Volume 87  ·   Issue 23  ·  2007

Objective to explore the classification, incidence, clinical characteristics, diagnosis and surgical treatment of pulmonary sequestration. Methods the clinical data and literature review of 23 cases of pulmonary sequestration were retrospectively analyzed. Results From June 1974 to November 2006, the incidence rate of 23 cases of pulmonary sequestration confirmed by surgical treatment and pathology accounted for 0.29% of the surgical operation in the same period, including 19 cases (83%) of intralobar type and 4 cases (17%) of extralobar type; 18 cases showed repeated pulmonary infection, with symptoms of fever, cough and hemoptysis, and 5 cases were asymptomatic. 14 cases (61%) were diagnosed or intended to be diagnosed before operation. Conclusion The main diagnostic methods of pulmonary sequestration are X-ray, chest CT and MRI. Once diagnosed, all patients should be treated by surgery.

Objective to analyze the clinical manifestations and auxiliary examination characteristics of spinobulbar muscular atrophy (SBMA), and make genetic diagnosis. Methods Detailed medical history, physical examination, blood biochemistry, electromyography and muscle pathology data of 5 patients with suspected SBMA were collected, and the copy number of CAG repeat sequence of androgen receptor (AR) gene was determined by PCR. Results The main clinical manifestations of SBMA were muscle atrophy, weakness and limb tremor, tongue muscle atrophy and dysarthria; Some patients showed endocrine symptoms and increased creatine kinase (CK). The electromyography showed denervated motor potential. The muscle pathology was neuropathic damage. The number of repeats of AR gene CAG was more than 50 times in patients, while that of normal controls was 19~24 times. Conclusion SBMA is a middle-aged male with latent onset, mainly showing atrophy and weakness of spinal cord and medulla oblongata muscles. The determination of AR gene CAG repeats is helpful for the diagnosis of SBMA.

Objective to analyze the factors affecting the survival of patients with skull base chordoma. Methods Thirteen factors that may affect the survival of patients with skull base chordoma, such as sex, age, first symptom, positive signs, tumor volume, operation before admission, radiotherapy before admission, tumor location and stage, texture and adhesion degree of tumor, pathological classification of tumor and surgical resection degree, were analyzed by Kaplan-Meier method, Cox regression and t-test. Results The univariate analysis of Kaplan-Meier method showed that the pathological classification of tumor, operation or radiotherapy before admission, surgical resection degree and adhesion degree of tumor to surrounding tissues were the risk factors affecting the survival of patients with skull base chordoma (all P<0.01). Cox regression multivariate analysis showed that pathological classification of tumor, surgery or radiotherapy before admission, and the degree of surgical resection had statistically significant effects on the survival of patients with skull base chordoma (all P<0.01). Conclusion Combining the related factors affecting the prognosis of patients with skull base chordoma, further improving the treatment methods including surgical techniques and reasonable arrangement of comprehensive treatment steps will help to improve the prognosis of patients with skull base chordoma.

Objective to explore the methods of repairing and reconstructing acetabular bone defects in total hip revision. Methods 21 patients (21 hips) were treated with metal mesh cover, allogeneic granular cancellous bone compression bone grafting and bone cement fixed polyethylene acetabular cup to repair the acetabular bone defects and reconstruct the acetabulum. The mean follow-up was 47 months; The clinical outcome, the healing of the host bone and the graft bone, and the change of the position of the acetabular cup were evaluated. Results the Harris score increased from 55.7 to 92.9; The mean time of bone healing was 11.4 months, the mean change of abduction angle of acetabular cup was 2.2°, and the mean change of 20 hips was 1.5°; One hip was 15.5°, with an average increase of 1.7° 3 months after operation; The increase was 2.0° at 6 months postoperatively; The medial displacement of the acetabular cup was 3.93 mm, 15 hips were below 4 mm and 6 hips were above 4 mm. The average upward displacement was 4.41 mm, of which 14 hips were below 4 mm and 7 hips were above 4 mm; At 3 months after operation, the average displacement to the medial and upper side was 3.21 and 3.97 mm respectively (P<0.05); Conclusion After reconstruction of the acetabulum, the position of the acetabular cup was mainly changed within 6 months after operation by reinforcing the bottom and edge of the acetabulum with metal mesh, repairing the bone defect with allogeneic granular cancellous bone and fixing the polyethylene acetabular cup with cement. The stability of the acetabular cup can be improved by maintaining the good initial stability of the joint prosthesis.

