To analyze the background of Sini Decoction prescription, taking the clinical emergency treatment of shock syndrome by Sini Decoction as the main line, to explore the following three problems on rescuing shock syndrome faced by Zhang Zhong-jing: The first is how to use Aconiti Lateralis Radix Preparata (fuzi) to restore yang for saving from collapse, in the case that the blood capacity can not be quickly supplied; The second is how the active constituents in fuzi could be quickly absorbed, in the pathological state of the shock with severe gastrointestinal disturbance; The third is how to relieve the toxicity of fuzi, in the condition that the active components are not affected; The aim of the study is to reveal the scientificality and rationality in the theory of traditional Chinese medicine, which could provide the guidance for the application of classical prescription in modern clinic or the development of new Chinese materia medica.

OBJECTIVE The present study was aimed to investigate the role of Wnt/β-catenin sig-naling in spinal VGLUT2 regulation and neuropathic pain. METHODS To elucidate the association be-tween VGLUT2 and neuropathic pain,we determined the expression and distribution characteristics of VGLUT2 in mice subjected to spared nerve injury(SNI),and then observed the effects of two VGLUT2 targeting shRNAs on mechanical allodynia and glutamate release.The effects of Wnt/β-catenin signal-ing on VGLUT2 expression and pain behavior were investigated by using Wnt agonist,Wnt1,and Wnt/β-catenin pathway inhibitor XAV939 in SNI mice.RESULTS SNI surgery induced significant up-regula-tion of VGLUT2 on postoperative days 7,14,and 21.Double immunofluorescence labeling of VGLUT2 with NeuN,MAP2,Iba-1,or GFAP showed that VGLUT2 was mainly expressed in neurons in the dor-sal horn of the spinal cord after SNI(NeuN,MAP2).Intrathecal administration of VGLUT2 shRNAs be-fore or after SNI surgery significantly decreased mechanical allodynia and glutamate release. Mean-while,Wnt1/β-catenin signaling increased significantly after SNI surgery.Over-expression of β-catenin in PC12 cells increased VGLUT2 protein level,intrathecal administration of Wnt agonist or Wnt1 signifi-cantly increased VGLUT2 protein expression in spinal cord, while Wnt/β-catenin pathway inhibitor XAV939 decreased VGLUT2 expression in PC12 cells and spinal cord.Additionally,intrathecal admin-istration of XAV939 7 days after SNI significantly attenuated mechanical allodynia in mice, which was in accordance with down-regulation of VGLUT2 protein levels.VGLUT2 shRNAs significantly attenuat-ed Wnt agonist or Wnt1 induced mechanical allodynia. CONCLUSION Wnt1/β-catenin signaling path-way up-regu-lates the spinal VGLUT2 expression,and this regulation is involved in neuropathic pain behavior.

