Diabetic Neuropathies ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Nitric Oxide ; blood ; Phytotherapy

Objective To investigate the diagnosis and treatment procedures of primary colonic malignant lymphoma(PCML). Methods Data of clinical and pathological findings, surgical treatment and prognosis of 12 cases with PCML verified by pathology were retrospectively analyzed, workups of barium clysma,colon-scopic examination and multislice spiral computed tomography(MSCT) were compared to evaluate their role in diagnosis. Results The classic presentation of PCML included abdominal pain, abdominal bulge, bowel obstruction, gastrointestinal bleeding, and serum levels of tumor markers were within the normal ran-ges. Six cases underwent procedure of barium clysma, and anomaly appeared in 2 cases, however, there were no indications of lymphoma, 6 cases underwent colon-scopic examination, anomaly in 3 cases, of which 1 revealed possibility of lymphoma, 10 cases underwent MSCT; 9 cases demonstrated tumor origin by CT scan of which diagnosis was established in 5 cases. All the patients underwent surgery. No incidence of peri-opreative death happened. Non-Hodgkin' s lymphoma was confirmed in all of cases. For all of the cases a T-cell origin was in 1 case and a B-cell origin in other cases. Ten cases were administrated postoperative chem-otherapy. 11 cases were followed up, and the overall 1-year and 3-year survival rates were 81.9% (9/11) and 54.5% (6/11), respectively. Conclusions Typical presentation is still lacking for PCML, workups of barium clysma and colon-seopic examination are little sensitive and specific to make the diagnosis. However, MSCT is useful in diagnosing PCML with its characteristic information as well as clinical findings. Surgical management and postoperative adjuvant-chemotherapy would be likely the optimal therapeutic maneuver of this disease in early period.

OBJECTIVETo study the anti-immune inflammation efficacy and toxicity of Tripterygium wilfordii decoction, in order to provide experimental basis for studies on its "efficacy-toxicity" correlation.

METHODThe delayed hypersensitivity model was established by dinitrofluorobenzene in mice. Different doses of T. wilfordii decoction was administered for 5 consecutive days. The ear swelling inhibition ratio and the toxic action were observed. After the final administration, the biochemical indexes of PGE2, TNF-α, IL-2, ALT, AST, PA, TBA, TBIL in serum were detected, and the visceral indexes of heart, liver, spleen and kidney were measured.

RESULTThe DNFB-induced ear swelling could be notably inhibited by multiple oral administration of T. wilfordii decoction, with the ED50 and its 95% confidence limit of 0.34 (0.21-0.42) g x kg(-1). The contents of PGE2, TNF-α, IL-2 in serum decreased in a dose-dependent manner. The activities of serum AST, ALT, TBA, TBIL and the PA content reduced.

CONCLUSIONT. wilfordii decoction shows a significant anti-immune inflammation efficacy within the dosage range between 0.59 and 2.34 g x kg(-1) in a dose-dependent manner. With a certain hepatotoxicity, high dose (2.34-4.68 g x kg(-1)) of T. wilfordii decoction can cause substantial liver injury, with a dose dependence in liver function index. Therefore, the efficacy and toxicity of T. wilfordii is dose dependent, which provides reference for preventing adverse drug reactions in clinic and developing early-warning schemes and ensure the clinical medication safety of T. wilfordii.

Animals ; Anti-Inflammatory Agents ; administration & dosage ; chemistry ; toxicity ; Drug Dosage Calculations ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; toxicity ; Edema ; drug therapy ; genetics ; immunology ; Humans ; Interleukin-2 ; genetics ; immunology ; Male ; Mice ; Tripterygium ; chemistry ; toxicity ; Tumor Necrosis Factor-alpha ; genetics ; immunology

