Volume 88  ·   Issue 03  ·  2008

Objective To compare the effects of adhesion releasing under nerve block and arthrolysis on adhesive scapulohumoral periarthritis.Methods Sixty patients with adhesive scapulohumoral periarthritis24 males and 36 females,aged 52.5(40-67),were randomly divided into 4 equal groups:Group Ⅰ,undergoing adhesion releasing under brachial plexus block,GroupⅡ,undergoing adhesion releasing under stellate ganglion block,Group Ⅲ,undergoing limited adhesion releasing under stellate ganglion block,and Group Ⅳ undergoing arthrolysis under stellate ganglion block.The clinical effects were recorded and compared.Results The short-term effect of Group Ⅳ was significantly superior to the other 3 groups(all P＜0.05).The frequency of block+manipulation treatment of Group-Ⅰ was significantly less than those of the other 3 groups(all P＜0.01),and the frequency of pain point injection of Group Ⅰ was significantly higher than those of the other 3 groups(all P＜0.01).Conclusion The 4 methods are all effective for the treatment of adhesive scapulohumoral periarthritis.In particular,arthrolysis under stellate ganglion block shows greater improvement in the joint function and less uncomfortableness caused by numbness and Weakness of the arm.

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.

Objective To investigate the feasibility of assessment of the cerebrovascular reserve (CVR)by perfusion CT combined with CO2 test in patients with symptomatic middle cerebral artery ischemia.Methods 38 healthy volunteers and 32 symptomatic middle artery ischemia inhaled mixed gas of 5% CO2 and 95% O2,and the changes of CO2 concentration by the end of inhalation were measured among as Dretest.Ten-row CT was with round area 24 mm in diameter at bilateral blood supply areas of middle cerebral artery as ROI.Forty patients with symptomatic middle cerebral artery ischemia underwent perfusion CT with 5% carbon dioxide and 95% oxygen.The end-expiratory CO2 content after inhalation of mixture gas was tested in 36 volunteers and 32 patients with symptomatic middle cerebral artery ischemia.Results After inhalation of a gas mixture with 5% CO2 and 95% oxygen the end-expiratory CO2 content increased by 0.93%±0.31% in the volunteers and 0.89%±0.23% in the patients with symptomatic middle cerebral artery ischemia(P＜0.05).The CVR of the patients with symptomatic middle cerebral artery ischemia could be bigger than 20%.The CVR of middle cerebral artery supply area was correlated with the collateral circulation number and scale, but not with the stenosis degree of M1 segment of middle cerebral artery.Conclusion It is safe and feasible to assess CVR with dynamic computer tomography and gas mixture with 5% CO2 and 95% oxygen in the patients with symptomatic middle cerebral artery ischemia.

Objective To investigate the anti-nuclear antibody(ANA)patterns in the diagnosis of primary biliary cirrhosis(PBC)and primary Sj(o)gren syndrome(SS).Methods Serum samples from 61 cases of PBC,28 cases of primary SS,and 11 cases of overlap syndrome of PBC and SS were collected to detect the ANA with indirect immunofluorescence staining,and the difference in ANA patterns was analyzed between the PBC and SS patients.Results Antinuclear antibodies were detected in 85.2% of the PBC patients,with the following hierarchy of specificities:37.7% being rim-like,21.3% being discrete speckled,18.0% being speckled,8.2% being multiple nuclear dots,and 4.9% being anti-lamin;89.3% of the primary SS patients was ANA positive with speckled antibody,only one of them presented discrete speckles(3.6%);and all of the PBC patients overlapped with SS(100%)were positive in ANA,and their contexture of ANAs was similar to those of the PBC patients:45.5% being rim-like,18.2% being discrete speckled,18.2% being speckled,18.2%being anti-lamin,and 9.1% being multiple nuclear dots.Rimlike pattern and multiple nuclear dots were statistically significant for the diagnosis of PBC,compared with primary SS(x2=14.236,3.781,P＜0.01,＜0.05).Conclusion The ANA patterns of PBC are different from those of primary SS.Among them,rim-like pattern and multiple nuclear dots are highly specific nuclear patterns of PBC and may be useful in diagnosing individuals without anti-mitochondrial antibodies.