Objective To investigate the effect of rosuvastatin on myocardial reperfusion and the recent clinical efficacy of patients with ST-segment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI) with/without the chronic pre-treatment of statins.Methods A total of 170 STEMI patients after primary PCI were enrolled.According to the history with the pre-treatment of statins,the patients were divided into long-term intervention group (pre-treatment of statins more than 3 months,n =45) and no long-term treatment group (without pre-treatment of statins or with less than 3 months pre-treatment of statins,n =125) patients.The no long-term treatment group was then randomly divided into the high dose group(n =64) and conventional dose group(n =61).The patients in high dose group were orally given treated with rosuvastatin 20 mg orally before PCI,and treated with rosuvastatin 10 mg qn after PCI,while the patients in the other two groups were treated with 10 mg rosuvastatin orally before PCI,and given rosuvastatin 10 mg qn after PCI.The three groups were treated for 40 d.All patients were orally given aspirin 300 mg + clopidogrel 600 mg before PCI,and treated with aspirin 100 mg qd + clopidogrel 75 mg qd after PCI for at least 12 months.Myocardial reperfusion,left ventricular end-diastolic dimension (LVEDD),fractional shortening (FS) and Left ventricular ejection fraction (LVEF),major adverse cardiovascular events(MACEs) and adverse drug reactions were compared among the three groups.Results In the high dose group,long-term intervention group and the conventional dose group,the rates of TIMI 3 grade were 93.75％,95.56％ and 85.25％ respectively,while the rates of STR were 93.75％,95.56％ and 86.89％,and the incidence of reperfusion arrhythmia was 60.94％,57.78％ and 36.07％.Significant differences were found in all the parameters above among all groups (P ＜ 0.05).Forty days after PCI,in the three groups LVEDD were (52.80 ± 4.82),(51.88 ± 4.79) and (52.85 ± 4.72) mm,FS were (39.65 ± 2.89) ％,(40.05 ± 2.25) ％ and (34.05 ± 2.89) ％,and LVEF were (53.78 ± 6.92)％,(54.08 ± 6.22)％ and(47.05 ± 6.10)％,the differences were statistically significant (P ＜ 0.05) when compared with the parameters measured 7 days after PCI.MACEs in the group with pre-treatment of statins were recurrent angina pectoris(1 case),cardiogenic shock (3 cases),heart failure (1 case) and severe ventricular arrhythmia(2 cases),and the incidence of cardiovascular adverse event was 15.56％ (7/45 cases).In high-dose group,MACEs were recurrent angina (3 cases),cardiogenic shock (1 case),heart failure (4 cases),severe ventricular arrhythmia (3 cases),death (1 case);the incidence of cardiovascular adverse events was 18.75％ (12/64 cases),and statistically significant differences were found when compared with the conventional dose group (P ＜ 0.05).Conclusion Conventional dose pre-treatment of rosuvastatin was able to further alleviate the ischemic myocardial reperfusion and improve the recent clinical efficacy for STEMI patients with long-term pre-treatment of statins after primary PCI.

OBJECTIVETo determine the effect of laparoscopic radiofrequency ablation of T1aN0M0 renal cell carcinoma (RCC) with regular follow-up.

METHODSAll patients underwent surgery from March 2006 to March 2009. Eight cases were solitary kidney. Twenty-two cases of left RCC and 18 cases of right RCC were diagnozed by ultrasonography and CT scanning.All of the cases were T1aN0M0 stage. No metastasis was found by iconography test. By ultrasound positioning, laparoscopic radiofrequency were performed on the renal tumor. All patients were followed up with eGFR and enhanced-CT.

RESULTSAll patients underwent laparoscopic radiofrequency ablation surgery successfully. The mean operation time was (101 ± 19) minutes and the mean blood loss was (90 ± 14) ml (no blood transfusion pre- and post-operation). During postoperative follow-up, enhanced CT revealed complete ablation in 39 cases (the success rate was 97.5%), and 1 residue tumor was confirmed by enhanced CT 7 days post operation. This patient was under close surveillance because of solitary kidney. No progression of the residue tumor was found during the follow-up. One case of recurrence was confirmed by enhanced CT in 6 month after operation. The 3-year recurrence rate was 2.5%. No further intervation was performed on this patient and no change was found in the recurrence area during the follow-up. Both 3-year total survival rate and 3-year cancer specific survival rate were 100%. The mean eGFR was (72 ± 9) ml/(min·1.73 m(2)) in 3 years after surgery. There was no significant difference between pre-and post-operation (P > 0.05).

CONCLUSIONMid-term follow-up results show the effectiveness and safety of laparoscopic radiofrequency ablation in the treatment for T1aN0M0 RCC and have no negative influence on the renal function.

Carcinoma, Renal Cell ; mortality ; surgery ; Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; mortality ; surgery ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; epidemiology ; Treatment Outcome

OBJECTIVETo study the diagnosis and treatment of Müllerian duct cysts and their involvement with malignancy.

METHODSA 44-year-old male patient with papillary cystadenocarcinoma involving a Müllerian duct cyst was presented. The presentation treatment, and pathological and radiological appearances were retrospectively analysed and discussed with literature review. The main manifestation was intermittent episode of hemospermia accompanying terminal hematuria and infertility for 15 years. Final diagnosis was determined by the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination and biopsy.

