Showing papers by "Chinese PLA General Hospital published in 2002"

An analysis of 10218 ulcerative colitis cases in China.

Abstract: AIM: To analyze the characteristics of ulcerative colitis (UC) in China METHODS: From 1981 to 2000, a total of 10218 patients of UC reported in Chinese medical literature and including our cases diagnosed were analyzed according to the diagnostic criteria of Lennard-Jones RESULTS: The number of cases increased by 308 times over the past 10 years (2506 patients were diagnosed from 1981 to 1990 while 7512 patients were diagnosed from 1991 to 2000)Lesion range were described in 7966 patients, 5592 (7020%) were proctosigmoiditis or proctitis, 1792( 2250%) left-sided colitis, 582(730%) pancolitis Among the 8122 patients, 2826 (348%) had first episode, 4272 (526%) had chronic relapse, 869 (107%) were of chronic persist type, 154 (19%) were of acute fulminant type The course of the illness were described in 5867 patients, 4427(755%) were less than 5 years, 910 (155%) between 5 and 10 years, 530 (91%) more than 10 years Six hundred and sixteen patients patients(61%) had extraintestinal manifestationsThe mean age at the diagnosis was 407 years(range 6-80 years, and the peak ages 30-49 years) The male to female ratio was109 Among 270 patients diagnosed in our hospital, 36 had histories of smoking, there was no negative association between the severity of UC and smoking (P > 005), 21 smokers were followed up for one year, 15 of them had given up smoking when the disease were diagnosed, and one year later, 7 patients relapsed, another 6 patients continued smoking, and one year later, 2 patients relapsed Among 270 UC patients diagnosed in our hospital, 4 patients(148%) from 2 families had familial history of UC Treatment was mentioned in 6859 patients, only 5-ASA and/or corticosteroid only in 1276 patients(186%), only Chinese herbs in 1377 patients(201%), combined Chinese and western medicine in 4056 patients(591%), surgery was performed in 87 patients(13%), other treatments in 63 patients(09%) CONCLUSIONS: In China, number of UC patients increased significantly in the past 10 years Lesions are commonly located to left side colon The course is short with rare extraintestinal manifestations The age of onset is relatively high Males and females are nearly equally affected No negative relation was found between smoking and severity of the disease Familial relatives are rarely involved Traditional Chinese medicine(TCM) is widely used in the treatment of UC

One-year open-label trial of thalidomide in ankylosing spondylitis.

Abstract: Objectives To test in a large open study whether thalidomide is potentially useful in treating ankylosing spondylitis, and to see if thalidomide induces any change in expression of genes in peripheral blood mononuclear cells (PBMC). Methods Thirty male patients with treatment-refractory ankylosing spondylitis were recruited into a 12-month open study using thalidomide at a dosage of 200 mg/day. Seven indices were measured as primary outcome measures, and 6 other indices as secondary outcome measures. Transcripts in the PBMC of some of these patients were first screened with microarray, and then measured with reverse transcriptase–polymerase chain reaction. Results Twenty-six patients completed the study. Of these, 80% showed a >20% improvement in 4 of 7 primary indices. Sharp declines in several parameters were noticed at 3–6 months. Nine patients became pain-free. There was also a statistically significant decrease in tumor necrosis factor α transcripts in the PBMC. Conclusion Thalidomide is a reasonably promising drug in treatment-resistant ankylosing spondylitis.

Frequent chromosome 9p losses in histologically normal nasopharyngeal epithelia from southern Chinese

Abstract: Nasopharyngeal carcinoma (NPC) is a common cancer among the Chinese population in the southern part of China. The incidence of this cancer drops markedly in northern China. A 6- to 24-fold difference exists between southern and northern Chinese. To investigate the early genetic events involved in the development of this cancer, we have examined loss of heterozygosity (LOH) on chromosome 9p, being one of the most frequent genetic alterations in NPC, in nasopharyngeal tissues including normal epithelia (NP), dysplastic lesions (DNP) and invasive carcinoma (NPC) from high-risk and low-risk regions. We found similar frequencies of 9p LOH in NPC from high-risk (77.8%) and low-risk (63.6%) regions (p = 0.43). In contrast, 45% of normal nasopharyngeal epithelia from the high-risk region showed 9p LOH, while none of the NP from the low-risk region showed such abnormalities (p = 0.002). Deletions of chromosome 9p were found in 66.7% dysplastic nasopharyngeal lesions. These findings suggest that LOH of chromosome 9p is an early event in the tumorigenesis of NPC. The increased risk of NPC in southern Chinese may be related to early loss of genetic materials as indicated by 9p LOH in the NP from high- and low-risk regions. We also reported previously that Epstein-Barr virus (EBV) latent infection was present in all high-grade DNP and NPC but not in any NP from fetuses or normal adults. Thus, early genetic alterations such as 9p LOH may take place prior to EBV latent infection and expand clonally thereafter.

