Objective To investigate the lung CT findings in patients with primary Sj(o)gren's syndrome (pSS) and clinical significance.Methods Images of lung CT scans of 68 patients with pSS were retrospectively observed.The distribution characteristics of lung lesions were observed.CT visual score were used to quantitatively analyze lung lesions.Binary classification unconditional logistic regression analysis was used to investigate the relationship between pulmonary arterial hypertension (PAH) and anti-SSB seropositivity in Patients with pSS.Results The 68 cases of patients with pSS,PAH in 13 (19％),anti-SSB seropositivity in 25(37％),CT shows normal in 13 (19％),interlobular septal thickening,ground-glass opacity and intralobular interstitial thickening were frequent findings.The lesion distribution was in the peripheral and lower lung fields.Interlobular septal thickening and cysts were associated with PAH in Patients with pSS (OR=1.780,2.513,P＜0.05),cysts was significantly associated with anti-SSB seropositivity (OR =10.530,P＜0.05).Conclusion Lung CT can quantitatively analyze the degree of pSS lung damage,and provide helps for clinical treatment and prognosis.

Objective To investigate the effects of triptolide on lipopolysaccharide (LPS)-induced acute lung injury in rats.Methods Sixty-five male SD rats weighing 200-250 g were randomly divided into 5 groups: control group (group C,n =5),LPS group (group L,n =15),different doses of triptolide groups (groups TP1-3,n =15).In group C normal saline was injected iv and 1％ DMSO injected intraperitoneally(ip).In group L LPS 5 mg/kg was injected iv and 1％ DMSO injected ip.In groups TP1-3 LPS 5 mg/kg was injected iv and triptolide 25,50 and 100 μg/kg was injected ip respectively.Blood samples were collected at 1 h before administration and 1,3,6 and 12 h after administration for blood gas analysis.The animals were sacrificed at 12 h after administration.TNF-α concentrations in serum and bronchoalveolar lavage fluid (BALF) were determined by ELISA.The lungs were removed for microscopic examination,evaluation of diffuse alveolar damage (DAD) score and determination of W/D lung weight ratio and the expression of Toll-like receptor4 (TLR4) protein and mRNA.Results Compared with group C,PaO2 was significantly decreased at 3,6 and 12 h after administration,DAD score and W/D lung weight ratio were increased in groups L and TP1-3,TNF-α concentrations in serum and BLAF were increased,expression of TLR4 mRNA and protein was up-regulated in groups L,TP1 and TP2,whlie TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 ( P ＜ 0.05).Compared with groups L and TP1,PaO2 was significantly increased at 6 and 12 h after administration,DAD score,W/D lung weight ratio and TNF-α concentrations in serum and BLAF were decreased,expression of TLR4 mRNA and protein was down-regulated in groups TP2 and TP3 ( P ＜ 0.05).There was no siginificant difference in blood gas parameters,DAD score and W/D lung weight ratio between group L and group TP1 and between group TP2 and TP3 ( P ＞ 0.05).Compared with group TP2,TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 (P ＜ 0.05).The lung pathologic injury was reduced in groups TP1-3 as compared with group L.Conclusion Triptolide can attenuate acute lung injury induced by LPS in a dose-dependent manner in rats,and the inhibition of up-regulation of TLR4 expression and release of TNF-α may be involved in the mechanism.