Objective to compare the static extraction strength of two kinds of transarticular fixation techniques for lower cervical vertebra.Methods Ten fresh cadaveric cervical vertebrae specimens (C3-T1) were dissociated into three cervical motor segments (C3-C4, C5-C6, C7-T1). The transarticular pedicle screws (TPS) and transarticular screws (TAS) were randomly fixed on both sides of the vertebral body, and the cortical bone screws with a diameter of 3.5 mm were inserted. The transarticular pedicle screws were inserted into the vertebral body of the lower segment through the pedicle of the articular joint and the lower segment. The insertion point of the transarticular screw was 1 mm medial of the center point of the lateral mass of the upper segment, and the insertion angle was 35~40 ° in tail tilt and 15~20 ° in external tilt, and the screw was fixed forward and downward to the articular process joint complex. After the insertion of the screw, the extraction strength test was performed to compare the maximum axial extraction strength of the two screws. Results The average extraction strength of the transarticular pedicle screw in the lower cervical vertebra was 668 kg · m · s-2, while the average extraction strength of the transarticular screw was 414 kg · m · s-2, and the difference between the two was statistically significant (t =23.09, P<0.05). There was no statistically significant difference between the transarticular pedicle screw and the transarticular screw in each segment of the cervical vertebra (F values in TPS and TAS groups were F =2.17, 2.03, P>0.05, respectively). Conclusion The static extraction strength of the transarticular pedicle screw in the lower cervical vertebra is significantly better than that of the transarticular screw, and it is feasible to be applied in biomechanics.

Objective to investigate the proliferation and molecular mechanism of peripheral blood T lymphocyte subsets in patients with asthma in remission. Methods Peripheral blood samples of 45 patients with acute asthma attack (15 cases each), patients with asthma in remission (15 cases each) and normal controls (control group) were collected. CD4+ and CD8+ T lymphocytes were isolated and cultured in vitro. The cell cycle phase distribution and the expression levels of cell cycle regulatory proteins [P27kip1, Cyclin D, E], PI3K and STAT6 were detected by flow cytometry. Results (1) There were statistically significant differences in the distribution ratio of G0/G1 phase, S phase, G2/M phase and (S + G2) /M phase of CD4+ T lymphocytes in the three groups (Z values were 12.35, 8.05, 9.16 and 12.80, respectively, all P<0.05). The distribution ratio of G0/G1 phase, S phase and (S + G2) / (2) The expression levels of P27kip1, Cyclin D and Cyclin E in CD4+ T lymphocytes of the three groups were statistically significant (Z value was 10.63, 10.66 and 6.64, respectively, all P<0.05), and the expression levels of P27kip1 in CD8+ T lymphocytes of the three groups were statistically significant (Z value was 9.30, P<0.05); (3) The expression levels of PI3K and STAT6 protein in CD4+ T lymphocytes in the three groups were significantly different (Z values were 9.04 and 18.08, P values<0.05 and 0.01, respectively). The proliferative CD4+ T cells in patients with asthma remission increased significantly compared with the normal controls, and the proliferative CD4+ and CD8+ T cells decreased significantly compared with those in patients with asthma attack. The PI3K signal transduction pathway may affect the proliferation and activation of CD4+ and CD8+ T cells by up-regulating CyclinD and/or CyclinE, while the JAK1-STAT6 signal transduction pathway may play a role by down-regulating P27kip1. Conclusion The hyperproliferation of CD4+ T cells in patients with asthma remission may be closely related to the abnormality of cyclin and signal transduction protein.