Objective To study the function and diurnal variation of hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-thyroid(HPT) axis,and the relationship with clinical characteristics of di-urnal rhythm in depressed patients. Methods Forty-nine depressed patients met diagnostic DSM-Ⅳ criteria and thirty-eight normal controls were collected. The plasma levels of cortisol (CORT), adrenocorticotropic hormone (ACTH), T3, T4, thyroid-stimulating hormone (TSH) at 7 am and 7 pm were measured by radioimmunoassay, then the results concemed were compared among the depressed groups with and without diurnal variation and control group by multivariate analysis of variance. Results The plasma level of morning CORT, morning and evening TSH ((365.94±120.78) nmol/L; (6.24±2.47)μIU/ml; (6.68±2.42)μIU/ml; respectively) were respective-ly higher than those of control group((284.91±83.39) nmol/L; (3.82±1.75)μIU/ml;(4.01±1.69)μIU/ ml, P<0.05). The plasma levels of morning and evening T4 were significantly lower than those of control group(P <0.05). The CORT morning-evening difference variable distinguished between depressed and control group (P< 0.001),but no significant differences could be found between the depressed groups with and without diurnal varia-tion. There were no significant differences in the CORT, T3, T4, TSH morning-evening difference variable between various clinical subtypes of depressed patient (unipolar/bipolar; psychotic/nonpsychotic). Conclusion Abnormal CORT morning-evening difference variable was observed in the depressed patients compared with normal controls,and may be used as a special trait mark of depressed group.

Objective To evaluate cerebrospinal fluid adenosine deaminase(CSF-ADA)activity in the diagnosis of tuberculous meningitis(TMB), and to observe its dynamic changes. Methods A total of 160 patients were included and were divided into two groups: 76 cases of TBM and 84 cases of non-TBM.Among the cases of non-TBM, there were 36 cases of bacterial meningitis, 30 cases of viral meningitis and 18 cases of cryptocoocal meningitis. All the patients were measured with their CSF-ADA activity by Enzymecoupled assay(Trinder method)and 47 patients of TBM were measured again after 2 weeks' and 6 weeks'antitubercular therapy. Results were expressed as(-x)± s. Mann-Whitney U test and paired-samples t test were used. Results CSF-ADA activity in TBM group was(12.9 ±6.4)U/L, while that in the non-TBM group was(6.0 ± 4.1)U/L, the difference was of statistical significance(U = 7.860, P ＜ 0.05). With the cutoff value of 9 U/L, the sensitivity and specificity to differentiate TBM from non-TBM was 84.21% and 83. 33%, respectively. CSF-ADA activity decreased in TBM patients after antitubercular treatment.Conclusions CSF-ADA activity can be an effective laboratory marker for early differential diagnosis of TMB with the cut-off value of 9 U/L. Dynamic changes of CSF-ADA activity may be a indicator for the effect of antitubercular treatment.

