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The paper explores the evolution of "bone-approaching" acupuncture, its effect target and mechanism. The concrete operation procedure of "bone-approaching" method is recorded originally in Huangdi Neijing (Inner Canon of Yellow Emperor) as short needling and Shu needling (referring to the category of the five needling technique). The periosteum is the most effective stimulation target of "bone-approaching" acupuncture for analgesia, regaining consciousness and regulating spirit. The "bone-approaching" acupuncture is not only prominently effective on bone bi syndrome, but also has the unique effect on painful, encephalogenic and emotional diseases. The paper summarizes and improves "bone-approaching" acupuncture, i.e. "touching bone surface" with needle tip by slow insertion, "touching bone surface" without pain by swift insertion and "touching bone" with needle body by oblique insertion. It contributes to the inheritance, development and supplementation to the bone needling techniques in Huangdi Neijing and is significant for broadening the clinical application range of acupuncture.
Subject(s)
Humans , Acupuncture Therapy , Periosteum , Analgesia , Pain Management , Consciousness , PainABSTRACT
In recent years, more and more patients with metabolic syndrome also have gallstones, and gallstones may lead to life-threatening diseases such as acute cholecystitis, acute obstructive cholangitis, and pancreatitis. This article summarizes the association of obesity, hyperlipidemia, hyperglycemia, and hypertension in metabolic syndrome with gallstones and discusses related mechanisms, in order to provide guidance for the screening, diagnosis, treatment, and prevention of gallstones.
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Objective To explore the diagnostic value of superb micro-vascular imaging (SMI) for patients with vulnerable plaque of carotid artery. Methods Totally 69 patient with carotid hypoechoic or predominantly hypoechoic plaque (108 plaques),which were identified by conventional ultrasound,underwent SMI and contrast-enhanced ultrasound (CEUS). Based on the scores of CEUS and SMI (0,1,and 2 points),the consistency of SMI and CEUS in detecting plaque neovascularization was assessed. Results SMI could more clearly display the profile and morphology of the plaques than conventional ultrasound. SMI showed that there were neovascularization in 75 plaques,and CEUS showed that there were neovascularization in 76 plaques;the number of scoring consistency in the plaque neovascularization under SMI and CEUS was 90,suggesting these two results were highly consistent (Kappa value=0.748). There were 6 ulcerated carotid plaques detected by SMI,and the same 6 ulcerated carotid plaques were detected by CEUS,showing complete consistency. Of these 108 plaques,55 caused stenosis of the lumen,and SMI showed there was no correlation between plaque neovascularization and stenosis of the lumen caused by plaques (P=0.473). Conclusion SMI can clearly display the morphology and outline of the plaques and the plaque neovascularization. Therefore,it can be used for evaluating plaque vulnerability.
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AIM:To investigate the distribution and mechanism of M 1/M2 macrophages in inflammatory injury and repair process of renal tissues .METHODS: SD male rats ( n=45 ) were randomly divided into 2 parts: ischemia-reperfusion injury (IRI) and unilateral ureteral obstruction (UUO) renal injury.The rats with IRI were divided into sham operation group and operation groups (0, 6, 24, and 72 h after operation), and the rats with UUO were divided into sham operation group and operation groups (3, 7 and 14 d after operation).Automatic biochemical analyzer was used to detect serum levels of creatinine and urea nitrogen .The degree of renal injury in IRI group and UUO group were detected by HE staining.The expression of CD68 was examined by immunohistochemical staining .The levels of inducible nitric oxide syn-thase (iNOS), arginase-1 (Arg-1), transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α(TNF-α) were measured by ELISA.The polarizations of M1 ( CD68 +, F4/80 + and CD16/32 +) and M2 ( CD68 +, F4/80 +and CD206 +) macrophages were analyzed by flow cytometry .RESULTS:In IRI group, the infiltration of CD68 +macrophages and the degree of injury were increased with the prolongation of time in the renal tissues .At 24 h, the tissue injury and macrophage infiltration were the most serious , but then decreased .At 72 h, the tissue damage and CD68 +macrophage in-filtration were significantly reduced .In UUO group, obstructive injury was increased with the prolongation of time , and at 14 d, marked fibrous hyperplasia occurred .The infiltration of CD68 +macrophages at 7 d was the most serious , but then reduced at 14 d.Flow cytometry analysis showed that M 1 macrophages were the majority in the early stages of UUO and IRI, and the result of ELISA identified the higher level of iNOS .At the late stage of injury , the M1 macrophages were de-creased, while the M2 macrophages were increased with higher level of Arg-1.M1 macrophage-mediated early injury was due to the induction of TNF-αexpression, and M2 macrophage-mediated later recovery was due to enhancing TGF-β1 levels.CONCLUSION:The polarization of M1 and M2 macrophages is involved in the processes of UUO and IRI .M1 macrophages play a key role in early injury , and M2 macrophages contribute to the late stage of fibrotic repair .The polari-zation of macrophages during renal injury and repair provides a guiding significance for the clinical treatment .
