Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.

AIM: To study the effect of interleukin-1β (IL-1β) on the activity of vacuolar proton pump (V-ATPase) and intracellular pH value in the osteoclasts for exploring the mechanism of IL-1β to promote osteoclastic bone absorption.METHODS: The mature osteoclasts were attained by induction of bone marrow monocytes/macrophages.The osteoclasts were cultured with α-MEM and treated with different concentrations (0.1, 0.3 and 0.5 μg/L) of IL-1β.After cultured for 48 h, the mRNA and protein expression of V-ATPase was detected.The effect of IL-1β on intracellular pH value, activity of V-ATPase and the bone absorption abilities of osteoclasts were examined.RESULTS: The expression level and activity of V-ATPase were significantly increased and the intracellular pH value of the osteoclasts decreased after incubated with IL-1β for 48 h.Under the same culture condition, the bone absorption capacity of the osteoclasts was promoted.The enhanced bone absorption capability of the osteoclasts was accompanied by an increase in the concentration of IL-1β.CONCLUSION: The mechanism of IL-1β participating in pathological bone absorption in the bone and joint inflammatory diseases is that IL-1β increases the expression and activity of V-ATPase, boosts the production and/or transportation of hydrogen ion, leading to increased osteoclastic bone absorption activity, and resulting in bone destruction.

AIM: DNA vaccines expressing protective domain of surface protective antigen A（spaA）of Erysipelothrix rhusiopathiae have been relatively ineffective at generating high-titer, long-lasting, neutralizing antibodies in murine models. METHODS: This paper report using a DNA vaccine expressing a fusion of the spaA protein and various elements, such as a secretion leader sequence from the highly expressed human gene encoding α1-antitrypsin (AAT), a highly soluble and stably folded domain from the rat cartilage oligomerization matrix protein (COMP), and three copies of the complement component, C3d3, to enhance the titers of neutralizing spaＡ-specific antibody. RESULTS: Analysis of titers of the antibody raised in vaccinated mice at different time points indicated that immunizations with the DNA expressing pcDNA3-AAT-COMP-spaAN-3C3d((pcD-ACSC)) had higher titers than pcDNA3-spaA_N(pcD-S) at weeks 4. Furthermore, the immune protective efficacy of the spaA-chimeras was demonstrated by lethal challenge with a virulent homologous strain 1249 against immunized mice. CONCLUSION: These results suggest that using a plasmid vector containing a strong heterologous signal sequence that mediate efficient antigen secretion in vivo and a fused piece of sequence improving antigens solubility, as well as C3d3, genetic adjuvant, could enhance the antibody responses level. This approach might be an efficient way to improve the antibody level of spaA_N DNA vaccination.

Objective To Research the efficacy and side effects of intra-abdominal chemotherapy immune to the abdominal cavity after colorectal cancer liver metastasis and local recurrence.Methods 172 eases of colorectal cancer patients after radical operation were randomly divided into conventional regulation 86 cases of abdominal chemotherapy group(control group) and the immune abdominal chemotherapy group of 86 cases(observation group).The control group received 5-FU1.0,MMC8mg intraperitoneal chemotherapy The observation group at the grass-rcots level to add IL-2 50 million U.Results Observation group effective rate .was 70.9% higher than 55.8% (P ＜0.05) ;the obsenation gionp the three-year survival rate 83.7%,dlsease-free survival rate was 44.2% higher than the 62.8%,22.1% (P＜0.05) ;observation group three-year recurrence rate of 25.6% and 34.9% lower than the rate of liver metastases in the control group of 37.8%,48.9% (P＜0.05) ;two groups of gastrointestinal reaction,ⅠⅡ or degree of bone marrow suppression,liver function mildly abnormal ( elevated alanine amiuotransferase) had no difference.Conclusion For advanced colorectal cancer patients with early immune abdominal chemotherapy,the effective prevention and treatment of abdominal cavity and liver metastasis planting to improve the survival rate,side effects of light,fewer complications,the extension of survival,worthy of clinical application.

