Showing papers in "National Medical Journal of China in 2014"

[Bone marrow mesenchymal stem cell-derived exosome protects kidney against ischemia reperfusion injury in rats].

Abstract: Objective To explore the protective effects and mechanism of exosomes derived from bone marrow mesenchymal stem cells (BM-MSC) on ischemia reperfusion injury (IRI) in rats. Methods Rat-MSC were isolated, cultured and identified.Exosome was extracted from BM-MSC and observed under transmission electron microscope (TEM). The expression of surface molecular marker CD63 was tested by flow cytometry.Male Sprague-Dawley rats were randomly grouped into sham-operated (Sham), ischemia reperfusion (IR), MSC-treated (IR+ MSC), MSC-derived exosome-treated (IR+ MSC-ex) and fibroblast-derived exosome-treated (IR+ F-ex) groups.The model for ischemia reperfusion injury was constructed.The serum levels of creatinine and blood urea nitrogen (BUN) were tested in each group.The histomorphological changes in of renal tissue samples were examined by hematoxylin and eosin-stained tissue samples.Cellular apoptosis was examined by terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) staining.The expression levels of proinflammatory cytokines interleukin 1β and tumor necrosis factor α were examined by reverse transcription (RT)-PCR.And the expression level of caspase-3 was examined by Western blot. Results Rat BM-MSCs were successfully isolated and cultured.Dectection of surface markers revealed high expression levels of CD29 and CD44 and a low expression level of CD34.MSC differentiated successfully into osteoblasts and lipocytes after growing in osteoblast- and lipocyte-inducing media respectively.Typical appearances of exosome were observed under transmission electron microscope.CD63 was positive on flow cytometry.Compared with the IR group, the IR+ MSC and IR+ MSC-ex groups showed low levels of serum creatinine and BUN, mild pathological injury, decreased number of apoptotic cells and low expression of inflammatory factors and caspase-3(IR group, 4 310±616; IR+ MSC group, 2 569±530; IR+ MSC-ex group, 3 144±343, both P<0.05). Conclusion Rat BM-MSC-derived exosome protects against ischemia reperfusion injury with decreased inflammatoryresponse and apoptosis in rats. Key words: Reperfusion injury; Kidney; Bone marrow mesenchymal stem cells; Exosome; Inflammation

Correlation of serum adropin level with coronary artery disease

Abstract: Objective To explore the correlation of serum adropin level with coronary artery disease (CAD). Methods According to coronary angiography, 356 consecutive patients with chest complaints from January 2011 to July 2012 were divided into 2 groups of CAD (n=264, with CAD) and control (n=92, without CAD). The serum adropin level and other CAD related metabolic parameters were measured and SYNTAX score was calculated. Results Serum adropin level was significantly lower in group CAD than that in control group ((56±15) vs(83±10)ng/L, P<0.01). Serum adropin levels in high, mild, low SYNTAX score group were (60±22), (56±12), (54±10) ng/L respectively, and there was no significant difference among 3 groups(P=0.116). Multivariate regression analysis revealed that adropin was an independent risk factor for CAD (OR=0.849, 95%CI: 0.817-0.882, P<0.01). Conclusions Lower serum adropin level is significantly associated with CAD. Thus it indicates a possible role of adropin in the prevention of CAD. Key words: Coronary disease; Risk factors; Adropin

Negative fluid balance predicts survival in patients with septic shock

Abstract: Objective To explore the change of fluid balance in patients with septic shock for seven continuous days and examine its effect on clinical prognosis. Methods A retrospective study was conducted for 105 patients with septic shock admitted into our intensive care unit (ICU) from May 2013 to February 2014. They were divided into non-survivors and survivors. Their baseline data, net balance quantity of fluid for seven continuous days and laboratory results were recorded and analyzed. Results Among them, 28 patients died. Duration of mechanical ventilation, sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were all lower in survivors than those in non-survivors (6 d vs 11 d, P=0.002; 7 d vs 9 d, P<0.001; 15 vs 19, P=0.035). Yet hospitalization time in survivors was longer than that in non-survivors (30 d vs 18 d, P=0.026). According to trend graph on net balance of each day, the cumulative net negative fluid balance in survivors increased over time while it remained stable in non-survivors. Among seven days, the cumulative net fluid balance at Day 7 was most negatively correlated with survival days (r=-0.278, P=0.006). Logistic regression analysis showed that SOFA score and cumulative net balance at Day 7 were the independent prognostic risk factors for septic shock. Moreover, at Day 7, no statistically significant inter-group difference existed in serum creatinine, alanine aminotransferase, PO2/FIO2 and cardiac troponin Ⅰ levels. But serum total bilirubin in survivors was lower than that in non-survivors (16.0 vs 27.9, P=0.031). Conclusion Cumulative net negative balance quantity of fluid in survivors was much more than that in non-survivors. SOFA score and net balance quantity of fluid at Day 7 were the independent prognostic risk factors for septic shock. Cumulative net fluid balance at Day 7 was most negatively correlated withsurvival days. No significant inter-group difference existed in organ function at Day 7. Key words: Shock, septic; Infection; Water-electrolyte balance; Resuscitation

[Effects of maternal age on pregnancy: a retrospective cohort study].

Abstract: Objective: To determine the pregnancy outcomes related with maternal age in China. Methods: A total of 110 450 cases were selected and divided into 6 age groups at intervals of 5 years. The clinical data were collected from 39 hospitals in mainland China. All deliveries were after 28 weeks of completed gestation in 2011. The unadjusted binary-logistic regression was employed for statistics. Results: The mean age of all pregnant women was 28 ± 5 at the time of delivery. The advanced age groups (35 - 39 yr and =40 yr) had higher risks than the 25-29 age group for pregestational diabetes [odds ratio (OR) 2.2 and 3.8] chronic hypertension (OR 4.6 and 6.5) leiomyoma (OR 4.2 and 5.8) gestational diabetes (OR 2.6 and 3.5) preeclampsia (OR 2.5 and 3.6) postpartum hemorrhage (OR 1.5 and 1.7) premature delivery (OR 1.8 and 2.4) placenta previa (OR 2.7 and 4.0) placental abruption (OR 1.4 and 2.5) cesarean delivery (OR 2.1 and 2.5) macrosomia (OR 1.2 and 1.2) low birth weight neonates (OR 1.6 and 2.3) and perinatal mortality (OR 1.6 and 3.7). The adolescent group had higher risks than the 25 - 29 age group for anemia (OR 1.4) preeclampsia (OR 1.6) preterm birth (OR 2.1) low birth weight neonates (OR 2.3) and perinatal mortality (OR 3.6). Conclusion: Maternal and neonatal risks are higher during both the adolescent and advanced maternal ages. And the age group of 20 - 30 years has the lowest risk for pregnancy and delivery.

