Objective To investigate the association between peripheral white blood cell count including its subtypes and cardiovascular disease (CVD) incidence and one-year all-cause mortality in maintenance hemodialysis (MHD) patients.Methods A total of 371 MHD patients at Zhongshan Hospital,Fudan University between March 2009 and February,2011 were enrolled.Demographic,hematological,nutritional and inflammatory markers were obtained.All patients were followed for one year to investigate the risks for CVD event and mortality.Spearman correlation and linear regression were used to assess the relationship between white blood cell count and other laboratory parameters.Difference in categorical factors between two groups were determined with Chi-square test,Difference in continuous values between two groups were assessed with t test.Kaplan-Meier analysis and Cox proportional hazards model were applied to assess one-year mortality predictors.Results Patients with CVD event had lower lymphocyte count level (1.17±0.38 vs 1.34±0.51,P＜ 0.05) and higher monocyte count level (0.44 ± 0.15 vs 0.37 ± 0.15,P＜0.01) than those without CVD event.Cox proportional hazard regression showed that an increased lymphocyte count was associated with reduced mortality risk,95％CI:0.136-0.719,P ＜ 0.01) and that an increased monocyte count was associated with increased mortality risk,95％ CI:2.657-74.396,P＜0.01) after adjustment for hsCRP.Conclusion Decreased lymphocyte level and increased monocyte level are significantly related to CVD event and are independent predictors of increased one-year all-cause mortality risk in MHD patients.

Objective To explore the effects of andrographolide(AP),extracted from the traditional Chinese herb Andrographlis paniculata(AP),on injury induced by radiation exposure.Methods Sixty male rats were randomly divided into 4 equal groups and irradiated with 60Co γ-rays at the doses of 1,2,and 4 Gy,respectively:low dose AP group(intragnstrically administered with AP at the dose of 100 ms/kg daily for 10 d before irradiation),and high dose AP group(intragastrically administered with AP at the dose of 200 ms/kg daily for 10 d before irradiation),model group(administered with the same volume of normal saline instead of AP for 10 d before irradiation),and control group(irradiated only at 3 different doses).One day after irradiation all rats were killed with their livers being fixed to make paraffin section.The morphological feature was observed under light microscope after HE staining,and the cell apoptosis was detected by TUNEL technology.Results Compared to the control and model groups,the pathological changes of liver were significantly gentler in the AP treatment groups.The apoptosis rates of the liver cells of all the AP sub-groups were significantly lower than those of the control and model subgroup(t=2.19-4.80.P<0.05).Conclusions AP might have prevention effect against radiation exposure.

BACKGROUND: Current studies on CD62P have focused mainly on cardiovascular diseases, while only few studies have evaluated the effects of CD62P on the development of sepsis and the association between endothelial cell injury with inflammation and coagulation. This study attended to explore the association between endothelial cell injury with inflammation and coagulation by evaluating the expression of soluble CD62P (s-CD62P) in plasma and its mechanism in patients with sepsis, thus to provide the evidence of effective treatment of sepsis with anti-adhesion therapy targeted CD62P. METHODS: A total of 70 critically ill patients with systemic inflammatory response syndrome (SIRS) admitted to intensive care unit (ICU) between September 2009 and February 2010 were enrol ed for a prospective and control study. According to the diagnostic criteria of sepsis/SIRS, the patients were divided into two groups: a sepsis group (n=38) and a SIRS group (n=32). Another 20 healthy volunteers served as a control group. Patients in the sepsis group and SIRS group were matched by clinical signs of high blood pressure, diabetes and its complications. The demographics of the patients including age, sex, body mass index (BMI), smoking and alcohol addict were compared among the groups. Six mL peripheral blood samples were collected within 24-hour admission in ICU for enzyme-linked immunosorbent assay (ELISA) to detect the plasma levels of s-CD62P, TNF-α, and hs-CRP. And variables of coagulation function such as platelet (PLT), prothrombin (PT), activated partial thromboplastin time (APTT), D-dimer and antithrombin-III (AT-III) were analyzed during 24 hours after admission to ICU. Meanwhile sequential organ failure assessment (SOFA) score of critically ill patients was evaluated. Data were expressed as mean±standard deviation and were statistical y analyzed by using SPSS 17.0 statistical software. The differences in plasma levels of s-CD62P of patients in each group were analyzed by ANOVA and the Kruskal-Wallis test. The relations between s-CD62P and inflammatory cytokines as well as with coagulation were determined by Pearson's product moment correlation coefficient analysis. Changes were considered as statistically significant if P value was less than 0.05. RESULTS: Compared with the control group and SIRS group, the sepsis group demonstrated significantly higher levels of s-CD62P, TNF-α and highly sensitive C-reactive protein (hs-CRP) (P<0.05). The plasma levels of D-dimer, PT, and APTT in the sepsis and SIRS groups were significantly higher than those in the control group, while the platelet count and the activity of AT-III were obviously lower (P<0.05). In the sepsis group, the plasma levels of hs-CRP and TNF-α were positively correlated with PT, APTT, and D-dimer, and negatively correlated with AT-III and PLT (P<0.05). The plasma levels of s-CD62P were significantly correlated with the plasma levels of TNF-α, hs-CRP, D-dimer, PT, and APTT, whereas they were correlated negatively well with PLT and AT-III (P<0.05). CONCLUSIONS: The concentration of plasma s-CD62P is elevated as a early biomarker in patients with sepsis, and it serves as one of the pathogenic factors responsible for endothelial cell damage. Coagulation and mediators of inflammation promote each other, aggravating the severity of sepsis. Plasma s-CD62P may be an important factor for the development of coagulation and inflammatory reaction.

