Showing papers in "National Medical Journal of China in 2008"

[Plasma levels of endogenous hydrogen sulfide and homocysteine in patients with Alzheimer's disease and vascular dementia and the significance thereof].

Abstract: Objective To investigate the plasma levels of endogenous hydrogen sulfide (H2S), a gasotransmitter, and homocysteine (Hcy) in patients with Alzheimer' s disease ( AD), vascular dementia ( VD), and cerebrovascular disease (CVD) and their role in the pathogenesis of AD and VD. Methods 31 AD patients, 28 VD patients, 20 CVD patients , and 23 normal controls ( NC group) underwent examination of plasma concentrations of H2S and Hcy, mini mental state examination (MMSE), activity of daily living scale (ADL), Hachinski ischemic score (HIS) , and Hamilton's depression scale (HRSD). The severity of AD and VD was evaluated according to the global deterioration scale (GDS). Results (1) The plasma H2S levels of the AD, VD, and CVD patients were (34 ± 7), (36±5), and (37 ± 7) μmol/L respectively, all significantly lower than that of the NC group [ (45±7) μmol/L,all P <0. 01 ]. However, there were no significant differences in the plasma H2S level among the AD, VD, and CVD patients (all P 0. 05). The plasma H2S concentration was negatively correlated the severity of AD. (2)The plasma Hcy levels of the AD, VD, and CVD patients were ( 14. 0 ± 3. 0), ( 16. 0 ± 6. 1 ), and ( 14. 4 ± 4. 9 ) μmol/L respectively, all significantly higher than that of the NC group [ (9.8±2.5) μmoL/L,P <0. 01 ). However, there was no significant difference in the plasma Hcy level among these 3 groups ( all P 0. 05). The plasma Hcy concentration was positively correlated with the severity of AD or VD. Conclusion H2S and Hcy are both involved in the pathogenesis of AD, VD, and CVD, and its alteration in level may be associated with the severity of AD and VD. Key words: Hydrogen sulfide; Alzheimer disease; Dementia,vascular; Homocysteine

[Significance of Golgi glycoprotein 73, a new tumor marker in diagnosis of hepatocellular carcinoma: a primary study].

Abstract: Objective To evaluate the sensitivity and specificity of Golgi glycoprotein 73(GP73) for the diagnosis of hepatitis B related hepatocelluar carcinoma (HCC). Methods Western blotting was used to detect the serum GP73level in 25 patients being HBV carrier, 24 HCC patients, 12 patients with non-liver disease, and 99 healthy controls. Serum α-fetoprotein (AFP) was detected by electrochemiluminescence reaction. The levels of sensitivity and specificity of serum GP73 in diagnosing HCC were compared with those of AFP. The serum GP73 levels of some HCC patients during the perioprative period were compared. Results The serum GP73 level of the HCC patients, all HBV positive, was (40. 36±64. 43)relative units, significantly higher than those of the HBV carriers, non-liver patients, and healthy controls [(7. 82±10. 72), (4. 48±5. 70), and(2. 59±5. 12)relative units respectively, all P＜0. 01]. There was no difference of GP73 levels between the heahhy controls and the patients of non liver diseases(P=0. 2925). The sensitivity of GV73 for the diagnosis of HCC was 76. 9%, significantly higher than that of AFP(48. 6%). The specificity for the diagnosis of HCC of GP73 was 92. 9%. Findings in a few HCC patients showed that the GP73 level remained not remarkably lowered within a week after surgical resection: but became lower 1. 5-2 years after surgery. There was no raise of GP73 in the patients with nonmalignant liver lesions.The GP73 levels of 4 of the 6 intra-hepatic cholangiocarcinoma patients were between those of the HCC patients and HBV carriers.Conclusion Serum GP73 has higher sensitivity and specificity in diagnosis of hepatitis B-related HCC than AFP，and it can become a new effective HCC tumor marker. Key words: Hepatitis B; Hepatocellular carcinoma; α-fetoprotein(AFP); Golgi glycoprotein 73(GP73); Serum tumor marker

[Treatment of unresectable pancreatic carcinoma by radiofrequency ablation with 'cool-tip needle': report of 18 cases].

Abstract: Objecfive To explore the effects of treatment of unresectable pancreatic tumors by radiofrequency ablation(RFA)with"cool-tip needle".Methods 18 patients with unresectable pancreatic tumors,8 with pancreatic head carcinoma and 10 with pancreatic body and tail carcinomas,12 males and 6females,aged 66.2,underwent RFA under laparotomy for 3 times and simultaneous infusion of iced normal saline.The clinical data were retrospectively analyzed.Results The level of CA19-9,a tumor marker,returned to normal after RF in 2 patients.Back pain was alleviated in 14 patients.B mode ultrasonography or CT examination showed decrease of tumor volume in 14 patients after RF.Pancreatic fistula occurred in 3 patients(16.7%)and then healed smoothly in 7～10 days with after routine abdominal drainage.The mortality was 22.2%(4/18).In the 4 death cases,tumors were all located in the pancreatic head;three patients died suddenly of massive gastrointestinal hemorrhage at Days 4,30,and 40 days postoperative respectivelyafter RF and the other patient died of acute renal failure at Day 2 postoperatiVedays after RF.8patients died 1～8 months after RF.After 51 months,1 patient still survived.Conclusion RFA is effective in relicving the back pain for in unresectable pancreatic tumor patientsis efficiently relieving the back pain.Standard use of cool-tip RFA is dangerous for pancreatic head tumor carcinoma close to portal vein,but safe for those located in the body and tail of the pancreas.Making the Infusion of icedcooling-water flow via a gastric tube into the duodenum and changing change of the parameters of the RF system can reduce the associated complications. Key words: Pancreatic neoplasms; Radiofrequeney ablation

Frequency and transcript variant analysis of gene fusions between TMPRSS2 and ETS transcription factor genes in prostate cancer

Abstract: Objective To investigate the frequencies and types of fusions between the transmembrane protease serine 2(TMPRSs2),ETS-related gene(ERG),ETS variant-1(ETV1),and ETS variant-4(ETV4)genes in prostate cancer(Pca)and significance thereof.Methods Biopsy samples of prostate were obtained under transrectal ultrasound(TRUS)from 32 Pca patients,aged(74 ± 8)and 34 patients with benign prostate hyperplasia(BPH).Nested RT-PCR and direct DNA sequencing were used to detect the fusion genes of TMPRSS2/ERG,TMPRSS2/ETV1,and TMPRSS2/ETV4.The association between the fusion-positive tumor rate and Gleason grading was analyzed.Results Of the 32 Pca patients,TMPRSS2/ERG fusion was detected in 17 cases(53.1%),including 5 variant fusion transcrips one of which was newly discovered with the GenBank accession number of EU090248.TMPRSS2/ETV1 fusion was detected in only 2 cases(6.3%),including one newly discovered variant fusion transcrips with the GenBank accession number of EU090249.TMPRSS2/ETW fusion was not detected.The positive rates of TMPRSS2/ERG and TMPRSS2/ETV1 fusions showed no statistical association with the Gleason grade(P=0.169).No fusion between the TMPRSS2 and ETS transcription factor genes was detected in the 34 BPH samples. Conclusion TMPRSS2/ERG and TMPRS22/ETV1 fusion genes with different subtypes exist in the tissues of Pca.TMPRSS2/ERG and TMPRSS2/ETV1 fusion genes may be used as diagnostic tools for Pca. Key words: Prostatic neoplasms; Gene fusion; Reverse transcriptase polymerase chain reaction: ETS:TMPRSS2

[Application of amplitude of low-frequency fluctuation to the temporal lobe epilepsy with bilateral hippocampal sclerosis: an fMRI study].