The Diabcare-Asia 1998 Study -Outcomes on Control and Complications in Type 1 and Type 2 Diabetic Patients

Abstract: SummaryThe aim of this study was to describe the glycaemic and metabolic control and diabetes-related complications in type 1 and type 2 Asian patients.Methods: Data of diabetes patients from 230 diabetes centres in 12 Asian regions were collected on a retrospective-prospective basis through review of medical records, interview and laboratory assessments. Analysis of glycated haemoglobin (HbA1c) was carried out in central laboratories appointed by Bio-Rad. The data collection case record forms were scanned electronically.Results: 22177 patients with valid data made up the analysis population. Among patients with type 1 and type 2 diabetes, there was a higher proportion of women than men (53% vs. 47% for type 1 patients and 56% vs. 44% for type 2 diabetes). Hypertension (61%) and overweight (40% with BMI >25 kg/m2) were common in type 2 patients. Dyslipidaemia was also present in at least half of both types of patients. Control of glycaemia (mean HbA1c and fasting blood glucose [FBG]) was poor in type 1 (9...

Analysis of intra-operative bleeding and recurrence of juvenile nasopharyngeal angiofibromas.

Abstract: The purpose of this study is to present our experience with 34 patients diagnosed with juvenile nasopharyngeal angiofibromas and treated in the Chinese PLA General Hospital between 1986 and 1999, and to examine the factors influencing intra-operative bleeding and tumour recurrence. The age of the patient, the duration of symptoms and tumour stage were related to the amount of intra-operative bleeding. The tumours were totally resected in 30 patients and recurred in five patients (16.7%), with a mean follow-up time of 77 months. The mean time to tumour recurrence after operation was 3.2 months (1-6 months). The incidence of recurrence had no correlation with the age of the patient, duration of symptoms, peri-operative treatment or surgical approaches (P > 0.05); but strongly correlated with tumour stage (P < 0.05).

Echocardiographic and pathological characteristics of cardiac metastasis in patients with lymphoma

Abstract: The purposes of this study were to investigate the patterns of lymphoma involvement in the heart and to correlate pathologic findings in the heart at autopsy with echocardiographic presentation prior to death in patients with malignant lymphoma. Lymphoma patients with complete echocardiographic records prior to death and conformed cardiac metastasis at autopsy were included in the study. Echocardiographic records were reviewed retrospectively. Pathological diagnoses were compared with echocardiographic findings using Fisher's exact test. Twenty-nine patients aged 19-71 (mean +/- SD, 51.5+/-12.7) years were included in the study. Among them 17 (58.6%) were male. There were 6 cases (20.7%) with Hodgkin's disease and 23 (79.3%) cases with non-Hodgkin's lymphoma. Twenty-two (75.9%) cases were diagnosed with cardiac metastases at autopsy by gross appearance of their hearts. The most common (41.4%) site of metastatic involvement was the pericardium. The frequency of tumor on the valves was significantly lower than in the chambers and on other parts of the heart (6.9% versus 93.1%). Metastatic masses in right heart were found in 8 (8/23, 34.8%) non-Hodgkin's lymphoma cases, which was higher than that in Hodgkin's lymphoma cases (0/6, 0%; p=0.15). The frequency of high-grade non-Hodgkin's disease metastasizing to the right ventricle was significantly higher than that for the other kinds of lymphoma (3/7, 42.9% versus 0/22, 0%; p=0.01). Sensitivity of echocardiographic examination to detect cardiac metastasis was 75.9%. Echocardiography has been shown to be a sensitive method for the diagnosis of cardiac involvement in the patients with lymphoma. Patterns of cardiac involvement vary by the types of lymphoma, suggesting that different pathologic types of lymphoma may have different mechanisms of metastasis to the heart.