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Objective · To explore the prognostic factors for postoperative radiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC) and the effects of lymph nodes metastasis status on the survival of patients and failure modes of treatment. Methods · Data of 121 patients with locally advanced ESCC who underwent radical resection and postoperative radiotherapy from 2006 to 2013 were collected. The overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier. Univariate analysis and multivariate analysis were performed to investigate prognostic factors with the log-rank test and the Cox regression model. The differences in OS and recurrence patterns between patients with different lymph node metastasis status were compared. Results · The median DFS of all patients was 22.57 months and median OS was 32.90 months.Multivariate analysis showed that KPS score, length of lesion, and positive lymph nodes ratio (pLNR) were independent prognostic factors for DFS and OS. For patients with positive lymph nodes, the median DFS of patients with pLNR ≤ 0.15 and pLNR>0.15 were 33.43 and 19.20 months (P=0.04).Patients without nodal skip metastasis (NSM) had better median OS than patients with NSM, but the difference was not statistically significant. OS was significantly worse in patients with pLNR>0.15 and NSM than in other patients with positive lymph nodes (median OS of 14.33 vs 32.50 months, P=0.02).pLNR had a better prognostic value for OS than the number of positive lymph nodes (AUC=0.673, P=0.04). Analysis of the failure patterns showed that more distant metastases were observed in patients with pLNR>0.15, while more local and regional recurrences were observed in patients with pLNR ≤ 0. 15. Conclusion · The status of lymph nodes metastasis is associated with the prognosis of postoperative radiotherapy for patients with locally advanced ESCC. pLNR has a better prognostic value for OS for patients with positive lymph nodes. The recurrence pattern varies in patients with different pLNR after postoperative radiotherapy. The patients with high pLNR and NSM have poor prognosis.
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Objective · To explore the prognostic factors for postoperative radiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC) and the effects of lymph nodes metastasis status on the survival of patients and failure modes of treatment. Methods · Data of 121 patients with locally advanced ESCC who underwent radical resection and postoperative radiotherapy from 2006 to 2013 were collected. The overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier. Univariate analysis and multivariate analysis were performed to investigate prognostic factors with the log-rank test and the Cox regression model. The differences in OS and recurrence patterns between patients with different lymph node metastasis status were compared. Results · The median DFS of all patients was 22.57 months and median OS was 32.90 months.Multivariate analysis showed that KPS score, length of lesion, and positive lymph nodes ratio (pLNR) were independent prognostic factors for DFS and OS. For patients with positive lymph nodes, the median DFS of patients with pLNR ≤ 0.15 and pLNR>0.15 were 33.43 and 19.20 months (P=0.04).Patients without nodal skip metastasis (NSM) had better median OS than patients with NSM, but the difference was not statistically significant. OS was significantly worse in patients with pLNR>0.15 and NSM than in other patients with positive lymph nodes (median OS of 14.33 vs 32.50 months, P=0.02).pLNR had a better prognostic value for OS than the number of positive lymph nodes (AUC=0.673, P=0.04). Analysis of the failure patterns showed that more distant metastases were observed in patients with pLNR>0.15, while more local and regional recurrences were observed in patients with pLNR ≤ 0. 15. Conclusion · The status of lymph nodes metastasis is associated with the prognosis of postoperative radiotherapy for patients with locally advanced ESCC. pLNR has a better prognostic value for OS for patients with positive lymph nodes. The recurrence pattern varies in patients with different pLNR after postoperative radiotherapy. The patients with high pLNR and NSM have poor prognosis.