Objective To investigate the causes of early death after lung transplant and its Drevention and management.Methods Lung transplantation was performed on 30 patients,12 with chronic obstructive pulmonary disease,10 with pulmonary fibrosis,3 with Eisenmenger's syndrome,3 with bronchiectasis,1 with pneumosilicosis,and 1 with pulmonary vascular leiomyoma,24 males and 6 females,aged 48±13(15-72),23 undergoing single lung transplantation,3 undergoing right single lung transplantation following ventricular septal defect repair with CPB,3 undergoing bilateral sequential lung transplantation without CPB,and 1 case undergoing bilateral sequential lung transplantation with CPB,during the period September 2002 to December 2005.All the patients received invasive monitoring,mechanical ventilation,immunosuppressive agents,antibacterial prophylaxis,and prevention of reperfusion iniury in ICU after operation.Results Six cases died in the early period with the causes of death(n=3),primary graft dysfunction(PGD)(n=1),acute rejection(n=1),and pulmonary infarction(n=1).Conclusion Infection,PGD,acute rejection and pulmonary infarction represent the most frequent causes of eady death after lung transplantation.

Objective To explore the clinical and pathological features of synchronous double primary cancer in stomach and large intestine.Methods The clinical data of 35 patients with synchronous double primary cancer in stomach and large intestine out of 1117 patients with gastric and colorectal cancers treated during the period from January 2001 to December 2006,including 766 cases of colorectal cancer and 351 cases of gastric cancer,were analyzed.Results The 35 patients of synchronous double primary cancer in stomach and large intestine,accounting for 3.13% of the cases of gastric and colorectal cancers,23 males and 12 females,aged 66.7(44-89),could be divided into 4 groups:intestine:intestine group(n=15),stomach-stomach group(n=3),intestine-extra-intestine group(n=13),and stomach-extra-stomach group (n=9);the last 2 groups included 5 case with their primary cancer located in stomach-and large intestine respectively.The number of cases with the 2 primary carcinoma foci both located in the entero-intestinal duct,stomach and large intestine,was 23,more than that of the cases with their 2 carcinoma foei located in stomach or large intestine and other organs respectively(n=12).The 3-year survival rate of the large intestine-large intestine group was higher than that of the stomach-stomach group.Conclusion Early diagnosis,correct distinguishing of the primary and metastatic cancer play an important role in the treatment of synchronous double primary cancer and improvement of the prognosis.

Objective To analyze of membrane proteins of human normal prostate epithelial cells.Methods Laser capture microdissection(LCM)technique was utilized to obtain the epithelial cells of human normal prostate.Shotgun-MS was used to generate protein profiles in the epithelial cells of human normal prostate.Results LCM technique successfully separated the normal prostate epithelial cells with homogeneity more than 95%.Under a stringent filter condition(charge+1,Xcorr≥1.9;charge+2,Xcorr≥2.2:charge+3,Xcorr≥3.75;DelCN≥0.1),1164 proteins were identified in the human normal prostate cells,of which 799 had a gene ontology annotation(GOA)indicating a cellular component,others have no GOA terms.Among the GOA terms,377(49.15%)were known membrane proteins or membrane associated proteins.In addition to the proteins known to be associated with the membrane,a significant number of novel proteins had also been identified,including several hypothetical proteins and cDNA sequences.Conclusion Shotgun-MS technique coupled with LCM effectively analyzes the proteins of human normal prostate cells,thus helping perfect the complete protein profiles of human normal prostate cells.