Efficacy and safety of therapeutic angiogenesis from direct myocardial administration of an adenoviral vector expressing vascular endothelial growth factor 165.

Abstract: OBJECTIVE To investigate whether direct administration of adenoviral vectors (Ad) containing the complementary deoxyribonucleic acid (cDNA) of vascular endothelial growth factor 165 (Ad-VEGF165) induces porcine coronary collateral vessel formation, improves regional myocardial perfusion and function and is safe. METHODS Three weeks after miniature swine underwent left thoracotomy and placement of an Ameroid constrictor on the left circumflex coronary artery (LCX), Ad-VEGF165 (n = 6) or the control, Ad expressing beta-galactosidase cDNA (Ad-Gal, n = 6), was directly administered into the ischemic myocardium in the circumflex distribution. All animals were sacrificed 4 wk after the second surgery. Myocardial perfusion and function were assessed by electrocardiogram-gated single photon emission computed tomography (GSPECT) imaging. Ex vivo coronary angiography was performed to examine collateral vessels. Toxicity was assessed by blood analyses on the day just before (day 0) and on day 1, 3, 7, 28 after vector delivery and by vascular, myocardial and liver histology after sacrifice. RESULTS GSPECT imaging 4 wk after administration of Ad-VEGF165 demonstrated significant reduction in ischemic area (P < 0.01) and rest ischemic severity (P < 0.01) and significant improvement in the left ventricular ejection fraction (P < 0.01) and regional wall motion (P < 0.05) compared with that of Ad-Gal and before administration of Ad-VEGF165. Collateral vessel development assessed by coronary angiography was significantly greater in the Ad-VEGF165 group than in the Ad-Gal group (P < 0.05). General safety parameters, including routine blood parameters, liver and kidney function and cardiac specific parameters demonstrated no difference between Ad-VEGF165 and Ad-Gal animals except for the red blood cell count on day 28 (P < 0.05) and blood urea nitrogen on day 7 (P < 0.05). Only transient elevations in creatine phosphokinase (P < 0.05) and aspartate transaminase (P < 0.05) on day 1 were revealed compared with that before vector administration in both groups. Histologically, no atherosclerotic lesion in the circumflex and no inflammation in liver were revealed and only a small myocardial necrosis was observed in one Ad-VEGF165 animal (area < or = 20%) and one Ad-Gal animal (area < 10%). CONCLUSIONS Ad-VEGF165 can induce coronary collateral vessel formation, improve regional myocardial perfusion and function and is safe by means of direct injection, which suggesting that this strategy may be useful in treating human ischemic heart disease.

Significance of changes in local immunity in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy.

Abstract: OBJECTIVE To assess the local immune response in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy (PMCT) METHODS Seventy-eight patients with hepatocellular carcinoma underwent PMCT Both cancerous and adjacent liver tissue were taken before, and 3, 17 and 30 days after PMCT using ultrasound-guided liver biopsy Specimens were stained by immunohistochemical techniques for detecting CD3, CD45RO, CD56, CD68, and CD20 positive cells RESULTS A few CD3, CD45RO, CD56, CD68 and CD20 positive cells were observed in the cancer stroma and surrounding sinusoids in liver tissue pre-PMCT The number of immunocytes, except for CD20 positive cells, was significantly increased both within the cancer and the adjacent liver tissue, with a larger increase in tumor tissue at day 3 post-PMCT compared with pre-PMCT These immunocytes were enlarged in size The number of CD3, CD45RO and CD56 positive cells peaked at day 17 and CD68 positive cells peaked at days 3 post-PMCT At day 30 post-PMCT, this increase still existed These infiltrating immunocytes distributed in the parenchyma of the tumor, and within the lumen of small blood vessels after PMCT In addition, more infiltrated immune cells were seen in cancer cell spaces CONCLUSIONS A change in immunocyte infiltration takes place in number, configuration and location after patients with HCC are treated with percutaneous microwave coagulation, suggesting that local immune function is enhanced post-PMCT

Time-dependent expression of chymase and angiotensin converting enzyme in the hamster heart under pressure overload