Effects of vitamin D supplementation on insulin resistance in patients with type 2 diabetes mellitus

Abstract: Objective To explore the effects of oral vitamin D supplementation on anthropometric parameters and insulin resistance (IR) in type 2 diabetes mellitus (T2DM). Methods A total of 164 subjects with T2DM, aged 30-75 years, were randomly divided into two groups of intervention and control. The intervention group received a daily dose of 0.50 μg calcitriol while the control group maintained the original treatment regimen. At the beginning and end of 12-week supplementation trial, the demographic and anthropometric data were recorded and the serum levels of glucose, insulin, HbA1C and 25(OH)D measured. IR was assessed by the homeostasis model approximation index. Results There was no significant inter-group difference at baseline. Compared with the baseline level, body mass index(BMI)((-0.7±1.7) vs (-0.4±1.4) kg/m2)(P 30 ng/ml group ((5±3)vs (4±3))(P<0.05). And BMI ((26±6) vs (26±4) kg/m2)(P<0.05), WC ((84±11) vs (82±12) cm) (P<0.05), FPG ((8±4) vs (6±4)mmol/L)(P<0.05), FPI ((17±4) vs (16±4)μU/ml)(P<0.05)and HbA1C((7.4±0.9)% vs(7.0±1.2)%)(P<0.05)decreased statistically significant only in 15-20 ng/ml group. Multivariate regression analysis showed that HOMA-IR was a significant independent risk factor for 25 (OH) D (OR=13, 95%CI=4-39, P<0.05). Conclusion There are significant improvements in BMI, WC, FPG, FPI, HbA1C and HOMA-IR after supplementation.Thus vitamin D supplementation may reduce insulin resistance in T2DM. Key words: Type 2 diabetes; Insulin resistance; Vitamin D

Application of dexmedetomidine combined with ropivacaine in the cesarean section under epidural anesthesia

Abstract: Objective To explore the anesthetic effect and neonatal effects of dexmedetomidine combined with ropivacaine in the cesarean section under epidural anesthesia. Methods Between January 2012 and March 2013 at the First Affiliated Hospital with Nanjing Medical University, sixty parturients with a single baby at full term in vertex presentation scheduled for caesarean section under epidural anesthesia, were randomly divided into 3 groups (n=20 each) according to the random digits table: dexmedetomidine + ropivacaine (RD), fentanyl + ropivacaine (RF) and normal saline + ropivacaine (RN). After identification of the epidural space and a negative aspiration test for blood or cerebrospinal fluid, 15 ml of 0.75% ropivacaine, was administered epidurally in three the groups with addition of 1 μg/kg of dexmedetomidine in RD group, 1 μg/kg of fentanyl in RF group and 2 ml of normal saline in RN group. Recording the mean arterial pressure (MAP) and heat rate (HR) before anesthesia (T0), at 10 min (T1) and 30 min (T2) after the end of epidural administration, and at end of operation (T3). Recording the onset time, maximum sensory analgesic level, time to maximum sensory analgesic level, time to two segmental dermatomal regressions, and time to chief complaint of postoperative pain. The modified bromage degrees, sedation scores and traction reaction were also assessed. The Apgar scores at 1 and 5 min were also recorded after delivery, and the blood samples were drawn from umbilical vein for gas analysis. Results MAP, HR and the motor block (Bromage scale) were no statistics differences among the three groups(P>0.05). Compared with RN group, the onset time and the time to maximum sensory analgesic level were significantly earlier [(6.3±2.4), (8.7±2.3) min vs(10.9±2.7)min; (11.5±3.9), (16.2±4.6) min vs(19.8±5.2) min , P<0.05], the time to two segmental dermatomal regressions and the time to chief complaint of postoperative pain were prolonged significantly[(22.5±4.6), (18.5±3.9) min vs(13.5±3.8)min; (415±92), (355±86) min vs( 273±68) min, P<0.05], level of sedation and degree of traction reaction were better in RD group and in RF group, and the incidence of shivering was lower in RD group (5% vs 40%, P<0.05), the incidence of dizziness was higher in RF group (20% vs 0, P<0.05). Compared with RF group, the same results were also seen about the onset time, the time to maximum sensory analgesic level, the time to two segmental dermatomal regressions and the time to chief complaint of postoperative pain, and the level of sedation was better, the incidence of drowsiness was lower in RD group. There were no statistics differences about both the blood gas analysis of umbilical vein and the Apgar scores at 1 and 5 min after delivery. Conclusion Administration of dexmedetomidine combined with ropivacaine can provide early onset, establishment of sensory anesthesia, much better sedation levels, decrease the degree of traction reaction and theincidence of shivering, and without adverse neonatal effects. Key words: Dexmedetomidine; Anesthesia, epidural; Cesarean section

Effects of telmisartan on inflammation and fibrosis after acute myocardial infarction in rats

Abstract: Objective To explore the protection mechanisms of telmisartan on inflammation and fibrosis after myocardial infarction in rats. Methods The model of acute myocardial infarction (AMI) was established by ligating left anterior descending coronary artery. The surviving rats were divided into AMI (AMI) and telmisartan treatment (telmisartan) groups. And another sham operation group (sham) was designated (n=8). At the end of study, total heart weight (THW), left ventricular weight (LVW) and weight index were measured; myocardial infarction and inflammatory reactions detected by hematoxylin and eosin and Masson staining; the serum levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNFα), monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6) and interleukin-1 beta (IL-1β) by enzyme-linked immunosorbent assay (ELISA); the levels of transforming growth factor 1 (TGFβ1), collagen Ⅰ, collagen Ⅲ and MMP9 mRNA in myocardial tissue by reverse transcription-polymerase chain reaction (RT-PCR); the expressions of TGFβ1, collagen Ⅰ, collagen Ⅲ, matrix metallopeptidase 9 (MMP9) and nuclear factor-kappa B (NF-κB) by Western blot. Results Compared with sham group, significant pathological changes of myocardium occurred in AMI group. The serum levels of CRP [(472±132) vs (104±28) ng/ml], TNFα [(229±41) vs (18±5) pg/ml], MCP-1[(558±116) vs (158±20) pg/ml], IL-6 [(404±63) vs (21±4) pg/ml] and IL-1β [(625±145) vs (189±34) pg/ml] increased (P<0.05). RT-PCR analysis showed that the expression levels of TGFβ1, collagen Ⅰ, collagen Ⅲ and MMP9 increased significantly. The results of Western blot were consistent and NF-κB was activated significantly (P<0.05). Compared with AMI group, the above-mentioned indicators decreased obviously in telmisartan group (P<0.05). Conclusion Telmisartan may regulate inflammation and myocardial fibrosis after acute myocardial infarction by signaling pathways of NF-κB and TGFβ in rats. Key words: Myocardial infarction; Inflammation; Fibrosis; Telmisartan

Comparison liver resection with transarterial chemoembolization for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma patients on long-term survival after SPSS propensity score matching