Objective To explore the effect of toll-like receptor 4 (TLR4), myeloid differentiation protein-2 (MD2), and stromal interaction molecular 1 (STIM1) for regulating human vascular endothelial calcium overload injury and inflammatory reaction induced by bacterial endotoxin (LPS).Methods Human umbilical vein endothelial cells (HUVECs) were cultured in Dulbecco's modification of Eagle's medium (DMEM). ① The levels of TLR4, MD2 and nuclear factor-κB (NF-κB) were detected by reverse transcriotion-polymerase chain reaction (RT-PCR) before and 0.5, 1, 6, 12, 24 hours after LPS stimulation. ② Intracellular calcium peak level was detected by confocal following probe fluo-3 AM loading in HUVEC cells induced with LPS and transfected by psiSTIM or psiTLR. ③ MD2, STIM1 or NF-κB protein level was detected by immunoprecipitation (IP) and immuno-blotting in HUVEC cells which were transfected by TLR4 inhibited expression (psiTLR) for 12 hours and followed by LPS stimulation for 6 hours. ④ HUVEC cells were randomly divided into 6 groups: control group, LPS group, PDTC 0.1 mg/L group, PDTC 1 mg/L group, psiTLR 1 h group and psiTLR 12 h group. Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by enzyme linked immunosorbent assay (ELISA) in supernatant. The mRNA levels of STIM1 and NF-κB were detected by RT-PCR.Results ① The mRNA levels of TLR4, MD2, and NF-κB gradually increased after LPS induction and peaked at 6 hours (2-ΔΔCt: 23.52±2.88, 17.43±3.43, 18.13±2.99, respectively), which were statistically significant before the stimulation with LPS (2-ΔΔCt: 7.02±2.81, 5.19±3.22, 8.11±1.42, allP < 0.05). ② Extracellular calcium influx in LPS group was increased significantly higher than control group (nmol/L: 108.13±22.33 vs. 41.57±13.19, P < 0.01). Extracellular calcium influx in psiSTIM+LPS group (nmol/L: 62.61±14.12 vs. 108.13±22.33,P < 0.05) and psiTLR+LPS group (nmol/L: 50.78±8.05 vs. 109.43±20.21,P < 0.01) were both suppressed as compared with LPS group. While extracellular calcium peak level in psiTLR+psiSTIM+LPS group further decreased (nmol/L: 39.31±6.42 vs. 109.43±20.21,P < 0.01). ③ MD2 protein but not STIM1 or NF-κB can be detected in anti-TLR4 precipitates in control (ctrl-) by immunoprecipitation. MD2 protein level increased in anti-TLR4 precipitates in LPS group (ctrl+) and was suppressed in TLR4 inhibiting group (psiTLR). ④ The levels of TNF-α in PDTC 1mg/L group were significantly lower than those of LPS group (ng/L: 0.60±0.24 vs. 1.77±0.66,P < 0.01). The levels of IL-6 in PDTC 0.1 mg/L, 1 mg/L group and psiTLR 12 h group decreased significantly lower than that of LPS group (ng/L: 232.10±63.54, 134.32±37.23, 284.23±56.14 vs. 510.22±89.23, allP < 0.05). Compared to LPS group, the mRNA levels of NF-κB and STIM1 were obviously inhibited in PDTC1 mg/L group and psiTLR 12 h group [NF-κB mRNA (2-ΔΔCt): 17.22±2.35, 13.24±3.54 vs. 30.16±2.06; STIM1 mRNA (2-ΔΔCt): 12.57±2.43, 12.21±2.46 vs. 25.12±2.02, allP < 0.05]. Conclusions TLR4, MD2, NF-κB signal and SOC calcium channel STIM1 mediate LPS induced-calcium influx and inflammatory mediators level in HUVEC cells. Extracellular calcium overload and inflammatory response by endotoxin induction can be effectively inhibited by down-regulation of TLR4, NF-κB and/or STIM1.

Objective To analyze the risk factors of pulmonary non-tuberculous mycobacterial (NTM) infection in sputum acid-fast bacilli positive and/or mycobacteria culture positive patients.Methods One hundred and sixty-three patients with pulmonary NTM infection were recruited from Jan 2006 to Jun 2011 in Shanghai Pulmonary Hospital and 326 patients with sputum positive pulmonary tuberculosis who were selected by random systemic sampling method in the same period were recruited as control.The data were retrospectively analyzed.The related factors were compared between groups by chi-square test.The risk factors of pulmonary NTM infection were analyzed by binary Logistic regression model.Results There were statistically significant differences of age,history of smoking,chronic obstructive pulmonary disease (COPD),bronchiectasis,thin walled cavities focus,purified protein derivative (PPD) test between patients with pulmonary NTM infection and patients with pulmonary tuberculosis (all P＜0.05).Univariate analysis showed that age [45-60year (OR=2.637,95％CI:1.631-4.264; P＜0.001); ＞60 year (OR=4.194,95％CI:2.581-6,813 ; P＜0.001)],history of smoking [10-20 year (OR=1.842,95％CI:1.0843.070; P=0.024),＞20 year (OR=2.040,95％CI:1.167-3.567; P=0.012)],COPD (OR=2.698,95％CI:1.588-4.583; P＜0.001),bronchiectasis (OR=3.566,95％CI:2.343-5.427;P＜0.001),thin walled cavities focus (OR=2.592,95％CI:1.581-4.250; P＜0.001) and a weak-positive reaction of PPD test (OR=2.389,95％CI:1.276-4.472; P=0.006) were all risk factors of pulmonary NTM infection.Multivariate analysis showed that age＞60 year (OR=3.961,95％CI:2.183-7.189 ; P＜0.001),bronchiectasis (OR =3.880,95 ％ CI:2.342-6.487 ; P＜0.001),thin walled cavities focus (OR=2.898,95％CI:1.567-5.360; P＜0.001),COPD (OR=2.503,95％ CI:1.289-4.857; P=0.007),age45-60 year (OR=2.452,95％CI:1.391 4.325; P=0.002)anda weak-positive reaction of PPD test (OR=2.295,95％CI..1.132-4.652; P=0.021) were independent risk factors of pulmonary NTM infection.Conclusion In sputum acid-fast bacilli positive and/or mycobacteria culture positive patients,age≥ 45 year,COPD,bronchiectasis,thin walled cavities focus and a weak-positive reaction of PPD test are risk factors of pulmonary NTM infection.The clinicians should pay close attention to the results of species identification.

