Volume 91  ·   Issue 28  ·  2011

Objective To analyze the private hospital the individual characteristics of virtual team members to run the hospital medical process for the impact of the differences, the private hospital managers to develop management strategies for scientific and rational basis. Methods Four different regions of the empirical investigation of private hospitals, and the use of SPSS software for statistical analysis of survey data. Results The ages of staff in dealing with the original terms of team cohesion were significant differences; gender, education, job titles and other features of the nature and impact of medical procedures for the difference was not statistically significant. Conclusion Older employees the minimum of the original team cohesion; women in trust and work among the members of the initiative are better than men; specialist qualifications of staff-level positive initiative, strongest work, job confidence among members of difference in performance prominent.

Objective To investigate the clinical features, diagnosis and therapeutics of extramammary Paget′s disease. Methods A total of 26 cases of scrotal Paget′s disease were included. According to Ray staging, 16, 7 and 3 cases had A1, A2 and B stages of Peget′s diseases respectively. All cases underwent surgical resection of their diseased sites after a biopsy. The excision margin was 2 cm apart from the edge of lesion. And resection depth reached deep fascia. During operation, frozen sections of excised tissue specimens in 18 cases were pathologically examined. And the excision margins were involved by tumor cell in 3 cases(16.67%). Thus extended excision was performed immediately. Postoperatively, excision margin involvement was confirmed in 1 case and phaseⅡoperation performed. Three cases with inguinal lymph node metastasis underwent unilateral or bilateral inguinal lymph node dissection. Results Paget′s disease was confirmed in all 26 cases. Tumor was localized in epidemis in 15 cases and skin invasion found in 11 cases. The lymph node was tumescent in 9 cases. Among them, 3 had pathologically confirmed metastasis and 6 was diagnosed with lymphadenitis. All cases received a mean follow-up period of 5 years (range: 1-7 years). Five locally recurrent cases healed after a second operation. Conclusion Chronic skin lesions of the scrotum should be biopsied as early as possible if extramammary Paget′s disease is suspected. Radical resection of diseased skin is its preferred therapy. A second operation may be performed for recurrence. The prognosis of extramammary Paget′s disease is excellent after radical surgery.

Objective To explore the efficacy and safety of autologous peripherial blood hematopoietic stem cell transplantation (APBHST) in patients with type 1 diabetes mellitus. Methods Hematopoietic stem cells were mobilized with cyclophosphamide and granulocyte colony stimulating factor for 16 patients with type 1 diabetes mellitus who admitted to our department during November 2009 to August 2010. And then stem cells were collected from peripheral blood by leukapheresis and cryopreservation. The cells were infused intravenously after conditioning with cyclophosphamide and antithymocyte globulin. To compare the daily dose of exogenous insulin requirements, the serum levels of hemoglobin A1c (HbA1c), C-peptide, islet cell function during the mixed meal tolerance test were measured before and at different times after APBHST. Blood glucose was monitored 7 times a day before and after APBHST. And the adverse effects were recorded during and after APBHST. Results The median follow-up was 28 weeks (range: 8-44 weeks). Twelve of 16 patients stayed free from insulin at 3-20 days post APBHST. And islet cell function greatly improved after APBHST. Four of 16 patients required exogenous insulin but the dosage decreased. And all 4 patients had a poor level of C-peptide before APBHSCT. There were no such severe adverse effects as myelosuppression. Conclusion Very encouraging results have been obtained in the patients treated with APBHST. There is definite therapeutic effects and safety in a short term. But further follow-up is necessary to confirm the duration of insulin independence and the mechanisms of action.

