The inspection of sitagliptin to metabolic index and carotid artery IMT in metabolic syndrome patients with type 2 diabetes / 中国医师杂志

Objective To evaluate the effects of sitagliptin on blood glucose,blood pressure,blood lip and carotid artery intima media thickness (IMT) in metabolic syndrome patients with type 2 diabetes.Methods The clinical data were collected for 64 cases of inpatient and outpatient patients with metabolic syndrome with type 2 diabetes.Those patients included anti-diabetes native patients and patients only used the stable metformin dose.After signed off the informed consent form,those patients were randomized to the sitagliptin treatment group or original treatment group,and the metabolic index and carotid artery intima-media thickness were evaluated after 24 weeks treatment.Results The body mass index (BMI),waist circumference (WC),fasting plasma glucose (FPG),triglycerides (TG),high density lipoprotein cholesterol (HDL-C),systolic blood pressure (SBP),diastolic blood pressure (DBP),glycated hemoglobin a1c (HbA1c),and carotid artery IMT in two groups were comparable at baseline.After 12 weeks treatment,the FPG,TG,DBP,and HbA1c in the sitagliptin group were significantly better than original treatment group and the baseline,while there was no different between two groups in other index.After 24 weeks treatment,the FPG,TG,HDL-C,DBP,HbA1c,and carotid artery IMT in the sitagliptin group were significantly better than original treatment group and the baseline.Conclusions Sitagliptin presents the functions of lowering blood pressure,adjusting blood lipid,and protecting vascular endothelial in addition to lowering blood glucose.

Correlation between molecular biomarkers and risk factors for the clinical progression of benign prostatic hyperplasia using tissue microarray immunostaining / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The pathogenesis of benign prostatic hyperplasia (BPH) has been widely studied, and several biomarkers are known to play roles in its development. This study aimed to investigate the possible role of cysteine-rich protein 61 (CYR61), vascular endothelial growth factor (VEGF), androgen receptor (AR), interleukin-6 (IL-6), cytochrome c, caspase-3, and proliferating cell nuclear antigen (PCNA) in the clinical progression of BPH.</p><p><b>METHODS</b>Tissue specimens from 96 BPH cases who underwent transurethral resection of the prostate were processed and transferred to tissue microarrays. Patient age, prostate volume, serum prostate-specific antigen (PSA) level, and International Prostate Symptom Score (IPSS) of all BPH cases were collected before surgery. The expression of CYR61, VEGF, AR, IL-6, cytochrome c, caspase-3, and PCNA was examined by immunostaining in the BPH specimens, and any possible correlation between the different biomarkers and risk factors for BPH clinical progression was analyzed.</p><p><b>RESULTS</b>The expression of CYR61, VEGF, AR, IL-6, cytochrome c, caspase-3, and PCNA in the BPH cases was 68.8% (66/96), 77.1% (74/96), 43.8% (42/96), 31.3% (30/96), 35.4% (34/96), 56.3% (54/96), and 29.2% (28/96), respectively. The expression of both CYR61 and VEGF was positively correlated with patient age, prostate volume, and serum PSA level (P < 0.05). Furthermore, cytochrome c and caspase-3 expression were inversely related to prostate volume (P < 0.05), and AR expression was positively related to serum PSA level (P < 0.05).</p><p><b>CONCLUSION</b>CYR61 and VEGF expression might serve as biomarkers for predicting the clinical progression of BPH due to effects on stromal cell proliferation and angiogenesis.</p>

Relationship between non-alcoholic fatty liver disease and cardiovascular events in type 2 diabetes / 中国医师杂志

Objective To investigate whether the non-alcoholic fatty liver disease ( NAFLD) can independently increase the risk of cardiovascular events in type 2 diabetes .Methods The cardiovascular endpoints were observed after 5 years follow up for fat liver group (46 cases, patient with fat liver and with diabetes more than 10 years), non-fatty liver group (50 cases, patients without fatty liver disease and with diabetes more than 10 years), and normal glucose group (46cases, patient with NAFLD and with normal glucose) in the same demographic characteristics.Results ⑴ Patient status before enrollment: The body mass index (BMI), and blood glucose levels in fat liver group and non-fatty liver group were higher than normal glucose group , while the high-density lipopro-tein cholesterol ( HDL-C) was lower than normal glucose group ( P 0.05 ) .⑵After 5 years observation:The BMI , blood glucose , and TG levels in fat-ty liver disease group were significant higher than other two groups , while the HDL-C was lower than other two groups .The glucose control level of fat liver group was higher than normal glucose group ( P 0.05 ) .Conclusions NAFLD can independent-ly increase the risk of cardiovascular events in type 2 diabetes.