Abstract: Objective To study the changes of amplitude of low-frequency fluctuation (ALFF) of the resting-fMRI in the mesial temporal lobe epilepsy (mTLE) with bilateral hippocampal sclerosis ( HS) , and discussed its underlying neuro-pathophysiological mechanism. Methods The resting-fMRI data of 20 TLE patients with HS and 20 normal volunteers were performed ALFF analysis. The amplitude of the blood oxygenation level-dependent activation of the resting-state brain was investigated. The brain structures showing increased and decreased ALFF in TLE patients were demonstrated by comparing to normal subjects with 2-sample t-test with threshold of P <0. 01. Results By comparison with that of normal subjects, the regions showing increased and decreased ALFF in TLE patients were distributed in the brain symmetrically and bilaterally. The regions showing increased ALFF were distributed with center of limbic system, such as parahippocampal gyri, araygdale, hypothalamus, dorsal anterior cingulate gyrus and part of posterior insular lobe, as well as the neocortices such as primary sensorimotor cortices, occipital cortices, inferior temporal gyri, orbital gyri, and the subcortical structures of verbal brainstem and mesial cerebellum. The point with maximal increased ALFF(T = 6. 02) located in the right precentral gyru (15, -12,51). While the regions showing decreased ALFF covered the areas of default mode, such as posterior cingulate cortex/ precuneus and medial prefrontal cortex /ventral anterior cingulate cortex, as well as other structures such as dorsal lateral prefrontal corties, superior temporal gyri, caudate heads, dorsal brain stem and the posterior cerebellum (3, -78, -21) with the maximal decreased ALFF(T= -4.42). Conclusion The method of ALFF allows the direct observation to the epileptic activation in TIE. The increased ALFF is considered the facilitation such as the epileptic activity generation and propagation; while the ALFF decrease is considered the function inhibition in these regions, especially implies the suspension in the default mode activity. Key words: Magnetic resonance imaging; Epilepsy, temporal lobe; Hippocampus; Sclerosis

[Urachal mass in adults: clinical analysis of 33 cases].

Abstract: Objective To summarize the experience in diagnosis and treatment of urachal mass in adults. Methods The clinical data of 33 patients with urachal mass, 21 male and 12 females, aged 49 (30-75), were analyzed retrospectively. Results The urachal masses of 11 patients (33%, 11/33) were benign, including 5 cases of abscess, 3 of cyst, 2 of malacoplakia, and 1 of xanthogranuloma. The most common symptom of the benign urachal mass was abdominal mass (36%). Seven patients underwent computed tomography (CT) and no calcification was found. All 11 patients were treated successfully by mass excision. Twenty-two cases (67%) had urachal carcinomas, including 17 cases of adenocarcinoma, 4 of squamous carcinoma, and 1 of transitional cell carcinoma. The most common symptom was gross hematuria (68%) in the malignant urachal mass patients and CT showed calcification in 38% of them (5/13). The overall 5-year cancer-specific survival rate was 45.2%. Nine patients with localized cancer underwent extended partial cystectomy with a 5-year cancer-specific survival rate of 78.3%. The patients with metastatic urachal cancer underwent multimodal treatment with an objective response rate of 50% for chemotherapy and 25% for radiation therapy. The median survival time after metastasis of the 8 cases given multimodal treatment was 14.0 months, 7.5 months longer than that of the 4 cases untreated (6.5 months, P = 0.09). Conclusion The majority of urachal mass in adults is malignant. CT helps in distinguishing the benignancy from malignancy of urachal mass. Surgical excision affords good course for benign urachal mass. Extended partial cystectomy provides a curative surgical treatment for localized urachal cancer. The prognosis of metastatic urachal cancer is poor. Active multimodal treatment may improve the survival of patients with metastatic disease.

[Expression of microRNA-21 in invasive ductal carcinoma of the breast and its association with phosphatase and tensin homolog deleted from chromosome expression and clinicopathologic features].

Abstract: Objective To investigate the expression of microRNA-21 (mir-21) in invasive ductal carcinoma (IDC) of the breast and its association with phosphatase and tensin homologue deleted from chromosome (PTEN)-I0 protein expression and the clinicopathologic features of IDC. Methods Specimens of IDC and normal tissues more than 5 cm away from the tumor tissues were collected from 40 IDC patients, all female, aged 53 (35 -77). Stem-loop real-time RT-PCR was used to examine the mir-21 expression. Immunohistochemistry was used to examine the PTEN protein expression in the tumor tissue. The association of mir-21 expression with the PTEN expression and the clinicopathologic features of the breast IDC were analyzed. Results Compared with the nontumor control samples, the median (M) of relative expression of mir-21 (2-△△Ct) was 5. 770 (25th-75th percentile, 3. 605-7. 255) in the tumor samples, significantly higher than that of the nontumor control samples (set at 1. 000, P < 0. 001). Reduced PTEN protein expression was seen in 45% (18/22) of all cases. The expression of mir-21 was higher in the group of reduced PTEN expression (with an M of 6.800) than in the group of high PTEN expression (with an M of 4. 850, P =0. 013). The up-ragulated expression of mir-21 was positively correlated with the TNM clinical stage, lymph node positivity, and proliferation index (P = 0. 021, 0. 010, and 0. 030 respectively). Conclusion mir-21 plays an important role in the development and progression of breast cancer. PTEN is possibly one of the targets of mir-21. Key words: Breast neoplasms; MicroRNA; MicroRNA-21; PTEN phosphohydrolase

[Correlation between FoxP3(+) regulatory T cells and chronic obstructive pulmonary disease].

Abstract: Objective To investigate whether FoxP3(+) regulatory T cells (Treg) are present in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the correlation between Treg and COPD. Methods Peripheral blood samples were collected from 21 patients of AECOPD, 20 males and 1 female, aged (70 +/- 9) (52-85). Lymphocytes were isolated by three-color labeled three colors monoclonal antibodies flow cytometry to examine the quantities and percentages of CD4(+)CD25(+), CD4(+)CD25(+)FoxP3(+) (CD4(+)Treg), CD8(+)CD25(+), and CD8(+)CD25(+)FoxP3(+) (CD8(+)Treg). ELISA was used to detect the expression of transforming growth factor beta1 (TGF-beta1), interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-alpha). Middle correlation coefficient r> or = 0.3 was analysed and discussed. Results The percentages of CD4(+)CD25(+), CD4(+)Treg, CD8(+)CD25(+), and CD8(+)Treg in AECOPD were (18 +/- 6)%, (19 +/- 13)%, (5 +/- 4)%, and (12 +/- 10)% respectively. Linear correlation analysis indicated that the quantity and percentage of Treg were significantly correlated with age, course of disease, smoking index, quantity of white cells, and blood pH, and there were complex causal relations between the immunity of patients and these factors. However, TGF-beta1 and IL-10 showed no correlation with Treg. Conclusion CD4(+)Treg and CD8(+)Treg are expressed in the peripheral blood of AECOPD patients and contribute to the immune suppression of these patients, so they can be used as new markers of immunity of these patients.