Objective To investigate the clinical characteristics, diagnosis and treatment of placenta increta.Methods A retrospective analysis was carried out on 13 admitted cases of placenta increta from 1989～2006. Results Among the 13 cases analysed, 5 cases with a history of Caesarian section had a 0% success rate of treatment with conservative care (0/5), 100% less than that of cases with no history of Caesarian section (8/8), P＜0.05; the success rate of treatment of partial placenta increta with methotrexate with Jia Wei Sheng Hua Tang was 100%. Conclusion Caesarian section is a risk factor of placenta increta, and its prognosis is poor; however, Jia Wei Sheng Hua Tang has proven satisfactory as a supplementary treatment for placenta inereta.

Objective To conduct a meta-analysis to evaluate the outcomes of donation after cardiac death (DCD) compared with donation after brain death (DBD) liver transplantatior.Methods The MELDINE (1950-2011),EMBASE,and Cochrane Library databases were searched.All original single institution studies reporting outcomes of comparing donation after DCD and DBD liver transplantation were considered.A meta-analysis of complication incidence and patients/grafts survival after liver transplantation was conducted.Odds ratios (OR) and 95 ％ confidence intervals (CI) based on random effects models were calculated.Results Thirteen studies,all retrospective cohort studies,involving 5867 DCD and 619 DBD recipients,were included.DCD recipients had a 2.5 times increased odds of biliary complications (95 ％ CI =2.0～3.12),an 11.24 times increased odds of ischemic cholangiopathy (IC) (95 ％ CI =5.58 ～ 22.64 ),and a 2.12 times increased odds of primary nonfunction (PNF).DCD recipients also experienced lower odds of 1-year patient survival (OR =0.78,95 ％ CI=0.59～1.02),83.8 ％,87.2 ％,separately,and 1-year graft survival (OR=0.55,95％ CI=0.45～0.68),72.2 ％ and 82.4 ％,separately.Three-year patient survival was present in 81.5 ％ of DCD vs 78.9 ％ of DBD,which has no significant difference.The 3-year graft survival was lower inDCD than that in DBD (OR =0.73,95 ％ CI =0.56～0.94),69.5 ％ and 73.6％,separately.Conclusion DCD liver transplantation is associated with higher risks of biliary complications.But regarding the comparable general outcomes with DBD transplantation,DCD could be a source of liver.

Objective:To investigate the prognostic value of systemic inflammatory score (SIS) in prognostic assessment of patients with unresectable metastatic colorectal cancer (mCRC).Methods:The clinical data of 130 patients with unresectable mCRC in Affiliated Haikou Hospital of Xiangya Medical College of Central South University from January 2014 to December 2016 were retrospectively analyzed. The relationship between SIS and clinicopathological characteristics of unresectable mCRC patients was also analyzed. The survival analysis was made by using Kaplan-Meier. The risk factors affecting the prognosis of unresectable mCRC patients were analyzed by using Cox regression model to make univariate and multivariate analysis.Results:According to SIS results, patients were divided into 0-score group (40 cases), 1-score group (58 cases), and 2-score group (32 cases). There were no significant differences in different SIS constitution patients stratified by age, gender, primary tumor location, functional status score, tissue type, RAS gene status, number of metastatic organs, peritoneal spread and molecular targeted therapy (all P > 0.05). Kaplan-Meier survival analysis showed that the 5-year overall survival rates of SIS 0-score, 1-score and 2-score group were 37.5%, 19.0%, 6.3%, respectively; and the difference was statistically significant ( χ2 = 3.152, P<0.01). Cox regression survival analysis showed that female, primary tumor location in right side and SIS (scores of 1-2) were independent risk factors for overall survival in patients with unresectable mCRC (all P<0.05). Conclusion:SIS may be an important indicator for prognostic assessment of patients with unresectable mCRC, and patients with high SIS have poor prognosis.

