Effects of Sevoflurane and Propofol on Neurological Recovery of Traumatic Brain Injury Patients in the Early Postoperative Stage: A Retrospective Cohort Study / 中国医学科学杂志(英文版)

Objective To investigate the effects of propofol and sevoflurane on neurological recovery of traumatic brain injury (TBI) patients in the early postoperative stage.Methods We retrospectively analyzed the clinical data of TBI patients who underwent craniotomy or decompressive craniectomy. Generalized additive mixed model (GAMM) was used to analyze effects of propofol and sevoflurane on Glasgow Coma Scale (GCS) on postoperative days 1, 3, and 7. Multivariate regression analysis was used to analyze effects of the two anesthetics on Glasgow Outcome Scale (GOS) at discharge.Results A total of 340 TBI patients were enrolled in this study. There were 110 TBI patients who underwent craniotomy including 75 in the propofol group and 35 in the sevoflurane group, and 134 patients who underwent decompressive craniectomy including 63 in the propofol group and 71 in the sevoflurane group. It showed no significant difference in GCS at admission between the propofol and the sevoflurane groups among craniotomy patients (β = 0.75, 95%CI: -0.55 to 2.05, P = 0.260). However, elevation in GCS from baseline was 1.73 points (95%CI: -2.81 to -0.66, P = 0.002) less in the sevoflurane group than that in the propofol group on postoperative day 1, 2.03 points (95%CI: -3.14 to -0.91, P < 0.001) less on day 3, and 1.31 points (95%CI: -2.43 to -0.19, P = 0.022) less on day 7. The risk of unfavorable GOS (GOS 1, 2, and 3) at discharge was higher in the sevoflurane group (OR = 4.93, 95%CI: 1.05 to 23.03, P = 0.043). No significant difference was observed among two-group decompressive craniectomy patients in GCS and GOS.Conclusions Compared to propofol, sevoflurane was associated with worse neurological recovery during the hospital stay in TBI patients undergoing craniotomy. This difference was not detected in TBI patients undergoing decompressive craniectomy.

Glucose metabolism: A link between traumatic brain injury and Alzheimer's disease / 中华创伤杂志(英文版)

Traumatic brain injury (TBI), a growing public health problem, is a leading cause of death and disability worldwide, although its prevention measures and clinical cares are substantially improved. Increasing evidence shows that TBI may increase the risk of mood disorders and neurodegenerative diseases, including Alzheimer's disease (AD). However, the complex relationship between TBI and AD remains elusive. Metabolic dysfunction has been the common pathology in both TBI and AD. On the one hand, TBI perturbs the glucose metabolism of the brain, and causes energy crisis and subsequent hyperglycolysis. On the other hand, glucose deprivation promotes amyloidogenesis via β-site APP cleaving enzyme-1 dependent mechanism, and triggers tau pathology and synaptic function. Recent findings suggest that TBI might facilitate Alzheimer's pathogenesis by altering metabolism, which provides clues to metabolic link between TBI and AD. In this review, we will explore how TBI-induced metabolic changes contribute to the development of AD.

Fungal endocarditis after heart prosthetic valve surgery:two case report and literature review on treatment strategies / 中国感染控制杂志

Objective To evaluate treatment strategies for fungal endocarditis after heart prosthetic valve surgery. Methods Two cases of severe fungal infection after heart prosthetic valves surgery were analyzed retrospectively, related literatures were reviewed.Results Two patients had fungal endocarditis after surgery,the valve function was affected,patients were hospitalized repeatedly after surgery.In case 1 ,fever occurred 45 days after cardiac sur-gery and patient was returned to the hospital for re-examination,emergency mitral valve replacement was performed under cardiopulmonary bypass,the postoperative vegetation culture suggested Aspergillus flavus.In case 2,the aortic wall vegetation was removed 5 months after heart surgery under cardiopulmonary bypass,pathology of post-operative vegetation suggested mucor.Two patients were promptly removed infection foci through surgery and trea-ted with standard antifungal agents,patient with Aspergillus infection died after rescue,and patient with mucor in-fection was cured,the latter was more powerful in antifungal therapy.Conclusion Prevention is the key to fungal endocarditis after heart prosthetic valve surgery,treatment should be prompt and effective,antifungal agents should be given in sufficient dose and course.