Abstract: Objective To compare the long-term survival of patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) undergoing either liver resection or transarterial chemoembolization (TACE) after propensity score matching (PSM). Methods One hundred sixty-seven and 70 BCLC-B HCC patients undergoing liver resection and TACE were retrospectively collected. PSM function of SPSS software was conducted to reduce confounding bias between the groups. And then survival analysis was performed for the matched data. Results Fifty-three pairs of patients were successfully matched. And then survival analysis showed that the median survival periods and their 95% confidence intervals were 35.0 (26.3-43.7)months in the liver resection group versus 20.0(15.0-25.0) months in the TACE group. The 1, 3, 5 and 7-year survival rates were 91.0%, 49.0%, 30.0% and 17.0% in the liver resection group versus 73.0%, 25.0%, 8.0% and 5.0% respectively in the TACE group (P=0.001). Cox regression analysis revealed that TACE, total bilirubin ≥34.2 μmol/L, alpha fetoprotein ≥400 ng/ml and tumor number≥3 were independent risk factors of survival (hazard ratio >1, P<0.05). Conclusion The balance of covariates may be achieved through PSM. And for patients with BCLC-B HCC, liver resection provides better long-term overall survival than TACE. Key words: Chemoembolization, therapeutic; Carcinoma, hepatocellular; Hepatectomy; Propensity score; Survival rate

[Diagnostic value of interleukin-27 in tuberculous pleural effusion].

Abstract: Objective To explore the diagnostic value of interleukin-27 (IL-27) in tuberculous pleural effusion. Methods A total of 76 patients of pleural effusion treated at Shandong Provincial Hospital from March 2013 to February 2014 in accordance with the natures of effusion fluid were divided into: (1) Tuberculosis group of tuberculous pleural effusion (n=40), including 22 males and 18 females; aged 19 to 73 years; (2) Malignant group of malignant pleural effusion (n=36), including 20 males and 16 females; aged 33 to 78 years old; including lung cancer (n=28), lymphoma (n=3), esophageal (n=1) and uncertain primary tumor site (n=4). The effusion and serum levels of IL-27 were detected by enzyme-linked immunosorbent assay (ELISA) and the results analyzed. And the curve of receiver operating characteristic (ROC) was employed to determine the diagnostic value of IL-27 in tuberculous pleural effusion. Results The level of IL-27 was (1 402±321) ng/L in tuberculous pleural effusion and it was significantly higher than those in malignant pleural effusion (556±133) ng/L and sera (499±88) ng/L (both P<0.05). According to the ROC curve, the cut-off value of IL-27 was 838 ng/L in diagnosing tuberculous pleural effusion. And the rates of diagnostic sensitivity, specificity and accuracy of IL-27 were 95.0%, 97.2% and 96.1% respectively. Conclusions Detection of pleural effusion IL-27 concentration is of great importance in the diagnosis of tuberculous pleural effusion. And it is worthy of wider clinical promotion. Key words: Interleukin-27; Pleural effusion; Tuberculosis, pleural; Adenosine deaminase; Interferon-γ

Significance of Septin9 gene methylation detection of plasma circulation DNA in colorectal cancer screening

Abstract: Objective To explore the role of detecting the methylation status of gene Septin9 (SEPT9) in plasma for colorectal cancer screening in Chinese population. Methods Patients were collected from Beijing Military General Hospital since September 2013 to February 2014. The performance of SEPT9 assay was validated in a single-blind study of 80 cases with colonoscopy and pathologically verified colorectal cancer and 52 normal controls. The detection of Septin9 gene methylation in peripheral blood was performed by fluorescence quantitative polymerase chain reaction (PCR). And immunoassay fecal occult blood test was conducted to compare the superiority of methylated Septin9 for screening colorectal cancer. Results The Septin9 assay successfully identified 75.0%(95%CI: 64.7%-83.6%) of cancers at a specificity of 98.1%(95%CI: 90.9%-99.9%). And it was superior to fecal occult blood screening for colorectal cancer (sensitivity 79.5% vs 53.8%, P<0.05). Conclusion Determination of SEPT9 methylation status is an innovative non-invasive plasma screening test for colorectal cancer. Key words: Colorectal neoplasms; DNA methylation; Genes, Septin9

Analysis on the relationship between adolescent myopia and serum sex hormone

Abstract: Objective To investigate the quantitative changes of the serum sex hormone levels in juvenile myopia patients. Methods In January 2013, investigation of wenzhou middle school 822 adolescents, including 432 male patients and 390 female patients were involved in the study Visual acuity ≥ 5 was set as the normal value. The subjects were divided into two groups, the myopia group and the non-myopia group. Chemiluminescence immunoassay analyzer was used to detect the subjects' sex hormone concentration of estradiol (E2), testosterone (T), follicle stimulating hormone (FSH) and luteinizing hormone (LH). Results The follicle stimulating hormone and luteinizing hormone of the female patients were significantly higher than those of male counterparts (P<0.01); among the two groups consisting female myopia and non-myopia patients, a significant difference in luteinizing hormone and follicle stimulating hormone was shown (P<0.05); the distinct differences in the level of luteinizing hormone and testosterone level showed in the male myopia group and non-myopia group were of outstanding statistics significance (P<0.01), showing the result that the level of sex hormone in myopia group was higher than that in the non-myopia group. Conclusion A close relationship perhaps between the level of sex hormone with gender differences and juvenile myopia is confirmed. Key words: Myopia; Sex hormone; Clinical study; Juvenile

[Clinical benefits after soluble dietary fiber supplementation: a randomized clinical trial in adults with slow-transit constipation].

Abstract: Objective To explore the effect of pectin, a kind of soluble dietary fiber, on colonic transit time (CTT), clinical symptoms and gut microbiota in adults with slow-transit constipation. Methods A total of 80 patients with slow-transit constipation were selected between June 2011 and December 2013. For this randomized controlled trial, we evaluated the efficacy of pectin on intestinal transit time and other indices of constipation in adults with slow-transit constipation. They were randomized to receive either pectin or placebo. Treatment consisted of 4-week supplementation with 24 g/d pectin (fiber group) or maltodextrin (placebo group). Before and after 4-week treatment, CTT, constipation symptoms and fecal bacterial population were compared between groups. Results CTT of the fiber group after treatment was lower than those of fiber group before treatment and those in the placebo group ((60.2 ± 11.2) h vs (80.3 ± 9.5), (79.4 ± 11.7) h, P Conclusions Four-week soluble dietary fiber use accelerates colon transit time and alleviates clinical symptoms in patients with slow-transit constipation. Additionally, supplementary fiber offers protective effects on gut microbiota by increasing the population of healthy microflora.

[Sedative effects of dexmedetomidine in post-operative elder patients on mechanical ventilation].

