Background:Cytapheresis has been used gradually in the treatment of ulcerative colitis( UC),however,its efficacy is still controversial. Aims:To systematically evaluate the efficacy and safety of cytapheresis on UC. Methods:PubMed, Embase,Web of Science,Cochrane Library,CNKI,Wanfang and VIP database were retrieved to collect the randomized controlled trials( RCTs)using cytapheresis for UC. Article selection,data extraction and quality evaluation were conducted independently by two reviewers. Meta-analysis was conducted by using RevMan 5. 3 software. Results:A total of 20 RCTs involving 1 354 UC patients were included. The results of the meta-analysis showed that cytapheresis was superior to conventional therapy or sham procedure in inducing clinical response(RR=1. 36,95% CI:1. 20-1. 55,P﹤0. 000 01), clinical remission(RR=1. 38,95% CI:1. 15-1. 66,P=0. 000 5)and maintenance of remission(RR=2. 92,95% CI:1. 40-6. 08,P=0. 004 ),and no differences in adverse events were found( RR =0. 37,95% CI:0. 11-1. 24,P =0. 110). Conclusions:Cytapheresis has porfound effect on induction of clinical response, clinical remission and maintenance of remission,and is safe as well. However,the conclusion should be verified by more large-scale and multi-center RCTs.

Objective To investigate the change of 25-hydroxyl vitamin D level and its impact on glucose metabolism and bone mineral density in type 2 diabetic patients.MethodsTwo hundred and fifty-eight cases of type 2 diabetic patients in our hospital were collected.In accordance with 25 (OH) D =50 nmol/L for the critical values,they were grouped into vitamin D deficiency group ( n =192) and the relative lack of vitamin D group ( n =66).Dual-energy X-ray absorptiometry (DXA) measurement of the lumbar vertebrae L2 - L4 and femoral neck bone mineral density were undertaking.Taking the total value of the lumbar spine,femoral neck and total value as judgment indicators,homeostasis model assessment of insulin resistance (HOMA-IR),we collected and statistically analyzed glucose metabolism and bone metabolism indicators in patients with diabetes.Results Among 258 cases of type 2 diabetes,there were 57 cases of osteoporosis accounting for 22.1％.There was significant difference on the duration of diabetes [ (7.98 ± 1.09 ) years old vs (3.77 ± 1.21 ) years old,t =4.849,P ＜0.05],FINS [ (6.42 ± 1.30) mU/L vs (5.79 ± 1.08) mU/L,t =3.871,P ＜0.05] and HOMA-IR [ (2.35 ±0.54) vs ( 1.85 ±0.41 ),t =2.705,P ＜0.05],but no significant difference on the FPG and HbA1c ( P ＞ 0.05 ) between two groups.PTH [ ( 36.51 ± 7.59) ng/L vs ( 32.02 ± 6.89 ) ng/L,t =2.008,P ＜ 0.05 ],bone mineral density in the lumbar total value [ (0.87 ±0.14) g/cm2 vs (0.99 ±0.12) g/cm2,t =2.799,P ＜0.05 ],femoral neck Neck [ ( 0.70 ± 0.10 ) g/cm2 vs ( 0.79 ± 0.11 ) g/cm2,t =2.564,P ＜ 0.05 ] and Total [ (0.84 ± 0.14) g/cm2 vs (0.97 ± 0.15 ) g/cm2,t =3.340 P ＜ 0.05 ] were statistically different,but no significant difference on the rest of the indicators.Conclusion The prevalence of vitamin D deficiency was found in patients with diabetes.Vitamin D level could affect insulin resistance and glycemic control and bone mineral density level.Therefore,routine vitamin D testing to the diabetic patients and giving vitamin D replacement therapy to vitamin D deficiency patients in a timely manner were necessary.

