Objective To investigate therapeutic effects of phlorizin on the early stage of diabetic retinopathy(DR)in diabetic db/db mice.Methods The 24 db/db male mice were divided into 3 groups of phlorizin-treated diabetic group(20mg/kg of phlorizin by intragastric gavage)(DMT,n =8),diabetic group(normal saline solution by intragastric gavage)(DM,n=8),with C57BLKS/J db/ m mice as the control group(CC,n=8)for ten weeks.After ten weeks,all mice were sacrificed and the retina was isolated.The specimen was embedded in paraffin wax and sliced.The sections were dyed with Sudan red and observed for retinal morphological change.Meanwhile,the expressions of GSK-3β and phospho-GSK-3β in retinas were determined by western blot.Results During the study,the CC group showed good condition.The DM group featured with polydipsia,polyphagia and a rapid increase of body weight.Phlorizin-treated diabetic mice displayed much better than the DM group.Compared with CC group,DM group showed cells proliferation in capillary endothelia and obvious thickening in basement membrane.After administration of phlorizin,the vascular lesion of central regions was remarkably improved.The expression level of phospho-GSK-3β protein was lower in DM group than in control group(76.2±15.8 vs.255.4 ± 10.7,t =16.30,P＜0.01)and was higher in Phlorizin-treated DM group(188.5±18.4)than in DM group(76.2± 15.8,t=8.05,P＜0.01).Conclusions Phlorizin decreases phospho-GSK-3β3expression in retina in db/db diabetic mice and suppresses the GSK-3βactivity,which leads to the protection of DR.

Objective To compare adductor canal block with femoral nerve block under multimodal analgesia for early analgesic effect and rehabilitation after total knee replacement (TKA). Methods Eighty patients who were scheduled to undergo TKA were randomly divided into two groups:adductor canal block (ACB) group and femoral nerve block (FNB) group. All the pa?tients were given Celecoxib (200 mg, bid) three days preoperative. The ACB group was given adductor canal block with ropivacaine (5 g/L, 20 ml) and 0.1 mg epinephrine half an hour before the surgery. The FNB group was given femoral nerve block with ropivacaine (3.33 g/L, 30 ml) and 0.1 mg epinephrine half an hour before the surgery. Both of the two groups were given local infiltration analge?sia with ropivacaine (2.5 g/L, 20 ml) and 0.1 mg epinephrine after click into the prosthesis. After surgery, all the patients were given Diclofenac Sodium (50 mg, q12h, p.o.), oxycodone hydrochloride sustained?release tablets (10 mg, q12 h, p.o.) and Parecoxib (40 mg, q12 h, i.m.) until discharged. The resting and motion Numeric Rating Scales (NRS) scores, the knee joint range of motion, the muscle strength of quadriceps femoris, total Meperidine hydrochloride consumption, postoperative hospital stay and the side effects and complications were recorded. Results The resting and motion NRS scores were similar to the ACB group of FNB group which were not statistically significant. The range of motion (1, 2, 3 days after surgery) and muscular strength of quadriceps femofis (within 24 hours) in the ACB group was better than in the FNB group. The average length of postoperative hospital stay was shorter in the ACB group than it was in FNB group. In the ACB group the range of motion at 14 day, total Meperidine hydrochloride con?sumption and the side effects were similar to the FNB group. Conclusion Under multimodal analgesia, the adductor canal block had similar early analgesia effects with the femoral nerve block when TKA was performed. However, compared with FNB, the ACB was more beneficial to patients regarding the early postoperative rehabilitation to patient.