Abstract: Objective To evaluate the efficacy and safety of dexmedetomidine for post-operative elder patients on mechanical ventilation (MV). Methods For this randomized controlled trial, 108 cases of post-operative patients on MV were enrolled and assigned into either dexmedetomidine group (n=54) or propofol group (n=54) for sedation. And propofol was used for rescue. The dose of sedation was regulated by Ramsay score for maintaining a sedative score of 3-4. In both groups, fentanyl was provided intravenously continually for analgesia. The amount of fentanyl was adjusted according to the numerical rating scale (NRS) score for maintaining an analgesic score of 0-3. The average Ramsay score, the frequency of propofol, the highest score of NRS, the total dosage of fentanyl and recovery time were compared. Additional outcomes included duration of mechanical ventilation and intensive care unit (ICU) length. And the incidence of delirium and cardiovascular adverse events were compared for two groups. Results No significant inter-group difference existed in the effectiveness of sedation. Compare with propofol group, the highest score of NRS decreased(1.8±1.12 vs 3.1±1.24, P<0.05), the total dosage of fentanyl significantly decreased(427.6±14.1 vs 658.4±27.3 μg, P<0.05) and recovery time became significantly shortened (0.3±0.02 h vs 1.1±0.3 h, P<0.05) in dexmedetomidine group. Median duration of mechanical ventilation in dexmedetomidine group(21.0 h, 95%CI: 18.6-21.4 h)was significantly shorter than that in propofol group(28.0 h, 95%CI: 25.6-30.4 h)(P<0.05). No inter-group differences existed in the ICU length of stay and the incidence of delirium. Two cases in dexmedetomidine group developed bradycardia while hypotension occurred in two cases of propofol group. Conclusion Sedative effects of dexmedetomidine are safe and effective for post-operative elder patients on MV. And it offers a better efficacy of analgesia and shorter durations of MV and recovery time. Butdexmedetomidine had no significant influence on the ICU length of stay or the incidence of delirium. Key words: Ventilators, mechanical; Conscious sedation; Analgesia; Aged; Dexmedetomidine

Roles of dermoscopy in differential diagnosis of psoriasis and eczema

Abstract: Objective To describe the dermoscopic patterns of plaque psoriasis and chronic eczema and explore the roles of dermoscopy in their diagnosis and differential diagnosis. Methods A total of 68 patients with plaque psoriasis or chronic eczema were recruited from our department from December 2013 to May 2014 to undergo dermoscopic and histopathological examinations. Dermoscopic features of vascular morphology, vascular arrangement, background color, scale color and scale distribution were evaluated. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of plaque psoriasis. Results Thirty-one patients with plaque psoriasis and 37 patients with chronic eczema were included. Dotted vessels in a regular arrangement (sensitivity 80.6%, specificity 73.0%) over a light red background (sensitivity 71.0%, specificity 75.7%) and white scales (sensitivity 71.0%, specificity 83.8%) were highly predictive for the diagnosis of plaque psoriasis. And chronic eczema more commonly showed yellow scales and dotted vessels in a patchy arrangement over a dull red background. Characteristic vascular structures of hairpin vessels and red loops were also found to be highly specific (91.9%, 94.6%) for the diagnosis of psoriasis. Conclusions Plaque psoriasis shows specific dermoscopic patterns compared with chronic eczema. And dermoscopy is valuable in the diagnosis and differential diagnosis of psoriasis. Key words: Dermoscopy; Psoriasis; Eczema

[Long-term effects of hydroxychloroquine on metabolism of serum lipids and left ventricular structure and function in patients of systemic lupus erythematosus].

Abstract: Objective To observe the long-term effects of hydroxychloroquine treatment on blood lipids and left ventricular function of systemic lupus erythematosus (SLE) patients. Methods A total of 72 SLE patients were randomly divided into 2 groups of hydroxychloroquine treatment (n=36) and non-hydroxychloroquine (n=36). The serum level of lipids, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), fractional shortening rate (FS), left ventricular ejection fraction (LVEF) and E/A ratio were measured before, 6 month, 12 month and 2 years after treatment. Results After long-term use of hydroxychloroquine, there were statistically differences in the levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). And LVEDD, LVWPT and E/A were statistically different (P<0.05) before and after hydroxychloroquine dosing. Conclusion The long-term use of hydroxychloroquine may improve lipid metabolism and left ventricular function in SLE patients. Key words: Lupus erythematosus, systemic; Hydroxychloroquine; Lipid metabolism disorders; Ventricular function, left

[Proximal femoral nail antirotation versus dynamic hip screw for intertrochanteric fracture in elders: a meta-analysis].

Abstract: Objective To assess the efficacies of proximal femoral nail antirotation (PFNA) versus dynamic hip screw (DHS) for intertrochanteric fracture in elders. Methods The databases of PubMed, Embase, CENTRAL, CBM, CNKI and WANFANG were searched for the relevant randomized controlled trials (RCTs) up to May 18, 2013. After quality evaluation and data extraction by two authors independently, meta-analyses were performed with the RevMan5.1 software. And the levels of evidence were evaluated by the GRADEprofile 3.6 software. Results A total of 17 studies (n=1 344) were included and there were 656 patients in PFNA group and 688 in DHS respectively. Meta-analyses showed that, as compared with DHS, PFNA could significantly decrease fixation failure rate (odds ratio (OR)=0.26, 95% confidence interval (CI)=[0.12,0.57], P=0.0008), reduce average fracture healing time (weighted mean difference (WMD)=-15.11, 95%CI=[-24.36,-5.85], P=0.001), improve excellent and good rate for Harris score (OR=0.29, 95%CI=[0.15,0.56], P=0.0002), yield a higher Harris score (WMD=6.88, 95%CI=[0.96,12.80], P=0.02) and reduce the rate of coxa vara (OR=0.40, 95%CI=[0.18,0.92], P=0.03). However, there was no statistical significance in 1-year mortality, postoperative nonunion and delayed union, postoperative femoral head necrosis, postoperative femoral fractures or femoral head necrosis. The importance of outcomes was "critical". And the level of evidences based on the GRADE approach was from "very low" to "low". Conclusion PFNA is superior to DHS. Due to the limitations of the included studies, more large-sample and high-quality RCTs are required. And subgroup analysis based on fracture types should be performed. Key words: Femural fractures; Fractures fixation, internal; Bone nail; Meta-analysis

[Platelet-rich plasma for treating acute wounds: a meta-analysis].

