Showing papers in "National Medical Journal of China in 2007"

Changes of osteoprotegerin before and after insulin therapy in type 1 diabetic patients

Abstract: OBJECTIVE To investigate the relationship between the plasma osteoprotegerin (OPG) level and endothelium-dependent arterial dilation in type 1 diabetic patients. METHODS Sandwich ELISA method was used to detect the plasma OPG levels of 22 newly diagnosed type 1 diabetic patients before and 6 months after treatment and of 28 healthy subjects. All patients were then given insulin therapy for 6 months. High resolution ultrasound was used to measure the brachial artery diameter at rest, after reactive hyperemia and after sublingual administration of glyceryltrinitrate (GTN). RESULTS The plasma OPG level of the patients before treatment was 3.09 ng/L +/- 0.70 ng/L, significantly higher than that of the healthy controls (2.07 ng/L +/- 0.75 ng/L, P < 0.001). After 6 months treatment, the OPG level of the patients decreased to 2.58 ng/L +/- 0.59 ng/L, significantly lower than that before treatment (P < 0.001). The flow-mediated endothelium-dependent arterial dilation in the patients before treatment was 3.35% +/- 0.67%, significantly lower than that of the healthy controls (5.17% +/- 0.83%, P < 0.001), and was increased to 4.27% +/- 0.63% after 6 months treatment, significantly higher than that before (P < 0.001). Multivariate analysis showed that OPG level was significantly associated with endothelium-dependent arterial dilation, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and ultra-sensitive C-reactive protein (CRP) at baseline (all P < 0.01). The absolute change in OPG level was significantly correlation with the changes in endothelium-dependent arterial dilation, FBG, HbA1c, and CRP in the diabetic patients during the course of treatment (all P < 0.01). CONCLUSION Plasma OPG level is elevated in newly diagnosed diabetic patients, and the plasma OPG level is significantly associated with endothelial function.

[Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials].

Abstract: OBJECTIVE To explore whether long-term continuous positive airway pressure (CPAP) ventilation is effective to decrease the blood pressure in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) accompanied with hypertension. METHODS Literatures of relevant randomized, controlled, prospective, clinical trials 2000 - 2006 in English and Chinese were retrieved from Medline and CNKI based on the criteria: the subjects being patients with OSAHS, the study lasting at least 4 weeks, and the effect on 24 hours ambulatory blood pressure in CPAP group being compared with that in no-CPAP group. The data thus collected underwent meta-analysis. RESULT 471 cases in 7 studies were included. Three of the 7 studies indicated that CPAP ventilation could decrease the diastolic blood pressure in the patients with OSAHS and four studies showed no significant difference in the effect of CPAP on blood pressure between the two groups. From meta-analysis, the weighted mean difference (WMD) in fixed effect model of 24 h diastolic blood pressure (DBP) was -1.78 [95% CI: -3.34, -0.22]; the WMD (fixed) of 24 h systolic blood pressure (SBP) was -0.95 [95% CI: -2.85, 0.94], and the WMD (random) of 24 h mean blood pressure (MBP) was -1.25 [95% CI: -4.00, 1.49]. CONCLUSION The long-term CPAP ventilation can decrease the 24 h DBP.

[Expression of severe acute respiratory syndrome coronavirus receptors, ACE2 and CD209L in different organ derived microvascular endothelial cells].

Abstract: Objective To investigate the expression of the 2 severe acute respiratory syndrome coronavirus (SARS-CoV) receptors, angiotensin-converting enzyme 2 (ACE2) and CD209L in different human organ/tissue derived microvascular endothelial cells. Methods Endothelial cells from the microvessels in human brain, lung, hepatic sennoside, fat adipose tissue, adrenal gland, esophagus, lymph nodes, and bone were culture. RT-PCR, Western blotting and immunocytochemistry were used to detect the expression of ACE2 and CD209L receptors. Results Both SARS-CoV receptors of ACE2 and CD209L were expressed in the 8 organ/tissue-derived endothelial cells. The expression of ACE2 receptor was the highest in the human lung microvascular endothelial cells, and lowest in the lymphatic endothelial cells. The expression of CD209L was relatively higher in the human lymphatic endothelial cells. Conclusion The organ derived microvascular endothelial cells are the important target of SARS-CoV. The pathological injury of lung and lymph system induced by SARS-CoV may be mediated respectively by different receptors of SARS-CoV.

Incidence and risk factors of acute radial artery occlusion following transradial percutaneous coronary intervention

Abstract: OBJECTIVE: To elucidate the incidence and risk factors of acute radial artery occlusion (RAO) following transradial percutaneous coronary intervention (TRI). METHODS: A total of 7215 patients who underwent TRI were divided into normal group and RAO group, according to whether the patient without and with RAO. Risk factors of RAO were analyzed by logistic regression model. RESULTS: Acute RAO occurred in 68 patients (0.94%). As compared to the patients in normal group, there were more female and diabetes mellitus patients in RAO group. The dosage of heparin used in the operational procedure in RAO group were significantly less than normal group (3723 IU +/- 556 IU vs 7603 IU +/- 1533 IU, P < 0.01). The post-procedure duration of high-pressure compression hemostasis were longer in RAO patients than normal patients (103.8 min +/- 23.3 min vs 87.7 min +/- 31.2 min, P = 0.02). Logistic regression analyses showed that the dosage of heparin used in the procedure, the category and size of sheath and the post-procedure compression time were independent risk factors for RAO. CONCLUSION: The incidence of RAO can be minimized by appropriate anticoagulation, proper sheath selection, and avoiding prolonged duration of high-pressure compression hemostasis following the procedure.

[Clinical trial with a new immunomodulatory strategy: treatment of severe sepsis with Ulinastatin and Maipuxin].

Abstract: OBJECTIVE To evaluate the efficacy of treatment of severe sepsis by combining anti-inflammatory and immune-enhancing agents. METHODS Multiple-center, prospective, randomized, controlled designs. Cases were from surgical or general ICU of 26 university teaching hospitals. Totally, 433 adult patients developing severe sepsis with Marshall score 5-20 were enrolled. Patients received either standard treatment based on SSC direction (as group control), or additional Ulinastatin (urinary trypsin inhibitor) 300 K units per day+thymosin alpha1 (Maipuxin) 1.6 mg per day for 7 days (as treatment group 1, adopted in the first trial), or double dosage of the above agents (as treatment group 2, adopted in the second trial). The outcome of 28 and 90 days, APACHEII and Marshall score, monocyte HLA-DR/CD14+ at several points until 28 days, and the lengths of ICU stay, antibiotics usage and mechanical ventilation were determinated. RESULTS In the first trial (91 cases), there was no significant difference in variables between treatment group 1 and control at 28 days. In the second trial (342 cases), the mortality of treatment group 2 decreased from 38.32% to 25.14% (P=0.0088), compared with group control at 28 days, and from 52.10% to 37.14% (P=0.0054) on 90 days. APACHEIIalso decreased from 14.32 to 12.70 (P=0.0384) and monocyte HLA-DR/CD14+ increased from 40.13% to 51.65% (P=0.0092) on 28 days in treatment group 2. Other variables had no significant differences between two groups. CONCLUSION Treatment by the combining anti-inflammatory and immune enhancing agents can significantly improve the outcome of severe sepsis. The efficacy of this therapy seems to be dose dependent on.

