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A 39-year-old female patient presented with a painful plaque with ulcers on the right cheek for 2 months.She had acute myeloid leukemia for 1 year.After treatment,the patient achieved remission,but experienced recurrence half a year prior to the presentation.Skin examination showed a violaceous plaque measuring 5 cm × 5 cm in size on the right cheek with erosions and ulcers in the center,whose surface was covered with yellowish brown crusts.Granulation tissues were observed on the plaque,and yellow pus was exuded after the crusts were removed.The boundary of the plaque was sharp and slightly elevated,and there was obvious tenderness on palpation.Laboratory examination revealed increased white blood cell (WBC,28.75 × 109/L) and lymphocyte counts (27.17 × 109/L),but decreased neutrophil (1.05 × 109/L) and red blood cell counts (2.20 × 1012/L),hemoglobin level (69 g/L) and platelet count (84 × 109/L) in the peripheral blood.The hepatic and renal function,electrolyte level and electrocardiogram were normal.Hematoxylin and eosin (HE) staining and periodic acid-Schiff staining of the lesion showed a large number of lymphocytes and histiocytes infiltrating in the dermis and broad aseptate hyphae.The fungal microculture yielded broad hyalinea septate hyphae,fungal rhizoids,stolons and spherical sporangia.The isolated fungus was identified as Mucor irregularis by using molecular biology techniques.The patient was diagnosed with primary cutaneous mucormycosis caused by Mucor irregularis complicated by acute myeloid leukemia.Then,the patient was treated with oral hydroxyurea at a dose of 0.5 g thrice a day,a single-dose intravenous infusion of 4 units of red blood cell suspension,and intravenous drip infusion of amphotericin B at an initial dose of 5 mg/d,which increased by 5 mg every day until 25 mg/d (about 0.5 mg· kg-1· d-1).After the treatment,the lesion gradually became fiat and smaller.After 12-day treatment,the patient was discharged because of a certain reason,and finally lost to follow-up.
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Objective To study the mechanism of adaptive immunity against Rhizopus arrihizus (R. arrihizus) infections. Methods Bone marrow derived dendritic cells (BMDCs) were separated from C57BL/6 mice and Card9-/- mice and then were cultured in vitro. Resting spores and swollen spores of R. arrihizus were in vitro co-cultured with BMDCs with or without Syk inhibition. Secretion of cytokines ( IL-23, IL-1βand IL-12) was analyzed by ELISA after 24 hours of culture. Na?ve T cells derived from C57BL/6 mice were in vitro co-cultured with spore-stimulated BMDCs for four days. Levels of IL-17A and IFN-γ in supernatants of cell culture were analyzed by ELISA. Flow cytometry was performed to analyze T cell differ-entiation. Confocal microscopy was used to observe the images of stained β-glucan on the surface of resting and swollen spores. Swollen spores were co-cultured with Dectin-1, Dectin-2, TLR2 and mannose receptor ( MMR) , and the binding results were analyzed by flow cytometry. Results Swollen spores but resting spores could induce the maturation of BMDCs and promote the secretion of cytokines (IL-23, IL-1βand IL-12). Co-culturing T cells with swollen spore-stimulated BMDCs enhanced their differentiation to Th17 and Th1. In addition, swollen spores promoted the secretion of Th1-related cytokine ( IFN-γ) and Th17-related cytokine (IL-17A). Adding Syk inhibitor to Card9-/-BMDCs or wild type BMDCs significantly inhibited the secretion of cytokines and T cell differentiation, especially in the Card9-/- group. β-glucan was overserved on the surface of swollen spores, but not on resting spores. On the surface of swollen spores existed pathogen associated molecular patterns ( PAMPs) that could bind with Dectin-1 and TLR2. Conclusion Swollen spores of R. arrihizus could active BMDCs to secrete cytokines of IL-23, IL-1β and IL-12 and trigger T cell responses in vitro. The possible mechanism might be associated with β-glucan exposed on the surface of swollen spores that binds with Dectin-1. The responses between BMDCs and R. arrihizus are Syk-Card9-dependent.
