Yellow nail syndrome accompanied by minimal-change nephrotic syndrome: A case report.

BACKGROUND: In most cases of yellow nail syndrome (YNS), the classic triad of yellow nails, lymphedema and respiratory manifestations rarely manifest simultaneously. Therefore, diagnosis is delayed or frequently missed. CASE SUMMARY: We report a 62-year-old YNS patient presenting with bilateral pleural, pericardial and peritoneal effusions who, 2 mo later, developed minimal-change nephrotic syndrome. After treatment with vitamin E, clarithromycin and prednisone for 3 mo, effusions in the chest, pericardium and abdominal cavity decreased while urine protein levels returned to within normal ranges. CONCLUSION: Clinicians should consider the possibility of YNS for patients presenting with multiple serous effusions and nephrotic syndromes.

Expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/Tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary diseases and their relationships with pulmonary vascular remodelling.

OBJECTIVE: This study aims at investigating the expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/ tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary disease (COPD) and their relationships with pulmonary vascular remodelling (PVR). METHODS: 60 para-tumour tissues were divided into the COPD group and the control group (n=30); the inflammations, pulmonary artery wall area/total artery area (WA%), and wall thickness/vascular outer diameter (WT%) were compared. The expressions of TLR-4, MMP-9/TIMP-1, and PCNA in pulmonary vascular smooth muscle cells were detected, and their relationships with PVR were then analysed. RESULTS: The inflammations (1.6±0.8), WA% (44.0±6.4), and WT% (27.3±3.3) in the COPD group were higher than in the control group (0.3±0.5, 26.1±2.8, 15.6±1.8), and the expressions of TLR-4 (31.4±147) and MMP-9/TIMP-1 (2.2±2.6) were increased compared to the control group (4.7±4.5, 1.9±12). Correlation analysis: TLR-4 and MMP-9/TIMP-1 were positively correlated with the inflammations (r=0.18, P<0.01), WA% (r=0.68, P<0.01), and WT% (r=0.73, P<0.01), as well as positively correlated with the expression of PCNA (r=0.44, P<0.01); the upregulation of TLR-4 was positively correlated with the expressions of MMP-9 and TIMP-1. CONCLUSIONS: The upregulation of TLR-4 in the pulmonary arterial smooth muscle cells of COPD patients could promote the inflammations and the MMP-9 expression, thus causing abnormal degradation of extracellular matrix, so it played an important role in the process of PVR.

Expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/Tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary diseases and their relationships with pulmonary vascular remodelling

SUMMARY OBJECTIVE: This study aims at investigating the expressions of TOLL-like receptor 4 (TLR-4) and matrix metalloproteinase 9 (MMP-9)/ tissue inhibitor of metalloproteinase 1 (TIMP-1) in pulmonary blood vessels with chronic obstructive pulmonary disease (COPD) and their relationships with pulmonary vascular remodelling (PVR). METHODS: 60 para-tumour tissues were divided into the COPD group and the control group (n=30); the inflammations, pulmonary artery wall area/total artery area (WA%), and wall thickness/vascular outer diameter (WT%) were compared. The expressions of TLR-4, MMP-9/TIMP-1, and PCNA in pulmonary vascular smooth muscle cells were detected, and their relationships with PVR were then analysed. RESULTS: The inflammations (1.6±0.8), WA% (44.0±6.4), and WT% (27.3±3.3) in the COPD group were higher than in the control group (0.3±0.5, 26.1±2.8, 15.6±1.8), and the expressions of TLR-4 (31.4±147) and MMP-9/TIMP-1 (2.2±2.6) were increased compared to the control group (4.7±4.5, 1.9±12). Correlation analysis: TLR-4 and MMP-9/TIMP-1 were positively correlated with the inflammations (r=0.18, P<0.01), WA% (r=0.68, P<0.01), and WT% (r=0.73, P<0.01), as well as positively correlated with the expression of PCNA (r=0.44, P<0.01); the upregulation of TLR-4 was positively correlated with the expressions of MMP-9 and TIMP-1. CONCLUSIONS: The upregulation of TLR-4 in the pulmonary arterial smooth muscle cells of COPD patients could promote the inflammations and the MMP-9 expression, thus causing abnormal degradation of extracellular matrix, so it played an important role in the process of PVR.