Re-discussion of warm ischemia time during retroperitoneal laparoscopic partial nephrectomy for renal carcinoma / 中国癌症杂志

Background and purpose:Laparoscopic partial nephrectomy has been one of the surgery options for patients with single renal carcinoma of T1 stage. Under the effect of some factors, intraoperative renal blood lfow clamping somtimes exceeds the safe limit of 30 minutes of warm ischemia time (WIT) for renal tissues, that might results in warm ischemia-reperfusion injury to severe extent. However, there still remains controversy about the depth of this warm ischemia-reperfusion injury. So this study aimed to evaluate the effects of longer WIT on ipsilateral residual renal tissues. Methods:Forty-four patients underwent retroperitoneal laparoscopic partial nephrectomy from Jan. 2012 to Jan. 2014. All of them were divided into observe group (WIT>30 min) and control group (WIT≤30 min). The differences of glomerular filtration rate (GFR) of operative kidney Pre- and post-operatively between two groups were analyzed. Results: The pre- and post-operative GFRs of operative kidney in observe group were 29.3-53.0 mL/min[(33.1±5.2) mL/min], 23.1-40.5 mL/min[(27.3±5.9) mL/min] respectively (P=0.054). The pre-and post-operative GFRs of operative kidney in control group were 27.4-49.6 mL/min[(32.3±4.1) mL/min], 23.8-44.4 mL/min[(29.1±5.0) mL/min], respectively (P=0.07). There was no statistically differences of the depth of the decrease of GFRs after surgery between the two groups (P=0.051). Conclusion: WIT of 30-60 min does not result in statistically signiifcant injury for ipsilateral residual renal function. However, it is still necessary to reserve more ipsilateral residual renal function through minimizing WIT under the premise of ensuring the safety of surgery.

The correlation between metabolic syndrome and benign prostatic hyperplasia in men over 50 years o1d / 中华泌尿外科杂志

ObjectiveTo evaluate the relationship between metabolic syndrome (MS) and benign prostatic hyperplasia ( BPH ) in men over 50 years old.Methods Male participants over 50 years old form a community in Beijing were randomly selected.Age,blood pressure,past history,and the international prostate symptom score (IPSS) were recorded.Plasma glucose,triglyceride,high density lipoprotein,prostate specific antigen (PSA),prostatic volume,and Qmax were measured.The morbidity and severity of BPH were compared with statistical analysis.ResultsFour hundred and forty men were enrolled,and were divided into 2 groups:MS group (n =105) and non-MS group (n =335).Compared to the non-MS,non-obesity,and non-hyperlipidemia group respectively,the morbidity of BPH was higher in MS,obesity and hyperlipidemia group (33.3％ vs.11.9％,P ＜ 0.05 ; 20.4％ vs.11.8％,P ＜ 0.05 ; 25.0％ vs.14.1％,P =0.007).The morbidity of moderate and severe LUTS in MS group was higher than non-MS group (61.9％ vs.31.3％,P ＜ 0.05).Significant differences were found in IPSS,prostate volume and PSA between the MS and non-MS groups ( P ＜ 0.05 ),but not found in Qmax ( P =0.069).Obesity,hyperlipemia and diabetes mellitus were risk factors of BPH (OR 1.75,95％ CI 1.40 -21.82,P =0.041 ; OR 3.36,95％ CI 2.34-48.13,P=0.037; OR 2.08,95％ CI 1.32-13.67,P=0.045). Conclusions There is higher morbidity of BPH in MS patient.MS could increase IPSS and prostate volume,and reduce PSA in BPH patient.Obesity,hyperlipemia and diabetes mellitus are risk factors of BPH.MS should be considered when treating BPH.