Feasibility of establishment of rat model of bone cancer pain by using Walker 256 cells cultured in vitro or in vivo

Abstract: Objective To investigate the possibility of establishing rat model of bone cancer pain using cancer cells cultured in vitro or by ascites passaging and verify the reliability of this method.Methods Syngeneic SD rat carcinoma cells of the line Walker 256 were cultured in vitro and inoculated into the peritoneal cavity of SD rats respectively.Two kinds of Walker 256 cell suspension were made.Thirty-two SD rats were randomly divided into 4 equal groups:Group N(undergoing injection of Hank's solution into cavitas medullaris of left tibia),Group K(undergoing injection of heat-killed Walker 256 cells),Group V (injected with Walker 256 cells cultured in vitro),and Group A(injected with Walker 256 cells passaged in ascites). After 6,12,and 18 days,the rats underwent roentgenography. Radio nuclide emission computed tomography(ECT)was conducted 12 days later.And MRI was conducted 15 days later.Thermal withdrawal latency(TWL)and pressure withdrawal threshold(PWT)were measured.Von Frey threshold and weight bearing of left hind limb were examined. On the 18th day after the establishment of model the rats were killed with their left tibia taken out to undergo microscopy.Results The rats of Groups A and V began to display decrease of left hint limb activity and roentgenography showed minute defect of bone trabecula in the proximal epiphysis by day 6.By day 12 roentgenography showed multiple defect of bone trabecula,ECT showed reactive bone formation.The rats of Groups A and V displayed signs of weight loss by day 14,and by day 18 roentgenography showed full thickness bicortieal bone loss and formation of soft tissue tumor.Histological examination 18 days later revealed that the bones inoculated with live cells showed infiltration of bone marrow spaces by malignant tumor.The PWT values gradually decreased since day 6 to day 18,and the PWT values in this period of Groups A and V were all significantly lower than those of Groups K and N ( a11 P＜0.01).The von Frey values gradually decreased since day 6 to day 18,and the yon Frey valties in this period of Groups A and V were all significantly lower than those of Groups K and N(all P＜0.01).The weight bearing value of left hind limb gradually decreased and the weight bearing difference between the 2 hind limbs gradually increased since day 6 to day 18,and the values of weight bearing difference between the 2 hind limbs of Groups A and V were significantly higher than those of Groups K and N(all P＜0.01).Sixteen rats underwent subcutaneous injection of morphine,and the PWT values increased 20,30,and 40 min later in a dose-dependent manner(P＜0.01).Naloxone injected 1 h later antagonized the analgesic effect of morphine.Condusion A SD rat model of bone cancer pain has been successfully established by using syngeneic rat bone carcinoma cells cultured in vitro or in vivo,and the latter being more convenient. Key words: Models,animal; Rats; Ascites; Vaccination; Pain; Tibia

[A highly sensitive enzyme-linked immunosorbent assay for measurement of leptin secretion in human adipocytes].

Abstract: Objective To establish a highly sensitive and specific ELISA method for measurement of leptin and further to study the secretion of leptin during human preadipecytes difierentiation and effects of troglitazone.Methods Rabbits Balb/c mice were immunized by recombinant human leptin and Balb/e mice were immunized by human leptin so as to produce rabbit anti-human leptin polyclonal antibodies(PAb) and mouse anti-human leptin monoclonal antibodies(MAb).Combination of the PAb as coating antibody,with a carefully paired biotinylated MAb as detector.and the avidin.horseradish peroxidase as the amplifier of detecting signals,a sandwich method,biotin-avidin ELISA(BA-ELISA)was established.Human omental preadipocytes were cultured,introduced to difierentiate,and treated with 10μmoL/L troglitazone;the leptin secretion in the supernatant was detected by BA-ELISA.Peripheral blood samples were collected from 114 healthy persons and the serum leptin was detected by BA-ELISA.Results The sensitivity of BA-ELISA was 0.03.s/ml with a working range of 0.05-5 ng/ml and a exogenous leptin recovery rate of 97.8%.and the intra-and interassay coefficients of variation(CVs)were less than 7.4%and 9.3% respectively.The assay detected only a single free leptin peak in gel chromatographic fractions from the mixed human sera or adipecytes culture media.The leptin secretion level detect 5ed bv BA-ELISA showed that the leptin secretion of the preadipocytes increased strongly when the cells difierentiated into mature adipocytes.The Deak leptin secretion level of the tmglitazone treated group waft 2 times as that of the control group.The leptin concentration of women was than 7.6 ng/ml,significantly higher than that of the men (3.2 ns/ml,P<0.001),and the serum leptin level was significantly correlated with body mass index both for men(r=0.67,P<0.001)and forwomen(r=0.61,P<0.001).Conclusion A highly sensitive BA-ELISA specific for free leptin has been developed that is especially suited for the accurate measurement of the rather low 1eptin levels of clinical blood specimens and for basic research use. Key words: Leptin; Antibody monoelonal; Enzyme-linked immunosorbent assay; Adipocytes

[Nummular headache: 21 new cases and therapeutic results].

Abstract: Objective To evaluate the clinical feature of nummular headache and the efficiency of treatment in China. Methods The data of 21 NH patients treated from February 2006 to February 2008,were aralyzed. Results They were 9 men, 12 women, aged 37±12 (18-63) years. Headache history ranged from 7 days to 30 years. 13 patients reported head pain confined to a circular area of 0.6 to 5 centimeter, and the other 8 patients had pain in an elliptical area of 1 -2 centimeter × 1.5 -3 centimeter.The symptomatic area was located in the parietal (n = 7), occipital (n = 8), temporal (n = 6), or border regions between temporal and parietal(n = 1). The right side was affected in 10 patients and the left side in the 9 patients, the middle of occipital and parietal areas were affected in 1 patient, respectively. Seven patients had mild pain, 8 patients had moderate pain and 6 patients had severe palm The characteristics of headache included stabbing pain (n = 6), sharp pain (n = 3), pulsating apin (n = 3), grinding pain (n =1) ,exploding pain(n =5), included light -dull apin (n = 3). Three patients were treated by local nerve block with lidocaine plus dexamethasone phosphate/acetate and one of them got some 30 hours of prominent pain relief, no relief was obtained for other two patients. One patient obtained pain remission by acupuncture after amitriptyline, paroxetine had been tried ineffectively. One patient, woman, 38 years old, was treated by carbamazepine (tegretol) and amitriptyline for 3 months and pain relief was obtained gradually and the head pain disappeared finally. 8 patients were treated effectively by amitripline combining indomethacium ,ibuprofen or carbamazepine. One patient was treated effectively by nimodipime. 2 patients were treatedineffectively by amitripline combining indomethacium. 4 patients were not treated. 3 patients were lost to follow-up. Conclusion NH is not very rare and some of NH patients may be treated effectively by acupuncture or amitripline combining indomethacium, ibuprofen or carbamazepine. Key words: Nummular headache; Mechanism of pathology; Diagnosis ; Treatment

[Effect of emergency care simulator combined with problem-based learning in teaching of cardiopulmonary resuscitation].

Abstract: Objective To evaluate the teaching effects of emergency care simulator ( ECS) combined with problem-based learning ( PBL) in teaching of cardiopulmonary resuscitation ( CPR) . Methods 42 medical students were randomly divided into 2 equal groups, control group receiving PBL and training of specific operation such as artificial respiration, external cardiac compression, tracheal intubation, and defibrillation, and ECS group receiving ECS training in addition. Then test was given to record the scores in artificial respiration. A questionnaire survey was conducted to collect the feedback. Results There were no significant differences in the scores of artificial respiration, external cardiac compression, tracheal intubation, and defibrillation between the 2 groups (all P > 0. 05 ) . There were significant differences between the Control group and the ECS group (P < 0. 05 ) The percentages of students with enhanced emergency awareness、 emergency skill, team spirit and cooperative effort, with improved analytic skill in clinical setting and in amalgamating the theoretic learning with textbook knowledge and clinical practice were all higher in the ECS group than in the control group (all P<0. 05). More than 86% of the students considered that there was significant difference between these two groups. Conclusion Using ECS combined with PBL in teaching CPR technique directly involves the medical students in " emergency practice" , resolving of " all sorts of problems" , enhancing emergency awareness, and emergency skill. It can improve teaching quality significantly that is in accordance with the development of modern medicine. Key words: Anesthesiology; Teaching methods; Simulate education

[Effects of enteral nutrition supplemented with glutamine and arginine on gut barrier in patients with severe acute pancreatitis: a prospective randomized controlled trial].