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Objective Paeoniflorin ( PAE) is a potential neuroprotective agent.In this study, we investigated the protective effect of PAE on cerebral ischemia/reperfusion ( CI/R) injury in gerbils and its underlying mechanisms. Methods The model of CI/R was established in 50 gerbils by bilateral common carotid occlusion for 10 min followed by 6-hour reperfusion.Then the animals were equally randomized into five groups:sham, model, 5 mg/kg PAE, 10 mg/kg PAE, and 20 mg/kg PAE.The latter three groups were treated with intraperitoneal injection of PAE once daily for 3 days before carotid occlusion, while the former two groups with saline only, all at 10 ml/kg.Stroke indexes were calculated during the reperfusion.The contents of endogenous neuropeptides, endothelin and calcitonin gene-related peptide ( CGRP) in the plasma were measured by radioimmunoassay.The levels of superoxide dismutase ( SOD) and malondialdehyde ( MDA) in the brain tissue homogenate were determined by the method of xanthine oxidase. Results The 5, 10, and 20 mg/kg PAE groups showed significantly decreased stroke index (14.8 ±3.6, 12.3 ±2.0, and 12.7 ±1.4) as compared with the model group (18.4 ±2.9) (P<0.05), but remarkably increased SOD activity ([99.30 ±9.71], [106.85 ± 15.13] , and [110.25 ±14.90] vs [86.54 ±10.22] nU/mgPro, P<0.05) .The MDA content was significantly lower in the 10 and 20 mg/kg PAE groups than in the model group ([69.23 ±8.42] and [65.91 ±7.64] vs [94.76 ±10.30] μmol/mgPro, P<0.01). The plasma endothelin level was markedly decreased in all the PAE groups in comparison with the model group ([24.06 ±5.37], [19.62 ±5.60] and [21.08 ±4.64] vs [30.52 ±7.13] ng/L, P<0.05). Conclusion The protective effect of PAE pretreatment in CI/R injury appears to be associated with the inhibition of the brain free radicals, lipid peroxidation and endothelin production.
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Objective To examine the anticancer effect of a novel histone deacetylase inhibitor (HDACi), JZ004, on colon cancer cells HCT-8 and HT-29, and to investigate the molecular mechanisms of proliferation inhibition and apoptosis induction of cancer cells treated by JZ 004.Methods Colon cancer cells were treated with a series of concentrations of JZ004 .MTT assay was used to detect the proliferation of cancer cells .The cell cycle distribution and apoptosis were deter-mined by flow cytometry .Rhodamine 123 and DCFH-DA were applied to detect the mitochondrial membrane potential (ΔΨm) and reactive oxygen species ( ROS) production.The protein expressions of acetyl-histone H3, p21, cyclin-dependent kinase(CDK)4, Bcl-2, Mcl-1 and Bax were assayed by Western blotting .Results JZ004 was found to inhibit proliferation and induce apoptosis of colon cancer cells in a time-and dose-dependent manner , accompanied by a dose-dependent hyperacetylation of histone H3.JZ004 induced the cancer cell arrest in G 0/G1 phase by increasing the expres-sion level of p21 while CDK4 was downregulated .JZ004 also increased cellular ROS production and reduced ΔΨm by regu-lating the expressions of Bcl-2 family proteins .Conclusion As a novel HDACi , JZ004 effectively inhibits proliferation and increases ROS production to induce apoptosis of colon cancer cells .The results indicate that JZ004 is a potential compound to be developed as an anti-colon cancer agent for clinic application .
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Objective To explore the influence of telephone follow-up after discharge on the re-admission rate of patients with chronic heart failure.Methods In total,161 patients were randomly divided into the observation(n=81)and control group (n=80).All participants received conventional guidance following discharge from our hospital.The patients in the observation group were subject to telephone follow-up for 6 months and individualized caring intervention.The re-admission rates after 6 months after discharge between two groups were statistically compared.Result The re-admission rate in the observation group was 30.9%, significantly lower compared with 42.5% in the control group(P<0.05).Conclusion The telephone follow-up combined with individualized caring intervention can reduce the re-admission rate among the patients with chronic heart failure.