Objective To evaluate the efficacy and safety of early percutaneous coronary intervention (PCI) within 24 hours of thrombolysis in acute ST-elevation myocardial infarction. Methods The databases of Medline, EMBASE, Elsevier, Cochrane library, Wanfang and CNKI were searched for randomized controlled trials. Quality assessment and data extraction were performed by two independent reviewers. Statistical analyses were conducted with Stata 10.0 and RevMan 5.0 software. Results Eight studies (NORDI-STEMI, TRANSFER-AMI, WEST, CARESS-AMI, CAPITAL-AMI, GRACIA-Ⅰ, SIAMI Ⅲ & PRAGUE-Ⅰ) involving a total of 3157 patients fulfilled the inclusion criteria. Meta-analysis results showed that, as compared with the control group, (1) the combined endpoint of 30 day mortality, re-infarction and ischemia was significantly lower in early PCI within 24 h of thrombolysis group [relative risk (RR)=0.52, 95% confidence interval (CI)0.42-0.65, P<0.001]; (2) 30-day re-infarction decreased in early PCI within 24 h of thrombolysis group (RR=0.57, 95% CI 0.40-0.81, P=0.002); (3) 30-day ischemia had a significant reduction in early PCI within 24 h of thrombolysis group (RR=0.27, 95% CI 0.14-0.52, P<0.001); (4) 30-day major hemorrhage or mortality rates were not significantly different between two groups (RR=1.07, 95% CI 0.78-1.46, P=0.69; RR=0.86, 95% CI 0.62-1.20, P=0.38 respectively). Conclusion When primary PCI is not feasible, our meta-analysis favors early PCI within 24 h of thrombolysis for acute ST-elevation myocardial infarction. Early PCI is associated with a lowered recurrence of major adverse cardiac events, ischemia and re-infarction. But there is no elevated risk of major hemorrhage and mortality.

Objective To explore the diagnostic features and therapeutic methods of intravenous leiomyomatosis with a potential of heart invasion.Methods Eight cases of cardiac involvement with intravenous leiomyomatosis treated at our hospital from November 2002 to August 2011 were analyzed and compared. Results Either imaging or surgery confirmed that in all 8 patients the pelvic lesions originated from the inferior vena cava and heart involvement without pulmonary embolism. In 3 cases, palpitations and chest tightness were noticed. Four cases showed lower extremity edema and abdominal distension while no obvious clinical symptom was found for 1 case. All 8 cases had a history of uterine fibroids and 6 underwent previous hysterectomy. Among 8 patients, there were 5 cases of cardiopulmonary bypassing right heart, inferior vena cava tumor resection and pelvic involvement vein ligation and 2 cases of routine off-pumping of inferior vena cava with pelvic tumor resection. Palliative therapy was administered in 1 case. Two patients were resection the right heart and inferior vena cava tumor in the cardiopulmonary bypass, 3 months later were resection gynecologic uterine, double-accessories and broad ligament and were not treated with hormone.After operation, another 5 surgery patients received high-dose hormone treatments. 2 cases of recurrence in each group were found by ultrasound follow-ups from 15-90 months. Conclusion Invasion of the heart intravenous leiomyomatosis is a rare case, which can be tackled with a good effect by completely surgical resection and a limited effect on hormone therapy to prevent recurrence.