Objective To observe the clinical efficacy of acupuncture plus medicine and function training in treating post-stroke shoulder-hand syndrome. Method Sixty patients with post-stroke shoulder-hand syndrome were randomized into a treatment group of 30 cases and a control group of 30 cases. The treatment group was intervened by acupuncture plus medicine and functional training, while the control group was only by functional training. Before and after intervention, the hand swelling degree, Visual Analogue Scale (VAS), shoulder joint motion scale, Fugl-Meyer Assessment (FMA) scale were used to measure the swelling and pain of hand, motion of shoulder, and motor function of upper limb. Result After intervention, the swelling and pain of hand, motion range of shoulder and motor function of upper limb were significantly improved in both groups (P<0.01), and the improvements in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture plus medicine and function training can enhance the efficacy in treating post-stroke shoulder-hand syndrome, superior to pure function training.

Objective To evaluate the cost-effectiveness of sequential therapy of levofloxacin in the treatment of type Ⅲa prostatitis.Methods A total of 280 in-patients diagnosed typeⅢa prostatitis were enrolled in this study and randomized to administer with either levofloxacin 500 mg( n =140 ) for intravenous injection once daily for 28 days ( control group) or administered of levofloxacin injection 500 mg ( n=140 ) once daily for 7 days followed by oral levofloxacin 500 mg once daily for 21 days( sequential group).Clinical results and safety were observed and cost-effectiveness analysis was made after 4 -week therapeutic dura-tion.Results The clinical effective rates showed no significant difference between 2 groups ( P<0.05 ).But cost -effectiveness ratio and sensitivity analysis in sequential group was significantly lower than that in control group(P<0.05).The adverse drug reaction rates in con-trol group ( 15.71%) and sequential group ( 5.71%) showed significant difference between 2 groups ( P<0.05 ).Conclusion The sequential therapy with the antibiotic therapeutic of levofloxacin 500 mg once daily achieved similar clinical efficacy to mono-therapy and offered an eco-nomic superiority and less adverse reactions in the treatment of type Ⅲa prostatitis.

Objective To investigate the expression and distribution of intrahepatic CD4+ CD25+regulatory T cells in immuno-tolerant and immuno-elearanee phase of patients with chronic hepatitis B. Methods The expression of FoxP3 was detected in 19 cases of immuno-tolerant phase and 12 cases of immuno-clearance phase by immunohistochemistry. The relation between the intrahepatic expression of FoxP3 and the clinico-pathological features were analyzed. Results The positive signal of FoxP3 is located in nuclear of lymphocyte and mainly aggregated in portal areas as well as occasionally scattered in hepatic sinusoids. The expression of intrahepatic FoxP3 in the group of immuno-tolerant phase was significantly increased than those in normal control(P<0.01), and greatly decreased than those in immuno-clearance phase (P<0.01). No correlation was observed among the expression of intrahepatic FoxP3, ALT, levels of HBV DNA, HBeAg positive, in patients of immuno-clearanee phase, respectively. There were significant differences between immuuo-tolerant phase and immuno-clearance phase age, ALT, TBIL, PTA, HBV-DNA and detection of HBeAg but not in sex and family history of HBV infection. Conclusion CD4+ CD25+ regulatory T cells may play important roles in the clearance of HBV as well as in liver inflammation and injury during chronic HBV infection.

Adult ; Female ; Humans ; Liver ; immunology ; pathology ; Liver Cirrhosis, Biliary ; immunology ; pathology ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo explore the molecular mechanisms of Glanzmann thrombasthenia caused by alpha II b L721R and Q860X compound heterozygous mutation.

METHODSAll exons and exon-intron boundaries of alpha II b and beta3 gene were amplified by PCR and analyzed by direct DNA sequencing. Gene polymorphisms were excluded by direct DNA sequencing. Alpha II b L721R and Q860X mutants expressing vectors were constructed by in vitro site-directed mutagenesis. The expression of alpha II b L721R and Q860X mutants on transfected cell membrane were analyzed by flow cytometry and the whole expression level was confirmed by Western blot. The subcellular localizations of alpha II b L721R and Q860X mutants were determined by immunofluorescent confocal scanning microscopy.

