Showing papers in "National Medical Journal of China in 2006"

[Surgical resection versus percutaneous thermal ablation for early-stage hepatocellular carcinoma: a randomized clinical trial]

Abstract: OBJECTIVE To compare the clinical results of surgical resection (SR) and percutaneous thermal ablation (PTA) for early-stage hepatocellular carcinoma (HCC) (single tumor nodule

Comparison of the diagnostic criteria of metabolic syndrome by International Diabetes Federation and that by Chinese Medical Association Diabetes Branch

Abstract: Objective To compare the accordance between the diagnostic criteria of metabolic syndrome (MS) by International Diabetes Federation (IDF) and that by Chinese Medical Association (CMA) Diabetes Branch Methods An epidemiological survey on diabetes mellitus (DM) was conducted among 2344 residents in Shijingshan community, Beijing, aged >or= 40 1870 of these 2344 people, 901 males and 969 females, without DM underwent physical examination, laboratory tests, questionnaire survey and oral glucose tolerance test so as to screen the MS patients by both diagnostic criteria The accordance of these 2 criteria was analyzed statistically by using the STATA70 software Results The accordance rate of these 2 MS diagnostic criteria was 7995% If the criterion for fasting blood glucose in the China criteria was adjusted to 56 mmol/L, the accordance increased to 8139% 1091 persons were diagnosed as with central obesity according to the IDF criteria, 626 of which could be diagnosed as central obesity according to the China criteria with an accordance rate of 5738% Out of these 1091 persons 578 (923%) had the BMI >or= 25 kg/m(2) Out of the 779 persons that failed to be diagnosed as with central obesity 113 persons were diagnosed as with central obesity according to the China criteria Fifty of these 113 persons had the BMI >or= 25 kg/m(2) 111 persons diagnosed as with MS did not have BMI abnormality According to the IDF criteria, the morbidity of myocardial infarction (MI) and/or cerebral stroke in those with MS was 1987%, significantly higher than in those without MS (1486%, P = 0004), and according to the China criteria, the morbidity of myocardial infarction (MI) and/or cerebral stroke in those with MS was 1952%, significantly higher than in those without MS (1521%, P = 0013) as well There was no significant difference in the morbidity of MI and cerebral stroke between the IDF criteria and China criteria (P = 0092) According to the IDF criteria the morbidity of microalbuminuria in the MS patients was 859%, significantly higher than that in the persons without MS (428%, P = 0000) According to the China criteria the morbidity of microalbuminuria in the MS patients was 855%, significantly higher than that in the persons without MS (449%, P = 0000) There was no significant difference in the morbidity of microalbuminuria between these 2 criteria (P = 0976) There were no significant difference in the morbidity of microalbuminuria in the persons with central obesity and those with the BMI >or= 25 kg/m(2) between these 2 criteria (P = 077) Conclusion The MS diagnostic criteria of IDF and that of CMA Diabetes Branch are in good accordance

Long term follow-up on emergent intracoronary autologous bone marrow mononuclear cell transplantation for acute inferior-wall myocardial infarction

Abstract: OBJECTIVE To investigate the effects of emergent intracoronary autologous bone marrow mononuclear cell (BM-MNC) transplantation on left ventricular function and myocardium lesion area in patients with first acute inferior-wall myocardial infarction. METHODS Forty patients with first onset of acute inferior-wall myocardial infarction, 28 males and 12 females, aged < or = 75, treated with emergent percutaneous coronary intervention (PCI) were randomly divided into 2 equal groups: group undergoing intracoronary transplantation of autologous BM-MNC via a micro-catheter right after PCI (BM-MNC group), and control group receiving normal saline and heparin. Blood routine examination, myocardium zymogram, and serum high sensitive C reactive protein (hsCRP) were detected, and 24-hour dynamic electrocardiography, delayed-enhancement myocardial magnetic resonance imaging (CMR), and angiography of the coronary artery and left ventricle were conducted before the transplantation and immediately, 1 week, and 6 months after transplantation. RESULTS CMR showed that 6 months later the left ventricular ejection fraction (LVEF) of the control group was 47.9% +/- 6.7%, significantly higher than that 1 week later (43.4% +/- 6.7%, P = 0.001), and the LVEF of the BM-MNC group 6 months later was 51.5% +/- 5.2%, significantly higher than that 1 week later (44.5% +/- 7.1%, P = 0.001; however, the absolute change of LVEF (DeltaLVEF) of the BM-MNC group was 6.95% +/- 3.33%, significantly higher than that of the control group (4.05% +/- 1.68%, P = 0.047). Six months later the myocardial lesion area of the BM-MNC group decreased more significantly in comparison with the control group. Nevertheless, there was no difference in change of left ventricular end diastolic volume (LVEDV) between these two groups. The serum hsCRP 48 h after transplantation of the BM-MNC group was 2.8 g/L +/- 0.8 g/L, significantly lower than that before transplantation (13.4 g/L +/- 3.6 g/L, P < 0.001). No severe clinical events, such death, recurrent cardiac infarction, malignant arrhythmia, occur in these 2 groups. CONCLUSION Emergent intracoronary transplantation of autologous BM-MNC in patients with acute inferior-wall myocardial infarction improves the left ventricular function and myocardial infusion, minimizes the myocardial lesion area significantly.

[Effects of testosterone on insulin receptor substrate-1 and glucose transporter 4 expression in cells sensitive to insulin].

Abstract: OBJECTIVE To investigate the molecular mechanism of the influence of testosterone (T) on insulin sensitivity. METHODS Preadipocytes of the line 3T3-L1 and myoblasts of the line C2C12 were cultured to develop into mature adipocytes and skeleton muscle cells. Testosterone of the concentration of 10(-9) mol/l was added into the culture fluids for 0, 4, 8, 12, 24 and 40 hours. And testosterone of the concentrations increased by 10 times from 10(-12) mol/L, 10(-5) mol/L was added for 24 hours. Then the cell protein was extracted and the expression of insulin receptor substrate-1 (IRS-1) and glucose transporter 4 (GLUT4) in were measured by Western blotting. RESULT (1) Treated with T of the concentration of 10(-9) mol/L, the IRS-1 expression in the 3T3-L1 adipocytes increased along with the treatment time, peaked 12 hours later with a peak value 1.42 +/- 0.42 times that at the 0 h, and the values 4, 8, and 24 hours later were 1.13 +/- 0.03, 1.19 +/- 0.05, and 1.08 +/- 0.02 times that at the 0 h (all P < 0.05). The expression of IRS-1 in the C2C12 cells increased along with the treatment time of the testosterone of the concentration of 10(-9) mol/L too, peaked 24 hours later, with the values 8, 12, and 24 hours later 1.41 +/- 0.18, 1.53 +/- 0.14, and 1.50 +/- 0.14 times that at the 0 h (all P < 0.05). The GLUT4 expression value in the 3T3-L1 adipocytes increased since 4 hours after the treatment, peaked 24 hours after the treatment (3.22 +/- 0.10 that at the 0 h) (all P < 0.05). The GLUT4 expression value in the C2C12 cells increased since 4 hours after the treatment, peaked 24 hours after the treatment (5.17 +/- 1.06 that at the 0 h) (all P < 0.05). (2) The IRS-1 expression in the 3T3-L1 adipocytes and C2C12 cells increased dose-dependently along with the increase of the T concentration and peaked when the T concentration was 10(-9) mol/l (4.23 +/- 0.27 and 3.16 +/- 0.15 times that of blank controls respectively, both P < 0.05), and then turned to decrease. (3) The GLUT4 expression in the C2C12 cells increased along with the increase of the T concentration, peaked when the T concentration was 10(-7) mol/L (2.99 +/- 0.15 times that of the blank control, P < 0.05), and then remained at the similar level. (4) The GLUT4 expression in the 3T3-L1 adipocytes was highest when treated with 10(-11) mol/L testosterone (2.58 +/- 0.02 times that of the blank control, P < 0.05), and then decreased along with the increase of the T concentration (P < 0.05). CONCLUSION Testosterone has bidirectional dose- and time-dependent effects on the cellular expression of IRS-1 and GLUT4, which increase with low dose and short time testosterone treatment and decrease with higher dose and longer time treatment.