Objective To explore the feasibility and safety of sedation with a low dose of dexmedetomidine (DEX) during intrathecal nesthesia in the elderly patients. Methods Thirty elderly patients were randomly divided into the DEX group (n=15) and the control group (n=15). There were 13 males and 17 females with a mean age of 77 years old (range: 65-89 years old). After an induction of intrathecal anesthesia, the patients in the DEX group received an infusion of 0.4 μg·kg-1·h-1 for 10 min. Then the infusion speed was adjusted between 0.2 and 0.4 μg·kg-1·h-1 to maintain the values of bispectral index (BIS) at around 80. An equivalent volume of normal saline was administered in the control group. Blood pressure, heart rate, respiratory rate, pulse oxygen saturation (SpO2), end-tidal carbon dioxide partial pressure (PETCO2) and BIS were recorded at the beginning of DEX infusion, 10, 20, 30 and 60 min after DEX infusion beginning and at the end of surgery. The observer′s assessment of alertness/sedation (OAA/S) scores and the clinical responses were also recorded. A statistical analysis was performed. Results All intraoperative hemodynamic and respiratory parameters were within the normal range in both groups. Compared with the beginning after infusion, blood pressure at the point of 10 min after infusion decreased about 10%-15% (P<0.05) in the DEX group. But there was no such change in the control group. The values of BIS also decreased significantly at each time point after 10 min infusion versus the beginning of administration (P<0.05); as compared with the control group, the values of BIS also decreased significantly at 30, 60 min and the end of infusion (P<0.05). The 95% confidence interval (CI) of BIS values were 70-95 in the DEX group and 80-100 in the control group (P<0.05). In the DEX group, the OAA/S scores were significantly lower at the points of 20, 30, 60 min and the end of infusion versus the beginning after infusion. And it was also lower in the DEX group than that in the control group (95%CI: 3-4 vs 4-5, P<0.05). No bradycardia occurred in the DEX group. Two of three patients with concurrent atrial fibrillation wereconverted to sinus rhythm after the administration of DEX. Patients with severe lung diseases (pulmonary fibrosis, asthma or chronic obstructive pulmonary disease) maintained normal cardiopulmonary functions in the DEX group. DEX showed a good sedation effect in 1 patient with mental diseases. ConclusionSedation with a small dose of DEX during intrathecal anesthesia in elderly patients is both feasible and efficacious. But studies of larger sample sizes are warranted to confirm its safety.

Objective To explore the relationship between fasting plasma level of total homocysteine (tHcy) and mild cognitive impairment in senile patients with type 2 diabetes mellitus.Methods A total of 88 senile type 2 diabetics with mild cognitive impairment treated at our hospital from July 2008 to November 2010 were recruited into the MCI group while 52 senile type 2 diabetics into the DNC group. And the control group was composed of 36 healthy elders. The parameters of tHcy, total glyceride (TG), total cholesterol (TC) , low density lipoprotein-C (LDL-C), high density lipoprotein-C (HDL-C),creatinine (Cr) , hemoglobin Alc ( HbAlc) , fasting plasma glucose (FPG), 2 h plasma glucose (2 hPG),fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR), folic acid (FA) and vitamin B12 (VitB12) were detected. Results The patients had a higher level of tHcy in the MCI group than those in the NCM and control groups [(11.3 ±1. 8) vs (9. 8 ±1.5) and (8. 1 ±1.1) μmol/L; P＜0.01]. ROC curve showed that tHcy level had some value of predicting the occurrence of mild cognitive impairment in senile patients with type 2 diabetes mellitus ( AUC 0. 825, 95% CI 0. 758 - 0. 893, P ＜0. 01). Logistic regression analysis showed that tHcy, SBP, HbAlc, 2 h PG, FINS, LDL-C, HOMA-IR, FA and VitB12 [OR value: 3.64, 1.68, 1.10, 1.05, 0.81, 1.42, 0.83, 0.74, 0.86 (P＜0.05 or 0.01)] were independent risk factors of mild cognitive impairment in senile diabetic patients. Conclusion Such factors as tHcy, SBP, HbAlc, FPG, 2 hPG, FINS, LDL-C, HOMA-IR, FA and VitB12 induce senile patients with type 2 diabetes mellitus to suffer mild cognitive impairment. But tHcy level may play an important role in senile diabetic patients with mild cognitive impairment.

