Objective To research the effect of letrozole combined with clomiphene on women with polycystic ovary induced infertility and the effect on matrix metalloproteinases-9(MMP-9),vascular endothelial growth factor(VEGF)and hepatocyte growth factor(HGF)levels.Methods 108 patients with polycystic ovary syndrome combined with infertility from February 2013 to August 2015 in our hospitolwere divided into control group and experimental group by lottery,54 cases in each groups,control group treated with clomiphene,the experimental group based on control group treatment with letrozole,the linical curative effect,MMP-9,VEGF and HGF level,sex hormones,insulin resistance index,adverse drug reactions of two groups were compared.Results The number of ovulation,advantage of ovulation number,normal rate of menstruation,ovulation rate and pregnancy ratesofin experimental group was higherthan the control group,the difference was statistically significant(P<0.05).The MMP-9,VEGF and HGF levels of experimental group was lower than the control group,the difference was statistically significant(P<0.05).The sex hormone level of experimental group was better than that of control group(P<0.05).The adverse reactions was no differences between the two groups.Conclusion The efficacy of letrozole combined with clomiphene in treatment of polycystic induced infertility,can inhibits MMP-9,VEGF and HGF expression,and with high safety.

Objective To evaluate the effect of exogenous wild type p53 (wtp53) gene on radiosensitivity of human lung adenoeareinoma cell line under hypoxia. Methods Human lung adenoeareinoma cell line A549 was transfected with adenovirus carrying recombinant exogenous wtp53. Four irradiation groups were studied : normal cell ( Group A), wtp53 transfeeted cell ( Group B ), normal cell under hypoxia (Group C) and wtp53 transfected cell under hypoxia( Group D). Ceils were irradiated with 9 MeV electron beams. Cellular survival fraction was analyzed. Multi-target single-hit model was used to plot the survival curve. D0,Dq ,oxygen enhancement ratio(OER) ,sensitizing enhancement ratio(SER) and other parameters were used to evaluate the effects of wtp53 gene on radiosensitivity of A549. The cell apoptotie rate of each group was examined by flow eytometry. Results OER was 1.75 and O. 81 before and after wtp53 transfeetion. SER was 1.77 in oxic circumstance and 3.84 under hypoxia. The cell apoptotie rate of Group A and B was lower than Group C and D(F=7.92 ,P=0.048) ,with Group A lower than B and Group C lower than D (F=82.50,P=0.001). But Group B and D were similar(t=2.04,P=0. 111). Conclusions Hypoxia can increase the radiation resistance of lung adenoeareinoma cell line .4,549. The wtp53 can promote apoptosis and improve tumor radiosensitivity,especially under hypoxia.

Objective To investigate the potential association between 163A/G and 950T/C polymorphisms of osteoprotegerin(OPG)gene and severe pre-eclampsia.Methods Eighty-five severe preeclamptic patients and 81 normal term pregnant women(as control group)were recruited from the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University during the period from July 2007 to March 2009,and they were all Han population living in Chengdu,China.Genotype and allele frequencies of 163A/G and 950T/C were determined by the PCR-restriction fragment length polymorphism(RFLP)assay.Clinical and biochemical parameters for different alleles between the patients and controls were compared for statistical significance respectively,such as blood pressure,serum creatinine and 24-hour urine protein.Results The observed and expected genotype counts were consistent with Hardy-Weinberg equilibrium.No significant differences were found in the genotype and allele frequencies of 163A/G and 950T/C polymorphisms between the two groups(P ＞ 0.05).However,in the preeclamptic group,serum creatinine was significantly higher in women with the AG + GG genotypes [(76 ±24)μmol/L]compared with AA genotype[(56 ± 18)μmol/L].Reversely,birth weight was lower in the AG + GG genotypes[(2040 ± 721)g]than those in the AA genotype[(2520 ± 810)g],and the P ＜0.05,respectively.In the severe pre-eclampsia,950T/C TT genotype carriers exhibited significantly higher systolic blood pressure[(153 ± 16)mm Hg(1 mm Hg =0.133 kPa)]and 24-hour urine protein [(4.0±2.5)g]compared with TT + TC carriers[(145 ±17)mm Hg,(2.9±1.8)g],respectively,furthermore the P ＜ 0.05.Conclusions In severe pre-eclampsia,carriers with G allele at position 163A/G has more genetic predisposition than A allele carriers,as well as 950T/C T allele carriers compared with C carriers.Taken together,this study suggested that OPG gene polymorphisms might be associated with some clinical parameters of severe pre-eclampsia.

