ObjectiveTo analyze the association between type 2 diabetics and cerebral infarction and to guide the future clinical practice.MethodsA comparison study was conducted between 68 patients with Type 2 diabetes mellitus complicated with cerebral infarction(DCI) and 76 patients with cerebral infarction but no diabetic cerebral infarction (NDCI) .They were hospitalized during January 2007 and April 2010 and compared for the difference in blood pressure(BP), the cholesterol (TG), the triglyceride (TC), the lipoprotein cholesterol(LDC-C), the ages, the position of infarction, the amount of infarction, the clinical manifestations and the prognosis.ResultsThe patients with DCI had more lacunar infarction(41.2％)and multiple infarctions (33.8％)than those with NDCI(15.8％ and 19.8％) .The difference was statistically significant (P ＜0.01) In the diabetic patients group, compared with the control group, the systolic blood pressure was ([155.8 ±24.0]mm Hg) vs.([138.5 ± 22.0]mm Hg), diastolic blood pressure was ([89.6 ± 15.0]mm Hg)vs.([84.7 ±14.0]mm Hg),the TG([1.6 ± 0.3]mmol/L vs.[1.2 ±0.2]mmol/L),the LDC-C(1.3 ±0.7]mmol/L vs.[2.7 ± 0.3]mmol/L) and the ages(50.6 ± 6.4) years vs.(57.8 ± 6.5)years.These parameters in DCI group patients were significantly higher than that of NDCI group(P ＜0.01) .The DCI patients had a longer hospitalization period ([17.8±5.7]and [14.5±6.3]d,t=1.67,P＜0.05].ConclusionDiabetes is a risk factor of cerebral infarction and of the deterioration of cerebral infarction.Prevention or treatment at a early stage of diabetes and strict control of blood sugar,the blood pressure as well as blood lipids is essential to reduce the occurrence of ischemic infarction and improve the prognosis.

Objective To evaluate the value of the four kinds of diagnostic method in acquired immune deficiency syndrome (AIDS) infection complicating tuberculosis (TB) .Methods 52 cases of human immunodeficiency virus (HIV) infection complica‐ting TB were taken as the observation group and 100 cases of TB without complicating HIV infection were taken as the control group .The two groups were performed the PPD test ,sputum Mycobacterium tuberculosis culture ,tuberculosis antibody and inter‐feron gamma release assay(IGRA) for conducting the diagnosis .Results The positive rate of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody in the control group were significantly higher than those in the observation group ,the differences were statistically significant (P<0 .01);the positive rate of the IGRA in the observation group was obviously higher than that of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody ,the differences had statistical sig‐nificance (P<0 .01) .The negative occurrence rate of the IGRA in the observation group treated by the antiretroviral therapy was obviously higher than the positive rate ,the difference was statistically significant (P<0 .05) .Conclusion The IGRA may be a sen‐sitive method for diagnosing HIV infection complicating TB and the antiretroviral therapy may have a certain impact on the results .

Racemic (±)-F18 (10-chloromethyl-11-demethyl-12-oxo-calanolide A), an analog of nature product (+)-calanolide A, is a new anti-HIV-1 nonnucleoside reverse transcript inhibitor (NNRTI). A successful enantioseparation of (±)-F18 offering (R)-F18 and (S)-F18 was achieved by a chiral stationary phase prepared HPLC. Their absolute configurations were determined by measurement of their electronic circular dichroisms combined with modem quantum-chemical calculations. Further investigation revealed that (R)-F18 and (S)-F18 shared a similar anti-HIV activities, however, (R)-F18 was more potent than (S)-F18 against wild-type virus, K101E mutation and P225H mutation pseudoviruses.
Anti-HIV Agents ; chemistry ; Chromatography, High Pressure Liquid ; HIV-1 ; drug effects ; Pyranocoumarins ; chemistry

OBJECTIVE: To analyze the clinical features of severe acute pancreatitis (SAP) in aged patients, and to explore the measures of its diagnosis and treatment. METHODS: The clinical data of 100 aged patients (55-85 years old) with SAP admitted from January 2003 to December 2005 were reviewed and compared with those of 221 non-aged SAP patients (11-54 years old) admitted at the same period. RESULTS: Totally 112 times of onset occurred in 100 aged patients, and the main causes for senile SAP were biliary diseases and hyperlipemia. Both acute physiology and chronic health evaluation II (APACHE II) and Ranson scores of the aged patients with SAP were higher than those of the control group (P<0.05); while there was no significant difference in Balthazar score between the two groups(P>0.05). The incidences of low serum calcium, low albumin and high aspartate aminotransferase (P<0.05), liver, kidney or brain impairment as well as the mortality were higher in the senile SAP group than those in the control group (P<0.05). CONCLUSIONS: Biliary disease and hyperlipemia are the main causes of senile SAP, which lacks characteristic clinical symptoms and is often associated with multiple complications such as infection and lung, gastrointestinal tract, liver, kidney, and brain impairment. Individualized differential treatment with integrated traditional Chinese and Western medicine based on stage classification is an effective approach.