Objective To evaluate the diagnostic and treatment of intravenous leiomyomatosis (IVL) with extension to inferior vena cava.Methods The clinical data of 6 cases of IVL involving inferior vena cava were analyzed retrospectively.Results Three of the 6 patients underwent phase Ⅰ operation,and 2 underwent phase Ⅱ operation,all successfully;and 1 did not undergo operation sue to poor cardioDulmonary function.No peri-operative death and complication were observed.The primary tumor and intravenous tumor embolus were completely resected in 4 out of the 6 patients. One patient who had serious adherence between the tumor and pelvic cavity due to multiple operations had some residual tumors left.However,after anti-estrin treatment, the residual tumors had obviously regressed. All the patients had relapsed after the operation.Conclusion IVL is very rare.The vascular surgeon must pay more attention to this disease.There are many therapeutic methods to choose when the IVL involves the inferior vena cava,among which operation is the best choice.Completely resection of the tumor is the key of the prevention of recurrence.

Objective To evaluate the clinical efficacy of percutaneous bipedicular kyphoplasty with double or single balloon Ⅰ treatment of osteoporosis vertebral compressive fractures.Methods Fifty-one patients with painful osteoporotic vertebral compressive fracture involving 69 vertebrae.19 males and 32 females,aged 72.5(63-85),underwent percutaneous kyphoplasty with double inflatable balloon(29cases,38 vertebrae)or single inflatable balloon(22 cases,31 vertebrae)under X-ray fluoroscopy monitoring.The fractured vertebral bodies were punctuated,balloon was put into the subsided areas and then distended,and bone cement was injected into the cavity.The vertebral height and Cobb angle,preoperative and postoperative,were measured by radiography. Follow-up was conducted for 6-12 months.Results All patients tolerated the procedure well with dramatic pain relief within 96 hours after the procedure.No clinical complication was found. Visual analog scale score was improved from 7.8 preoperatively to 2.6 postoperatively(P＜0.01).Oswestry disability index was decreased from 73% preoperatively to 26% postoperatively.In the double balloon group,the heights loss of the anterior and middle portions of the vertebral body reduced from 14.7 mm and 10.5 mm to 10.1 mm and 5.5 mm respectively(both P＜0.01),and the Cobb angle was corrected from 22.4° to 12.3°(P＜0.01).In the single balloon group,the heights loss of the anterior and middle portions of the vertebral body reduced from 14.7 mm and 10.6 mm to 10.4 mm and 6.5 mm respectively(both P＜0.01),and the.Cobb angle was corrected averagely from 21.2° to 11.6°(P＜0.01).The mean vertebral height restoration rates were 72.8% and 70.1% in the double and sinde balloon groups respectively.The mean Cobb angle correct degrees were 10.1° and 9.5° in double and single balloon groups respectively.There were no significant differences in the average height restoration rate and Cobb angle correction between the double and single balloon groups(72.8% vs 70.1%,and 10.0° vs 9.5° both P＞0.05).The pain relief and functional recovery were substantial and maintained to the last follow up.Conclusion Percutaneous bipedicular kyphoplasty with double or single balloon for painful osteoporotic vertebral body compressive fractures is effective and safe.

Objective To screen biomarkers for classification in lung adenocarcinoma and lung squamous carcinoma by using laser capture microdissection ( LCM)and surface-enhanced laser desorption ionization time-of-flight mass spectrometry(SELDI-TOF-MS)and support vector machine(SVM).Methods Six specimens of lung adenocarcinoma tissues and seven specimens of lung squamous carcinoma tissues obtained during operation were made into frozen sections and stained by improved H-E solution.About 1.2×105 of homogeneous adenocarcinoma cells and 1.4×105 of homogeneous lung squamous carcinoma cells were collected using LCM.Then SELDI profiles based on PBS Ⅱ+ SELDI-TOF-MS (IMAC protein chip)and the data were analyzed by support vector machine(SVM).Results Eilghty seven differential protein peaks were found and top ten of them were identified as candidate biomarkers.The expression levels of 6 proteins among them with the molecular weights of 3333,3592,3848,5036,5191,and 5211 respectively in the lung squamous cancer tissues were weaker than those in the adenocarcinoma tissues,and the expression levels of 4 proteins with the molecular weights of 2505,4004,4847,and 11 412 in the lung squamous carcinoma tissues were stronger than those in the adenocarcinoma tissues.The expression of the protein with the molecular weight of 4847 in the squamous cancer was significantly stronger than that in the adenocarcinoma (P+0.032).A discriminatory pattern consisting of 3 proteins with the molecular weights of 4847,11 412,and 3592 was established with a sensitivity of 100% and a specificity of 100% respectively in separating adenocarcinoma from squamous carcinoma.Conclusion There is a difference in protein component between adenocarcinoma and squamous carcinoma.LCM combined with SELDI-TOF-MS help screen a biomarker pattern to distinguish lung adenocarcinoma from lung squamous carcinoma with high sensitivity and specificity.

