Objective To assess the value of intra-aortic balloon pump (IABP) support in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 41 patients with AMI complicated by CS receiving emergency PCI with IABP support were retrospectively reviewed, and 47 patients receiving emergency PCI without IABP support at the same time were included as the control group. Left ventricular function was evaluated in the 2 groups at 2 weeks and at 3 months after the operation respectively. The incidence of MACE was compared between the 2 groups at 30 days and also at 3 months after the operation. Results Patients receiving IABP support had greater improvement in left ventricular function at 2-week and 3-month after operation (43.8?8.2% vs 39.4?5.9%, 45.5?6.6 vs 40.6?4.6%, both P

The diagnosis and treatment of prostate cancer are being improved due to the popularized screening of prostate specific antigen. Advanced prostate cancer, in spite of its response to androgen deprivation therapy, may finally develop into castration-resistant prostate cancer (CRPC) and shorten the overall survival of the patients. Many efforts have been made by worldwide researchers for new approaches to the management of CRPC, including new hormonal therapy, cytotoxic chemotherapy, immunotherapy, and bone metastasis-targeted therapy. This paper reviews the emerging agents undergoing clinical evaluation and drugs that have received approval for the treatment of CRPC in order to provide doctors and patients with more treatment options for CRPC and improve the overall survival rate and quality of life of the patients.
Androgen Antagonists ; Bone Neoplasms ; prevention & control ; Humans ; Immunotherapy ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms, Castration-Resistant ; therapy ; Quality of Life

Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; Spinal Cord Injuries ; therapy

To study the regulation of androgen receptor (AR) expression in human prostate cancer LNCaP cells by triptolide (TP) and the possible mechanism, by using qRT-PCR and Western blot, the AR mRNA and protein levels in TP treated LNCaP cells were detected, and the AR protein level in TP and NF-κB inhibitor treated LNCaP cells was also detected; a series of pGL3-AR promoter reporter gene vectors were built using restriction-free cloning method, and the vectors were employed to investigate the effects of TP on the transcriptional activity of AR promoter in LNCaP cells; the upstream proteins which may play regulatory roles were detected using western blot assay. After treated LNCaP cells with TP for 48 h, AR mRNA and protein expressions decreased with increasing TP concentration. The expression of AR target gene PART1 and prostate specific antigen (PSA) was also downregulated by TP treatment; a series of pGL3-AR promoter reporter vectors were constructed and validated by sequencing and luciferase activity; the results of dual luciferase reporter assay showed that TP downregulated AR at the transcriptional level; PI3K/AKT/NF-κB pathway which is associated with AR promoter activity was drowregulated by TP. In conclusion, our results demonstrated that the transcriptional activity of AR in LNCAP cells was downregulated by TP, and PI3K/AKT/NF-κB pathway may be involved in the regulation mechanism.

Objective To investigate miR-146a-Smad4 expression during ultraviolet A(UVA)-induced photoaging of human skin fibroblasts (HSFs), and to evaluate effects of up-regulation of miR-146a expression on its target gene Smad4 and cell photoaging. Methods HSFs were isolated from the prepuce, and subjected to primary culture and maintained up to 10th passage. Then, the HSFs were classified into 4 groups: blank control group receiving no treatment, UVA group irradiated with 10 J/cm2 UVA, miR-146a group transfected with a lentiviral vector expressing miR-146a, UVA+ miR-146a group transfected with the lentiviral vector expressing miR-146a followed by UVA radiation. Real time PCR was performed to measure miR-146a expression in HSFs in the UVA group on day 0, 3, 7 and 14 after UVA radiation.Fluorescence microscopy was carried out to estimate transfection efficiency on day 7 and 14 in the miR-146a group after transfection, and real time PCR was performed to quantify miR-146a expression in these cells. Methyl thiazolyl tetrazolium (MTT)assay was conducted to evaluate proliferative activity of HSFs, real time PCR to quantify mRNA expressions of photoaging-related genes p53, p21 and p16, and Western blot analysis to measure Smad4 protein expression in these cells. Statistical analysis was carried out by using repeated-measures analysis of variance and factorial design analysis of variance. Results Repeated-measures analysis of variance showed that the expression of miR-146a decreased over time in both the UVA group and blank control group(F = 213.840, P < 0.01), and significantly lower in the UVA group than in the blank control group (F = 52.55, P < 0.01), with the difference between the two groups increasing over time. After transfection with the lentiviral vector expressing miR-146a-Smad4, HSFs showed a strong fluorescence intensity of miR-146a. The expression level of miR-146a was significantly higher in the miR-146a group than in the blank control group on day 7 and 14 after transfection(10.31 ± 0.17 vs. 8.33 ± 0.13 on day 7, 9.65 ± 0.19 vs. 7.86 ± 0.11 on day 14, F =42.49, P < 0.01), but insignificantly different between day 7 and 14 in the miR-146a group (P > 0.05). Factorial design analysis of variance showed that UVA radiation had an inhibitory effect on the proliferative activity of HSFs (P < 0.01), which was significantly lower in the UVA group than in the blank control group(P < 0.01), and lower in the UVA + miR-146a group than in the miR-146a group (P < 0.01). The lentivirus-mediated up-regulation of miR-146a expression also affected cellular proliferative activity (P < 0.01), which was significantly higher in the UVA + miR-146a group than in the UVA group(P < 0.01), but insignificantly different between the miR-146a group and blank control group(P > 0.05). Real time PCR and Western blot analysis both revealed that UVA radiation could increase the expressions of p53, p21 and p16 mRNAs as well as Smad4 protein(all P < 0.01). Concretely speaking, the expressions of p53, p21, p16 mRNAs and Smad4 protein were all significantly higher in the UVA group than in the blank control group (all P < 0.01), and higher in the UVA +miR-146a group than in the miR-146a group (all P < 0.01), but significantly lower in the UVA + miR-146a group than in the UVA group (all P < 0.01), and insignificantly different between the blank control group and miR-146a group (all P >0.05). Conclusion The expression of miR-146a is inhibited in UVA-induced photoaged HSFs, and its up-regulation may counteract cell photoaging by suppressing Smad4 expression in, and promoting proliferation of, photoaged HSFs.