Abstract: Objective To evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of acute wounds. Methods Randomized controlled trials (RCT) were identified from PubMed (1950.1-2014.2), Cochrane Central Register of Controlled Trials (CENTRAL, issue 4, 2014) of Cochrane Library, China National Knowledge Infrastructure (CNKI, 1979.1-2014.2), China Biology Medicine (CBM, 1978.1-2014.2) WANFANG database (1990.1-2014.2). References of retrieved articles were also identified. The quality of each RCT was evaluated by the Cochrane collaboration's tool for assessing the risk of bias. Data analysis was performed with Review Manager 5.1 to evaluate the efficacy of PRP in the treatment of acute wounds. Results A total of 13 articles involving 982 patients were included. The results of systematic review and analysis showed that wound healing time of PRP treatment group was shorter than that of control group, so did length of hospital stay (mean difference (MD): -1.45, 95%CI: -2.07 to -0.83; P<0.01), the incidence of wound healing disturbance in PRP treatment group was less than that of control group (relative risk (RR): 0.11, 95%CI: 0.01 to 0.83; P<0.05), so did blood product transfusion. Moreover, post-traumatic pain level of PRP treatment group was lower than that of control group (MD: -1.26, 95%CI: -1.71 to -0.82; P<0.01). Conclusion Use of PRP can shorten acute wound healing time and length of hospital stay, reduce the incidence of disturbed wound healing and blood products transfusion and alleviate post-traumatic pain. Moreover, it has some effect on the control of wound infections. Key words: Platelet-rich plasma; Wounds and injuries; Wound healing; Meta-analysis; Systematic review

Clinical analysis for treatment of 1 080 cases of infantile hemangiomas with oral propranolol

Abstract: Objective To explore the indications of hemangiomas of different types by observing the clinical efficacy of oral propranolol. Methods For this retrospective study from October 2009 to June 2013, a total of 1 080 cases were classified into 5 types according to their clinical characteristics. There were 338 males and 742 females. Their types were telangiectasis (n=58), papular (n=424), plump (n=106), deep (n=176) and mixed (n=306). Propranolol was orally administered at a dose of 1.0 or 1.5 mg/kg daily (1.0 mg/kg for infants aged 2.5 months or under; 1.5 mg/kg for those aged 2.5 months or above). Dynamic observations of hemangioma size, texture or color change and adverse events during treatment were performed. Drug withdrawal was usually made after dosing for 1 year or under when there was a total regression of hemandiomas. The efficacy was evaluated on a 4-level scale. Results Rank test results showed no significant differences between 5 types during the changes of lesions (χ2=1.738, P>0.05). Changing of lesions occurred 8.0 (3.7, 16.2) hours after dosing in telangiectasis type, whereas 6.5 (4.1, 14.3) hours in papular type, 7.0 (5.5, 12.7) hours in plump type, 7.5 (3.8, 11.3) hours in deep type and 6.5 (4.2, 13.4) hours in mixed type. After a follow-up of 6 months to 2.5 years, there were 378 grade Ⅳ case (35.00%), 574 grade Ⅲ case (53.15%), 120 grade Ⅱcases (11.11%) and 8 gradeⅠcases (0.74%). And there were significant differences between patients of different types (P<0.05). Patients of deep type had the best grade Ⅳ curative effect rate of 59.09% (104/176), then papular type of 51.25% (162/316) and telangiectasis type of 26.41% (112/424). Conclusion As a first-line treatment for hemangioma, propranolol shows excellent efficacies for patients of deep, mixed, plaque and papular types. Key words: Hemangioma; Infant; Propranolol; Treatment outcome; Adverse effects

[Effects of ribavirin aerosol on viral exclusion of patients with hand-foot-mouth disease].

Abstract: Objective To explore the roles of ribavirin aerosol in the prevention and treatment of hand-foot-mouth disease (HFMD). Methods For this prospective, multicenter, randomized, double-blind and placebo-controlled trial, a total of 300 HFMD outpatients from 3 class 3A hospitals from July 2011 to June 2013 were divided into treatment (ribavirin aerosol) and control (placebo) groups (n=150 each). The age range was 6 months to 6 years. The proportion of male and female was 1.5∶1. Temperature, herpes of mouth and skin rash were observed before and after treatments. Before treatment and 6-7 days after, their specimens of throat swab were collected and the levels of EV71 and CA16 detected with reverse transcription (RT)-PCR. The software SAS 9.2 was used for statistic data analyses. Results Before treatment, no significant statistical difference existed in parameters between treatment and control groups (all P>0.05). After treatment, the degree of herpes of mouth and papulovesicle of skin in treatment group was better than that in control group(100.0%(147/147)vs 83.9%(120/143), χ2=109.21, P 0.05). The effective rate of comprehensive efficacy in treatment group was higher than that in control group(93.9%(122/130) vs 52.0%(64/123), χ2=111.08, P<0.01). No obvious adverse drug reaction was observed. Conclusions Ribavirin aerosol has multiple advantages of lower dose, quicker onset, higher local concentration, better clinical efficacy and fewer side-effects. Its therapeutic effect for local lesion is better than that for systemic lesion. Thus it may shorten the duration of oropharyngeal and skin lesions and lower the number and time of viral release. Key words: Hand, food and mouth disease; Entervirus infections; Disease transmission; Ribavirin; Child

Promoter region methylation of DNA damage repair genes in human gastric cancer

Abstract: Objective To detect the status of promoter region methylation of damage repair genes in gastric cancer and analyze its association with clinicopathologic characteristics. Methods A total of 70 human gastric cancer tissue samples representing all stages of disease were obtained from surgical resection specimens. DNA was extracted with the phenol-chloroform method. The technique of methylation specific polymerase chain reaction (MSP) was used to examine the methylation status of MLH1, CHFR, MGMT, FANCF, Rassf1A, BRCA1 and GSTpi in gastric cancer specimens. And MSP products were analyzed with 2% agarose gel electrophoresis. Results The methylation rates of DNA damage related genes in human gastric cancer were as follows: MLH1 22.9% (16/70) , CHFR 47.1% (33/70), MGMT 34.3% (24/70), FANCF 11.4% (8/70), RASSF1A 7.1% (5/70), BRCA1 1.4% (1/70) and GSTpi 0% (0/70). And CHFR methylation was correlated with patient age (<60 year) (P=0.035), tumor size (diameter ≥5 cm) (P=0.031) and low differentiation (P=0.019). In addition, CHFR methylation was associated with MLH1 methylation and MGMT methylation respectively. Conclusion In human gastric cancer, the DNA damage repair genes of MLH1, CHFR and MGMT are frequently methylated while FANCF, RASSF1A, BRCA1 and GSTpi infrequently. Thus MLH1, CHFR and MGMT may play important roles during carcinogenesis of gastric cancer. And these methylated genes may serve as potential detection markers for gastric cancer. Key words: Gastric neoplasms; DNA methylation; DNA repair

[Effects of walking exercise during late trimester on pregnancy outcome of low-risk primipara].