BACKGROUND:Mechanical, inflammatory, and biochemical factors, particularly matrix metaloproteinases and reactive oxygen lead to chondrocyte degeneration in osteoarthritis. Curcumin has been shown to be a potent antioxidant; however, its protective effects against chondrocyte degeneration in osteoarthritis remain unclear.
OBJECTIVE:To investigate the potential molecular mechanisms underlying the protective effects of curcumin on articular cartilage of osteoarthritis in rats.
METHODS:A total of 30 Sprague-Dawley rats were used and randomly divided into model group (positive control,n=15) and normal group (negative control,n=15). Rat models of traumatic osteoarthritis were established, and then cartilage cels were isolated from articular cartilage and culturedin vitro. Chondrocytes were treated with curcumin (curcumin group) or PDTC (an inhibitor of nuclear factor-kappa B) for 24 hours. The expression level of nuclear factor-kappa B P65 in nucleus and cytoplasm in chondrocytes were determined by western blot assay and immunofluorescence. Moreover, mRNA expressions of type II colagen, matrix metaloproteinase-1 and -13 were analyzed using RT-qPCR.
RESULTS AND CONCLUSION: Nuclear factor-kappa B P65 protein was mainly expressed in nucleus, but few in cytoplasm in positive control group; the reversed results were found in the curcumin group. Nuclear translocation of nuclear factor-kappa B P65 was observed mainly in nucleus in the positive control group; however, that was observed mainly in cytoplasm in the negative control, curcumin, and PDTC groups. Matrix metaloproteinase-1 and -13 mRNA expressions were significantly decreased, while type II colagen mRNA expression was significantly increased in the curcumin group compared with the positive control group. These findings indicated that curcumin protect chondrocytes against degeneration through inhibiting the activation of nuclear factor-kappa B signaling pathway, suppressing nuclear translocation of nuclear factor-kappa B P65 and inhibiting the expressions of matrix metaloproteinase-1 and -13, which are responsible for upregulation of type II colagen expression.

Objective To observe the effect of 5-aza-2'-deoxycytidine(5-aza-CdR)on the normal epithelial specific-1 gene(NES1)and the growth of human gastric cancer xenografts in nude mice,and to explore the possible anti-tumor mechanisms and search for new treatment for gastric cancer.Methods Human gastric caner xenograft model in nude mice was established and treated with 5-aza-CdR.The growth of xenografts in nude mice was observed,and the status of methylation and protein expression of NES1 gene were detected by MSP and immunohistochemistry respectirely.Results After treatment with 5-aza-CdR,the growth of the xenografts in nude mice was greatly inhibited(P

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.

AIMTo investigate the transforming growth factor beta1 (TGF-beta1) and basic fibroblast growth factor (bFGF) expressions in benign prostatic hyperplasia (BPH) and the effect of beta-radiation.

METHODSTGF-beta1 and bFGF expression was studied by means of an immunohistochemical method in nine normal prostatic (NP) tissues, 15 hyperplastic prostatic tissues and 35 hyperplastic prostatic tissues treated with 90Sr/90Y.

RESULTSThe TGF-beta1 expression in the epithelium and stroma of normal prostatic tissues was 68.2 % +/- 10.5 % and 29.7 % +/- 4.6 %, respectively, while it was 64.8 % +/- 9.3 % and 28.6 % +/- 4.1 %, respectively, in hyperplastic prostatic tissues. Compared with the controls, TGF-beta1 expression in the epithelia and stroma of BPH treated with 90Sr/90Y increased significantly (P <0.01). The bFGF expression in epithelia and stroma of normal prostatic tissues was 17.4 % +/- 3.7 % and 42.5 % +/- 6.8 %, respectively, and was 46.3 % +/- 8.2 % and 73.2 % +/- 12.1 %, respectively, in hyperplastic prostatic tissues. Compared with the controls, expressions of bFGF in the epithelia and stroma of BPH treated with a 90Sr/90Y prostatic hyperplasia applicator decreased significantly (P <0.01).

CONCLUSIONExposure of beta-rays had noticeable effects on BPH tissues, enhancing TGF-beta1 expression and inhibiting bFGF expression.

Aged ; Aged, 80 and over ; Beta Particles ; Case-Control Studies ; Fibroblast Growth Factor 2 ; metabolism ; radiation effects ; Gene Expression ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prostate ; metabolism ; radiation effects ; Prostatic Hyperplasia ; metabolism ; radiotherapy ; Strontium Radioisotopes ; therapeutic use ; Transforming Growth Factor beta ; metabolism ; radiation effects ; Transforming Growth Factor beta1 ; Yttrium Radioisotopes ; therapeutic use

OBJECTIVETo examine the effects of H-ras gene silence on cell cycle, proliferation and apoptosis of salivary adenoid cystic carcinoma -M (SACC-M) cell lines.

METHODSThe plasmid H-ras-shRNA, containing the sequence of shRNA targeting H-ras, and HK-shRNA (without interfering effect) were constructed and transfected into SACC-M cells. The cell line with shRNA plasmid stable expression was isolated by G418. The expression levels of H-ras were detected by RT-PCR and protein immunofluorescent assay; cell cycle and cell apoptosis were analyzed by flow cytometry (FCM). The proliferation of cell was also determined by subcutaneous tumor formation in nude mice.

RESULTSAfter transfection of H-ras-shRNA plasmid, the mRNA expression of H-ras in SACC-M cells was down-regulated by 61.80% and protein expression of H-ras was inhibited by 62.76%; the cell proliferation was inhibited obviously; the G0G1 phase cells were increased. The cell apoptosis rate of H-ras-shRNA group was significantly higher than that of HK-shRNA group (P <0.05). The volume of subcutaneous tumor in nude mice was significantly smaller in Hras-shRNA group than in control group.

