To study the influence of 5?-reductase on the pathogenesis of human benign prostatic hyperplasia (BPH), the activity of this enzyme was measured in mechanically separated stroma and epithelium from 7 normal and 16 hyperplastic prostates. Samples were incubated in the presence of tritium labelled testosterone. The yield of DHT was used to estimate the enzyme activity. The results showed that the specific activity of the enzyme (pmol DHT / mg protein/30 rain) was91.4?18,1 and 28.6?7.4 in stroma (S) and epithelium (E) of BPH, 44.7?8.9 and 23.9?6.8 in S and E of normal prostates respectively. It indicated that the enzyme is predominantly localized in the stroma and is elevated ia BPH, the primary abnormality of BPH is in the stroma and the increase of 5?-reductase may have some contribution to the pathogenesis of BPH.

Dextroscope workstation is an advanced equipment developed in recent years and isused to make virtual reality model.We not only used it in surgical planning of thyroid disease,but also applied it in clinic teaching.Application of Dextroscope virtual reality system can help to improve students'capabilities of clinical thoughts and clinical techniques,stimulate their learning interest,enlarge the knowledge,shorten learning curve and release the conflict in practice.Dextroscope system will push forward the progress of education reform,so it is worth spreading.

A series of adefovir mono-L-amino acid esters, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs with more potent anti-HBV activity and lower nephrotoxicity were designed and synthesized. Adefovir bis (L-amino acid) ester was used as lead compound, according to pathological and pharmacological findings that non-steroidal anti-inflammatory drugs can effectively inhibit the organic anion transporter 1 (hOAT1)-mediated adefovir phosphonic acid pairs of anion transport across tubular basement membrane thereby reducing the nephrotoxicity of adefovir. Flatten design principle was used to introducing non-steroidal anti-inflammatory drugs structural fragments to design and synthesize target adefovir mixture ester prodrugs. HepG2 2.2.15 cell line was used as in vitro anti-HBV activity evaluation model. Five compounds exhibited antiviral activity, and compound 18 showed the most potent anti-HBV activity and relatively high selective index (EC50 3.92 micromol L(-1), SI 9.97). HK-2 cell line was used as in vitro model to evaluate nephrotoxicity. Results suggested the target compounds have lower cytotoxicity than the positive control. Moreover, by analyzing the primary structure and activity relationship of these compounds, it could suggest that mono-L-amino acid ester, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs strategy has significant potential in the acyclic nucleoside phosphonates prodrug design.

Objective To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) using diffusion tensor imaging (DTI) and to analyze its correlations with clinical disability scores.Methods Thirty patients with MS (MS group),28 patients with NMO (NMO group) and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner.DTI indices of cervical spinal cord from all participants were measured,including mean diffusivity (MD) and fractional anisotropy (FA),and the correlations between the DTI metrics and the expanded disability status scale (EDSS) scores were assessed.One-way ANOVA,Dunnett-t test and Spearman correlation analysis were used for statistics.Results (1) The values of MD among three groups were different at C3 level for left lateral and dorsal columns,C4 level for the central gray substance and dorsal columns,and C5-C6 level for all structures.There were significant differences among them (F =4.006-36.814,P ＜ 0.05).The values of FA were significantly different at all levels (F =5.561-98.128,P ＜0.05).(2) Compared with the control group,the values of MD were increased and FA were decreased for both MS and NMO groups,there were significant differences among them (t =-0.320-3.138,P ＜0.05).In MS and NMO groups,there were no significant differences of MD (t =-1.183-0.069,P ＞0.05),while the FA at C4-C6 levels (including the central gray substance,dorsal columns,right lateral columns and left lateral columns) for NMO group were 0.57 ± 0.09,0.56 ± 0.11,0.54 ±0.10,0.57±0.09,0.55 ±0.11,0.52 ±0.13,0.55 ±0.11,0.54 ±0.13,0.54±0.10,0.54±0.11,0.53 ±0.13,0.52 ±0.11 ;and for MS group were 0.67 ±0.10,0.68 ±0.10,0.68 ±0.10,0.70 ±0.12,0.68 ±0.11,0.69±0.10,0.68 ±0.11,0.69 ±0.12,0.67 ±0.14,0.68 ±0.15,0.69 ±0.14,0.69 ±0.16,and there were significant differences between two groups (t =-0.011-0.169,P ＜ 0.05).(3)Univariate correlations between DTI measures and the average EDSS scores were assessed.The MD at all levels showed significant positive correlations with disability scores (r =0.324-0.541,P ＜ 0.05),and FA significant negative correlated with disability scores (r =-0.632--0.294,P ＜ 0.05),except C4 level for lateral columns and C2 level.Conclusions DTI metrics are sensitive to cervical spinal cord damage in demyelinating diseases,providing an important way of distinguishing MS from NMO,and can be potentially useful quantitative biomarkers for monitoring the evolution of demyelinating diseases.