Abstract: Objective To explore the effects of walking exercise during late trimester on pregnancy outcome of low-risk primipara. Methods A prospective randomized controlled study was conducted for 123 cases of low-risk primipara who had regular prenatal care at Shengjing Hospital, China Medical University from July 2012 to June 2013. And informed consent was obtained. The control group included 116 cases of other low-risk primipara in the same period. Except that the experimental group had regular structured walking exercise from 34 weeks of gestational age to delivery, other consulting guidance were the same as the control group. The inter-group differences, such as delivery mode, mean body weight gain per week after 34 weeks of gestation, duration of labor, labor pain perception, neonatal weight and neonatal birth condition, were detected and analyzed. Results Finally there were 13 and 8 dropouts in experimental and control groups respectively. For two groups, the rate of caesarean section was 12.7% and 18.5%, the mean body weight gain per week after 34 weeks of gestational age (0.41±0.13) and (0.56±0.09) kg, the labor pain score are 6.1±1.9 and 7.6±2.3, the duration of labor (12±4) and (15±6) h, the neonatal birth weight (3.4±0.3) and (3.7±0.6) kg and the rate of macrosomia 4.5% and 7.4% respectively. The differences had statistical significance (P 0.05). Conclusion Simple, safe and effective, walking exercise during late trimester may improve the pregnancy outcomes of low-risk primipara. Key words: Pregnancy outcome; Exercise; Delivery

[Effects of intravenous immunoglobulin upon the overexpression and over-activation of nuclear factor-κB and matrix metalloproteinase-9 in murine model of Kawasaki disease].

Abstract: Objective To explore the changes of expression and biological activity of nuclear factor-kappa B (NF-κB) and matrix metalloproteinase-9 (MMP-9) after using intravenous immunoglobulin (IVIG) in a murine model of Kawasaki disease (KD) and elucidate the therapeutic mechanism of IVIG for the treatment of KD. Methods A total of 72 mice were categorized randomly into IVIG, KD and control groups.Lactobacillus casei cell wall extract (LCWE) was prepared and injected intraperitoneally into C57BL/6 mice to induce KD (0.5 mg single injection). IVIG group received an intraperitoneal injection of IVIG (2 mg/g) while KD model group had an intraperitoneal injection of normal saline. At Days 14, 28 and 56, the diameter of coronary artery was by echocardiography in 8 mice of each group. At the same time, the stains of hematoxylin & eosin and elastic fiber were used to observe the pathological damage of coronary artery. Western blot was used to evaluate the expressions of NF-κB and MMP-9, electrophoretic mobility shift assay (EMSA) was used to measure the activity of NF-κB and Gelatin zymography was used to evaluate the activity of MMP-9 in heart samples of murine model of KD. Results The local inflammatory infiltrate, composed predominantly of mononuclear lymphocytes, of coronary artery trunk and branches was observed at Days 14 and 28 while broken elastin was observed at Day 56. And the inflammatory cell infiltrate was less severe and no apparent broken elastin was observed in IVIG and control groups. On echocardiography, the average value of diameter of left coronary artery in KD model group was higher than that in IVIG and control groups (28 d: (0.48±0.07) vs (0.41±0.03) and (0.35±0.02) mm, all P<0.01). Compared with the other two groups, the result of Western blot showed that the expressions of NF-κB and MMP-9 in KD model group were markedly higher than those in IVIG treatment group and that in control group at each time point (28 d: (58±14) vs (25±14) & (19±11) μg/L, (100±41) vs (39±19) & (35±19) μg/L, all P<0.01). The activity of NF-κB by EMSA and the result from KD model group were much higher than those from the control and IVIG groups (28 d: (84 788±2 081) vs (27 220±4 990) & (50 192±1 586) μg/L, all P<0.01]. And it was in accord with the expression of NF-κB. The outcome of gelatin zymography demonstrated that the activity of MMP-9 had similar change with the expression of MMP-9(18 560±7 963) vs (9 112±3 398) & (11 834±4 996) μg/L, all P<0.05). Conclusions NF-κB/MMP-9 is overexpressed and over-activated in the heart of KD mouse models. IVIG may inhibit the inflammatory cell infiltration and alleviate coronary artery. And such a therapeutic effect is possibly achieved by a suppression of the overexpression and over-activation of NF-κB/MMP-9 pathway. Key words: Mucocutaneous lymph node syndrome; gamma-Globulins; NF-kappa B; Matrix metalloproteinase 9; Mice

[Selective Laser Sintering-produced porous titanium alloy scaffold for bone tissue engineering].

Abstract: Objective To evaluate the biocompatibility of SLS-produced titanium alloy scaffold in vitro and investigate the therapeutic effects in repairing segmental bone defects. Methods Porous titanium alloy scaffolds were produced by SLS and their surfaces were either left untreated or acid etched. In vitro, mouse pre-osteoblasts (MC3T3-E1 cells) were cultured on these 2 group scaffolds, and then cell proliferation and differentiation were examined after cell seeding. In vivo, bone defects were artificially made in 15 New Zealand rabbits and the porous titanium specimens were implanted into the radius of rabbits for 3 months. The regulating checks of X-ray were determined. The osteointegration of the implants was investigated by Micro-CT and histological examination at 12 weeks after surgery. Results A gradual increase in cell-specific ALP synthesis by cells cultured in both groups was observed with longer culture time (14 d). ALP activity did not differ significantly between two groups(0.834±0.092 vs 0.815±0.081, P>0.05). Both Micro-CT and the histological analysis indicated that the titanium alloy scaffolds had excellent ability to facilitate the osteointegration in vivo. The results were significantly different between the empty control and the 2 different surface modifications of SLS-implants (25.4%±4.2% vs 23.6%±8.4% vs 12.3%±4.7%, P 0.05). Conclusion Selective Laser Sintering-Produced porous titanium alloy scaffold possessed admirable biocompatibility in vitro. It also could be contributed to the healing of long tulular bone defect. The porous Ti6Al4V implant not only reduced the stress-shielding but also exerted appropriate osteoconductive properties. Key words: Bone remodeling; Laser coagulation; Bone substitutes; Titanium

Combined surgical and endovascular treatments of complex cerebral arteriovenous malformation in hybrid operating room

Abstract: Objective To summarize the clinical experiences of microsurgical and endovascular treatments of complicated arteriovenous malformation (AVM) in the conditions of hybrid operating room. Methods The clinical data were collected and analyzed for 8 patients of complex AVM between June 2012 to June 2013. There were Spetzler grade Ⅲ (n=2) and grade Ⅳ(n=6). And the lesions were complicated with intracranial aneurysms (n=3) and located in motor area (n=2) and basal ganglia (n=2). Five cases of AVM with cerebral hemorrhage underwent emergency surgery, including digital subtraction angiography (DSA) plus intraoperative embolization plus surgical resection of AVM plus intraoperative DSA (iDSA). Two cases underwent embolization plus aneurysm surgery while another had AVM embolization plus AVM resection and γ knife treatment. Results All surgical procedures, including iDSA, were completed in the same hybrid operating room. There was no change of surgical position or intraoperative mortality. Five patients of AVM hemorrhage undergoing emergency hematoma evacuation had no residue of AVM on iDSA. Their postoperative consciousness improved without neurological dysfunction. Two patients of limb paralysis recovered to paresis at 3 months postoperation. One case with blurry vision improved somewhat. Two cases undergoing elective surgery had a complete resection of AVM after embolization. Conclusion Surgery plus endovascular treatment in hybrid operating room is efficacious for complex cerebral AVM. It avoids multiple surgeries and inspections. And any lesion residue may be assessed immediately with postoperative DSA. Key words: Arteriovenous malformation; Embolization; Microsurgery; Hybrid operation

[Cognitive function in breast cancer patients on chemotherapy: a longitudinal study].