Effectiveness of backward walking treadmill training in lower extremity function after stroke

Abstract: Objective To examine the effectiveness of backward walking treadmill training for restoration of motor function, balance and walking speed in patients with stroke. Methods Twenty-six patients with stroke, 17 males and 9 females, aged 36 - 64, with the lower extremity Brunnstrom motor recovery stage at 3 or 4, able to walk for 10 m without walking aid or orthosis, were randomly divided into two equal groups: The patients in the control group were to participate in a 60-minutes conventional training five times a week for three weeks, and the patients in the experimental group received 30-minute conventional training and then 30-minute backward walking training five times a week for three weeks. Before the training and 3 weeks after the training, Fugl-Meyer assessment was used to assess the motor function of the lower extremity (FMA-L), Berg balance scale (BBS) was used to assess the balance function, and 10 m maximum walking speed was measured. Results After the three-week training period, the FMA-L score of the experimental group was 28.0 +/- 3.3, significantly higher than that of the control group (25.5 +/- 2.3, P = 0.033); the BBS score of the experimental group was 51.4 +/- 1.8, significantly higher than that of the control group (47.3 +/- 3.7, P = 0.001, and 10 m MWS of the experimental group was 57 +/- 17, significantly higher than that of the control group (43 +/- 16, P = 0.034). Conclusion A safe and feasible intervention, additional backward walking therapy helps improve the damaged motor function, balance, and walking speed of the patients with stroke.

[Current status of primary hypertension in China: an epidemiological study of 12 provinces, 1 autonomous regions, and 1 municipality].

Abstract: OBJECTIVE To investigate the current prevalence of primary hypertension in China in 2002 so as to lay a foundation for further control of hypertension in future. METHODS Physical examination, including measurement of the blood pressure using international standardized methods especially, was conducted among 29,076 persons aged 35 - 85, 13,555 males (46.6%) and 15,521 females (53.4%), by cluster sampling in Tianjin, Inner Mongolia, Shanxi, Henan, Shandong, Hubei, Hunan, Sichuan, Guangdong, Jiangxi, Yunnan, and Shaanxi. RESULTS The prevalence of hypertension was 27.9% in general. The prevalence increased along with the age. The rate of awareness of being ill with hypertension was 60.71% in general (9872/29,076), and was 55.64% among the males, significantly lower than that among the females (65.42, P < 0.001). The treatment rate 49.65% (4901/9872) in general, and was significantly higher among the females than among the males (P < 0.01). The control rate was 5.7% (562/9872). In general, the prevalence of hypertension was higher in the North than in the South, and was becoming lower and lower from the North to the South. CONCLUSION The prevalence of hypertension is high, while the rates of awareness, treatment and control are low in China.

Time trends in the prevalence of asthma and allergic diseases over 7 years among adolescents in Guangzhou city

Abstract: Objective To assess time trends in the prevalence of asthma, allergic rhinitis and eczema in Guangzhou urban adolescents. Methods A cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Ⅲ protocol was conducted in 2001. Cluster randomized samples of 3516 schoolchildren aged 13-14 from 10 secondary schools of four central districts were recruited for the study in Guangzhou city. The results were compared with those obtained in ISAAC Phase Ⅰ Study (1994-1995), which used the identical and validated core questionnaires. Each subject was given an ISAAC Phase Ⅲ written questionnaire to complete, followed by the video questionnaire about asthma at the same session in school. Results The prevalence rate of physicians’diagnosis of asthma in Phase Ⅲ was 4.6%, which was similar to that of 3.9% in Phase Ⅰ(P0.05). But the prevalence rates of wheeze and exercise-induced wheeze in the past 12 months by written questionnaire have increased from 3.4% and 17.4% in Phase Ⅰ to 4.8% and 23.4% in Phase Ⅲ respectively (all P0.01). By the video questionnaire, the 12-months prevalence rates of wheeze at rest and exercise-induced wheeze were also significantly higher in Phase Ⅲ (3.8% and 11.3%) compared with those in Phase Ⅰ (2.0% and 6.9%) (P0.01). The 12-months prevalence rates of nasal symptoms without common cold, both related to rhinitis and rhinoconjunctivitis had also increased from 39.5% and 8.7% in Phase I to 45.5% and 11.1% in Phase Ⅲ, respectively (both P 0.01). Meanwhile, the prevalence rates of physicians’diagnosis of hayfever and allergic rhinitis in Phase Ⅲ were 4.1% and 22.7%, which were significantly higher than that of 2.9% and 17.4% in Phase Ⅰ (both P0.05). The 12-months prevalence rate of flexural eczema symptoms had increased from 1.3% in Phase I to 2.2% in Phase Ⅲ(P0.01). However, the prevalence rates of physicians’diagnosis of eczema were similar in both surveys (P0.05). The absolute percentage changes in 12-months prevalence rate related to symptoms and physicians’diagnosis for asthma, allergic rhinitis and eczema were more in males than those in females. Conclusion There is a general tendency towards an increase in the prevalence of asthma, allergic rhinitis and eczema over 7 years among adolescents in Guangzhou city, remarkably more so among males than females.

[Over-expression of Hypoxia-inducible factor 1alpha increases invasive potency of LNCaP cells in vitro].

Abstract: OBJECTIVE To evaluate the effect of hypoxia-inducible factor-1alpha (HIF1alpha) over-expression on the invasive potency of human prostate cancer cell. METHODS Human prostate cancer cells of the line LNCaP were cultured and transfected by the recombinant plasmid pcDNA3.1(-)-HIF-1alpha containing the gene HIF1alpha with Lipofectamine 2000 system. The positive clone cells were selected by G418 and confirmed by Western blotting and immunofluorescence staining (LNCaP/HIF1alpha cells). Transwell chambers with polycarbonate filter were coated by 100 microl Matrigel at 1:20 dilution in serum-free medium. LNCaP cell suspension and LNCaP/HIF1alpha cell suspension were inoculated into the Transwell chambers respectively for 24 hours to analyze the invasive potency. Western blotting was used to detect the expression of E-cadherin, vimentin, matrix metalloproteinase-2 (MMP-2), cathepsin D, and urokinase-type plasminogen activator receptor (uPAR). RESULTS The expression level of HIF1alpha in the LNCaP/HIF1alpha cells was distinctly higher than that in the LNCaP cells. The numbers of LNCaP-HIF1alpha cells penetrating through the Transwell polycarbonate filter was 4.6 +/- 0.4 x 10(4), significantly higher than that of the LNCaP cells (3.2 +/- 0.3 x 10(4), P < 0.01). The expressions of vimentin, MMP-2, cathepsin D, and uPAR were all up-regulated in LNCaP-HIF1alpha cells than those of the LNCaP cells. Whereas, the expression of E-cadherin was down-regulated in the LNCaP-HIF1alpha cells. CONCLUSION Over-expression of HIF-1alpha stimulates the invasion potency of human prostate carcinoma cell. The expression of E-cadherin, vimentin, MMP-2, cathepsin D, and uPAR, all playing an established role in the invasion of tumor, can be regulated by HIF-1 in human prostate cancer cell.

Evaluation of the four simple methods in the diagnosis of diabetic peripheral neuropathy

Abstract: Objective To evaluate the efficacy of neuropathy symptom score/neuropathy disability score (NSS/NDS), Michigan Neuropathy Screening Instrument (MNSI), vibration perception threshold (VPT) and 24010 g monofilament examination in the diagnosis of diabetic peripheral neuropathy (DPN). Methods 240 patients with type 2 diabetes underwent the 4 simple tests: NSS/NDS, MNSI, VPT, and 10 g monofilament examination and nerve conduction velocity (NCV) examination. Using the results of NCV as golden criteria, the sensitivity, specificity, positive and negative predictive values, accuracy and kappa values of these tests were analyzed. Results The sensitivity, specificity, accuracy, and kappa value of MNSI score over 2 were 78.15%, 88.43%, 83.33%, and 0.67 respectively. The validity could be ranked in the following order with respect to the diagnosis of DPN: MNSI > VPT > NSS/NDS > 10 g monofilament examination. Conclusion MNSI is a rapid, simple and reliable test for screening DPN in both diabetes clinics and epidemiological surveys.

