Objective:Comparing the effect of different doses of simvastatin in lowering the serum lipid.Methods:79 patients were randomized into group A and group B,and were given simvastatin 10 mg*d-1 (group A) and 20 mg*d-1 (group B),respectively for a total of 8 weeks.Results:Comparing with baseline,in group A,TC,TG,LDL-C were decreased by 23.4%,20.0% and 30.7%,respectively (P＜0.01); HDL-C was increased by 17.5%.The content of serum TC,TG and LDL-C was decreased to the normal range in 12.8%,28.2% and 15.4% of the patients in group A.For the group B,TC,TG,LDL-C were decreased by 32.7%,22.8% and 42.8%,respectively (P＜0.01); HDL-C was increased by 13.7%.The content of serum TC,TG and LDL-C was decreased to the normal range in 65.0%,57.5% and 65.0% of the group B patients.Conclusion:Oral intake of 20 mg of simvastatin once a day can effectively reduce the serum lipid.The patients can well tolerate and no obvious side effect was observed in our study.

Objective To evaluate the effect of noninvasive ventilation (NIV) on hypercapnic encephalopathy syndrome (HES) induced by acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods An extensive search of related literature from the PubMed, EMBASE, Cochrane library, CNKI and Wanfang databases up to January 2015 was performed. Randomized controlled trials (RCTs) and case control studies regarding comparison of the effect of NIV and conventional mechanical ventilation (CMV) on the HES were collected. Critical appraisal skills program (CASP) was adopted to assess the quality of the studies. Data including mortality, trachea intubation rate, duration of mechanical ventilation and complication rate were collected, and Meta-analysis was performed by RevMan 5.3. Results Finally, 6 studies were included with 225 subjects, among whom 112 were in NIV group and 113 in CMV group, and the average Kelly-Matthay score was 3. Compared with CMV group, the mortality [20.5% (23/112) vs. 32.7% (37/113), risk ratio (RR) = 0.63, 95% confidential interval (95%CI) = 0.40-0.98, P = 0.04], intubation rate [35.7% (40/112) vs. 100.0% (113/113), RR = 0.38, 95%CI = 0.26-0.55, P < 0.000 01], incidence of ventilation related complications [26.2% (21/80) vs. 50.6% (42/83), RR = 0.52, 95%CI = 0.34-0.79, P = 0.002] in NIV group were significantly decreased, and the duration of mechanical ventilation was significantly shortened [days: 7.1 vs. 16.2, standard mean difference (SMD) = -0.93, 95%CI = -1.39 to -0.46, P < 0.000 1]. Conclusion NIV could significantly lower the mortality rate, intubation rate, and complications in the treatment of HES induced by AECOPD under close monitoring.

Objective To evaluate the safety and efficacy of induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapywith capecitabine in patients with locally advanced pancreatic cancer (LAPC).Methods A total of 42 patients with locally advanced pancreatic cancer were enrolled.All patients received seven cycles of induction chemotherapy of gemcitabine 1 000 mg/m2,once a week.Concurrent chemoradiotherapy began 1 week after completion of induction chemotherapy.Radiotherapy was delivered with a median dose of 54 Gy (34-64 Gy) with 1.8-2.0 Gy in a fraction.The radiotherapy was combined with capecitabin at a dosage of 825 mg/m2 twice daily,5 d/week.Results Twenty patients (47.6％) were evaluated as clinical benefit response (CBR).Two cases were observed with complete remission (CR),8 with partial remission (PR),27 with stable disease (SD),and 5 with progressive disease (PD).The median overall survival was 10.1 months (range of 4-36 months).The 1-,2-year overall survival rate was 38.2％ and 18.2％,respectively.Myelosuppression was recorded in 20 patients with grades 1-2,and 5 patients with grade 3.Twenty-two patients suffered from grade 1-2 gastrointestinal toxicities,while 4 patients suffered from grade 3.Conclusions The preliminary results showed that induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapy with capecitabine in patients with LAPC might achieve encouraging efficacy with better tolerance.

Objective To explore the effect of leg massage during operation on deep venous thrombosis(DVT)in patients of vascular surgery department.Methods Ninety-four DVT patients were randomized into experiment group and control group according to the computer-generated numbers ,46 cases in the latter and 48 in the former.The routine care measures were applied in the control group, while intraoperative leg massage was used in the observation group.The two groups were compared in terms of curative effect and the incidence of DVT.Result The incidences of DVT in the experiment group and the control one were 2.08%(1/48)and 15.22%(7/46)respectively, showing significant difference between them(P<0.05).Conclusion The intraoperative lag massage are significant in the reduction of DVT incidences after operation.

