Growth differentiation factor(GDF)-15,a distant member of the transforming growth factor-? cytokine superfamily,is a powerful cardioprotective factor.Many studies have demonstrated that serum GDF-15 level is a novel marker closely associated with the diagnosis,risk stratification,and prognosis of several cardiovascular diseases.This article mainly reviews the characteristics of GDF-15 and its multifunction in cardiovascular diseases.

The data of 173 cases with acute mastitis were collected and reviewed from January 2010 to October 2012.The liquor puris samples were collected for bacterial culture.And drug sensitive test was performed by Kirby-Bauer method.98 samples were cultured with a positive rate of 56.7％.A total of 98 bacterial strains were isolated,Gram-positive bacteria were 91 strains (92.9％) and Gram-negative 7 strains (7.1％).The most common bacteriun Staphylococcus aureus,accounted for 83.7％ was highly resistant to penicillin and erythromycin with resistant rates of 90.2％ and 86.6％ respectively.And there was no resistance to vancomycin and teicoplanin.

Objective To summarize the experience with adapalene in the treatment of ache vulgaris and to provide a clue to improve the clinical use of adapalene in ache vulgaris. Methods Chinese literature over the past ten years related to the evaluation of efficacy and safety of 0.1% adapalene gel in acne vulgaris were searched and assessed. Results Combination therapy with 0.1% adapalene was more effective than monotherapy with it. The efficacy of adapalene gel was higher than that of non-tretinoin topical agents, but equivalent to that of other tretinoins. Furthermore, the incidence of adverse events was lower for adapalene than for other tretinoin formulations. Conclusions Adapalene is safe and effective for the treatment of mild to moderate acne vulgaris, and can be used as monotherapy, maintenance treatment, or in combination therapy of acne vulgaris.

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

Objective To study the expression of matrix metalloproteinase(MMP)-1,-3 and-9 in sun-exposed and-unexposed skin as weil as its significance in the mechanism of skin photoaging.Methods Skin samples were resected from the exmnsor side of forearm(sun-exposed area)and flexor side of upper arm(sun-unexposed area)of 23 healthy female volunteers.The expression of MMP-1,-3 and-9 was detected by immunohistochemical staining in 46 skin samples.Immunoreactive intensity distribution index (IRIDI)was calculated to assess the expression of MMP-1,-3 and-9.Wilcoxon signed ranks test,Mann-Whitney U-test and Spearman rank correlation analysis were performed.Results MMP-1,-3 and-9 were expressed in both sun-exposed and -unexposed skin.The average IRIDI value for MMP-1,-3 and-9 was 7.70(range,3 to 12).9.22(range,6 to 12),8.30(range,6 to 12)in sun-exposed skin,and 4.26 (range,2 to 6),5.39(range,2 to 9),4.04(range,1 to 6)in sun-unexposed skin,respectively;significant difierence existed between sun.exposed and-unexposed skin in the three parameters(all P＜0.01).A significant inerease was observed in the average IRIDI value for MMP-1,-3 and-9 in sun-exposed skin vs.sun-unexposed skin in women above 50 years of age (9.17 vs 4.75,10.58 vs 6.42,8.92 vs 4.33,respectively,all P＜0.05).In women younger than 50 years,the average IRIDI value for MMP-1,-3 and-9 was 6.09(range,3 to 8),7.73(range,6 to 9),7.64(range,6 to 12)in sun-exposed skin,significantly higher than that in sun-unexposed skin[3.73(range,2 to 6),4.27(range,2 to 8),3.73(range,1 to 6),all P＜0.05].Increased IRIDI scores of MMP-1,-3 and -9 were noticed in sun-exposed skin in women above 50 years of age vs.those younger than 50 years.but there was no statistical difrerence in MMP-I or MMP-9 between the two aged groups in sun-unexposed skin(all P＞0.05).The IRIDI scores of MMP-1,MMP-3 and MMP-9 were positively correlated with age(r=0.66,0.69,0.74,all P＜0.01)in sun-exposed skin,but the IRIDI scores of MMP-1 and MMP-9 uncorrelated with age in sun-unexposed skin.Conclusions There isan elevated expression of MMP-1,-3 and.9 in sun-exposed skin VS.SUn.unexposed skin.hinting that these three MMPs play a role in the occurrence and development of photoaging,but their biological mechanism may be different.

