Toll like receptors and inflammatory factors in sepsis and differential expression related to age

In recent years, the incidence of systematic severe .infection in intensive care units （ICUs） has increased significantly. Sepsis is a＂ complex, multifactorial syndrome that can develop into conditions of different severity, described as severe sepsis or septic shock. The immunology of severe sepsis and septic shock is poorly defined, despite many studies investigating the pathogenesis of this syndrome. With mortality rates of up to 50%, greater understanding of the interactions between host and microbe is necessary to improve patient outcome. Given the rapid progression of sepsis and immediate recruitment of the inflammatory cytokine cascade, the early innate response of the immune system to the pathogen is likely to play a critical role.     

Treatment of Post－Menopausal Urethral Syndrome with the Formula Niao Chang Shu——A Report of 40 Cases

Post-menopausal urethral syndrome is a morbid condition characterized by frequent urination and dysuria due to changes in the bladder and urethra subsequent to lack of estrogens^1. Clinically, this syndrome is often misdiagnosed as urinary infection and mis-treated with antibiotics. Although the disease could be treated with estrogens as a replacement therapy, the potential risk of carcinogenesis and other adverse reactions discovered in recent years leads to a poor acceptance of this modality. From December 2000 to February 2003, we treated 40 cases of the disease with a formula called Niao Chang Shu Fang(尿畅舒方) and obtained satisfactory results. This is reported as follows.     

Obstacle and solution of Chinese evidence-based orthopedics

Over the past decade,evidence-based medicine (EBM)is increasingly advocated as the “gold standard” of clinical practice.In 2001,the New York Times identified it as one of the ideas that made a difference,1 although EBM was still an academic concept in 1990.In 1996,Sackett et al2 first defined EBM as the conscientious,explicit,and judicious use of current best evidence in making decisions about the care of individual patients.It means integrating the best research evidence with clinical expertise and patient values.In China,EBM related studies seem to still be a “step behind”.For example,a PubMed search of “spine and China,limited to randomized controlled trial (RCT)” revealed two citations before 2000,but by 2012,the number was 183;compared with total published papers on spine limited to RCT found 842 citations before 2000 and by 2012,3895citations.     

The Predictive Value of Plasma Fibronectin Concentration on Fetal Growth Retardation at Earlier Stage of the Third Trimester

The prevalence of intrauterine growth retarda-tion( IUGR) is about3%— 1 4% .The perinatalmorbidity and mortality of IURG is high as 6— 8times as the normal birthweight neonates,further-more the fetus future health and intelligence will beaffected[1] .The mechanism of IUGR is notcomplete-ly clear.When the disease is advanced ( >34weeks) ,it continues to be a clinical problem even inthe face of recent advance in obstetrics and pedi-atrics.So the earlier prediction and prevention arethe ke…     

Serum Glypican 4 Levels Are Associated with Metabolic Syndrome in a Han Population from Guizhou Province,China

Metabolic syndrome (MetS) is the presence of a battery of cardiovascular risk factors including abdominal obesity, hypertension, dyslipidemia, and disturbed carbohydrate metabolism[1]. MetS affects 20% of adults in the Western world and 33% of adults in China[2] and has become a serious public health problem worldwide. However, the mechanism underlying the occurrence and progression of MetS is still largely unclear. It is now well established that excess fat deposition leads to abdominal obesity, which plays a vital role in the underlying mechanism. Adipose tissue can function as an endocrine organ that secretes various adipokines. The dysregulated expression of adipokines caused by excess adiposity and adipocyte dysfunction, has been linked to the pathogenesis of MetS[3]. Some serum adipokines such as leptin, adiponectin, interleukin 6 (IL-6), and tumour necrosis factor-α(TNF-α), might be potential markers for MetS development.     

Effect of Salvia Miltiorrhiza on Left Ventricular Hypertrophy and Cardiac Aldosterone in Spontaneously Hypertensive Rats

Left ventricular hypertrophy ( LVH) is themostpopular cardiac complication of hypertension,as well as an important and independent predictorof cardiac morbidity and mortality. Cardiac fibro-sis,the remodeling of extracellular matrix withinmyocardium during the development of pressureoverload,is the pathological basis of ventriculardysfunction and arrhythmia[1] . Previous studieshave shown that a functioning system involvingboth circulating and local aldosterone ( Aldo) con-tributes to the adv…     

Kounis syndrome: allergic acute coronary syndrome

Kounis syndrome is defined as a group of acute coronary syndromes that manifests as unstable vasospastic or nonvasospastic angina,and even as acute myocardial infarction triggered by the release of inflammatory mediators following an allergic insult.1 Kounis syndrome is a rare and complex syndrome.Instant treatment decisions need to be made once it happens.Here,we defined a case of severe Kounis syndrome,culminating in acute coronary syndrome,as a result of an acute allergic reaction,which was likely related to iodinated contrast media or dextran-40 use.     