Objective To establish a rapid and accurate analysis method for food-derived ACE inhibitory peptides activity in vitro.Methods Reaction time of ACE and substrate was by measuring the hippuric acid liberated in the ACE reaction mixture at regular intervals;An optimal RP-HPLC method to measure food-derived ACE inhibitory peptides activity in vitro was set up.The hippuric acid from ACE reaction mixture(sea cucumber peptides were regarded as ACE inhibitor) was estimated by Zorbax SB-C_(18) analytical column with acetonitrile and ultrapure water as mobile phase.Results The reaction time of ACE with substrate was determined at sixty minutes;The elution was carried out with the ratio of acetonitrile to ultrapure water was 1:1(0.1%TFA) at a flow rate of 0.4 mL?min~(-1).The ahsorbance of the eluent was monitored at 228 nm,and column temperature was 25℃.The relationship between hippuric acid concentration and peak area exhibited a good linearity in the concentration ranges of 0～200?g?mL~(-1) and 200～800?g?mL~(-1).The RP-HPLC method was further validated by captopril,the oyster hydrolysate and the anchovy hydrolysate.Conclusion The method has been proved to be convenient,accurate and suitable for the analysis of foodderived ACE inhibitory peptides activity in vitro.

Objective To observe the effect of sodium butyrate on the invasion and migration of human salivary gland ade‐noid cystic carcinoma cell line ACC‐2 in vitro and to investigate the underlying mechanisms .Methods The cultured ACC‐2 cells were treated with different concentrations of sodium butyrate for 24 h ,and detected the viability rate of the cells by methyl thiazolyl tetrazolium(MTT) assay ;the drug′s influence on invasion and migration on ACC‐2 were detected by Transwell experiment ,while the protein and mRNA expression of HMGB1 and TLR4 explored by Western‐blot and RT‐PCR assay ;the relationship between TLR4 expression and HMGB1 was investigated .Results Compared with control group ,0 .625 ,1 .250 ,2 .500 ,5 .000 ,10 .000 mmol/L groups of sodium butyrate inhibited the proliferation of ACC‐2 cells(P<0 .05);the influence of sodium butyrate on the in‐vasion of ACC‐2 cells of all groups had no significant difference(P>0 .05);only 2 .500 ,5 .000 and 10 .000 mmol/L groups inhibited ACC‐2 cells migration and down‐regulated the protein and mRNA of HMGB1 and TLR4(P<0 .05) .Correlation analysis showed a positive correlation between the TLR4 protein and HMGB1 protein(r=0 .810 ,P<0 .05) .Conclusion Sodium butyrate could inhib‐it ACC‐2 cells proliferation and high concentration gropes inhibit ACC‐2 cells migration ,while reducing HMGB1 and TLR4 mRNA and protein expression ,suggesting that NaB might inhibite ACC‐2 cells migration through down‐regulated the mRNA and protein expression .

Objective To explore the characteristics of attenuated plaque (AP) in culprit lesions for acute coronary syndrome (ACS) in elderly patients.Methods This study included 166 ACS patients meeting the conditions from Jan.1, 2013 to Sep.31, 2014.Clinical data, vascular lesions determined by coronary angiography and intravenous ultrasound (IVUS)-demonstrated characteristics of culprit plaque, which included presence of AP, maximum attenuation arc, extravascular elastic membrane area, lumen area, plaque area, plaque burden and remodeling index, were recorded.Results Compared with non-elderly group, elderly group had a higher proportion of multiple coronary-artery lesions (50.0％ vs.35.1％, x2=6.525, P =0.038), more attenuation plaques (62.0 ％ vs.45.9％, x2 =4.245, P=0.039), a larger maximum attenuation arc[(142±80)° vs.(115±54)°, t=5.254, P=0.000], larger plaque area[(14.2±3.9)mm2 vs.(12.3 ± 4.1) mm2, t=2.325, P=0.022], more plaque burden [(81.1±14.2)％ vs.(76.4±13.5)％, t=2.025, P=0.042] and higher remodeling index [(1.19±0.17) vs.(1.09±0.13), t=4.245, P=0.031].Conclusions The onset of ACS is more closely related with the unstable plaque in elderly patients, and strengthening the measures for plaque stabilization will be helpful in the prevention and treatment of ACS in the elderly.