BACKGROUND: Stem cell transplantation can significantly improve heart function foUowing myocardial infarction. This is correlated with the differentiation of stem cells into cardiomyocytes and promotion effect on angiogenesis. Paracrine and ventricular reconstruction inhibition (especially extracallular collagen reconstruction) have important effects on improving heart function.OBJECTIVE: To investigate the effects of bone marrow mesenchymal stem cell (BMSC) transplantation on coUagen remodeling after acute myocardial infarction in rabbits.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of Acupuncture and Electrophysiology of Liaoning University of Traditional Chinese Medicine from June to August 2007.MATERIALS: A total of 57 healthy Japanese rabbits were purchased from Experimental Animal Center, Uaoning University of Traditional Chinese Medicine.METHODS: BMSCs were acquired from the bone marrow of two rabbits, and marked with BrdU before transplantation. Ten rabbits served as a normal group. Forty-five rabbits were used to establish the left ventricular infarct by ligation of the left coronary artery. Thirty success models of myocardial infarction were randomly divided into 3 groups (n=10)" model, saline and call transplantation groups. Following 7 days of myocardial infarction, rabbit models in the cell transplantation group were injected in the ear vein with 1 mL of BMSCs (2x106 cells). Rabbits in the saline group were infused with 1 mL of saline. The culture was performed for 5 weeks.MAIN OUTCOME MEASURES: Fibrous structure of myocardial stroma was observed, and collagen volume fraction was measured by Masson Trichrome staining. The ratio of type Ⅰ and Ⅲ collagen was determined by immunohistochemistry.RESULTS: BrdU-positive BMSCs could be seen in the cell transplantation group. After myocardial infarction, a few collagen fibers was confluent in or surrounding the infarct area, arranged orderly in the cell transplantation group. Collagen fiber plaque-shaped confluence was significant, and arranged disorderly in the model and saline groups. At 5 weeks following myocardial infarction, compared with the normal group, collagen volume fraction was significantly decreased in and surrounding the infarct region (P < 0.05), and the ratio of type Ⅰ and Ⅲ collagen was increased significantly in the model group (P < 0.05).Compared with the model group, collagen volume fraction and the ratio of type Ⅰ and Ⅲ collagen were significantly decreased (P< 0.05).CONCLUSION: BMSCs could survive in infarct heart. BMSCs transplantation could reduce collage volume and improve collage ratio and had beneficial effects on collage remodeling processes after acute myocardial infarction.

OBJECTIVETo observe the effect of emodin on motility signal transduction and calcium ion in colonic smooth muscle cells (SMC) in rats with bacterial peritonitis caused multiple organ dysfunction syndrome (MODS).

METHODSObservation was conducted in colon of MODS model rats on (1) effects of emodin on the contraction of muscular strip and cells of colonic smooth muscle, and influences of specific myoglobulin light chain kinase inhibitor (ML-7) and selective proteinkinase C inhibitor (Calphostin C) on these effects; and (2) effect of emodin on calcium ion in SMC.

RESULTSEmodin could directly contract the muscular strip and cells of smooth muscle; ML-7 and Calphostine could inhibit these contractile action to some extent. Under MODS condition, emodin could still increase the intracellular calcium ion concentration; this effect could be inhibited by heparin (inosamine triphosphate receptor inhibitor IP3 and ryanodine receptor inhibitor in MODS model but the calcium chelator EGTA and nifedipine (the specific cell membrane voltage dependent calcium channel blocker) showed no influence on it.

CONCLUSIONEmodin could directly contract the colonic smooth muscle in MODS model rats, which is mediated by raise the signal path MLCK of calcium ion and the PKCa path for increase calcium sensibility. The mechanism of increasing calcium ion is mainly through IP3 and RyR the two calcium ion channel receptor in the sarcoplasm.

Animals ; Calcium ; metabolism ; Colon ; drug effects ; Emodin ; pharmacology ; Enzyme Inhibitors ; pharmacology ; Gastrointestinal Motility ; drug effects ; In Vitro Techniques ; Male ; Multiple Organ Failure ; physiopathology ; Muscle Contraction ; drug effects ; Muscle, Smooth ; cytology ; drug effects ; Myocytes, Smooth Muscle ; drug effects ; physiology ; Rats ; Rats, Wistar ; Signal Transduction