CT guided radioactive seed 125I implantation in treatment of pancreatic cancer

Abstract: OBJECTIVE To investigate the clinical value of CT guided radioactive seed (125)I implantation in treatment of pancreatic cancer. METHODS Twenty-six patients with pancreatic cancer 6.1 cm in size on average, 21 males and 5 females, aged 60 +/- 13 (47 - 73), underwent CT guided radioactive seed (125)I implantation. Of the 26 patients 15 had the symptom of severer abdominal pain and 10 had jaundice. Three of them were in the TNM (pTNM) stage II, 30 in the stage III, and 3 in the stage IV. Treatment plan system was used to design the distribution of the seed (125)I needed. Under CT guidance, the (125)I seeds of (2.2 - 3.3) Mq were implanted into the pancreatic cancer at a distance of 1.0 - 1.5 cm. A follow-up for 3 - 12 months was conducted. RESULTS Complete relief (CR) of the symptoms was seen in 9 patients, partial relief (PR) in 2 patients, and no change (NC) in 4 cases with an effective rate of 73.4%. The abdominal pain was relieved 3 - 7 days after the implantation. CT performed 2 months after implantation showed CR in 2 cases, PR in 13 cases, NC in 5 cases, and progression in 5 cases with an overall effective rate of 57.7%. Four patients died of local progression and 2 patients died of distant metastasis. Migration of the seeds into the liver was seen in 3 patients and slight decrease of white blood cells was seen in 1 patient during the 2-month follow-up. No severe complications, such as pancreatic leakage, acute pancreatitis, intestinal hemorrhage, etc, were found. CONCLUSION Safe and with minimal damage and few complications, CT guided radioactive seed (125)I implantation is effective in treatment of pancreatic cancer.

Effect of carbon dioxide pneumoperitoneum during laparoscopic surgery on morphology of peritoneum

Abstract: Objective To investigate the influence of carbon dioxide (CO_2) pneumoperitoneum during laparoscopic surgery on morphology of peritoneum Methods Forty patients with myoma of uterus or simple ovarian cyst excluding peritonitis were randomly divided into 2 equal groups to undergo laparoscopic surgery with CO_2 pneumoperitoneum or laparotomy respectively Specimens of parietal peritoneum were obtained at different time points, 0, 30, 90, and 120 min after the beginning of observation, ie e, insufflation or opening of the peritoneal cavity, to undergo transmission electron microscopy and scanning electron microscopy to observe the morphological changes of mesothelial cells Results In the laparotomy group, up to the time point of 60 min, there was no marked change of mesothelial cells Intercellular cleft were occasionally found since 90 min and became significant 120 min after However, in the CO_2 pneumoperitoneum group bulging up of mesothelial cells was evident immediately at the time of filling of CO_2, intercellular spaces could be found 30 min later, 60 min later intercellular cleft deep to the underlying basement membrane could be seen and the basement membrane lost its continuity and became uncovered, and 120 min later such changes became more significant and a small amount of lymphocytes and macrophages were found in the intercellular clefts Conclusion Carbon dioxide pneumoperitoneum during laparoscopic surgery causes significant morphological changes in the peritoneum duration of insufflation dependently

[Evaluation of long-term therapeutic effects of ultrasound-guided percutaneous microwave ablation of liver metastases].

Abstract: OBJECTIVE: To explore therapeutic results of local microwave ablation for hepatic metastasis and the factors influencing the survival after percutaneous microwave ablation therapy. METHODS: From July 1995 to June 2005 128 patients with 282 hepatic metastases nodules with the primary diseases of upper gastrointestinal tumor (n = 26), colorectal tumor (n = 44), breast carcinoma (n = 19), pulmonary carcinoma (n = 15), and malignant tumor in other part of the body (n = 24), underwent percutaneous microwave ablation therapy and were followed up for 29.7 +/- 19.9 months (1 - 103 months). The largest diameter of the metastatic nodules was 3.5 +/- 1.6 cm (0.7 - 8.6 cm). Sixty-four cases had 140 nodules 3.0 cm in diameter. Forty-seven patients had single nodule, 44 patients had 2 nodules, and 93 patients had 3 or more nodules. Fifty-seven patients had tumor of low differentiation, 53 had tumor of middle differentiation, and 18 had highly differentiated tumors. Kaplan-Meier method was used to calculate the cumulative survival rate. Statistical comparison of the effects of potential predictive factors on survival rate was performed using log-rank analysis. Multivariate analysis of the survival rates was performed by using Cox's proportional hazard model. RESULTS: The 1, 2, 3, 4, and 5-year cumulative survival rates of all 128 patients were 90.88%, 73.84%, 51.09%, 36.14%, and 31.89% respectively. Univariate analysis showed that tumor size (P = 0.028), tumor differentiation (P = 0.026) and local recurrence or new metastases (P < 0.001) significantly affected the survival. Multivariate analysis revealed that tumor size (P = 0.035), recurrence or new metastases (P = 0.001) and tumor differentiation (P = 0.038) each had a significant effect on survival. CONCLUSION: There is a significantly higher probability of long-term survival for patients with well-differentiated tumors 3.0 cm or less in diameter and without recurrence or new metastasis after percutaneous microwave ablation.

[Endovascular stent-graft repair for penetrating atherosclerotic ulcer of the descending aorta]

Abstract: Objective To summarize the clinical experience and effectiveness of endovascular stent-graft placement for the treatment of penetrating atherosclerotic ulcer of the descending thoracic aorta. Methods From August 2002 to February 2006, 14 patients with penetrating atherosclerotic ulcer accepted endovascular stent-grafts placement. All patients were men, their average age was 60 years. The clinical symptoms included thoracalgia or notalgia or celiodynia (n = 13) and hemoptysis (n = 3). 11 patients had hypertension. All patients were diagnosed by CT or MRI scans. Via the cutdown on a femoral artery at local anesthesia, the stent-graft was placed after completion angiography. Then DSA examine was repeated. X-ray and EBCT or MDCT scans were performed at follow-up. Results 16 Stent-grafts were successfully placed in 14 patients, in which 2 cases were placed with two stent-grafts respectively. There were Talent stent-grafts (n = 11) and Aegis stent-grafts (n = 5). The diameter of endovascular stent-graft ranged 32 mm to 38 mm exceeding by 10% - 20% of aortic diameter of anchoring zone. Instant angiography revealed no endoleak in 12 patients, minor endoleak in 2 patients. Within the follow-up average 17.2 months, CT scans demonstrated the disappearances of penetrating atherosclerotic ulcer or exclusion of aortic pseudoaneurysm in all patients, and absorption of intramural hematoma in two patients. One patient died of rupture of aortic pseudoaneurysm after one month. Conclusion Penetrating atherosclerotic ulcer can leads to intramural hematoma, dissection, aneurysmal dilatation, pseudoaneurysm, or aortic rupture. Therefore it should be treated once diagnosed. Endovascular stent-graft placement may be an effective treatment for penetrating atherosclerotic ulcer, especially in patients with poor condition.

[Indication of liver transplantation for hepatocellular carcinoma: Shanghai Fudan Criteria].