Brugada syndrome masquerading as acute myocardial infarction in a patient presenting with ventricular fibrillation

Idiopathic ventricular fibrillation (VF) has been reported to account for 3%-9% of all sudden arrhythmic deaths.1 In 1991, Pedro and Josep Brugada first described a subgroup of patients with idiopathic VF who presented with a right bundle branch block (RBBB) pattern and marked ST-segment elevation in the right precordial leads V1-V3 during sinus rhythm in the absence of any structural heart disease.2 This is now known as the Brugada syndrome. In Hong Kong the first two cases of Brugada syndrome were reported in April 1999 in local medical literature. Since then more patients from different local hospitals were identified to suffer from the syndrome. We report here a male patient suffering from Brugada syndrome which masqueraded as an acute anteroseptal myocardial infarction 10 years ago.     

Brugada syndrome masquerading as acute myocardial infarction in a patient presenting with ventricular fibrillation

Idiopathic ventricular fibrillation (VF) has been reported to account for 3%-9% of all sudden arrhythmic deaths.1 In 1991, Pedro and Josep Brugada first described a subgroup of patients with idiopathic VF who presented with a right bundle branch block (RBBB) pattern and marked ST-segment elevation in the right precordial leads V1-V3 during sinus rhythm in the absence of any structural heart disease.2 This is now known as the Brugada syndrome. In Hong Kong the first two cases of Brugada syndrome were reported in April 1999 in local medical literature. Since then more patients from different local hospitals were identified to suffer from the syndrome. We report here a male patient suffering from Brugada syndrome which masqueraded as an acute anteroseptal myocardial infarction 10 years ago.     

Plummer-Vinson syndrome associated with solid- pseudopapillary tumor of the pancreas

Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with an increased risk of hypopharyngeal and/or cervical esophageal cancer. Three to 15 percent of the patients with PVS, mostly women between 15 and 50 years of age, have been reported to develop esophageal or pharyngeal cancer. There is a decreasing trend in the overall incidence of hypopharyngeal cancer in women, probably due to the diminished prevalence of PVS. There are few reports of gastric cancer in association with PVS.2[第一段]     

Corticosteroid resistance in chronic obstructive pulmonary disease: new uses of theophylline

Chronic obstructive pulmonary disease (COPD) is a major global health problem with a rising morbidity and mortality,which is expected to account for about 27％ of tobacco related deaths and is anticipated to move from the fifth to the fourth leading cause of death worldwide from 2002 to 2030.1 COPD is characterized by the abnormal and chronic inflammation induced by cigarette smoking and other inflammatory insults in both small airway and lung parenchyma.2,3 Glucocorticosteroids (also called glucocorticoids,corticosteroids or steroids) are the most effective anti-inflammatory drugs available for the treatment of many chronic inflammatory and immune diseases.4 However,corticosteroids have limited benefit in treating stable COPD5 defined as (relative) steroid insensitivity or resistance6 and may be characteristic of all phenotypes of COPD.Although anti-inflammatory treatments are expected to effectively treat inflammation of COPD,almost all anti-inflammatory approaches risk increasing the extent of infection by blunting host defence mechanisms.Their effectiveness in humans has been limited by various side effects.5 Therefore,it is important to develop a treatment to enhance corticosteroid anti-inflammatory action in COPD.     

Analysis on Menarche Age of Chinese Reproductive Women

Age of menarche( AM) ,considered as a sign of female sexual maturity,is animportantindicatorof female growth and development[1 ,2 ] .Consequently,ithas beenextensively studied in many provinces,municipalitiesand autonomousregions aswellas different ethnic groups since more than a century ago[3～ 6 ] .The age of menarchehas shown a seculartrend towardsa lowerage in differentpopulations.Theobjectofthe study was to presentthe trend of menarche age of the Chinese women as well asits possible affe…     

Cardiorenal syndrome: pathophysiological mechanism, preclinical models, novel contributors and potential therapies