Objective To investigate the effect of tea polyphenols on global cerebral ischemia reperfusion injury in rats.Method Forty-five pathogen-free male SD rats weighing 180-220 g were randomly divided into 3 groups( n =15 each):sham operation group (group S),cerebral ischemia reperfusion group (group IR) and tea polyphenols group (group TP).Global cerebral ischemia reperfusion injury was establish by four-vessel occlusion method.At 24 h of reperfusion,five rats were chosen and Evan's blue(EB) was injected iv,and then sacrificed and brain was removed for determination of EB content; another five rats were sacrificed and brain was removed for determination of water content; five rats were chosen for Morris water maze test.Result Compared with group S,EB content and water content in brain tissue were increased in groups IR and 'rP,and escape latency was prolonged,frequency of crossing the original platform was reduced in group IR ( P ＜ 0.05 ).Compared with group IR,EB content and water content in brain tissue were decreased,and escape latency was shortened,frequency of crossing the original platform was increased in group Tp ( P ＜ 0.05).Conclusion Tea polyphenols can attenuate global cerebral ischemia reperfusion injury in rats.

ObjectiveTo investigate the effect of acute normovolemic hemodilution (ANH) on the apoptosis in hippocampal cells induced by global cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy 50-60 day old male SD rats weighing 280-320 g were randomly divided into 3 groups ( n =12 each):group sham operation (group S); group global cerebral I/R (group I/R) and group ANH.Global cerebral I/R was produced by 4-vessel technique described by Pulsinelli et al.in groups I/R and ANH.ANH was carried out at 24 h after cauterization of bilateral vertebral arteries,before occlusion of bilateral carotid arteries.Blood was withdrawn from femoral artery until Hct was reduced to 30％ and equal volume of hydroxyethyl starch 130/0.4 sodium chloride was infused into femoral vein simultaneously.Bilateral carotid arteries were blocked for 5 min at 10 min after ANH.The rats were sacrificed at 24 h of reperfusion and their hippocampi were isolated.Apoptosis was detected by flow cytometry.The expression of Apaf-1 mRNA and caspase-3 mRNA was determined by RT-PCR.Results Global cerebral I/R significantly increased apoptosis index and up-regulated Apaf-1 mRNA and caspase-3 mRNA expression in group I/R as compared with group S.ANH significantly attenuated apoptosis and down-regulated Apaf-1 mRNA and caspase-3 mRNA expression in group ANH compared with group I/R.ConclusionANH can reduce hippocampal cell apoptosis induced by cerebral I/R through down-regulation of Apaf-1 and caspase-3 expression in hippocampus.

Objective To investigate the efficacy and safety of ultra-mini percutaneous nephrolithotomy for the treatment of renal or upper ureteral stones.Methods The data of 32 patients diagnosed as renal or upper ureteral stones were retrospectively reviewed,who underwent ultra-mini percutaneous nephrolithotomy from June to October,2015,including 29 kidney stones,3 upper ureteral stones,of which 21 single stone,7 multiple stones,and 4 staghorn stones.There were 8 cases with inferior calyx stones,10 with renal pelvis stones,3 with upper ureteral stones,10 with renal pelvis stones plus inferior calyx stones and 1 with renal pelvis stones plus upper calyx stones.The mean stone size was (20.1 ±7.6) mm (ranging from 10 to 41mm).The mean Hounsfield unit (HU) was (1 125.9 ±225.9) Hu (ranging from 520 to 1 550Hu).In this cohort,13 cases had mild hydronephrosis,2 moderate hydronephrosis,1 severe hydronephrosis while no hydronephrosis identified in the other 16 patients.One case had concomitant kidney and ureter duplication malformation,and 1 case had residual stones after laparoscopic nephrolithotomy.Results All of the patients were treated by single tract UMP.Among them,middle calyceal puncture was performed in 9 cases,and the other 23 cases underwent lower calyceal puncture,including 4 cases of intercostal puncture,and 28 subcostal puncture.The mean operating time was (30.3 ± 15.0) min (ranging from 10 to 90 min).The mean postoperative hospital stay was (1.9 ± 1.0)days (ranging from 1 to 5 days).The mean hemoglobin decrease was(14.6 ±8.4)g/L (ranging from 1 to 46 g/L).No analgesics were used.Peri-operative complication rate was 3.13％ (1/32) with 1 case of collection system perforation.There was no fever,severe bleeding,urinary extravasation,pleural injury,or blood transfusion.The SFR was 93.75％ (30/32) and 96.88％ (31/32) on the first day and the first month after the operation,respectively.Conclusions UMP could be a safe and effective method for the treatment of renal or upper ureteral stones,especially for inferior calyceal stones less than 2cm.It offers high stone clearance rate,minimally invasiveness,quick recovery,short length of hospital stay and improved quality of life.