Influence of tumor characteristics on the outcome of liver transplantation among patients with hepatocellular carcinoma

Abstract: Objective To identify the influence of tumor characteristics on the outcome of liver transplantation(LT)among patients with hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed on 251 consecutive patients with HCC who underwent LT between April 2001 and February 2006 at our institution.We compared the outcome of the patients classified by different tumor related factors.Survival analysis was performed using Kaplan-Meier and Cox proportional hazards regression methods.Results Macroscopic vascular invasion,lymph node metastasis,Edmondson pathologic classification,microscopic tumor thrombosis,tumor location,satellite nodules and α-fetal protein(AFP)all significantly affected the overall survival and/or recurrence-free survival post-LT(P0.01 or P0.05). Pre-operative treatment and hepatitis background had no effect to the prognosis(P0.05 ).At multivariate Cox regression analysis,the factors associated with mortality or recurrence were macroscopic vascular invasion,microscopic tumor thrombosis and satellite nodules(P0.01 or P0.05).Conclusion Edmondson grade Ⅲ-Ⅳ,microscopic tumor thrombosis,left lobar or bilobar tumor,satellite nodules and AFP≥300μg/L were predictive factors of poor prognosis.Presence of macroscopic vascular invasion or lymph node metastasis should be contraindicated.

[Effects of calorie restriction on SIRT1 expression in liver of nonalcoholic fatty liver disease: experiment with rats].

Abstract: OBJECTIVE: To investigate the molecular mechanisms of calorie restriction (CR) in treatment of nonalcoholic fatty liver disease (NAFLD). METHODS: 25 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n = 7) fed with regular diet and high fat diet-NAFLD model group (HFM, n = 18) fed with high-fat diet. Two months later, the rats in Group HFM were further divided into 2 subgroups: continuous high-fat feeding group (HF, n = 9) and normal diet feeding with 60% calorie restriction group (CR, n = 9). The rats were sacrificed after 1 month calorie restriction. By the end of experiment, body weight (BW), visceral fat mass (VF), fasting plasma glucose (FPG), fasting serum insulin (FINS), blood lipids (BL), including total cholesterol (TC) and triglyceride (TG), and hepatoultrastructure changes were examined to evaluate the effect of different feeding protocols on the experimental animals. The mRNA expression of the longevity gene SIRT1 in the liver was detected by RT-PCR. Western blot analysis was performed to determine the expression of SIRT1 protein in each group. RESULTS: Electron microscopy showed that the rats in group HF displayed obviously abnormal hepatoultrastructure, and the ultramicropathology changes of liver cell were improved obviously in Group CR. The VF, FINS, FPG, TC, and TG of the Group HF were 15.1 g +/- 4.1 g, 29.22 mU/L +/- 7.28 mU/L, 6.2 mmol/L +/- 1.46 mmol/L, 2.61 mmol/L +/- 0.29 mmol/L, and 1.35 mmol/L +/- 0.21 mmol/L respectively, all significantly higher than those in Group NC (9.0 g +/- 0.4 g, 13.09 mU/L +/- 1.18 mU/L, 4.4 mmol/L +/- 0.57 mmol/L, 1.41 mmol/L +/- 0.28 mmol/L, and 0.67 mmol/L +/- 0.10 mmol/L respectively, all P < 0.01). The mRNA expression of SIRT1 in the liver of Group HF was significantly lower than that of Group NC (P < 0.05), and the mRNA expression of SIRT1 in the liver of Group CR was significantly higher than those of Group HF and Group NC (both P < 0.01). The protein expression of SIRT1 of Group HF was significantly lower than that of Group NC (P < 0.01), and that of Group CR was significantly higher than that of Group HF, however, still significantly lower than that of Group NC (both P < 0.01). The BW and VF, FINS, FPG, TC, and TG of Group CR were all significantly lower than those of Group HF (all P < 0.01). CONCLUSION: CR can reverse NAFLD significantly. The increased expression of SIRT1 in liver induced by CR may be an important molecular mechanism involved in the improvement of NAFLD by CR.

[Prohibitin suppresses renal interstitial fibroblasts proliferation and phenotypic change induced by transforming growth factor-beta1].

Abstract: OBJECTIVE To illuminate the possible role of Prohibitin (PHB) in tubulointerstitial fibrosis. METHODS (1) Forty-eight renal biopsy specimens were obtained from the patients with various primary glomerulonephritis, 26 male and 22 female, aged 7.5 +/- 5.5 (2.5 - 13 years), and nine kidney tissue specimens were obtained form the tissues far away from the tumor tissues and confirmed by pathological examination as normal tissues in the kidney dissected during operation as normal control. Immunohistochemistry was used to detect the protein expression of PHB and alpha-smooth muscle actin (alpha-SMA). The correlation between PHB and degree of tubulointerstitial lesion was compared. (2) Rat kidney fibroblastoma cells of the line NRK-49F were cultured, and laser scanning confocal microscopy was used to observe the subcellular location of PHB protein. The changes of PHB protein and mRNA expression in the NRK-49F cells upon TGF-beta1 stimulation were detected by Western blotting and RT-PCR analysis. (3) PHB expression plasmid was constructed and transfected into the NRK-49F cells. Then, cell cycle analysis was performed by flow cytometry, and Western blotting and RT-PCR were performed to detect the PHB and alpha-SMA protein and mRNA expression in the NRK-49F cells treated with or without TGF-beta1. RESULTS (1) PHB protein expression was found in the normal renal tissues by immunohistochemistry, with a positive distribution in the interstitial cells and tubular epithelial cells. PHB was strongly down-regulated in the damaged interstitial and tubular epithelial cells, the higher the grade of damage, the lower the expression of PHB (all P < 0.01), and the PHB expression amount was negatively correlated with the degree of tubulointerstitial lesions (r = -0.802, P < 0.01). (2) Confocal microscopy showed that PHB was mainly located in the cytoplasm and weakly expressed in the nucleus of the NRK-49F cells. Treated with TGF-beta1, the PHB protein expression and mRNA expression in the NRK-49F cells were decreased both time-dependently and dose-dependently (all P < 0.01). (3) A recombinant pcDNA3.1 (-)/PHB plasmid was successfully constructed. PHB protein expression in the transfected NRK-49F cells was 2.54 times higher compared with the non-transfected cells. (4) The proportions of the cells in the S and G(2)/M phases were higher in the NRK-49F cells stimulated by TGF-beta1, however, more NRK-49F cells remained in the G(0)/G(1) phase after transfection of PHB (P < 0.01). (5) Both alpha-SMA protein and mRNA were not expressed in the control cells while de novo expression of alpha-SMA in the NRK-49F cells was increased after the treatment of TGF-beta1. Over-expression of PHB did not affect he basic alpha-SMA expression but dramatically repressed TGF-beta1-initiated alpha-SMA expression in the NRK-49F cells (P < 0.01). CONCLUSION PHB protein is expressed in the normal renal tissues and adversely correlated with the degree of tubulointerstitial lesions. Extraneous PHB suppresses renal interstitial fibroblast proliferation and cell phenotypic change induced by TGF-beta1.