Abstract: Objective To explore whether cognitive impairment in breast cancer patients after the completion of chemotherapy treatment in comparisons with breast cancer patients without chemotherapy treatment and matched healthy controls Methods A neuropsychology battery was applied in all breast cancer patients at our hospital from January 2012 to February 2013 Forty-two breast cancer patients with chemotherapy treatment (CT) underwent neuropsychologic testing before the start of chemotherapy (T1) and after treatment (T2) And 37 patients without chemotherapy treatment (non-CT) and matched healthy controls (HC) underwent the same assessment at matched intervals Results The CT group performed significantly worse on attention, memory and executive function tests at T2 versus T1 (P<005) As compared with HC and non-CT groups, the correct numbers of backward, digit symbol, delayed recall and recognition were lower in the CT group (P<005) The reacting time of TMT test B, Stroop test B and Stroop test C were longer in the CT group (P<005) There was significant time interaction in three groups (P<005) Conclusion There are longitudinal changes in cognitive functioning of memory, attention and executive functions in breast cancer patients on Chemotherapy Key words: Breast cancer; Chemotherapy; Cognitive impairment; Neuropsychological test; Longitudinal study

[Functional electrical stimulation based on a working pattern influences function of lower extremity in subjects with early stroke and effects on diffusion tensor imaging: a randomized controlled trial].

Abstract: Objective To explore the possible mechanisms for improving lower extremity motor function in patients with early stroke through combining magnetic resonance diffusion tensor imaging (DTI) technology and functional electrical stimulation (FES) based on human walking patterns. Methods From August 2012 to September 2013, a total of 48 eligible patients were stratified according to age, gender, disease course, Brunnstrom staging and types of stroke. And the Minimize software was used to divided them randomly into four-channel FES group (n=18), dual-channel FES group (n=15) and comfort stimulation group (n=15). For all three groups, general medication and standard rehabilitation were provided. Based on normal walking pattern design of FES treatment, four-channel FES groups received the stimulations of quadriceps, hamstring, anterior tibialis and medial gastrocnemius. For the dual-channel FES group, the stimulations of tibialis anterior, peroneus longus and peroneus brevis muscles were applied. In comfort electrical stimulation group, the electrode positions were identical to the stimulation group, but there was no current output during stimulation. Before and after 3-week treatment, three groups received weekly rehabilitation evaluations of Fugl-Meyer assessment (FMA), posture assessment of stroke scale (PASS), Brunel balance assessment (BBA), Berg balance scale (BBS) and modified Barthel index (MBI). Before and after treatment, DTI examination was performed for some patients. Results Among three groups, general patient profiles and pre-treatment evaluations showed no significant difference. For intra-group comparisons versus pre-treatment, at week 1, 2 and 3, the scores of PASS, BBA, BBS, FMA and MBI had statistically significant differences (P<0.05); At week 3 post-treatment, when four-channel and double-channel FES groups were compared versus pre-treatment, the scores of ipsilateral FA had statistically significant differences (P<0.05). At week 1 post-treatment, MBI had statistically significant difference among 3 groups (P=0.037). As compared with placebo, four-channel group had statistically significant difference [(52±12) vs (38±18), P<0.05]; At week 2 post-treatment, the scores of PASS and MBI were (29±3, 73±13) in four-channel FES group versus (24±8, 60±17) in dual-channel FES group. And the scores of PASS, BBA, BBS, FMA and MBI were (9±3, 8.3±2.4, 37±7, 22±5, 73±13) in four-channel FES group versus (21±7, 6.2±3.1, 24±16, 15±8, 47±20) in comfort electrical stimulation group. When dual-channel FES and comfort stimulation groups were compared, MBI had significant statistical difference [(60±17) vs (47±20), P<0.05]. At week 3 post-treatment, four-channel and dual-channel FES groups were compared, there was also statistical significance in FMA [(25±5) vs (20±7), P=0.055]. The scores of PASS, BBS, FMA and MBI were (31±3, 43±8, 25±5, 81±13) in four-channel FES group versus (25±8, 29±17, 17±9, 54±25) in comfort stimulation group respectively. When dual-channel FES and comfort stimulation groups were compared, the scores of MBI were (71±15) and (54±25) respectively. And the difference was statistically significant (P<0.05). At week 3 post-treatment, the scores of FA significantly increased [four-channel FES group (0.321±0.172) vs comfort stimulation group (0.217±0.135) (P=0.020)]. When dual-channel FES group (0.333±0.164) and comfort stimulation group (0.217±0.135) (P=0.049) were compared, the differences were statistically significant. DTI showed that four-channel FES group increased significantly, but contralateral fiber bundle was not obvious. And the improvements of dual-channel FES and comfort stimulation groups were insignificant. Conclusion Compared with traditional dual-channel FES, functional electrical stimulation based on human walking patterns is more efficacious. And it helps to restore brain structure and function and promote motor function recovery in patients with early stroke. Key words: Stroke; Functional electrical stimulation; Lower extremity; Diffusion tensor imaging

[Diagnostic and prognostic values of serum procalcitonin and C-reactive protein in patients of bacterial sepsis].

Abstract: Objective To explore the diagnostic and prognostic values of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients of bacterial sepsis. Methods From July 2012 to May 2013, a total of 120 critically ill patients at our intensive care unit (ICU) were recruited. They included septic (sepsis group, n=63) local infection (local infection group, n=57) and healthy people (control group, n=30). The serum levels of PCT and CRP were measured. Septic patients were divided into survival and death groups according to the prognosis. They were also divided into gram-positive and gram-negative bacteria groups according to the results of bacterial cultivation. Results The serum levels of PCT and CRP, as well as acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores and sepsis related organ failure assessment (SOFA) scores in the sepsis group were significantly higher than those in the local infection and control groups (P 0.05). When PCT was ≥10.0 μg/L, the patients of gram-negative bacteria were more than those of gram-positive bacteria (P<0.05). Conclusion The serum levels of PCT and CRP are reliable in the diagnostic and prognostic evaluations of bacterial sepsis. Both also have certain reference value for local infection. Moreover the sensitivity and specificity of serum PCT were better those of serum CRP. Key words: Sepsis; Bacterial infections; C-reactive protein; Procalcitonin