Objective. To ascertain the relationship between the Ala54Thr variation of FABP2 gene and general as well as regional adipose tissue depots.Subjects. 165 subjects, in which 86 were subjects with normal glucose tolerance (NGT) [age 54.45±9.80, male/female 1.05,body mass index (BMI)26.48±4.01] and 79 were subjects with non-insulin-dependent diabetes mellitus (NIDDM)(age 55.86±10.00,male/female 1.08,BMI 26.75±3.30).Design and measurements. An association study of FABP2-Ala54Thr variation detected by PCR/HhaI digestion with general and regional adipose tissue depots determined by BMI and magnetic resonance imaging [abdominal subcutaneous and visceral adipose tissue area (SA and VA) and femoral subcutaneous adipose tissue area (FA)].Results. The geneotype and allele frequencies of FABP2-Ala54Thr variation in Chinese were quite close to the frequencies in American Caucasians and Pima Indians reported in the literature. Significant difference in genotype frequency distribution was observed between FA subgroups comparisons (FA≥75cm2 versus FA＜75cm2)in NIDDM subjects (X2＝11.460,P＝0.003),with significantly increased in Thr54-carrier[Thr54(+)]genotype frequency and Thr54 allele frequency in NIDDM subject with FA＜75cm2(odd ratio for genotype was 4.62,X2＝10.112,P＝0.001;and for allele＝2.36,X2＝5.379,P＝0.020).The FA in NIDDM-Thr54(+)subgroup was significantly lower than that in subjects with NIDDM-Thr54(-)sugroup(61.19±21.51cm2 versus 75.36±31.70cm2,P＝0.021). Stepwise regression analysis revealed that FABP2-Thr54 genotype variation was an independent factor contributing to the variation of FA in NIDDM(P＝0.003).Conclusion. FABP2 is associated with regional adipose tissue depot.The decreased femoral subcutaneous adipose tissue depot in NIDDM subjects is related to FABP2-Thr54 variant.

Background:Epilepsy is a chronic disorder characterized by recurrent seizures and has significant psychological and social consequence for everyday living.Epilepsy affects various aspects of ones' social life.The present study aimed to investigate the influence of marital status on the quality of life of adult Chinese patients with epilepsy.Methods:This study surveyed 805 Chinese adults who have been clinically diagnosed with epilepsy for longer than 1 year in 11 hospitals in Beijing.In this survey,532 (66.1％) participants were married.All of them completed the case report form with enquiries on demographic data,social factors,and illness.The marriage status of adult epileptic quality of life was the dependent variable,and demographic data and clinical data were independent variables,analyzed through the multiple linear regression analysis methods.The patients' quality of life was assessed using the Quality of Life in patients with Epilepsy-31 items (QOLIE-31) questionnaire,the Patient Health Questionnaire-9 items (PHQ-9),and the Generalized Anxiety Disorder-7 items (GAD-7).Results:The PHQ-9 and GAD-7 scores in the unmarried group (PHQ-9 =6.0 and GAD-7 =5.0) were significantly higher than that of the married group (PHQ-9 =4.0 and GAD-7 =3.0).The scores of married adult patients with epilepsy on QOLIE (61.8 ± 15.3) and social function (70.9 ± 22.7) were higher than the scores of the unmarried patients aged between 20 and 44 years.The scores of married adult epileptics on the QOLIE (58.4 ± 14.6) and the energy/fatigue (62.1 ± 20.4) were higher than the scores of the unmarried patients (QOLIE =58.4 ± 14.6 and the energy/fatigue =62.1 ± 20.4) aged between 45 and 59 years.For the adult epilepsy patients,depression,anxiety,seizures within the last year,disease course,medical expense category,and marriage* age are negatively correlated with the quality of life.Occupation,educational level,and average monthly income are closely related to the quality of life.Conclusions:Married adult epileptic patients have better quality of life than that of unmarried adult patients in young and middle-aged age groups.Unmarried adult patients with epilepsy are more anxious and depressed than married adult patients.