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Objective To design an anatomic locking plate for the posterior malleolus using 3D reconstruction CT of the ankle joint and software Mimics.Methods The CT data of 20 normal ankles were imported into software Mimics in.dicom format for 3D reconstruction of the ankle joint.The angles of posteromedial and posterolateral varus,the twist height on the sagittal plane and the height of safe screw placement zone,the width of the posterior malleolus were measured for the posterior malleolus.After the anatomic locking plate was designed using the anatomic data measured and software Ungraphics NX5.0,it was 3D printed in a proportion of 1:1.Next,the model plate was tested and evaluated in 15 fresh cadaveric specimens of the ankle all the soft tissues of which were removed to fully expose the bony structure of the posterior malleolus.Results The anatomic measurements showed that the angles of postemmedial and posterolateral varus increased gradually towards the medial and lateral sides along the central axis of the posterior malleolus while the twist height reduced from the lateral to the medial side,and that the width of the posterior malleolus increased gradually from the superior to the inferior.It was found that after placement in the 15 fresh cadaveric specimens the anatomic model plate fit the posterior malleolus very well,fulfilling all the designed requirements for the anatomic locking plate for the posterior malleolus.Conclusion A novel anatomic locking plate for the posterior malleolu has been successfully designed and manufactured using 3D reconstruction CT of the ankle joint,software Mimics and 3D printing.
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Objective To explo the antioxidant effect and molecular mechanism of gastrodin (Gas) in epilepsy (EP) rats induced by LiCl-pilocarpine (PILO) . Methods Eighty male SD rats were randomly divided into 5 groups: sham group, EP group, therapy groups (pretreated with 60 mg/kg, 90 mg/kg, 120 mg/kg of gastrodin respectively) . The EP model was esteblished by peritoneal injection of LiCl-PILO. Therapy groups were pretreated with various concerntration of Gas. The control group was given the same dosage of normal saline. The alteration of behavior was observed, the concentration of catalase (CAT), glutathion (GSH), superoxide dismutase (SOD), glutathion reductase (GR), total antioxidtion (T-AOC) and malondialdehyde (MDA) in rats brain cortex were detected by chemical colorimetric method, phosphorylation of p38 was determined by western blot. Results There was no EP seizure in sham group,and the EP seizure degree in therapy groups (gas pretreated groups) was significantly decreased,and had statistically significant difference with EP group (P<0.05) . The EP model rats exhibited a significant decrease in the concentration of endogenous antioxidants (CAT, GSH, SOD, GR and T-AOC), while an increase of the concentration of MDA and phosphorylation p38 protein as compared to sham group (P<0.05) . After treatment of the Gas,treatment group rats attenuated the seizure degree,exhibited a significant increase of the concentration of endogenous antioxidants (P<0.05),while a decrease in concentration of MDA and phosphorylation of p38 as compared to model group (P<0.05) . Conclusion Gas may have a neuroprotective role in central nervous system of epileptic rats modle by down-regulateing the seizure degree and the activity of p38 kinase and up-regulateing the content of endogenous antioxidants.