Objective To investigate the qualitative accuracy of pulmonary artery systolic pressure (PASP) as estimated by transthoracic Doppler echocardiography (TDE). Methods A retrospective study was conducted on 102 adult patients with idiopathic pulmonary arterial hypertension undergoing Doppler echocardiography within 72 hours prior to right heart catheterization. During this period, all patients were stable without any specific drug therapy. Compared with right heart catheterization, the accuracy of PASP as measured by TDE was evaluated. Results Among them, there were 38 males and 64 females with an average age of (31±11) years old (range: 18-59 years old). There was a moderate correlation between the measurements of PASP by TDE and right heart catheterization (r=0.64, P<0.01). Through the analysis of Bland-Altman, the bias for the TDE estimates of PASP was 6.7 mm Hg with a 95% limit of agreement ranging from -47.6 to 34.3 mm Hg. There were 60 (58.8%) cases with absolute differences over 10 mm Hg between two methods. Overestimation and underestimation of PASP by TDE occurred in 15.7% (16/102) and 43.1% (44/102) respectively. The magnitude of pressure underestimation and overestimation was insignificant [(25±12) vs (26±16) mm Hg, P=0.765]. The probability of underestimate was higher than that of overestimate. As to the corresponding diagnostic categories of severity that each subject would fall into for each technique, the diagnostic categories of 16 overestimated patients were in accordance. Among 44 underestimated patients, 9 (20.5%) had their pressure underestimated within one diagnostic category (minor error) while 2 (4.5%) were within two diagnostic categories (major error). Conclusion Due to a frequent rate of inaccurate estimation of PASP, TDE can not replace right heart catheterization. TDE tends to underestimate PASP and results in a diagnostic misclassification of degree.

Objective To determine whether or not morphine postconditioning can induce ischemic/hypoxic tolerance in neurons subjected to reperfusion injury after oxygen-glucose deprivation (OGD). Methods Hippocampal slices of 400 μm thickness were prepared from healthy adult male BALB/c mice. The slices were incubated in oxygen-saturated ACSF without or with calcium, then were subjected to OGD for 20 min. After recovery, the samples were immersed in oxygenated artificial fluid for 2 hours in the presence or absence of morphine postconditioning at 3 μmol/L during the first 5-60 min. The assessment of slices injury was performed by a determination of the intensity of slice stain incubated with TTC (2% 2, 3, 5-triphenyltetrazolium chloride) and the leakage rate of LDH also evaluated. At the designated periods during incubation, some slices were immersed into liquid nitrogen for a later analysis of Western blot. The frozen slices were homogenized, sonicated and centrifuged to separate soluble and particulate proteins. 10% SDS-PAGE Western blot was used to identify the changes of membrane-specific translocation of cPKCβⅡ/γ. Results After reperfusion, the cell survival significantly decreased with the elongation of OGD (51.4%). The release rate of LDH (184.05%) significantly increased simultaneously. In hippocampal slices postconditioned with morphine for 20-60 min, the release rate of LDH (136%, 142%, 144%) significantly decreased as compared with the group OGD. In the hippocampal slices postconditioned with morphine for 10-30 min, the cell survival rate (64.9%, 69.9%, 63.5%) significantly increased as compared with reperfusion alone. cPKCγ of particulate fraction increased versus the control. And there was a corresponding decrease of cytosolic fraction. Morphine postconditioning significantly inhibited the cPKCγ isoform-specific membrane translocation. It declined from 136% in the group OGD to 123%, 118%, 114% in the group morphine 20-60 min. cPKCβⅡmembrane translocation had no change. Conclusion Morphine postconditioning can induce ischemic tolerance in nerons. The protective mechanism may be through inhibiting the cPKCγ isoform-specific membrane translocation.