Objective To investigate the relationship between serum progesterone level at the day with human chorionic gonadotrophin (hCG) administration and pregnant outcome from in in-vitro fertilization-embryo transfer(IVF-ET). Methods From Mar. 2002 to Apr. 2007, 786 cycles with serum progesterone measurement on the day of hCG administration for final oocyte maturation in IVF were analyzed retrospectively in Reproductive Medicine Center in First Affiliated Hospital of Nanjing Medical University.All stimulations were down-regulated with gronadotrophin release hormone agonist (GnRH-a) in both long protocols and short protocols before gonadotrophin stimulation. When the thresholds of serum progesterone were set at 5.5, 6.0,6.5,7.0,7.5,8.0,8.5 and 9.0 nmol/L, respectively. If the level of progesterone was less than the thresholds, those patients were in lower progesterone group, on the contrary, more than the threshold value, those patients were in higher progesterone group. The laboratory results and the clinical outcomes between all patients at lower and higher progesterone group at different thresholds value were analyzed. Results The rate of normal fertilization, quality embryos, successful implantation, chemical pregnancy, clinical pregnancy and live birth did not exhibit remarkable difference between patients with higher and lower serum progesterone level at multiple thresholds on the day of hCG administration in the 786 cycles (P >0.05). However, when the thresholds of serum progesterone were at 8.5 and 9.0 nmol/L, early abortion rates of 27.3% (3/11) and 3/7 in higher progesterone group were significantly higher than 8.8% (26/297) and 8.6% (26/301) in lower progesterone group (P<0.05). And the total abortion rates of 3/7 in higher progesterone group were significantly higher than 11.0% (34/301) in lower progesterone group when the thresholds of serum progesterone were 9.0 nmol/L (P<0.05). Conclusions This study did not prove the correlationship between progesterone level at the clay with hCG administration and the probability of clinical pregnancy or live birth. However, early abortion rates or the total abortion rates were associated with higher progesterone level when the thresholds of serum progesterone were at 8.5 nmol/L or 9.0 nmoL/L.

Objective: To explore deep vein thrombosis (DVT) occurrence in patients after right heart catheterization and the effect of anticoagulant therapy. Methods: A total of 171 consecutive patients with electrophysiological study (EPS) and/or radiofrequency catheter ablation (RFCA) in our hospital from 2015-01 to 2016-05 were enrolled. All patients had supra-ventricular tachycardia and completed a venous surgery, they were randomly divided into 2 groups: Anticoagulation group,n=87 and Non-anticoagulation group,n=84. Lower extremity vascular Doppler ultrasonography was performed at (24-48) h post-operation to compare the incidence of DVT between 2 groups. Results: There were 13/171 patients were excluded for not completing post-operative lower extremity vascular Doppler ultrasonography including 9 patients in Anticoagulation group and 4 in Non-anticoagulation group. 158 patients finished post-operative examination and follow-up study. Anticoagulation group had 7/78 (8.97%) patients suffered from DVT, Non-anticoagulation group had 41/80 (51.3%) patients suffered from DVT,P<0.001. Conclusion: The incidence of DVT was higher after right heart catheterization without anticoagulation; heparin treatment may reduce DVT occurrence in relevant patients.

OBJECTIVETo screen and verify differentially expressed genes in prostate cancer.

METHODSUsing DNA microarray, we screened differentially expressed genes in prostate cancer tissue and its adjacent tissue followed by verification by PCR.