Abstract: The role of a dual angiotensin (Ang) II-forming pathway from the local renin angiotensin system (RAS) of the cardiac tissue was determined in a hamster model of cardiac hypertrophy. Time-dependent expressions of chymase and angiotensin converting enzyme (ACE) genes and their enzymes activities, and Ang II levels were measured in the hamster heart at 3 days, and at 4 and 8 weeks after pressure overload. Cardiac hypertrophy was induced by an operation to constrict the abdominal aorta. Compared to the sham-operated group, the cardiomyocyte diameters of hamster hearts at 3 days after overload underwent no obvious changes, while those at 4 and 8 weeks after overload increased markedly (p<0.01), and both transcriptional expressions of chymase and ACE genes gradually increased in the hamster hearts at 3 days, and at 4 and 8 weeks after overload, but the transcriptional expressions of angiotensin II type 1 receptor (AT1R) gene gradually decreased. Chymase and ACE activities (U/mg) (0.441+/-0.040 vs. 0.175+/-0.014, 0.446+/-0.036 vs. 0.160+/-0.016 and 0.522+/-0.014 vs. 0.148+/-0.038) (p<0.01) and (0.142+/-0.023 vs. 0.056+/-0.038, 0.317+/-0.017 vs. 0.079+/-0.016 and 0.466+/-0.010 vs. 0.098+/-0.003) (p<0.01), respectively and Ang II levels (pg/g) (98.7+/-4.5 vs. 71.2+/-4.9, 134.4+/-7.8 vs. 71.9+/-12.8 and 151.6+/-10.1 vs. 80.7+/-3.0) gradually increased in the hamster hearts, vs. sham treatment, respectively, at 3 days, and at 4 and 8 weeks after overload. However, the increases in chymase and ACE activities were much higher than those in their respective mRNA levels, and the levels of chymase activities were also higher than those of ACE activities during the development of cardiac hypertrophy. The results suggested that the increase in Ang II levels via the dual pathway of Ang II formation by chymase and ACE plays an important role in the cardiac hypertrophy of hamsters caused by the overloaded state. Importantly, in the non-hypertrophied hamster heart in the early stage after overload (at 3 days), chymase could be activated by mechanical stress in advance of an increase in its mRNA, and the Ang II level increased significantly.

Loud sound-induced changes in cochlear mechanics.

Abstract: To investigate the inner ear response to intense sound and the mechanisms behind temporary threshold shifts, anesthetized guinea pigs were exposed to tones at 100-112 dB SPL. Basilar membrane vibration was measured using laser velocimetry, and the cochlear microphonic potential, compound action potential of the auditory nerve, and local electric AC potentials in the organ of Corti were used as additional indicators of cochlear function. After exposure to a 12-kHz intense tone, basilar membrane vibrations in response to probe tones at the characteristic frequency of the recording location (17 kHz) were transiently reduced. This reduction recovered over the course of 50 ms in most cases. Organ of Corti AC potentials were also reduced and recovered with a time course similar to the basilar membrane. When using a probe tone at either 1 or 4 kHz, organ of Corti AC potentials were unaffected by loud sound, indicating that transducer channels remained intact. In most experiments, both the basilar membrane and the cochlear microphonic response to the 12-kHz overstimulation was constant throughout the duration of the intense stimulus, despite a large loss of cochlear sensitivity. It is concluded that the reduction of basilar membrane velocity that followed loud sound was caused by changes in cochlear amplification and that the cochlear response to intense stimulation is determined by the passive mechanical properties of the inner ear structures.

Association of genetic variants of vit D binding protein (DBP/GC) and of the enzyme catalyzing its 25-hydroxylation (DCYP2R1) and serum vit D in postmenopausal women.