Objective To explore the effects of combined enteral nutrition (CEN) on the hemorheologic parameters and the changing levels of inflammatory factors in an animal model of severe acute pancreatitis (SAP). Methods The experimental animals were divided randomly into 3 groups, i.e. early enteral nutrition (EEN) group, CEN group and parenteral nutrition(PN)group (n=20 each). Enteral nutrition was administered to the EEN and CEN group animals at 24 h and 72 h post-modeling respectively. The PN group animals were supported by parenteral nutrition all time. Hemorrheologic indices of all experimental animals were examined on Days 1, 3 and 7 post-modeling. And the inflammatory factors were examined on Days 1 and 7. Results Compared with the EEN and PN groups, some hemorrheologic indices of the CEN group decreased significantly (P<0.05) on Day 7 post-modeling. They included blood sedimentation, hematocrit (HCT), whole blood high-cut reduction viscosity and whole blood low-cut reduction viscosity. As compared within the CEN group, each hemorrheologic index was lower on Day 7 than that on Day 1 (P<0.05). Except for whole blood high-cut reduction viscosity and erythrocyte aggregation index in the EEN group after a 7-day nutrition support, there was no significant change for all hemorrheologic indices in the PN group. As to the level of inflammatory factors, the values of interleukin 8 (IL-8) and tumor necrosis factor-α (TNF-α) in the CEN group were lower than those in the PN group on Day 7 post-modeling (P<0.05). The values of IL-8 and IL-6 in the CEN group were lower than those in the EEN group on the same day(P<0.05). As compared within the CEN group, the values of IL-6 and TNF-α were lower on Day 7 than those on Day 1 post-modeling (P<0.05). Conclusion The modulatory mechanism of EN over SAP should be achieved by correcting hemorrheologic index change and lowering the level of inflammatory factors. A proper timing of EN is probably the most optimal nutrition support mode of SAP therapy.

Objective To investigate the effects and the possible mechanistic pathway of phosphodiesterase type 5 (PDE5) inhibitors on rats with overactive bladder. Methods A total of 24 adult male spontaneously hypertensive rats (SHRs) were randomly divided into 3 groups: daily lavage group, discontinuous lavage group and blank group (n=8 each). Daily vardenafil (10 mg·kg-1·d-1), discontinuous vardenafil (10 mg·kg-1·d-1) and daily normal saline were administered respectively to 3 groups by lavage. And 8 adult male SD rats were included into the control group. Bladder urodynamic examinations were conducted in each group 2 weeks later. Then bladder detrusor muscle strips isolated from each group were further divided into two parts. One part was first pre-contracted and then the relaxant effects of sodium nitroprusside and Y-27632 were observed. For another part, enzyme-linked immunosorbent assay was used to measure cyclic guanosine monophosphate (cGMP). Results As compared with the control group, the values of bladder intercontraction interval (ICI) and bladder capacity (BC) were significantly lower [(409±36)s vs (568±60)s,(284±25) μl vs (395±42)μl,P<0.01] while the bladder nonvoiding contraction (NVC) was significantly higher in the blank group[(2.03±0.49) number/min vs(1.07±0.30)number /min,P<0.01]. Compared with the blank group, the values of ICI and BC were elevated. NVC decreased obviously in the discontinues and daily lavage groups [(486±53)s and (564±44) s;(337±37)μl and (392±30) μl;(1.82±0.32 )number/min and (0.52±0.23) number/min,P<0.05]. The effects were more significant in the daily lavage group (P<0.01). The maximal relaxant effect of sodium nitroprusside was obviously enhanced in the discontinues and daily lavage groups [(50.6±2.1)% and (67.9±4.1)% vs(25.3±5.0)%,P<0.01]. However the sensitivity of Y-27632 decreased significantly [(35.8±2.5)% and (20.2±2.3)% vs (71.6±2.8)%,P<0.01], while the level of cGMP was significantly higher in the bladder detrusor muscle [(20.6±4.1) fmol/mg and (29.4±4.3) fmol/mg vs (12.9±2.1) fmol/mg,P<0.01]. The effects of the daily lavage group were more pronounced (P<0.01). Conclusion The phenomenon of bladder overactivity is observed in the SHRs. The PDE5 inhibitors are effective in treating overactive bladder. And the effect of daily supplement is much better. In addition, the mechanism may operate through the cGMP-dependent protein kinase G-RhoA/Rho kinase signaling pathway.