Abstract: Objective To investigate the effects of continuous early enteral nutrition (EEN) supplemented with glutamine and arginine on gut barrier function in patients with severe acute pancreatitis (SAP). Methods Thirty two patients with a diagnosis of acute pancreatitis predicted to develop severe disease were randomized into 2 groups: EEN group (n = 18) and EEN + glut-mine and arginine group (enteral immunonutrition group, n = 14). EEN was initiated when homeostasis was achieved within 72 hours after attack, and both group received isocaloric isonitrogenoas nutrition. Glutamine and arginine were administered into jejunum in the enteral immunonutrition group. Serum amylase, plasma diamine oxidase (DAO), C-reactive protein (CRP), plasma endotoxin, urinary excretion of lactulose (L), and mannitol (M) were measured, and APACHE-Ⅱ scores were recorded on days 1, 7, and 14. Complications, and length and cost of hospitalization were recorded as well. Results EEN and enteral immunonutrition were both tolerated well. There was no difference in APACHE-Ⅱ score between the two groups(P ＞ 0.05). The DAO, CliP, plasma endotoxin, and urinary L/M levels decreased with the course of SAP. However, the plasma endotoxin and urinary L/M on day 7 of the enteral immunonutrition group were (10.0 ± 3.8) EU/ml and 0.29 ± 0.15 respectively, both significantly higher than those of the EEN group [ (7.9 ± 2.8) EU/ml and 0. 16±0.08 respectively, both P＜0.05]. The length of hospital stay and cost showed no differences between the two groups. Conclusion EEN is safe and feasible in treatment of SAP. Enteral immunonutrition containing glutamine and arginine improves the gut barrier function by reducing the gut permeability and decreasing plasma endotoxin level in the early stage of SAP. Key words: Pancreatitis, acute necrotizing; Enteral nutrition; Glutamine; Arginine

[Effects of sulfur dioxide, on the proliferation and apoptosis of aorta smooth muscle cells in hypertension: experiments with rats].

Abstract: Objective To explore the effects of sulfur dioxide (SO2) on the proliferation and apoptosis of aorta smooth muscle cells in hypertension ratsand possible mechanism thereof. Methods Sixteen 4-week-old male spontaneously hypertensive rats (SHRs) were randomly divided into 2 equal groups:control and Na2SO3/NaHSO3 (a SO2 donor ) -treated group. Eight 4-week-old male WKY (Wistar Kyoto) rats were assigned for normal control group. Five weeks later, the pressure was measured. The rat aortas were dyed with Hart's method. The morphometric parameters were calculated by Leica workstation.The plasma level of SO2 was determined by HPLC method. VSMC apoptosis was measured by TUNEL technique. The expression levels of proliferating cell nuclear antigen ( PCNA), Bcl-2, Fas and caspase-3were detected by immunohistochemical assay. Results ( 1 ) Compared with those of the WKY rats, the blood pressure, ratio of media to lumen radius, and proliferation index (PI) of the SHRswere increased [(172 ± 10)mm Hg vs (112 ± 9)mmHg,0.073 ± 0.004 vs 0.057 ± 0.004,0.32 ± 0.06 vs0.05 ±0.03, respectively], but the plasma level of SO2 and the apoptosis index (AI) were decreased in the SHRs [(6.4 ± 1.5)μmoL/L vs (11.3 + 1.0)μmol/L, 0.16 ± 0.07 vs 0.30 ± 0.19, respectively]. The expression of Bcl-2 was increased (0. 209 ±0. 007 vs 0. 202 ± 0. 006), and the expression levels of Fas and caspase-3 of SHRs were both lower than those of the WKY rats (0.205 ±0. 006 vs 0. 211±0.005, 0.229 ± 0. 005 vs 0. 244 ± 0. 010, respectively). (2) Compared with the SHR control group, the systolic blood and the ratio of media to lumen radius were decreased [ (128 ± 7)mm Hg,0. 066 ± 0. 002,respectively], but the plasma level of SO2 was increased [ (8.3 ± 1 ) μmol/L] for the SHR + Na2SO3/NaHSO3 group. Plwas lower (0. 14 ± 0.03) and Al was higher (0.40 ± 0. 11) in SHR + Na2SO3/NaHSO3 group than those in SHR control group. The expression of Bel-2 of VSMCs was down-regulated (0.199 ± 0. 006), but the levels of Fas and caspase-3 were up-regulated (0.218 ± 0. 003 and 0.251 ± 0.011respectively) in the SHR + Na2SO3/NaHSO3 group. Conclusion SO2 may attenuate the structural remodeling through reducing the proliferation and enhancing the apoptosis of smooth muscle cells in SHRs.SO2 may modulate the process of apoptosis possibly through the downward regulation of the level of Bcl-2 and enhance the expression of Fas and caspase-3. Key words: Sulfur dioxide; Hypertension; Aorta; Cell proliferation; Apoptosis

[Spinal navigation with intra-operative 3D-imaging modality in lumbar pedicle screw fixation].

Abstract: Objective To evaluate the efficacy and Bafety of spinal navigation with intra-operative 3D-imasing madality in lumbar pedicle screw fixation.Methods 401 patients with lumbar degenerativedisorders or fracture were randomly divided into 2 groups:Group A,undergoing pedicle screw fixation by spinal navigation with inca-operative 3D-imaging system,and Group B undergoing pedicle screw fixation by traditional method.The position of pedicle screw was assessed by intr-operative 3D-imaging system.Theexcellent rate of pedicle screw position,mean time of pedicle Screw implantation,operating time,blood loss,and post-operative complication were compared.Results The excellent rate of pedicle screw position was higher Group A wag 95.3%,significantly higher than that of Group B(84.1%,P＜0.001).The mean time of pedicle screw implantation and operating time of Group A were(3.70±0.65)min,significantly shorter than that of Group B[(7.83±2.32)min,P＜0.1301].The blood loss amount ofGroup A was(272±153) ml,significantly less than that of Group B[(455±289)ml,P＜0.05].However,the total operating time of Group A Was(134±48)min,not significantly different from that of Group B[(179 ±62)min,P＞0.05].Conclusion With spinal navigation combined with the intra-operative 3D-imaging modality,implantation of lumbar pedicle screw is more simplified,more accurate,safer,and with shorter operating time. Key words: Spinal diseases; Therapy,computer-assisted; Imaging,three-dimension

[Effects of hydrogen sulfide on vascular inflammation in pulmonary hypertension induced by high pulmonary blood flow: experiment with rats].