ObjectiveTo investigate the variation of thalamus metabolism in patients with multiple sclerosis (MS) or neuronmyelitis optica (NMO) using 1H-MRS.Methods1H-MRS was performed to 32 MS patients (MS group),28 NMO patients (NMO group) and 35 healthy volunteers (normal control group).The ratios of metabolism in thalamus,including N-acetylaspartic acid/creatine (NAA/Cr),choline/creatine (Cho/Cr) and myo-inositol/creatine (mI/Cr) were calculated and compared.ResultsThere was statistical difference of NAA/Cr in thalamus among the three groups (P＜0.05).NAA/Cr in thalamus of MS group was significantly lower than that of normal control group (t= -3.45,P＜0.05),while no statistical difference of Cho/Cr and mI/Cr was found (t=0.086,0.661,all P＞0.05).No statistical difference of NAA/Cr,Cho/Cr or ml/Cr was found between NMO group and normal control group (t=-0.792,1.408,1.735,all P＞0.05).Conclusion1H-MRS shows the decrease of thalamus NAA/Cr that suggesting axon damage in MS patients,but in NMO patients no same result is found.1 H-MRS can reflect the pathological changes of MS and NMO,and improve the differential diagnosis of the two diseases.

Objective To investigate the relationship between expression of surfactant protein B (SP-B) gene product and neonatal respiratory distress syndrome (NRDS) in Han ethnic group.Methods Unrelated 20 cases with NRDS of Han ethnic group were selected as NRDS group while unrelated 20 cases of Han ethnic group with other diseases were selected as a control. The cases in the control group had congenital heart disease or bronchopulmonary dysplasia or persistent pulmonary artery hypertension. Blood sample was taken from each case. Lung tissues were taken from the patients in half an hour after their death in the two groups. Expression of SP-B in the lung tissues was determined with immunohistochemical technique. Genetic deficiency variant of SP-B intron Ⅳ was screened with polymerase chain reaction (PCR).Results Two cases at gestational age of 26 weeks, one at 34 weeks and two at 42 weeks in the NRDS groups had lower expression level of SP-B in the lung tissues than those at the same age in the the control group. Expression of SP-B in the lung tissues of the control group increased with gestational age, but no such phenomenon was found in NRDS group. Further two cases at gestational age 42 weeks of NRDS group had genetic deficiency variant of SP-B intron Ⅳ with gene analysis of five cases who had lower expression of SP-B. Clinical data suggest that patients at 42 weeks of gestational age had severe illness.Conclusion Decrease of SP-B expression may be involved in occurrence of NRDS, genetic deficiency variant of SP-B intron Ⅳ exists in NRDS cases of Han ethnic group of China.

IgG4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition of autoimmune etiology in recent twenty years, mainly manifesting as mass-forming lesions in single or multiple organs. In the past, it was often missed or misdiagnosed as inflammation or tumor. Patients may die from multiple organ failure due to end-stage fibrosis if they are not treated promptly. However, the number of clinically confirmed cases has gradually increased with the improvement of diagnostic level in recent years, and these patients have benefited greatly after receiving early treatment. Although patients generally respond well to traditional immunosuppressors including glucocorticoids and disease-modifying anti-rheumatic drugs, refractory and recurrent cases, even patients with glucocorticoid contraindication are common. Important mechanistic insights have been derived from studies of B-cell depletion therapy, but greater awareness of the pathophysiology of IgG4-RD is still badly needed to identify novel therapeutic targets. In this article, we reviewed the pathogenesis progress and promising therapy of IgG4-RD to seek better clinical management of IgG4-RD.

INTRODUCTIONIt is challenging for dialysis patients to maintain adherence to their medical regimen, and symptoms of depression are prevalent among them. Limited data is available about adherence and depression among patients receiving peritoneal dialysis (PD). This study aimed to examine the rates of treatment non-adherence and depression in PD patients.