Objective To evaluate the expression of Th17 cell in a cigarette smoke-induced mice model of emphysema and explore the probable mechanisms of its elevation. Methods Forty male Balb/c mice were randomly divided into 4 groups: control group for 12 weeks (C12), control group for 24 weeks (C24), smoke-exposure group for 12 weeks (S12) and smoke-exposure group for 24 weeks (S24)（n=10 each）. Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI). The percentages of Th17, Th1, Th17/Th1, CD4+IL-17+CCR6+T and CCR6+Th17 cells were determined by tetra-color flow cytometry while the levels of interleukin （IL）-1β, IL-6, IL-23, transforming growth factor (TGF)-β, interferon (IFN)-γ and CC chemokine ligand (CCL)-20 assayed by enzyme-linked immunosorbent assay (ELISA). Results The values of Lm [(39±4) μm, (47±7) μm] and DI [(39.1±1.6), (45.2±3.1)] were significantly higher in S12 and S24 than those in C12 [(33±3) μm, (28.2±1.6)] and C24 [(32±4) μm, (28.9±2.1)], particularly in C24 (all P<0.05). The percentages of Th17 cell [(3.27±1.12), (7.19±2.24)], Th17/Th1 cell [(0.61±0.30), (1.82±0.52)] and Th1 cell [(10.02±3.68), (26.21±6.04)] in the lungs of S12 and S24 significantly increased than those in C12 [(1.80±0.75), (0.27±0.12), (3.75±1.72)] and C24 [(1.99±0.59), (0.28±0.11), (4.16±1.32)], particularly in C24 (all P<0.01). The percentages of Th17, Th17/Th1 and Th1 cells in the lungs of S12 and S24 had a positive correlation with Lm and DI (all P<0.01). The percentages of CD4+IL-17+CCR-6+T cell [(0.69±0.34), (1.11±0.48)] and CCR6+Th17 cell [(12.23±2.13), (18.65±1.17)] were significantly elevated in S12 and S24 compared to those in C12 [(0.22±0.18), (6.55±2.13)] and C24 [(0.25±0.17), (7.29±1.57)], particularly in C24 (all P<0.05). Furthermore, a positive correlation between CCR6+Th17 cell and emphysematous lesions was also found (all P<0.05). The levels of IL-1β, IL-6, IL-23, TGF-β, IFN-γ and CCL20 significantly increased in S12 and S24 as compared with those of C12 and C24 (all P<0.05). Meanwhile, the percentage of Th17 cell had a positive correlation with IL-1β, IL-6, IL-23, TGF-β, IFN-γ and CCL20. Conclusion There is an up-regulated expression of Th17 in lungs of cigarette smoke-induced emphysema mice. The CCR6/CCL20 axis and the elevated levels of IL-1β, IL-6, IL-23, TGF-β and IFN-γ may be related with the above effect.

Objective To discuss the regulating mechanism of iron regulatory protein-2 (IRP2) in the iron metabolism of lung cancer. Methods The cultured A549 cells were divided into 3 groups: liposome group (including liposomes 20 mg/L), random oligonucleotide group (SCODN group) and antisense oligonucleotide group (ASODN group). And the liposome-mediated transfection was employed with the liposome and SCODN groups as controls. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to examine the mRNA and protein expressions of iron metabolism-related transferring (Tf), transferrin receptor (TfR) and ferritin (Fn) genes, etc. Results After a 48-hour transfection, the mRNA expression of Tf had no statistically significant difference among three groups (F=2.18, P=0.078); the mRNA expression of TfR in the ASODN group was significantly lower than that in the liposome and SCODN groups (P＜0.05). The expression of Fn mRNA in the ASODN group (0.56±0.06) was higher than that in the liposome (0.36±0.05) and SCODN groups (0.39±0.03) (P＜0.05). After a 48-hour transfection, the IRP2 protein expression of the ASODN group was significantly lower than those of the liposome and SCODN groups (P<0.05). The Tf protein expression was not statistically different in three groups (F=2.67, P=0.088). The TfR protein expression of the ASODN group was lower than those of the liposome and SCODN groups (P<0.05). And the Fn protein expression of the ASODN group was higher than those of the liposome and SCODN groups (P<0.05). Conclusion IRP2 may affect the expressions of TfR and Fn in lung adenocarcinoma A549 cells by changing the amount of protein and regulating the iron metabolism.