Protective Effects of Calpain Inhibition on Neurovascular Unit Injury through Downregulating Nuclear Factor-κB-related Inflammation during Traumatic Brain Injury in Mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In addition to neurons, all components of the neurovascular unit (NVU), such as glial, endothelial, and basal membranes, are destroyed during traumatic brain injury (TBI). Previous studies have shown that excessive stimulation of calpain is crucial for cerebral injury after traumatic insult. The objective of this study was to investigate whether calpain activation participated in NVU disruption and edema formation in a mouse model of controlled cortical impact (CCI).</p><p><b>METHODS</b>One hundred and eight mice were divided into three groups: the sham group, the control group, and the MDL28170 group. MDL28170 (20 mg/kg), an efficient calpain inhibitor, was administered intraperitoneally at 5 min, 3 h, and 6 h after experimental CCI. We then measured neurobehavioral deficits, calpain activity, inflammatory mediator levels, blood-brain barrier (BBB) disruption, and NVU deficits using electron microscopy and histopathological analysis at 6 h and 24 h after CCI.</p><p><b>RESULTS</b>The MDL28170 treatment significantly reduced the extent of both cerebral contusion (MDL28170 vs. vehicle group, 16.90 ± 1.01 mm΃ and 17.20 ± 1.17 mm΃ vs. 9.30 ± 1.05 mm΃ and 9.90 ± 1.17 mm΃, both P < 0.001) and edema (MDL28170 vs. vehicle group, 80.76 ± 1.25% and 82.00 ± 1.84% vs. 82.55 ± 1.32% and 83.64 ± 1.25%, both P < 0.05), improved neurological scores (MDL28170 vs. vehicle group, 7.50 ± 0.45 and 6.33 ± 0.38 vs. 12.33 ± 0.48 and 11.67 ± 0.48, both P < 0.001), and attenuated NVU damage resulting (including tight junction (TJ), basement membrane, BBB, and neuron) from CCI at 6 h and 24 h. Moreover, MDL28170 markedly downregulated nuclear factor-κB-related inflammation (tumor necrosis factor-α [TNF-α]: MDL28170 vs. vehicle group, 1.15 ± 0.07 and 1.62 ± 0.08 vs. 1.59 ± 0.10 and 2.18 ± 0.10, both P < 0.001; inducible nitric oxide synthase: MDL28170 vs. vehicle group, 4.51 ± 0.23 vs. 6.23 ± 0.12, P < 0.001 at 24 h; intracellular adhesion molecule-1: MDL28170 vs. vehicle group, 1.45 ± 0.13 vs. 1.70 ± 0.12, P < 0.01 at 24 h) and lessened both myeloperoxidase activity (MDL28170 vs. vehicle group, 0.016 ± 0.001 and 0.016 ± 0.001 vs. 0.024 ± 0.001 and 0.023 ± 0.001, P < 0.001 and 0.01, respectively) and matrix metalloproteinase-9 (MMP-9) levels (MDL28170 vs. vehicle group, 0.87 ± 0.13 and 1.10 ± 0.10 vs. 1.17 ± 0.13 and 1.25 ± 0.12, P < 0.001 and 0.05, respectively) at 6 h and 24 h after CCI.</p><p><b>CONCLUSIONS</b>These findings demonstrate that MDL28170 can protect the structure of the NVU by inhibiting the inflammatory cascade, reducing the expression of MMP-9, and supporting the integrity of TJ during acute TBI.</p>

Efficacy observation of treating diabetic nephropathy by shenshuaining granule combined telmisartan tablet / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Shenshuaining Granule (SG) combined telmisartan on serum creatinine (SCr) levels and urinary albumin contents in diabetic nephropathy (DN) patients, and to explore its efficacy.</p><p><b>METHODS</b>Totally 204 DN patients were recruited, and further assigned to 3 groups, i.e., the early DN group, the clinical stage of DN with normal renal function group, the clinical stage of DN with insufficient renal function group. Patients in the same group were randomly allocated to the telmisartan treatment group, the SG treatment group, and the combination of SG and telmisartan treatment group, 68 in each group. Patients in the telmisartan treatment group took telmisartan tablet, 80 mg per day, once daily. Those in the SG treatment group took SG, 5 g each time, 3 times per day. Those in the combination of SG and telmisartan treatment group took telmisartan tablet (80 mg per day, once daily) and SG (5 g each time, 3 times per day). The therapeutic course for all was 3 successive months. SCr levels, serum urea nitrogen (BUN),24 h urine microalbumin (24 h U-MA) were detected before and after treatment. Results In three different treatment groups, 24 h U-MA decreased after treatment in the telmisartan treatment group; SCr and BUN decreased after treatment in the SG treatment group; and 24 h U-MA, SCr and BUN decreased after treatment in the combination of SG and telmisartan treatment group (P<0.05). In the clinical stage of DN with insufficient renal function group, SCr obviously increased after treatment in the telmisartan treatment group (P <0. 05). In the 3 DN stages, SCr and 24 h U-MA obviously decreased in the combination of SG and telmisartan treatment group, when compared with the telmisartan treatment group and the SG treatment group (P<0.05). Compared with the telmisartan treatment group, SCr and BUN obviously decreased in the SG treatment group, but 24 h U-MA quantitation obviously increased (P<0.05). BUN obviously decreased in the combination of SG and telmisartan treatment group (P<0. 05).</p><p><b>CONCLUSION</b>The combination of SG and telmisartan could decrease urinary albumin, and stabilize SCr levels.</p>