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<p><b>BACKGROUND</b>A sensitive method is required to detect retinal hamartomas in patients with tuberous sclerosis complex (TSC). The aim of the present study was to compare the color fundus photography, infrared imaging (IFG), and optical coherence tomography (OCT) in the detection rate of retinal hamartoma in patients with TSC.</p><p><b>METHODS</b>This study included 11 patients (22 eyes) with TSC, who underwent color fundus photography, IFG, and spectral-domain OCT to detect retinal hamartomas. TSC1 and TSC2RESULTS: The mean age of the 11 patients was 8.0 ± 2.1 years. The mean spherical equivalent was -0.55 ± 1.42 D by autorefraction with cycloplegia. In 11 patients (22 eyes), OCT, infrared fundus photography, and color fundus photography revealed 26, 18, and 9 hamartomas, respectively. The predominant hamartoma was type I (55.6%). All the hamartomas that detected by color fundus photography or IFG can be detected by OCT.</p><p><b>CONCLUSION</b>Among the methods of color fundus photography, IFG, and OCT, the OCT has higher detection rate for retinal hamartoma in TSC patients; therefore, OCT might be promising for the clinical diagnosis of TSC.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Diagnostic Techniques, Ophthalmological , Eye Diseases , Diagnosis , Fundus Oculi , Hamartoma , Diagnosis , Photography , Methods , Tomography, Optical Coherence , Methods , Tuberous Sclerosis , DiagnosisABSTRACT
<p><b>OBJECTIVE</b>To study the effect of Zhibai Dihuang Pill (ZBDHP) on urokinase-type plasminogen activator (uPA) and sperm quality in ureaplasma urealyticum (Uu) infection infertile patients.</p><p><b>METHODS</b>Recruited were 80 infertility patients with Uu infection at Andriatrics Clinics and Department of Reproduction, including 130 cases of positive Uu semen and 50 cases of negative Uu semen. Patients with positive Uu semen were randomly assigned to the observation group (72 cases) and the control group (58 cases) according to the visit sequence. All patients took antibiotics for 2 weeks. Patients in the observation group additionally took ZBDHP, 6 g each time, twice daily. Those in the control group additionally took Vit E (100 mg each time, twice per day) and ATP (40 mg each time, twice per day). The therapeutic course for all was 90 days. Semen parameters and uPA contents of the sperm membrane were detected and comparatively analyzed.</p><p><b>RESULTS</b>The sperm membrane uPA content, the sperm motility, the sperm viability, and the percentage of normal morphology sperm in Uu positive infected patients were lower than those in Uu negative infected patients with statistical difference (P < 0.05), but with no significant difference in the sperm density between the two groups (P > 0.05). There was no statistical difference in pre-treatment sperm membrane uPA contents and sperm parameters between the two groups (P > 0.05). Compared with before treatment in the same group, the sperm membrane uPA content, the sperm motility, the sperm viability, and the percentage of normal morphology sperm obviously increased in the two groups with statistical difference (P < 0.05). After treatment, the sperm membrane uPA content increased more obviously in the observation group, with statistical difference when compared with the control group (P < 0.05).</p><p><b>CONCLUSIONS</b>Infection with Uu leads to decreased uPA content of sperm membrance and the sperm motility. ZBDHP could effectively treat Uu infected infertility possibly through fighting against Uu damaged sperm membrane and make the sperm membrane uPA content return to normal, and elevate the fertilizability of sperms.</p>
Subject(s)
Humans , Male , Anti-Bacterial Agents , Pharmacology , Therapeutic Uses , Communicable Diseases , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Infertility , Infertility, Male , Semen , Semen Analysis , Sperm Count , Sperm Motility , Spermatozoa , Ureaplasma Infections , Drug Therapy , Ureaplasma urealyticum , Urokinase-Type Plasminogen Activator , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To compare the effect of An's Shaobei Injection ([symbols; see text]) with Xiaozhiling Injection ([symbols; see text]) in patients with internal hemorrhoids of grade I-III.</p><p><b>METHODS</b>This cohort study included 1,520 internal hemorrhoids patients with grade I-III who were scheduled for liquid injection treatment from July 2003 to July 2009. The cohort included patients who underwent either An's Shaobei Injection treatment (the treatment group, 760 cases) or Xiaozhiling Injection treatment (the control group, 760 cases). All patients were followed up regularly for 3 years; the observing indices included anal function recovery and clinical response after operation.