Risk factors of spontaneous rupture of hepatocellular carcinoma and prognostic factors of long-term survival / 中华肝胆外科杂志

Objective To determine the risk factors of ruptured hepatocellular carcinoma (HCC) and to study the prognostic factors of long-term survival.Methods Of the 4209 patients with HCC diagnosed and treated at the Eastern Hepatobiliary Surgery Hospital from Apr 2002 to Nov 2006,200 patients (4.8％) presented with ruptured HCC.These patients were studied retrospectively and the results of treatment were evaluated and compared with a randomly selected group of 202 patients who had no history of rupture and were treated during the study period.Results On multivariate logistic regression analysis,co-existing hypertension and cirrhosis,tumor size ＞5 cm,vascular thrombus and extrahepatic invasion were predictors of spontaneous rupture of HCC.For the 200 patients with spontaneous rupture of HCC,105 patients underwent elective one stage hepatic resection,33 received transcatheter arterial chemoembolization (TACE),and 62 were treated conservatively.The median survival time (MST) for patients with spontaneous rupture of HCC was 6 months (range,1-72 months),and the overall survival rates at 1-,3-and 5-year were 32.5％,10％ and 4％,respectively.The MST was 12 months (range,1-72 months) in the surgical group,4 months (range,1-30 months) in the TACE group and 1 month (range,0-19 months) in the conservative group.The 1-,3-and 5-year overall survival rates in patients with ruptured HCC who received partial hepatectomy were 57.1 ％,19.0％ and 7.6％,respectively,compared with 77.1％,59.8％ and 41.2％ in 98 patients who underwent partial hepatectomy for HCC without rupture (P＜0.001).Conclusions For patients with HCC who had underlying of hypertension and cirrhosis,extrahepatic invasion and tumor size ＞5 cm,there was a high propensity to rupture.Prolonged survival could be achieved in selected patients who received one-stage partial hepatectomy,although the survival results were inferior to the patients had no rupture.

Influence of Reduced Folate Carrier and Dihydrofolate Reductase Genes on Methotrexate-Induced Cytotoxicity / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study is to investigate the effect of genetic variations and the expression of the reduced folate carrier (RFC) and dihydrofolate reductase (DHFR) on the drug sensitivity to methotrexate (MTX) in different cancer cell lines. MATERIALS AND METHODS: We examined the six human cancer cell lines (MCF-7, AGS, A549, NCI-H23, HCT-116 and Saos-2). The cytotoxicity of MTX was measured by sulforhodamine B (SRB) assay. The expressions of the DHFR and RFC were evaluated by real-time PCR and western blotting. Four single nucleotide polymorphisms (SNPs) of the DHFR and two SNPs of the RFC were genotyped. RESULTS: The IC50s of MTX was in an extensively broad range from 6.05+/-0.81 nM to>1,000 nM in the cell lines. The Saos-2 (>1,000 nM) and MCF-7 (114.31+/-5.34 nM) cells were most resistant to MTX; in contrast, the AGS and HCT-116 cells were highly sensitive to MTX with an IC50 of 6.05+/-0.81 nM and 13.56+/-3.76 nM, respectively. A reciprocal change of the RFC and DHFR mRNA expression was found between the MTX-sensitive AGS and MTX-resistant Saos-2 cells. There was no significant difference in the expression levels of RFC protein in both the AGS and Saos-2 cells, whereas DHFR protein was more increased in the MTX-resistant Saos-2 cells treated with MTX. The genotype of the MTX-sensitive AGS cells were mutant variants of the DHFR; in contrast, the Saos-2 cells had the wild-type of the DHFR. CONCLUSION: In conclusion, this study showed that inverse change of the RFC and DHFR mRNA and protein expression was associated with RFC and DHFR polymorphisms and it is postulated that this phenomenon might play an important role in sensitivity of certain cancers to MTX.

Related factors for the motor recovery after vectriculoperitoneal shunt in normal pressure hydrocephalus / 国际外科学杂志

Objective Ventriculoperitoneal shunt (VPS)is preferable in treatment for normal pressure hydrocephalus (NPH). In this study, the factors related to the motor recovery after VPS were analysed.Method Twenty-six patients were treated with VPS, and four factors, that are duration of symptoms, open lumbar puncture(LP) pressure, improvement after LP ,and motor recovery of twelve months after operation,were assessed. Results Twelve months after VPS, the better motor recovery after VPS was related to shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP. Conclusion The patients with shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP are often responsive to VPS.