RESUMO OBJETIVO: Este estudo tem como objetivo investigar as expressões de TOLL-like receptor 4 (TLR-4) e metaloproteinase 9 da matriz (MMP-9)/inibidor de tecido da metaloproteinase 1 (TIMP-1) em vasos sanguíneos pulmonares com doença pulmonar obstrutiva crônica (DPOC) e suas relações com o remodelamento vascular pulmonar (PVR). MÉTODOS: Sessenta tecidos paratumorais foram divididos em grupo COPD e o grupo controle (n = 30). Foram comparadas as inflamações, área da parede da artéria pulmonar/área da artéria total (WA%) e espessura da parede/diâmetro externo vascular (WT%). As expressões de TLR-4, MMP-9/TIMP-1 e PCNA em células de músculo liso vascular pulmonar foram detectadas, e suas relações com PVR foram então analisadas. RESULTADOS: As inflamações (1,6 ± 0,8), WA% (44,0 ± 6,4) e WT% (27,3 ± 3,3) no grupo COPD foram maiores que no grupo controle (0,3 ± 0,5; 26,1 ± 2,8; 15,6 ± 1,8). E as expressões de TLR-4 (31,4 ± 14,7) e MMP-9/TIMP-1 (2,2 ± 2,6) foram aumentadas em relação ao grupo controle (4,7 ± 4,5, 1,9 ± 1,2). Na análise de correlação, TLR-4 e MMP-9/TIMP-1 foram positivamente correlacionadas com as inflamações (r = 0,18; P <0,01), WA% (r = 0,68; P <0,01) e WT% (r = 0,73; P <0,01), bem como correlacionadas positivamente com a expressão de PCNA (r = 0,44; P <0,01). A elevação da TLR-4 foi correlacionada positivamente com as expressões de MMP-9 e TIMP-1. CONCLUSÕES: A regulação positiva do TLR-4 nas células do músculo liso arterial pulmonar de pacientes com DPOC poderia promover as inflamações e a expressão de MMP-9, causando assim uma degradação anormal da matriz extracelular, por isso desempenhou um papel importante no processo de PVR.

Efficacy study of edaravone and acetylcysteine towards bleomycin-induced rat pulmonary fibrosis.

The aim of this study was to investigate the interventional effects of Edaravone (EDA) and Acetylcysteine (NAC) towards the Bleomycin (BLM)-induced pulmonary fibrosis. 48 Wistar rats were divided into the control group, the BLM group, the hormone group, the EDA group, the NAC group and the combination group. After performing the BLM intratracheal injection to prepare the pulmonary fibrosis model, the rats were administrated EDA, dexamethasone (DEX), NAC and EDA+NAC combined intervention, the lung HRCT examination was performed on the 7(th), 21(st) and 31(st) day. On the 31(st) day, the rats were killed for the detection of serum malondialdehyde (MDA) and superoxide dismutase (SOD) contents; the lung tissues were performed the HE and Masson staining and determined the hydroxyproline content. The rats of the intervention group exhibited mild hypoxic phenomenon, with less ground-glass shadow and consolidated shadow than the BLM group, the MDA content decreased while the SOD content increased, and the degrees of alveolar inflammatory cell infiltration and fibrosis were low. The results of the EDA group and the NAC group were similar, and those of the combination group were better. EDA could inhibit the BLM-induced pulmonary fibrosis through adjusting the oxidant/antioxidant imbalance, with the effect similar to NAC, and the combined application of these 2 drugs were much more effective.