Objective To explore the mutation of androgen receptor(AR)gene in a patient with 46,XY disorder of sex development(DSD)and to improve the diagnostic level and understanding of androgen insensitivity syndrome(AIS).Methods The clinical data of the child was analyzed,including physical examination,relevant laboratory examination,karyotype,pelvic B ultrasound,pelvic magnetic resonance imaging(MRI)and AR gene mutation.The peripheral blood of the child and his parents were drawn,and peripheral blood DNA was extracted.The polymerase chain reaction(PCR)-DNA sequencing method was used to amplify all exons of the AR gene in the child and his parents.Then,they were directly sequenced.Results A 7-years and 2-months old child who suffered from DSD,revealed physical examination that the child had normal female external genitalia,as the clitoris length was 2.0 cm×0.8 cm,with visible vaginal opening,and there were masses at bilateral inguinal region,with a size of 1.5 cm×0.8 cm.The results of human chorionic gonadotropin(HCG)stimulation test:testosterone was 0 nmol/L,androstenedione was 1.78 nmol/L,dihydrotestosterone was 0.07 nmol/L before HCG was injected;but testosterone was 4.69 nmol/L,androstenedione was 2.10 nmol/L,dihydrotestosterone was 0.33 nmol/L after HCG was injection.Sex chromosome analysis reported 46,XY karyotype.Pelvic B ultrasound revealed the absence of a uterus and ovaries and the presence of bilateral testes like gonad at each side of internal inguinal ring,with a size of 1.4 cm×1.0 cm×0.8 cm in the left,1.5 cm×0.7 cm×0.8 cm in the right;but the kidney,ureter,urinary bladder,adrenal gland and retroperitoneal for B ultrasound revealed no abnormality.Pelvic MRI(non-enhanced and enhanced)showed the presence of a blind ending vagina between rectum and urinary bladder(40 mm in depth)and the absence of uterus and ovarian tissue.DNA sequencing found one c.1685T>C heterozygous mutation(p.Ile562Thr)on exon 2 of AR gene in the child.But retrieving and summarzing documents of the domestic and foreign information databases and websites,the locus mutation of AR gene had never been reported.The structure prediction of the mutated protein(Polyohen2 and SIFT software)was significantly changed.By verifying the locus site of the parents of this child,it was found that his mother carried the same mutation,but his father was found to be normal.Conclusions A c.1685 T>C mutation(p.Ile562Thr)on exon 2 of AR gene is a novel mutation.Combined with the patient's clinical manifestations and computer prediction results,it may suggest that the novel mutation of AR gene can lead to the occurrence of AIS.

Objective:To investigate the effect of flt-3 ligand on the preparation of the fusional vaccine with dendritic cells and colorectal cancer cells,and the anti-tumor immunological reaction of the vaccine. Methods: ①In the presence of Flt-3 ligand、GM-CSF、IL-4 and TNF,the maturation of dendritic cells was made from peripheral blood;The preparation of the fusional vaccine was made in the presence of PEG. ②The biological characteristics of fusion cells,including their morphological specialties, the expression of cell surface phenotypes, their growth curves, inducing specific cytotoxic T lymphocyte(CTL), their possibility to proliferate into a new carcinoma in nude mice etc, were tested to verify their safety when used as anti-tumor immune reactions. Results: ①Flt-3 ligand can stimulate the full maturation of dendritic cells. Dendritic cells and Lovo cells could be fused by PEG. ②The fusion cells exhibited typical biological characteristics. They could not proliferate into new carcinomas in nude mice, and can inhibit the proliferation of Lovo cells efficiently. Conclusion: Flt-3 ligand can enhance the maturation of dendritic cell. The fused cells had poor proliferation abilities and could not proliferate into new carcinomas in immunodeficient animals. The fusion vaccine could induce specific cytotoxic T lymphocytes in vitro and was safe as a vaccine.

Objective: To compare the histopathological changes after neo-adjuvant radiotherapy and to elucidate the mechanism of radiotherapy in rectal cancer. Methods: 80 patients with rectal cancer in pTNM stage Ⅱ or Ⅲ were enrolled between April 2000 and December 2002.They were randomly assigned to surgery alone or preoperative neo-adjuvant radiotherapy.The conventional radiotherapy scheme was followed: 40 Gy in 2.0 Gy fractions.The treatment last 4 weeks and it is usually followed by an interval of 1-2 weeks before the operation.Pathological changes including necrosis of tumor and changes of matrix and vessels were graded. Results: Significant tumor regression(RCRG 1) was seen in 14 cases(35 percent) after radiotherapy,while partially tumor regression(RCRG 2) was seen in 18 cases(45 percent).Significant necrosis was observed in 72.5 percent of cases after preoperative radiotherapy,most foci of adenocarcinoma were replaced by fibrosis in 80 percent of cases,and intimal thickening in most of the vessels were seen in 77.5 percent of cases.The frequency of these pathological changes after radiotherapy was significantly more than control group. Conclusion: Necrosis,fibrosis and thickening of vascular intima in the rectal cancer tissue after radiotherapy is more frequent than those without radiotherapy.It may be the potential reason for increased resection rate and sphincter-saving after radiotherapy.

Objective To examine the galectin-3 expression in bladder cancer and explore the relationship between the galectin-3 expres-sion and the clinicalpathological characteristics of bladder cancer.Methods Immunohistochemical streptavidin-peroxidase（S-P）method was employed to examine the expression of galectin-3 in 45 bladder cancer tissues and 6 normal bladder tissues.The relationship between galectin-3 expression and the clinicopathological parameters was analyzed in bladder cancers.Results The positive rate of galectin-3 ex-pression in bladder cancer was 62.2%,significantly higher than that in 6 normal bladder tissues（P 〈 0.05）.The positive rates of galectin-3 expression in primary cases and recurrent cases were 60% and 70% respectively without significant difference（P 〉 0.05）.The up-regulated expression of galectin-3 was positively correlated with the pathological degree and clinical stage of bladder cancer（P 〈 0.05）.Conclusion Galectin-3 expression is up-regulated in bladder cancer and its increased expression is useful for diagnosis of bladder cancer.Additionally,it could be used as an important index to evaluate the pathological degree and clinical stage of bladder cancer.