Abstract: OBJECTIVE To investigate the effects of hydrogen sulfide (H2S) on vascular inflammation in pulmonary hypertension induced by high pulmonary blood flow. METHODS Forty-four male SD rats were randomly divided into 8 groups: 4-week control group (n = 7), 4-week shunt group (n = 7), 4-week shunt + propargylglycine (PPG, an endogenous H2S release inhibitor) intraperitoneal injection group (n = 8), 11-week control group (n = 7), 11-week shunt group (n = 7), and 11-week shunt + sodium hydrosulfide (NaHS, a H2S donor) intraperitoneal injection group (n = 8). Right ventricular catheterization was used to measure the mean pulmonary arterial pressure (mPAP). Immunohistochemistry was used to detect the expression of inflammatory related factor intercellular adhesion molecule-1 (ICAM-1), and the key molecules of nuclear factor-kappaB (NF-kappaB) signal transduction pathway, including NF-kappaB p65 and inhibitor of NF-kappaB (IkappaBalpha), in the pulmonary artery, and ELISA was used to detect the concentrations of the inflammatory related factors, including ICAM-1, interleukin-8 (IL-8), and monocyte chemoattractant protein-1 (MCP-1) in blood plasma and lung tissues so as to reflect the corresponding inflammatory responsiveness. RESULTS The plasma and lung tissue ICAM-1, IL-8 and MCP-1 contents of the 4-week shunt group were all significantly higher than those of the 4-week control group (P < 0.05 or P < 0.01). The mPAP of the 4 week shunt + PPG group was (20.3 +/- 1.7) mm Hg, significantly higher than that of the 4-week shunt group [(16.2 +/- 1.5) mm Hg, P < 0.01]. The expression levels of ICAM-1 and NF-kappaB p65 in the small and median pulmonary artery endothelin cells of the 4-week shunt + PPG group were both significantly stronger than those of the 4-week shunt group (P < 0.05 or P < 0.01), whereas the expression of IkappaBalpha was weaker than that of the 4-week shunt group (P < 0.05). The plasma IL-8 content of the 4-week shunt + PPG group was (148 +/- 29) micromol/L, significantly higher than that of the 4 week-shunt group [(118 +/- 23) micromol/L, P < 0.05], and the lung tissue ICAM-1 and MCP-1 levels of the 4-week shunt + PPG group were (27.3 +/- 5.0) micromol/g and (12.9 +/- 1.1) micromol/g respectively, both significantly higher than those of the 4-week shunt group [(21.9 +/- 2.1) and (10.2 +/- 1.4) micromol/g respectively, both P < 0.05]. The mPAP and expression levels of ICAM-1 and NF-kappaB p65 of the large, median, and small pulmonary artery endothelia cells of the 11-week shunt group were all higher than those of the 11-week control group (P < 0.05 or P < 0.01), whereas the expression levels of IkappaBalpha were all less obvious (P < 0.05 or P < 0.01). The plasma and lung tissue ICAM-1, IL-8, and MCP-1 levels of the 11-week shunt group were all significantly higher than those of the 11-week control group (all P < 0.01). The mPAP of the 11 week shunt + NaHS group was (23.2 +/- 3.0) mm Hg, significantly lower than that of the 11-week shunt group [(27.5 +/- 1.9) mm Hg, P < 0.05]. The ICAM-1 and NF-kappaB p65 expression levels of large, median, and small pulmonary artery endothelia cells of the 11-week shunt + NaHS group were all significantly weaker than those of the 11-week shunt group (P < 0.05 or P < 0.01), whereas the protein expression levels of IkappaBalpha in small and median pulmonary artery endothelia cells of the 11-week shunt + NaHS group were significantly higher than those of the 11-week shunt group (both P < 0.05). The plasma and lung tissue ICAM-1 contents of the 11-week shunt + NaHS group were (124 +/- 11) micromol/L and (19.9 +/- 2.5) micromol/g, both significantly lower than those of the 11-week shunt group [(154 +/- 20) micromol/L and (23.9 +/- 3.6) micromol/g respectively, both P < 0.01]. The plasma and lung tissue IL-8 contents of the 11-week shunt + NaHS group were (92 +/- 11) micromol/L and (15.0 +/- 1.7) micromol/g, both significantly lower than those of the 11-week shunt group [(121 +/- 17) micromol/L and (19.0 +/- 3.9) micromol/g respectively, both P < 0.01]. The lung tissue MCP-1 content of the 11-week shunt + NaHS group was (10.8 +/- 1.6) micromol/g, significantly lower than that of the 11-week shunt group [(13.5 +/- 1.4) micromol/g, P < 0.01]. CONCLUSION H2S attenuates the development of pulmonary hypertension induced by high pulmonary blood flow through ameliorating pulmonary vascular inflammation. The inhibitory effect of H2S on the pulmonary vascular inflammation involves elevating IkappaBalpha expression, down-regulating NF-kappaB p65 expression and then inhibiting the expression of inflammatory related factors.

Diagnosis of inborn errors of metabolism using tandem mass spectrometry and gas chromatography mass spectrometry

Abstract: Objective To investigate the effects of tandem mass spectrometry (MS/MS) combined with gas chromatography mass spectrometry (GC-MS) in the diagnosis of inborn errors of metabolism in children. Methods Amino acids and acylcarnitines in the dry blood filter papers were tested by MS/MS, and the organic acid profiles in urea were tested by GC-MS among 4981 children suspected to be with inborn errors of metabolism from more than 100 hospitals in China. A few pediatric patients underwent analysis of activity of enzyme and gene mutation analysis too. Results 319 of the 4981 children (6.4%) were diagnosed as with 24 kinds of diseases: 155 of the 319 cases (48.6%) with 8 kinds of amino acid diseases (97 with hyperphenylalaninemia, 14 with maple syrup urine disease 13 with ornithine transcarbamylase deficiency, 13 with citrullinemia type Ⅱ, 10 with tyrosinemia type Ⅰ , 5 with citrullinemia type Ⅰ ,2 with homocystinuria, and 1 with arginasemia) ; 150 of the 319 cases (47.0%) were diagnosed as with 10 kinds of organic acidemias (81 with methylmalonic acidemia, 17 with propionic acidemia, 17 with multiple CoA carboxylase deficiency, 11 with glutaric acidemia type Ⅱ, 8 with isovaleric acidemia, 6 with β-keto thiolase deficiency, 5 with 3-methylcrotonyl-CoA carboxylase deficiency, and 3 with 3-hydroxy-3-methylglutaryl-CoA lyase deficiency) ; 14 cases (4.4%) were diagnosed as with 6 kinds of fatty acid disorders (5 with medium chain acyl-CoA dehydrogenase deficiency, 3 with very long chain acyl CoA dehydrogenase deficiency, 2 with short chain acyl-CoA dehydrogenase deficiency, 2 with multiple acyl-CoA dehydrogenase deficiency, 1 with carnitine palmitoyl transferase type Ⅱ , and 1 with carnitine palmitoyl transferase type Ⅰ ). Conclusion MS/MS is specific for amino acid diseases and fatty acid disorders. GC-MS is specific for detect organic acidemias. And the diagnoses of part of amino acid diseases need the combination of both methods. Key words: Tandem mass spectrometry; Gas chromatography-mass spectrometry; Amino acid; Inborn errors of metabolism

Mechanism of hepatic stellate cell migration during liver fibrosis

Abstract: Objective To study the mechanism of migration of hepatic stellate cells (HSCs) within the space of Disse microenvironment during liver fibrosis, and to explore the novel pathogenesis of liver fibrosis from the view of cell migration. Methods Human HSCs of the line LX2-HSC were cultured. A modified in vitro Boyden chamber system was used to partially mimic the microenvironment of Disse space of normal basement membrane like matrix or that in fibrosis. HSCs were put in the upper chamber, and transforming growth factor (TGF)-beta1, plate-derived growth factor (PDGF)-BB, epidermal growth factor (EGF), vascular epithelial growth factor (VEGF), bfibroblast growth factor (bFGF), and collagen type I or type IV were put into the lower chamber. Four hours later cell migration assay was conducted. HSCs were put into 6-well plate and then added with TGF-beta1, PDGF-BB, EGF, VEGF, bFGF, and collagen type I or type IV, zymography was used to examine the activity of matrix metalloproteinases 2 and 9. SDS-gel immunoblotting was used too. Results Stimulation of HSCs with PDGF-BB, TGF-beta1, and/or EGF resulted in an increase in their migratory capacity and up-regulated MMP-2 activity. And the increase of MMP-2 could enhance Migration of HSC by 4.9-fold. The migration of HSCs (3.2-fold) was induced by type I collagen and inhibited by type IV collagen (1.2-fold). Migration induced by PDGF-BB, TGF-beta1, and collagen I could be inhibited by alpha1- and/or alpha2-integrin blocking antibodies. Conclusion In liver fibrosis, alterations within the space of Disse microenvironment facilitate the migration of HSCs; the mechanism is associated with up-regulation of MMP-2 and with mediation of alpha1beta1 and alpha2beta1 integrins. Extracellular matrix by it self shows feedback actions to migration of HSCs.