Objective To explore whether endothelial progenitor cells (EPCs) exerts therapeutic effects on rats with diabetic peripheral neuropathy (DPN).Methods Diabetes was induced by streptozotocin.Male SD rats were divided into normal control group(NC group), diabetic peripheral neuropathy group(DPN group), DPN+saline group(DPN+S group), and DPN+EPCs group.Sciatic nerve motor nerve conduction velocity(MNCV) was measured by a electromyography and trigger potentiometer instrument.Pathological changes were observed under optical microscope and electron microscope.Results Compared with normal control group [(52.91 ± 4.53) m/s], both DPN group and DPN+S group had slower sciatic nerve MNCV [(36.51 ± 6.30 and 25.37 ± 5.48) m/s, P＜0.01].Compared with DPN group, the MNCV of sciatic nerve in DPN + EPCs group had improved significantly [(36.51 ± 6.30 vs 46.20 ± 11.70) m/s, P ＜ 0.01].Sciatic nerve pathological changes, characterized by demyelination and axonal degeneration under light microscope and electron microscope were observed in DPN group, DPN+EPCs group, and DPN+S group.Compared with DPN+S group, the sciatic nerve pathological changes of DPN+EPCs group were alleviated.Conclusion After fed for 12 weeks, diabetic rats could progress to DPN rats.Transplantation of EPCs could improve MNCV, demyelination and axonal degeneration changes of sciatic nerver of the DPN rats.

Objective To evaluate the role of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) in diabetes mellitus-induced reduction of hypoxic postconditioning (HPO)-induced protection of cardiomyocytes and the relationship with glycogen synthase kinase-3β (GSK-3β)-mediated mitochondrial apoptotic pathway.Methods H9c2 cells incubated in high-glucose (30 mmol/L) medium for 24 h were divided into 6 groups (n =5 each) using a random number table:normoxia group (group N),hypoxia-reoxygenation (H/R) group,group HPO,PTEN gene silencing normoxia group (group P-N),PTEN gene silencing H/R group (group P-H/R),and PTEN gene silencing HPO group (group P-HPO).H9c2 cells were exposed to 95％ N2-5％ CO2 for 4 h followed by 2 h reoxygenation with 90％ O2-10％ CO2.HPO was induced by 3 cycles of 5 min reoxygenation followed by 5 min hypoxia before reoxygenation.At the end of reoxygenation,the level of lactate dehydrogenase (LDH) in the supernatant was detected by enzyme-linked immunosorbent assay,the changes in mitochondrial membrane potential (MMP were assessed by JC-1 fluorescence assay,the cell apoptosis was detected by AnnexinV-FITC/PI flow cytometry,and the expression of PTEN and phosphorylated GSK-3β (p-GSK-3β) was determined by Western blot.The JC-1 monomer/polymer ratio and apoptosis rate were calculated.Results Compared with group N,the amount of LDH released,JC-1 monomer/polymer ratio and apoptosis rate were significantly increased,and the expression of PTEN was up-regulated in H/R and HPO groups (P＜0.05).There was no significant difference in the parameters mentioned above between group H/R and group HPO (P＞0.05).Compared with group HPO,the amount of LDH released,JC-1 monomer/polymer ratio and apoptosis rate were significantly decreased,PTEN expression was down-regulated,and the expression of p-GSK-3β was up-regulated in group P-HPO (P＜0.05).Compared with group N,the expression of PTEN was significantly down-regulated,and no significant changes were found in the other parameters mentioned above in group P-N (P＞0.05).Compared with group H/R,the expression of PTEN was significantly down-regulated,and no significant changes were found in the other parameters mentioned above in group P-H/R (P＞0.05).Conclusion PTEN is involved in diabetes mellitus-induced reduction of HPO-induced protection of cardiomyocytes,and the mechanism is associated with PTEN-induced activation of GSK-3β-modulated mitochondrial apoptotic pathway.

Background and purpose: Ovarian lymphoma (OL) is usually misdiagnosed as ovarian cancer with bulk lymph node invasion (OC-BLN), and vice versa. Therefore, to distinguish these two types of disease, we compared their clinical characteristics in this study. Methods: This study retrospectively reviewed 14 OL and 14 OC-BLN patients from Fudan University Shanghai Cancer Center and Shanghai Eighth People's Hospital. The clinical char-acteristics, image and laboratory examination data were compared. Results: There was no significant difference in age, symptom, fever, weight loss and volume of ascitic fluid between the two groups. Comparing with OC-BLN, OL patients have larger tumor in ovaries [(13.04±5.94) cm vs (7.78±6.38) cm, P=0.033], and higher percentage of solid ovarian tumor (85.71% vs 28.5%, P=0.006). Lactate dehydrogenase(LDH)/CA125 was higher in OL (7.66±8.03) than OC-BLN (0.31±0.27, P=0.009). Using LDH/CA125 to diagnose OL, area under the curve (AUC) was 0.952. When the threshold value was set at 1, the sensitivity and specificity was 91.7% and 100%, respectively. Conclusion: OL and OC-BLN are easily to be misdiagnosed. OL has larger and more solid tumor than OC-BLN. LDH/CA125 can help to distinguish these two diseases and guide clinical decision making.