Objective To study the clinical efficacy and safety of leflunomide combined with irbesartan in the treatment of lupus nephritis . Methods 80 cases of patients with lupus nephritis in Yueqing Hospital Affiliated to Wenzhou Medical University from May 2014 to May 2016 were selected and randomly divided into leflunomide group ( leflunomide combined with irbesartan group ) and cyclophosphamide group ( cyclophosphamide combined with irbesartan group),40 cases in each group.The urine indexes and blood indexes levels,clinical curative effect,adverse reaction of the two groups were statistically analyzed.Results The 24h urine protein,urine beta 2-MG,urine red blood cell count,blood beta beta2-MG,ESR,Cr levels of the leflunomide group were significantly lower (P<0.05),the serum albumin,C3 levels were significantly higher (P<0.05),the total treatment efficiency 97.5%was significantly higher than the cyclophosphamide group 82.5%(P<0.05),the incidence of adverse reactions 5.0%was significantly lower than the cyclophosphamide group 22.5%(P<0.05).Conclusion Leflunomide combined with irbesartan is safe and effective in the treatment of lupus nephritis.

Cardiovascular Diseases ; therapy ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Objective TNF-related apoptosis-inducing ligand(TRAIL)was a new member of TNF family.It could quickly inactivate tumor cell originated from different tissues but no effects on normal tissue in vitro.Osteosarcoma was the most common primary malignant bone tumor with the survival rate of 5years no more than20%after simple surgical management.The induced apoptosis and selective cytotoxicity of human soluble TRAIL for MG -63cell line were investigated in order to explore the feasibility of sTRAIL in clinical treatment of osteosarcoma.Methods sTRAIL-mediated cytotoxicity by MTT assay in MG-63osteosarcoma cell line,MRC-5human diploid lung cell line and L-02fetus hepar cell line were assessed,apoptotic cellular morphological transformation by phase contrast microscope and electron micro-scope was observed.The expression of TRAIL receptors mRNA in the cell lines was examined by RT -PCR.The apoptotic rates of MG-63cell line were shown by flow cytometry.Moreover,the apoptosis of MG-63cell line induced by sTRAIL was confirmed by terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL).Results MG-63,MRC-5and L-02cell lines were treated for 24hours with dif ferent concentrations of sTRAIL and the inhibitive rates of sTRAIL were evaluated with MTT assay,the in hibitive rates of 500ng /ml,1?g /ml ,2?g /ml and5?g /ml TRAIL inducing MG-63osteosarcoma cell line were10.1%,24.3%,50.6%and more than95%respectively.By flow cytometry,an obvious apoptosis peak ahead the diploid peak was obtained when MG-63cell line incubating with2?g/ml TRAIL for 6hours,howev er,the consequences of MRC-5and L-02cell line were non-differentiated.Therefore,MG-63cell line was significantly sensitive to sTRAIL-mediated apoptosis,but MRC-5and L-02cell line were resistant to sTRAIL-induced cell death.Under phase contrast microscope,when MG-63cell line were treated by sTRAIL,some cells began to became small and round in3to8hours.In24hours a large number of cells exfoliated and drifted in culture medium.Moreover,karyopyknosis and crescent aggregation of chro-matin were observed by electron microscope.By RT-PCR,the expression of TRAIL-R1,R2and R3but not R4mRNA on MG -63and MRC -5cell line were observed,and there were the expression of TRAIL-R1,R2,R3and R4mRNA on L-02cell line.In TUNEL assay,the nucleus of the apoptotic cells became brown or yellow.Conclusion TRAIL is able quickly to kill MG-63osteosarcoma cell line in vit-ro.Fur thermore,TRAIL is non significant cy-totoxic for normal tissue.TRAIL or TRAIL com bined with chemotherapy and radiotherapy is a potential and valuable proposal for clinical treatment of osteosarcoma.