Objective to evaluate the efficacy and safety of combined M-receptor blocker and α-receptor blocker in the treatment of lower urinary tract symptoms (LUT) in benign prostatic hyperplasia (BPH). Methods 69 patients with BPH/LUT were selected after 1 week of terazosin treatment. The main exclusion criteria were maximum urinary flow rate (Qmax)<10 ml/s, residual urine>50 ml and prostate volume>50 ml. They were randomly divided into two groups, the terazosin group was treated with terazosin, and the combination group was treated with tolterodine and terazosin. After 6 weeks of medication, the evaluation contents included total symptom score (IPSS), obstruction symptom score, irritation symptom score, urine flow rate and residual urine volume, and the adverse events were registered. Results There was no significant difference in basic clinical indexes between the two groups. After 6 weeks of medication, the IPSS score of the combination group decreased from 19.1 ± 2.9 to 14.0 ± 4.2, P<0.001, the irritation symptom score decreased from 13.2 ± 3.2 to 9.2 ± 2.9, P<0.001, the IPSS score of the terazosin group decreased from 18.5 ± 3.2 to 17.3 ± 4.1, P =0.033, and the irritation symptom score decreased from 12.7 ± 3.1 to 11.7 ± 3.0, P =0.001. After treatment, the comparison between the two groups showed: (1) The improvement of IPSS score in the combination group was better than that in the terazosin group (-5.09 vs-1.19, P<0.001), and the improvement of stimulation score in the combination group was better than that in the terazosin group (-4 vs-1, P<0.001), while the obstruction symptom . (2) There was no significant difference in Qmax and residual urine between the two groups after 6 weeks of treatment. There was no acute urinary retention and other serious complications in the combination group. Conclusion the combination of tolterodine and α-receptor blockers in patients with mild to moderate prostatic hypertrophy and mild to moderate prostatic hypertrophy can reduce the IPSS score to varying degrees, and the improvement of irritation symptom score is more obvious.

Objective to compare the effects of insomnia symptoms, depressive symptoms and quality of life of outpatients with depression in the initial stage of antidepressant therapy (paroxetine) with or without sleeping pills (zolpidem), and to explore the necessity and significance of improving insomnia symptoms in the initial stage of antidepressant therapy. Methods A multicenter cooperative, randomized controlled study was conducted for 4 weeks; Evaluation tools include self-compiled questionnaire, HAMD-17, HAMA, PSQI, and quality of life questionnaire (SF-36); 229 outpatients with depression and insomnia were randomized into the paroxetine + zolpidem group or the paroxetine group, of which 221 patients underwent intention analysis (ITT), and 207 patients underwent completion analysis. Results After 1 week of treatment, the mean PSQI decreased by 5.7 points (sleep improvement) in the paroxetine + zolpidem group, while the mean PSQI decreased by 1.6 points in the paroxetine group (P =0.00); After 4 weeks of treatment, the PSQI score reduction was 9.7 ± 3.6 points, the HAMD score reduction rate was 68.5%, the HAMA score reduction rate was 66.2%, and the SF-36 score improvement rate was 89.0% in the zolpidem group, while the score changes in the paroxetine only group were 6.0 ± 3.5 points (PSQI), 56.8% (HAMD), 57.1% (HAMA), and 73.0% (SF-36), respectively. The differences between the groups were statistically significant. Conclusion The combination of antidepressants and hypnotics in the early stage of depression treatment is helpful to improve insomnia and quality of life of patients quickly, and also has a synergistic effect on improving depressive symptoms and anxiety symptoms.

Objective to prepare the tracing of mouse embryos in cells (ESC) with superparamagnetic iron oxide (SPIO) and magnetic resonance imaging for cardiomyocyte transplantation in vivo. Methods Mouse ESC and its differentiated cardiomyocytes were incubated with SPIO by electron microscope analysis, intracellular iron content determination, [Ca2+] confocal determination and MR imaging. Iron uptake using the transfection technique was higher than in the unused group; T2WI and T2*WI scanning sequences showed that the signal of labeled cells decreased, and the degree increased with the increase of label concentration; Conclusion SPIO can effectively label ESC and its differentiated cardiomyocytes, but has no obvious effect on cell activity and differentiation ability. Conventional 1.5TMR apparatus can be used to imaging labeled cells.

