Objective To explore the effect of berberine hydrochloride on serum HIF-1α,Caspase -3 levels in patients with acute cerebral infarction with a multicenter study.Methods 126 patients with acute cerebral infarction from January 2012 to January 2014 were selected in the Affiliated Hospital of Hebei Engineering University,the First Hospital of Handan City,Handan Central Hospital were divided into experimental groups and control group using random number table.Control group had 63 cases,were given 80 mg ozagrel sodium injection intravenously,twice a day,and 800 mg calf blood protein injection intravenously,once per day on the basis of conventional treatment;at the same time,100 mg of oral aspirin tablets were taken,once per night,7 days for a course of treatment.Experimental group were given berberine hydrochloride on the basis of conventional treatment,0.7 g orally,three times a day,7 days for a course of treatment.After a course of treatment,serum HIF-1α,Caspase-3 levels in patients with acute cerebral infarction were observed before and after treatment.Results Serum HIF-1αlevels in two groups were reduced after treatment,and its level in experimental group[(733.49 ±225.01)ng/mL]was lower than that in control group [(975.32 ±311.35)ng/mL],the difference was statistically significant (P<0.05 ).Serum Caspase-3 levels in two groups after treatment were decreased,and its level in experimental group [(1 1.88 ±2.66 )ng/mL]was lower than the control group [(12.51 ±3.77)ng/mL],the difference was statistically significant (P <0.05).Conclusion Berberine hydrochloride could improve the serum HIF-1α,Caspase-3 levels in patients with acute cerebral infarction,reduce the fatality rate,and could be actively used in the recovery of patients with acute cerebral infarction treatment.

Objective To assess the value of contrast enhanced ultrasound (CEUS) in diagnosing subtypes of postpartum placenta accreta.Methods 31 puerperal clinically diagnosed of postpartum placenta accreta were collected.They were inspected by using CEUS and 2-dimensional color Doppler ultrasound,respectively.The operation was used as a reference.Results Both 2-dimensional color Doppler and CEUS could identify the sizes of residual placenta for the patients,but CEUS showed more explicit boundary for placenta and uterus and the rich/poor blood flow areas in the placenta.Among the 31 patients,7,23 and 1 were classified of accreta,increta and percreta,respectively,by using 2-dimensional color Doppler ultrasound,while 11,16 and 4 were classified of accreta,increta and percreta,respectively,by using CEUS based on the myometrial thickness and contrast agent subsided time.With respect to operation,10 patients were confirmed of accrete,with the other diagnosed of increta and percreta.The misclassification rate of 2-dimensional color Doppler ultrasound was 19.6 ％,while CEUS had only 6.5 ％.CEUS had a good agreement with operation (Kappa =0.859,P ＜ 0.001).Conclusions CEUS has higher accuracy in diagnosing subtypes of postpartum placenta accrete compared with 2-dimensional color Doppler ultrasound.CEUS can increase the accuracy and reliability for diagnosing those who were clinically considered of postpartum placenta accrete,and can provide helpful guidelines for clinical treatment.

BACKGROUND:Adult cardiomyocytes show no regenerative ability, and celltherapy for myocardial regeneration and repair may improve myocardial ischemic injury function. OBJECTIVE:To confirm the effect and reveal the mechanism of bone marrow mesenchymal stem cells (BMSCs) on acute myocardial infarction (AMI). METHODS:BMSCs were isolated, cultured from bone marrow of Sprague-Dawley rats using density gradient centrifugation. AMI models were produced in 20 rats by ligating the left anterior descending (LAD) coronary artery, and randomly divided into model group and BMSCs group. In the BMSCs group, cells were subsequently injected with a sterile microinjection via the tail vein. RESULTS AND CONCLUSION:Six months postoperatively, the cardiac function was improved, the vessel density was increased, the percentage of apoptotic cells was decreased in the BMSCs group than that in the model group;the expression levels of inflammatory factors, including vascular endothelial growth factor, von Wil ebrand factor, transforming growth factor 3β, and interleukin-1βmRNA were significantly improved in the BMSCs group than that in the model group. These results showed that BMSCs can protect the myocardium from AMI by regulating the secretion of inflammatory cytokines and angiogenic factors.

To study whether the late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival and proliferation of T cells through the survivin pathway, ICOS signals deficient T-cells were infected with adenovirus carried survivin gene, other T-cells were given ICOS co-stimulatory signals, then infected with adenovirus carried dominant-negative mutant survivin gene. Apoptosis and proliferation were determined by TUNEL and CCK-8 respectively. The results show that engagement of ICOS signal increased the expression level of survivin significantly. Survivin can sustain co-stimulatory deficient T cells survival and suppress the apoptosis. Mutant survivin inhibits ICOS signal positive T cells survival and increase its apoptosis. Late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival of T cells through the survivin pathway.