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In plants, proteins with A20/AN1 zinc finger domain are involved in stress responses, named as "Stress Associated Protein" (SAP) gene family. Based on Expressed Sequence Tag (EST) sequences information in Badila Saccharum officinarum mature related cDNA library, we cloned an SAP gene from sugarcane full length cDNA library, named ShSAP1 (GenBank: Accession No. HM991960). To characterize ShSAP1, we analyzed its genome structure and expression pattern. Southern blot analysis showed ShSAP1 was present as one or two copy in the genome of Badila. Comparison of ShSAP1 1 008 bp full length cDNA with a genomic frangment (2 241 bp) generated by PCR amplification and sequencing, revealed the presence of two introns (202 bp and 1 052 bp) located in the 5'UTR region. Semiquantitative RT-PCR analysis found ShSAP1 expressed in leaves, roots and stalk in mature sugarcane. Compared with immature stems, ShSAP1 expressed higher in mature stalk. ShSAP1 was induced by different types of treatments, such as salt (200 mmol/L NaCl), drought (10% PEG 6 000), GA3 (200 mg/L), ABA (100 micromol/L) and ET (1 mmol/L) during sugarcane seedling stage. These results indicated that ShSAP1 may function in sugarcane maturation and abiotic stress response processes.
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Amino Acid Sequence , Cloning, Molecular , Gene Expression Regulation, Plant , Molecular Sequence Data , Plant Proteins , Genetics , Saccharum , Genetics , Metabolism , Stress, Physiological , Genetics , Zinc Fingers , GeneticsABSTRACT
@#Objective To observe effect of hemiplegic gymnastics on motor function and activities of daily living(ADL)of stroke patients.Methods 60 stroke patients were randomly divided into the rehabilitation group and hemiplegic gymnastics group with 30 cases in each group.All patients of two groups received conventional physical therapy and occupational therapy training,using neural technology for development.The course was eight weeks.At same time the patients of the gymnastics group also received hemiplegic gymnastics treatment.Before and after treatment,all patients of the two groups were assessed with Fugl-Meyer Assessment(FMA)for motor function and Modified Barthel Index(MBI)for ADL respectively.The changes of FMA and MBI scores of patients in two groups were compared.Results Before treatment,there was no significant difference in FMA and MBI scores between two groups(P>0.05);after treatment,the FMA and MBI scores of the patients in the gymnastics group were superior to that of the rehabilitation group(P<0.01).Conclusion Hemiplegic gymnastics combined with conventional rehabilitation training can improve motor function and ADL of stroke patients.
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@#ObjectiveTo observe the ultrastructures of vessel and endotheliocyte in the early stage(2 h after stimulation finished) after acute mechanical middle cerebral artery(MCA) vasospasm in cats.MethodsThe right MCA of 6 cats were mechanically stimulated using a small smooth stainless steel nail in the field acrossing the olfactory tract for 30 min.The diameter of MCA was recorded by metrical ocular of microscope.The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull.The ultrastructure of vessel and endotheliocyte were investigated through the electron microscope.ResultsThe diameter of MCA decreased to 68.78% of normal.2 h later,the diameter of MCA recovered.The perfusion index of the cortex surface decreased to 42.59% of normal and up to 61.87% 2 h later.The chromatin of endotheliocyte congregated to the side and formed the lunular body.The heaves of mitochondria(MIT) are blurry 2 hours after the mechanical stimulation.ConclusionThe persistent mechanical stimulation can cause acute cerebral vasospasm,which may involve the apoptosis of endotheliocyte of MCA.It is important to reduce the mechanical stimulus to the cerebral vessel in order to avoid acute cerebral vasospasm during clinical and basic craniotomy.