Objective to observe the effects of dezocycline (MK801), an antagonist of excitatory glutamate receptor (NMDA receptor), on the expression of P-gp after seizure in rats with limbic lobe epilepsy, and to investigate whether NMDA receptor can regulate the expression of P-gp after seizure. Methods Sixty rats were randomly divided into six groups: control group and 0, 3, 6, 24 and 72 h after seizure termination. The expression of P-gp mRNA in hippocampus of rats with epilepsy was detected by real-time fluorescence quantitative RT-PCR at different time courses after seizure termination. Another 60 rats were randomly divided into control group, status epilepticus model (SE) group and MK801 intervention group. Each group was divided into 6 h and 24 h after seizure termination. The expression of P-gp mRNA in hippocampus of rats with epilepsy was detected by real-time fluorescence quantitative RT-PCR at 6 h after seizure termination, and the expression of P-gp protein in hippocampus at 24 h after seizure termination was detected by immunohistochemistry. Results Its expression was significantly increased immediately after SE termination [5.6 (2.9) ×105 mRNA copy number/40 ng total RNA, P<0.05], and its expression was further increased at 3 h after SE termination [7.6 (6.3) ×105, P<0.01], and the expression of mdr1a mRNA remained at this level until 72 h after SE termination; The expression of mdr1b increased transiently in animals with limbic lobe attack, and the expression of mdr1a [(4.3 ± 0.8) ×105] and mdr1b [(2.0 ± 0.7) ×104] gene in MK801 group was significantly lower than that in SE group at 3 and 6 h after the attack termination (P<0.01); The expression of P-gp protein in MK801 group was significantly lower than that in SE group [(39.0±4.1) microvessels/400fold visual field, P<0.01]. Conclusion NMDA receptor antagonist MK801 downregulates the overexpression of P-gp in epileptic rats after seizure, suggesting that NMDA receptor may be involved in the regulation of P-gp expression during seizure, and effective inhibition of NMDA receptor overactivation may help to prevent the overexpression of P-gp after seizure.

Objective to investigate the protective effect and mechanism of Camellia oleifera saponin C (CS-C) pretreatment on hypoxia/reoxygenation (A/R) injury of cultured neonatal rat cardiomyocytes. Methods SD rat cardiomyocytes cultured for 3~4 days were randomly divided into 5 groups (8 wells in each group): normal control group, simple hypoxia/reoxygenation group (A/R), hypoxia preconditioning group (AP), Camellia oleifera saponin C preconditioning (CS-C) and glibenclamide preconditioning group (Glib). (2) the content of lactate dehydrogenase (LDH) in the culture solution; (3) Ultrastructural changes of myocardial cells were observed by transmission electron microscopy. Results Compared with the control group, the LDH content of A/R group (57.8 U/L ± 6.4 U/L) was higher than that of the control group (12.3 U/L ± 1.7 U/L), and the difference was statistically significant (P<0.01). The survival rate of myocardial cells (51.0%±1.9%) was lower than that of the control group (92.0%±2.0%), and the difference was statistically significant (P<0.01). The LDH content (39.8 U/L ± 3.9 U/L) and cardiomyocyte survival rate (76.4% ± 3.5%) in the CS-C pretreatment group were lower than those in the A/R group (P<0.01), and the results were similar to those in the AP group (32.4 U/L ± 5.2 U/L, 78.0% ± 2.0%, P>0.05, respectively). The LDH content (55.8 U/L ± 5.0 U/L) in the Glib group was higher than that in the CS-C pretreatment group, and the cardiomyocyte survival rate (54.1% ± 3.7%) was lower than that in the CS-C pretreatment group (P<0.05). Conclusion The effect of CS-C pretreatment on hypoxia/reoxygenation injury and hypoxia preconditioning in neonatal rat cardiomyocytes is similar, and its protective effect may be related to the opening of KATP + channels.