[Psychological status of congenital microtia patients and relative influential factors: analysis of 410 cases].

Abstract: OBJECTIVE: To investigate the psychologic status of congenital microtia patients and related influential factors. METHODS: In a cross-sectional survey for congenital microtia, 410 patients, 314 males and 96 females, aged 12 +/- 6 (5 - 37), underwent psychological survey with the symptom checklist-90 (SCL-90) or Achenbach child behavior checklist (CBCL), centering on the 3 main psychological problems: depression, interpersonal sensitivity or social difficulties, and hostility or aggression. A questionnaire was designed to investigate the influencing factors, such as the patients' own factors, and psychological factors of the patients' families Chi square test and logistic regression analysis were performed to find the factors contributing to those psychological problems. RESULTS: Psychological status of congenital microtia patients were depression existed in 83 patients (20.2%), interpersonal sensitivity or social difficulties existed in 150 patients (36.6%), and hostility or aggression existed in 108 patients (26.3%). The factors, such as age (OR = 1.75), microtia grade (OR = 2.77), mother's education (OR = 2.49), having been subjected to ridicule (OR = 2.58), pressure of family affection (OR = 1.96), family attitude to patient (OR = 2.45), and deficiency of family harmony (OR = 2.57) were risk factors contributing to depression of patients. The factors, such as age (OR = 1.62), having been subjected to ridicule (OR = 3.34), and pressure of family affection (OR = 1.89) were risk factors contributing to interpersonal sensitivity or social difficulties of the patient. The factors, such as having been subjected to ridicule (OR = 2.47), and pressure of family affection (OR = 1.80) were risk factors contributing to hostility or aggression of the patient. CONCLUSION: Having been subjected to ridicule, deficiency of family harmony, and pressure of family affection are mainly risk factors of psychological problems of congenital microtia patients. Early education and early operation for the patients are necessary. Language: zh

Combined effects of genetic polymorphisms in cytochrome P450s and GSTM1 on lung cancer susceptibility

Abstract: OBJECTIVE To investigate the relationship between the gene polymorphism of metabolizing enzymes and the genetic susceptibility to lung cancer as well as to study the synergistic effects between smoking and the genes. METHODS Peripheral blood samples were collected from 279 patients with primary lung cancer and 684 age-, nationality-, and native place-matched controls, including patients with benign diseases and healthy volunteers. PCR-RELP was used to detect the distribution of CYP1A1, 2D6, 2E1, and GSTM1 genotypes. The correlation of these genes with the sensibility to lung cancer was analyzed. RESULTS The CYP1A1 variant allele frequency of the lung cancer group was 67.4%, significantly higher than that of the control group (55.7%, P = 0.001). GSTM1-null genotype was found to be associated with lung cancer (OR = 1.58, P = 0.002). The risk of lung cancer in the individuals carrying GSTM1-null genotype and CYP1A1 (w/m, m/m) genotype was 2.75 times that of the individuals not carrying these genotypes (P < 0.01). There were no significant differences in the frequencies of CYP2D6 and CYP2E1 genotypes between these two groups. In the heavy smokers GSTM1-null, CYP1A1, CYP2D6, and CYP2E1 genotypes increased the risk of lung cancer by 5.71 - 11.67 times (P = 0.000). CONCLUSION The individuals who carry GSTM1-null genotype and CYP1A1 (m) genotype have an increase risk of lung cancer. The combined effect of I phase metabolizing enzymes and II phase metabolizing enzymes is observed. In heavy smokers the polymorphism of GSTM1 and CYPs affects the susceptibility to lung cancer.

CT guided radioactive 125I seed implantation in treating localized advanced pulmonary carcinoma

Abstract: Objective To investigate the clinical value of CT guided radioactive 125I seed implantation (CTRISI) in the treatment of localized advanced pulmonary carcinoma. Methods Thirty-two biopsy -confirmed localized advanced pulmonary carcinoma patients (Group A) with 48 lesions, 5.5 (4.5 -7.5) cm in diameter, clearly demarcated from the adjacent normal tissue, who failed to be improved in the first line chemotherapy, underwent CI-guided implantation of 125I seeds of 23.3 - 30.0 megabecquerel (MBq) into these lesions with the matched peripheral dose of 100-150 Gy. Thirty patients (Group B) treated by first line chemotherapy were randomly selected as the control group. Results CT follow-up two months later proved that the local control rate of Group A was 78.1%, significantly higher than that of Group B; the one year survival rate of Group A was 65.0%, significantly higher than that of Group B (48.0%); the median survival time of Group A was 15 months, significantly longer than that of Group B (11 months); no myelosuppression was found in Group, and the myelosuppression rate of Group B was 46.3%. In Group A small amount of effusion was observed, pneumothorax occurred in 4 cases with one of the lungs compressed by less than 30% that was improved after conservative treatment; one week after the procedure bloody sputum occurred in 15 cases. Conclusion Improving the living quality obviously and with good short-term effects and few complications, CTGRISI procedure is safe and well-tolerated in treating localized advanced pulmonary carcinoma in Chinese patients.

Reducing oxidative DNA damage by adding antioxidants in human semen samples undergoing cryopreservation procedure

Abstract: Objective To evaluate the protective effects of oxidative DNA damage by adding antioxidants:ascorbate,catalase (CAT),and superoxide dismutase (SOD) in human semen samples undergoing cryopreservation procedure.Methods Semen sample form 30 fertile men were mixed with modified cryoprotectant and divided into six groups according to the category and concentration of antioxidants:ascorbate 300 μmol/L,ascorbate 600 μmol/L,CAT 200 U/ml,CAT 400 U/ml,SOD 200 U/ml,and SOD 400 U/ml.Comet assay was conducted to measure the percentage of comet ceils,and the nuclear DNA damaged parameters:tail DNA percentage (TD%) and Olive tail moment (OTM).Flow cytometry was used to detect the reactive oxidative species (ROS).The motility (a+b grade),viable recovery rate,nuclear DNA integrity and reactive oxidative species (ROS) of all groups were analyzed before and/or after freeze-thawing.Results ①After cryopreservation,compared with the control group,the a + b grade sperm rates of the ascorbate 300 μmol/L,CAT 200 U,and CAT 400 U groups were all higher than that of the control group (all P0.05),however,the levels of reactive oxygen species (ROS) of the ascorbate 300 μmol/L,CAT 200 U,and CAT 400 U groups were 30±13,30±11,and 30±11 respectively,all significantly lower than that of the control group (37±17,all P0.05).The viable recovery rates of tire ascorbate 300 μmol/L,CAT 200 U,and CAT 400 U groups were 67%±14%,68%± 14%,and 69%±15% respectively,all significantly higher than that of the control group (59%±10%,all P0.05).②The TD% levels of the aseorbate 300 μmol/L,CAT 200 U,and CAT 400 U groups were 41%±4%,40%±7%,40%±6%,all similar to that of the raw semen (all P0.05),but significantly lower than that of the control group(46%±6%,all P0.01).The OTM levels of the ascorbate 300 μmol/ L.CAT 200 U,and CAT 400 U groups were 7.7±1.2,7.5±1.6,and 7.8±1.9,all similar to that of the raw semen(all P0.05),but significantly lower than that of the control group (10.1±3.1,all P0.01) too.The TD% and OTM levels of the other groups were all significantly higher than that of the raw semen (all P0.01),but not significantly different from those of the control group(all P0.05).③ROS was significantly negatively correlated with the motility in all groups (P0.05 or P0.01).Apart from the ascorbate 600 μmol/L group,the TD% and OTM of the other groups were all significantly positively correlated with the ROS(P0.05 or P0.01).Conclusion Supplementation of ascorbate or CAT reduces the level of ROS that induces sperm nuclear DNA damage,and improves the human sperm quality in the process of freeze-thawing.