RESULTSExploratory laparotomy was performed through a suprapubic retrovesical approach. The finding that a duct-like wedge of tumor tissue passed through the prostate near cyst neck to the posterior urethra without affecting the adjacent prostatic tissue during tylectomy confirmed that it arises from Müllerian duct system. Pathohistologic examination disclosed a papillary cystadenocarcinoma and it infiltrated the wall of the cyst. Both seminal vesicles and ejaculatory duct had no carcinoma invasion.

CONCLUSIONMüllerian duct cyst involving with malignancy is exceedingly rare, the diagnosis is based on the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination. The final diagnosis depends on the pathohistologic examination. Lumpectomy is effective and have a good outcome.

Adult ; Cystadenocarcinoma, Papillary ; diagnosis ; surgery ; Cysts ; diagnosis ; surgery ; Genital Neoplasms, Male ; diagnosis ; surgery ; Humans ; Male ; Mullerian Ducts

OBJECTIVETo study the BRCA1 mutations in patients with early-onset breast cancer and their affected relatives in Guangdong province and explore the relationship between BRCA1 mutation and the expressions of estrogen receptor(ER), progesterone receptor(PR), HER2 and ALN.

METHODSFrom 58 patients with early-onset breast cancer and their affected relatives, the genomic DNA was extracted from the peripheral blood mononuclear cells and the coding regions of the BRCA1 gene was amplified using polymerase chain reaction. BRCA1 gene mutations were screened by denaturing high performance liquid chromatography (DHPLC) and subsequent direct DNA sequencing. The expression of ER, PR, HER2 and ALN were detected with immunohistochemistry and their relations with the gene mutation were analyzed.

RESULTSDisease-related BRCA1 mutations were detected in 2 of the 58 patients, who were younger than 35 years old, including 1 with a novel splice-site mutation (IVS5-1 G-->A). No association was found between this novel mutation and the expressions of ER, PR, HER2 and ALN.

CONCLUSIONThe incidence of BRCA1 mutation is significantly lower in patients with early-onset breast cancer and their affected relatives in Guangdong province than in the Western populations. The novel mutation identified in BRCA1 gene may represent a mutation characteristic of the patients in Guangdong province. BRCA1 gene mutations may not have any relation with the expression of ER, PR, HER2 and ALN.

Adult ; Age of Onset ; Base Sequence ; Breast Neoplasms ; genetics ; China ; DNA Mutational Analysis ; Female ; Genes, BRCA1 ; Genotype ; Humans ; Molecular Sequence Data ; Mutation ; Receptor, ErbB-2 ; genetics ; Receptors, Estrogen ; genetics ; Receptors, Progesterone ; genetics

Obiective Tend to explore the correlation between thyroid function and the severity of coronary artery lesions in chinese coronary heart disease(CHD)patients. Methods A total of 558 patients who underwent coronary angiography at the cardiology department of Peking University First Hospital from January 2013 to June 2015 were enrolled in this retrospective study. All patients were divided into coronary heart disease group and non-coronary heart disease group. Thyroid hormone levels were tested in all patients before angiography,and clinical characteristics,lipid profiles and SYNTAX scores were also obtained. Results Of the 558 patients,409 were diagnosed of CHD(73.3％),and among them,5 patients were hyperthyroid/subclinical hyperthyroid(1.2％),13 patients were hypothyroid/subclinical hypothyroid(3.2％),14 patients had euthyroid sicknesssyndrome(ESS)(3.2％),377 patients were euthyroid(92.2％). Among the 149 non-CHD patients(26.7％),3 patients were subclinical hyperthyroid(2.0％),8 patients were hypothyroid/subclinical hypothyroid(5.4％),2 patients were ESS(1.3％),172 patients were euthyroid(91.3％). The proportion of patients with ESS in the CHD group was significantly higher than that of the non-CHD group (3.4％ vs. 1.3％,P=0.018). Except for the patients with ESS,FT3 level was significantly lower the in CHD group than that in the non-CHD group[(4.52±0.57)pmol/L vs.(4.65±0.63)pmol/L,P=0.015]. There were no significant differences in FT4,T3,T4 levels between the two groups(P>0.05). In the CHD group,there was an association between the SYNTAX score groups and free triiodothyronine(FT3)levels(F=6.260,P=0.002). A significant correlation was also observed between the FT3 level and the number of coronary artery lesions(F=5.691, P=0.004). There was no correlation between the SYNTAX score groups or number of coronary artery lesions and thyroid hormone levels,respectively. There were no correlations between lipid profiles and thyroid function. Patients were further divided into three subgroups according to their serum TSH levels. The prevalence of CHD is significantly higher in the subgroup with elevated TSH(85.7％)than in the subgroup with normal TSH(68.6％, P=0.022). Conclusions FT3 level is weakly associated with the severity of CHD. Higher TSH level may be a risk factor of CHD.