CONCLUSIONSThe recombinant plasmid HRAS-shRNA could efficiently down-regulate the expression of H-ras gene and protein, induce apoptosis of SACC-M cells and simultaneously inhibit proliferation of these cells in vitro and in vivo.

Animals ; Apoptosis ; Carcinoma, Adenoid Cystic ; genetics ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Female ; Gene Silencing ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Proto-Oncogene Proteins p21(ras) ; genetics ; RNA, Small Interfering ; genetics ; Salivary Gland Neoplasms ; genetics ; pathology ; Transfection

Objective To analyze three different classification criteria, the clinical characteristics of antiphospholipid syndrome(APS)in a cohort of Chinese patients. Methods From January 1996 to October 2006, APS patients diagnosed with different classification criteria were retrospectively studied. Results There were totally 120 APS patients fulfilled at least one criterion, One hundred and one patients fulfilled the 1988 Asherson criteria, 96 patients fulfilled the 1999 Sapporo criteria, and 115 patients fulfilled the 2006 Sydney criteria. The ratio of male to female in a cohort of 115 definite APS patients was 1 to 10.5. The mean period of the disease until entry into the study was 82.6 months, the mean age at study entry was(41?12)years. Ninety patients had thrombosis episodes, among which the most common presenting manifestations were deep venous thrombosis, stroke and skin vasculitis. Forty-six of 92 married women in our cohort had fetal morbidity. Catas- trophic APS occurred in 7 patients. The presence of anticardiolipin antibodies(aCL)was detected in 86 pa- tients, anti-beta-2 glycoproteinⅠantibodies in 58 patients and lupus anticoagulant(LA)in 27 patients. Conclusion The most common presenting manifestations are deep venous thrombosis, stroke and cutaneous manifestations. The sensitivity of Sydney classification criteria is improved by adding anti-beta-2 glycopreteinⅠantibody as one of the laboratory criteria. However, primary APS patients who only presented with thrombo- cytupenia and positive laboratory tests could not satisfy this criterion. In addition, the significance of autoanti- bodies to some coagulant factors in APS needs further study.

Sarcopenia and physical deconditioning are common complications in patients with liver cancer,which are frequently caused by insufficient physical activity and poor nutritional status,resulting in physical frailty and a significant impact on the patient's physical fitness.Notably,sarcopenia,frailty,and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer.Exercise intervention significantly improves various health parameters in liver cancer patients,including metabolic syndrome,muscle wasting,cardiorespiratory endurance,health-related quality of life,and reduction in hepatic venous pressure gradient.However,the link between physical exercise and liver cancer is commonly overlooked.In this article,we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer.This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors.In brief,physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.

OBJECTIVETo assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.

METHODSThirty-five cases of equinus deformity follow-ing tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed. The complications, the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients'subjective evaluation were recorded and analysed.

RESULTSAmong the 35 patients, 15 had previously undergone surgical treatment twice on the same limb, 13 had thrice and 7 had to be operated on four times before ankle fusion. An anterior midpoint approach to the ankle joint was adopted in 29 cases, while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases, whereas lateral approach in 6 cases. Tarsus joint fusion was performed on 4 cases. The follow-up period ranged 6-124 months, averaged 40.6 months. Bone grafting was not performed in this series. Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment. Incision dehiscence located at previous Achilles tendon incision was found in two patients. As a result, one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change. Two patients failed to bony union 5 months postoperatively, in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting. Terminal necrosis of the toe due to blood supply dysfunction was not found in this series. All the patients were satisfied with the ankle joint function postoperatively. The time for bony union on X-rays was 9.8 weeks on average. Except for one patient who demanded removal of intramedullary nail, all the intramedullary nails were not retrieved at the end of follow-up. Nail breakage happened in one patient and no other breakage or backing out of the nail was found.

CONCLUSIONSLower extremity compartment syndrome and residual ankle deformity often extremely impact ambulation and are hard to deal with because several pathologic phenomena might exist in these patients, for instance, poor skin conditions due to repeated preexisting surgery; poor perfusion in distal limbs following blood vascular injury; reflux limitation and long-term limb swelling due to muscle strength disturbance; osteoporosis as a result of long-term immobilization or limb disuse. Ankle fusion with a retrograde locked intramedullary nail is an optimal protocol to solve these clinical symptoms and rather ensures a definite fusion and firm fixation to these patients with simple manipulation and few complications.

Ankle ; Bone Nails ; Compartment Syndromes ; Fracture Fixation, Intramedullary ; Humans ; Lower Extremity