Objective To establish a gas chromatography ( GC) method for determination of aniline,2-aminophenol and 4-aminophenol in mesalamine sustained release granules. Methods An HP-5 (10 m×0.53 mm,2.65 μm) capillary GC column was adopted. The carrier gas was high purity nitrogen at a flow rate of 15 mL.min-1 . The inlet temperature was controlled at 280 ℃ and the FID detector temperature was 300℃. The oven temperature was initially held at 70℃ for 2 min and was then programmed to 150 ℃ at 10℃.min-1 and held for 6 min. Results A good resolution was obtained between the peaks of the 3 impurities at chromatographic conditions above. The recoveries of aniline, 2-aminophenol and 4-aminophenol were among 98.04% to 103.00%. The precision and linearity equations were good. Conclusion The method can be adopted for the quality control of mesalazine sustained release granules.

Objective To summarize the clinical characteristics,diagnosis and treatment of autoimmune pancreatitis(AIP).Methods The retrospective descriptive study was adopted.The clinical data of 43 patients with AIP who were admitted to the First Affiliated Hospital of China Medical University between January 2010 and December 2014 were collected.All patients underwent laboratory tests and imaging examinations.For the patients who had the definite diagnosis of AIP,corticosteroid therapy was adopted,and for the patients who had the suspicion of pancreatic cancer,surgical operation was carried out.Observed indexes included clinical manifestations,laboratory findings,imaging findings,treatment,pathological findings and follow-up status.The follow-up of imaging examinations and laboratory tests via outpatient and inpatient examinations was performed on the patients until January 2016.Measurement data with skewed distribution were presented as average (range).Results (1) Clinical manifestations:of the 43 patients,33 demonstrated obstructive jaundice,19 had loss of weight,18 had upper abdominal pain and 5 had acute mild pancreatitis (the same patient with a variety of symptoms).Extrapancreatic organ involvement was detected in 23 of the 43 patients,including focal nephritis in 15 patients,sicca syndrome in 7 patients,pulmonary involvement in 5 patients,autoimmune thyroiditis in 5patients,hilar IgG4-associated cholangitis in 3 patients,retroperitoneal fibrosis in 3 patients and ulcerative colitis in 1 patient (the same patient with a variety of diseases).(2) Results of laboratory tests:17 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 15 patients.(3) Imaging findings:all the 43patients underwent enhanced computed tomography (CT) scan of pancreas.Diffused enlargement of pancreas with appearance of sausage was observed in 34 patients and localized pancreatic head enlargement was observed in 9patients.Twenty patients had peripancreatic vascular involvement including stenosis or occlusion of splenic vein,stricture at the confluence of superior mesenteric vein,portal vein and splenic vein resulting in regional portal hypertension which led to gastric venous varices and splenomegaly.Three patients showed that superior mesenteric artery was surrounded by tissue masses with massive ascites.Five patients had pancreatic pseudocyst with splenic vein involvement and peripancreatic effusion.The abdominal CT examination of 15 patients with renal involvement showed renal cortical wedge or nodular lesions.Pulmonary inflammatory pseudotumor and interstitial pneumonia appeared in 5 patients,CT of whom showed solid pulmonary nodules or diffuse ground-glass opacities and patchy shadows in pulmonary interstitium.Thirty-two patients underwent magnetic resonance cholangiopancreatography and 28 patients underwent endoscopic retrograde cholangiopancreatography.The results showed the focal and diffuse or segmental stenosis of the main pancreatic duct were detected in 28 patients (diffuse stenosis in 23patients,local stenosis in 5 patients),stenosis of the intrapancreatic common bile duct in 32 patients,stenosis of hilar bile duct in 3 patients.Nine patients underwent endoscopic ultrasonography examination.The results showed 3 patients had hypoechoic mass in the head of pancreas and 6 patients had diffuse or heterogeneous hypoechoic of the pancreatic parenchyma.(4) Treatment status:of 43 patients,30 patients received initial steroid treatment.After steroid treatment,the clinical symptoms of 27 patients gradually improved and laboratory and imaging findings were both improved.Eleven patients didn 't receive initial steroid treatment,of whom 2 patients with obstructive jaundice underwent endoscopic biliary stent implantation,7 patients underwent surgical biliary drainage and 2 received neither endoscopic treatment nor surgical treatment.Two patients underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma and were diagnosed as AIP based on postoperative pathological results and treated with steroid after operation.(5) Pathological examination:of the 43 patients,22 underwent pathological examination.Results of pathological examination of superficial lymph nodes showed lymph follicles hyperplasia,and immunohistochemistry staining showed massive IgG4 positive plasmocytes in 5 patients,supporting the diagnosis.Results of fine needle aspiration cytology in 15 patients showed no cytological evidence were detected in 14 patients and epithelial cells of malignant tumors in 1 patient.Results of pathological examination of surgical specimens showed dense infiltration of lymphocyte and immunohistochemistry staining showed massive IgG4 positive plasmocytes.(6) Follow-up status:of 43 patients,41 were followed up for an average time of 28 months (range,12-71 months).Of the 30 patients who received steroid treatment,27 had complete response and 3 had partial response.Of the 27 with complete response,4 patients relapsed during followup and were cured by continuous steroid treatment and extending treatment course,3 patients did not relapse,1 patient relapsed again,and long-term low dose steroid maintenance therapy was needed.The 3 patients with partial response were treated with mycophenolate mofetil for 6,4,4 months and imaging abmormalities disappeaved absolutely.Eleven patients received no steroid for the initial treatment,in whom 2 patients were lost to follow-up,1 patient with common bile duct jejunum anastomosis died in 1 year after surgery.In the other 8 patients,the imaging abnormalities were spontaneous remission or clinical and imaging manifestations were improved after steroid treatment and no recurrence was found.Two patients who underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma received steroid treatment after operation and no recurrence was observed.Conclusion Clinicians should combine clinical manifestations,serological examination,imaging findings and pathological examination to make definite diagnosis of AIP and make differential diagnosis of pancreatic cancer to avoid unnecessary surgical treatment by misdiagnosis.