Objective To investigate the effect of chemokine stromal cell-derived factor-1(SDF-1) and its receptor CXCR4 on the peritoneal earcinometastasis of gastric cancer.Methods Human gastric cancer cells of tlle lie NUGC4 and mesothelial cells of the line HMrSV were cultured.RT-PCR was used to detect the expression of CXCR4 and SDF-1 mRNA in the NUGCA and HMrSV cells.The proliferation of NUGCA cells was detected bv MTT method.In mesothelial cell adhesion teat NUGC4 cells were cultured with confluent HMrSV mesothelial cells in 24-well plate and then divided into 3 groups:chemokine group,added with SDF-1,antibody blocking group,in which the NUGCA cells were pre-incubated with CXCR4 monoclonal antibody for 2 h and then SDF-1 was added,and control group added with only culture fluid.Microscopy was used to calculate the number of gastric cancer cells adhered with mesothelial cells.In the mesothelial cell migration test HMrSV cells were put in the upper chamber of a Transwell chamber so as to cover tlle infiltration membrane.This Transwell chamber was put into a culture plate,NUGC4 cells,divided into 3 groups as mentioned above were put into the upper chamber,24 h later HE staining and microscopy were performed to calculate the number of the NUGC4 cells that penetrated the membrane.BALB/c nu/nu female nude mice underwent intraperitoneal injection of NUGC4 cells,and then with PBS or AMD3100,small molecular specific antagonist,one day after the cancer cell injection once a day for 2 weeks.Then the mice were killed to observe the intraperitoneal tumorogenesis.Results CXCR4 mRNA was highly expressed in the NUGCA cells but only very weekly expressed in the HMrSV cells.SDF-1 mRNA expression was seen in the HMrSV cells but in the NUGC4 cells.Anti-CXCR4 monoclonal antibody(Mcab)inhibited the proliferation of NUGC4 cells significantly(P＜0.05).In mesothelial cell adhesion test,the number of the NUGC4 cells adhered with HMrSV cells after SDF-1 stimulation was 84.4±21.2,significantly higher than that of the control group(43.6±12.4,P＜0.05).The number of migrating NUGC4 cells in the chemokine group was 170.8±24.2,significantly higher than hat of the control group(102.8±18.2,P＜0.05);and the number of migrating NUGC4 cells in the antibody blocking group was 114.7±20.3,significantly lower than that of the chemokine group(P＜0.05).The survival time of the mice injected with both NUGC4 cells and AMD3100 was(43.8±2.8)days,significantly longer than that of the control group[(28.2±2.5) days,P＜0.01].The tumor number of the AMD3100 group was(54.6±8.2),significantly lower than that of the control group[(103±12.4),P＜0.01].Conclusion SDF-1 and its receptor CXCR4 play an important role in the development of peritoneal carcinometastasis from gastric cancer. Interfering with the SDF-1/CXCR4 biological axis may become a potential strategy in the prevention and treatment of peritoneal carcinometastasis from gastric cancer.