Abstract: OBJECTIVE: To determine if GC (group-specific component globulin) and CYP2R1 genetic variants have an association with serum 25-OHD3 levels, BMD or bone turnover markers in a population of Chinese postmenopausal women. DESIGN: We randomly selected 1494 postmenopausal women of the Han ethnic group from seven communities in Beijing. BMD was determined by dual energy X-ray absorptiometry; serum bone turnover markers and 25-OHD3 were measured by the automated Roche electrochemiluminescence system; genotypes of GC and CYP2R1 were detected by the TaqMan allelic discrimination assay. Multiple statistic methods were used to test the associations of SNP genotypes and vitamin D levels. RESULTS: In our sample, 89.6% women had vitamin D deficiency and another 9.8% had vitamin D insufficiency. The variants of rs2298849 (β=0.105, P < 0.001) in GC were significantly associated with serum 25-OHD3 levels. Allele G of rs2298849 might be protective for serum 25-OHD3 level. Among the haplotypes of rs222020-rs2298849, CG (β = 0.104, P=0.001) corresponded to increasing serum 25-OHD3 concentrations. CYP2R1 polymorphisms showed some significant association with serum β-CTX and P1NP levels. CONCLUSIONS: We found that GC variants had a significant association with serum 25-OHD3 levels among postmenopausal women of the Han ethnic group in Beijing, while CYP2R1 variants were not found to be significant.

Thalidomide in ankylosing spondylitis.

Abstract: Despite potential side effects dominated by teratogenicity and peripheral neuropathy, thalidomide has recently been used to treat severe ankylosing spondylitis (AS). Over 50 patients have been treated across several 6-12 month open studies. Altogether 68% of the patients improved and the drop-out rate was 19%. Inhibition of NF-kappaB and/or TNFalpha is a putative mechanism for thalidomide efficacy in AS.

[A prospective study on smoking, quitting and mortality in a cohort of elderly in Xi'an, China].

Abstract: Objective To prospective examine the relationship between smoking, quitting and mortality in older Chinese men by in Xi'an, China. Methods The design was a cohort analytic study. One thousand two hundred and sixty-eight retired male military veterans aged 60 or older were examined in 1987. At baseline, there were 388 never-smokers, 461 former smokers and 419 current smokers. Main outcome measure was all-cause and tobacco-associated mortality. Results Through 1999, 299 had died, 943 were alive and 26 lost. The mean follow-up time was 11 years and total person-year of follow-up was 14 163. After adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol intake, exercise and existing diseases, using Cox proportional hazard regression model, the relative risks (95% confidence intervals) for ever-smoking, deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer and coronary heart disease (CHD) were 1.34 (1.02 - 1.76), 3.23 (0.95 - 10.91), 2.31 (0.95 - 5.61) and 1.60 (0.81 - 3.19) respectively. The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death (93%), but had higher risks for COPD death (excess risk increased 174%). Conclusions Smoking is a major cause of death in older Chinese men and quitting can save lives. These results showing that higher risks of COPD death in former smokers with or without existing diagnosed COPD at baseline than those in current smokers could be explained by either the "healthy smoker effect" or the "ill quitter effect" or both. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized as strategies in the control of the growing tobacco epidemic.

[Oral venous lakes: a clinicopathologic analysis of 20 cases].

Abstract: OBJECTIVE: To improve the recognization and treatment for oral venous lakes (OVL). METHODS: Clinicopathologically analysis of 20 cases of oral venous lakes was performed. All the samples were removed by surgically. RESULTS: All the lesions occurred in senile persons and located under the mucosa. Among the 20 cases, 11 were male patients and 9 were female; 18 of 20 occurred in the lower lip, another two in the upper lip and buccal mucosa. The lesions were 0.3 approximately 1.2 cm in size. Pathologically, the oral venous lake was composed of single or a few large, dilated and irregular veins. Thrombosis and organization were found within the lesions sometimes. CONCLUSIONS: Oral venous lakes are a kind of focal anomalies of venous structure. All the 20 cases (with a follow-up time from 8 months to 4 years) has no recurrence after surgical treatment.

Effect of Photosensitizer Photobleaching on Vascular Selectivity of Photodynamic Therapy

Abstract: Objective To investigate the photobleaching characteristics of hematoporphyrin monomethyl ether(HMME) and hematoporphyrin derivative (HpD), and to assess the relationship between photosensitizer photobleaching and vascular selective mechanism of photodynamic therapy (PDT) Methods Thirty four port wine stain(PWS) patients were irradiated by copper vapor laser with power densities 100 mW/cm 2 and energy densities from 200 to 300 J/cm 2 after 5 mg/kg HMME or HpD intravenous injection Photosensitizer fluorescenece of tissue was excited by Nd∶YAG laser (wavelength 355 nm) and analyzed by using an optical multichannel analyzer (OMA) Results The fluorescenece intensity of photosensitizer in superficial layers of PWS skin descended rapidly after laser irridiation The descent speed and amplitude of fluorescenece intensity of HMME was more than that of HpD Conclusions The photobleaching speed of photosensitizer in PWS skin was quicker than the diffusion speed of photosensitizer, and the photobleaching characteristics of photosensitizer was very important for vascular selective effect of PDT

[Influencing factors of local immunocyte infiltration in hepatocellular carcinoma tissues pre- and post-percutaneous microwave coagulation therapy].