</p><p><b>RESULTS</b>Among the 1,520 patients, 1,508 (99.2%) completed the 3-year follow-up. The efficacy rate was 97.5% in the treatment group, significantly higher than the control group (91.8%, P<0.01). The recurrence rate in the treatment group was 0.5%, significantly lower than that of the control group (1.3%, P<0.01). In addition, perianal callosity occurred in 8 cases (1.1%) and anorectal stricture in 26 cases (3.5%) after operation in the control group. There was no perianal callosity and anorectal stricture in the treatment group.</p><p><b>CONCLUSION</b>The treatment with An's Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anal Canal , Pathology , Drugs, Chinese Herbal , Follow-Up Studies , Hemorrhoids , Drug Therapy , Pathology , Injections, Intralesional , Mucous Membrane , Pathology , Prospective Studies , Recurrence , Sclerosing Solutions , Severity of Illness Index , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of Helicobacter pylori (Hp) eradication therapy on prognosis in children with Henoch-Schonlein purpura (HSP).</p><p><b>METHODS</b>A total of 153 children with HSP were divided into Hp infection treatment group (n=22), Hp infection control group (n=21), and Hp infection-negative group (n=110). The Hp infection treatment group received one-week triple therapy for Hp eradication in addition to conventional treatment, while the Hp infection control group and Hp infection-negative group received conventional treatment. All patients were followed up for prognostic evaluation.</p><p><b>RESULTS</b>The response rates of the Hp infection treatment, control, and negative groups were 86% (19/22), 90% (19/21) and 85% (94/110), respectively (P>0.05). The recurrence rates of HSP in the Hp infection treatment, control, and negative groups were 14% (3/22), 24% (5/21) and 31% (34/110), respectively (P>0.05). The incidence of Henoch-Schonlein purpura nephritis (HSPN) in the Hp infection-negative group (36%, 40/110) and control group (33%, 7/21) was significantly higher than that in the Hp infection treatment group (5%, 1/22) (P<0.05 for both), but no significant difference in the incidence of HSPN was found between the control and negative groups (P>0.05).</p><p><b>CONCLUSIONS</b>One-week triple therapy for Hp eradication may be useful to reduce the incidence of HSPN in children with HSP infected with Hp.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Helicobacter Infections , Drug Therapy , Helicobacter pylori , Incidence , Prognosis , IgA Vasculitis , Epidemiology , RecurrenceABSTRACT
Objective To investigate the clinical features of acute focal bacterial nephritis (AFBN) in children,and to evaluate the strategy of diagnosis and therapy on children with AFBN,avoiding any blind spots of clinical treatment.Methods The clinical features of 12 cases of AFBN children admitted in Shenzhen Children's Hospital from Jan.2006 to Dec.2012 were analyzed.The clinical features and treatment strategy of AFBN were summarized.ResultsSeven in 12 cases(58.3％) were younger than 1 year old,fever was the initial and cardinal symptom,most cases were lack of typical or local urinary symptoms and signs.Peripheral blood leukoeytes,C-reactive protein and procalcitonin were highly increased in all cases,comparing with simple urinary tract infection.Five cases combined with pyeloureterectasis.One case combined with vesicoureteral reflux (VUR).Blood culture:staphylococcus aureus (1 case),staphylococcus epidermidis (1 case),E.Coli (2 cases).Urine culture:E.Coli (4 cases),E.Coli and enterococcus faecalis (1case),staphylococcus aureus (1 case),white candida yeast (1 case),mixed flora (2 cases).Urinary ultrasound:renal swelling was showed in involved kidney.Echo of renal parenchyma were enhanced or nonuniform,multiple hypoechoic area were easily visible in involved renal parenchyma,with boundary ambiguity.CT or MRI scan:typical findings were reducing perfusion with multiple wedge-shaped or quasi-circular lesions.Broad-spectrum antibacterial treatment was effective and necessary.The medication of antimicrobial was under the guidance of drug susceptibility test.The average course of treatment was 14-55 days.Eleven cases were cured by conservative treatment.Conclusions The morbility of AFBN in young infants are high.The combination of urinary tract deformity,pyeloureterectasis or VUR should be highly vigilant in AFBN children.Imageological inspection of urinary tract is the necessary method on AFBN diagnosis.The major pathogen is E.Coli,which shows a high resistance to antibiotics.Conservative antibacterial treatment is effective in AFBN.