Application of minimally invasive surgery in traumatic brain injury / 中华创伤杂志(英文版)

This article aims to expound the essence of minimally invasive surgery as well as when and how to use it in craniocerebral trauma surgery according to the characteristics of the disease. In neurosurgery, the importance of tissue protection should be from the inside to the outside, i.e. brain--dura--skull--scalp. In this article, I want to share my opinion and our team's experience in terms of selecting surgical approaches and incision, surgical treatment of the skull, dura handling, intracranial operation and placement of drainage based on the above theory. I hope this will be helpful for trauma surgeons.

Precautionary study on acupuncture pretreatment for stroke at the early stage / 中国针灸

<p><b>OBJECTIVE</b>To assess the clinical efficacy of acupuncture pretreatment for the prevention of stroke based on promoting the circulation of the Governor Vessel and regulating mentality, and explore its effect mechanism.</p><p><b>METHODS</b>Seventy cases of transient ischemic attack (TIA) were randomized into an acupuncture group (35 cases) and a western medicine group (35 cases). In the acupuncture group, acupuncture therapy of promoting the circulation of the Governor Vessel and regulating mentality was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Shenzhu (GV 12), Dazhui (GV 14), Yamen (GV 15), Fengfu (GV 16), Baihui (GV 20) and Neck-Jiaji (EX-B 2). Acupuncture was given 6 times a week, at the interval of one day between two weeks. Totally, 21 days of treatment were taken as a session. In the western medicine group, aspirin enteric coated tablets were prescribed, 25 mg/tablet, 100 mg/day, once a night for oral administration, and 21 days of medication were taken as 1 session. There were 3 days at the interval between two sessions in each group and totally 2 sessions were required. Transcranial Doppler (TCD) was adopted before treatment and in two sessions of treatment to observe, mean flow velocity (Vm) of middle cerebral artery (MCA), vertebral artery (VA), basilar arte ry (BA) and pulsatility index (PI). The standard of the efficacy assessment of stroke aura was taken as the main efficacy index in the assessment of theraputic effect, the adverse reaction was observed.</p><p><b>RESULTS</b>1In TIA, MCA blood flow was accelerated in internal carotid system, and BA blood flow was accelerated in vertebral-basilar artery system. The treatments in the two groups enabled the blood flow in the responsible blood vessels slow down and the results in the acupuncture group L(60. 54+/-11.76)cm/s, (36. 17+/-8. 65)cm/s] were better than those in the western medicine group [(72. 34+/-9. 15)cm/s,(65. 23 +/-8. 99)cm/s] (P<O. 05). 2The results of clinical efficacy and adverse reactions in the acupuncture group [96. 77% (30/31),6. 45% (2/31)] were superior to the western medicine group [75. 76%(25/33),45. 46%(15/33)] (both P<0. 05). 3Concerning to the recurrence of disease at the different period after treatment, the case number of cerebral infarction was not different significantly between the two groups (P>0. 05).</p><p><b>CONCLUSION</b>Acupuncture intervention based on promoting the circulation of the Governor Vessel and regulating mentality achieves the superior efficacy on TIA and less adverse reactions as compared with aspirin. The effect mechanism is related potentially to the improvement of cerebral vascular hemodynamic.</p>

An association study of single nucleotide polymorphisms of the FOXP3 intron-1 and the risk of Psoriasis vulgaris.