RESULTSThe alpha II b compound heterozygous mutations, T2255G (L721R) and C2671T (Q860X), were identified in the proband, the former being inherited from the maternal side and the latter the paternal side. The 293T cells cotransfected with mutated alpha II b L721R and wild-type beta3 expression plasmids expressed 2.1% of normal amount of alpha II b on the cell surface as shown by FACS, in contrast to 31.9% of normal amount of alpha II b on the cells cotransfected with cDNAs of mutated alpha II b Q860X and wildtype beta3 expression plasmids. Western blot of the cell lysates showed no detectable mature alpha II b in cells lysates with L721R mutant. While, truncated alpha II b protein was detected in cell lystes with Q860X mutant. Immunofluorescence studies demonstrated that both L721R and Q860X mutant pro-alpha II bbeta33 complex colocalized in endoplasmic reticulum, but a little in Golgi.

CONCLUSIONSThe L721R and Q860X mutations of alpha II b prevent transport of the pro-alpha II bbeta3 complex from the endoplasmic reticulum to the Golgi, hindering its maturation and surface expression. The impaired alpha II bbeta3 transport is responsible for the thrombasthenia.

Animals ; CHO Cells ; Child, Preschool ; Cricetinae ; Cricetulus ; Female ; Genetic Vectors ; Heterozygote ; Humans ; Integrin alpha2beta1 ; genetics ; metabolism ; Mutagenesis, Site-Directed ; Mutation ; Thrombasthenia ; genetics ; Transfection

Objective: To investigate the survival and prognostic factors of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) for patients with myeloid neoplasms and RUNX1 mutations. Methods: From July 2014 to April 2018, the clinical data of forty-two AML/MDS patients with RUNX1 mutations in the First Affiliated Hospital of Soochow University were retrospectively analyzed. The clinical characteristic features and distribution of the mutations frequently observed with RUNX1 mutations were summarized, the prognosis of allo-HSCT for these patients was also analyzed. Results: Among 42 AML/MDS patients with RUNX1 mutations, 27 were male, 15 were female. The median age was 43.5 (16-68) years old. There are 31 patients in allo-HSCT group and 11 patients in chemotherapy group. RUNX1 mutations co-occurred with many other gene mutations, the most frequent mutations were FLT3 (26.2%, 11/42) . Interestingly, FLT3 mutations only occurred in AML patients compared with MDS patients (P=0.014) . ASXL1 (25%, 3/12) mutations were observed as the most frequent co-mutations in MDS patients. One-year overall survival (OS) , disease-free survival (DFS) of allo-HSCT and chemotherapy patients were (70.6±9.0) %, (61.0±9.4) % and (34.4±16.7) %, (22.4±15.3) %, respectively. When OS and DFS between allo-HSCT and chemotherapy patients were compared, significant differences (χ(2)=4.843, 4.320, P<0.05) were showed. In univariate analysis, transplant age >45 years was a negative effect for OS [HR=4.819 (95% CI 1.145-20.283) , P=0.032] and DFS [HR=5.945 (95% CI 1.715-20.604) , P=0.005]. Also, complex chromosome karyotype abnormality was a negative effect for OS [HR=5.572 (95%CI 1.104-28.113) , P=0.038]. Conclusion: Transplant age (>45 years) and complex chromosome karyotype abnormality were negative prognostic factors in allo-HSCT for myeloid neoplasms patients with RUNX1 mutations.
Adult ; Aged ; Core Binding Factor Alpha 2 Subunit/genetics* ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute/genetics* ; Male ; Middle Aged ; Mutation ; Prognosis ; Retrospective Studies ; Transplantation, Homologous

OBJECTIVETo evaluate the symptoms and surgical management results of metastatic disease in the retropharyngeal space.

