides from cuttlebone. The total sugar contents of crude polysaccharides were determined. DEAE Sepharose. F. F column and Sepharose CL-6B column were applied to separate CPS-1 from the crude polysaccharides. The active components were determined by animal experiments and Sephacryl S-300 column was used to further purification of CPS-1. HPLC was used to determine the purify of refined CPS-1 and the molecular weight of CPS-1 was determined by polysaccharides standard curve. Results: Crude polysaccharides were successfully extracted from cuttlebone. After purification with DEAE Sepharose F. F column, Sepharose CL-6B column and Sephacryl S-300 column and activity study, refined CPS-1 with average molecular weight (1 × 106 was obtained, and the sugar content reached 93.6%. Conclusion: Different extraction conditions have different extraction results for crude polysaccharides and different separation materials can separate the mixed polysaccharides by their molecular weights or charge characteristics. CPS-1 is a natural active polysaccharide extracted from cuttlebone.

Objective: To study the protective effects of cuttlebone polysaccharide CPS-1 on experimental ulcerative colitis (UC) in mice. Methods: Dextran sodium sulfate (DSS) was used to induce UC in mice and mice treated with SMP + TMP were taken as control. The protective effects of cuttlebone polysaccharide CPS-1 (high and low dose) on experimental UC in mice were evaluated with clinical symptoms, body weight changes and pathological changes in local intestinal mucous membrane. Cytokines related to endothelial cell proliferation and inflammation were determined in mice serum using ELISA kits. Results: There was no obvious change in body weight in mice treated with CPS-1 and the mice were well alive. Serum EGF and PDGF in CPS-1 treated mice were obviously increased compared with those in normal mice, while serum TNF-α in CPS-1 treated mice was significantly lower than that of positive control mice(P<0.05). Conclusion: Cuttlebone polysaccharide CPS-1 can obviously increase EGF and PDGF levels in experimental UC mice and accelerate the concrescence and repair of ulcer. Meanwhile, it can also decrease the expression of TNF-α and relieve inflammation.

Objective To establish the method for quality control of ethyl-acetate parts of Ferula sinkiangesis. Methods HPLC was used to detect the contents of ferulic acid, farnesiferol A and farnesiferol C. Waters XTerra RPC18 column (250 mm×4.6 mm, 5 μm) was used; acetonitrile-0.1% phosphoric acid was as mobile phase with gradient elution; flow rate was 1.0 mL/min; detective wavelength was 324 nm; temperature was 30℃; sample volume was 10 μL ResultsFerulic acid, farnesiferol A, and farnesiferol C showed a good linear relationship range from 0.05– 1.0 mg/mL, 0.132–2.64 mg/mL, and 0.118–2.36 mg/mL, respectively. The average recovery rates were 99.34%, 98.96% and 99.24% respectively. The contents of ferulic acid, farnesiferol A and farnesiferol C were 33.4, 76.5, 72.3 mg/g respectively.Conclusion The method was simple, accurate and repeatable, with good repeatability and stability, which can be used for the quality control of ethyl-acetate parts ofFerula sinkiangesis.