Abstract: OBJECTIVE To investigate the influencing factors of the local immunity in tissues of hepatocellular carcinoma (HCC) before and after percutaneous microwave coagulation therapy (PMCT). METHODS Seventy-eight patients with HCC diagnosed by needle biopsy of liver underwent PMCT. Before the treatment and three and 17 days after the treatment specimens of carcinoma tissues were obtained by ultrasound-guided liver biopsy. The extents of infiltration of CD3(+) cell, natural killer cells (CD56(+)), and macrophages (CD68(+)), and the expression rate of proliferating cell nuclear antigen (PCNA) were evaluated by immunohistochemistry. The relation between the extents of immunocyte infiltration and the clinical parameters was analyzed with multiple regression. RESULTS Before PMCT infiltration of the three kinds of immunocytes was found in the carcinoma tissues to different degrees with a great variation among individuals. A remarkable increase in the extent of infiltration of the three kinds of immunocytes was found three days after the treatment and continued or remained till the 17th post-PMCT day (P < 0.01). The post-PMCT extent of immunocyte infiltration was positively correlated with the pre-PMCT extent (CD3(+): r = 0.256, P = 0.005; CD56(+): r = 0.257, P = 0.002; CD68(+): r = 0.275, P = 0.001). A negative correlation was found between the extent of immunocyte infiltration and serum alpha-fetal protein (AFP) and between the extent of immunocyte infiltration and tumor size (for serum AFP, CD3(+): r = -0.075, P = 0.049; CD56(+): r = -0.062, P = 0.041; CD68(+): r = -0.007, P = 0.035; for tumor size, CD3(+): r = -0.074, P = 0.051; CD56(+): r = -0.100, P = 0.012; CD68(+): r = -0.109, P = 0.038). No correlation was found between the extent of immunocyte infiltration and age of patient, Child-Pugh class of tumor, grade of tumor differentiation, and number of tumor. The extent of immunocyte infiltration was lesser in the carcinoma tissues with higher expression rate of PCNA. The extent of immunocyte infiltration was greater in the carcinoma tissues where PCNA expression was negative and carcinoma cells had necrotized but with their structure recognizable. No immunocyte infiltration was found in the necrotic and structureless tumor tissues. CONCLUSION The local immunocyte infiltration in patients with HCC was influenced by serum AFP and the grade of tumor cell necrosis pre- and post-PMCT. Destruction of tumor tissue in situs by PMCT is the premise of increase of immunocyte infiltration. Before PMCT improving the immune status of the patients helps enhance the local immune response.

Management of sinonasal inverting papilloma with recurrence and malignant transformation

Abstract: OBJECTIVE To investigate the clinical characteristics and optimum management of sinonasal inverting papilloma with recurrence and malignant transformation. METHODS Retrospective analysis of inverting papilloma with recurrence and malignant transformation treated from 1990 to 2000 in PLA general hospital. RESULTS All the 22 patients with recurrence had the history of sinonasal surgery. Among them, 13 patients recurred once, 7 recurred 2 times, 1 recurred 3 times and 1 recurred 4 times. The recurrence time was from 3 months to 11 years. Among the 22 patients with recurrence, the recurrence ratio of different surgery was different, for example intranasal approach was 100%, maxillectomy 60% and lateral rhinotomy 42%, 10 patients were operated with endoscope or endoscopic assisted surgery with no recurrence after 1-5 year's follow-up. Among 8 patients with malignant transformation, 4 received lateral rhinotomy, 1 Caldwell-Luc operation, all of them were given radiation therapy after operation (40-70 Gy) and no recurrence were found during 2 to 6 years follow-up. Of the other 3 patients, 2 died and 1 lost follow-up. CONCLUSION The endoscopic surgery(including the method of endoscopy combined with extranasal incision) is the optimum management for inverting papilloma in nasal cavity and paranasal sinuses. To the patients with malignant tumors, extensive excision and post-operative radiotherapy should be considered, but the prognosis is not satisfactory.