[Mutation of GJB2 gene in nonsyndromic hearing impairment patients: analysis of 1190 cases].

Abstract: OBJECTIVE To analyze the sequence of GJB2 gene in nonsyndromic hearing impairment (NSHI) patients in China METHODS Peripheral blood samples were obtained from 1190 NSHI patients randomly selected from the Deaf and Mute Schools of Beijing, Hebei, Heilongjiang, Jilin, Inner Mongolia, Shanxi, Henan, Hubei, Shaanxi, Gansu, Ningxia, Qinghai, Anhui, Jiangsu, Shanghai, Fujian, Guangdong, and Guangxi, and 301 children with normal hearing level used as controls Genomic DNA was extracted by extraction kits to undergo polymerase chain reaction and sequencing so as to detect the mutations of GJB2 gene RESULTS Sixteen pathogenic mutations of GJB2 gene were found, the most common of which included 235delC, 299-300delAT, and 176del16bp 250 patients (2105%) carried definite GJB2 mutations, 245 of which (98%) carried at least one of these 3 common mutations 222 of the 250 patients (8880%) carried the mutation 235delC with a detection rate of 1866% 62 of the 250 patients (2480%) carried the mutation 299-300delAT with a detection rate of 521% 19 of the 250 patients (760%) carried the mutation 176del16bp with a detection rate of 160% The detection rates of these 3 mutations in the NSHI patients were all significantly higher than those among the controls (all P<001) CONCLUSION The hot spot of GJB2 gene mutations in Chinese NSHI patients is 235delC, followed by 299-300delAT and 176del16bp These results establish a fundamental basis for drawing a spectrum of GJB2 gene mutation among Chinese population

[Protective effects of ketamine on allergen-induced airway inflammatory injure and high airway reactivity in asthma: experiment with rats].

Abstract: OBJECTIVE To observe the effects of ketamine on bronchial hyperresponsiveness and airway inflammation in equal asthma METHODS 56 Brown-Norway rats were randomly assigned to seven groups: negative control group (Group A), asthma model group (Group B) and inhalation groups with nebulized ketamine at different concentrations (Group C, D, E) and intraperitoneal injection groups with ketamine at different doses (Group F, G) The rats were sensitized by injection of ovalbumin (OVA) together with aluminum hydroxide and Bordetella pertussis as adjuvants, then challenged by repeated intermittent (thrice weekly) exposure to aerosolized OVA for two weeks Before challenge, the sensitized rats were exposed to an aerosol of phosphate buffered saline (PBS) or ketamine at the concentrations of 125 mg/ml, 25 mg/ml and 50 mg/ml respectively in Groups B, C, D and E The sensitized rats were intraperitoneally injected with ketamine at the doses of 50 microg/kg or 100 microg/kg respectively in Group F and G The sensitized rats in Group A received phosphate buffered solution (PBS) by inhalation The airway reactivity to acetylcholine (ACH) was assessed in vivo 24 hr after the last OVA challenge, then the lungs were removed for measurement of the mRNA and protein expression of iNOS and production of NO and lung sections for histopathologic examination RESULTS (1) In the OVA-sensitized and challenged rats, the dose-response curve of the expiratory resistance (Re) shifted to the upper-left +/- ward compared with that of PBS control rats In addition, the provocation doses required to increase the Re by 100%, 200% and 400% for OVA-sensitized and challenged rats in Group B were significantly lower than those of the PBS control rats (1465 +/- 119 vs 3228 +/- 143, 1517 +/- 119 vs 3891 +/- 139, and 1628 +/- 118 vs 5653 +/- 138, all P < 001) The OVA-sensitized rats treated with ketamine before OVA challenge demonstrated a significant decrease in AHR by a rightward shift of the dose-response curves to ACH and significant higher provocation doses compared with that of the OVA control rats (P < 005) (2) Marked inflammatory changes in the airways of Group B were present, while obviously lessen inflammatory cell infiltration in peribronchial and perialveolar tissues and improved lung edema were observed in the groups treated with ketamine (3) Quantitation by densitometry showed that the relative density of iNOS mRNA bands normalized to beta-actin was significantly higher in the OVA control than the PBS control (10 +/- 007 vs 048 +/- 007, P < 001) Treatment with ketamine significantly decreased the expression of iNOS mRNA in Group C (065 +/- 007), Group D (058 +/- 009), Group E (056 +/- 100), and Group F (066 +/- 006) when compared with Group B (all P < 005) (4) The relative iNOS protein levels (ratios of iNOS/beta-actin) determined by densitometry analysis showed a 4-fold increase in Group A compared with those in the negative group (054 +/- 008 vs 013 +/- 008, P < 005) When compared with those of the OVA control, the levels of relative iNOS protein expression showed a significant decrease in the lungs from the rats treated with ketamine inhalation at the doses of 125 mg/ml (020 +/- 003) and 25 mg/ml (018 +/- 003) and with ketamine and intraperitoneally the at dose of 50 microg/kg (021 +/- 004) (P < 005) (5) NO production in pulmonary tissues was significantly higher in the OVA-treated rats compared to the PBS controls (039 +/- 004 micromol/g protein vs 013 +/- 001 micromol/g protein, P < 001), but this OVA-triggered NO production was significantly decreased by treatment with 125 and 25 mg/ml inhaled ketamine (019 +/- 003 micromol/g and 017 +/- 003 micromol/g, both P < 005) and 50 microg/kg ip-injected ketamine (016 +/- 004 micromol/g, P < 005) when compared with the OVA-treated rats CONCLUSION Both inhalation and systemic administration of ketamine attenuate inflammatory the lung injury and airway hyperreactivity of the OVA-induced asthma model The protective effects of ketamine is achieved by inhibiting OVA-provoked over-expression of mRNA and protein of iNOS and reducing the production of NO in pulmonary tissues

Laparoscopic splenectomy and pericardial devascularization for treatment of portal hypertension due to liver cirrhosis

Abstract: Objective To evaluate the safety and efficacy of laparoscopic splenectomy (LS) and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis. Methods Twenty three cases with hepatitis B and schistosoma cirrhosis and portal hypertension underwent LS and paraesophagogastric devascularization performed by one treatment team. Follow-up was conducted for 9 months. Results LS combined with pericardial devascularization was successfully performed on these 20 cases. Three cases were converted to open surgery due to intra-operative bleeding. The mean operative time was 235 min (180 - 350), and mean intra-operative blood loss was 520 ml (200 - 1600 ml). All patients were treated with plasma transfusion, antibiotics, and abdominal drainage post-operatively. Peristalsis of stomach and intestine recovered 24 - 72 hours after operation. The mean hospitalization time was 8.5 days (6 - 17 days). The peri-operative complication included plural effusion in 3 cases and subphrenic abscess in one case, .mild ascites in two cases, and wound dehiscence in one case. No mortality occurred. Rebleeding rare was 0%. Conclusion LS combined with pericardial devascularization is relatively safe and effective in treatment of portal hypertension due to liver cirrhosis. The keys to success include experienced laparoscopic skills, use of harmonic scalpel and careful manipulation.