Hepatectomy for huge focal nodular hyperplasia of the liver / 中华肝胆外科杂志

Objective To evaluate the safety and feasibility of hepatectomy for huge focal nodu-lar hyperplasia of the liver. Methods The clinical data of 29 cases of huge FNH of the liver with an average diameter of 12.5 cm (10-26 cm) who were admitted to our hospital from 1996 to 2007 were retrospectively analyzed. Lesions protruded from the liver in 26 cases, compressed extrahepatic organs in 10 and adjoined or compressed hepatic hila in 19. Results All the lesions were successfully resected without operative death. The mean intraopreative blood loss was 747 ml (100-4000 ml). The first he-patic portal blocking was performed in 27 cases and the mean blocking time was 26 min (13-78 min).Among 19 cases of huge FNH involving hepatic hila, the mean intraopreative blood loss was 1011 ml,the mean blocking time 30 min and the liver cross-section was not completely sutured in 7 of these ca-ses. The intraoperative hemorrhea occurred in 7 and postoperative biliary fistula in 1. Twenty-seven cases were followed up for a median of 46 months (4-132 months) with no recurrence and the longest survival time had reached to 11 years. Conclusion Hepatectomy is a safe and feasible means for huge focal nodular hyperplasia of the liver. For those involving hepatic hila, distinguishing between the le-sion and intrahepatic vessels, performing resection closely around the lesion and dealing with the liver cross-section properly may be helpful to reduce the surgical complications.

Reproduction and evaluation of VX2 pulmonary careinoma model in rabbits / 解放军医学杂志

Objective To reproduce a pulmonary carcinoma model by injecting VX2 tumor tissue block suspension into rabbits' lung,and to compare the result with that of injecting VX2 tumor cells suspension.Methods A total of 50 New Zealand white rabbits were divided into two groups randomly with 25 in each.The VX2 tumor tissue block suspension and cell suspension were injected respectively into the right lower lung of each rabbit in two groups.The growth and metastasis of tumor in the thorax were observed with CT scan.The general condition of the animals was observed as well.Results The pathological pictures of the VX2 tumors were the same in two groups.The ratio of successful transplantation was 100% in the tissue block suspension group,while it was 48% in the cells suspension group,a remarkable difference in the success rate of tumor transplantation was found between the two methods(P

Study of effect and mechanism of cyclooxygenase-2 on the prostatic hyperplasia in rats / 中华泌尿外科杂志

Objective To investigate the effect and molecular mechanism of cyclooxygenase-2 (COX-2) on the benign prostatic hyperplasia (BPH) in rat model. Methods Thirty-six SD rats were randomly divided into 3 groups:normal control (group A,n=12),BPH model (group B,n=12) and BPH+selective COX-2 inhibitor celecoxib (group C,n=12). At the 5th week after treatment, the weight of the prostates was measured, and the morphological changes were examined under light microscope.Detection of ki-67 and TUNEL in prostatic epithelial and stromal cells was undertaken to assess the proliferation and apoptosis status.The protein and mRNA expression of COX-2,epidermal growth factor (EGF),basic fibroblast growth factor (bFGF) and transforming growth factor-?1 (TGF-?1) were analyzed by means of immunohistochemisty and RT-PCR. Results The prostate index [prostate wet weight (mg)/rat body weight (g)] of group B was significantly higher compared with those in groups A and C (1.88?0.17 vs 1.70?0.09 and 1.74?0.16,P0.05). Conclusions The increased expression of COX-2 may play an important role in the pathogenesis of BPH by modulating the expression of growth factors and affecting the proliferation and apoptosis of prostate cells.

The inhibitory effects of skeletal muscle conditioned medium on thoracic malignant tumors / 中国医师杂志

Objective To explore the organic micro environmental effect of skeletal muscles on the proliferation of thoracic malignant cells, its significance in the rarity of metastases in skeletal muscles and the prospect for its clinical applications.Methods Primary culture of new born Wistar rat skeletal muscle cells was established.The murine skeletal muscle conditioned medium(MMCM)was prepared to test its effect on thoracic malignant cell lines of A549、Anip-973,PLA-801C,NCI-H466,Eca109 and benign cell line of BHK-21 by MTT assay.Results Proliferations of thoracic malignant cell lines of A549,Anip-973,PLA-801C,NCI-H466,and Eca109 were significantly restrained when cultured with MMCM,while the proliferation of benign renal cell line(BHK-21)was not affected.Conclusions The conditioned medium of new born Wistar rat skeletal muscle cells could selectively inhibit the proliferation of thoracic malignant cells in vitro.Moreover,it affects tumor cells only and has no apparent effect on normal cells,which differs from most of the chemotherapeutic agents.These findings suggest a sound mechanism in the rarity of metastases in skeletal muscles.A therapeutic agent could be generated from MMCM to complement surgery and/or chemotherapy.