Abstract: OBJECTIVE To evaluate the effects of different selection criteria on the prognosis of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) and to explore the new criteria adapted for Chinese National Situation. METHODS A retrospective analysis was performed on 251 consecutive patients with HCC who underwent LT between April 2001 and January 2006 at our institution. We compared the outcome of the patients meeting different criteria such as milan, UCSF and the Pittsburgh modified TNM criteria. Survival rates were calculated using the Kaplan-Meier method, and differences between the curves were assessed by log-rank test. RESULTS There was no significant difference in 1, 2, 3-year survival rates and recurrence-free survival rates between milan criteria (n = 93; 86%, 77%, 77% and 91%, 86%, 86%) and UCSF criteria (n = 131; 90%, 83%, 83% and 92%, 89%, 89%). According to Pittsburgh criteria (n = 207), the 1, 2, 3-year survival rates and recurrence-free survival rates were 84%, 74%, 67% and 85%, 83%, 73%, respectively. For advanced tumors (over all the criteria), the survival rates and recurrence-free survival rates decreased significantly (n = 44; 65%, 43%, 43% and 47%, 43%, 43% respectively). When criteria (named as Shanghai Fudan Criteria) were expanded to HCC patients with solitary lesions < or = 9 cm in diameter, or no more than 3 lesions, the largest < or = 5 cm, with a total tumor diameter < or = 9 cm, there was no significant difference in 1, 2, 3-year survival rates and recurrence-free survival rates (n = 151; 88%, 80%, 80% and 90%, 88%, 88%, respectively) as compared with milan criteria, but more patients using Shanghai Fudan Criteria could undergo liver transplantation. CONCLUSION Shanghai Fudan Criteria, which expanded the tumor size limits, does not adversely impact survival of HCC patients after LT.

[Association of Taq I T/C and Fok I C/T polymorphisms of vitamin D receptor gene with outcome of hepatitis B virus infection].

Abstract: OBJECTIVE To determine whether Taq I T/C and Fok I C/T polymorphisms of vitamin D Receptor (VDR) gene was associated with the outcomes of hepatitis B virus (HBV) infection. METHODS A total of 212 HBV self-limited infection individuals, 244 asymptomatic HBsAg carriers and 391 chronic hepatitis B (HB) patients were recruited to conduct a case-control study. VDR-Taq I T/C and VDR-Fok I C/T polymorphisms were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS The frequency of VDR-Fok I allele C in the chronic HB patients was 45.8%, significantly higher than 38.2% of the self-limited infection individuals (chi(2) = 6.43, P = 0.01). The frequencies of VDR-Fok I genotypes TT, TC, and CC in HB patients were 30.7%, 47.1%, and 22.2% respectively, and 41.0% (TT), 41.5% (TC), and 17.5% (CC) in the self-limited infection individuals. There was a statistically significant difference between HB patients and self-limited infection individuals (chi(2) = 6.76, P = 0.03). The results of univariate analysis showed that the subjects carrying VDR-Fok I CC/TC genotype had 1.57-fold elevated risk for developing chronic HB when they were infected HBV (OR = 1.57, P = 0.01). A multiple logistic regression analysis revealed that VDR-Fok I CC/CT was independently associated with chronic HB after adjusting both potential confounding effects of gender (OR = 1.70, P = 0.021). The statistically significant association between TaqI T/C polymorphism and outcome of HBV infection was not demonstrated in the study. The frequency of haplotype TC of VDR-TaqI and Fok I in HB patients was 2.3080%, significantly higher than 0.5391% of the self-limited infection individuals (chi(2) = 6.08, P = 0.01). However, the frequency of haplotype TT in the HB patients was 1.5283%, significantly lower than 3.7061% of the self-limited infection individuals (chi(2) = 5.65, P = 0.02) and 3.4820% of the HBV carriers (chi(2) = 5.12, P = 0.02). CONCLUSION VDR gene polymorphism is probably an influence factor on the genetic susceptibility of HBV infection.

[Large-scale screening of mtDNA A1555G mutation in China and its significance in prevention of aminoglycoside antibiotic induced deafness].

Abstract: Objective To explore the necessity of large-scale screening of mtDNA A1555G mutation in prevention of aminoglycoside antibiotic induced deafness (AAID) and to develop a feasible method to prevent AAID. Methods A total of 1836 patients with non-syndromic hearing impairment (NSHI), 1352 students of schools for deaf-mutes in 11 provinces and municipality in China, 413 out-patients, and 71 persons from the families with maternal relatives suffering from AAID, underwent questionnaire survey and/or PCR for A-to-G mutation at nucleotide 1555 of the mitochondrial genome. Results Sixty three patients with mtDNA A1555G mutation were found among the 1836 NSHI patients. Fifty-two maternal pedigrees were identified. 536 cases with normal hearing from these pedigrees were informed to avoid using aminoglycoside antibiotics (AmAn). Conclusion Large-scale screening of mtDNA A1555G mutation and relevant health education to avoid use of AmAn are effective to prevent ototoxicity in the A1555G carriers and their maternal relatives.

[Cytokine-induced killer cell fusion to lower recurrence of hepatocellular carcinoma after transcatheter arterial chemoembolization sequentially combined with radiofrequency ablation: a randomized trial].

Abstract: OBJECTIVE To ed evaluate the clinical effects of autologous cytokine-induced killer cell (CIK) fusion to lower recurrence of primary hepatocellular carcinoma (HCC) and the anti-hepatitis B virus (HBV) effect after transcatheter arterial chemoembolization (TACE) sequentially combined with radiofrequency ablation (RFA) METHODS Sixty-four HCC patients underwent TACE sequentially combined with RFA without residual tumor or extrahepatic metastasis were randomly divided into 2 groups: study group (n = 33), receiving autologous CIK fusion of the dose of (11 - 15) x 10(10) via the peripheral vein or hepatic artery, firstly once every 3 - 4 weeks for 4 times, and then once every 4 weeks for 4 times; and control group (n = 31) All patients were followed up for 1 year RESULTS In the study group, 29 patients (29/33) were recurrence-free during the 1 year follow-up, 3 had recurrence in the liver 5, 6, and 7 months later respectively, and 1 patient had lymphoadenopathy in the hepatic portal 9 months later In the control group, 23 patients (6801%) were recurrence-free, 7 had recurrence in the liver within 1 year, and 1 had lung metastasis 11 months later In the study group, the number of the patients with the HBV DNA content < 1 x 10(3) before treatment was 19, and increased to 29 after the treatment; 2 of the 19 patients who were HBsAg positive before the treatment became HBsAg negative after the treatment, and number of the patients with the HBV DNA content of 10(3) - 10(4) was 3 before the treatment, and became 13 after the treatment among which 1 patient had his HBV DNA content dropping from 16 x 10(7) to 16 x 10(4) In the control group, only 1 patient showed his HBV DNA content dropping from 11 x 10(5) to below 10(3) CONCLUSION Capable of reducing recurrence, prolonging the recurrence-free span, and attacking HBV, autologous CIK fusion after TACE sequentially combined with RFA is an effective novel therapeutic strategy for HCC

The trend of clinical characteristics of colorectal cancer during the past 20 years in Guangdong province

Abstract: OBJECTIVE To study the trend of clinical characteristics of colorectal cancer during the past 20 years in Gaungdong province. METHODS The clinical data of 3870 cases of colorectal cancers confirmed pathologically who were hospitalized to Nanfang Hospital and Huizhou Municipal Hospital, Guangdong province, 1985 - 2004 were divided into 5-year groups and analyzed. RESULTS The hospitalization number of colorectal cancer in the 2000 - 20004 5-year period was 102%, higher than that of the 1985 - 1989 period with an annual increase of 5.1%. The median age of incidence 2000 - 2004 was 58.6 years, 8.4 years higher than that in 1985 - 1989. The male to female ratio of the 3870 patients was 1.42:1. The male to female ratio 2000 - 2004 was 1.35:1, lower than that 1985 - 1989 (1.50:1). The proportion of rectal cancer 2000 - 2004 was 49.7%, significantly lower than that in 1985 - 1989 (64.8%), while the proportion of right hemi-colon cancer 2000 - 2004 was 28.7%, significantly higher than that in 1985 - 1989 (18.0%). The proportion of moderately and well differentiated cancer 2000 - 2004 was 80.6%, higher than that in 1985 - 1989 (70.1%), and the proportion of poorly differentiated cancer 2000 - 2004 was 19.4%, lower than that in 1985 - 1989 (29.9%). The proportion of colorectal cancer at Dukes A stage 2000 - 2004 was 9.8%, higher than that in 1985 - 1989 (3.2%). CONCLUSION In the past 20 years, the incidence of colorectal cancer has increased in Guangdong province with a n increase of median age of incidence, The male to female ratio has decreased, and the incidence of right hemi-colon cancer, the rates of higher differentiated cancer and Dukes A stage cancer have increased.