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BACKGROUND: Cerebral ischemia and reperfusion affects not only cellular necrosis at acute stage, but also delayed neuronal apoptosis in central neural system.OBJECTIVE: To observe apoptosis rate, necrosis rate and expression of Bcl-2 and Bax apoptpsis-regulating proteins in hippocampal neurons at various reperfusion stages of complete cerebral ischemia in rats so as to probe into the regulation of injury induced by complete cerebral ischemia and reperfusion.DESIGN: Randomized control experiment.SETTING: Department of Neurosurgery and Department of Anesthesiology in Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences.MATERIALS: The experiment was performed in Beijing Institute of Neurosurgery Affiliated to Capital University of Medical Sciences from January 2003 to January 2004. Totally 33 healthy adult male Wistar rats of clean grade were employed, randomized in 5 groups, named ischemia +reperfusion 24 hours group (24 hours group) (7 rats), ischemia + reperfusion 48 hours group (48 hours group) (7 rats), ischemia + reperfusion 72hours group (72 hours group) (7 rats), ischemia + reperfusion 7 days group (7 days group) (7 rats) and sham-operation control (control) (5 rats).INTERVENTIONS: Model of complete cerebral ischemia and reperfusion was prepared in rat. Cerebral hippocampal tissues were collected in 24, 48,72 hours and 7 days after reperfusion successively. The flow cytometer was used to determine cellular apoptosis rate and necrosis rate and expression of Bcl-2 and Bax proteins in cerebral hippocampal neurons in rats.percentages of Bcl-2 and Bax proteins.hippocampal neurons in 7 days group was the highest [(24.59±0.97) %].The peak value of necrosis rate presented in 24 hours group [(16.67±1.04)%], which was remarkably higher than the control [(1.28±0.50)%,low [(1.07±0.27)%], but high expression of Bax presented [(46.09±5.37)%].and reperfusion [(14.41±0.67)%] and the peak value of Bax protein presented in 72 hours after ischemia and reperfusion [(77.38±1.52)%].CONCLUSION: Hippocampal neuronal apoptosis rate is increased gradually and expression of Bcl-2 and Bax apoptosis-regulating genes was increased abnormally after injury induced by complete cerebral ischemia and reperfusion, which suggests that Bcl-1 and Bax proteins are involved in apoptosis regulation in the injury induced by complete cerebral ischemia and reperfusion.
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BACKGROUND: Cerebral vascular spasm is the main complication of intracranial aneurysm during perioperative period. Anesthesia of clamp operation of intracranial aneurysm not only meet the basic requirement of anesthesia, but also prevent cerebral vascular spasm and protect cerebral function possibly.OBJECTIVE: To observe the changes of angiotensin Ⅱ and endothelins of paitents with intracranial aneurysm under the anesthesia of desflurane during the clamp operation so as to discuss the effect of desflurane on cerebral protection.DESIGN: Case analysis.SETTING: Department of Neurosurgery and Department of Anesthesiology of Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences.PARTICIPANTS: Totally 64 patients, 30 males and 34 females, who were prepared for clamp operation of intracranial aneurysm, were selected from Department of Neurosurgery of Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences between October 2002 and June 2004.METHODS: After anesthesia induction, tracheal cannula was used to control respiration and desflurane was used to maintain the anesthesia. Totally 4 mL arterial blood were collected at the four time points: before anesthesia induction, cutting dura mater, clamp aneurysm and 30 minutes after clamp aneurysm. Levels of angiotensin Ⅱ and endothelins in plasma were assayed with radioimmunoassay.MAIN OUTCOME MEASURES: Levels of angiotensin Ⅱ and endothelins at the four time points: before anesthesia induction, cutting dura mater,clamp aneurysm and 30 minutes after clamp aneurysm.RESULTS: Aneurysm of two patients was disrupted during the operation of angiotensin Ⅱ was ranged normally before operation, and that at the other three time points during the anesthesia of desflurane did not changed endothelins: Level of endothelins at the three time points of cutting dura mater, clamp aneurysm and 30-minutes after clamp aneurysm was lower than that at the time point of pre-an esthesia induction [(40.4±10.3),(40.0±9.6), (40.7±12.3), (49.3±12.7) ng/L, (P=0.002, 0.001, 0.009)].CONCLUSION: Levels of angiotensin Ⅱ and endothelins which anesthetizes by desflurane are not increased during the whole clamp operation of intracranial aneurysm. However, level of endothelins is obviously lower than that at the time point of pre-anesthesia induction, and there is not significantly different from that at various time points of the operation. This suggests that anesthesia of desflurane can avoid the onset of acute cerebral vascular spasm induced by the increasing liberation of angiotensin Ⅱ and endothelins and decrease the onset of secondary cerebral ischemic injury so as to protect brain.