METHODSA total of 20 PD patients (response rate 71.4%; mean age 64.4 ± 11.6 years) were assessed using the Beliefs about Medicines Questionnaire, Self Efficacy for Managing Chronic Disease Scale, Hospital Anxiety and Depression Scale (HAD) and Kidney Disease Quality of Life-Short Form. A self-reported adherence (PD exchanges, medication and diet) scale developed for the study was also included. Medical information (e.g. most recent biochemistry results) was obtained from chart review.

RESULTSThe mean self-reported scores indicated an overall high level of adherence, although a significant proportion of patients were non-adherent. Among the latter, 20% of patients were non-adherent to medication and 26% to diet due to forgetfulness, while 15% and 26% of patients admitted to deliberate non-adherence to medication and diet, respectively. Treatment modality, employment, self-care status and self-efficacy were associated with overall adherence. Using a cutoff point of 8 for HAD depression and anxiety subscales, 40% of patients were found to be depressed and 30% had symptoms of anxiety.

CONCLUSIONThis is the first study to document treatment adherence and depression among PD patients in Singapore. Findings of high prevalence of depression and anxiety, and reports of poor adherence warrant development of intervention programmes.

Aged ; Anxiety ; complications ; Cohort Studies ; Cross-Sectional Studies ; Depression ; complications ; Female ; Humans ; Kidney Failure, Chronic ; complications ; therapy ; Male ; Medical Records ; Middle Aged ; Patient Compliance ; Peritoneal Dialysis ; methods ; Prevalence ; Surveys and Questionnaires

OBJECTIVETo investigate the inhibition effect of curcumin on the proliferation of the human esophageal carcinoma cell line Ec109 and its impact on PEN/PI3K/Akt signaling pathway.

METHODSEsophageal carcinoma Ec109 cells were cultured in vitro conventionally and were treated with curcumin at different concentrations. The cell proliferation level was examined by MIT colorimetry, the ultrastructure of curcumin-treated Ec109 cells were detected with transmission electron microscope (TEM) and cell apoptosis was observed by FCM with AnnexinV-FITC/PI double staining. The protein levels of PTEN, Akt, GSK3P and Caspase 3 of curcumin-treated Ec109 cells were detected by Western blot.

RESULTSMTT test showed that curcumin could inhibit the proliferation of Ec109 cells in a time and concentration-dependent manner. TEM examination indicated that curcumin could induce Ec109 cell apoptosis. FCM detection showed that Ec109 cell apoptotic rate increased significantly with the increase of drug concentration. On the other hand, curcumin could promote the expression of PTEN, GSK3beta and Caspase 3 yet reduce the expression of Akt.

CONCLUSIONCurcumin could obviously up-regulate the expression of PTEN, GSK3beta and Caspase 3, surpress PI3K/Akt signaling pathway and hence inhibit the proliferation of Ec109 cells.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Curcumin ; pharmacology ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Oncogene Protein v-akt ; metabolism ; PTEN Phosphohydrolase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Signal Transduction ; drug effects

Objective To investigate the effect of multidisciplinary diagnosis and treatment including ex-utero intrapartum treatment (EXIT) procedure to improve the prenatal survival rate of fetus with neck mass.Methods Multidisciplinary diagnosis and treatment model were carried out in four pregnancy women with fetal neck mass from September 2007 to February 2010.The model included prenatal assessment and monitoring,EXIT procedure during cesarean section,neonatal reassessment and surgical treatment by the cooperation of obstetricians,neonatologists,children surgeons,sonographers and anesthetists.Results All patients underwent cesarean section after 37gestational weeks.Mean delivery time was 37+4 weeks (37-38+3 weeks); mean birth weight was 2972 g (2600-3250 g); mean operation time was 4 min (2-7 min).The gestational age of primary diagnosis of fetal neck mass was 24-34 gestational weeks.After delivery,the size of neck mass was from 3.0 cm × 2.0 cm × 1.0 cm to 6.2 cm× 5.8 cm × 6.8 cm.The tracheal compression and displacement were found by color doppler ultrasound scan and magnetic resonance imaging in all cases.Two of them were completed with polyhydramnios and the others with normal volume of amniotic fluid.EXIT procedure was successfully carried out during cesarean section.Neonatal reassessment showed the trachea of three infants were obviously compressed and lapsed by enhanced CT; the infants relied on mechanical ventilation after birth and underwent operation on day 6 to 8.Tracheal impression was not presented in one infant and trachea cannula was removed on the second day,operation was not performed.All of those infants had good outcomes.Conclusions The multidisciplinary diagnosis and treatment model,including EXIT procedure,is a safe,efficient and feasible strategy,which is necessary for fetus with neck mass.