Psoriasis vulgaris (PV) is a common autoimmune disease that involves the dysfunction of CD4+CD25+ regulatory T cells. FOXP3 is a key transcription factor in the development and function of CD4+CD25+ regulatory T cells. Previous studies have demonstrated a genetic association between the FOXP3 gene and some autoimmune diseases. To elucidate the association between the FOXP3 gene and the risk of PV, 408 patients diagnosed with PV and 363 age and sex-matched healthy controls from a cohort of the Chinese majority Han population were recruited. Four single nucleotide polymorphisms (rs2232365, rs3761547, rs3761548 and rs3761549) of the FOXP3 gene were analyzed using the polymerase chain reaction and ligase detection reaction. The major allele of three single nucleotide polymorphisms (SNPs — rs2232365 A, rs3761547 A and rs3761549 C) were associated with an increased risk of PV in a clinical subgroup of female patients, who were less than 40 yrs of age, had a family history of the disease and did not have disease complications (p < 0.05 for all parameters). The haplotype was structured between rs3761547 and rs3761549. An increased risk of PV was observed in haplotype A/A-T/T (p = 0.0055; adjusted OR = 3.188; 95% CI = 0.4354-23.34) and A/G-C/C (p = 0.0082; adjusted OR = 1.288; 95% CI = 0.1529-10.85) between rs3761547 and rs3761549. A synergistic effect was found among the three SNPs. Subjects with the rs2232365AA- rs3761547 AG + GG genotype were more susceptible to PV (p = 0.0393; OR = 2.90; 95% CI = 1.05-7.97). No correlation was found between rs3761548 and the onset of PV. Therefore, the FOXP3 polymorphisms appear to contribute to the risk of psoriasis among the Chinese majority Han population. These findings may aid in our understanding of the pathogenesis of psoriasis

Research on the relationship between levels of soluble cluster of differentiation 40 ligand, matrix metalloproteinase 9 and pregnancy-associated plasma protein A in serum and stability of carotid plaques / 中华外科杂志

<p><b>OBJECTIVES</b>To study the relationship between serum levels of some inflammatory markers and stability of carotid plaques in the patients with carotid plaques and evaluate the ability of each serum marker in identifying vulnerable carotid plaques.</p><p><b>METHODS</b>The study included 65 consecutive patients with carotid plaques confirmed by imaging examinations from March 2008 to March 2010. All the patients were classified as stable plaques group (n = 21) and unstable plaques group (n = 44) according to the characteristic findings of the plaques in MRI such as the thickness of fibrous cap, the existence of large lipid core and the intra-plaque hemorrhage. The patients of unstable plaques group were further classified as unruptured plaques group (n = 29) and rupture plaques group (n = 15) according to the integrity of fibrous cap. Serum levels of soluble cluster of differentiation 40 ligand (sCD40L), matrix metalloproteinase 9 (MMP-9) and pregnancy-associated plasma protein A (PAPP-A) were determined by ELISA.</p><p><b>RESULTS</b>Serum levels of sCD40L and MMP-9 in patients of unstable plaques group, unruptured plaques group and rupture plaques group were all significantly enhanced compared to individuals of stable plaques group (SCD40L: χ(2) = 6.45, 12.04 and 16.23, P < 0.01; MMP-9; F = 2.55, 5.10 and 4.69, P < 0.05). Serum levels of PAPP-A in patients of unstable plaques group and rupture plaques group were all significantly enhanced compared to individuals of stable plaques group (χ(2) = 11.71 and 13.55, P < 0.05). Serum levels of PAPP-A in patients of rupture plaques group were significantly enhanced compared to individuals of unruptured plaques group (χ(2) = 13.19, P = 0.000). sCD40L ≥ 673.22 ng/L (OR = 22.47, 95%CI: 2.11 - 239.81, P = 0.010), MMP-9 ≥ 84.09 µg/L (OR = 10.01, 95%CI: 1.74 - 57.78, P = 0.010) and PAPP-A ≥ 0.101 µg/L (OR = 14.29, 95%CI: 2.69 - 75.90, P = 0.002) were all significantly correlated with the vulnerability of carotid plaques.</p><p><b>CONCLUSIONS</b>There appear to be a relationship between the serum levels of sCD40L, MMP-9 and PAPP-A and the stability of carotid plaques in patients with carotid plaques. High serum levels of the above-mentioned markers may indicate that the plaques were vulnerable or ruptured.</p>

Perioperative nursing of 83 patients with sialolithiasis treated by sialoendoscope / 中华护理杂志

This paper introduces the perioperative nursing of 83 sialolithiasis patients undergoing sialolithectomy by sialoendoscope. The key points of successful nursing care were careful preoperative psychological nursing and equipment preparation, correct and skilled intraoperative cooperation, and early postoperative health instruction. As a result, all the patients underwent the surgery succesfully and recovered well except 3 cases who needed gland removal later.

