Objective To investigate the expression level of human telomerase RNA component (hTERC) and C-myc in cervical lesions.Methods Fluorescence in situ hybridization (FISH) was applied to detect hTERC and C-myc expression in 62 cases of cervical tissue including 35 cases of cervical intraepithelial neoplasia,8 cases of invasive cervical cancer,19 cases of inflammation as controls.Results The positive rates of hTERC on chromosome 3 in chronic cervicitis organizations,CIN Ⅰ,CIN Ⅱ-Ⅲ and cervical cancer were 5.3 ％ (1/19),16.7 ％(2/12),87.0 ％ (20/23),87.5 ％ (7/8) (x2 =36.299,x2 =40.237,P ＜0.01).The positive rates of C-myc in chronic cervical inflammation organization,CIN Ⅰ,CIN Ⅱ-Ⅲ and cervical cancer were 5.3 ％ (1/19),8.3 ％ (1/12),78.3 ％ (18/23),62.5 ％ (5/8) (x2 =30.200,x2 =34.224,P ＜0.01 ).The differences among groups were statistically significant.hTERC had a positively correlation with C-myc expression (r =0.514,P ＜ 0.01).Conclusion The expression of hTERC and C-myc on chromosome 3 is closely related to cervical cancer progression.

In this study, 116 subjects with impaired glucose tolerance were followed up for 3 years. The results showed that the incidences from diabetes and coronary heart disease in acarbose treatment group were less than those in the control group.

Objective:To analyze the expression of the four mismatch repair genes protein (hMLH1,hMSH2,hMSH6 and hPMS2) of patients with colorectal cancer and its clinical significance.Methods:177 cases of patients with colorectal caner in the Third Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2015 were randomly selected.Tested the expression of the hMLH1,hMSH2,hMSH6 and hPMS2 by immunohistochemistry,the relationship between protein expression and clinical parameters was analyzed.Results:Among 177 cases ofcolorectal cancer tissue,the deletion rate ofhMLH1 protein was 6.2％ (11/177),the deletion rate of hMLH2 protein was 4.0％(7/177),the deletion rate of hMSH6 protein was 1.7％(3/177),the deletion rate of hPMS2 protein was 8.0％(14/177),the sum of the four values accounted for 19.8％(35/177) of all cases of colorectal cancer.The loss of expression of the four mismatch repair genes protein were correlated to tumor location (P＜0.05),besides,the loss of expression of the hMLH1 and hPMS2 protein were correlated to degree of tumor differentiation (P＜0.05),he loss of expression of the hMSH6 protein were correlated to depth of tumor invasion(P＜0.05);But the loss was not correlated to age,sexes,lymph node metastasis and distant metastasis(P＞0.05).Conclusion:The expression of loss phenomenon with mismatch repair protein appears in part of colorectal cancer,the loss phenomenon with mis match repair protein were correlated to tumor location and degree of tumor differentiation.Mutations of four genes in hMLH1,hPMS2,hMSH6 and bMSH2,to provide a reference value for the clinical judgment of prognosis and to develop a treatment plan.

BACKGROUND:Studies have shown that bone marrow mesenchymal stem cells have the ability to persistently generate hepatocytes and biliary cells, and thus in the repair process of liver injury, replenish the reduced number of hepatocytes due to damage and participate in damaged liver structure.
OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cells transplantation on acute liver failure and the expression of CD163 and interleukin-10 in rat serum and liver tissue.
METHODS:D-galactose and lipopolysaccharidewere used to make acute liver failure models in 60 Sprague-Dawley rats. Then, the rats were divided into control group and transplantation group. Bone marrow mesenchymal stem cells at passage 3 were injected through tail vein in the transplantation group, and normal saline was injected in the control group. After transplantation 24, 120, 168 hours, serum samples and liver tissues were col ected.
RESULTS AND CONCLUSION:After transplantation 120 and 168 hours, the serum alanine transaminase and aspartate aminotransferase activities of the transplantation were significantly lower than those of the control group (P<0.05). In the transplantation group the apoptotic index was stil lower compared with the control group, and the difference was significant (P<0.05). The levels of CD163 and interleukin-10 in the serum and liver tissue in the transplantation group were decreased significantly compared with the control group (P<0.05). The results suggested that there were highly significant correlations between CD163 and interleukin-10 (P<0.01). Bone marrow mesenchymal stem celltransplantation has a therapeutic effect on acute liver failure rats. CDl63 and interleukin-10 play a very important role in the pathogenesis of acute liver failure, which can be used as sensitive serum marker proteins for diagnosis and prognosis of acute liver failure.