OBJECTIVE: To observe whether injection of medicine into low hydraulic resistance point along meridian brings about higher medicinal effect and to explore the efficacy of the theory that meridians are made up of channels featuring low hydraulic resistance by observing the diuretic effect of injecting furosemide or saline into the low hydraulic resistance point Shuifen (CV 9), vein and Zusanli (St 36) respectively. METHODS: Acute edema was induced in pigs by rapid intravenous injection of 2 000 ml normal saline. The pigs were divided into four groups: Shuifen (CV 9) injection of half dose furosemide group (SFF group), intravenous injection of full dose furosemide group (VF group), Zusanli (St 36) injection of full dose furosemide group (ZSLF group), and Shuifen (CV 9) injection of half dose normal saline group (SFS group). The accumulated urine quantity and the urine quantity generated in every 15-minute period were measured in each group respectively, every 15 minutes after injection, and the measurement lasted for two hours at one experiment. Each group involved eight times of experiments with one pig used for one experiment, which means the whole observation involved 32 times of experiments. RESULTS: The accumulated urine quantities observed in both SFF group and VF group were higher than those in the ZSLF group and the SFS group all through the measurement, showing significant differences during the period from the 15th minute to the 45th minute (P<0.05). But no significant difference was observed between the SFF group and the VF group during the whole 2-hour measurement (P>0.05). Analysis of urine quantity generated in every 15-minute period showed that diuretic effect climaxed during the 15th minute to the 30th minute in both SFF group and VF group. By contrast, ZSLF group reached diuresis climax during the 45th minute to 60th minute and no diuresis climax was observed in the SFS group all through the measurement. CONCLUSION: Injection of medicine into low hydraulic resistance point along meridian generates faster and more powerful medicinal potency, and this is likely to be applied to clinical practice. The theory that meridians are channels featuring low hydraulic resistance is important to the elucidation of meridians.

Objective To study the effects of different stimulators on the production of matrix metalloproteinases (MMPs) by peripheral blood mononuclear cells (PBMCs),and to evaluate the effects of the culture supernatant of activated PBMCs,named conditioned media (CM),on the proliferation of and production of MMPs by cultured human fibroblasts.Methods PBMCs were isolated from the venous blood samples of healthy volunteers and divided into three groups to be stimulated by phytohemagglutinin (PHA group),the combination of antibodies against CD3 and CD28 (double-antibody group),or the RPMI 1640 medium containing 10％ fetal calf serum (control group).After 72-hour stimulation,CM was collected from all the three groups,diluted to several different degrees.Cultured human fibroblasts were classified into several groups to be treated with different dilutions of CM from the three groups for 48 or 24 hours,with the fibroblasts untreated with CM serving as the control group.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity,semi-quantitative reverse transcription (RT)-PCR to detect the expressions of MMP-1,MMP-3 and MMP-9 mRNAs in cells,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of interleukin (IL)-6,MMP-1,MMP-3 and MMP-9 proteins in the culture supernatant of cells.Statistical analysis was carried out mainly by using one-way analysis of variance (ANOVA),Tukey HSD test,and GamesHowell test.Results Compared with the control group,the PHA group showed increased cellular proliferative activity,IL-6 and MMP-3 protein levels in the culture supernatant of activated PBMCs (all P ＜ 0.05).Significant differences were observed among the PHA group,double-antibody group and control group in the relative mRNA expression level (expressed as the ratio of target mRNA to β-actin mRNA) of MMP-1 in activated PBMCs (0.083 ± 0.016 vs.0.188 ± 0.030 vs.0.714 ± 0.104,F =85.905,P ＜ 0.05),but neither MMP-3 nor MMP-9 mRNA was expressed by activated PBMCs.MMP-3 protein was detectable in the culture supernatant of fibroblasts after the treatment with CM,and the level of MMP-3 protein was highest in that of fibroblasts treated with undiluted CM,and lowest with 1/10 diluted CM;at the same dilutions,the level of MMP-3 protein was highest in the culture supernatant of fibroblasts treated with CM from the PHA group,but lowest with that from the control group.Neither MMP-1 nor MMP-9 protein was detected in the culture supernatant of activated PBMCs or treated fibroblasts.There were no significant differences in cellular proliferative activity of and mRNA expressions of MMP-1 or MMP-3 in fibroblasts among these groups (all P ＞ 0.05),and MMP-9 mRNA expression was undetected in the treated fibroblasts.Conclusions PBMCs can be induced to express MMP-1 mRNA and secret MMP-3 protein after activation.However,the culture supernatant of activated PBMCs has no capacity to stimulate the expressions of MMP-1,MMP-3 and MMP-9 mRNAs or proteins by fibroblasts,suggesting that inflammatory cells may function through self-production of MMPs.