Objective To investigate the effects of soy isoflavones (SI) on the expression of estrogen receptor-α (ER-α) in senile rat ovaries and ovarian granulosa cell cultured in vitro treated with genistein, a major active component of SI. Methods The animal model of perimenopause rats was established by unforced aging. The animals were treated by intragastric administration (ig) with low (50 mg/kg), middle (158 mg/kg) and high (500 mg/kg) dose of SI for 8 weeks. The expressions of ER-α mRNA and protein were detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry respectively. The granulosa cells of rat ovaries were isolated and administered with genistein(0, 0.1, 1, 5, 10, 100 μmol/L) for 48 h and the expression levels of ER-α mRNA detected by RT-PCR. Results The ER-α mRNA expression levels of the low, middle and high dose groups of SI (0.207±0.014, 0.316±0.073 and 0.402±0.170 respectively) were higher than those of the model group (0.671±0.170) (all P<0.01). The expression levels of ER-α protein for the low, middle and high dose groups of SI (7.35±4.90, 13.90±5.12 and 23.79±10.31 respectively) were higher than those of the model group (2.74±0.09) (all P<0.01). The expression levels of ER-α mRNA in granulosa cells treated with 1, 5, 10 μmol/L genistein for 48 h were 0.927±0.232, 1.067±0.154, 1.118±0.126 respectively(all P<0.01). They were higher than those of the control group (0.671±0.170). But the expression levels of 100 μmol/L genistein group were lower than those of the control group (P<0.05). Conclusion Soy isoflavones can up-regulate the expressions of ER-α mRNA and protein in senile rat ovaries. As a major active component of soy isoflavones, genistein can regulate the expressions ER-α mRNA in granulosa cells of rat ovaries. Such an effect is concentration-dependent. And 1-10 μmol/L genistein may up-regulate the expression of ER-α mRNA.

Objective To explore the therapeutic effect of transplantation of bone marrow mesenchymal stem cells (BMSCs) over-expressing Cx43 on heart failure in post-infarction rats. Methods Sixty SD rats were randomly divided equally into 4 groups: sham group , DMEM/F12 group injected with DMEM/F12, EGFP group with transplanted EGFP transfected BMSCs and Cx43 group with transplanted Cx43 transfected BMSCs. Myocardial infarction model was established by ligating anterior descending branch and the cells were transplanted after 30 minutes. At Week 4 post-infarction, the heart functions of rats were evaluated by echocardiography. After the rats were sacrificed, their tissue samples were collected. The areas of myocardial infarction and the levels of collagen fiber content were measured. And the expressions of EGFR and Cx43 were observed under laser confocal microscopy. The level of Cx43 mRNA was measured by reverse transcription-polymerase chain reaction (RT-PCR). Results As compared with the DMEM/F12 group, cardiac function was improved significantly, myocardial infarct area shrunk and collagen fiber content decreased significantly in the EGFP and group in Cx43 groups the . Survival of BMSCs and the formation of gap junction between BMSCs and the host myocardium could be observed under laser confocal microscopy both in EGFP group and Cx43 groups. And the post-infarction, expression of Cx43 mRNA in myocardial tissue decreased significantly in the group DMEM/F12, when compared with sham group(0.18±0.05 vs 0.78±0.14, P<0.01). There was no significant difference on expression of Cx43 mRNA between DMEM/F12 group and EGFP group (0.18±0.05 vs 0.20±0.09, P>0.05). The lever of Cx43 mRNA was higher in group Cx43 than in group DMEM/F12 and group EGFP(0.39±0.14 vs 0.18±0.05, P<0.01; 0.39±0.14 vs 0.20±0.09, P<0.05). Conclusion Transplantation of BMSCs attenuates ventricular remodeling and improves cardiac functions. It may result from the over-expression of Cx43 gene through its effects of improving gap junction remodeling and increasing electro-mechanical coupling between myocardial cells in peri-infarct area.