Objective To explore the histopathological features of 850 patients with esophageal malignant tumor in 10 years.Methods From January 2002 to January 2012, 850 patients diagnosed with esophageal malignant tumor were enrolled.Tumor location, general type, pathological type and TNM stage were retrospectively analyzed.All the data were described as case number and percentage.Results Among the 850 cases of esophageal malignant tumor, 33 lesions (3.9％) located in the neck segment of esophagus, 119 lesions (14.0％) located in the upper segment, 44 lesions (5.2 ％) located in the upper-middle segment, 409 lesions (48.1％) located in the middle segment, 123 lesions (14.5 ％) located in the middle-lower segment, 122 lesions (14.4％) located in the lower segment.Among the 724 eases clearly diagnosed as esophageal malignant tumor by general type, the most cases were ulcer type (305 cases, 42.1％), followed by medulla type (260 cases, 35.9％), fungating type (80 cases, 11.0％) and constrictive type (70 cases, 9.7％), and the least cases were intraluminal type (nine cases, 1.2％).Among the 850 cases of esophageal malignant tumor, squamous cell carcinoma (794 cases, 93.4 ％) was the most common cytological type, followed by small cell carcinoma (19 eases, 2.2％), and the least common cytological type was adenocarcinoma (seven cases, 0.8 ％).Among the 724 cases with clear TNM staging, case number of Tis, T1, T2, T3 and T4 stage was eight (1.1％), six (0.8％), 271 (37.4％), 278 (38.4％) and 161 (22.2％), respectively.Among the 122 cases of distal esophageal carcinomas (104 cases with clear TNM staging), most cases were squamous cell carcinoma (112 cases, 91.8 ％), the others cases were adenocarcinoma (three cases, 2.5 ％), small cell carcinoma (three cases, 2.5 ％), basaloid squamous cell, adenosquamous, neuroendocrine carcinomas and carcinosarcoma (one case in each type, 0.8％).Conclusions Esophageal carcinoma was mostly located in the middle segment of in which squamous cell carcinoma was predominant while adenocarcinoma was less common.Esophageal cancer located at lower segment of esophagus is with a wide range of pathological spectrum, squamous cell carcinoma was still dominant, however, esophageal adenocarcinoma is rare.

Objective To explore the clinical and histopathological features of Barrett esophagus and its related adenocarcinoma as well as the relationship between them.Methods From January 2002 to January 2012,the clinical data of 35 patients with Barrett esophagus,850 patients with esophagus cancer and 218 patients with esophageal-gastric junction cancer were collected,and the histopathological features of all the patients and the follow-up in patients with Barrett esophagus were retrospectively analyzed.Results Among 35 patients with Barrett esophagus,six cases(17.1 ％) had specialized intestinal metaplasia and all of them did not develop into esophageal adenocarcinoma or Siewert type Ⅰ esophageal-gastric junction cancer.Among 850 patients with esophageal cancer,794 cases (93.4％) were squamous carcinoma,19 cases (2.2％) were small cell carcinoma,seven cases (0.8％) were adenocarcinoma.And besides,there were adenosquamous carcinoma,basaloid squamous carcinoma,carcinosarcoma,and neuroendocrine carcinoma.Among 218 patients with esophageal gastric junction cancer,nine cases (4.1％) were Siewert type Ⅰ,150 cases (68.8％) were Siewert type Ⅱ,59 cases (27.1％) were Siewert type Ⅲ.A total of 180 cases (82.6％) were adenocarcinoma and others were signet ring cell carcinoma,mucous adenocarcinoma,squamous carcinoma,adenosquamous carcinoma,small cell carcinoma,neuroendocrine carcinoma,carcinoid and spindle cell carcinoma.Conclusions Specialized intestinal metaplasia is rare in patients with Barrett esophagus in China,and the probability of Barrett esophagus developing into adenocarcinoma is low.Barrett esophagus related adenocarcinoma such as esophageal adenocarcinoma and Siewert type Ⅰ esophageal-gastric junction cancer is rare.