Objective: To observe the short- and long-term clinical outcomes of fraction flow reserve (FFR)-guided percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients with SYNTAX score≥33 unsuitable for coronary artery bypass grafting (CABG). Methods: A total of 117 CAD patients admitted in our hospital from 2012-01 to 2015-06 were enrolled. Since SYNTAX score≥33, EuroSCORE>6, the patients were unsuitable for CABG and treated in 2 groups: Medication group, n=20 and PCI group, during FFR-guided PCI procedure, patients received ROTA or IVUS according to physician's experience, n=97. All patients were followed-up for at least 12 months. Meanwhile, taking "coronary stent and bypass", "CABG and PCI" as key words, we searched relevant documents in VIP Chinese science and technology journal full-text database, WanFang medical database, ChinaNet and Chinese biomedical literature database from 2012-01-01 to 2015-12-31, patients' outcomes were compared with the above references to explore the clinical benefit. Results: ① PCI group and Medication group had similar SYNTAX score and EuroSCORE, P>0.05. The common pathogenesis was LAD involvement, chronic occlusion was 31.3% (5/16) in patients with partial revascularization.②PCI group had 18.6% (18/97) incidence of major adverse cardiac and cerebral events (MACCE), 2 patients died during follow-up period and 9 received revascularization; Medication group had 60% (12/20) incidence of MACCE, 3 patients died during follow-up period; the difference between 2 groups showed statistical meaning, P<0.05.③There were 22 relevant documents retrieved as comparison; in our research, PCI group had similar incidence of MACCE to the documents, P>0.05; Medication group had increased incidence of MACCE than the documents, P<0.05. Conclusion: FFR-guided PCI could bring clinical benefit in CAD patients with SYNTAX score≥33 unsuitable for CABG.

OBJECTIVETo investigate DNA methylation variation in human cells induces by B(a)P, and to explore the role of PARP1 during this process.

METHODSThe changes of DNA methylation of 16HBE and its PARP1-deficient cells exposed to B(a)P (1.0, 2.0, 5.0, 10.0, 15.0, 30.0 µmol/L) were investigated by immunofluorescence and high performance capillary electrophoresis, and simultaneously, the expression level of PARP 1 and DNMT 1 were monitored dynamically.