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<p><b>OBJECTIVE</b>To investigate the ultrasonographic features of congenital intrahepatic portosystemic venous shunt (CIPSVS) and to assess the clinical value of ultrasonography in the diagnosis of CIPSVS.</p><p><b>METHODS</b>Six cases of CIPSVS diagnosed in our hospital between March 2010 and March 2012 and confirmed by enhanced computed tomography (CT) were retrospectively reviewed. Five of the six cases had follow-up data that was included in the analysis.</p><p><b>RESULTS</b>Among the six CIPSVS cases, only one was classified as Park's type II and the rest were classified as Park's type III. Five cases involved the right lobe of the liver and only one case involved the left lobe. The lesion shapes included cystic, tubular, and irregular with clear contour and appeared to be anechoic on CT scan. The lesions ranged in size from 1.1*0.6 cm to 2.0*1.7 cm. For all cases, the color Doppler ultrasound images showed blood flowing from the portal vein to the hepatic vein, and single-phase spectrum was detected in the diversion channel. The differences observed in level of lesion size and blood flow velocity at the shunt from the time of examinations at diagnosis and subsequent follow-up did not reach statistical significance (P = 0.223 more than 0.05 and P = 0.930 more than 0.05 respectively).</p><p><b>CONCLUSION</b>Although cases of CIPSVS are rare, they share some specific sonographic features that may help in diagnosis. Color Doppler ultrasound findings have high diagnostic accuracy and may represent a preferred modality for follow-up monitoring.</p>
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Aged , Female , Humans , Male , Middle Aged , Portal Vein , Congenital Abnormalities , Diagnostic Imaging , Retrospective Studies , Ultrasonography , Vascular Malformations , Diagnostic ImagingABSTRACT
Multiple sequence alignment is one of the basic techniques in bioinformatics, and it plays a vital role in structure modeling, functional site prediction, and phylogenetic analysis. In this paper, we review the methodologies and recent advances in the multiple protein sequence alignment, e.g., speeding up the calculation of distances among sequences and employing the iterative refinement and consistency-based scoring function, with emphasis on the use of additional sequence and structural information for improving alignment quality.
Subject(s)
Algorithms , Proteins , Chemistry , Sequence Alignment , Methods , Sequence Analysis, Protein , MethodsABSTRACT
<p><b>OBJECTIVE</b>Henoch-Schonlein purpura (HSP) is one of the most common small vessel forms of autoimmune vasculitis in children. Immunologic derangement including humoral and cellular immunity disequilibrium and proinflammatory factors dysfunction are involved in the acute stage of HSP. Recently data revealed that regulatory T cells (Tr) play a pivotal role in preventing development of autoimmune and allergic diseases. This study aimed to explore the role of Tr cells in pathogenesis of HSP and the factors affecting development of Tr cells.</p><p><b>METHODS</b>Twenty patients with HSP and 20 age-matched healthy children were enrolled into this study. Flow cytometric (FCM) analysis was performed to detect the percentage of regulatory T cells subpopulation (including CD(4+)CD(25+) Tr, Tr1 and Th3) and helper T cells subpopulation (Th1 and Th2). Reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR were used to analyze Foxp3 expression in peripheral blood mononuclear cell (PBMC).</p><p><b>RESULTS</b>Compared with healthy control subjects, the proportions of Th2 cell in patients with HSP were significantly higher (P < 0.05), and the ratio of Th1/Th2 was remarkably decreased (P < 0.05). The proportions of three subpopulation of regulatory T cells including CD(4+)CD(25+) Tr, Tr1, Th3 in patients with HSP were all significantly lower than those of controls (P < 0.05). The mRNA expression of Foxp3 in patients with HSP showed similar tendency (P < 0.001).