Objective:To investigate the application value of pulse-indicated continuous cardiac output (PICCO) monitoring combined with critical care ultrasound-oriented convulsive therapy in the management of fluid intake in shock patients.Methods:Eighty-two patients with shock who received treatment in Shaoxing People's Hospital, China between May 2017 and May 2020 were included in this study. They were randomly assigned to undergo either PICCO monitoring (control group, n = 41) or PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy (study group, n = 41). Fluid intake management-related indexes [24-hour total fluid intake, central venous pressure, mean arterial pressure, oxygenation index and lactic acid] and treatment outcome-related indexes (mechanical ventilation time, intensive care unit length of stay, 24-hour remission rate, 28-day mortality rate, sequential organ failure assessment score) were compared between control and study groups. Results:24-hour total fluid intake and lactic acid level in the study group were (2 516.98 ± 254.78) mL and (0.60 ± 0.05) mmol/L, respectively, which were significantly lower than those in the control group [(2 920.02 ± 295.33) mL, (1.34 ± 0.15) mmol/L, t = 16.573, 3.837, P < 0.01, P = 0.041). Central venous pressure, mean arterial pressure and oxygenation index in the study group were (13.381 ± 1.41) mmHg, (82.34 ± 8.22) mmHg and (224.06 ± 23.21) mmHg, respectively, which were significantly higher than those in the control group [(8.53 ± 0.85) mmHg, (70.92 ± 7.18) mmHg, (192.30 ± 19.70) mmHg, t = 5.152, 6.754, -2.498, all P < 0.05]. Mechanical ventilation time and intensive care unit length of stay in the study group were (7.54 ± 0.72) days and (11.46 ± 1.11) days, respectively, which were significantly shorter than those in the control group [(11.72 ± 1.13) days, (18.29 ± 1.73) days, t = 4.727, 5.224, both P < 0.05). 24-hour remission rate in the study group was significantly higher than that in the control group [85.37% (35/41) vs. 63.41% (26/41), χ2 = 5.185, P < 0.05]. 28-day mortality rate in the study group was significantly lower than that in the control group [7.32% (3/41) vs. 29.27% (12/41), χ2 = 6.608, P < 0.05]. Sequential organ failure assessment score in the study group was significantly lower than that in the control group [(6.86 ± 0.63) points vs. (11.05 ± 0.91) points, t = 4.814, P < 0.05]. Conclusion:PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy exhibits an obvious effect in the management of fluid intake in shock patients, which can greatly reduce total fluid intake and remarkably improve treatment outcome-related indexes.

Objective To evaluate the efficacy and safety of perioperative anticoagulation and antiplatelet therapy of carotid endoarterectomy (CEA). Methods A retrospective study on 110 cases (122 CEAs) of carotid stenosis between Jan 2004 and Dec 2008 was undertaken. 122 cases were divided into anticoagulation group and antiplatelet group according to the perioperative medical treatment. Postoperative results of stroke/death and wound hemotoma were compared between the two groups and statistically analyzed. Results 45 CEAs were given perioperative combination of anticoagulation and antiplatelet treatment. This comprised the anticoagulation group. The antiplatelet group consisted of the other 77 CEAs which were treated with antiplatelet solely. Perioperative stroke/death rates were equivalent (2.2% anticoagulation vs. 2.6% antiplatelet, P =0.897). Wound hemotoma rates were found with statistical significant difference between the two groups (13.3% anticoagulation group vs. 1.3% antiplatelet group, P = 0. 006 ). Conclusion Our results suggest that perioperative antiplatelet therapy in perioperative carotid endoarterectomy does not increase perioperative stroke/death risk, while perioperative anticoagulation increases the risk of wound hematoma.

Objective: To evaluate the effect of exogenous insulin on endoplasmic reticulum stress in myocardial tissues during insulin resistance in the rabbits undergoing cardiopulmonary bypass (CPB). Methods: Forty healthy adult New Zealand white rabbits of both sexes, weighing 2.5-3.0 kg, were divided into 4 groups (n=10 each) using a random number table method: control group (group C), CPB group, CPB plus insulin group (group I) and CPB plus normal saline group (group NS). Group C received no treatment.An insulin resistance model was established in group CPB.Insulin was continuously infused (the infusion rate was adjusted according to the blood glucose) starting from establishing CPB to 1 day after operation in group I. The equal volume of normal saline was given starting from establishing CPB to 1 day after operation in group NS.Blood samples were collected from the left femoral artery, and myocardial tissues obtained before CPB (T₁) and at 15, 30 and 60 min after aortic opening (T_2-4). The level of blood glucose was determined using oxidase method, the level of glucagon was detected by the radioimmunoassay method, and the insulin resistance index was calculated.The expression of inositol-requiring protein-1α(IRE1α), XBP1 and caspase-12 was measured by Western blot.The expression of IRE1α, XBP1 and caspase-12 mRNA was measured by fluorescent quantitative real-time polymerase chain reaction.Cell apoptosis was detected by TUNEL. Results: Compared with group C, blood glucose and glucagon levels at T_2-4 and insulin resistance index at T₄ were significantly increased, and the expression of inositol-requiring protein-1α(IRE1α), XBP1 and caspase-12 protein and mRNA was up-regulated at T₄ in CPB, I and NS groups (P<0.05). Compared with group CPB, blood glucose and glucagon levels at T_2-4 and insulin resistance index at T₄ were significantly decreased, and the expression of IRE1α, XBP1 and caspase-12 protein and mRNA was down-regulated at T₄ in group I (P<0.05). Conclusion Exogenous insulin significantly improves insulin resistance in myocardial tissues, and the mechanism is related to inhibiting endoplasmic reticulum stress and reducing cell apoptosis in the rabbits undergoing CPB.