Objective To screen the suitable bacteriophage as virus indictor in irradiation sterilization.Methods Suspensions of bacteriophage T4,φX174D,MS2,and f2,Escherichia coli 8099,and Bacillus subtilis var. niger.sp.ATCC9372 were irradiated with60 Co-γ ray.The mean log10 inactivation value levels of the bacteriophage T4,ΦX174,f2,and MS2 were 6.31,6.92,5.74,and 4.46 log10 respectively,var.niger.sp.ATCC9372 was 1.61 log10.Conclusion The order of resistance of the above six microorganisms to gamma-radiation from the biggest to the smallest iS as follows:Bacillus subtilis var.niger.sp.＞bacteriophage MS2＞bacteriophage f2＞bacteriophage T4＞bacteriophage φX 174D＞E. coli.

Objective To investigate the correlation between chondrocyte apoptosis of cartilage endplate and intervertebral disc degeneration.Methods Forty adult New Zealand rabbits were randomized into 2 equal groups:experimental group,undergoing exposure of the upper and lower margins of vertebral bodies C4 and C5,lower ARFIN OF c3,and upper margin of C6,and wadding of bone cement to the depth of posterior margin to interrupt the nutrition supply to the vertebral endplate,thus establishing the models of intervertebral disc degeneration,and control group,only undergoing exposure of the cervical vertebrae.Four and 8 weeks later ten rabbits from each group were sacrificed to obtain specimens of cartilage endplate and tissues of intervertebral disc.TUNEL approach was used to detect the apoptosis of chondrocytes in the vertebral cartilage endplate and immunohistochemistry was used to determine the expression of type Ⅱ collagen from the intervertebral disc tissues.Results Four weeks after the operation the number of apoptotic chondrocytes of the cartilage endplate in the experimental group was 9.9±0.88/HP,significantly higher than that of the control group(9.7±0.94/HP,P＜0.05).Eight weeks after the operation the number of apoptotic chondrocytes of the cartilage endplate in the experimental group was 12.4±0.71/HP,significantly higher than that of the control group(11.7±0.91/HP,P＜0.05).Four and 8 weeks after the operation,the numbers of type Ⅱ collagen positive cells of the experiment group were 27.7±1.52/HP and 19.5±1.57/HP respectively,both significantly lower than those of the control group ( 29.6±1.54/HP and 20.6±1.40/HP respectively,both P＜0.05). Correlation analysis showed that vertebral cartilage endplate chondrocyte apoptosis wag highly negatively correlated with the expression of type Ⅱ collagen operation 4 and 8 weeks after the operation with the coefficient values of 0.86 and 0.82 respectively(both P＜0.05).Conclusion Chondrocyte apoptosis in vertebral cartilage endplate may result in the decreased expression of type Ⅱ collagen in intervertebral discs and lead to the degeneration of intervertebral discs.

Objective To screen in vivo induced genes of Mycobacterium tuberculosis and search possible molecular targets of new drugs,vaccines,and early diagnostic methods.Methods In vivo induced antigen technology(IVIAT)was used in this study.Genomic DNA from M.tuberculosis of the strain H37Rv was extracted.The DNA was partially digested with Sau3A I and the purified fragments were inserted into the pET30a(+),pET30b(+)and pET30c(+)expression vectors to construct a genomic library.The library was induced with IPTG and then was screened with pooled tuberculosis patient sera preabsorbed with in vitro grown M.tuberculosis of the strain H37Rv and Escherichia coli of the strain BL21(DE3).The inserts of positive clones were sequenced with primer T7 promoter.The sequences were aligned in the genomic database of M.tuberculosis strain H37Rv(http://genolist.pasteur.fr/Tuberculist)to identify the open reading frame(ORF).Results The genomic expression library included 4.3 x 104 clones,and more than eighty percent were recombinant plasmids.The library reached the theoretic requirement.The successive adsorptions significantly decreased the anti-M.tuberculosis antibody titer of sera,and no significant difference was found between the last two adsorption groups,suggesting that the antibodies reactive against tlle M.tuberculosis H37Rv antigens expressed in vitro were removed.After screening of the genomic expression library and searching in the genome database,51 ORFs were identified and they were classified into 8 categories according to the classification criterion on the website,including 1 virulence gene,13 cell wall and cell processes genes,11 intermediary metabolism and respiration genes,7 lipid metabolism genes,2 information pathways genes,3 PE/PPE genes,12 conserved hypotheticals,and 2 conserved hypotheticals with an orthologue in M.bovis.Conclusion Genes expressed specially during human M. tuberculosis infections can be identified with in vivo induced antigen technology.Analysis of these genes identified using IVIAT shows that some genes are related to virulence,some are essential genes for M.tuberculosis,and some encoded proteins have strong immunogenicity,suggesting that some of them can be used as molecular targets of anti-tuberculosis drugs,vaccines,and tuberculosis early diagnosis.