Objective:To investigate the relationship between the expression of P16 protein and the clinico-pathology of squamous cell carcinoma(SCC) of buccal mucosa and its precursor lesions. Methods:The immunohistochemical stain against p16 was performed in 30 cases of SCC of buccal mucosa, 32 cases of buccal leukoplakia and buccal lichen planus and 10 cases of normal buccal mucosa. All data were analyzed quantitatively by imag analysis technique. Then, the results were compared with clinico-pathological parameters.Results:The positive expression of P16 protein was found in all normal buccal and hyperplasia mucosa (100.0%), in 9 out of 10 cases of atypical hyperplasia (90.0%), in 12 out of 30 cases of SCC of buccal mucosa (40.0%). The positive expression rate of P16 protein in SCC of buccal mucosa was significantly lower than that in atypical hyperplasia (P

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.

Objective To investigate the clinical value of pregnancy-associated plasma protein A (PAPP-A) in patients with acute coronary syndrome (ACS).Methods The study subjects comprised of 249 patients with ACS [ 50 patients with ST elevation acute myocardial infarction( STEMI),43 patients with non-ST elevation acute myocardial infarction (NSTEMI), 156 patients with unstable angina pectoris (UAP) ] from July 2008 to December 2009 at Shanghai East Hospital affiliated to Tongji University.The patients were divided into single-vessel lesions group,double-vcssel lesions group and three-vessel lesions group according to the coronary artery stenosis.A group of 205 healthy subjects admitted for health physical examination were used as conuols.Blood samples were collected from ACS patients and control subjects.Serum PAPP-A,creatine kinaseisoenzyme MB (CK-MB),high-sensitivity troponin-T (hs-TnT) were measured by clectrochemiluminesence and high-sensitivity C-reactive protein (hs-CRP) was measured by immune scatter turbidity method.Analysis of variance ANOVA and Kruskal-Wallis H test were used for statistical analysis.Results Serum PAPP-A in the STEMI,NSTEMI,UAP and normal control group were 10.45(5.54 - 16.08),6.56(4.68 - 9.55),5.70(4.12 - 8.50),5.23 (4.00 - 5.88) mIU/L,respectively,and the difference was statistically significant (H =43.94,P ＜ 0.01 ).Pairwise comparison showed that PAPP-A in STEMI,NSTEMI,UAP were significantly higher than the healthy control group and differences were statistically significant ( t =6.80,2.46,1.72,P ＜ 0.05 ).The PAPP-A had a sensitivity of 52.2％ and specificity of 80％ in diagnosis of ACS.The positive rate of PAPP-A was 44.5％ (69/155) in patients with negative hs-TnT.The serum levels of PAPP-A in the three-vessel lesions group [7.72(5.03 -12.46) mIU/L] was higher than that in the single,double groups [ 5.35 ( 4.14 - 8.59 ),6.05 (4.42 -9.58 ) mIU/L ],and the difference had statistical significance( t =2.00,1.57,P ＜ 0.05 ).There was obvious correlation between the level of serum PAPP-A and the level of hs-CRP ( r =0.524,P ＜ 0.05 ),and there was weak correlation between the PAPPA and CK-MB or hs-TnT (r=0.326,0.343,P＜0.05).Conclusions The results shows that PAPP-A is elevated in patients with ACS.It may be used as a serum biomarker for vulnerable plaques in patients with ACS and has a clinical value for ACS diagnosis especially in patients with negative hs-TnT.