[Genetic characteristics of familial type 2 diabetes pedigrees: a preliminary analysis of 4468 persons from 715 pedigrees].

Abstract: Obiective To analyze the inheritance character of type 2 diabetes mellitus(T2DM)pedigrees.Methods 4468 persons from 715 T2DM pedigrees(including the spouses)undergo peripheral blood sample collection to examine blood sugar and physical examination.Questionnaire survey was conducted to explore the family history.Type 1 DM and maturity-onset DM of young people were to be ruled out.Pedigree chart were made.Results The prevalence rates of 12 DM and impaired glucose regulation(IGR)wsa 47.62%,including 218 T2DM and 422 IGR newly discovered.The prevalence rates of T2DM and IGR were 38.33% and 14.25% in the siblings,and 56.81% and 12.58% in the parents,all significantly higher than those in the second-degree relatives(9.55% and 6.10%)and spouses(10.57% and 9.55% respectively,all P＜0.01).The prevalence and newly discovered rates of IGR in the offspring were 12.46% and 11.73% respectively,both significantly higher than those in the spouses(9.55% and 9.55% respectively,all P＜0.01).Conclusion There is significant familial aggregation in T2DM.The first-degree relatives of T2DM patients are high risk populations,so long term monitoring and early screening should be performed. Key words: Diabetes mellitus,type 2; Prevalence; Pedigree

[Effectiveness and safety of proton pump inhibitor and levofloxacin based first-line triple therapy in the eradication of Helicobacter pylori: a meta-analysis].

Abstract: Objective To evaluate the effectiveness and safety of the proton pump inhibitor and levofloxacin based first-hne triple therapy in the eradication of Helicobacter pylori (Hp). Methods Correlated randomized controlled clinical trials (RCTs) evaluating the effectiveness and safety of proton pump inhibitor and levofloxacin based first-line triple therapy to eradicate Hp were searched in Medline, Embase, OVID, Cochrane Library, Clinical evidence online, Socolar searching platform, and National Knowledge Infrastructure (1994 -2008) . The final searching date was 17 May 2008. The quality of trials was assessed according to the Jadad standard. Effective model for calculation was selected according to statistical heterogeneity between the trials evaluated by Stata 9.0. Egger regression model and trim-and-fill method were utilized to evaluate publication bias, and trim and fill method was employed to estimate the outcomes of the articles unpublished. Results Eleven RCTs including 1926 cases were selected for analysis in accordance with the enrollment criteria. As the first line treatment, proton pump inhibitor and levofloxacin based triple therapy was more effective than standard triple therapy (total OR = 1.56, 95% CI = 1.25 - 1.94, P=0.000), had lower side effect rate than standard triple therapy (total OR =0.57, 95% CI = 0.44 - 0.74, P = 0.000), and there was no significant difference in the compliance with the two therapies (totalOR =0.72, 95%CI=0.34-1.49, P =0.374). Conclusion Proton pump inhibitor and levofloxacin based triple therapy is effective in the eradication of Hp, and should be advocated to be the first- line regime in the treatment of Hp. Key words: Ofloxacin; Helicobacter pylori; Meta-analysis

Prevention and treatment of hepatitis B recurrence after liver transplantation

Abstract: Objective To investigate the effect of the regimen of lamivudine(LAM)combined with hepatitis B immunoglobulin(HBIG)in prevention and treatment of re-infection of hepatitis B virus ( HBV) and recurrence of hepatitis B after orthotopic liver transplantation(OLT)for HBV related end stage liver diseaseMethods The clinical data of 183 adult liver transplantation patients who lived more than 6 months and were followed up for 146 months with complete data were studied retrospectivelyAccording to the HBV prevention strategy,these recipients were divided into two groups:group of pure IAM(n=106) and group of LAM plus intramuscular injection of low dose HBIG(n=77)Results The rate of HBsAg negative conversion 1 week after OLT of the LAM group was 8210%(87/106)significantly lower than that of the LAM + HBIG group [9481%(73/77),P=0010 ]The rates of HBV reinfection,HB recurrence,and YMDD mutation of the lamivudine group were 1698%(18/106),1132%(12/106),and 849%(9/106)respectively,all significantly higher than those of the JJAM+HBIG group[649%(5/77),260%(2/77),and 130%(1/77)respectively,P=0035,0028,and 0035 respectively]All the patients with YMDD mutation were treated with adefovir(ADF)with improvementAnalysis showed no obvious difference in the effect of LAM given intramuscularly or intravenouslyConelusion The protocol of combination of LAM and HBIG is highly effective,safe,and cost-effective in preventing the recurrence of HBV after OLTYMDD mutation can be treated by ADF with satisfactory results Key words: Liver transplantation; HBV infection; Lamivudine; Hepatitis B Immunoglobulin

Effects of sulfur dioxide on cardiac function of isolated perfusion heart of rat

Abstract: OBJECTIVE To observe the effects of sulfur dioxide (SO2) on cardiac function of isolated perfused heart of rat and to explore the physiological regulation of endogenous SO2 on myocardial action. METHODS The hearts of 64 Wistar rats were isolated, perfused with Krebs-Henseleit (KH) solution through Langendorff apparatus, and randomly divided into 8 equal groups: Four groups underwent perfusion of SO2 of the concentrations 1, 10, 100, 1000 micromol/L respectively for 5 min and then perfused with KH solution for 15 min. Eight hearts underwent perfusion of SO2 of the physiological concentration (10 micromol/L) for 20 min. The control group underwent perfusion of KH solution for 20 min. Eight hearts of the nicardipine group underwent perfusion of nicardipine, a L-type calcium channel blocker, 2.5 micromol/L for 5 min, SO2 10 micromol/L for 5 min, and then KH solution for 10 min. The heart in the hydroxamate (HDX) group underwent perfusion of HDX, an inhibitor of SO2 endogenous generating enzymes, for 5 min, and then perfused by KH solution for 15 min. The heart rate (HR), difference of left ventricular pressure (LVP), left ventricular peak rate of contraction (+ dp/dtmax), peak rate of relaxation (- dp/dtmax), and coronary flow (CF) were measured. Then transmission electron microscopy was conducted. RESULTS SO2 concentration-dependently inhibited the left ventricular +/- dp/dtmax, LVP, HR, and CF (all P < 0.01). The left ventricular +/- dp/dtmax, LVP, and HR were inhibited (P < 0.05) by the physiological concentration (10 micromol/L) SO2 donor continuous perfusion for 20 min. During perfusion 20 min, the LVP, + dp/dtmax, - dp/dtmax, and HR after perfusion for 20 min of the physiological concentration (10 micromol/L) SO2 donor continuous perfusion group were (15 +/- 3) mm Hg, (485 +/- 74) mm Hg/s, (339 +/- 64) mm Hg/s, and (114 +/- 26)/min respectively, all significantly lower than those 5 min after perfusion [(23 +/- 7) mm Hg, (595 +/- 93)mm Hg/s, (436 +/- 83) mm Hg/s, and (159 +/- 31)/min, all P < 0.05]. The LVP, + dp/ dtmax, -dp/dtmax, and HR of the nicardipine group were(37 +/- l0)mm Hg, (1025 +/- 287)mm Hg/s, (570 +/- 181)mm Hg/s, and (139 +/- 48)/min respectively, all not significantly different from those of the control group. The LVP, + dp/dtmax, - dp/dtmax, and CF after perfusion of the HDX group were (50 +/- 11)mm Hg, (1167 +/- 270) mm Hg/s, (889 +/- 72) mm Hg/s, and (6.3 +/- 1.9) ml/min respectively, all significantly lower than those before perfusion [(69 +/- 16) mm Hg, (1579 +/- 315) mm Hg/s, (1186 +/- 263) mm Hg/s, and (9.5 +/- 1.3) ml/min, all P < 0.05]. CONCLUSION Exogenous SO2 has negative inotropic effect on myocardium. by the mechanism related to voltage-gated calcium channel. Nicardipine blocks the inhibitory effect of SO2 at physiological concentration.