HIV-associated parkinsonism reversed with antiretroviral therapy

Human immunodeficiency virus (HIV) infection can cause variable movement disorders, including parkinsonism. HIV-related parkinsonism usually responds well to highly-active antiretroviral therapy (HAART), suggesting a possible reversible dysfunction of the dopaminergic system. We report the case of a 42-year-old man who presented with rapidly progressive symmetric parkinsonism, cognitive decline, and loss of postural reflex as the initial manifestation of HIV infection. A significant improvement of his parkinsonism after HAART demonstrates a potentially reversible dopaminergic system dysfunction secondary to HIV infection. A normal 99mTc-TRODAT-1 SPECT image after HAART treatment paralleled the clinical improvement in extrapyramidal symptoms. Early identification of HIV-related parkinsonism, especially in patients with symmetrical akinetic-rigidity and early loss of posture reflex, is important for its potential reversibility with HAART therapy.

How many heads are better than one? The reliability and validity of teenagers' self- and peer assessments.

Self- and peer assessments are becoming more popular in classrooms, but there are few data on the reliability and validity of such assessments performed by school children. Because these factors are greatly affected by the number of raters, we conducted two studies to determine the rating behaviours of teenagers in self- and peer assessments, and how the number of raters influences the reliability and validity of self- and peer assessments. The first study involved 116 seventh graders (the first grade of middle school), where students individually playing musical recorders were subject to self- and peer assessments. The second study involved 110 eighth graders, with Web pages constructed by students being subject to self- and peer assessments. Generalizability theory and criterion-related validity were used to obtain the reliability and validity coefficients of the self- and peer ratings. Analyses of variance were used to compare differences in self- and peer ratings between low- and high-achieving students. The coefficients of reliability and validity increased with the number of raters in both studies, reaching the acceptable levels of 0.80 and 0.70, respectively, with 3 or 4 raters in the first study (involving assessments of individual performance) and with 14-17 raters in the second study (involving assessments of group work). Furthermore, low- and high-achieving students tended to over- and underestimate the quality of their work in self-assessment, respectively. The discrepancy between the ratings of students and experts was higher in group-work assessments then in individual-work assessments. The results have both theoretical and practical implications for researchers and teachers.

Diisopropyl [(benzoyl-amino)-(phen-yl)meth-yl]phospho-nate.

The title compound, C(20)H(26)NO(4)P, has been obtained by the reaction of benzoyl chloride and diisoprop-yl[amino-(phen-yl)meth-yl]phospho-nate. The dihedral angle between the planes of the benzoyl-amino group and the phenyl ring is 77.0 (2)°. The crystal structure is stabilized by strong inter-molecular N-H⋯O hydrogen bonds between the doubly bonded phosphoryl O atom and the amide N atom which link the mol-ecules into pairs about a center of symmetry.

Proliferation of retinal pigment epithelial cells induced by (R,R)-XY-10 and (S,S)-XY-10 and their action mechanisms / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the mechanism of proliferation effect induced by (R,R)-XY-10 and (S,S)-XY-10 on retinal pigmented epithelial cells(ARPE-19).METHODS: Human retinal pigmented epithelial cells(ARPE-19) and human umbilical vein endothelial cells (HUVECs) were used to investigate the effect of (R,R)-XY-10 and (S,S)-XY-10 on cell growth,and their mechanisms of proliferative action by using ERK、 AKT、PI3K、Protein kinase C (PKC)and Nitric oxide synthase (NOS) inhibitors.RESULTS: (R,R)-XY-10 and (S,S)-XY-10 dose-dependently increased ARPE-19 cell proliferation,but not on HUVECs. When treated with proliferative inhibitors,H7(5μmol/L)、hypericin(20μmol/L)、PD98059(2μmol/L)、LY294002(50μmol/L)、SH-5 (10μmol/L) and L-NAME (100μmol/L),the proliferative effect was reduced by H7、hypericin、PD98059 and LY294002,but not by SH-5 and L-NAME.CONCLUSION: (R,R)-XY-10 and (S,S)-XY-10 can induce cell proliferation through MAPK and PI3K dependent pathway. KEYWORDS: age-related macular degeneration; (R,R)-XY-10; (S,S)-XY-10; ARPE-19 cells; human umbilical vein endothelial cells; proliferation

