Objective To investigate the effects of emodin on the migration and proliferation of vascular smooth muscle cell (VSMC) and the metabolism of emodin in VSMC. Methods The effects of emodin on the migration or proliferation of vascular smooth muscle cell were measured by “transwell" migration system and MTT assay. Results The migration of VSMC could be significantly inhibited by emodin and the inhibitory ratio was 83.8% in 5 ?g/mL emodin group. The antiproliferative effect of emodin was in a dose- and time- dependent manner. However, the supernatant concentration of emodin insignificantly dereased after culture for 24 h. The cytotoxicity of emodin and cellular ROS was not influenced by CYP inducer or inhibitor. The mRNA expression of emodin's primary metabolic enzyme (cytochrome p450 oxidase, CYP) up-regulated insignificantly after treatment of emodin for 24 h. Conclusion Emodin can inhibit the migration and proliferation of VSMC and can not be metabolized by VSMC. Emodin may be a choice for the medication of drug-eluting stent.

OBJECTIVETo study the characteristics of the arch form of skeletal Class III malocclusion and provide references for diagnosis and treatment plan.

METHODS7 indexes in dental casts of 47 patients with skeletal Class III malocclusion and 50 individuals with normal occlusion were measured respectively. And differences between corresponding upper and lower measurements were calculated. Independent samples t-test was employed for comparing between the two groups by SPSS 17.0.

RESULTSCompared with normal occlusion sample, Class III malocclusion group had smaller anterior segment lengths and larger canine angles (P<0.05). Differences between upper and lower first premolar widths were larger in males with skeletal Class III malocclusion. And differences between upper and lower anterior segment lengths were smaller in males with skeletal Class III malocclusion (P<0.05).

CONCLUSIONArch widths of patients with skeletal Class III malocclusion are basically normal. The lengths of anterior segment are smaller and the anterior arch forms are straighter.

Bicuspid ; Dental Arch ; Dental Occlusion ; Female ; Humans ; Male ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumors in the gastrointestinal tract. Though surgical resection is the only radical treatment, postoperative recurrence and metastasis often occur. The first-line therapy for the treatment of recurrent, metastatic and unresectable GIST is imatinib. More than 80% of patients can benefit from imatinib treatment, but half of patients will still have recurrence or metastasis within 2 years after treatment initiation, and secondary drug resistance is a major cause of disease progression. Therefore, adeep understanding of the mechanisms of secondary drug resistance will guide us to develop personalized therapeutic schedule in the future. This article describes the mechanism of IM secondary resistance from the aspects of gene alteration, abnormal activation of signal transduction pathway, autophagy, apoptosis and drug concentration. It is found that single drug therapy has certain limitations in patients with secondary resistance to IM. Using IM combined with downstream signaling molecule inhibitors, autophagy inhibitors, insulin-like growth factor 1 receptor (IGF-1R) inhibitors, heat shock protein 90 (HSP90) inhibitors, cytotoxic T lymphocyte - associated antigen - 4 (CTLA - 4) antibodies and mitochondrial inhibitors provide us new therapeutic ideas. However, these combination treatments are still in the research phase, and further trials are needed to confirm the safety and efficacy. With the gradual deepening of research on drug resistance mechanisms, it will provide more solutions to the current serious drug resistance problem.

Objective To report the experiertce of management of complicated renal stones by percu taneous nephrolithotripsy (PCNL) with pneumatic and ultrasonic power by ultrasound guidance. MethodsThree hundred and eighty two cases(218 males,164 females,4 74 years) who underwent PCNL by u sing the third generation Swiss LithoClast Master for kidney stones from 2004 to 2007 were retrospectivelyreviewed. Clinical data including operation time,stone free rate and complications were analyzed. ResultsPhaseⅠlithotripsy was performed in 397 sides and delayed phaseⅡlithotripsy in 8 sides. Twenty three casesunderwent simultaneous bilateral PCNL. The operation time ranged from 70 to 190 min,average time was(93±11)min. Nine cases needed blood transfusion. Severe complications did not occur during operations.Stone free rate was 91.8% (372/405). Residual stone fragment was found in 33 cases after delayed phase Ⅱlithotripsy and 14 cases received adjuvant extracorporeal shock wave lithotripsy. One hundred and forty sixcases were followed up for 3 to 24 months and showed no recurrence. Conclusion PCNL with pneumaticand ultrasonic power could be an efficient treatment for complicated kidney stones.

Objective To explore the safety of the elderly donors in living related donor kidney transplantation. Methods Forty-five elderly donors (51 - 78 years,study group) who underwent ne-phrectomy for living related donor kidney transplantation from April 1993 to December 2007 were retrospectively investigated. Clinical data including serum creatinine (SCr), glomerular filtration rate (GFR) in pre-and post-operation, operation complications and hospital stay time were analyzed and compared with the control group(62 cases, the donors age were younger than 50 years). Results The operations of all living donors were successful. The SCr and GFR in pre-operation were (82.16 ± 10.86)μmol/L, (85. 82±6.26)ml/min(study group)and (78. 66±10. 41)μmol/L, (88. 74±9. 44) ml/min (control group) respectively. There were no significant differences in SCr and GFR between the groups at different time points (P>0. 05). The average hospitalization time was 9 days in study group and 8 days in control group. There were no severe perioperative complications and no renal function failure was found in long-term following-up in study group. Conclusions Age is not the absolute contraindication of donor for living related donor kidney transplantation. The preoperative evaluation and careful operation can ensure the safety of elderly donors.