Objective To investigate the relationship between the variation of endothelial progenitor cells (EPC) number and cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients ,and discuss the function of EPC in the progression of CVD in MHD. Methods One hundred and fifteen MHD patients over 18 years whose dialysis vintage was over six months from Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. They were divided into CVD group and non ? CVD group by medical history, electrokardiographie (EKG), cardiac ultrasound, peripheral vascular imaging and cardiovascular imaging. Peripheral blood (5 ml) was collected for detecting EPC number by flow cytometry as CD34/CD133/vascular endothelial growth factor receptor 2 (VEGFR2) cells. The EPC number between CVD group and non?CVD group was compared. The relationship between the decrease of EPC number and CVD risks in MHD patients was analyzed by logistic regression analysis. In a three?year follow?up, the death and new CVD events of the two groups were compared in order to discuss the relationship between EPC number and adverse events. Results Among 115 MHD patients, the average age was 61.57 ± 12.76, male/female was 71/44, the average dialysis vintage was (86.24 ± 56.31) months, the average Kt/V was 1.69 ± 0.29 and average ultrafiltration volume was (2.48 ± 0.90) L. Forty?four patients in 115 (38.3%) were with concurrent CVD. The EPC number in CVD group was significantly lower than that in non CVD group (P=0.015). The CVD group had higher serum phosphate (P=0.013), higher glycosylated hemoglobin (P<0.001), but serum calcium, intact parathyroid hormone (iPTH) and other indicators had no significant difference between two groups. Multiple Logistic regression analysis showed that older age (OR=1.061), history of diabetes (OR=9.796), dialysis vintage (OR=1.015), serum phosphate (OR=3.766), decrease of EPC number (OR=0.909) were the independent impact factors of CVD events in MHD patients. There were 22 patients of the 115 MHD patients had encountered a new CVD event in a three?year follow?up between December 2012 and December 2015, 9 patients from the CVD group and 13 patients from the Non?CVD group, and there was no significant difference between two groups (P=0.776). Nine patients from the CVD group and 7 patients from the Non?CVD group died in the follow?up, and there was no significant difference (P=0.111). Seventy?one MHD patients from the non?CVD group were divided into two groups by the median of EPC number. There were 3 patients in the higher EPC number group encountered CVD events and 10 patients in the lower EPC number group encountered CVD events, which had significant difference (P=0.024). Conclusion The decrease of circulating EPC number may be related with CVD events in MHD patients. Even adjusted by age, sex, diabetes, dialysis vintage and serum phosphate, decreased EPC number is still the independent risk factor of CVD events in MHD patients. The decrease of EPC number in MHD patients may be used to predict the occurrence of cardiovascular events.

Objective To investigate the characteristics of quality of life (QoL) and self-awareness in girls with idiopathic central precocious puberty (ICPP) and the correlation between QoL and the self-awareness.Methods The inventory of subjective life quality (ISLQ) and Children's self-concept scale (PHCSS) were employed to evaluate the level of QoL and self-awareness in 24 ICPP girls with ICPP (ICPP group) and 24 normal control girls (control group),and the correlation analysis between QoL and the self-awareness in the ICPP group was made.Results The score of overall (70.85±14.11 vs 80.21±6.07) and emotion component satisfaction (62.61± 12.91 vs 73.74±5.02),dimensions satisfaction on school life (5.80± 1.44 vs 6.69±0.65),depression experience (6.55± 1.14 vs 7.29±0.45),anxiety experience (5.93± 1.35 vs 6.96±0.82) and physical emotion (6.33±1.17 vs 7.12±0.83) in ICPP group was respectively lower than control group (P＜0.05).There was no difference in cognitive component between control group and ICPP group,as well as for other dimension satisfaction.Moreover,the score in total self-awareness,physical appearance and anxiety in ICPP group was respectively lower than those in control group (P＜0.05).In addition,a positive correlation was found between the subjective QoL and the children self-concept in ICPP group (P＜0.01).Conclusion The girls with ICPP show a lower subjective QoL and self assessment than normal girls.It is important to take care of the psychological feature of the girls with ICPP to improve the self-assessment and overall QoL during the medication.