Objective to investigate the effects of fetal growth restriction (FGR) and postnatal high-fat diet (HF) on the occurrence of insulin resistance (IR) in female SD rats, as well as the effects on pubertal development and reproductive function.Methods FGR model was established by low-protein diet.FGR and normal group (C) newborn female rats were randomly divided into 2 groups, 16 rats in each group were fed with high-fat and conventional diet (N) respectively (i.e. FGR/HF group, FGR/N group, C/HF group and C/N group). At the 13th week, 10 rats were randomly selected from each group to measure body weight (Bw), body length and perirenal fat weight (Fw); At the same time, blood glucose (FPG), insulin (FINS) and testosterone (T) levels were measured by fasting blood sampling, and HOMA-IR and ISI were calculated; Results FGR/N group, FGR/HF group and C/HF group all showed obesity trend and IR phenomenon in adulthood, showing increased FINS level (20±12, 19±8, 26±15 vs 7±7, all P<0.05) and decreased ISI level (3.0±1.1, 2.7±1.1, 2.9±0.7 vs 4.8±2.0, all P<0.05); There was delayed puberty in the FGR/N group and thin ovulation in the FGR/N group, FGR/HF group and C/HF group. The fertility of the FGR/HF group was significantly reduced; Conclusion FGR rats have delayed puberty, thin ovulation and adult IR, and high-fat diet after birth aggravates the severity of IR and reproductive endocrine disorders in FGR rats.

Objective to investigate the effects of budesonide (BUD) on airway remodeling and regulation of JAK1, signal transducer and transcriptional activator 6 (STAT6) expression in bronchial asthma mice. Methods Thirty female BALB/c mice were randomly divided into control group, asthma group and BUD group. Animals were sensitized and challenged with chicken egg protein as allergen to establish a chronic asthma airway remodeling model. The airway reactivity of animals was measured by BUXCO pulmonary function instrument, and the lung tissue sections were stained with periodate Schiff (PAS) and Masson staining. The infiltration of peribronchial inflammatory cells and the proliferation of goblet cells were scored, and the content of hydroxyproline in lung tissues was determined. The changes of JAK1, STAT6, α-SMA protein and α-SMA mRNA expression were detected by immunohistochemistry, immunoblotting and RT-PCR, respectively. Results the airway reactivity of asthmatic animals was significantly higher than that of control group, logPC100 was 0.62±0.78 and 1.88±0.34, respectively, P<0.01. The airway reactivity of BUD group was lower than that of asthmatic group (1ogPC100 was 1.79±0.18, P<0.01). Compared with asthmatic group, the airway epithelial hyperplasia was improved, the collagen deposition was decreased, and the expression of α-SMA protein and mRNA was lower in BUD group than that of asthmatic group. The mucus index score of BUD group was (1.35±0.26) points, the lung hydroxyproline content was (284±16) μ g/100 mg, and the contents of IL-4 and IL-13 in BALF were (7.3±0.6) There was no significant change in the distribution of STAT6 in asthma group and BUD group.Immunoblotting showed that the expression of JAK1 and STAT6 protein in asthma group was stronger than that in the control group, while BUD could significantly down-regulate the expression of these two signaling proteins.Correlation analysis showed that the contents of JAK1 and STAT6 were positively correlated with airway PAS fraction, α-SMA protein expression and hydroxyproline content in lung tissue, respectively, and also positively correlated with IL-4 and IL-13 levels in BALF (both P<0.05). Conclusion BUD inhibits airway remodeling in asthma. BUD may inhibit airway remodeling dependent on JAK1/STAT6 pathway by down-regulating the expression of JAK1 and STAT6.