Objective To explore the relation between clinical-pathological features,Siewert classification and prognosis of esophagogastric junction (EGJ) carcinoma,and to assess the applicability of the new edition of American Joint Committee of Cancer (AJCC) staging guideline on EGJ adenocarcinoma in China.Methods From 2002 to 2012,the clinical data,pathological features,treatment and prognosis of 218 patients with EGJ malignant tumor were retrospectively analyzed.The patients were typed according to Siewert classification criteria and each case was staged according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma and gastric cancer.Kaplan-Meier method and Log-rank test were performed for survival analysis.Results According to the Siewert classification,type Ⅰ was rare (nine cases,4.1％),type Ⅱ was the most common type (150 cases,68.8％) and followed by type Ⅲ (59 cases,27.1％).There was no significant difference in survival curve among the three types (P＞0.05).The survival curve was drawn according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma.In T staging,the prognosis of patients at T4b was better than that of patients at T4a,the prognosis of patients at ⅡB was better than that of patients at ⅡA.The survival curve of patients at Ⅲ C obviously crossed with that of patients at Ⅳ,which was not in conformity with clinical results.The survival curve was drawn according to 7th edition of AJCC staging criteria for gastric cancer.In T staging,the survival curve of patients at Tis was overlapped with that of patients at T1a.The survival rate of patients at ⅡB could not be accurately predicted by the overall staging.In general,the survival of patients with EGJ carcinoma was better predicted according to 7th edition of AJCC staging criteria for gastric cancer than 7th edition for esophagus adenocarcinoma.Conclusions Neither 7th edition of AJCC staging criteria for esophagus adenocarcinoma nor for gastric cancer could accurately predict its prognosis.In our country,EGJ malignant tumor was similar to gastric cancer and had specific clinical-pathological features.It is necessary to research and establish EGJ carcinoma staging criteria instead of applying the current staging criteria for esophagus adenocarcinoma or gastric cancer.

Objective To investigate the effect of dexmedetomidine postconditioning on acute lung injury (ALI) induced by lipopolysaccharide (LPS) in rats.Methods Fifty male Spragne-Dawley rats,aged 7-8 weeks,weighing 200-250 g,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C),LPS group and postconditioning with 3 different doses of dexmedetomidine groups (LD,MD and HD groups).ALI was induced with LPS 8 mg/kg injected via the caudal vein in LPS,LD,MD and HD groups.Dexmedetomidine 5,10 and 15 μg/kg were injected intraperitoneally in LD,MD and HD groups,respectively,at 1 h after LPS injection.The equal volume of normal saline was injected intraperitoneally in C and L groups.Blood samples were taken from the left ventricle at 6 h after dexmedetomidine administration,then the animals were sacrificed and broncheoalveolar lavage fluid (BALF) was collected.The concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in plasma and BALF were detected by ELISA.The lungs were removed for microscopic examination of pathological changes and for determination of wet/dry lung weight (W/D) ratio and expression of Toll-like receptor 4 (TLR4) mRNA (by RT-PCR) in lung tissues.Results Compared with group C,W/D ratio,pathological scores,and the concentrations of IL-6 and TNF-α in plasma and BALF were significantly increased,and the expression of TLR4 mRNA was up-regulated in LPS,LD,MD and HD groups.Compared with LPS and LD groups,W/D ratio,pathological scores,and the concentrations of IL-6 and TNF-α in plasma and BALF were significantly decreased,and the expression of TLR4 mRNA was down-regulated in MD and HD groups.There was no significant difference in the parameters mentioned above between LPS and LD groups,and between MD and HD groups.Conclusion Dexmedetomidine postconditioning can alleviate ALI induced by LPS in rats,and up-regulated TLR4 mRNA expression and reduced inflammatory responses may be involved in the mechanism.

AIM:To explore the molecular mechanism through which curcumin reverses hepatocyte growth factor (HGF)-induced resistance to gefitinib in lung cancer cells.METHODS:The methods of MTT assay, wound healing assay and Western blot were used to observe the effects of HGF, curcumin and gefitinib on the migration, drug susceptibility, epithelial-mesenchymal transition, and related signaling pathways in the PC9 lung cancer cells.RESULTS:HGF reduced susceptibility of the PC9 cells to gefitinib, and curcumin significantly reversed HGF-induced resistance to gefitinib.HGF induced migration and epihelial-mesenchymal transition, and promoted c-Met/AKT/mTOR pathway activation in the PC9 cells.Gefitinib alone did not prevent the above activities.However, combined with curcumin, gefitinib prevented the above activities.CONCLUSION:Curcumin reverses HGF-induced resistance of the PC9 cells to gefitinib by preventing epithelial-mesenchymal transition and inhibiting c-Met/AKT/mTOR activation.