Cerebral venous thrombosis and factor V Leiden mutation

Abstract: Objective To investigate the relationship between factor V Leiden mutation and cerebral venous thrombosis in China. Methods 20 patients and 50 controls of Chinese origin were studied by polymerase chain reaction followed by Mnl I restriction enzyme analysis. Results The PCR products of all the people supervised were digested to three segments with the length of 37 bp, 67 bp, and 116 bp. No factor V Leiden mutation was found in any subjects. Conclusion Factor V Leiden mutation is not a crucial risk factor of cerebral venous thrombosis.

Mechanism of Photosensitized Reaction Induced by Hematoporphyrin Monomethyl Ether in vitro

Abstract: Objective To investigate the mechanism and characteristic of photosensitized reaction induced by hematoporphyrin monomethyl ether (HMME) and hematoporphyrin derivative (HpD) in vitro Methods The mechanism and characteristic of photosensitized reaction and the effect of scavengers of 1 O 2 and ROS were assessed using luminol chemiluminescence induced by HMME and HpD Results Scavengers of 1 O 2 almost completely inhibited chemiluminescence induced by HMME and HpD However, scavengers of ROS had no effect on chemiluminescence The highest volume of chemiluminescence and the total output of 1 O 2 induced by HMME in 48 second were 509 595 mV and 12 230 280, respectively while the highest volume of chemiluminescence and the total output of 1 O 2 induced by HpD in 235 second were 49 000 mV and 5 757 500, respectively Conclusions In vitro, the main outcome during photosensitized reaction induced by HMME and HpD was 1 O 2 1 O 2 Quantum yield induced by HMME was apparently higher than that of HpD HMME, rate of producing 1 O 2 and photobleaching were much more rapid than that of HpD When blood supply is normal, the killing effect of photosensitized reaction induced by HMME could be possibly stronge and HMME PDT, tissue selectivity could be probably good in the treatment

[Aging changes of gelatinase activity in kidney tissue of autoimmune MRL/lpr mice].

Abstract: OBJECTIVE To determine whether increased expressions of gelatinases occur with aging in vivo in kidney tissue of autoimmune MRL/lpr mice by in situ zymography. METHODS MRL/lpr mice at the age of 8 weeks, 16 weeks and 24 weeks were investigated. Kidney protein extracts were compared for activities of MMP-2/9 by gelatin zymography. Immunohistochemistry and SDS-PAGE gelatin zymography were used to determine the expressions and activities of gelatinase A (MMP-2) and gelatinase B (MMP-9). To determine the net gelatinase activities in murine lupus kidney, in situ zymography was used with autoradiographic emulsion as substrate. RESULTS Both gelatinase A and B were seldom detected in the kidney tissue in 8 week old mice, Increased expressions of both latent and activated form enzymes of MMP-2/9 were identified in kidney extraction by SDS-PAGE gelatin zymography and immunohistochemical staining showed both MMP-2 and MMP-9 were obviously up-regulated within glomerulus as well as tubular-interstitium in mice at the age of 16 and 24 weeks. In situ zymography showed markedly increased gelatinase activities in kidney tissue consistent with the results of immunohistochemical staining, it is mainly derived from MMPs and inhibited by EDTA but not by PMSF or aprotinin. CONCLUSIONS These in vivo results suggested that MMP-2/-9 expressions were significantly up-regulated with aging in murine lupus nephritis, which may play an important role in promoting the remodeling formation of ECM and thus contribute to the progression of renal damage in this model.

Direct gastroscopy for detecting gastric cancer in the elderly.

Abstract: Objective To evaluate the safety and effectiveness of direct gastroscopy for detecting gastric cancer. Methods Clinical screening by direct gastroscopy was performed for gastric cancer (GC) from September 1985 to July 1998. 3048 elderly people were screened. Their age ranged from 60 to 93 years, and 2034 of the 3084 were followed up. Results Ninety-two patients with gastric cancer were discovered by gastroscopy, representing 3.02% of the screened population. The rate of early gastric cancer (EGC) was 63.04% (58/92) of all gastric cancers detected. The rate was up to 79.59% (39/49) on follow-up, and was 74.14% (43/51) in asymptomatic patients with gastric cancer. The excision rate was 88.89% for patients with gastric cancer, and 100% for patients with early gastric cancer. The 5-year survival rate was 91.89% for patients with gastric cancer, and 96.30% for patients with early gastric cancer. Conclusion Clinical screening and follow-up by direct gastroscopy in persons over 60 years of age are a safe and effective method for raising the 5-year survival and detection rate of gastric cancer, especially early gastric cancer.