Objective to study the effect of transforming growth factor β 1 (TGF-β 1) on tissue engineering valve (TEHV) construction in vitro. Methods Acellularized valves were prepared by enzyme + detergent method. Liposome-mediated pcDNA3.0/TGF-β 1 gene was transfected into rat myofibroblasts, and TGF-β 1 gene was stably expressed by G418 screening for 3 weeks after 48 h. Transgenic cells were implanted in acellularized valves in experimental group A, non-transgenic cells were implanted with TGF-β 1 (10 μ g/L) in experimental group B, and non-transgenic cells were implanted without TGF-β 1 in control group. After 2 weeks, HE staining and scanning electron microscopy were used to detect the content of hydroxyproline and DNA and the maximum loading capacity of valve leaflets. Results SABC method showed that myofibroblasts expressed TGF-β 1 instantaneously and stably after 48 h and 4 weeks of transfection. The morphology showed that the cells of A and B in experimental group were tightly united and the extracellular matrix was abundant. The content of hydroxyproline in group A (5.83‰±0.67‰) and group B (5.02‰±0.40‰) were higher than those in group A The DNA content in group A (0.126‰±0.013‰) and group B (0.109‰±0.004‰) was higher than that in the control group (0.089‰±0.011‰); The maximum loading capacity in group A (13.4±1.0) N and group B (11.8±1.4) N was higher than that in control group (10.0±1.1) N. Conclusion TGF-β 1 can promote cell growth and extracellular matrix secretion, which is beneficial to improve the mechanical properties of TEHV.

Objective to construct a human papillomavirus (HPV) type 18 E6/E7 antisense fluorescent eukaryotic expression vector and study its effect on the proliferation and apoptosis of cervical cancer HeLa cells. Methods the 716bp fragment of HPV type 18 E6/E7 region was amplified by PCR and reverse cloned into the fluorescent eukaryotic expression vector pEGFP-C1, and the recombinant pEGFP-HPV18E6E7as (EGFP-18AS) was constructed and transfected into human cervical cancer HeLa cells. The changes of mRNA and protein levels of E6 and E7 genes after transfection were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. The proliferative activity of transfected cells was detected by microenzymatic reaction colorimetric method of tetramethylazole salt; The apoptosis rate of transfected cells was detected by flow cytometry; The morphological changes of apoptotic cells were observed under fluorescence microscope.Results the mRNA expression and protein synthesis of E6 and E7 genes in HeLa cells were significantly down-regulated after transfection of EGFP-18AS recombinant; Cell proliferation is inhibited; Flow showed that the cell G1 phase was obviously blocked; Conclusion The recombinant plasmid pEGFP-HPV18E6E7as can effectively inhibit the growth and proliferation of human cervical cancer HeLa cells and induce their apoptosis, which proves the effectiveness of antisense RNA technology and provides a new possible way for gene therapy of cervical cancer.

A 26-year-old female was admitted to the hospital due to repeated fever, hematuria and proteinuria for 18 months and headache for 6 months. Eighteen months ago, the patient developed fever without obvious trigger, body temperature 38~39 ℃, accompanied by chills and chills, no edema of both lower limbs and eyelids, no low back pain, and routine urine examination showed a small amount of hematuria and proteinuria.

Patients with lung cancer have a relatively high risk of duplicate lung carcinoma after surgical treatment, and the incidence of duplicate lung carcinoma is increasing. In recent years, people have made some new progress in the understanding and surgical treatment of duplicate lung carcinoma.

bronchial thermoplasty (BT) is a new interventional technique. Thermal energy is transferred to the bronchial wall through bronchoscopy, which leads to long-lasting thinning of airway smooth muscle, thus reducing bronchoconstriction.

At present, there are many evaluation scales for cerebrovascular diseases, but the related evaluation scales for transient ischemic attack (TIA) are still rare. Therefore, Cuffe et al.<Stroke>published in the journal<The study of Oxford ABCD score in the risk of Stroke early after transient ischemic attack (Stroke, 2006, 37:2892-2897) has attracted much attention in academic circles.

A 26-year-old female was admitted to the hospital on November 14, 2006 due to "repeated facial flushing for 20 years". The patient was found to be prone to flushing at the age of 6, and it became more serious after entering puberty. The flushing often appeared under the conditions of nervousness, fear, stimulation, muggy weather, exercise, etc., and gradually disappeared spontaneously after lasting for 1min to 1h.