Effect of local mild hypothermia on expression of aquaporin-4 following intracerebral hemorrhage in rats

Abstract: OBJECTIVE To examined the effect of local mild hypothermia on the expression of aquaporin-4 (AQP-4) following intracerebral hemorrhage (ICH) in rats and clarified the mechanism of hypothermia on brain edema formation following ICH. METHODS Two hundreds and forty male Wistar rats were randomly divided into two groups: the intracerebral hemorrhage (ICH) group, in which autologous arterial blood were stereotaxically injected into right caudate nucleus; the local mild hypothermia (ICH + H) group, in which the rats were given 4 h local mild hypothermia after the injection of blood. Each group was divided into 6 subgroups: control, 6 h, 24 h, 72 h, 5 d and 7 d after operation; Brain water content was determined by dry-wet weight method and the permeability of BBB was measured by Evans-Blue extravasation. RT-PCR and Western blot were respectively used to evaluate AQP-4 mRNA and protein expression. RESULTS In ICH group, compared with control, ICH significantly increased BWC, the permeability of BBB and the expression of AQP-4 mRNA, all began at 6 h and peaked at 72 h (P < 0.01), the increased protein expression of AQP-4 began at 24 h and also peaked at 72 h (P < 0.01). AQP-4 expression positively correlated, both at the mRNA and the protein level, with the permeability of BBB (r = 0.78 and r = 0.76 respectively). In ICH + H group, compared with ICH group, the elevation of BWC, BBB permeability and AQP-4 protein expression were strongly attenuated at all time point by hypothermia treatment (P < 0.01), while AQP-4 mRNA levels demonstrated a modest attenuation from 48 h. At 72 h, AQP-4 mRNA optical density (A) decreased from 1.25 +/- 0.03 (ICH group) to 1.04 +/- 0.02 (P < 0.01), AQP-4 protein expression (A) decreased from 0.77 +/- 0.08 (ICH group) to 0.25 +/- 0.04 (P < 0.01). CONCLUSIONS This study indicates that BBB breakdown can increase the expression of AQP-4; local mild hypothermia can significantly reduce brain edema formation after ICH by suppressing the elevation of AQP-4 protein expression; Inhibition of BBB breakdown and the elevation of AQP-4 protein expression with local mild hypothermia appear to contribute to brain protection in this model.

[Cross-sectional investigation of prevalence of type 2 diabetes in Shanghai].

Abstract: Objective To investigate the prevalence of type 2 diabetes and impaired glucose regulation among the permanent urban and rural inhabitants in Shanghai.Methods Questionnaire survey,physical examination,and laboratory testing were conducted among 14401 urban and rural inhabitants aged 15~74 in Shanghai selected by multistage cluster random sampling.The data about the prevalence of type 2 diabetes and impaired glucose regulation were collected and analyzed.Results The respondent rate of this investigation was 80.5%(11 589/14 401).The prevalence rates of type 2 diabetes,impaired glucose tolerance(IGT) and impaired fasting glucose(IFG) were 8.6%(1000/11 589),6.9%(802/11 589),and 1.0%(120/11 589) respectively(the standardized rates were 6.2%,5.1% and 0.8%).The prevalence rates of type 2 diabetes,IGT,and IFG were significantly higher in those with overweight,obesity,central obesity,and hypertension.The prevalence rates of type 2 diabetes,IGT,and IFG in men were 8.9%(412/4621),6.4%(296/4621),and 1.0%(47/4621) respectively,all not significantly different from those of the women,i.e.e.,8.4%(588/6968),7.3%(506/6968),and 1.0%((73/6968)) respectively(all P0.05).The prevalence rates of type 2 diabetes and IGT in the urban area were 11.2%(730/6500) and 6.4%(419/6500) respectively,both significantly higher than those in the rural area,i.e.,5.3%(270/5089) and 7.5%(383/5089) respectively(both P0.05).The prevalence rate of IFG in the urban area was 1.2%(77/6500),not significantly different from that in the rural area(0.8%,43/5039,P0.05).The prevalence of type 2 diabetes,IGT,and IFG increased apparently with age,body mass index,waist hip ratio,and waist circumference.The ratios of undiagnosed type 2 diabetes in the urban area and rural area were 39.6%(289/730)and 69.3%(187/270) respectively(χ~2=74.07,P0.01).Conclusion The prevalence rate of type 2 diabetes in Shanghai is higher than the mean national level and shows an increasing tendency.Screening of type 2 diabetes in rich rural areas should be emphasized.

[High D-glucose alters PI3K and Akt signaling and leads to endothelial cell migration, proliferation and angiogenesis dysfunction].

Abstract: OBJECTIVE To investigate the effects of high D-glucose on migration, proliferation, and angiogenesis of endothelial cells and to make sure whether PI3K and Akt signaling pathway plays an important role in the pathogenesis of diabetic vascular complications. METHODS Human umbilical vein endothelial cells (HUVECs) were cultured. D-glucose of the concentrations of 5 mmol/L, 15 mmol/L, and 30 mmol/L and mannitol of the concentrations of 5 mmol/L, 15 mmol/L, and 30 mmol/L were added in to the medium, the migration rate of the cells was measured by wound healing test and the cell proliferation was examined with CellTiter 96 AQ(ueous) One Solution cell proliferation assay. Matrigel was spread on 96-well plate, and culture of HUVECs with D-glucose and mannitol of different concentrations were added. Microscopic photography was used to calculate the total area of vascular bed, average vessel length, vessel number, branch points, so as to observe the angiogenesis. Immuno-precipitation was used to detect the expression of p85/PI3K. Western blotting was used to detect the protein expression of p85/PI3K, p-PI3K, GSK3beta (downstream kinase of Akt), p-Akt (Threonine308) and p-GSK3beta. LY294002, a PI3K inhibitor, of the concentrations of 0.1 micromol/L, 1 micromol/L, and 10 micromol/L was added into the culture fluid with 5 mmol/L D-glucose, then the endothelial cell migration, proliferation number, total area of blood bed, etc were observed. RESULTS The migration rate of the 5 mmol/L D-glucose group was 100 +/- 23/microm2, and D-glucose dose-dependently decreased the migration rate, e.g. the migration rates of the 15 mmol/L and 30 mmol/L D-glucose groups were 77 +/- 18/microm2 and 46 +/- 18/microm2 respectively, both significantly lower than that of the 5 mmol/L D-glucose group (both P < 0.01). LY294002 of the concentrations of 0.1 micromol/L, 1 micromol/L, and 10 micromol/L dose-dependently decrease the endothelial cells migration rates to 68 +/- 16/microm2, 36 +/- 12/microm2, and 13 +/- 3/microm2 respectively (all P < 0.01) The cell proliferation rate of the 5 mmol/L, 15 mmol/L) and 30 mmol/L D-glucose groups were 59,128 +/- 7415/well, 33,144 +/- 9082/well, and 11,625 +/- 4196/well respectively, showing that D-glucose dose-dependently decreased the cell proliferation (all P < 0.01). LY294002 of the concentrations of 0.1 micromol/L, 1 micromol/L, and 10 micromol/L dose-dependently decrease the endothelial cell proliferation to 42,560 +/- 4213/well, 17,688 +/- 7198/well, and 5704 +/- 558/well respectively (all P < 0.01). 15 mmol/L and 30 mmol/L D-glucose decreased the numbers of total area of vascular bed, average tubule length, number of capillaries, and number of vessel branch pint formed on the Matrigel. LY294002 dose-dependently inhibited the angiogenesis (P < 0.05 or P < 0.01) 15 mmol/L and 30 mmol/L D-glucose dose-dependently inhibited the phosphorylation of p85/P13K and Akt (P < 0.05 and P < 0.01). However, D-glucose did not influence the protein expression of p85/PI3K and Akt. Mannitol did not influence the cell proliferation, angiogenesis, and the expression of p85/PI3K, phosphorylated p85/PI3K, Akt, phosphorylated Akt (Thr308), and phosphorylated GSK3beta. CONCLUSION Hyperglycemia-impaired PI3K-Akt signaling may lead to migration, proliferation and angiogenesis dysfunction of endothelial cells in diabetes patients, which is likely to contribute to the pathogenesis of diabetic vascular complications.