?AIM: To discuss the effect of laser exposure on visual acuity and macula.?METHODS: Retrospective and consecutive case series. A retrospective analysis of 11 patients (11 eyes) with laser retinal injury was carried out from January 2014 to June 2015 in Ophthalmology Department of No. 474 Hospital of Chinese PLA. All individuals underwent visual acuity, best corrected visual acuity ( BCVA ) , and spectral-domain optical coherence tomography ( SD-OCT) for macular at first visit, and fundus fluorescein angiography ( FFA ) , visual field, and multifocal electroretinogram ( mf ERG ) were perform if necessary. Symptomatic therapies, supportive therapies and pars plana vitrectomy ( PPV ) were performed depended on the patient’s condition. The patients were followed-up at 1, 3 and 6mo after the first visit, and patients were undertaken visual acuity, BCVA, macular SD-OCT and so on.?RESULTS: Eight patients ( 73%) were under 18 years old and all patients were young males, who were injured by laser pointers when playing. Three patients ( 27%) over 18 years old were injured accidentally at work. Ten (91%) patients’ BCVA were ≤0. 3, while one ( 9%) patient’s BCVA was higher ≥0. 3. Full-thickness macular holes ( the diameter 224-519 μm ) were detected in 10 patients (91%), while sub-foveal RPE changes and IS/OS injury in 1 patient ( 9%) . Macular hole with traction or cystoid edema in 6 eyes (55%) were received PPV, while the other 5 eyes ( 4 eyes with stable macular hole and 1 eyes with RPE injury ) received conservative treatment. Macular hole closed successfully in 1 eye ( 17%) after PPV, while macular hole in the other 5 eyes ( 83%) were stable after PPV of which the cystoid edema faded. The 4 patients with macular hole and 1 patient with RPE injury were stable during follow-up period. However, the BCVA in all patients had no significant improvement at end.?CONCLUSION: Exposure to laser devices could lead to severe macula injury that could reduce central vision, which is permanent.

BACKGROUND: Because of the prevalence of diabetes, the treatment of diabetic foot is still challenging. Even an exactly proved effective and practical method can't be listed except vascular surgery which is not a long-term way for it. Spinal cord stimulation (SCS) is a very promising option in the treatment algorithm of inoperable chronic critical leg ischemia (CLI). DATA SOURCES: We searched Pubmed database with key words or terms such as "spinal cord stimulation", "ischemic pain" and "limb ischemia" appeared in the last five years. RESULTS: The mechanism of SCS is unclear. Two theories have emerged to interpret the benefits of SCS. Pain relief from SCS can be confirmed by a majority of the studies, while limb salvage and other more ambitious improvements have not come to an agreement. The complications of SCS are not fatal, but most of them are lead migration, lead connection failure, and local infection. CONCLUSIONS: SCS is a safe, promising treatment for patients with inoperable CLI. It is effective in pain reduction compared with traditional medical treatment.