Regulatory effects of luteolin on airway inflammation in asthmatic rats

Abstract: Objective To explore the regulatory effects of luteolin on airway inflammation in asthmatic rats. Methods A total of 48 male Sprague-Dawley (SD) rats were randomly divided into 3 groups of control, asthmatic and luteolin(n=16 each). The rat model of bronchial asthma was established in asthmatic and luteolin groups. The model was induced by intraperitoneally injecting a mixture of ovalbumin and aluminum hydroxide at Day 1 and 8. After two weeks, aomization excitation of normal saline (containing 1% ovalbumin) was induced thrice weekly. The treatment lasted 8 weeks. In control group, the mixture of ovalbumin, aluminum hydroxide and normal saline containing 1% ovalbumin was replaced by normal saline. At 30 min after aomization excitation, normal saline was given to rats in control and asthmatic groups, while 1 mg/kg luteolin was given intraperitoneally to luteolin group. The inflammatory cell number and level of interleukin-4 (IL-4) were measured in bronchoalveolar lavage fluid (BALF). The histopathological changes were observed under light microscope. The activities of peroxisome proliferator-activated receptors (PPARγ) and p38 mitogen-activated protein kinases (p38MAPK) in pulmonary tissues were detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). Results The bronchial wall thickness of asthma group, along with smooth muscle thickness ((93.3±7.4), (34.9±2.3) μm) was more than that of control ((61.9±8.2), (19.3±1.5) μm) and luteolin ((76.6±6.7), (25.4±4.6) μm) groups (all P<0.05). The total cell count ((5.61±0.63)×109/L), neutrophil count ((1.83±0.09)×109/L), eosinophil count ((0.59±0.09)×109/L) and level of IL-4 ((78.23±12.73) pg/ml) in BALF of asthmatic group were markedly higher than those of control ((1.53±0.31)×109/L, (0.45±0.21)×109/L, (0.07±0.03)×109/L and (21.21±2.53)pg/ml) and luteolin ((3.24±0.25)×109/L, (1.54±0.10)×109/L, (0.33±0.05)×109/L and (43.24±8.65) pg/ml) groups (all P<0.05). The results of semi-quantitative immunohistochemical analysis showed that the p38 protein level in control group (0.143±0.017) and luteolin group (0.251±0.021) was significantly less than that in asthmatic group (0.362±0.008) (both P<0.01). As compared with asthmatic group, the expression of PPARγ protein markedly increased (0.247±0.034) in control (0.331±0.056) and luteolin (0.442±0.031) groups (all P<0.05). The level of p38 mRNA in asthmatic group (0.718±0.064) was significantly higher than that of control (0.312±0.052) and luteolin (0.426±0.067) groups (all P<0.01). However, the PPARγ mRNA level in asthmatic group (0.266±0.036) was much less than that in control (0.573±0.042) and luteolin (0.687±0.054) groups (all P<0.01). Conclusion The anti-inflammatory effects of luteolin may be associated with the regulation of PPARγ expression and p38MAPK signaling pathway in asthmatic rats. Key words: Asthma; Luteolin; Peroxisome proliferator-activated raceptors; p38 Mitogen-activated protein kinases; Rats

Effects of extracts of Prunella Vulgaris L. on proteome of human lung adenocarcinoma cell line A549

Abstract: Objective To explore the effect of extracts of Prunella vulgaris L. on proteome of human lung adenocarcinoma cell line A549 by two-dimensional electrophoresis and mass spectrometry and elucidate the mechanism of anti-lung adenocarcinom effect of Prunella vulgaris L. at the level of proteome. Methods The proliferative activity of human lung adenocarcinoma cell line A549 was evaluated by methyl thiazolyl tetrazolium (MTT) colorimetric assay. According to the difference of culture medium, all subjects were divided into the experimental group with culture medium of extracts of Prunella vulgaris L. (300 μg/ml) and the control group with culture medium of DMSO (0.3%). Proteins were isolated by two-dimensional electrophoresis and proteomic maps acquired by silver staining. And proteomic analysis was processed by Image Master 2D Quant Platinum 6.0. The proteins with > 2-fold differences were used to analyze by mass spectrometry and confirmed by Western blot. Results The expressions of inositol 1, 4, 5-triphosphate receptor-interacting protein-like 2 precursor, heat shock cognate protein 70, serine-threonine kinase receptor-associated protein, tropomyosin 2(β) isoform 1, cyclin B3, MED12L protein and macrophin 1 isoform 2 were higher in experimental group than those in control group(ratio (medicial/normal) 2.051 93, 1 000 001, 2.203 08, 5.042 01, 15.178 00, 1 000 001, 1 000 001). And the expressions of enolase 1, M2-type pyruvate kinase, heat shock protein 27, Rho GDP-dissociation inhibitor 1, heat shock protein β1, TapasinERP57 heterodimer chain A, inorganic pyrophosphatase and mitochondrial Cysteinyl-tRNA synthetase 2 (putative) were lower in experimental group than those in control group(ratio (medicial/normal) 0.485 18, 0.491 53, 0.465 43, 0.454 71, 0.499 34, 0.450 36, 0.494 62, 0.437 33). Conclusions The extracts of Prunella vulgaris L. have multi-target and multi-pathway effects on anti-lung adenocarcinoma. And its possible mechanisms may be due to the regulation of steady state of calcium ion, cell cycle and its steady state and the inhibition of tumor cell proliferation and metastasis. Key words: Prunella; Lung neoplasms; Proteome

[Effects of non-physical factors on neck and shoulder pain and low back pain of adolescents].

Abstract: Objective To explore the incidence of self-reported neck or shoulder pain (NSP) and lower back pain (LBP) among Chinese adolescents in Shanghai and identify the influencing factors for the incidences of NSP and LBP. Methods A total of 3 600 students were selected from 30 high schools randomly chosen from 237 regular full-time high schools registered in Shanghai. From each school, 40 students were selected from each of the tenth, eleventh and twelfth grades for a total of 120 students per school. The questionnaire involved questions pertaining to demographic profiles, learning environment and exercise habits of each student. And it also contained questions regarding the amount of weight carried by each student while commuting to and from school, and it was also used to collect specific information related to the occurrence of NSP and LBP. Logistic regression was performed to analyze the potential risk factors for NSP and LBP. Results Among 3 600 questionnaires, a total of 2 842 valid ones were returned. The results revealed that the incidence of NSP and LBP in the Chinese adolescent population was 41.1% and 32.8% respectively. Both NSP and LBP were more common in girls than in boys, and 6.3% students reported at least one NSP- or LBP-induced absence from school. A relatively large portion of Chinese adolescents reported experiencing problems such as sedentary behavior (26.7% of the students continued to sit for more than 3 hours after school), a lack of exercise (29.3% exercised less than once each week and 38.2% of students reported that their exercise duration was less than half an hour each time) and overweight backpacks (53.0% complained that their backpack was too heavy). Multivariate logistic regression analysis revealed that gender, grade, physical activity and learning environment were all significantly correlated with the occurrences of NSP and LBP. Conclusion The incidences of NSP and LBP are relatively high among adolescents in Shanghai. And several factors, including sedentary behavior, personal exercise habits and backpack weight, influence the occurrencesof NSP and LBP in adolesents. Key words: Low back pain; Adolescence; Mental status schedule; Family; Habits