</p><p><b>CONCLUSIONS</b>The decrease of three subpopulations of regulatory T cells might be involved in pathogenesis of HSP and associated with the decreased expression of Foxp3 gene.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Case-Control Studies , Flow Cytometry , Forkhead Transcription Factors , Genetics , Leukocytes, Mononuclear , Allergy and Immunology , IgA Vasculitis , Blood , Genetics , Allergy and Immunology , RNA, Messenger , Reverse Transcriptase Polymerase Chain Reaction , Severity of Illness Index , T-Lymphocytes, Helper-Inducer , Allergy and Immunology , T-Lymphocytes, Regulatory , Allergy and Immunology , Th1 Cells , Allergy and Immunology , Th2 Cells , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>Human mannose-binding lectin (MBL) is a C-type serum lectin synthesized by the liver as an acute-phase protein. MBL can bind to glycoproteins terminated with mannose and N-acetylglucosamine present in the cell walls on a variety of microorganisms. Therefore, MBL appears to play an important role in the immune system. Low levels of MBL in human have been associated with a susceptibility to recurrent infections. MBL deficiency and low serum MBL levels are strongly associated with the presence of three point mutations at codon 52, 54 and 57 of exon 1 in the human MBL gene, and in Chinese population, the codon-54 mutation occurs at a frequency of 0.11 - 0.17. The data suggested that MBL insufficiency might also predispose to the development of autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The possibility that Kawasaki disease (KD) is an infectious disease has been discussed and investigated for decades, in light of the implication that infections are involved in the pathogenesis of KD. It has been suggested that MBL insufficiency might predispose to the occurrence of KD. This study was aimed to investigate the genetic association of MBL codon-54 polymorphism in patients with KD, and to investigate possible associations with clinical manifestations of the disease.</p><p><b>METHODS</b>There were 95 patients with KD and 160 healthy subjects in the study. The genotype of MBL gene 54 codon was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Clinical characteristics and biochemical examination were also performed.</p><p><b>RESULTS</b>The genotype frequency of heterozygote (GGC/GAC) was significantly higher in KD group than that in healthy subjects (45.2% vs 25.0%, P < 0.01), and the allele frequency of GAC mutation was also higher in KD patients than that in control group (0.258 vs 0.138, P < 0.01). The variant allele (GAC) was markedly associated with KD (OR = 2.18, 95% CI = 1.38 approximately 3.44, P < 0.05). But there was no significant difference in the allele frequency of GAC between patients with and without coronary artery lesion (CAL) in KD cases (0.281 vs 0.246, P > 0.05). In addition, in cases of KD, more patients carrying the variant allele (GAC) had episodes of upper respiratory or gastrointestinal infections prior to the onset of KD than wild homozygotes (P < 0.01).</p><p><b>CONCLUSION</b>The codon 54 polymorphism of MBL gene was associated with KD. It is possible that MBL gene codon 54 mutation might be related to the pathogenesis of KD.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Codon , Genetics , Genetic Predisposition to Disease , Genetics , Mannose-Binding Lectin , Genetics , Mucocutaneous Lymph Node Syndrome , Genetics , Polymerase Chain Reaction , Polymorphism, Genetic , Genetics , Polymorphism, Restriction Fragment LengthABSTRACT