Objective To evaluate the safety of enterovirus type 71 (EV71) inactivated vaccine (human diploid derived) for infection prevention in an animal model by investigating the immune responses and related patho-inflammatory reactions. Methods In the neonatal monkey model for EV71 vaccine protection, vaccinated group (n=4) and unvaccinated group (n=4) were attacked with live virus at the same time, the parameters of clinical observations, antibodies and inflammatory factors in peripheral blood and cerebrospinal fluid (CSF) were detected. And the pathological changes in major organs were used to determine the patho-inflammatory reactions during the immune responses elicited by vaccination. Results The neutralizing antibodies of vaccine group reach to 1∶ 32. There was no obvious changes of inflammatory factors in peripheral blood and CSF of monkeys challenged or unchallenged by live virus. In peripheral blood of unvaccinated group, the level of basophilic granulocyte higher 4-5 times than normal level and the interferon-γ(IFN-γ) showed obvious increase. Live virus infected after 7 days, the interleukin-6(IL-6)and IFN-γ in peripheral blood of unvaccinated group(18.5、12.7 pg/ml)were higher than vaccinated group (10.2、7.6 pg/ml). Furthermore, the IL-6 in CSF(102.0 pg/ml) had 4-5 times increased than vaccinated group (12.4 pg/ml) at 7 days after virus exposure. Meanwhile, the pathological analysis revealed that no obvious changes were detected in CNS and other organs of vaccinated monkeys challenged with live virus. However, the pathological damages induced by virus infection could be determined in the unvaccinated control monkeys, including neuronal damage, massive cellular infiltration associated with pulmonary edema/hemorrhage and pulmonary/bronchial damage due to an infiltration of inflammatory cells. Conclusion Capable of inducing an immune response, the EV71 inactivated vaccine offers protection to neonatal rhesus monkeys against the attacks of live virus. Based on the results of no patho-inflammatory reaction and pathological damage after viral infection in vaccinated animals, the excellent safety of this vaccine may be confirmed in neonatal monkey.

Coronary CT can clearly show plaque, but it is difficult to distinguish the subtle features of plaque with naked eye [1]. If different CT values are coded by color, the contrast will be more obvious, and the recognition of plaque will become easier. This paper reports the effect of color coding of coronary CT plaque in one case, and compares it with intravascular ultrasound (Figures 1-4).

Bleomycin is a glycopeptide antibiotic, which is usually used in chemical pleurodesis, the treatment of skin verruca, and the treatment of many kinds of tumors.An article published in the New England Journal of Medicine on December 9, 2010 (N Engl J Med, 2010, 363:e36) reported that a 39-year-old woman from Harvard Medical School in Boston, USA, was treated with bleomycin for internal sclerotherapy due to vascular malformation in the posterior tongue. After one week, she showed no pain, no itching, whipping-like pigmentation in the trunk, no hair loss, no obvious changes in nails and mucosa, no dyspnea and pulmonary symptoms.

At present, most randomized subjects for asthma treatment select patients in ideal state, and often do not consider many factors such as smoking, poor reversibility, poor lung function, medication compliance, inhalation device use technology and tolerability.

A 15-year-old male, weighing 32 kg, was admitted to our hospital for surgical treatment due to scoliosis.There was no history of food or drug allergies.Personal history and family history were not special. Pulmonary function test (PFT) showed restrictive ventilatory dysfunction.1 s forced expiratory volume (FEV1) accounted for 29.5% and forced vital capacity (FVC) accounted for 24.5% of the predicted values. Arterial blood gas analysis during inhalation showed that arterial oxygen partial pressure (PaO2) was 99.2 mm Hg (1 mm Hg =0.133 kPa), arterial carbon dioxide partial pressure (PaCO2) was 40.2 mm Hg.