[Gray matter abnormalities in developmental stuttering determined with voxel-based morphometry].

Abstract: OBJECTIVE To investigate the differences of regional grey matter volume between adults with persistent developmental stuttering and fluent speaking adults, and to determine whether stutterers have anomalous anatomy of speech-relevant brain areas that possibly affect speech fluency METHODS High-resolution magnetic resonance imaging (MRI) scanning was performed on 10 adults with developmental stuttering, aged 26 (21 - 35) with the onset age of 4 (3 - 7) and 12 age, sex, hand preference, and education-matched controls The customized brain templates were created in order to improve spatial normalization and segmentation Then automated preprocessing of MRI data was conducted using an optimized version of VBM, a fully automated unbiased and objective whole-brain MRI analysis technique RESULTS VBM analysis revealed that compared with the controls, the stuttering adults had significant clusters of locally gray matter volume increased in the superior temporal, middle temporal, precentral and postcentral gyrus, and inferior parietal lobule of the bilateral hemisphere (P < 0001), the numbers of increased gray matter volume in the right and left hemispheres were 60,247 and 48,782 voxels respectively The, Grey matter decrease was shown with an overall decreased gray matter volume of 32 394 voxels, mainly in the bilateral cerebella posterior lobe and dorsal part of medulla, especially inferior semi-lunar lobule, followed by cerebellar tonsil and bilateral medulla in comparison with the controls (P < 0001) CONCLUSION The reduction of the regional gray matter volume of bilateral cerebella and medulla is related to the neural mechanism of the controlling disorder of speech production and may be the essential cause of stuttering Some areas with increased gray matter volume in temporal lobe, parietal lobe, and frontal lobe, may be the result of long term functional compensation for the cerebella and medulla function deficiency

[A random, comparative study on endovenous laser therapy and saphenous veins stripping for the treatment of great saphenous vein incompetence].

Abstract: Objective To evaluate the therapeutic effects of endovenous laser therapy (EVLT) and saphenous veins stripping in the treatment of great saphenous vein incompetence.Methods Eighty cases (80 limbs) with great incompetent saphenous vein were randomly divided into 2 equal groups:EVLT group and stripping group.The patients in the EVLT group underwent EVLT and those in the stripping group underwent upper ligation and stripping of great saphenous vein.The duration of operation,blood losing, complications,pain grade,and hospitalization time were compared.All cases were followed up for 6 months and 12 months using Doppler sonography and air Plethysmography.Results The blood losing(P0.01), hospitalization time (P0.05) and pain grade (P0.05) in the EVLT group were all significantly less than those in the stripping group,while the operation duration and complication were not significantly different between the two groups (P0.05).All patients in both groups got improvements of venous volumn (P 0.05),Venous Filling Index (P0.01),and residual Venous Fraction (P0.01),yet there were no statistical differences between the two groups (P0.05).Conclusion Endovenous laser therapy is a safe, effective,minimal invasive procedure for the patients with great saphenous vein incompetence.Its short-time efficiccy is similar to that of the traditional upper ligation and laceration of greater saphenous vein.

In vivo MR imaging tracking of supermagnetic iron-oxide nanoparticle-labeled bone marrow mesenchymal stem cells injected into intra-articular space of knee joints:experiment with rabbit

Abstract: Objective To evaluate the feasibility of in vivo magnetic resonance imaging (MRI) with 1.5T system tracking of the survival, migration and differentiation of magnetically labeled seed cells-bone marrow-derived mesenchymal stem cells (MSCs) injected into the articular cavity. Methods Rabbit MSCs were isolated, purified, expanded, and then coincubated in vitro with supermagnetic iron oxide particles (SPIO) and 5-bromo-2-deoxyuridine (BrdU). Prussian blue staining and transmission electron microscopy were performed to observe the intracellular iron. Some labeled MSCs were subjected to chondrogenic differentiation and the phenotype was examined to assess their chondrogenic differentiation capacity. MSCs colabeled with SPIO nanoparticles and (BrdU were suspended in chitosan and glycerophosphate (C-GP) gel. Eighteen rabbits underwent damage to the femoral trochlea to create cartilage defect models, and randomly divided into 3 groups 1 week later: Group A (n=6) undergoing injection of the MSC suspension in C-GP gel into the intra-articular space of knee joints, Group B (n=6), injected with un-labeled MSC suspension in C-GP gel, and Group C (n=6), without injection. MRI of the knee was performed 1, 4, 8, and 12 weeks after the injection respectively on a certain numbers of rabbits. and then the rabbits were killed with their knee joints taken out to undergo immunohistochemistry. The MR imaging findings were compared with the histological findings. Results Prussian blue staining and transmission electron microscopy showed intracytoplasmic nanoparticles in the SPIO-labeled cells. Safranin-O staining showed deposition of proteoglycan and type II collagen outside both the labeled and unlabeled MSCs, showing chondrogenesis. GRE T2-weighted MR image showed marked hypointense signal void areas, representing the implanted MSCs, in the intra-articular space after the MSC injection in Group A that persisted for 12 weeks at least; 2 week after the MSC injection hypointense signal could be seen in the defect, which peaked in the signal intensity about 4 weeks later, and then gradually decreased in the signal intensity; and 12 weeks after the injection no recognizable hypointense signal in the defect was detected. Immunohistochemical staining demonstrated the presence of Prussian blue-positive cells and BrdU-positive cells in the tissue sections in the areas corresponding well to the signal intensity loss regions in the MRI images. Group B and Group C showed no signal intensity loss in the intra-articular spaces by GRE T2-weighted MR imaging. Histological observation showed that the defects were repaired with fibrocartilage in Groups A and B, and with fiber tissue in Group C. Conclusion Labeled with SPIO, the MSCs remains their ability of chondrogenic differentiation. It is feasible to track the fate and dynamic redistribution of magnetically labeled MSCs, the seed cells, injected into the articular cavity by 1.5T MRI, an efficient noninvasive technique.

[Executive function impairment in patients with temporal lobe epilepsy: neuropsychological and diffusion-tensor imaging study].