A clinical trial of using antiplatelet therapy to prevent restenosis following peripheral artery angioplasty and stenting

Abstract: Objective To evaluate the clinical effect and restenosis rate of antiplatelet therapy following peripheral artery angioplasty and stenting.Methods After successful placement of peripheral artery stents to 103 patients with peripheral arterial occlusive disease(PAOD)in were randomized assigned to 2 groups:antiplatelet therapy group receiving clopidogrel 75 mg plus aspirin 100 mg(n=56)and control group(n=47)receiving anticoagnlation therapy low molecular weight heparin(LWMH)for 7 d plus longterm warfarin.The patients were f01lowed up 1 day,and 1,6,12,and 18 months after the operation to undergo color Doppler uhrasonography,and examinations of blood routine,bleeding time,coagulation time,and ankle-brachial Index.The primary endpoint events included major bleeding rate.and composite rate of restenosis and reocclusion.The secondary endpoint events included cardiovascular events,death,and adverse drug reaction.Results There were no significant differences in the baseline data between these two groups.The thrombotic occlusion rate was 1.8% in the antiplatelet group and 0% in control group.and the restenosis rate was 14.3% in the antiplatelet group and 25.5% in control group(both P＞0.05).The bleeding complication rate of the antiplatelet group was 1.8%.significantly lower than that of the anticoagulation group(19.1%,P＜0.01).There were not significant difierences in cardiovaseular event rate and mortality 18 months after operation between these two groups.Conclusion Antiplatelet therapy combined with clopidogrel plus aspirin is effective and safe in preventing restenosis following peripheral artery angioplasty and stenting. Key words: Stents; Catheterization,peripheral; Thrombosis

[Relationship between blood glucose variability and microalbuminuria in type 2 diabetic patients with well-controlled glycosylated hemoglobin].

Abstract: Objective To investigate the relationship between the blood glucose variability and microalbuminuria (MAU) in type 2 diabetic patients with well-controlled glycosylated hemoglobin (HbAlc) and the influencing factors of blood glucose variability. Methods One hundred and seventy-six type 2 diabetic patients with HbAlc under 6.5% and 48 subjects with normal glucose regulation were monitored using the continuous glucose monitoring system (CGMS). The mean blood glucose (MBG) and mean amplitude of glucose excursions(MAGE) were analyzed. Results ( 1 ) The MBG and MAGE levels of type 2 diabetic patients were (7.0±0.9) and (3.8±2.5) mmol/L respectively, both higher than those of the subjects with normal glucose regulation [ (5.4±0.6) and (2.0±0.7) mmol/L respectively, both P< 0.01]. (2)The incidence ratio of MAU of the patients with ascended SAGE level was 18.7%, significantly higher of those with normal MAGE (7.1%, P<0.05). (3) The SAGE level was positively correlated with age, duration of diabetes, and systolic blood pressure, and negatively correlated with glomerular fdtration rate and the levels of fasting and postprandial C-peptide. Multivariant regression analyses indicated that duration of diabetes and the level of postprandial C-peptide 30 min after meal were the independent influential factors of MAGE. (4) In the type 2 diabetic patients, the MAGE of the MAU group was higher than that of the non-MAU group (P<0.05). Logistic regression analyses indicated that diastolic blood pressure and MAGE were the risk factors of MAU (OR=1.201 and 1.357, both P<0.05). Conclusion In weB-controlled patients with type 2 diabetes, blood glucose variability is one of the risk factors for MAU, duration of diabetes and early stage of insulin secretion function are the main factors influencing glycemic variability. Key words: Diabetes mellitus, type 2; Albuminuria; Continuous glucose monitoring

A pilot study on diagnosing laryngopharyngeal reflux disease by pH monitoring in laryngopharynx

Abstract: Objective To analyze the significance of pH monitoring and reflux symptom index (RSI) in the diagnosis of laryngopharyngeal reflux disease (LPRD) and the characteristics of LPRD in symptoms and pH monitoring. Methods RSI questionnaire survey and laryngopharyngeal pH monitoring were conducted on. 31 patients with laryngopharyngeal reflux-related symptoms, 15 males aged (50 +/- 13) years and 16 females aged (48 +/- 11) years, Gastroscopy was conducted on 13 patients to detect reflux esophagitis. The patients with the RSI scores > or = 13 were suspected as with LPRD and those with the reflux times > or = 7 or reflux area index (RAI) > or = 6.3 were diagnosed as with LPRD. McNemar test and Kappa test were performed on the RSI scores and reflux area indexes. Results Seventeen patients met the pH criteria. There were 8 patients suffering from voice disorders, 17 from clearing throat, 13 from excess throat mucus, 11 from dysphagia, 9 from cough after eating or with supine posture, 9 from dyspnea, 13 from cough, 12 from foreign body sensation, and 14 from digestive symptoms with the foregoing symptoms' mean scores of 1.4, 3.1, 2.1, 2.0, 1.1, 1.6, 1.8, 2.9, and 2.9 respectively. The P value with McNemar test on pH monitoring and RSI scoring was 0.289, and the P value with kappa test was 0.007. RSI was correlated with RAI(r(s) = 0.302, P = 0.049), reflux time (r(s) = 0.454, P = 0.005), and reflux time percentage (r(s) = 0.439, P = 0.007), but not correlated with the reflux frequency (r(s) = 0.252, P = 0.086). Supine reflux was seen in only 7 of the 224 reflux events in 17 patients, lasting only 96 seconds during the 84.6 minutes' supine acid exposure time. Conclusion The common symptoms of LPRD are clearing throat, digestive symptoms, excess throat mucus, and foreign body sensation. Laryngopharyngeal pH monitoring and RSI scoring have the same value in diagnosing LPRD. Acid exposure in laryngopharynx is correlation to patients' self-report symptom. Almost all reflux events occur when the patients are in upright position.

