ObjectiveTo discuss the clinical features, diagnosis and treatment of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome in children.Methods The clinical features and treatment process of two children with MELAS were retrospectively analyzed.ResultsThe main clinical features of MELAS were stroke-like epi-sodes, seizure, visual anomaly and lactic acidosis. Cephalic MRI ifndings performed during episode periods were in accord with the typical radiographic features of MELAS. Gene testing on the two children and their mothers showed the point mutation of A3243G in mitochondrial genome. The symptoms were improved signiifcantly after energy supply and corticosteroid treatment. Conclusions MELAS syndrome is easy to be misdiagnosed due to the varied clinical features. The diagnosis depends on the musclebiopsy and gene testing. Corticosteroid therapy is effective for MELAS syndrome.

Objective To investigate the efficacy and safety of tiotropium bromide aerosol combined with salmeterol in the treatment of ACOS. Methods 76 patients with ACOS were enrolled in this study from October 2014 to November 2016. They were divided into experimental group and control group according to the random number table method. The test group was given tiotropium bromide combined with salmeterol Casson aerosol treatment, the control group was given salmeterol tacrolone aerosol treatment, compared the two groups of patients with clinical efficacy and adverse reactions. Results The total effective rate was 92.11% in the experimental group and 73.68% in the control group, the difference was statistically significant (Z = 4.547, P<0.05). The ACT score of the test group was higher than that of the control group, the CAT score was lower than that of the control group, the difference was statistically significant (P<0.05); The incidence of adverse reactions in the test group was 10.53%, the incidence of adverse reactions in the control group was 13.16%,the difference was not statistically significant (χ2 = 0.126). Conclusion Tiotropium powder combined with salmeterol tegon aerosol in the treatment of bronchial asthma-chronic obstructive pulmonary syndrome is reliable and worthy of clinical practice.

OBJECTIVE To study the effect of valproic acid ( VPA) on radiosensitivity to MCF7 breast cancer cells. METHODS MCF7 cells were pretreated with VPA 0.5 and 1 mmol.L-1 for 0, 24, 48 and 72 h respectively, irradiated with 8 Gy lR, and at 6 h post-lR, the γ-H2 AX foci formation in MCF7 cells was tested by immunofluorescence assay. MCF7 cells were pretreated with VPA 0.5 and 1 mmol.L-1 for 72 h, irradiated with 4 Gy lR, and at 48 h post-lR, the cell survival rate was detected by MTT assay. MCF7 cells were pretreated with VPA 0.5 mmol.L-1 for 24 h, and then irradiated according to the amount of cells: 2 Gy (500 and 1000 cells per plate), 4 Gy (2000 and 4000 cells per plate), 6 Gy (8000 and 16000 cells per plate), and the cloning efficiency was calculated. MCF7 cells were pretreated with VPA 0.5 and 1 mmol.L-1 for 0, 24, 48 and 72 h respectively and the cell cycle profile was analyzed via flow cytometry. RESULTS After treatment with VPA alone for 24 h, MCF7 cells showed a significant increase in the amount of γ-H2 AX foci formation ( P < 0. 01). lt was also found that VPA increased lR-induced γ-H2 AX foci formation, which obviously prolonged the pretreatment time of VPA(P<0.01) in a time-dependent manner(r=0.98, P<0.05). VPA 0.5 and 1 mmol.L-1 had the same effect on γ-H2 AX foci formation. Furthermore, VPA was able to cause a significant decrease in lR-induced clonogenic survival but an increase in lR-induced cytotoxicity by MTT assay. Also, VPA alone decreased the plating efficiency of MCF7 cells. However, the cycle profile of MCF7 cells treated with both VPA 0.5 and 1 mmol.L-1 was not changed. CONCLUSION Without affecting the cell cycle profile, both the safe and critical dose of VPA used in clinical epilepsy treatment can significantly increase the accumulation of DNA double strand breaks in the cells and sensitize the cells to lR treatment, suggesting that VPA can induce radio-sensitization of breast cancer cells.