Abstract: Objective To explore the cognitive changes and the relation with the parameters of DTI in the brain areas in patients with temporal lobe epilepsy by neuropsychological test and DTI study. Methods Thirty-two patients with temporal lobe epilepsy, 11 males and 8 females, aged 32 +/- 12, with the education year of 8.6 +/- 1.2, and 42 sex, age, and education level-matched healthy controls underwent and a comprehensive test battery test including verbal fluency (VI), digit span (DSp), digit symbol (DSy), Stroop color-word test, trail making test, and so as to evaluate the intelligence level. Nineteen patients and twenty-one control subjects underwent diffusion tensor imaging (DTI) of the head. The correlation between the results of DTI and cognitive function tests of the patients was analyzed. Results VI test showed that the number of word spoken in 1 min by the healthy control group was (16 +/- 4), significantly more than that of the patient group [(11 +/- 4), P = 0.00]. The DSp score of the control group was (14.6 +/- 3.1) points, significantly more than that of the patient group [(11.1 +/- 2.8), P = 0.00]. The number of DSy filled by the patient group was (47 +/- 17), significantly less than that of the control group [(60 +/- 16), P = 0.00]. The time needed to make trail of the patients was (56 +/- 20) s, significantly longer than that of the control group [(37 +/- 11) s, P = 0.01]. The Stroop reaction time of the patient group was (6.1 +/- 4.5) s, significantly longer than that of the control group [(30 +/- 5) s, P = 0.00]. The Stroop error number of the patient group was (6.1 +/- 4.5), significantly more than that of the control group [(1.4 +/- 1.2), P = 0.00]. The fractional anisotropy (FA) values of the posterior limb of left internal capsule and of the bilateral thalami of the patient group were significantly lower than those of the control group (P = 0.01 or P = 0.00). VI was negatively correlated with the mean diffusivity (MD) in left caudamen (r = -0.56, P = 0.04), right putamen (r = -0.58, P = 0.04), left putamen (r = -0.58, P = 0.04), and right thalamus (r = -0.64, P = 0.02), and was positively correlated with the FA in white matter of left frontal lobe (r = 0.43, P = 0.04)and left occipital lobe (r = 0.47, P = 0.02). DSp was negatively correlated with the MD in splenium of corpus callosum (r = 0.58, P = 0.04) and left putamen (r = -0.59, P = 0.04). TMT was positively correlated with the MD in the posterior limb of right internal capsule (r = 0.65, P = 0.02) and posterior limb of left internal capsule (r = 0.59, P = 0.03). Conclusion The prefrontal cortex is a vital component of the circuitry subserving executive function. But the corresponding damaged area in patients with impaired executive function was not limited to frontal lobe,more areas beyond frontal lobe may be involved in executive function.

Vitamin D receptor gene polymorphisms in female adolescent idiopathic scoliosis patients

Abstract: Objective To investigate the association of vitamin D receptor(VDR)gene polymorphisms with abnormal growth pattern and low bone mass in adolescent idiopathic scoliosis(AIS) patientsMethods Peripheral blood samples were obtained from 164 female patients with AIS,aged 144±2(9-20),and 122 age-matched healthy girlsPolymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)technique was used to detect the VDR gene distributionsResults The frequency of Bb genotype was significantly higher in the AIS patients than in the controls(P001)The frequency of B alleles of the AIS patients was significantly higher than that of the controls(P001)In AIS patients,the expression rate of Aa genotype of the AIS patients with the body mass index(BMI)≥18 kg/m~2 was significantly higher than those with the BMI18 kg/m~2(P005),and the expression rate of Bb genotype of the AIS patients with the BMI18 kg/m~2 and arm span160 cm was significantly higher than that of the AIS patients with the BMI≥18 kg/m~2 and arm span≥160 cm(P005)Conclusion The BsmI site polymorphism of vitamin D receptor gene may be associated with abnormal growth pattern and low bone mass in girls with AIS

[Change and significance of serum pigment epithelium-derived factor in type 2 diabetic nephropathy].

Abstract: OBJECTIVE To investigate the change of pigment epithelium-derived factor (PEDF) in type 2 diabetic nephropathy, and to explore the significance of PEDF in the development of diabetic nephropathy. METHODS ELISA was used to detect the serum PEDF and immunoturbidimetry was used to measure the urinary albumin excretion (UAE) in 49 healthy controls and 132 type 2 diabetic patients, including 48 with normal urinary albumin excretion rate (NA group), 50 with microalbuminuria (MA group), and 34 with overt diabetic nephropathy (PR group). HbA1c, triglyceride (TG), total cholesterol, high density lipoprotein cholesterol (HDL-c), and highly sensitive C-reactive protein (hs-CRP) were simultaneously determined. RESULTS The serum PEDF levels of the NA, MA, and PR groups were (3.7 +/- 2.2) mg/L, (4.7 +/- 2.9) mg/L, and (5.7 +/- 2.8) mg/L respectively, all significantly higher than that of the control group (2.7 +/- 1.3) mg/L. P < 0.05, 0.01, and 0.01 respectively). The serum PEDF levels of the MA and PR groups were significantly higher than that of the NA group (both P < 0.01), and that of the PR group was significantly higher than that of the MA group (P < 0.05). Correlation analysis demonstrated that serum PEDF level was positively correlated with HbA1c (r = 0.198, P < 0.01), FPG (r = 0.231, P < 0.01), TG (r = 0.302, P < 0.01), hs-CRP (r = 0.214, P < 0.01), and urinary albumin excretion rate (UAER) (r = 0.169, P < 0.05), significantly, but negatively correlated with HDL-c (r = -0.237, P < 0.01). Stepwise multiple linear regression analysis showed that TG (beta = 0.314, P < 0.01), hs-CRP (beta = 0.260, P < 0.01), and UAER (beta = 0.148, P < 0.05) were significant independent determinants for serum PEDF. CONCLUSION Serum PEDF level significantly increases in type 2 diabetic patients, and the magnitude of PEDF is related to the severity of diabetic nephropathy. TG, hs-CR and UAER are significant independent determinant for serum PEDF. The increase of PEDF may involve in the development of diabetic nephropathy.

[mRNA expression and activity of ADAM17 in hippocampus after chronic cerebral hypoperfusion: experiment with aged rats].

Abstract: OBJECTIVE To explore the effect of alpha-secretase on the pathogenesis of cognitive impairment following cerebral ischemia. METHODS Forty-eight 12~16-months-old Wistar rats were randomly divided into 2 equal groups: hypoperfusion group, undergoing permanent occlusion of bilateral common carotid arteries to mimic cerebral hypoperfusion, and sham-operation group. Each group was further divided into 1, 2, 4, and 16 week subgroups. Y-maze test was conducted before operation and at different time points as mentioned above to examine the spatial learning and memory ability. The rats tested by Y-maze were killed with their hippoccampi taken out. Realtime PCR was used to assay the mRNA expression of a disintegrin and metalloproteinase (ADAM)-17 representing alpha-secretase in the hippocampus, and fluorescence spectrometry was applied to measure activity thereof. RESULTS The numbers of electric stroke since 2 weeks after hypoperfusion were significantly higher than that before hypoperfusion in the same group and those of the sham-operation group (P < 0.05 or P < 0.01). The mRNA expressions of hippocampal ADAM17 of the hypoperfusion subgroup 2, 4, and 16 weeks after operation were 0.78 +/- 0.03, 0.78 +/- 0.02, and 0.54 +/- 0.03 respectively, all significantly lower than those of the sham-operation group (1.12 +/- 0.05, 0.99 +/- 0.04, and 1.01 +/- 0.04 respectively, all P < 0.01). The average fluorescence values of hippocampal alpha-secretase 1, 2, 4, and 16 weeks after hypoperfusion of the hypoperfusion group were 33,880 +/- 1086, 37,496 +/- 817, 32,295 +/- 864 and 30,069 +/- 1111, respectively, all significantly lower than those of the sham-operation group (39 497 +/- 838, 39 802 +/- 1052, 40,137 +/- 776, and 39,894 +/- 1076 respectively, all P < 0.01). CONCLUSION The mRNA expression of ADAM17 that represents alpha-secretase in the hippocampus is down-regulated and the activity of alpha-secretase is decreased after chronic cerebral hypoperfusion. That may subsequently result in accumulation of beta amyloid precursor protein, substrate of alpha-secretase, (APP), and then activate the other pathway cleaving APP, i.e., the pathway by beta secretase. At last, the production of beta amyloid protein in brain after chronic cerebral hypoperfusion increases and impairs the memory.