Surgical results of T4 lung cancer invading left atrium and great vessels

Abstract: Objective To analyzed the indication and prognostic factors of surgical treatment of lung cancer invading left atrium and great vessels (T4). Methods We retrospectively reviewed the database of 136 T4 lung cancer (tumors invading left atrium and great vessels) patients who received surgical treatment in Cancer Hospital of Chinese Academy of Medical Science (CAMS) from September 1981 to January 2007. There are 114 men and 22 women, the median age was 58 years (range 28 - 76). All patients were divided into three subgroups according to the invading site: tumor invading left atrium group, tumor invading superior vena cava group and tumor invading pulmonary artery group. All patients were divided into two subgroups according to the character of operation: complete resection group and incomplete resection group. Patients were divided into three subgroups according to pathological lymph node status: N0, N1 and N2 group. Results One hundred and thirty six lung cancer patients received resection of primary lesions plus arterioplasty of pulmonary artery (PA) (n = 83) and/or angioplasty of superior vena cava (SVC) (n = 21) and/or partial resection of left atrium (LA) (n = 32). Complete resection was possible in 120 patients and 16 patients underwent incomplete resection. Five-year survival was 43.0% for entire group, 52. 8% for PA group, 18.2% for SVC group and 18.4% for LA group. Factors significantly influencing the overall 5-year survival were the pathologic N status (5-year survival 15.1% for N2, 5-year survival 44.9% for N1, 5-year survival 74% for N0 group; N2 versus N1 versus N0, P = 0.028) and the completeness of resection (5-year survival 37.5% for complete resection, 5-year survival 22.4% for incomplete resection group; complete versus incomplete, P = 0.042). Pathological lymph node status but not histology and character of operation was an independent prognostic factor using Cox regression analysis (P = 0.01, RR = 1.923, 95% CI: 1.172 -3. 157). Conclusion Pathological lymph node status is an independent prognostic factor for T4 lung cancer. Patients with pathological N0-1 lung cancer invading left atrium and great vessels (T4) may benefit from surgical treatment. In the preoperative workup, every possible effort should be made to achieve a careful evaluation of mediastinal lymph noda status. Compared with incomplete resection group, complete resection group may have a better prognosis. Tumor invading extrapericardial PA may be defined as T2.

[Influence of expression of six transmembrane epithelial antigen of the prostate-1 on intracellular reactive oxygen species level and cell growth: an in vitro experiment].

Abstract: Objective To investigate the STEAP1 gene function of the newly discovered gene six transmembrAne epithelial antigen of the prostate-1(STEAP1).Methods Total RNA was obtained from human prostate cancer tissue and underwent PCR amplification.The full length of STEAP1 gene thus obtained was cloned. Mammalian expression vector pcDNA3. 1-STEAP1 was constructed and Stably transfected into the human thyroid epithelial cells of the line FRTAP2320.A growth curve of the transfected cells was drawn.The intracellular reactive oxygen species(ROS)level was determined by flow cytometry (FC)with dichlorodihydrofluorescein diacetate(DCFHDA).Results The growth curve showed that the STEAP1 transfected cells grew faster than the control cells.FC showed that the fluorescence intensity of he intracellular ROS of the STEAP1 transfected cells was 42.13±1.13,significantly higher than those of the cell transfected with blank plasmid(10.02±1.42)and un-transfected cells(13.02 ±2.42,both P＜0.01).Conclusion STEAP1 promotes the cell growth through inducing the intracellular ROS level. Key words: Prostatic cancer; STEAP 1 protein; Reactive oxygen species(ROS)

In vitro tendon engineering using human dermal fibroblasts

Abstract: OBJECTIVE To examine the feasibility of using human dermal fibroblasts (DFbs) and polyglycolic acids (PGA) to engineer tendon in vitro. METHODS Human dermal fibroblasts (DFbs) were isolated from the foreskin tissues of children obtained during operation with collagenase and cultured in vitro. Human tendon was obtained from a patient undergoing amputation during operation to isolate tenocytes. The DFbs of second passage were seeded on PGA fibers to form cell-scaffold constructs in shape of tendons. Those constructs were divided into 4 groups: experimental group (n = 15) with the DFbs inoculated on PGA scaffold under constant tension generated by a U-shaped spring, control group 1 (n = 15) with the DFbs inoculated on PGA scaffold without tension, control group 2 (n = 3), i. e., cell-free pure PGA scaffolds under tension, and control group 3 (n = 5), i. e., tenocyte-scaffold constructs under tension that was harvested only at the ninth week. Samples were harvested 2, 5, 9, 14, and 18 weeks later to undergo histological examination and biomechanical test. RESULTS Two weeks later histological examination showed that the constructs were mainly composed of PGA fibers in both the experimental group and the group without tension. Transmission electron microscopy showed fine cell attachment and stretching on the scaffold. By the 5th week, a neo-tendon was formed in all groups except for the cell-free group, and histology revealed the formation of collagen fibers. At the 9th week, the PGA fibers of the cell-free group were broken and partially degraded, the neo-tendon's diameter of the experimental group was (1.18 +/- 0.25) mm, significantly thinner than that of the group without tension[ (2.43 +/- 0.49) mm, P = 0.017]. The gross morphology of tendons of the experimental group and tenocyte group were similar to each other except for more cells in the experimental group. In experimental group, immunohistochemistry revealed the production of fibers of collagen type I & III that were aligned longitudinally along the force axis like the normal tendon pattern. An irregular collagen pattern was observed in the group without tension. The maximum tensile stress of the experimental group was (2.75 +/- 0.59) MPa, similar to that of the tenocyte group [(3.08 +/- 0.30) MPa, P = 0.439], and significantly greater than that of the group without tension [(0.82 +/- 0.21) MPa, P = 0.006]. At the 14th week the PGA fibers of the cell-free group were mostly degraded. In addition, more dead cells and tissue atrophy were observed in the experimental group, and the tensile stress was higher than that of the same group by the 9th week. In the 18th week the number of hollow fiber of the experimental group was more obvious, the number of dead cells increased, and the tensile stress was lower, however, there was no significant difference in other characteristics compared with those in the 14th week. CONCLUSIONS DFbs can be used for in vitro tendon engineering as tenocytes. Mechanical stimulation by statistic strain is beneficial for tissue formation, but the effect may not be optimal if the tension is applied for too long.

[Expression of matrix metalloproteinase MMP-9 in the plasma and hematoma fluid of intracerebral hemorrhage patients].

Abstract: Objective To investigate the matrix metalloproteinase (MMP)-9 played in secondary brain injury following intracerebral hemorrhage(ICH).Methods Hematoma fluid and peripheral blood samples were collected from 60 ICH patients,34 males and 26 females,aged 60±13(37-81)n the days 1,4,and 7 after evacuation of hematoma.Peripheral blood samples were collected form.30 sex,and agematched healthy adults as normal controls.Cerebrospinal fluid(SCF)samples were collected from 10 sex,and age-matched patients to undergo operation during lumbar anesthesia.ELISA was used to detect the content of MMP-9.Tada formula was used to calculate the perihematomal edema volume.The National Institutes of Health Stroke Scale(NIHHS) and Glasgow Coma Score(GCS)were used to assess the condition of patients.Results ( 1)The MMP-9 levels in the plasma and hematoma fluid of the ICH patients at all time points were all significantly higher than those of the normal controls(all P＜0.01).MMP-9 was not found in the normal CSF.(2)The plasma and hematoma fluid MMP-9 levels were increased already in the day 1,peaked in the day 4,and then kept at a high level until the day 7.(3)The MMP-9 levels in hematoma fluid t all time points were all significantly higher than those in the plasma(all P＜0.01).(4)The MMP-9 level was positively correlated with the hematoma volume and NIHSS score,and negatively correlated with the GCS score(both P＜0.01).Conclusions MMP-9 may takes part in the secondary iniury after ICH,and its change is correlated with the hydrocephalus of patients.The dynamical change of the plasma MMP-9 level is consistent with the hematoma fluid MMP-9 level after ICH.There is a positive correlation among the MMP-9 level,perihematomal edema volume,and severity of ICH. Key words: Cerebral hemorrhage; Plasma; Matrix metalloproteinases; Hematoma fluid