Objective To determine the relationship between serum soluble Klotho (sKL) level and adverse outcome in maintenance hemodialysis (MHD) patients.Methods One hundred and twenty nine cases of MHD patients were collected prospectively.Serum sKL was detected by ELISA.Abdomen lateral plain was used as a criterion to determine the abdominal aortic calcification.The abdominal aortic calcification score (AAC) was calculated.Cox regression analysis was used to determine the risk factor of cardiovascular death (CVD) in MHD patients.Kaplan-Meier showed the relationship between sKL and CVD in MHD patients.Results There were 27 cases (20.9％) of allcause death and 19 cases (14.7％) of cardiovascular death.The median sKL was 612.6(379.2-816.6) nig/L,and log[iPTH] was an independent factor of sKL concentration.Low sKL had high AAC and CVD death rate.Kaplan-Meier method showed that the all-cause death rate was similar between two groups,and CVD death rate increased significantly in low sKL patients (P=0.036).Cox regression indicated that lower sKL level was associated with high CVD death rate [OR=0.352,95％CI(0.127-0.977),P=0.045].After adjustment for the general condition,biochemical indicators,the relationship still existed [OR=0.331,95％ CI (0.117-0.933),P=0.037].In no or mild vascular calcification patients (AAC ≤4),compared with high sKL patients,low sKL patients had no significant difference rate in all-cause mortality.The CVD mortality was significantly higher in high sKL (P=0.035) compared with low sKL.In severe calcification group (AAC ＞ 4),all-cause death and CVD death rates were similar between different sKL groups (P=0.991 and 0.522,respectively).Conclusions Lower sKL has the high CVD death rate and sKL level decreasing is an independent risk factor for CVD death in MHD patients.The lower sKL concentration in MHD patients with no or mild calcification may predict CVD mortality.This study suggests that sKL levels may be helpful in predicting the outcome of patients with MHD.

The maintenance of the balance between oxygen supply and oxygen consumption is a key measure in preventing acute kidney hypoxic/reoxygenation injury. Morphine can inhibit metabolism and reduce the oxygen consumption. We tried to investigate the protective effects of morphine hypoxic preconditioning on acute kidney hypoxic/reoxygenation injury in rabbit and its influence on expression of caspase-3 protein. Kidney hypoxic and reoxygenation were induced by making the tested rabbits inhale 8% oxygen for three hours firstly, and then putting them in the air to breathe in normal oxygen for another three hours. Morphine hypoxic preconditioning was induced by administering morphine 3 mg/kg, and then hypoxic of 8% oxygen was induced. Caspase-3 protein expression in renal tissue was assessed by immunohistochemical method. In the present study, the expressions of caspase-3 protein were significantly higher in saline-control hypoxic group than in morphine hypoxic preconditioning group ((29.3+/-5.7)% vs. (12.16+1.23)%, P<0.05). These observations suggested that morphine hypoxic preconditioning can protect rabbit against acute kidney hypoxic/reoxygenation injury by decreasing expression of caspase-3 protein.
Animals ; Caspase 3 ; metabolism ; Ischemic Preconditioning ; methods ; Kidney ; blood supply ; metabolism ; Male ; Morphine ; pharmacology ; Rabbits ; Random Allocation ; Reperfusion Injury ; prevention & control ; Superoxide Dismutase ; metabolism