[A meta-analysis on interleukin-1 gene cluster polymorphism and genetic susceptibility for ankylosing spondylitis].

Abstract: OBJECTIVE To investigate the association between interleukin (IL)-1 gene cluster polymorphism and the genetic susceptibility for ankylosing spondylitis (AS). METHODS Relevant published data were retrieved through Pubmed, EMBASE, Cochrane library and Chinese Bio-medicine Database (CBM). Studies eligible for this meta-analysis had to meet all the following inclusion criteria: (1) the content was associated with population-based case-control studies, (2) the study was on the relationship between the IL-1 gene cluster polymorphism and AS, (3) the diagnosis of AS was based on the modified New York criteria (1984) by the rheumatologist. (4) the raw data including the frequencies of alleles and certain genotypes in case and control groups could be collected. and (5) the distribution of studied loci in the populations was in accord with the Hardy-Weinberg equilibrium. Researches that didn't meet the inclusion criteria, as well as the duplicated reports, family-based studies were excluded. All analyses were conducted with the software 'Review Manager' Version 4.2.8. RESULTS (1) A total of 6 literatures, including 9 population samples, were studied. The overall combined data were verified to be heterogeneous, and the heterogeneity disappeared after stratification by the race. Then, the fixed-effect model could be applied. (2) The combined data revealed the frequencies of allele 2 and its genotypes of IL-1RN intron 2 variable number of tendem repeats were higher in the AS groups than in the controls in the Caucasian population (allele 2: OR=1.52, 95% CI=1.26 approximately 1.84, P T (rs1800587) was higher in the AS group than in the controls in the Caucasian population (allele T: OR=1.36, 95% CI=1.12 approximately 1.66, P T (rs1800587) and IL-1F8 SNP (rs1900287). Furthermore, there is a distinct discrepancy for this association among races.

[Hematological abnormalities in systemic lupus erythematosus and clinical significance thereof: comparative analysis of 236 cases].

Abstract: OBJECTIVE To investigate the hematological abnormalities and their relationship to the disease activity of systemic lupus erythematosus (SLE). METHODS The clinical data of 236 SLE patients, 29 males and 207 females with the age of confirmed diagnosis of 33.4, were divided into 3 groups: anemia group, with the hemoglobin (Hgb) < 100 g/L, including 2 subgroups, i.e. subgroup of anemia caused by chronic diseases (ACD) and subgroup of hemolytic anemia; low white blood cell group 1 (Group WBC1) with the WBC count < 4.0 x 10(9)/L, white blood cell group 2 (Group WBC2) with the WBC count 3.0 approximately 3.9 x 10(9)/L, immune thrombopenic purpura group (ITP group) with a platelet count < 100 x 10(9)/L, and control group without hematological changes. 72 patients underwent morphologic characterization of their bone marrow. The hematological data and the relationship thereof to the disease activity in different groups were analyzed. RESULTS Among the 236 SLE patients 168 (71.18%) had hematological abnormalities and 68 of them (28.82%) without hematological abnormalities. 123 of the 168 patients with hematological abnormalities (52.1%) had anemia, 82 of which (66.7%) had characteristics of anemia caused by chronic diseases, 18 (14.6%) had hemolytic anemia, 8 (6.6%) had hematopoietic abnormalities, and the remaining 15 patients (12%) had anemia caused by unknown reasons. 73 of the 236 SLE patients (30.9%) had a WBC count < 4.0 x 10(9)/L and 57 patients (24.2%) had a platelet count < 100 x 10(9)/L. In the groups with hemolytic anemia, WBC count < 3.0 x 10(9)/L and thrombocytopenia, the complement levels were significant lower, and the levels of C-reactive protein (CRP) and positive anti-dsDNA antibody were significantly higher than those of the controls (all P < 0.05) The rate of positive antiphospholipid antibody of the hemolytic anemic patients and patients with thrombocytopenia were 22.2% and 15.8% respectively, both significantly higher than that of the controls (2.9%, both P < 0.05). 49 of the 72 patients undergoing morphologic characterization of bone marrow had normal cell morphology and a normal appearing bone marrow, 10 had varying degrees of pathologic hematopoietic changes, 2 lacked megakaryocytes, 9 expressed decreased proliferation in all three hematopoietic lineages, and 2 had only a decrease in erythropoiesis. CONCLUSION The reason of the high proportion of anemia among the SLE patients in China may be the higher proportion of anemia caused by ACD in comparison with that abroad. Although SLE patients have lower rates of hemolytic anemia, HA is an important index of SLE disease activity. Thrombocytopenia and a WBC count < 3.0 x 10(9)/L are related to SLE disease activity. Abnormalities of hemopoiesis by bone marrow is one of the reasons of sever hematological changes in part of the SLE patients.

A clinical study of impedance graph in verifying tracheal intubation

Abstract: OBJECTIVE: To evaluate the clinical usefulness of impedance pneumography in determining the tube placement during endotracheal intubation. METHODS: Thirty-six endotracheally-intubated patients for elective operations underwent general anesthesia and endotracheal intubation, and then a second identical tube was inserted into the esophagus under laryngoscopic control. The ventilation circuit was then attached either to tracheal or esophageal tube. The tube position was determined by 2 blinded examiners, one experienced and the other inexperienced, using three methods: impedance pneumography, capnography, and auscultation. The order of the tubes tested and the order of the methods used were randomized. The observation results and the time needed to determine were recorded by another assistant. RESULTS: Of the 216 tests conducted, both examiners correctly diagnosed the position of the tube using impedance pneumography and capnography. In the auscultation method there were two false-negative results (with the tracheal tube identified as esophageal) and one false-positive (with the esophageal tube identified as tracheal) by the experienced examiner, while five false-negative results (with the tracheal tube identified as esophageal) and nine false-positive (with the esophageal tube identified as tracheal) by the inexperienced examiner. With the sensitivity and specificity of impedance pneumography as standards (100%), the sensitivity and specificity of the capnography were both 100% too, and the sensitivity and specificity of the auscultation method were 90% and 86% respectively, both significantly lower than those of the other 2 methods (all P<0.01). Capnography needed 3.4 s+/-1.3 s and 3.7 s+/-1.4 s to verify tracheal intubation and esophageal intubation respectively, both significantly longer than those of the auscultation methods (1.7 s+/-0.7 s and 2.5 s+/-1.7 s) and impedance pneumography (1.6+/-0.3 and 2.1+/-1.1s, all P<0.01). It took less time for impedance pneumography and auscultation to verify the tracheal intubation than to verify esophageal intubation (both P<0.01). CONCLUSION: Impedance pneumography is one of the reliable methods for diagnosing tracheal tube position.