AIM:To observe the effects of the combination of berberin and epirubicin on the cell cycle of T24 bladder cancer cells and the underlying mechanisms.METHODS:The cancer cells were exposed to epirubicin in the presence or absence of different concentrations of berberin.The viability of the cancer cells was determined by MTT assay.The cell cycle distribution was detected by flow cytometry, and the protein levels of cyclin D1, CDK2, CDK4, P21 and P27 were detected by Western blot.RESULTS:Berberine markedly enhanced the inhibitory effect of epirubicin on the viability of T24 cells and promoted epirubicin-induced cell cycle arrest at G0/G1 phase as compared with the negative control cells.Epirubicin increased the protein expression of P27 and P21, both of which were enhanced by treatment with berberin.In contrast, berberin exposure further decreased the protein expression of cyclin D1, CDK2 and CDK4 in epirubicin-treated T24 cells.CONCLUSION:Berberine significantly promotes epirubicin-induced G0 /G1 phase arrest in human bladder cancer cells by up-regulating P27 and P21 expression and inhibiting the expression of cyclin D1, CDK2 and CDK4.

BACKGROUND:Percutaneous pedicle screw fixation has been applied in the treatment of thoracolumbar fracture,and has achieved satisfactory clinical efficacy.Injectable calcium sulfate holds good biocompatibility,degradability and fast curing.OBJECTIVE:To explore the clinical efficacy of percutaneous pedicle screw fixation combined with calcium sulfate cement for single-level thoracolumbar fracture.METHODS:Clinical data of 40 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively.All fractured vertebrae were compressed more than 30％ and at least one pedicle was complete.All patients were treated with percutaneous pedicle screw fixation combined with calcium sulfate cement.The Visual Analog Scale and Oswestry Disability Index scores were recorded at baseline,3 months postoperatively and last follow-up;the height of the fractured vertebra body and sagittal Cobb angle were measured on X-ray;the patient's satisfaction and healing rate were recorded.RESULTS AND CONCLUSION:(1) The Oswestry Disability Index at 3 months postoperatively and last follow-up was 16.3％ and 4.4％,respectively.Compared with baseline,the Cobb angle and Visual Analog Scale scores were significantly reduced,and height of the fractured vertebra body was significantly increased after surgery (P ＜ 0.01).(3) The healing rate at last follow-up was 95％,nonunion was not found,and the patients' satisfaction reached 95％.(4) The loss of vertebral height and Cobb angle was found at last follow-up compared with 3 months postoperatively,but had no significant difference (P ＞ 0.05).(5) These results indicate that percutaneous pedicle screw fixation combined with calcium sulfate cement is safe and reliable for single-level thoraclumbar fracture,which not only restores the vertebral height and relieves pain,but also has satisfactory long-term curative efficacy and high healing rate.

Objective To investigate the clinic effect of the Salvia miltiorrhiza combined with dextran to prevent veno-occlusive disease after hematopoietic stem cell transplantation. Methods In the process of the pretreatment of the hematopoietic stem cell transplantation, patients were treated with salvia miltiorrhiza (20 ml/d), dextran(250 ml, twice a day) by venous transfusion and the drugs to protect the liver cell was used in the same time. When the count of platelet dropped to 30×109/L, salvia miltiorrhiza and dextranware stopped applying forever. Results Veno-occlusive disease and hemorrhage has not occurred during 85 times of the hematopoietic stem cell transplantation treated with salvia miltiorrhiza and dextran. Conclusion We conclude that the combined treatment with salvia miltiorrhiza and dextran is safe and effective to prevent veno-occlusive disease after hematopoietic stem cell transplantation.