Objective:To investigate the effect of hemoglobin on Shp2 expression in brain tissues and adherens junction in blood brain barrier in rats after cerebral hemorrhage.Methods:Eighty male SD rats were randomly allocated into sham-operated group and groups of cerebral hemorrhage for 6 h, 24 h, 3 d, and 7 d ( n=16). Rat models in the groups of cerebral hemorrhage were established by intracerebral injection of 20 μL of hemoglobin. Six h, 24 h, 3 d, and 7 d after injection, neurological functions were assessed by Longa scale; brain water content and brain organ coefficient in the harvested cerebral tissues were calculated by wet-dry weighting method; Shp2 mRNA expression was analyzed by real-time fluorescence quantification reverse transcription PCR (qRT-PCR); Shp2 positive neurons was detected by immunohistochemistry; the protein expressions of Shp2, α-catenin, β-catenin and vascular endothelial (VE)-cadherin, and phosphorylated (p-) α-catenin, p-β-catenin and p-VE-cadherin were explored by Western blotting. Results:As compared with those in the sham-operated group, Longa scale scores in groups of intracerebral hemorrhage for 6 h, 24 h, 3 d and 7 d were significantly increased ( P<0.05). As compared with the sham-operated group, groups of intracerebral hemorrhage for 24 h, 3 d and 7 d had significantly increased brain water content and brain organ coefficient, statistically reduced Shp2 mRNA expression, statistically samller amount of Shp2 positive neurons, and statistically reduced Shp2 protein expression, and significantly increased protein expressions of p-α-catenin, p-β-catenin and p-VE-cadherin ( P<0.05). Conclusion:Intracerebral injection of hemoglobin can downregulate Shp2 expression and promote phosphorylation of adherens junction proteins, therefore induce the disruption of adherens junction, which might be a critical mechanism of blood-brain barrier disruption and brain edema.

Objective To explore the association of fibroblast growth factor-23 (FGF23) with abdominal aortic calcification(AAC) and adverse outcomes in maintenance hemodialysis patients.Methods One hundred and fourteen cases of MHD patients were collected prospectively.Serum intact FGF23 was detected by ELISA.Abdomen lateral plain was used as a criteria to determine the abdominal aortic calcification and the abdominal aortic calcification score was counted.Logistic regression analysis was used to determine the risk factors of AAC.Kaplan-Meier analysis was applied to compare the survival rate among different groups and COX regression analysis was used to determine the association of FGF23 and mortality in MHD patients.Results Seventy-six patients present abdominal aortic calcification.The median of AACS was 4.0(0.0,11.0).The median level of FGF23 was 7277.4(2535.0,9990.8) pg/ml.The median follow-up duration was 72.0(67.8,72.8) months.During the follow-up,22 patients (19.3％) died of all-cause death and 17 cases (14.9％) died of cardiovascular diseases.Serum FGF23 level was positively correlated with AAC (r=0.285,P=0.002).Logistic regression analysis showed that longer age (OR=1.059,95％CI:1.020-1.100,P=0.003) and dialysis vintage (OR=I.009,95％CI 1.000-1.017,P=0.039),smoking history (OR=3.010,95％CI 1.177-7.696,P=0.021) and higher FGF23 level(OR=2.831,95％CI 1.010-7.937,P=0.048) were independent risk factors of moderate to severe AAC in MHD patients.Kaplan-Meier survival curves showed that the patients with AACS≥ 5 had significantly higher all-cause mortality(P=0.028) and CVD mortality (P=0.035) than those with AACS ＜ 5.However,the Kaplan-Meier analysis showed no significant difference regarding the level of serum FGF23 with the all-cause and CVD mortality.Cox regression demonstrated that FGF23 was not associated with increased mortality risk,neither in crude nor in multivariate adjusted models.Conclusions Abdominal aortic calcification had a high prevalence in MHD patients.The all-cause and CVD mortality was higher in patients with moderate to severe AAC.FGF23 was an independent risk factor of moderate to severe AAC,but it can't yet be a predictor for the allcause and CVD mortality of MHD patients.

A 60-year-old man presented with severe watery diarrhea for 2 months complicated with weight loss and acute kidney injury.He did not respond well to antidiarrheal medicines,empirical antibiotics and dietary exclusion of gluten or even complete bowel rest.The final diagnosis of autoimmune enteropathy (AIE) was made based on histopathologic findings of endoscopic biopsy from duodenal mucosa after excluding neoplastic disease,inflammatory bowel disease,and infectious diarrhea,etc.Chronic diarrhea and oliguria alleviated after the administration of corticosteroids.