[Primary pediatric central nervous system tumors statistic: study of 763 cases in a single institution].

Abstract: Objective To investigate the epidemiology of primary pediatric central nervous system tumors. Methods The clinical data of 763 pediatric patients aged under 18 diagnosed as with primary central nervous system tumors in the past 10 years in Huashan Hospital were analyzed retrospectively. Results The mean age was 12.68 and the male to female ratio was 1.56:1. Among the tumors intracranial tumors accounted for 93.4% (713/763), whereas spinal tumors accounted for 6.6% (50/763). 476 of the 763 tumors (62.4%) were supratentorial, including pineal-quadrigeminal tumors, which was predominant to infratentorial tumors (30.5%, 233/763). 688 of the 763 patients had pathological diagnosis. The most common 5 categories of tumors were: astrocytic tumors (25.7%, 177/688), craniopharyngioma (12.8%, 88/688), medulloblastoma (9.3%, 64/688), germ cell tumors (8.9%, 61/688), and pituitary adenoma (7.5%, 52/688). Conclusion As the main neurological medical center in the southern part of China, the statistics of Huashan Hospital can be representative. The epidemiology of pediatric central nervous system tumors has its own specialty. Therefore, it is crucial to deal with primary pediatric central nervous system tumors according to children's characteristics.

Vasculogenic mimicry in human primary gallbladder carcinoma and clinical significance thereof

Abstract: OBJECTIVE To investigate if there is vasculogenic mimicry (VM) in human primary gallbladder carcinoma and clinical significance thereof. METHODS Seventy-four specimens of primary gallbladder carcinoma obtained from operation underwent HE staining and double staining of CD(31) and PAS to observe the existence of VM. The correlation of pathological examination and clinical outcomes was analyzed. RESULTS VM was seen in 10 of the 74 (13.5%) specimens. VM was not correlated with age, sex, location, diameter, differentiation degree, Nevin stage, and invasion depth of tumor, and existence of lymph node metastasis; but was associated with histological type (chi(2) = 10.241, P = 0.017), hepatic metastasis (chi(2) = 11.904, P = 0.01), and poor overall survival (chi(2) = 5.771, P = 0.016). Cox analysis showed that existence of VM, invasion depth, lymph node metastasis, hepatic metastasis, and operational method were independent risk factors of the prognosis of primary gallbladder carcinoma. CONCLUSION VM exists in human primary gallbladder carcinoma. Those cases of human primary gallbladder carcinoma with VM have a poorer prognosis.

Effect of UGT1A6 genetic polymorphisms on the metabolism of sodium valproate

Abstract: OBJECTIVE To investigate the effect of UGT1A6 genetic polymorphisms on the serum concentration of sodium valproate so as to help better individualize the medication for patients with epilepsy. METHODS Peripheral blood samples were collected for 67 patients receiving sodium valproate after more than 5 half-time periods, aged 17.5 (5 - 52). The genotypes of UGT1A6 were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay to examine the alleles 552A-->C. Fluorescence polarization immunoassay (FPIA) was used to measure the serum concentration of sodium valproate and the results were standardized by dosage and body weight. RESULT Out of the 67 cases, 40 (59.7%) were with the wild genotype of UGT1A6 gene, 24 (35.8%) were with the A/C genotype, and 3 (4.5%) were with the C/C genotypes. The frequencies of 552A-->C were 22.4%. The mean value of the serum concentration of sodium valproate with A/A genotype was 4.32 +/- 0.2, significantly higher than that of the patients with A/C genotype (3.43 +/- 0.30, P < 0.05). When the genotypes A/C and C/C were considered as a group, the mean value of the serum concentration of sodium valproate was 3.40 +/- 0.28, significantly lower than that of the patients with A/A genotype (P < 0.05). CONCLUSIONS Sodium valproate is metabolized via uridine diphospho-glucuronosyltransferase. The genetic polymorphisms of UGT1A6 gene affect the metabolism of sodium valproate. The dosage of sodium valproate for the patients with 552C allele in UGT1A6 should be more than the usual dosage.

Changes in plasma concentrations of osteoprotegerin before and after levothyroxine replacement therapy in hypothyroid patients

Abstract: OBJECTIVE To investigate the alteration of plasma osteoprotegerin (OPG) concentration before and after levothyroxine (L-T4) replacement therapy and its association with endothelium-dependent arterial dilation in patients with overt hypothyroidism (oHT) and subclinical hypothyroidism (sHT). METHODS L-T4 therapy was given to 20 oHT patients and 20 sHT patients, all female, till the free serum triiodothyronine (FT3), free thyroxin (FT4), and thyroid-stimulating hormone (TSH) were near or within the respective normal ranges. Twenty healthy women were used as controls. Sandwich ELISA was used to measure the plasma OPG concentration before and after treatment. RESULTS The plasma OPG levels before treatment of the oHT and sHT patients were 3.13 ng/L +/- 0.27 ng/L and 2.95 ng/L +/- 0.24 ng/L respectively, both significantly higher than that of the controls (2.42 ng/L +/- 0.26 ng/L, both P = 0.000). Multivariate analysis showed that OPG was significantly associated with TSH (r = 0.306, P < 0.05) and endothelium-dependent arterial dilation (r = -0.675, P < 0.01) at baseline. After the normalization of thyroid function the OPG levels of the oHT and sHT patients decreased markedly to 2.53 ng/L +/- 0.28 ng/L and 2.54 ng/L +/- 0.21 ng/L respectively (both P = 0.000), very close to that in the controls. The absolute changes of OPG was significantly positively correlated with the changes of TSH (P < 0.05), negatively correlated with the changes of endothelium-dependent arterial dilation (P < 0.01), and not significantly correlated with other parameters in the hypothyroid patients during the course of treatment. CONCLUSION OPG may act as an important regulatory molecule in the vasculature and, particularly, may be involved in the development of vascular dysfunction in hypothyroid patients.

[Expression of Fas, Fas ligand, Fas-associated death domain protein, caspase 8 and mutant P53 protein in esophageal squamous cell carcinoma].

Abstract: OBJECTIVE To investigate the expression of five apoptosis-related proteins, Fas, Fas ligand (FasL), Fas-associated death domain protein (FADD), caspase 8, and mutant p53, in human esophageal squamous cell carcinoma (ESCC) tissue, and analyze the association of these proteins with ESCC malignant progression. METHODS 116 ESCC specimens obtained during operation. Tissue microarray composed of the 116 specimens of cancerous tissues and corresponding paracancerous normal epithelium tissues was constructed. The expression of Fas, FasL, FADD, caspase 8, and mutant p53 was detected in the ESCC tissues and paracancerous normal epithelium tissues and analysis was conducted for the correlation between the expression of these proteins and the pathoclinical features and prognosis. involvement, differentiated grade, pTNM stages and disease-free survival. RESULTS The positive rate of Fas in the ESCC tissues was 41.4%, significantly lower than that in the normal squamous epithelium was 95.7%, P 0.05). CONCLUSION The apoptosis-related markers, such as Fas, FasL, FADD, caspase 8, and mutant p53 protein may play important roles in the development and progression of ESCC, and FADD can be used as a marker to predict the advance and prognosis of ESCC.