Objective To review the current knowledge about the pathophysiological mechanisms,preclinical models,novel contributors and potential therapies of cardiorenal syndrome.Data sources The literature concerning cardioranal syndrome in this review was collected from PubMed published in English up to January 2014.Study selection Original articles and critical reviews related to cardiorenal syndrome were selected and carefully analyzed.Results Cardiorenal syndrome is a condition characterized by kidney and heart failure where failure of one organ worsens the function of the other thus further accelerating the progressive failure of both organs.The pathophysiology of cardiorenal syndrome is not fully understood,but may be caused by a complex combination of neurohormonal system activation,endothelial dysfunction,proteinuria,oxidative stress,uremic toxins and other factors.Managing cardiorenal syndrome is still a major therapeutic challenge in clinical practice because many of the drugs used to control heart failure can worsen renal function,and vice versa.Non-dialyzable uremic toxins,such as indoxyl sulfate,causing detrimental effects on the heart and kidney as well as stimulation of inflammatory responses,may be an effective therapeutic target for cardiorenal syndrome.Conclusions Suitable disease models of cardiorenal syndrome are urgently needed to investigate the pathophysiology and effective therapeutic approaches to the condition.Non-dialyzable protein-bound uremic toxins that may have cardiac and renal effects may provide therapeutic benefit to cardiorenal syndrome patients.     

Whether Syndrome Differentiation Affects Treatment Result: Study Protocol of MaZiRenWan (麻子仁丸) for Functional Constipation in A Randomized Controlled Trial

Background: Syndrome is one of the most important concepts in Chinese medicine(CM) theory. However, it was not well accounted in most of randomized controlled trials(RCTs). Objective: To determine whether CM syndrome differentiation affects the treatment results, functional constipation(FC) was selected as a target disease, and MaZiRenWan(麻子仁丸, MZRW), a classic CM formula commonly used for constipation with excessive heat syndrome, was selected for study. Methods: It is an 18-week prospective double-blinded, doubledummy RCT, including 2-week run-in, 8-week treatment and 8-week post treatment follow-up. A total of 120 FC patients diagnosed as excessive heat syndrome will be recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. Patients will be randomly allocated into fixed MZRW(f_MZRW) granule group, modified MZRW(m_MZRW) granule group or bisacodyl group. For m_MZRW group, no more than two herbal granules can be added according to the syndrome differentiation for individual participants. The primary end point is the mean of complete spontaneous bowel movements(CSBMs) per week during the treatment period. Secondary end points include mean of CSBMs per week during follow-up, stool form, global symptom improvement, constipation and constipation-related symptoms assessment, CM syndrome change, and reported adverse events. Discussion: This trial is designed to evaluate the effectiveness of these three interventions for FC patients with the CM syndrome of excessive heat, and to determine the change of CM syndrome and the progress of disease during the treatment course. The results are important to explore whether syndrome differentiation is important for the therapeutic effect of a formula on a disease.     

Enhancing the treatment of metabolic syndrome with integrative medicine

Metabolic syndrome,with the main clinical manifestations of obesity,dyslipidemia,elevated blood pressure,and elevated blood glucose levels,has become an increasingly prevalant global public health concern.@@Metabolic syndrome is a convergence of multiple risk factors related to cardiovascular disease.When the concept of metabolic syndrome was initially proposed,some researchers thought the concept was unnecessary,since there were already measures in place to describe the separate cardiovascular risk factors such as dyslipidemia,hypertension and diabetes.However,a large number of epidemiological investigations confirmed that even if blood glucose or blood pressure did not reach the cutoff point of the diseases,the superposition of multiple risk factors serves to amplify the damage of a single factor to the cardiovascular system.A meta-analysis of 87 clinical studies including 951 083 cases showed that the relative risk (RR) of metabolic syndrome for cardiovascular disease is 2.35,RR of death from cardiovascular disease is 2.40,and RR of stroke is 2.27.     

Effect of 935-MHz phone-simulating electromagnetic radiation on endometrial glandular cells during mouse embryo implantation

This study examined the impact of 935MHz phone-simulating electromagnetic radiation on embryo implantation of pregnant mice.Each 7-week-old Kunming (KM) female white mouse was set up with a KM male mouse in a single cage for mating overnight after induction of ovulation.In the first three days of pregnancy,the pregnant mice was exposed to electromagnetic radiation at low-intensity (150 μW/cm2,ranging from 130 to 200 μW/cm2,for 2-or 4-h exposure every day),mid-intensity (570 μW/cm2,ranging from 400 to 700 μW/cm2,for 2-or 4-h exposure every day) or high-intensity (1400 μW/cm2,ranging from 1200 to 1500 μW/cm2,for 2-or 4-h exposure every day),respectively.On the day 4 after gestation (known as the window of murine embryo implantation),the endometrium was collected and the suspension of endometrial glandular cells was made.Laser scanning microscopy was employed to detect the mitochondrial membrane potential and intracellular calcium ion concentration.In high-intensity,2-and 4-h groups,mitochondrial membrane potential of endometrial glandular cells was significantly lower than that in the normal control group (P<0.05).The calcium ion concentration was increased in low-intensity 2-h group but decreased in high-intensity 4-h group as compared with the normal control group (P<0.05).However,no significant difference was found in mitochondrial membrane potential of endometrial glandular cells between low-or mid-intensity groups and the normal control group,indicating stronger intensity of the electromagnetic radiation and longer length of the radiation are required to inflict a remarkable functional and structural damage to mitochondrial membrane.Our data demonstrated that electromagnetic radiation with a 935-MHz phone for 4 h conspicuously decreased mitochondrial membrane potential and lowered the calcium ion concentration of endometrial glandular cells.It is suggested that high-intensity electromagnetic radiation is very likely to induce the death of embryonic cells and decrease the chance of their implantati     