Objective To investigate the effect of Rho/Rho-kinase inhibitor fasudil combined with conventional vasodilating agents nitroglycerin in treatment of unstable angina pectoris.Methods Twenty patients[mean age (61 ± 11) years old]with unstable angina pectoris (angiospasm in the left anterior descending coronary artery) were selected and divided into fasudil group and control group with 10 cases each by random digits table.All the patients were examined by the acetylcholine stress test.Coronary diameter at the spasm site was measured and compared at baseline and after the administration of nitroglycerin in the following order: intracoronary nitroglycerin (300 g), intravenous fasudil (30 mg, fasudil group) or saline (control group), and again nitroglycerin (300 g) during coronary angiography.Results There was no significant difference in coronary diameter at the first nitroglycerin administration between fasudil group and control group[(38.2 ± 23.6)% vs.(42.6 ± 17.2)% ,P ＞0.05].Coronary diameter at intravenous fasudil and again nitroglycerin administration in fasudil group was expanded, and there was significant difference compared with that of the first nitroglycerin administration[(2.48 ±0.79), (2.51 ± 0.78 ) mm vs.( 2.11 ± 0.62 ) mm](P ＜ 0.01 ), but there was no significant difference in control group (P ＞ 0.05).There was no adverse effect in two groups,and blood pressure and heart rate was stable in fasudil group.Conclusions Fasudil further dilates the site of coronary spasm, which had already been treated with nitroglycerin in patients with vasospastic angina.These findings support and extend the previous results that shows the feasibility of employing fasudil as a novel therapeutic approach for coronary spasm.

In recent years,with the change of lifestyle and environment,the incidence of colorectal cancer is increasing.Colorectal polyp is an important precancerous lesion of colorectal cancer;endoscopic early detection,early diagnosis are important for the prevention and treatment of colorectal cancer.Aims:To investigate the endoscopic findings, pathology and clinical features of colorectal polyps.Methods:Patients with colorectal polyps from January 2014 to June 2016 at the Third People's Hospital of Shenzhen were enrolled,and the general information data,endoscopic findings, pathology and canceration rate were retrospectively analyzed.Results:A total of 740 patients had colorectal polyps detected,the ratio of male to female was 1.75:1,559 (75.5%)patients were aged >40 years,70.4% of polyps were located in left hemicolon,the main pathological type of polyps were inflammatory polyps (29.0%),hyperplastic polyps (29.6%),tubular adenoma (30.3%).Cancer was found in 38 patients,canceration rate was 5.1%;the main pathological types of cancerated adenoma were tubular adenoma,tubular villous adenoma and villous adenoma,and 87.2%had a diameter greater than 1.5 cm,and were mainly located in left hemicolon (76.9%).Conclusions:Gender,age,pathological type, diameter of colorectal polyps are important factors of canceration.Male colorectal polyps patients with age >40 years, diameter greater than 1 .5 cm,tubular villous adenoma and villous adenoma should be paid attention and followed up.

Objective:To study the differences of ventilation function in patients between chronic right heart failure secondary to pulmonary arterial hypertension and chronic whole heart failure secondary to left heart diseases.
Methods:A total of 102 patients with clinical stable chronic heart failure (CHF) were studied. The patients were divided into 2 groups:Whole heart failure (WHF) group, n=41 and Right heart failure (RHF) group, n=61. The ventilation function test at rest and cardiopulmonary exercise test (CPX) were conducted and compared between 2 groups.
Results: The rest ventilation function was similar between 2 groups. For CPX examination, compared with WHF group, RHF group had the lower peak minute ventilation (VE), higher anaerobic threshold and peak minute ventilation/CO2 production (VE/VCO2), higher peak dead space volume/tidal volume (VD/VT), all P<0.05.
Conclusion:At exercise condition, RHF patients had decreased ventilation function and ventilation index due to severe abnormality of ventilation/perfusion (V/Q).

Objective To establish the chromatographic fingerprint of mushroom polysaccharides by 1-phenyl-3-methyl-5-pyrazolone( PMP) pre-column derivatization. Methods The mushroom polysaccharides was extracted by hot distilled water, precipitated by alcohol, and hydrolyzed into monosaccharides by Trifluoroacetic Acid (TFA). The hydrolysate was derivatized with 1-phenyl-3-methyl-5-pyrazolone ( PMP ) and tested via HPLC to study the monosaccharide components in mushroom polysaccharides. Results Fingerprint was established with 13 common peaks, 6 peaks in which were identified as mannose, D-glucuronic acid, D-glucose, galactose, xylose and L-fucose. The glucose accounted for the most, followed by mannose, galactose and fucose. Conclusion Development of fingerprint chromatogram by HPLC is a stable, simple, and repeatable way, which can be applied to the quality control of mushroom polysaccharides.