Objective To investigate the effects of thiopentone and propofol on cerebral ischemia-reperfusion injury during open heart surgery under deep hypothermia circulatory arrest in infants and young children. Methods Twenty patients with VSD and pulmonary hypertension (13 male, 7 female), aged 3-23 months and weighing 4-11 kg were randomly divided into three groups: in group A thiopentone 5mg.kg was added in CPB machine when body temperature was reduced to 30℃ (n = 7); in group B propofol 2 mg.kg-1 was added ( n =8) and group C served as control ( n - 5). When rectal temperature was reduced to 20℃, CPB was stopped and intracardiac manipulation was started. Anesthesia was induced with midazolarn 0. 2mg.kg -1, fentanyl 20 ?g.kg1 and vecuronium 0. 1mg.kg1 . After tracheal intubation the patients were mechanically ventilated and anesthesia was maintained with O2-N2O-isoflurane and intermittent boluses of fentanyl and vecuronium infusion (70?g.kg-1.h1). Radial artery was cannulated and internal jugular vein (IJV) was retrogradely cannulated until bulb, and blood samples were taken simultaneously from artery and IJV before CPB (T1 ), during circulatory arrest (T2 ) at the beginning of reperfusion ( T3 ) and 24h after operation ( T4 ) for blood gas analysis and determination of plasma concentration of lactic acid (LA), creatine kinase-BB (CKBB) activity and neuron-specific endase (NSE). Cerebral arterial-venous O2 content difference (Ca-vO2) and cerebral O2 extraction ratio (CO2ER) were calculated. Results Plasma concentration of lactic acid was increased at T3 in all three groups and was the highest in group A. Cerebral O2 metabolism decreased at T2 in all three groups and was the lowest in group B and resumed at T4 CKBB activity was increased at T3 and NSE level was increased at T3 and T4 in all 3 groups. The increase in CKBB activity and NSE level was slightest in group B. Conclusion Propofol can protect brain from ischemia-reperfusion injury in infants and young children during open heart surgery under deep hypothermic circulatory arrest.

Background Flickering light is different from the normal light environment.Animal experiment proved that flickering light can induce myopia.But its mechanism remains unclear.Objective This study was to investigate the expression of c-fos gene in retina of myopic C57BL/6J mice induced by flickering light and monocular form deprivation.Methods Ninety clean C57BL/6J mice aged 28-day-old with the similar refraction in both eyes were randomly assigned to five groups.Fifteen mice in the control group were exposed to continuous white light environment.The white flickering light with the frequency of 10,5,2 Hz were used to irradiate the mice respectively in high frequency flickering group (15 mice),moderate frequency flickering group (15 mice) and low frequency flickering group (15 mice),respectively.The right eyes of other 30 mice were monocularly occluded with a semitransparent hemispherical thin plastic shell to establish the form deprivation models and then were exposed to white light environment.The diopter and ocular axial length were measured by murine-specific eccentric infrared photorefraction and A-scan ultrasonography before experiment and two weeks after the treatments.At the end of experiment,the mice were sacrificed by neck dislocation.Mice eyes were enucleated and retinal samples were prepared for the detect of c-fos protein and its mRNA by immunohistochemistry,Western blot and reverse transcription polymerase chain reaction (RT-PCR),respectively.Results Immunohistochemistry showed that the expressing rate ofc-fos protein in retina was (68.000±10.368)％,(51.000±6.519)％,(46.000±6.519)％,(31.000±7.416)％ and (25.000 ± 7.071)％ in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group respectively 2 weeks after experiment.The expression rates of c-fos protein in retina in different frequencies of flickering light groups and form deprivation group were significantly lower than that in the control group (t =3.104,4.017,6.490,7.661,all P＜0.05),with the lowest rate in the form deprivation group (P＜0.05).The expression of c-fos detected by Western blot assay exhibited that the relative values of c-fos protein in retina (c-fos/GAPDH) was 0.804±0.050,0.687±0.047,0.667±0.036,0.558±0.036 and 0.532 ±0.056,respectively in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,illustrating significantly lowing in different frequencies of flickering light groups and form deprivation group compared with control group (t =2.961,3.184,6.971,6.276,all P＜0.05),whereas the c-fos in the low frequency group and form deprivation group,c-fos protein was less expressed in comparison with the higher frequency flicking group (P＜0.05).The expression level of c-fos mRNA (c-fos mRNA/GAPDH mRNA) in retina was 0.820±0.056,0.663±0.061,0.627±0.034,0.521±0.041 and 0.474 ±0.045 in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,respectively.These results demonstrated a significant decline in the expression of c-fos mRNA in different frequencies of flickering group and form deprivation group compared with the control group(t=3.262,5.070,7.173,8.305,all P＜0.05),and the inhibition ability of low frequency of flickering group and form deprivation group was much stronger.Conclusions The c-fos gene level in the retina has a negative relationship with the severity of myopia induced by flickering light and form deprivation.