RESULTSA total of 1 444 genes were found to be differentially expressed (differentiation ≥ 1.5-fold; P≤ 0.05) in the prostate cancer tissue, of which 769 (53%) were up-regulated and 675 (47%) down-regulated. Fifty percent of the differentially expressed genes showed a 1.5- to 2-fold differentiation, including 396 up-regulated and 182 down-regulated ones. Additionally, 308 up-regulated and 334 down-regulated genes exhibited a >2- to 5-fold, 46 up-regulated and 78 down-regulated genes a > 5- to 10-fold, and 19 up-regulated and 81 down-regulated genes a > 10-fold differentiation. Verification by subjecting 15 most significantly up-regulated and another 15 most markedly down-regulated genes to quantitative real-time PCR (qRT-PCR) showed that most of the genes had a transcriptional profile similar to that in the microarray data, with a Pearson correction coefficient of 0.83 between the microarray data and qRT-PCR results. Totally, 10 significantly differentially expressed genes were identified.

CONCLUSIONDNA microarray analysis provides reliable information on differentially expressed genes in prostate cancer and benign tissues. The 10 significantly differentially expressed genes verified by qRT-PCR could possibly become new bio-markers and specific molecules for tumor identification.

Cell Differentiation ; Down-Regulation ; Gene Expression ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction ; Prostatic Neoplasms ; genetics ; Transcriptional Activation ; Up-Regulation

OBJECTIVEIt is clear that PAI-1 is a very important factor inhibiting extracellular matrix (ECM) degradation in the pathology process of IgA nephropathy (IgAN), so we design to investigate the relationship between PAI-1 promoter 4G/5G polymorphism and IgAN pathogenesis and progression.

METHODSClinical baseline data such as blood pressure, urinary protein excretion, serum profile, and extent of renal tissue damage at the time of renal biopsy were collected. The genotypes of PAI-1 were profiled by PCR-RFLP.

RESULTS(1) The distributions of genotype 4G 4G, 4G5G, 5G5G in PAI-1 gene promoter showed no significant difference between the IgAN group (0.33, 0.19, 0.48) and control group (0.3, 0.23, 0.47; chi-square =1.63, P>0.05); (2) There is an increasing frequency of 4G4G homozygote in the IgAN group who had severe pathology change proved by biopsy (0.39 vs 0.28; chi-square =7.86, P<0.05); in the patients group,the ones who carried 4G4G genotype got lower Ccr than 4G5G genotype cases did (P<0.05).

CONCLUSIONThe data here suggest that the 4G/5G polymorphism of PAI-1 is not a risk factor in IgAN etiology, but may facilitate the process of IgAN to end stage renal disease.

Adolescent ; Adult ; Child ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Glomerulonephritis, IGA ; genetics ; pathology ; Homozygote ; Humans ; Male ; Middle Aged ; Plasminogen Activator Inhibitor 1 ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Young Adult

OBJECTIVETo investigate the therapeutic effect and safety of Sorafenib in the treatment of tumor recurrence after orthotopic liver transplantation (OLT).

METHODSBetween January, 2009 and June, 2011, 10 patients with tumor recurrence after OLT were treated with Sorafenib (group A) and another 8 recipients received no Sorafenib treatment (group B); 25 patients with hepatocellular carcinoma (HCC) also received Sorafenib treatment (group C). The tumor-bearing survival time, adverse effect and toxicity associated with sorafenib were compared between the 3 groups.

RESULTSIn group A, the median tumor-bearing survival time was 10 months (5-22 months), as compared to 4 months (1-8 months) in group B and 4 months (2-21 months) in group C, showing a significant difference in the survival time among the 3 groups (Kaplan-Meier, log-rank test, P=0.045). No recipient experienced acute graft rejection, but one recipient in group A died due to gastrointestinal bleeding. No significant difference was found in adverse effects associated with Sorafenib between groups A and C (P<0.05).

CONCLUSIONSorafenib can prolong the survival time of patients with tumor recurrence after OLT without increasing the risk of acute graft rejection.

Carcinoma, Hepatocellular ; drug therapy ; surgery ; Female ; Humans ; Liver Neoplasms ; drug therapy ; surgery ; Liver Transplantation ; Male ; Neoplasm Recurrence, Local ; drug therapy ; Niacinamide ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; therapeutic use ; Postoperative Period ; Survival Rate ; Treatment Outcome