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 evaluate the occurrence and management of complications following ultrasound-guided minimally invasive percutaneous nephrolithotomy (MPCNL). MethodsFrom November 2003 to January 2011,2300 cases of ultrasound - guided MPCNL were performed for upper urinary tract stones in our department.Of these cases,renal calculi were found in 1305 cases,upper ureteral calculi in 322,renal and coexisting ureteral stones in 673. Results Among the 2300 cases of MPCNL,a total of 756 (32.9％) patients encountered complications.Of these cases,peel-away sheath placement failure occurred in 184 cases( 8.0％ ),in which six cases needed secondary surgery.Collecting system perforation occurred in 308 cases ( 13.4％ ),fever in 303 cases ( 13.2％ ),including septicemia in 20 cases (0.87％).The 20 septicemia patients received intensive antibiotic treatment and were successfully cured.Thrity-six patients required transfussions due to severe hemorrhaging ( 1.57％ ).Renal vein injury occurred in three cases (0.13％),for which these patients received intensive care therapy to provide haemostasis with a second procedure months later.There was extensive hemorrhage in 16 cases (0.70％) post-MPCNL,super-selective renal artery embolisation was performed in 12 cases and nephrectomy in 1 case.Pleural injury occurred in one case (0.04％) and pleural effusion in two cases (0.09％),all of which were cured with conservative therapy.There were no cases of abdominal organ injury.ConclusionsThe rate of ultrasound guided complications in MPCNL was lower than that of X-ray guided MPCNL in adjacent organ injury,but higher in complications related to the access ( such as:peel-away sheath placement failure,collecting system perforation),parenchymal bleeding and fever.Most complications (i.e.,bleeding,fever) could be managed conservatively or with minimally invasive procedures ( i.e.superselective renal embolisation,antibiotics treatment) when the complications were recognized early.Renal severe hemorrhage in operation,delayed hemorrhage and infection after MPCNL were several of the severe complications that required active prevention and cure measurement.

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.

Aim To observe the effect of methotrexate (MTX) on proliferation, migration and apoptosis of cultured vascular smooth muscle cells (VSMC). Methods Rabbit thoracaortic VSMC were cultured in vitro.VSMC proliferation was evaluated by cell counting and cell cycle analysis. Monolayer cell scrape was used to observe VSMC migration. Apoptosis was observed with flow cytometry, DNA gel electrophoresis and TUNEL stain. Results MTX (25～100 nmol?L -1) inhibited VSMC proliferation in a dose-dependent manner.25 nmol?L -1 and 50 nmol?L -1 MTX increased the percentage of the S phase cells and decreased the percentage of the G 2/M phase cells (P

OBJECTIVETo investigate the action targets of ginseng (GS) and Panax notoginseng (PN), Chinese herbs for benefiting qi and activating blood circulation, on angiogenesis signaling pathway (VEGFR-2-Ras-MAPK) in human umbilical vein endothelial cells (HUVEC).

METHODSTo block the signal pathway by turns, at the first, added the IC50 of VEGFR-2 inhibitor, SU5416, and detected its downstream signaling protein Ras, MAPK expression using Western Blot. Secondly, added the IC50 of the Ras inhibitor, FPP, and detected its downstream signaling protein MAPK expression.

RESULTSCompared with the control group, adding SU5416 made the Ras, MAPK expression significantly decreased (P < 0.05, P < 0.01); and adding FPP made the expression of MAPK significantly decreased (P < 0.01). Compared with the group treated by SU5416 alone, the expression of downstream signaling protein Ras, MAPK were significantly higher in the group treated by SU5416 plus GS and PN (P < 0.05, P < 0.01); same state also found in comparison MAPK expression between groups treated with FPP alone and FPP plus GS and PN (P < 0.05).

CONCLUSIONThe angiogenesis mechanism of GS and PN on HUVEC may be realized by increasing the protein expression of three key signals, VEGFR-2, Ras and MAPK, respectively.

Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Mitogen-Activated Protein Kinase Kinases ; metabolism ; Neovascularization, Physiologic ; drug effects ; Panax ; chemistry ; Panax notoginseng ; chemistry ; Signal Transduction ; drug effects ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism ; ras Proteins ; metabolism