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@#ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.
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90 bpm and nicardipine 10?g?kg-1 when MAP increased by 20% of the baseline value. Radial artery was cannulated for continuous BP monitoring and blood sampling. MAP, ECG, HR, SpO2 , PET CO2 and body temperature were continuously monitored during anesthesia. Blood samples were taken before induction of anesthesia (T1), when dura was cut (T2), when aneurysm was clipped (T3 ) and 30 min after clipping (T4 ) for determination of plasma concentrations of AT- Ⅱ , ET and CGRP by radioimmuno-assay.Results Plasma concentration of AT- Ⅱ and HR did not change significantly through out the study. Plasma CGRP concentration and MAP decreased significantly during operation at T2-4 as compared to the baseline values (T1 ) . Plasma ET concentration increased significantly at clipping (T3 ) as compared to that at T2. Conclusion The action of vaso-constrictors (AT- Ⅱ , ET) predominates over that of vaso-dilator during operation. It is important to prevent acute cerebral vasospasm during intracranial aneurysm clipping.
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Objective To investigate the effect of isoflurane at different concentration on the quantitative electroencephalogram(SEF and BIS) , intracranial pressure(ICP) and hemodynamics during neurosurgery Methods Thirty ASA grade Ⅰ Ⅱ patients with saddle tumor ,scheduled for selective operation, were randomly divided into three groups after induction with fentanyl propofol vecuronium and intubation Anesthesia was maintained with inhalation of 0 5,1 0 or 1 5 MAC of isoflurane in each group respectively MAP,HR,ICP,SEF and BIS were recorded before induction,reaching the designed MAC, at incision ,sawing bones and opening dura Results SEF and BIS decreased significantly with increases in concentration of isoflurane MAP decreased markedly at1 5 MAC compared with that at 0 5 MAC (P
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Objective: To observe the effects of total intravenous anesthesia(TIVA)and spontaneous respiration on brain oxygen balance status in patients undergoing brain stem neoplasm resection. Method: Thirty patients,ASA grade Ⅰ-Ⅱ, received endotracheal intubation with spontaneous respiration and TIVA. TIVA was maintained with intravenous 0.2% lidocaine 2-3mg?kg~(-1). h~(-1),0.4% propofol 4-6mg?kg~(-1),h~(-1)and 1% ketamine 1-1.5mg?kg~(-1). h~(-1). Arterial and jugular bulb blood samples were taken before and after induction,sawing skull and removing trmor seperately to analyse blood gas. According to Fick principle, the level of CaO_2,CjvO_2 and C (a-jv)O_2 were calculated. Result:The hymodynamics, SaO_2 and CaO_2 remained stable during whole procedure. In comparison with the baselines. respiratory rate, minute volume, arterial blood pH and C(a-jv)O_2 were decreased, and PaCO_2.SjvO_2, and CjvO_2 were increased significantly (P
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Cerebral topographic map (CTM) and electroencephalogram (EEG) can evaluate the functional activity of brain, and the purpose of this study was to objectively compare the effect of intravenous anesthetics on brain. Forty-five patients, ASA grade Ⅰ-Ⅱ, undergoing neurosurgery,were randomly divided into three groups after administration of Innovar 2 ml, and then equivalent effective dose of propofol(2～2.5 mg/kg)(Ⅰ),sodium thiopental (4～6mg/kg)(Ⅰ) or gama hydroxybutyrate sodium (70～80mg/kg)(Ⅲ) was intravenously given respectively. All patients were monitored continuously during induction. The high frequent excitative activities of ? rhythm appeared immediately after each anesthestic was injected. During the most effective period: in group Ⅰ, there were no ? rhythm in EEG and obvious power change on CTM; in group Ⅱ irregular ? rhythm took place in EEG occasionally and great increase in top power on CTM occured, which showed evident elevation compared with group Ⅰ (P