Objective To observe the regulation of Toll-like receptor 4 (TLR4) signal and the release of inflammation factors after angiotensin Ⅱ (Ang Ⅱ) stimulation in rat mesangial cells under high glucose condition,revealing the innate immune-related mechanism of injury by Ang Ⅱ on mesangial cells under high glucose.Methods After synchronization,cells incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) were used as the stimulation group,cells without stimulation were as normal control (5.6 mmol/L glucose).To determine the role of TLR4 and the adaptor myeloid differentiation factor 88 (MyD88),equal number of HBZY-1 cells were added with 10-5 mmol/L irbesartan and/or TLR4 blocker (10 mg/L) for 1 h and then incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) for 12 h or 24 h respectively.Real-time PCR was used to analyze TLR4 mRNA and MyD88 mRNA expression after 12 h.Immunofluorescence was used to observe TLR4 protein expression after 24 h; Western blotting was used to observe TLR4,MyD88 and nuclear factor κB (NF-κB) protein; ELISA was used to detect the concentration of MCP-1,IL-6 in cell supernatant respectively.Results Compared with normal control group,TLR4 mRNA and MyD88 mRNA were highly expressed in high glucose or Ang Ⅱ-induced HBZY-1 cells (P ＜ 0.01),TLR4,MyD88 and NF-κB protein as well as MCP-1,IL-6 were also up-regulated significantly (P ＜ 0.01).Compared with high glucose or Ang Ⅱ group,MyD88 and NF-κB protein as well as MCP-1,IL-6 were further up-regulated markedly in Ang Ⅱ and high glucose costimulated group (P ＜ 0.01).In HBZY-1 cells that were preincubated with irbesartan and/or TLR4 blocker,TLR4 and MyD88 protein expression were obviously inhibited,IL-6 and MCP-1 production were also decreased remarkably compared with high glucose and/or Ang Ⅱ group (P ＜ 0.01).Conclusions High glucose and Ang Ⅱ stimulate the release of proinflammatory factors in rat glomerular mesangial cells via TLR4-MyD88 pathway.This process is inhibited by irbesartan or TLR4 blocker via modulation of the signal.Ang Ⅱ has the positive-regulation potential on the release of inflammation factors via TLR4 signal in rat mesangial cells under high glucose condition.

Objective:To explore the effect of red blood cell distribution width (RDW) on long-term follow-up study in patients with acute pulmonary thromboembolism (APE).
Methods:A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups:RDW≤15%group, n=202 and RDW>15%group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension (CTEPH). The independent predictor for CTEPH occurrence was studied by uni-and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve.
Results: All patients ifnished the follow-up study at the mean of (31±17) months. The overall occurrence rate of CTEPH was 7.5% (16/214), which was higher in RDW>15% group than that in RDW≤15% group (33.3% vs 5.9%, P=0.002). Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW>15%was still the strong predictor for CTEPH occurrence (OR=7.916, 95%CI 1.474-42.500, P=0.016). Adding RDW to the evaluating model, the predictive capability could be signiifcantly improved by ROC curve (AUC increased from 0.856 to 0.901, P<0.01).
Conclusion: Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.

Objective To investigate the expression and clinical significance of COX-2 and telomerase activity in esophageal carcinoma tissues(ECT)and resection margin of the esophagus(RME),and to analyze their diagnostic and prognostic value for esophageal carcinoma.Methods The expression of COX-2 and telomerase activity in ECT and RME was examined in 82 patients with esophageal carcinoma and 40 normal esophageal epithelium tissues(NEET) by tissue array with EnVision imimunohistochemistry.Their correlations with the clinicopathologic factors were analyzed statistically.Results The positive expression rates of COX-2 and telomerase in ECT and RME were significantly higher than those in NEET(82.9 ％,29.3 ％vs 12.5 ％;and 87.8 ％,18.3 ％vs 5.0 ％;respectively;all P ＜ 0.05).The expression of COX-2 and telomerase in ECT and RME was correlated to TNM stage,tumor cell differentiation and lymph node metastasis (all P ＜0.01),while both expression in RME was closely related to anastomotic recurrence following resection of esophageal carcinoma (P＜0.01).The survival rate in esophageal carcinoma patients with the positive expression of COX-2 and telomerase in RME could be much lower than those with negative expression of COX-2 and telomerase in RME (P=0.000,Log-rank test).COX-2 expression was positively correlated to telomerase in ECT and RME (r=0.786,0.218,P＜0.05).Conclusion COX-2 and telomerase might be important biological markers for malignant transformation and invasion and metastasis of esophageal carcinoma.The activity of COX-2 and telomerase in RME could prognosticate anastomotic recurrence,and could be potential biomarkers evaluate the surgical treatment and prognosis of esophageal carcinoma.