Objective To investigate the correlations between the soluble form of B7-H3 ( sB7-H3) and the cytokines of IL-17 and IL-8 in serum samples from patients with primary hepatocellular carcino-ma ( HCC) and to evaluate their clinical values for early diagnosis of HCC.Methods Serum samples were collected from 63 patients with HCC and 50 healthy subjects.The expression of sB7-H3, IL-17 and IL-8 in serum samples were detected by ELISA.Receiver operating characteristic ( ROC) curve was generated to an-alyze the diagnostic values of sB7-H3, IL-17 and IL-8 for hepatoma.The logistic regression model was used to predict the probability of hepatoma by using sB7-H3, IL-17 and IL-8 in combination.Results The levels of sB7-H3, IL-17 and IL-8 in serum samples collected from the patients with HCC were significantly higher than those from healthy subjects.A positive correlation was found between the levels of sB7-H3 and IL-17 in serum samples from patients with HCC.No correlation was found between sB7-H3 and IL-8.A negative cor-relation was found between the levels of IL-17 and IL-8 in serum samples from patients with HCC.ROC curve analysis showed that the area under the curve (AUC) of sB7-H3, IL-17 and IL-8 were 0.832, 0.657 and 0.953, respectively, indicating the statistical significance of them for the diagnosis of HCC.The logistic regression showed that the AUC, diagnostic sensitivity and specificity of the regression model PRE in the pre-diction of HCC were 0.960, 91.30% and 94.29%, respectively, which was much better than using the three indicators alone.Conclusion The levels of sB7-H3 were positively correlated to the levels of IL-17 in serum samples from patient with HCC.The logistic regression model of combination of sB7-H3, IL-17 and IL-8 obtained in this study could be used for early clinical diagnosis of HCC in the future.

[ Abstract] Objective To investigate the effect of IL-8 on the viability and migration of HepG2 cells and the potential effect of integrins (αsubunits ) on the migration of HepG2 cells.Methods HepG2 cells were stimulated by IL-8 at different concentrations ranging from 0 to 125 ng/ml in vitro.MTT assay was preformed to detect the viability of HepG2 cells.Scratch wound migration assay was used to explore the effect of IL-8 on the migration of HepG2 cells at the time points of 0, 4, 8, 12 and 24 h,respectively.Transwell assay was conducted to detect the vertical migration of HepG2 cells after stimulation with IL-8 for 24 h.The F-actin of HepG2 cells was observed by immunofluorescence analysis after treatment with IL-8 at different concentrations.The expression of αsubunits of integrins in HepG2 cells treated with IL-8 for 8h was detected using Western boltting assays.Results Compared with the control group, HepG2 cells treated with IL-8 showed improved proliferation activities, but there was no significant difference between the groups of HepG2 cells treated with IL-8 at different concentrations.The cell scratch healing assays and Transwell analysis both indicated that IL-8 promoted the migration of HepG2 cells in a dose-dependent manner.Meanwhile, the cytoskeleton of HepG2 cells was rearranged and the number of filopodium-like protrusions (FLPs) was increased rapidly after treatment with IL-8.Western blotting analysis showed that IL-8 up-regulated the expression of αsubunit of integrins and there was a concentration difference betweenαsubunits.Conclusion IL-8 promotes the migration of HepG2 cells by up-regulating the expression ofαsubunits, and different αsubunits may play different roles.