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objective To investigate the changes in angiotensin-Ⅱ (AT-Ⅱ), endothelin (ET) andcalcitonin gene-related peptide (CGRP) during clipping of intracranial aneurysm performed under desfiuraneanesthesia. Methods Forty-five ASAⅠ -Ⅱ patients (20 male, 25 female) aged 14-66yr undergoing electiveclipping of intracranial aneurysm two weeks after acute subarachnoid bleeding. Anesthesia was induced withmidazolam 0 .05 mg?kg~(-1), fentanyl 2?g?kg~(-1), propofol 2 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1). The patientswere mechanically ventilated after tracheal intubation and P_(ET)CO_2 was maintained at 30-35 mm Hg. Anesthesia wasmaintained with desflurane at 1 .0-1 .5 MAC with low flow (0.3-0.5 L?min~(-1) ) supplemented with intermittentintravenous boluses of vecuronium. Radial artery was cannulated for direct continuous BP monitoring. ECG, HR,SPO_2 and P_(ET) CO_2 were continuous monitored during operation. Blood samples were taken before induction ofanesthesia (T_1, baseline), when dura was opened (T_2 ), while aneurysm was being clipped (T_3 ) and 30 min afterclipping for determination of plasma concentrations of AT-Ⅱ, ET and CGRP. Results Plasma concentration ofAT-Ⅱ did not change significandy throughout the surgery. Plasma ET concentration decreased significantly at T_2and T_3 compared with the baseline (P
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Objective To study the adverse health effects of indoor decoration on the inhabitants and to provide scientific evidences for improving the living conditions.Methods To investigate the condition of room decorating,fitment and the health situation of inhabitants,then analyze the data by multiple Logistic regression.Results The indoor air pollution caused by indoor decoration could cause many kinds of complaints.The result of single factor analysis showed that less than 6 months after the decoration(OR=9.45),to live in the room in less than half month after the decoration(OR=1.97)and living in the room for less than 1 month(OR=16.19)maybe increase the risk of complaints.When adjusted the effects of the other influence factors,the result showed that the longer the time of decoration was finished,the lower the risk of complaints was(OR=0.82,95%CI:0.73-0.91).Keeping ventilation could decrease the risk of complaints(OR=0.68,95%CI:0.54-0.87).Conclusion The results of this investigation indicate that the discomfortable symptoms of inhabitants living in the room decorated recently are the combined results of many factors which include room decorating,the surrounding of living,the working condition,individual habit and living habits.To prolong the time of living in the room after decoration and keep the room ventilation can decrease the adverse effects of decoration pollution.
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Lymphocyte culture media are commonly supplemented With calf serum.The use of calf sera of different sources may introduce uncontrollable variables,which often make trobles in explaining the results.In this papor the influence of calf sera from two different supplies(serum A and B)on lymihocyte funetion assay in vitro was compared.It was found that no difference was observed in B lymohocyte pr- oliferative rosponse to Staphylococcus aureus Cowen strain l(SAC)or to goat F(ab) anti-human ? chain spocific antibody and in plaque-formation cell response induced by SAC or Pokeweed mitogen(PWM)or in PHA induced T cell proliferation in using calf serum A and B.However,in Con?A-driven T cell proliferation,serum B.However, in Con?A-driven T cell proliferation,serum B gave highor cpm m all three experim- ents.The results were 7934?3859?versus 1435?124(p