Objective To study the effect of CBT resection on blood pressure in essential hypertensive subjects.Methods Clinical data of 24 essential hypertensive patients (BP ＞ 140/90 mmHg or was using anti-hypertensive drugs) with CBT resection from May 2005 to March 2016 was analyzed,retrospectively.The heart rate,blood pressure were recorded continuously during the peri-operative and follow-up period.All of the patients were followed-up for at least 1 year.Results The systolic blood pressure(SBP) and pulse pressure (PP) decreased 1-3 months after the operation,and the difference was significant (P ＜ 0.001),while the diastolic blood pressure (DBP) and heart rate (HR) did not change significantly (P ＞ 0.05).Postoperative patients used less amount of antihypertensive drugs,but the difference was statistically not significant (P ＞ 0.05).Conclusions Unilateral CBT resection is associated with short-term to intermediate-term lowering of BP in hypertensive patients (P ＞ 0.05).

Objective:To summarize the surgical treatment of malignant carotid body tumor (MCBT).Methods:A retrospective analysis of 14 MCBT patients admitted at our hospital from Mar 2005 to Nov 2019 was made, and the imaging data, surgical records, perioperative complications and follow-up data were collected.Results:There were 8 males and 6 females, with an average age of (40.8±11.3) years. 10 patients underwent surgical resection of CBT, with one case undergoing tumor enucleation only, nine cases underwent internal carotid artery reconstruction, and all patients underwent intraoperative lymph node biopsy.Tumors were completely removed in all 10 patients. No perioperative death or cerebral infarction occurred. The intraoperative blood loss was (955±658.5) ml. Four patients had permanent nerve injury after surgery. The follow-up time ranged 1-132 months. There were no cases of cerebral infarction or death, and the reconstructed graft remained patent. Apart from the 2 patients who developed tumor metastasis after surgery, other patients recovered uneventfully with no disease progression.Conclusions:Surgery is still the main treatment for MCBT, but MCBT is large and Shamblin class is more advanced. Therefore, complete tumor removal and reconstruction of the carotid arteries are difficult. Surgery should seek to completely remove the tumor and neck lymph node biopsy should be performed to determine the lymph node metastasis.

OBJECTIVETo analyze the clinical features of statin-induced myopathy.

METHODThe statin-induced myopathy case reported as adverse drug reaction (ADR) to the Beijing Center for ADR Monitoring during January 2007 to December 2012 was summarized, patients were divided to myopathy group and rhabdomyolysis group, according to the absence or presence of rhabdomylysis. The clinical characteristics, medication history and outcome were compared between the two groups.

RESULTSA total of 160 statin-induced myopathy cases (54 in rhabdomyolysis group (33.8%) and 106 cases in myopathy group (66.3%)) were collected from the database (mean age: (64.22 ± 13.55) years old, 51.2% male, n = 82). The ADR occurred immediately after the first medication and up to 4 years after medication. Observed clinical features were myalgia, myositis, asymptommatic creatine kinase (CK) elevation or rhabdomyolysis. The average age were (68.54 ± 15.41) years old in rhabdomylysis group and (62.02 ± 12.41) years old in myopathy group (P = 0.004). There was no gender difference between the rhabdomylysis group and myopathy group (P = 0.406) . Twenty-four cases (44.4%) in rhabdomyolysis group and 26 cases (16.5%) in myopathy group were treated with high dose statin (P < 0.001). Percent of simvastatin treatment was significantly higher in rhabdomyolysis group (70.4% (38/54) ) than in myopathy group (32.1% (34/106), P < 0.001). Spearman correlation analysis showed that age, high-dose statin treatment and simvastatin use were all positively correlated with rhabdomylysis (P < 0.001), and the correlation coefficients (r value) were 0.305, 0.290 and 0.364, respectively. Four patients (aged from 71 to 85 years) died because of ADR and all 4 cases received high-dose statin treatment, 3 of them suffered from complex combined diseases, acute disease progression and complex multiple drug use history.

CONCLUSIONSSevere statin-induced myopathy, like rhabdomyolysis, is more likely to occur in old patients, in patients taking high-dose statin, especially simvastatin.

Aged ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; adverse effects ; Male ; Middle Aged ; Muscular Diseases ; chemically induced ; Myositis ; chemically induced ; Rhabdomyolysis ; chemically induced ; Simvastatin ; adverse effects