Objective To construct CyclinD(CycD)(-/-)/Patched(Ptc)(+/-)double knockout mice to stuay the relationship between Hedgehog and Rb signaling pathways.Methods Amphimixis was performed between female heterozygote CycD knockout mice CycD(+/-)and male heterozygote Ptc knockout mice Ptc(+/-),thus CycD(+/-)/Ptc(+/-)double knockout mice were obtained.These mice underwent secondary matched and thus construct CycD(-/-)/Ptc(+/-)double knockout mice.Results CycD(-/-)/Ptc(+/-)double knockout mice,CycD(+/-)/Ptc(+/-) heterozygote double knockout mice, and CycD knockout mice CycD( -/-)/Ptc( +/+) were gained.Conclusion The method of amphimixis can construct CycD (-/-)/Ptc (+/-)double knockout mice that can be used to disclose the regulation between Ptc gene and CycD gene and the relativity between Hedgehog and Rb pathways in mammals.

Objective To explore the electrophysiological properties of outward voltage-gated potassium channels of neural stem cells(NSCs)from adult rat hippocampus.Methods NSCs were isolated from the hippocampus of adult SD rats with Serum-free incubation and single-cell cloning technique.Immunochemistry technique was employed to identify the clone cells and clone cell-derived progeny.Electrophysiological recordings of various outward voltage-gated potassium channels were pertormed at room temperature using whole-cell patch clamp.Results The floating neural spheres from the hippocampus showed the expression of nestin antigen,and were able to differentiate into neural cells expressing Yuj1 antigen and glial fibrillary acidic protein(GFAP)respectively in vitro.Three type specialized ion channels were find in cultured NSCs:The outward delayed rectifier outward K+ currents(IDR)was characterized by a slow activation with depolarization and a sensitivity to tetraethylammonium(TEA).The current density of transient A type K+ currents(IA)was 11 pA/pF ±3 pA/pF and 29 pA/pF ±7 pA/pF(n=11)at+20 mV and +50 mV respectively,which was characterized by a rapid activation with depolarization and could be blocked bv 4-AP.The large conductance calcium activated potassium(BKCa)channels was identified by the inhibition of iberiotoxin(IbTX).The current density of this channel at +80 mV was 56 pA/pF ±4 pA/pF and 45 pA/pF±4 pA/pF(n=6,P＜0.05) before and after application of 100 nM IbTX respectively.Conclusion The cultured NSCs of adult rat hippocampus express at least three kinds of outward voltage-gated potassium channels,IDR,IA,and BKCa in vitro.

misoprostol (misoprostol), a derivative of prostaglandin (PG) E1, was synthesized by Searle Company (now merged into Pfizer Company) in 1973. It has been widely used in clinical practice as a drug for the treatment of gastric ulcer after being marketed in 1985.

Supravaginal intraepithelial neoplasia (VAIN) is a precancerous lesion first reported by Graham and Meigs in 1952 [1] and accounts for approximately 1.0% of female lower genital tract intraepithelial neoplasia [2].

Alzheimer's disease (AD) is a progressive neurodegenerative disease with a recessive onset and is characterized by progressive decline in memory and other cognitive functions.

A 50-year-old male, farmer, was admitted to hospital due to the inability to extend the right ring finger for 2 weeks. Six months ago, the patient developed swelling of the metacarpophalangeal joint of the right ring finger without obvious inducement, no fever, cough, night sweat, weight loss, no local pain and sensory disturbance, and did not see a doctor.