Objective To discuss the safety and efficacy of simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) for bilateral renal or upper ureteral calculi. Methods Forty-eight cases (26 males, 22 females, 24-57 years )who underwent SBPCNL with pneumatic and ultrasonic power for bilateral renal or upper ureteral calculi were retrospectively reviewed. Clinical data including opera-tion time, blood loss, transfusion rates, length of hospital stay, stone free rate and complications were analyzed. Results The percutaneous renal access was successfully established under ultrasonic guid-ance in all patients. The average operation time was(105±18) rain(range 80-190 min). The average drop in hemoglobin was 21 g/L (range 5-54 g/L), with 5 patients requiring blood transfusion. In 43 patients, a single stage was performed on both sides, while 5 required the second stage PCNL on one side. A single tract was adopted on both sides in 44 patients, while 4 cases of the patients required two tracts on one side. No one required two tracts on both sides or more than one stage on both sides. The stone-clearance rate was 87.5 %. The average hospital stay was 6.5 d. There was no severe complica-tion occurred. Conclusion SBPCNL might be safe and effective for bilateral renal or upper ureteral calculi for selected patients.

Multiple sclerosis (MS) is an autoimmune disease characterized by demyelination, axonal injury, and neuronal loss in central nervous system. Experimental autoimmune encephalomyelitis (EAE) animal model is widely used in MS. Accumulating evidences indicate that the programmed cell death-1/programmed cell death-ligands-1 (PD-1/PD-L1) pathway participates in pathogenesis of autoimmune diseases. The authors comprehensively review the roles of PD-1/PD-L1 pathway in pathogenesis of MS and EAE animal model, and discuss the potential of this pathway as a new therapeutic target for MS, to provide reference for immunotherapy research of MS.

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans ; Male

OBJECTIVETo investigate the association between CHADS2 score and long-term ( ≥ 3 years) outcomes post catheter ablation in patients with atrial fibrillation (AF).

METHODSAF patients who received single catheter ablation in our hospital from January 2004 to March 2009 in our department were included and patients received regular follow-up. AF recurrence was defined as the occurrence of atrial arrhythmias (AF, atrial flutter and atrial tachycardia) recorded by electrocardiogram monitor ( ≥ 30 seconds) after ablation during follow-up period (after 3 months blanking period). The relationship between baseline clinical and echocardiographic characteristics and the time to recurrence during follow-up was evaluated using Cox multivariate analysis.

RESULTSA total of 280 patients who received single catheter ablation procedure were included in the study, 3 patients died and there were 50 patients lost to follow-up. A total of 227 patients with AF (163 paroxysmal and 64 non-paroxysmal ) were enrolled in the final analysis. During a median follow-up of 51 months (41-56 months), 109 patients experienced AF recurrences and the recurrence rate after catheter ablation ( ≥ 3 years) was 48.0% (109/227). Cox multivariate analysis showed that the high CHADS2 score (HR: 1.417, 95%CI 1.194-1.682, P < 0.001) and AF non-termination during ablation (HR: 2.077, 95%CI 1.380-3.126, P = 0.043) were risk factors of AF recurrence. AF recurrence rates in the termination and non-termination group were 41.0% (75/183) and 77.3% (34/44), respectively. In the AF termination group, the recurrence rates and the median recurrence free time in patients with CHADS2 score ≥ 3 were 80.0% (12/15) and 1 year, respectively. In the non-AF termination group, the recurrence rates in patients with CHADS2 score = 0, CHADS2 score = 1-2 and CHADS2 score ≥ 3 were 60.0% (6/10), 77.8% (21/27) and 100% (7/7), respectively; the median recurrence free time of patients with CHADS2 score = 0, CHADS2 score = 1-2 and CHADS2 score ≥ 3 were 30 months, 12 months and 6 months, respectively.

CONCLUSIONSCHADS2 score is a predictor of AF recurrences after catheter ablation. Patients with high CHADS2 score is associated with higher risk of long-term ( ≥ 3 years) AF recurrences.

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Recurrence ; Risk Factors ; Treatment Outcome

Objective To evaluate the application of real-time three-dimensional transesophogeal echocardiography(RT-3D TEE)in percutaneous left atrial appendage closure and its follow-up in patients with non-valvular atrial fibrillation.Methods Fifteen patients including 6 males and 9 females were refractory to percutaneous closure of left atrial appendage.The morphology of the left atrial appendage (LAA)in those patients was evaluated by RT-3D TEE.Combined with two-dimensional transesophogeal echocardiography(2D-TEE),RT-3D TEE was performed during the procedure of LAA occlusion,including the measurement of left atrial appendage,the selection of occluder,the puncture of atrial septal,the delivery and release of occlusive device.Finally,it was also used immediately to evaluate the effect of blocking and complications after the operation.The closure effect and related complication were also evaluated by RT-3D TEE at 3 months and 1 2 months followed up,respectively.Results Fifteen patients were successfully undergone the LAA closure procedures with LAmbre TM device.The dimension of LAA landing zone was (21.60±4.08)mm,the measurement of cardiac angiography(CAG)during the procedure was(20.91 ± 3.93)mm and finally the fixed plate size of LAmbreTMdevice was(26.13±4.69)mm.Correlation between the measurements by RT-3D TEE and selective angiography was significant(r =0.84,P =0.0001). Bland-Altman plot showed that 86.67% of plots were among limits of agreement.The width of the flow jet was <3 mm near the LAA closure device in 2 patients immediately after the procedure.At the 3 months and 1 2 months follow-up,the LAA closures had good morphology,fixed position,and no thrombus formation on the surface.There was still slight flow j et near the closure device in 2 patients at that time. Conclusions RT-3D TEE plays an important role in the procedure of left atrial appendage closure and its follow-up.There is better correlation and consistency between the measurements by RT-3D TEE and CAG.