Objective:To investigate the influencing factors of the therapeutic effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in patients with epidermal growth factor receptor (EGFR) mutant advanced non-small cell lung cancer (NSCLC).Methods:The clinical data of 104 EGFR mutant advanced NSCLC patients who received EGFR-TKI treatment in Wuxi No.2 Hospital Affiliated to Nanjing Medical University from January 2015 to October 2019 were collected. The correlation of different types of EGFR mutation with the clinicopathological characteristics, the hematological examination results and the treatment mode of patients was analyzed. Cox proportional hazard model was used to analyze the association of the progression-free survival (PFS) time of patients receiving EGFR-TKI treatment with the different types of EGFR mutation, the clinicopathological characteristics, hematological related indexes and treatment mode. Kaplan-Meier method was used to analyze the independent influencing factors for the PFS of the stratified patients.Results:The overall disease control rate (DCR) of patients receiving EGFR-TKI treatment was 92.3% (96/104). Cox univariate analysis showed that the levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), D-dimer, and previous surgical treatment history of patients receiving EGFR-TKI treatment were associated with PFS of patients (all P < 0.05). Cox multi-factor analysis showed that EGFR mutation type ( HR =2.371, 95% CI 1.298-4.332, P = 0.005), combination therapy ( HR = 0.489, 95% CI 0.245-0.978, P = 0.043) and choice of therapeutic drugs ( HR = 0.261, 95% CI 0.113-0.606, P = 0.002) were independent influencing factors for the PFS of patients receiving EGFR-TKI treatment. The PFS of EGFR 19 exon-mutant patients with advanced NSCLC was longer than that of those with EGFR 21 exon-mutant (median PFS time: 14.0 months vs.9.5 months, P<0.05); the PFS of combination of radiotherapy or chemotherapy was longer than that of EGFR-TKI single therapy (median PFS time: 15.0 months vs. 9.0 months, P<0.05), the PFS of patients receiving erlotinib was better than that of those receiving gefitinib ( P<0.05). According to EGFR mutation types, it was found that EGFR 19 exon-mutant patients receiving EGFR-TKI in first-line treatment could obtain better PFS than those who receiving EGFR-TKI in second-line and above treatment (median PFS time: 14.0 months vs. 9.5 months, P<0.05). When receiving EGFR-TKI, EGFR 19 exon-mutant patients with CA125 <85 U/ml could obtain longer PFS time than those with CA125 ≥85 U/ml (median PFS time: 14.0 months vs. 6.5 months, P<0.05). Conclusions:The therapeutic effect of EGFR-TKI in EGFR-mutant patients with advanced NSCLC is positive. EGFR 19 exon-mutant NSCLC patients with low-level CA125 receiving EGFR-TKI in first-line treatment can obtain better PFS.

Objective To observe the expression level of inhibitor of differentiation 2 (Id‐2) and matrix metalloproteinases‐9 (MMP‐9) in rectal cancer ,analysis the correlation of the expression level of them ,to study the relationship between the expression level of them and the clinical pathology indicators of rectal cancer .Methods Rectal cancer tissues and normal tissue adjacent to rec‐tal cancer were obtained from the rectal cancer resection of 56 patients with rectal cancer ,using immunohistochemical method to ob‐serve the expression level of Id‐2 and MMP‐9 in normal tissue adjacent to rectal cancer and rectal cancer and Spearman correlation test to detect the correlation between the expression level of Id‐2 and MMP‐9 ;then we analyzed the relationships between the ex‐pression level of Id‐2 and MMP‐9 and the index of rectal cancer clinical pathology .Results The positive expression rate of Id‐2 in the in rectal cancer tissues is more higher than that of normal tissue of adjacent to rectal cancer (73 .21% vs .48 .21% ,P<0 .05) . The positive expression rate of MMP‐9 in the in rectal cancer tissues is higher than that of normal tissue of adjacent to rectal cancer (71 .43% vs .44 .64% ,P<0 .05) .Spearman correlation test showed that there is the positive correlation between the expression level of Id‐2 and MMP‐9 (r=0 .393 ,P=0 .003) .The expression levels of Id‐2 and MMP‐9 in rectal cancer were correlated with the degree of tumor differentiation ,TNM stage and lymph node metastasis (P<0 .05) ,but had no differences between the elements of age and sex (P>0 .05) .Conclusion There is a close relationship between the expression levels of Id‐2 and MMP‐9 in rectal cancer and the occurrence and development of rectal cancer .Rectal cancer with the higher Id‐2 expression level may be the ways to achieve tumor invasion and metastasis through MMP‐9 as a facilitator .