Dynamic Imaging of Autophagy-lysosomal Pathway and Autophagy Function Following Pulmonary Hypoxia/Reoxygenation In Vitro

Alterations of the autophagy-lysosomal pathway(ALP) and autophagy have been involved in lung ischemia-reperfusion(I/R) injury. However, dynamic imaging of ALP function under lung I/R injury particularly is not fully understood. Here we depicted the live-cell fluorescence imaging of autophagosome to monitor ALP activation and autophagy function. The p As Red2-N1-LC3 vectors were transfected into CRL-2192 NR8383(an alveolar macrophage cell line) and CCL149(an alveolar epithelial cell line) successfully. 0-h, 2-h, 4-h, and 6-h hypoxia/0-h, 2-h, 4-h, and 6-h reoxygenation were then induced with an ALP inhibitor(3-MA) or activator(rapamycin) in the culture of transfected cells separately. ALP activation was conformed by up-regulating AMPK and beclin1 expression. Apoptosis was not obvious in 2-h hypoxia/2-h reoxygenation. p As Red2-N1-LC3 CCL149 and p As Red2-N1-LC3 NR8383 cells revealed gradually enhanced As Red2 from 2-h to 6-h hypoxia/reoxygenation. As Red2 varied sensitively to 3-MA and rapamycin interventions during 2-h hypoxia/reoxygenation. Our data provides a simple method of autophagosome imaging to monitor ALP activation and autophagy function in lung I/R injury.     

Familial Wolff-Parkinson-White syndrome is linked to the locion chromosome 7q3

Objective Wolff-Parkinson-White syndrome (WPW) is considered to be an autosomal dominanthereditary disease, but the gene is not identified. The objective of this study was to localize the genetic loci of Wolff-Parkinson-White syndrome. Methods Linkage analysis between the disease of Wolff-Parkinson-White syndrome and 3 STR (short tandem repeats) markers on 7q3 (D7S505, D7S688, and D7S483) was tested in 3 kindreds of the Wolff-Parkinson-White syndrome (101 numbers in total) by genotyping. Results Wolff-Parkinson-White syndrome was linked to the loci above. The maximum two-point Lod score detected at D7S505 was 6. 4 at a recombination fraction (θ) of 0. 1; the Lod score of D7S688, D7S483 was 5. 3 vs 2. 5. Conclusion The gene of Wolff-Parkinson-White syndrome is located at 7q3.     

血瘀证日本研究现状及分子生物学分析

Blood stasis syndrome is one of the pathological concepts of Oriental traditional medicine. In Oriental traditional medicine, blood is thought of as not only blood but also as a living component of the body. In fact, blood stasis syndrome is related to not just circulation disorders but dermatological and gynecological and other diseases. In Japan, the concept of blood stasis syndrome is based on the past literature, for instance, Synopsis of Golden Chamber （Jin Kui Yao Lue）, etc. There are many signs of this syndrome, such as a dry mouth, fullness of the abdomen and rough skin. However, the levels of importance of these signs had been unclear. Therefore, in order to determine the levels of seriousness, a scoring system of blood stasis syndrome was made based on multivariate analysis by Dr. Terasawa （Terasawa＇s Blood Stasis Score）. Using the scoring system, we have studied blood stasis syndrome mainly related to blood circulation using modem techniques of analysis. From the results, we found that patients with blood stasis syndrome showed hemorheological abnormalities, and an improvement in these abnormalities was shown after administration of removing-blood stasis formulae. Furthermore, we have studied blood stasis syndrome from the point of view of molecular biology. We searched for the specific protein expression in blood stasis syndrome by proteomic analysis, and found no specific protein expression. However, there may be a possibility of developing a diagnostic algorithm for blood stasis by construction of a decision tree. During the past few years, as one of the molecular biological factors affecting blood stasis syndrome, we have been studying hypoxia inducible factor, which is located in the upstream of many genes. Above all, blood stasis syndrome is more than just circulatory deficit but encompasses the pathological concept of constant multilateral change in the living body.