<p><b>OBJECTIVE</b>Kawasaki disease (KD) is an acute febrile vasculitic syndrome of unknown etiology that preferentially affects coronary artery. It has been suggested that proinflammatory cytokines like tumor necrosis factor alpha (TNF-alpha) and interleukin-10 (IL-10) are key players during acute KD. Recently, the polymorphisms relative to major transcriptional start site of TNF-alpha and IL-10 gene were shown to influence the level of TNF-alpha and IL-10 production in vitro. This study was aimed to investigate the genetic association of TNF-alpha and IL-10 promoter polymorphisms in juvenile patients of Han nationality with KD, and to investigate the possible associations with clinical manifestations of the disease.</p><p><b>METHODS</b>Four polymorphism sites of TNF-alpha and IL-10 gene promoter regions from 96 children with KD were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). One hundred and sixty age-matched normal children of the Han nationality were used as control. All patients accepted Doppler echocardiography examination in order to differentiate coronary artery lesions.</p><p><b>RESULTS</b>There was significant difference in allele frequencies of -308 (A/G) site of the TNF-alpha gene between children of the Han nationality and those of Japanese and Caucasian in America. There were significant differences in the allele frequencies of -1082 (G/A), -819 (C/T) and -592 (A/C) of IL-10 gene between children of the Han nationality and their British Counterparts (P < 0.01). There was no significant difference in allele frequencies of -308 (A/G) site of TNF-alpha gene between children with KD and normal controls. There was no significant difference in the haplotypes and the allele frequencies of the above three sites of IL-10 between the two groups. However, when clinical features were examined, the genotype frequency of TNF-alpha-308A was significantly higher in IVIG-resistant KD patients than that of TNF-alpha-308G genotype (67% vs 5%, chi(c)(2) = 90.48, P < 0.01). The genotype of TNF-alpha-308A was closely associated with IVIG-resistant KD (P < 0.01, relative risk 42.25, 95% confidence interval 15.81-112.88). The haplotype frequency of IL-10 -1082A/-819T/-592A was also higher in patients with coronary artery lesion (CAL) caused by KD than those of Non-ATA haplotype (52% vs 20%, chi(2) = 18.36, P < 0.01). The haplotypes of IL-10 -1082A/-819T/-592A was significantly associated with CAL caused by KD (P < 0.01, relative risk 4.26, 95% confidence interval 2.20-8.25).</p><p><b>CONCLUSION</b>The genotype of TNF-alpha-308A is one of the important factors that probably influence the therapeutic effect of KD. The haplotypes (-1082/-819/-592) of IL-10 gene promoter might be related to the pathogenesis of coronary artery complication of KD and -1082A/-819T/-592A haplotypes might be regarded as a genetic marker of risk factor for coronary artery lesion in KD.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Interleukin-10 , Genetics , Mucocutaneous Lymph Node Syndrome , Genetics , Pathology , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Promoter Regions, Genetic , Genetics , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
Objective:To investigate the mechanism of intravenous procaine analgesia. Method: Six adult patients, ASA grade Ⅰ-Ⅱ, scheduled for abdominal surgery were investigated. Anesthesia was induced with intravenous fentanyl and propofol. Endotracheal intubation was facilitated with vecuronium. Anesthesia was maintained with continuous intravenous infusion of procaine(1mg?kg~(-1)?min~(-1))and inhalation of isoflurane. All patients were artifically ventilated with 100% O_2. Cerebrospinal fluid(CSF)and plasma concentrations of procaine were measured with gascbromatography 10,20,30 and 60 min following initiation of the constant infusion of procaine,at 5th, 15th, 30th and 60th min after the discontinuation. Result: Plasma steady-state levels were achieved within 30 min after commencement of the continuous infusion of procaine, The mean plasma steady-state level was 14.8?2.95?g/ml. Fifteen min after discontinuing the procaine infusion, 78% of plasma procaine content was eliminated. CSF steady-stale level was not achieved until 15 min after discontinuing the procaine infusion. The mean CSF steady state level was 4.47?0.94?g/ml. The elimination of the procaine in CSF was quite slow,and at 60th min after discontinuing the infusion,the mean CSF procaine level was 1.85?0.19?g/ml. Conclusion: The delayed total subarachnoid blockade induced by procaine infusion may be the mechanism of intravenous procaine analgesia.