Objective To investigate the histological and biochemical responses associated with periprosthetic osteolysis,including the changes of tumor necrosis factor-?(TNF-?),osteoprotegerin(OPG) and os- teoprotegeria ligand (OPEL) in the interface membrane in rat models so as to understand the mechanisms of these interactions.Methods Twenty-four male SD rats were used in this study.A titanium alloy plug was inserted into each distal femur through the knee joint.Polyethylene particles were injected into the left knee at 2,4,6,8 and 10 weeks after implantation of the plugs.Saline solution was injected into the right knee as the control.The animals were killed 12 weeks after implantation.The distal femur was taken from each knee to make histological sections. The samples were made decalcified and stained with hematoxylin and eosin.The histopathological changes were observed under a light microscope.The concentrations of TNF-?in the membrane were assayed by a ELISA kit and the mRNA expressions of OPG and OPEL extracted from the tissue around the plug were detected by RT-PCR. Results The interface membrane taken from the experimental side was found to contain extensive fibrous tissues which extended deeply into the surrounding hone.TNF-?concentrations in the membrane of the experimental side were higher than in the control membrane.There was a significant decrease of OPG mRNA and a significant increase of OPGL mRNA in the membrane around the plug at the experimental side compared with the control side.Con- clusions Polyethylene particles can induce inflammatory responses around the titanium alloy plug.The increase of OPGL expression and reduction of OPG expression in membrane at the experimental side may be induced by TNF-?. Such changes might contribute to the differentiation of osteoclasts and result in the periprosthetic osteolysis.

Objective To compare the clinical outcomes of in vitro fertilization-embryo transfer(IVF-ET) in polycystic ovary syndrome(PCOS) patients with different body mass index(BMI).MethodsEighty-seven PCOS patients who received IVF-ET were classified into four groups according to BMI: group A,BMI0.05).ConclusionThe doses of gonadotropins are increased in PCOS patients with increasing BMI.The number of usable embryo is significant decreased in PCOS patients with BMI≥25 kg/m2.

Objective To investigate the effects of smad7 on transdifferentiation and collagenⅠsynthesis in advanced glyeosylation end-products(AGE)-stimulated NRK52E cells.Methods NRK52E cells were transferred by pTet-on plasmid system and the cell lines of doxycycline(Dox)-regulated Smad7 expression were selected for the study.Transnuclear location of p-Smad2/3 was examined with immunocytochemistry.The mRNA and protein expressions of Smad7,?-SMA,E-cadherin,collagenⅠwere detected with RT-PCR and Western blot. Results AGE-induced expressions of Smad7 mRNA and protein were further increased in NRK52E cells by the addition of Dox in a dose-dependent manner.Overexpression of Smad7 caused a marked inhibition of p-Smad2/3 transnuclear location at 30 min(68.3% vs 31.2%,P