Characteristics of coronary microvascular lesions in autopsied elderly with hypertensive left ventricular hypertrophy.

Abstract: OBJECTIVE To observe the characteristics of coronary microvascular lesions (CML) in the autopsied elderly cases with hypertensive left ventricular hypertrophy (LVH) and the difference of CML among the groups of essential hypertension (EHT), coronary heart disease (CHD) and diabetes (NIDDM) also with LVH. METHODS A retrospective study was performed in 206 cases > or = 60 years old of EHT, CHD and NIDDM with LVH and 30 normal cases as control, out of 3195 consecutive autopsied cases from 1954 to 1996 in our hospital. Arterioles with diameters of 10 - 60 microm and capillaries in the muscular layer were shown by the methods of HE, Elastic fiber + VG staining and immunohistochemistry of CD31. Quantitative measurements on the arteriole density (AD), the ratio of arteriolar wall and cavity (RWC), capillary density (CD) and the area of endothelial cell (AEC) were performed with light microscope observation and image analysis by computer. According to the thickness of the left ventricle free wall, the severity of LVH was divided into four degrees from 0 to III. LVH of degree 0-III was observed in EHT group, while only LVH of degree I was found in CHD, EHT + CHD, and NIDDM groups. SAS system was used for statistical analysis. RESULTS AD and RWC increased while CD and AEC decreased significantly with the progression of LVH in EHT groups (P < 0.05 - 0.01). There was a similar but more severe change in the (HT + CHD) group (P < 0.01); the AD increased (P < 0.05) while all other measurements did not show obvious changes in the CHD group. The AD increased, CD and AEC decreased (all P < 0.05), but RWC did not change very much in the NIDDM group. CONCLUSION CML in the EHT group was characterized by an increased AD and RWC, decreased CD and AEC, among which the increased RWC was the typical change in EHT groups compared with the groups of CHD and NIDDM. Damaged CML may be one of the main factors for decreased coronary flow reserve and myocardial ischemia in cases of EHT with LVH.

[The diagnosis and treatment of primary tumors of facial nerve: a report of 14 cases].

Abstract: OBJECTIVE To summarize the clinic characteristics of the tumors of facial nerve and discuss the diagnosis and treatment. METHODS Fourteen cases of primary facial nerve tumors confirmed pathologically and treated in the Chinese PLA General Hospital from 1986-2000 were reviewed. The clinic manifestation, diagnosis and treatment in this series were analyzed. RESULTS Among the 14 cases, there were 9 of facial neurilemmoma, 3 of facial neurofibroma and 2 of facial nerve hemangioma. The commonest first symptom was facial paralysis (10/14), the next was hearing loss(6/10). The commonest sign was the facial paralysis. The following was tumor in tympanic cavity (5/14) and the next was tumor in external auditory canal(4/14). The tumors in all 14 cases were totally resected surgically. The function of the facial nerve was normal in one case with nerve being preserved intact during operation, and in grade II in one case and grade III in other one case with nerves being preserved partly continuous. Facial--great auricular-facial nerve cable grafting were done in 6 cases, as result their facial nerve were in grade II in 2 cases, grade III in 3 case and grade IV in 1 case. The facial-lateral femoral cutaneous-facial nerve cable grafting was done in one case, and the facial nerve function was in grade III with 6 years of following-up. The second-stage facial-hypoglossal nerve anastomosis was done in one case, and the facial function consequently recover to grade II with 3 years of following-up. Three cases of facial nerve remained discontinuity and their facial nerve function showed no recovery (in grade VI). CONCLUSIONS Once the facial nerve tumors were diagnosed, the surgical treatment should be done as early as possible. At the same time of tumor resection, the continuity of facial nerve should be kept and reconstructed in one stage as possible as we can, otherwise the second-stage surgery have be conducted soon after.