RESULTSThe percentage of methylated DNA of overall genome (mCpG%) in 16HBE and 16HBE-shPARP1 cells were separately (4.04 ± 0.08)% and (9.69 ± 0.50)%. After being treated by 5-DAC for 72 hours, mCpG% decreased to (3.15 ± 0.14)% and (6.07 ± 0.54)%. After both being exposed to B(a)P for 72 hours, the mCpG% in 16HBE group (ascending rank) were separately (5.10 ± 0.13), (4.25 ± 0.10), (3.91 ± 0.10), (4.23 ± 0.27), (3.70 ± 0.15), (3.08 ± 0.07); while the figures in 16HBE-shPARP1 group (ascending rank) were respectively (10.63 ± 0.60), (13.08 ± 0.68), (9.75 ± 0.55), (7.32 ± 0.67), (6.90 ± 0.49) and (6.27 ± 0.21). The difference of the results was statistically significant (F values were 61.67 and 60.91, P < 0.01). For 16HBE group, expression of PARP 1 and DNMT 1 were 141.0%, 158.0%, 167.0%, 239.0%, 149.0%, 82.9% and 108.0%, 117.0%, 125.0%, 162.0%, 275.0%, 233.0% comparing with the control group, whose difference also has statistical significance (t values were 11.45, 17.32, 32.24, 33.44, 20.21 and 9.87, P < 0.01). For 16HBE-shPARP1 group, expression of PARP 1 and DNMT 1 were 169.0%, 217.0%, 259.0%, 323.0%, 321.0%, 256.0% and 86.0%, 135.0%, 151.0%, 180.0%, 229.0%, 186.0% comparing with the control group, with statistical significance (t values were 9.06, 15.92, 22.68, 26.23, 37.19 and 21.15, P < 0.01). When the dose of B(a)P reached 5.0 µmol/L, the mRNA expression of DNMT 1 in 16HBE group (ascending rank) were 125.0%, 162.0%, 275.0%, 233.0% times of it in control group, with statistical significance (t values were 12.74, 24.92, 55.11, 59.07, P < 0.01); while the dose of B(a)P reached 2.0 µmol/L, the mRNA expression of DNMT 1 in 16HBE-shPARP1 group were 135.0%, 151.0%, 180.0%, 229.0%, 186.0% of the results in control group, and the differences were statistically significant (t values were 23.82, 40.17, 32.69, 74.85, 46.76, P < 0.01).

CONCLUSIONThe hypomethylation of 16HBE cells induced by B(a)P might be one important molecular phenomenon in its malignant transformation process. It suggests that PARP1 could regulate DNA methylation by inhibiting the enzyme activity of DNMT1, and this effect could be alleviated by PARP1-deficiency.

Benzo(a)pyrene ; adverse effects ; Cell Line ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; metabolism ; DNA Damage ; DNA Methylation ; Epithelial Cells ; drug effects ; metabolism ; Humans ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerases ; genetics ; metabolism

OBJECTIVETo observe the dynamic changes of CD3+, CD4+, and CD8+ T lymphocytes in the peripheral blood of patients with sepsis and discuss the clinical significance.

METHODSSixty-four patients admitted in the Emergency Center and Emergency Intensive Care Unit of the Second Hospital of Wenzhou Medical University between August, 2007 and July, 2009 were enrolled in this study. CD3+, CD4+, and CD8+ T lymphocytes in the peripheral blood were detected by flow cytometry on days 1, 7 and 14 after admission, and the results were compared between the patients with improvement of the condition and those without improvement, with 20 healthy subjects as the control group.

RESULTSOn day 1 after admission, CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio were obviously lower in the 2 groups of patients with sepsis than in the control group (P<0.05), but no significant difference was found in CD8+ T lymphocytes. The sepsis patients with clinical improvement showed significant higher CD3+ and CD4+ T lymphocyte percentages and CD4+/CD8+ T cell ratio than those without improvement on day 1. In the patients with clinical improvement, CD3+ and CD4+T lymphocytes and CD4+/CD8+ T cell ratio increased gradually with time and till day 14, they were comparable with the control levels; in the patients without improvement, CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio showed no obvious alterations in the course of observation.

CONCLUSIONImmune imbalance occurs in patients with sepsis represented by lowered CD3+ and CD4+T lymphocyte percentages and CD4+/CD8+ T cell ratio in relation to the severity of the condition. CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T cell ratio can be used as the indicators for assessing the severity of sepsis.

Adult ; Aged ; Aged, 80 and over ; CD4-CD8 Ratio ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Male ; Middle Aged ; Sepsis ; blood ; immunology ; T-Lymphocyte Subsets ; cytology