Antioxidant effect of hydralazine on retinal pigment epithelial cells and its potential use in the therapy of age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the antioxidant effect of hydralazine under hypoxia-induced damage on retinal pigment epithelial (ARPE-19) cells and the role of reactive oxygen species (ROS) in this effect.METHODS: Human retinal pigment epithelial (hRPE) cells were used to investigate the effect of hydralazine on oxidative stress, including tert-butyl hydroxyperoxide (t-BHP), H2O2, sodium azide (NaN3), and hypoxia induced cell damage. Cell viability was determined by MTT assay.RESULTS: When ARPE-19 cells were treated with oxidative stress induced by ROS, hydralazine showed concentration-dependent protection against t-BHP, H2O2 and hypoxia induced cell damage but not NaN3. Nitric oxide (NO) was not involved in this effect.CONCLUSION: Hydralazine showed antioxidant potential against oxidative stress induced damage in ARPE-19 cells. These effects might be caused through scavenger of ROS. Thus, hydralazine could be used for the treatment of age-related macular degeneration (AMD).

[Apoptosis versus proliferation activities of pulmonary artery smooth muscle cells in pulmonary arterial hypertension associated with chronic obstructive pulmonary disease].

OBJECTIVE: To investigate the apoptosis versus proliferation activities of pulmonary artery smooth muscle cells (PASMC) in pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD) and pulmonary vascular structural remodeling. METHODS: Forty-five patients were divided into three groups: patients without COPD and PH (non-COPD group, n = 15), COPD patients without PH (COPD with non-PH group, n = 15) and patients with PH associated with COPD (COPD with PH group, n = 15). Lung tissue samples were obtained from surgically resected specimens. The remodeling of pulmonary arteries were observed under microscope, and the changes of morphology-the ratio of the thickness of the wall to the external diameter of the pulmonary arterioles (WT%) and the ratio of the area of the wall to that of the pulmonary arterioles (WA%) were analyzed by computer-based image analysis system. The proliferation of PASMC was detected by proliferating cell nuclear antigen (PCNA) with immunohistochemical technique, and TUNEL (terminal deoxynu-cleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP)-digoxigenin nick end labeling) was used for the detection of the apoptosis of PASMC. RESULTS: In the COPD with non-PH group, the arterial walls were thicker and the lumens narrower than that of the non-COPD group. In the COPD with PH group, the walls were thicker and the lumens narrower than that of the COPD with non-PH group. In the COPD with non-PH group and the COPD with PH group, the WT% and WA% [(20 +/- 4)% and (35 +/- 5)%; (28 +/- 5)% and (50 +/- 6)%, respectively] were higher than those of the non-COPD group (16 +/- 3)% and (25 +/- 3)% (P < 0.01), and the WT% and WA% of the COPD with PH group were higher than those of the COPD with non-PH group (P < 0.01). Both proliferative and apoptotic PASMC were found in the patients of the three groups. The proliferation indexes (PI) of the COPD with non-PH group and the COPD with PH group [(19 +/- 5)% and (38 +/- 7)%] were significantly higher than that of the non-COPD group [(8 +/- 2)%, P < 0.01], while the apoptosis indexes (AI) [(4.5 +/- 1.3)% and (3.1 +/- 1.3)%] were lower than that of the non-COPD group [(6.9 +/- 1.9)%, P < 0. 01]. The PI of the COPD with non-PH group was lower than that of the COPD with PH group; the AI was higher than that of the COPD with PH group (P < 0.05). The PaO(2) of the COPD with non-PH group and the COPD with PH group was negatively related with the PI (r = -0.519, P = 0.003), but positively related to the AI of the PASMC (r = 0.441, P = 0.015). CONCLUSION: The imbalance of the increased proliferation and decreased apoptosis of PASMC may contribute to the pulmonary vascular structural remodeling and pulmonary arterial hypertension in patients of COPD. Hypoxia is one of the main causes of increased proliferation and decreased apoptosis of the PASMC.