The dissertation review and defense process of medical science degree graduate stu-dents has become a mere formality because of the manner of postgraduates cultivation, cultural factors and objective factors, resulting in poor quality of degree dissertation. This paper deeply analyzed the reasons for the above problems, and proposed five aspects of adjustment through the reviewer choosing, review process, evaluation scale, evaluation content and evaluation opinions to perfect the eval uation system. It also proposed four aspects of adjustment through strengthen the significance, thesis defense, defense supervision content development process and the detalled reply results to perfect defense system.

BACKGROUND:Autologous fat transplantation has been widely used in soft tissue defect repair and cosmetic surgery, and the 1-year transplant survival rate is 20%-80%. Therefore, the establishment of timely and adequate blood supply at early period after transplantation is very important for the survival of transplanted fat tissues.
OBJECTIVE:To observe the proliferation of human adipose-derived mesenchymal stem cel s transfected with vascular endothelial growth factor 165.
METHODS:Human adipose-derived mesenchymal stem cel s were subcultured in vitro. Recombinant adenovirus carrying vascular endothelial growth factor 165 and blank virus were respectively transferred into adipose-derived mesenchymal stem cel s. Cel s cultured normal y served as blank group.
RESULTS AND CONCLUSION:Compared with the control and blank groups, the expressions of vascular endothelial growth factor 165 mRNA and protein were higher in the experimental group (P<0.05). Experimental findings suggest that the recombinant adenovirus carrying vascular endothelial growth factor 165 transferred into adipose-derived mesenchymal stem cel s cannot only maintain the expression of target protein but also obviously promote the proliferation of adipose-derived mesenchymal stem cel s.

Objective To investigate the change of Th22 cells in peripheral blood of patients with Primary sjogren’s syndrome (pSS)and evaluate clinical significance.Methods 37 patients with pSS from January 2014 to November 2015 were enrolled the study as the observation group.Then 37 healthy adults receiving check-up during the same period were selected as con-trol groups in accordance with the proportion of 1∶1.Flow cytometry was performed to evaluate the levels of Th22 cells in peripheral blood,and tenzyme-linked immuno sorbent assay (ELISA)was used to measure the serum IL-22 levels.Pearson analysis was performed to investigate the relationship between Th22 level and serum IL-22 level,C3,C4,anti-SSA,anti-SSB, ANA antibody,EULAR Sjogren's syndrome disease activity index (ESSDAI)score in observation group.Then the levels of Th22 cells and serum IL-22 were compared among different labial gland pathologic stage in patients with pSS.Results The levels of Th22 cells and serum IL-22 in the observation group were (2.53±1.56)%,718.6±176.8 pg/ml respectively,and significantly higher than (1.24±0.51)%,258.9±72.4 pg/ml in control group (P<0.05).Th22 cell level was positively related with the level of serum IL-22,anti-SSA,anti-SSB and ESSDAI score,and negatively related with the content of C3 and C4 (P<0.05).There were no significant differences in the levels of Th22 cells and serum IL-22 different labial gland pathologic stage in patients with pSS (P>0.05).Conclusion The levels of Th22 cells and serum IL-22 significantly in-creased in patients with pSS,and related to other inflammatory indexes and disease activity,so they may participate in the genesis and development of pSS.

Cancer stem cell(CSC)plays a very important role in the genesis、relapse、metastasis and drug resistance of cancer.Traditional chemotherapeutics may kill a large part of malignant cells,but it has little effect on scanty CSC.It is enough for the relic CSC to make cancer relapse and metastasis.Targeted therapy aimed directly at CSC is the only way to cure cancer fundamentally.The specific biologic character of CSC is helpful for studying and developing targeted therapy to CSC.

Acute ischemic stroke caused by posterior circulation occlusion is extremely dangerous, with a mortality rate of more than 90%.In recent years, mechanical thrombectomy had become an important method in the treatment of acute anterior circulation ischemic stroke, but whether it is effective and safe in the treatment of posterior circulation acute ischemic stroke is not clear.In this paper, the safety and effectiveness of intravascular treatment of acute ischemic stroke with posterior circulation occlusion were reviewed.