Abstract: Objective To investigate the influence of the variation of SARS-CoV-2 on the clinical feature, and to provide early warning signs for the variation of SARS-CoV-2 in clinical work. Methods From Jan 2, 2021 to Jun 30, 2021, a total of 105 COVID-19 patients were included in the study using a case-control method. Nasal swab samples were collected from the study subjects, the viral genes were sequenced, and patients were divided into Delta variant group and non-Delta variant group according to their gene sequences. Clinically relevant data were collected from the two groups, and indicators such as days of hospitalization, age distribution, lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, and IL-10 were compared; subgroup analysis was performed based on the number of days of viral negativity in the study subjects as the basis for grouping, and differences in immunological characteristics were compared, including lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, IL-10, etc. Results The theoretical hospitalization days of Delta variant group were (22.2±8.33) d, which were significantly longer than (17.6±10.50) d of non-Delta variant group (t=2.396, P<0.05). The total lymphocyte count and IL-4 of Delta variant group were (1.22±0.86) ×109/L and (0.80±0.23) ng/mL, which were significantly lower than corresponding (1.91±0.70) ×109/L and (1.59±0.59) ng/mL of non-Delta variant group (t=4.329, 9.072, P<0.05), while IL-10 was (7.16±7.77) ng/mL, which was significantly higher than (4.26±3.91) ng/mL of non-Delta mutation group (t=1.980, P<0.05). Subgroup analysis showed that the total lymphocyte count and IL-4 concentration in Delta variant group were (1.04±0.60) ×109/L and (0.74±0.25) ng/ml, which were significantly lower than corresponding (1.62±0.56) ×109/L and (1.56±0.52) ng/mL in non-Delta variant group, in patients with delayed discharge (P<0.05). Conclutions SARS-CoV-2 variant has an impact on clinical manifestations. The patient's B cell count and IL-10 concentration increased or IL-2 and IL-4 concentration decreased within 12 hours of admission indicated variant virus infection. The decrease of total lymphocyte count, especially T lymphocyte reduction, strongly suggests discharge delay due to viral clearance disorder.

Objective To investigate the effect of calcium antagonist verapamil on the function of rat?- cells and tolbutamide (D860)-induced insulin release.Methods Insulin released from isolated islets were measured in control,verapamil,D860,and verapamil+D860 groups.Furthermore,intravenous glucose tolerance test (IVGTT) was conducted in acute experiments treated with verapamil and D860 respectively to assess?-cell function in rats with the same allocation as in vitro.Another IVGTT was performed in the end of 4 weeks' treatment.The insulin contents in pancreas were assayed and pancreas islets morphology were observed with immunohistochemistry.Results Verapamil could inhibit insulin release from isolated islets.Verapamil group was [(1.244?0.082)ng?ml~(-1)?islet~(-1)]and control group (2.623?0.226) ng?ml~(-1)?islet~(-1)(P0.05).Also,similar results were obtained in normal rats during acute experiments and verapamil reduce the hypoglycemic effect promoted by D860. However,above results were not observed in the end of 4 weeks experiments,and no difference for insulin content and morphological change in islets was found among four groups.Conclusion Treatment of verapamil chronically does not impair islet function and interfere with the hypoglycemic effect of D860 in rats .

Objective To retrospectively assess diagnostic accuracy of magnetic resonance imaging (MRI)in preoperative assessment of local extent of breast ductal carcinoma in situ(DCIS)and DCIS with small invasive foci,compared with the mammography and ultrasonography(US)imagings.Methods Results of MRI,mammography,and US imaging from 17 consecutive women with known breast DCIS and DCIS with invasive foci were analyzed,and then compared with pathologic examination.Results(1) Fourteen lesions showed enhancement on dynamic breast MRI,of which 11 lesions were no-mass-like enhancement.Six of 11 lesions appeared segmental enhancement,and 2 were regional enhancement.Ductal and multiple focal areas enhancement were 1 case respectively.Symmetric diffuse enhancement in bilateral breast was showed in 1 patient.Ductal dilation was visible in ipsilateral breast on pre-contrast MRI in 2 cases,which manifested bloody nipple discharge in clinical examination,and duct enhanced on post- contrast imaging in one of them.Two lesions appeared mass enhancement with irregular shape and homogeneous signal.Linear enhancement surrounding the oval homogeneous mass with smooth margin found in 1 case.(2)Thirteen of 17 patients underwent bilateral mammography.There were various findings in mammograms,including microcalcifications(6 cases),normal mammograms(2 cases),calcifications with other appearance(2 cases),and non-calcification abnormity(3 cases).In 8 lesions with calcifications, 5 were noted higher probability of malignancy calcifications and 3 intermediate concern calcifications. Calcifications distributed clustered(5 cases),regional(2 cases)and diffuse(1 case)shape.(3)Sixteen of 17 patients were performed breast US examination.Eleven lesions,which were correct diagnosed, appeared higher echo spots within irregular lower echo area.One lesion diagnosed benign and 4 were negative on US examination.(4)Regarded the size measured on pathologic examination as golden standard, accordance of lesion extent was 13 of 17 case in MRI,7 of 13 in mammography,and 7 of 16 in US.There were 2 lesions overestimation of extent in MRI,3 in mammography,and 2 in US.Underestimation of extent showed 1 case and 3 cases in mammography and US imaging respectively.The difference was not significant (P = 0.161).Conclusion The MR imaging features of DCIS and DCIS with small invasive loci were characteristic.The combination of MRI and mammography could improve diagnostic accuracy.