[Screening of a sub-clone of human breast cancer cells with high metastasis potential].

Abstract: Objective To screen a sub-clone of human breast cancer cell of the MCF-7 line with high metastasis potential. Methods Human breast cancer cells of the MCF-7 line were injected subcutaneously into 10 severe combined immunodeficiency (SCID) mice. Sixty-eight days after the mice were killed and their lungs were taken out. Primary cell culture was conducted. When the cells were passed on to the third generation a sub-clone was screened from the lung tissue and termed LM-MCF-7. Microscopy was performed on the lung tissues. The growth curve was drawn. Flow cytometry was used to examine the cell cycle. Chromosome analysis was done. Immunohistochemistry was used to detect the expression of breast cancer specific antigen CAI5-3. Western blotting was used to detect the protein expression of the protein associated with tumor metastasis: nm23 (a metastasis-suppressing gene), myosin light chain kinase (MLCK, a kinase related to cell movement), survivin, bcl-2 and p27 (a gene related to cell cycle). LM-MCF-7 cells were injected into other SCID mice and these mice were killed 30 days later to observe the metastasis of cancer so as to detect the tumorigenic ability of the LM-MCF-7 cells. Results When the cells from the mouse lung tissues were passed on to the third generation a sub-clone with high metastasis potential was screened and termed LM-MCF-7. The morphology of the new cell line was typically epithelioid. Flow cytometry showed that the DNA relatively contents were 53.40% of the LM-MCF-7 cells were in the G(0)/G(1) phase, a lower percentage than that of the MCF-7 cells, and 17.10% in the S phase and 23.20% in the G(2+)M phase, both percentages higher than those of the MCF-7 cells. The proliferating time of the LM-MCF-7 cell population was about 20 +/- 14 hours, much shorter than that of the parent strain cells. The chromosomes of the LM-MCF-7 cells, numbering 16-123, showed the morphology characteristic c of human chromosomes. The marker of human breast cancer CA15-3 was detected in both MCF-7 and LM-MCF-7 cells. The protein expression of nm23 and p27 was down-regulated, but the protein expression of MLCK, bcl-2 and survivin was up-regulated in LM-MCF-7 cells in comparison with those in MCF-7 cells. The tumorigenesis rate of LM-MCF-7 cells was 100% (5/5), with a latent period of 5.0 +/- 0.0 d, and the tumor metastasized to lung, kidney, spleen, bone marrow, lymph node and heart. Conclusion A human breast cancer line, LM-MCF-7 cell line, with high metastasis potential has been derived from the human breast cancer cells of MCF-7 line.

[Long-term results of percutaneous sonographically-guided microwave ablation therapy of early-stage hepatocellular carcinoma].

Abstract: OBJECTIVE To evaluate the long-term results of percutaneous microwave coagulation therapy in the treatment of early hepatocellular carcinoma. METHODS From May 1994 to June 2004, a total of 216 patients with 275 nodules of hepatocellular carcinoma whose diameter

[Effect of chronic mild and moderate iodine excess on thyroid anti-oxidative ability of iodine deficiency and non-iodine deficiency Wistar rats].

Abstract: OBJECTIVE To investigate the effects of chronic mild and moderate iodine excess on thyroid oxidative injury and anti-oxidative ability of iodine deficiency and non-iodine deficiency Wistar rats METHODS Four-week-old Wistar rats were fed with iodine deficient diet for three months to make iodine deficient goiter models, then divided randomly into three groups: iodine deficient control group (Group IDC) fed with double distilled water, iodine-supplement group I (Group IS I) fed with potassium iodate solutions with the iodine concentrations of 100 microg/L, and iodine-supplement group II (Group IS II), fed with potassium iodate solution with the iodine concentrations of 330 microg/L Another four-week-old Wistar rats were fed with normal diet for three months, and then divided randomly into three groups: normal control group (NC) fed with double distilled water, iodine-excess group I (IEI) fed with potassium iodate solution with the iodine concentration of 300 microg/L, and iodine-excess group II (Group IEII), fed with potassium iodate solution with the iodine concentration of 660 microg/L 1, 2, 4, 8, and 24 weeks after treatment samples of urine were collected to detect the median urine iodine (MUI), samples of plasma were collected from the hearts of 8-14 rats from each group and then rats were killed Their thyroid glands were taken out to measure the wet weight and made into homogenate Biochemical method was used to measure the activities of glutathione-peroxidase (GSH-P(X)) and superoxide dismutase (SOD) as well as the contents of malonyldialdehyde (MDA) and H2O2 in the homogenates of thyroid glands RESULTS The GSH-P(X) activity 2 weeks after treatment of Group IS II was significantly lower than that of Group IDC (P < 005), and the GSH-P(X) activity 4 weeks after treatment of Group IS I was significantly lower than that of Group IDC (P < 0001) The activities of GSH-P(X) 4, 8, and 24 weeks after treatment of Groups IS I and IS II were all lower than those of Group C at the same time points significantly (P < 0001, < 001, and < 005 respectively) The activities of SOD were decreased gradually in Groups IS I and IS II and were significantly lower than those of Group IDC since 8 weeks after treatment (P < 0001 or < 005) The SOD activities in thyroid glands of Groups IEI and IEII since 8 weeks after treatment decreased significantly in comparison with Group NC (all P < 001 or < 0001) The contents of H2O2 in thyroid glands of Groups IS I and IS II were significantly lower than those of Group IDC at different time points (P < 0001, < 001, or < 005), and were significantly lower than those of Group NC 8 and 24 weeks after treatment (P < 0001 or < 001) The contents of MDA in thyroid glands since 2 weeks after treatment of Group IEI were all significantly lower than those of Group IDC at the same time points (all P < 005), and the content of MDA in thyroid glands since 1 week after treatment of Groups IS II were all significantly lower than those of Group IDC at the same time points (all P < 005) CONCLUSION Supplementation of 100 microg/L and 330 microg/L iodine on iodine deficiency Wistar rats may alleviate the oxidative injury but weaken the anti-oxidative protection of thyroid The anti-oxidative protection of thyroid glands of non-iodine deficiency Wistar rats may also be weakened by supplementation of 300 microg/L and 660 microg/L iodine

Microsatellite alterations of circulating DNA in the plasma of patients with hepatocellular carcinoma

Abstract: OBJECTIVE To explore the features of microsatellite alterations of circulating DNA in the plasma of patients with hepatocellular carcinoma (HCC) and whether they are in concordance with those in the carcinoma tissues. METHODS Peripheral blood samples were collected from 62 HCC patients and the corresponding tumor tissues were obtained during operation. Three high-polymorphic microsatellite markers located at chromosome 8p, D8S277, D8S298, and D8S1771, were selected to be used to detect the loss heterozygosity (LOH) and microsatellite instability (MSI) by PCR and sequencing. RESULTS Joint detection showed that 39 out of the 62 tissue samples showed LOH at all the 3 loci, and the same alterations at the same loci were seen in 33 matched plasma samples with a concordance rate of 84.6%. Nineteen tissue samples showed MSI at all 3 loci, and the same alterations were shown in 14 matched plasma samples with a concordance rate of 73.3%. The rate of LOH for at least one locus in the plasma DNA was 58.1% (36/62), significantly higher than the rate of MSI at at least one locus in the plasma samples (29.0%, 18/62, P < 0.01). The MSI positive rate in the loci D8S277 of the plasma DNA was 22.6%, significantly higher than those of the other 2 loci (4.8% and 4.8% respectively, both P < 0.05). The MSI positive rate at the loci D8S277 of the cancer tissue was 46.8%, significantly higher than those of the other 2 loci (38.7% for D8S298 and 37.1% for D8S1771, both P < 0.05). CONCLUSION Microsatellite alterations show a high concordant pattern between the tissue and plasma DNA in HCC, which indicates that the microsatellite alterations of tumor tissue are reflected by plasma DNA, LOH may play an important role in hepatocarcinogenesis whereas MSI may also contribute to this progress in a less significant way, and D8S277 is a sensitive locus to MSI in HCC.