METHODSSix patients with malignant tumors were collected, in which enlarged lymph nodes presented both in neck and retropharyngeal space. They consisted of two supraglottic carcinoma (T3N2MO), one thyroid carcinoma (TXN2MO), one nasal melanoma (TXN2MO), one oropharyngeal carcinoma (T2N2M0) and one hypopharyngeal carcinoma (T3N2MO). The enlarged nodes in the retropharyngeal space were measured with CT and (or) MRI, which ranged from 1.5-2.5 cm in diameter. Based on the control of the primary and neck disease, the mass in the retropharyngeal space was dissected and sent for pathologic exam separately.

RESULTSMetastasis in the retropharyngeal space was pathologically proved in all of them, along with the involved internal jugular lymph nodes of 3/15, 3/17, 4/19, 5/19, 6/20, and 6/23, respectively. No serious complications occurred, such as fistula and central nerve damage. The patient with hypopharyngeal carcinoma died of lung metastasis 2 years after operation. The one suffering nasal malignant melanoma was out of follow-up in the 14th months. The patient with oropharyngeal carcinoma locally relapsed in the 18th months and died at the 24th months postoperatively. The rest was alive with tumor free within the follow-up period from 2 to 4 years.

CONCLUSIONSCT or Mifi are the mainstay of diagnosis of the metastatic disease in the retropharyngeal space and can he surgically controlled with safety.

Aged ; Carcinoma, Squamous Cell ; pathology ; Female ; Head and Neck Neoplasms ; pathology ; secondary ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; diagnosis ; prevention & control ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pharynx ; pathology ; Tomography, X-Ray Computed

BACKGROUND: Chinese medicine is effective for preventing and treating glucocorticoid-induced osteoporosis, however, the underlying mechanism remains unclear. DKK1, an inhibitor of Wnt/β-catenin signaling pathway, can be up-regulated by glucocorticoid. Thereafter, DKK1 is an important target in the prevention and treatment of osteoporosis. OBJECTIVE: To explore the regulatory effect of Zuogui pill on DKK1 in the prevention and treatment of glucocorticoid-induced osteoporosis. METHODS: Eighteen three-month-old female Sprague-Dawley rats were randomly divided into three groups: control group, model group and Zuogui pill group. Rats in the model and Zuogui pill groups received the subcutaneous injection of dexamethasone to establish the model of glucocorticoid-induced osteoporosis. The Zuogui pill group rats were administrated Zuogui pill extracts, and the control rats were given the same volume of normal saline. At 1 month after modeling, the lumbar vertebrae were removed to test the bone mass and microstructures by micro-CT scanning. The biomechanical properties were detected by compression test. The mRNA expression levels of DKK1, Runx2 and CTSK were determined by Qpcr. The serum alkaline phosphatase activity was tested. RESULTS AND CONCLUSION: Compared with the control group, in the model group, the volumetric bone mineral density, trabecular bone volume fraction, trabecular number, and trabecular thickness were significantly decreased (P ＜ 0.05), the trabecular separation and structure model index were significantly increased (P ＜ 0.05). The serum alkaline phosphatase activity was on a decline. The mRNA expression level of DKK1 showed a significant up-regulation (P ＜ 0.05). The mRNA expression level of Runx2 showed a down-regulated trend while mRNA expression level of CTSK showed an up-regulated trend. Compared with the model group, the Zuogui pill group showed significantly enhanced volumetric bone mineral density, trabecular bone volume fraction, and trabecular number (P ＜ 0.05); the structure model index was significantly decreased (P ＜ 0.05); the trabecular separation was reduced; the serum alkaline phosphatase activity was enhanced; the mRNA expression level of DKK1 showed a significant down-regulation (P ＜ 0.05); the mRNA expression level of Runx2 showed an up-regulated trend while mRNA expression level of CTSK showed a down-regulated trend. The vertebral compressive strength in the Zuogui pill group was significantly higher than that in the model group (P＜0.05). In summary, Zuogui pill prevents and treats glucocorticoid-induced osteoporosis possibly through the down-regulation of mRNA expression of DKK1.