[Natural course from rhinitis to asthma in the patients with autumnal pollinosis: a clinical study of 1096 patients].

Abstract: OBJECTIVE: To investigate the natural course from rhinitis to asthma in the patients with autumnal pollinosis. METHODS: 1096 patients with autumnal pollinosis, 488 males and 632 females, aged 38 +/- 14 (5 - 77), 511 with pure allergic rhinitis and 585 with allergic rhinitis complicated with asthma, underwent skin test of inhalant allergens, serum IgE specific to autumnal pollens, and questionnaire survey. RESULTS: The age range of rhinitis induced by autumnal pollens was 2 - 75. The peak onset age of rhinitis was 15 - 44, and the peak onset age of asthma was 25 - 54. 33% of the rhinitis patients complicated with asthma (194/585) had their first attack of rhinitis and the first attack of asthma in the same year, 66% of them (386/585) had the first attack of asthma later than the first attack of rhinitis, and only 0.8% of them (5/585) had their first attack of asthma earlier than that of rhinitis. 37% of the patients with autumnal pollen allergic rhinitis (410/1096) developed asthma within 5 years, 47% (511/1096), within 9 years, 5% (58/1096) within 10 approximately 19 years, and 1.5% (16/1096) within 20 - 40 years. CONCLUSION: Almost half of the patients with autumnal pollen allergic rhinitis develop to seasonal allergic asthma within 9 years.

[Perinatal outcomes of intrahepatic cholestasis of pregnancy: analysis of 1210 cases].

Abstract: Objective To study the perinatal outcomes of intrahepatic cholestasis of pregnancy (ICP). Methods The clinical data of 1210 cases of ICP in recent ten years were retrospectively analyzed. Results The incidence rates of perinatal outcomes of ICP were as follows: 19.0% (230/1210) for threatened premature labor, 24.0% (290/1210) for premature delivery; 23.2% (281/1210) for meconium stained amniotic fluid, 7.1% (86/1210) for neonatal asphyxia, 22.5 per thousand (27/1210) for perinatal mortality, 85.9% (1039/1210) for cesarean section, 0.9% (11/1210) for fetal growth restriction (FGR), 1.4% (17/1210) for postpartum hemorrhage, and 8.1% (101/1210) for preeclampsia. Threatened premature labor occurred beyond the gestation gestation period of 32 weeks in 88.7% (204/230) of the patients, and the fetal death rate in threatened premature labor was 46.7% (7/15). Premature delivery occurred after 34 weeks of gestation in 96.2% of the patients (279/290) 89.7% (260/290) of which were caused by cesarean section because of abnormal fetal monitoring. 41.3% of the cases with meconium stained amniotic fluid (116/281) occurred before the onset of labor. Fetal death accounted for 56% (15/27) of perinatal death, 80% (12/15) of which happened after the gestation week of 35 (36.5 +/- 1.2) with normal fetal heart rate monitoring. 95% (19/20) of the fetal death and stillbirth occurred after threatened premature labor and occasional uterine contractions, or at the early stage of labor. Conclusion The rates of FGR, postpartum hemorrhage, and preeclampsia in ICP are almost the same as those of the normal pregnancy. Routine fetal heart rate monitoring methods cannot predict fetal death. The important measures to decrease the perinatal mortality include paying attention to fetal monitoring when threatened premature labor, occasional uterine contractions and prenatal meconium occur, and at the early stage of labor, and management of threatened premature labor and timely intervention of pregnancy (at the gestation period of 34 - 37 weeks).

Establishment of liver metastasis model of human gallbladder cancer and isolation of the subpopulation with high metastatic potential

Abstract: Objective To establish an experimental liver metastatic model of gallbladder cancer and isolate the subpopulation with high metastatic potential from the model, which may serve as a reliable tool in research on liver metastasis of gallbladder cancer in vivo and in vitro. Methods Human gallbladder cancer cells of the line GBC-SD were cultured. Ten nude athymic BALB/c mice, aged 4 approximately 5 weeks, underwent inoculation of suspension of GBC-SD cells into the spleens and then their spleens were resected. Three weeks later laparotomy was performed to observe if liver metastasis occurred. Once liver metastasis was discovered, the mice were killed and the livers were taken out to undergo microscopy, tumor cells were isolated from the metastatic foci and cultured in vitro, and then inoculated into other 10 mice in the same way as their parents cells for the second round of selection. The similar steps were repeated, altogether for three rounds of selection and a total 30 mice were inoculated in 3 rounds so as to find subpopulation with high metastatic potential. Another 10 mice underwent subcutaneous inoculation, 90 days later the mice were killed to observe if pulmonary metastasis occurred. PCR was used to detect the 3 microsatellite sequences D14S68, D18S69, and D20S199 in the DNA samples of the gallbladder cancer cells of the parent cell line GBC-SD, the isolated cells of the subpopulation with high metastatic potential, and the liver of experimental animal. Results 90% of the mice inoculated subcutaneously with the GBC-SD cells developed subcutaneous tumors, however, no mouse in this group died and no pulmonary metastasis was found. The liver metastatic rate was 65% in the 10 mice undergoing intrasplenic inoculation. Thus a metastatic model of human gallbladder cancer in nude mice was established. The liver metastatic tumors were uniformly distributed throughout the liver parenchyma with predominance to the periphery. Despite multiple sites of involvement, the left lobes were most commonly affected in all experimental animals. Histological examination of the metastatic lesion demonstrated adenocarcinoma. Gross hepatic metastasis was detected 10, 7, and 5 weeks after the inoculation respectively in the first, second, and third round selection respectively with an incidence rate of metastases of 60%, 70%, and 90% respectively. From the third round metastatic model a subpopulation with high metastatic potential was isolated and designated as GBC-SD/M, which exhibited the similar histological characteristics as its parent cell line GBC-SD under inverted light microscopy. The three amplified bands at the sites 14S68, D18S69, and D20S199, amplified with the three pairs of specific primers for the three homo-specific microsatellites, were detected in the GBC-SD cells and GBC-SD/M cells, but not in the liver of tumor-bearing animal. Conclusion A liver metastasis model of human gallbladder cancer has been established, a reliable and efficient tool for study on the metastasis of gallbladder cancer to liver in vivo. Isolated from hepatic metastasis, the line of GBC-SD/M is a subpopulation with high metastatic potential, retaining the histological properties and identification of genetic background of its parent cell line GBC-SD.

Effects of Ginkgo biloba extract against excitotoxicity induced by NMDA receptors and mechanism thereof

Abstract: OBJECTIVE To observe the effects of Ginkgo biloba extract (GBE) on N-methyl-D-aspartate (NMDA) excitotoxicity and focal cerebral ischemia, and further explore the neuroprotective mechanisms of GBE. METHODS Neonatal SD rat hippocampus was taken out to make into cell suspension. immunohistochemistry with neuron nucleoprotein monoclonal antibody (NeuN) was used to calculate the percentage of NeuN positive cells. Twelve days after incubation the suspension of neurons were randomly divided into 4 groups: normal control group (exposed to normal saline for 15 min and then to DMEM without NMDA and glycine for 24 h), NMDA group (exposed to culture fluid with NMDA of the terminal concentration of 100 micromol/L and glycine of the terminal concentration of 10 micromol/L for 15 min and then to DMEM without NMDA and glycine for 24 h), MK-801 group (exposed to MK-801, an NMDAR antagonist, for 2 min, to culture fluid with NMDA for 15 min, and then to DMEM without NMDA and glycine for 24 h), and GBE pretreatment group (exposed to GBE of the terminal concentration of 150 microg/ml for 3 d, culture fluid with NMDS for 15 min, and then to DMEM without NMDA and glycine foe 24 h). Trypan blue staining was used to calculate the survival rate of the neurons. The lactic dehydrogenase (LDH) level in the supernatant of cultured cell suspension was detected. Whole-cell patch clamp recording was carried out to evaluate the modulatory effects of GBE on NMDA-activated currents in the rat hippocampal neurons. 108 SD rats were randomly divided into 5 groups: sham operation group (n = 12), standard middle cerebral artery occlusion (MCAO) group (n = 24, undergoing MCAO and then reperfusion), MK-801 acute administration group (n = 24, undergoing MCAO and immediate peritoneal administration of MK-801 1 mg/kg), GBE acute administration group (n = 24, undergoing peritoneal injection of GBE 100 mg/kg immediately after the MCAO), and GBE pretreatment group (n = 24, undergoing peritoneal administration of GBE every day for 7 days before the MCAO). The 4 groups were re-divided into 4 subgroups with 3 approximately 4 rats: 0.5 h ischemia, and 3 h, 1 d, and 7 d ischemia-reperfusion (IR) subgroups. The neurological symptoms were evaluated by Longa's scoring after the rats became conscious. The rats were killed at different time-points, their brains were taken out to undergo 2, 3, 5-triphenyl-tetrazolium chloride staining, the areas of cerebral infarction were calculated, and immunohistochemistry was used to evaluate the contents of NeuN and microtubule-associated protein (MAP-2). RESULTS The cell viability of the GBE group was 85% +/- 5%, significantly higher than that of the NMDA group (39.8% +/- 2.1%, P < 0.01), and significantly lower than that of the MK-801 group (93.8% +/- 2.7%, P < 0.05). The LDH efflux of the GBE group was 87 U/L +/- 8 U/L, significantly lower than that of the NMDA group (138 U/L +/- 12 U/L, P < 0.01) and significantly higher than that of the MK-801 group (47 U/L +/- 7 U/L, P < 0.05). The inward current (I(NMDA)) of the NMDA group was significantly activated, The inhibitory rate of the NMDA-activated I(NMDA) of the GBE group was 40% +/- 17%, significantly lower than that of the MK-801 group (78% +/- 18%, P < 0.05); After washing out with standard extracellular solution, the I(NMDA) could recover to 91% +/- 8% in the GBE group, but not in the MK-801 group (P < 0.05), which indicated that GBE had lower affinity to NMDA receptor than MK-801. The Longa's scores of the 3 h and 24 h IR subgroups of the GBS pretreatment group were all significantly lower than those of the corresponding subgroups of the standard MCAO and GBE acute administration groups. The symptoms of the MK-801 were the most severe. Cerebral infarction began to appear in the 1-day subgroups. The cerebral infarction areas of the 1 d subgroups of the GBF pretreatment and MK-801 groups were 11.5% +/- 1.3% and 6.5% +/- 0.9% respectively, both significantly smaller than those of the MCAO and GBE acute administration groups (24.5% +/- % and 22.9% +/- 1.3% respectively, both P < 0.01), however, there was no significant difference in the cerebral infarction area between the GBE acute administration and MCAO group. It was true too for the cerebral infarction areas of the 7 d subgroups. Except in the control group, loss of NeuN positive neuron was seen in all groups, especially the MCAO and GBE acute administration groups. Except in the control group, the MAP-2 positive neurons were decreased in all groups, especially the MCAO and GBE acute administration groups, and 1 day and 7 days after the IR MAP-2 positive neurons were almost unseen in the MCAO and GBE acute administration groups, however, could be seen in small amounts in the GBE and MK-801 groups (all P < 0.01). CONCLUSION GBE pretreatment protects the neurons from excitotoxicity induced by over-activated NMDA receptor and focal cerebral ischemia, which can be explained by the mild blocking effect of GBE on NMDA receptor with low affinity, comparing with MK-801, and GBE is expected to interfere in excitotoxicity in clinic without neurotoxic behaviors.

Correlation of limb and myocardial ischemia postconditioning with acute myocardial reperfusion injury

Abstract: OBJECTIVE We tested the hypothesis that remote postconditioning, which is induced by a single 5-min episode of femoral artery occlusion and reperfusion applied just before the onset of coronary artery reperfusion, protects the myocardium from reperfusion injury. METHODS In anesthetized open-chest rabbits, the left anterior descending artery (LAD) was occluded for 30 min and reperfused for 3 hrs. All rabbits were randomly divided into four groups (n = 10 in each group): (1) CONTROL: LAD occlusion and reperfusion only, with no other intervention; (2) Myocardial ischemic preconditioning (Pre-con): Three cycles of myocardial ischemia (5 min) and reperfusion (5 min) preceded the index ischemia/reperfusion protocol; (3) Myocardial ischemic postconditionng (Post-con): After 30 min of LAD occlusion, reperfusion was initiated for 30 s followed by 30 s reocclusion. Three cycles of myocardial ischemia (30 s) and reperfusion (30 s) followed the index ischemia/reperfusion protocol. (4) Remote postconditioning (Re Post-con): After 24 min of LAD occlusion, the femoral artery was occluded for 5 min and released for 1 min before 3 hrs of LAD reperfusion. Myocardial infarct size and tissue myeloperoxidase (MPO) activity were determined at the end of the experiment. Plasma creatine kinase (CK) activity and malondialdehyde (MDA) activity were measured at baseline, the end of ischemia, and after 3 hrs of reperfusion respectively. RESULTS Myocardial infarct size was significantly reduced in Pre-con (15.5% +/- 1.7%, P < 0.01), Post-con (16.15% +/- 2.05%, P < 0.01) and Re Post-con (17.11% +/- 1.70%, P < 0.01) groups as compared to CONTROL (31.46% +/- 1.28%). Results were confirmed by plasma CK activity (in Re Post-con 18.0 IU/g +/- 1.6 IU/g vs. CONTROL 45.6 IU/g +/- 5.5 IU/g). Plasma MDA was significantly less at 3 hrs of reperfusion in Pre-con (2.12 micromol/ml +/- 0.30 micromol/ml, P < 0.01), Post-con (2.17 micromol/ml +/- 0.24 micromol/ml, P < 0.01) and Re Post-con (2.16 micromol/ml +/- 0.33 micromol/ml, P < 0.01) than that in CONTROL (3.49 micromol/ml +/- 0.32 micromol/ml). Neutrophil accumulation (MPO activity) in the area at risk was less in Pre-con (1.43 U/100 g +/- 0.32 U/100 g, P < 0.01), Post-con (2.26 U/100 g +/- 0.28 U/100 g, P < 0.01) and Re Post-con (2.45 U/100 g +/- 0.28 U/100 g, P < 0.01) than that in CONTROL (5.44 U/100 g +/- 0.46 U/100 g). CONCLUSION Remote limb postconditioing applied just before the onset of coronary artery reperfusion provides potent myocardial infarct size reduction, which is similar to the cardioprotective effect of myocardial postconditioning exerted during the first minutes of coronary reperfusion. The potential mechanism of this inter-organ remote postconditioning phenomenon might be associated with decreasing the injury caused by oxygen free radicals and strengthening the action of antioxidation.