HPLC-DAD conbined with TOF/MS technique in determination of saikosaponin a, baicalin and glycyrrhizic acid in Xiaochaihu Decoction / 第二军医大学学报

Objective: To establish a method for determination of saikosaponin a, baicalin and glycyrrhizic acid in Xiaochaihu Decoction. Methods: A combined method of HPLC-DAD and time of flight mass spectrometry (TOF/MS) was used; the chromatography condition was as following: Agilent Zorbax XDB C18 column (25°C, 2.1 mm × 50 mm, 1.8 μm); mobile phase: methanol (0.025%, V/V, formic acid)-water 0.025%, V/ V, formic acid) with gradient elution at a flow rate of 0.15 ml · min-1. The injection volume was 0.25 μl. Atomospheric pressure electronic spray ionization was used to quantify saikosaponin a at the capillary voltage of 4 000 V, the flow and temperature of drying gas were 10.0 L · min-1 and 350°C, respectively; nebulizer pressure was 40 psi (275 792 Pa), and the fragment voltage was 200 V; the m/z of saikosaponin a was 803.420 0-803.490 0 for quantitative analysis. The wavelengths for detection of baicalin and glycyrrhizic acid were 275 nm and 250 nm, respectively. Results: The calibration curves were Y=461 182X + 2 000 000(r=0.999 0),Y=0.949 9X-1.046 4(r=0.999 5) and Y=5.978 9X-27.418(r=0.999 5) for saikosaponin a (0.211 6-127.3 μg · ml-1), baicalin (0.758-455 μg · ml-1) and ammonium glycyrrhizinate (2.268-136.8 μg · ml-1), respectively. The recovery rates of the low, medium and high concentrations were (95.54 ± 1.60)%, (99.39 ± 3.97)% and (103.8 ± 1.97)% for saikosaponin a, (102.3 ± 0.47)%, (100.9 ± 1.32)% and (97.15 ± 2.10)% for baicalin, and (102.6 ± 1.96)%, (100.3 ± 3.12)% and (97.75 ± 1.25)% for ammonium glycyrrhizinate, respectively. The intra-day and inter-day RSD was both less than 5% and the RSD was less than 5% for 21 days. Conclusion: The method in the present study is simple, sensitive, rapid, and accurate for quality control of Xiaochaihu Decoction.

Screening of high-arsenic water resources in Dali Prefecture, Yunnan / 中国地方病学杂志

Objective To find out the distribution characteristics of drinking water with high arsenic in Dali Prefecture, Yunnan. Methods General investigation plus sampling survey was adopted in the city of Dali and 11 counties. The arsenic content in water was tested by half-quantitative fast reagent-box method. The water samples exceeding the standard(≥0.03 mg/L) were re-tested by silver diethyldithiocarbamate eolorimetric method or mercury-atomic fluorescence spectrometric method. Population and children exposed by high-arsenic were statistically analyzed. Results Arsenic content in 15 180 samples from 2639 villages are screened, of which 14 976 samples were less than 0.01 mg/L, reaching 98.66% (14 976/15 180); 110 samples was no less than 0.05 mg/L, only accounting for 0.72%(110/15 180). Water sources with excessive arsenic was found in 29 villages, in a percentage of 1.1% of all covered villages(29/2639). The samples were constituted of 10 399 portions of well water(well was less than 10 m deep), 3903 from spring, 93 from river water, 69 from hot spring water, 26 from reservoir water and 690 from surface water. And for the samples which arsenic content were ≥0.05 mg/L, 89 samples(0.86%, 89/10 399) were from well water, 15 from spring water(0.38%, 15/3903) and 6 from spring water(8.70%, 6/69). A total of 1 561 553 individuals were investigated, in a percentage of 67.83%(1 561 553/2 302 156) of the whole population, among those 420 513 were children, rating 26.93% of the investigated population(420 513/1 561 553); 27 865 were exposed to arsenic, accounting for 1.78% of the investigated population 27 865/1 561 553; 8993 children were exposed, rating 2.14% of the investigated population(8993/420 513). Conclusions There exists high-arsenic water resources in Dali Prefecture, Yunan, so the local inhabitants are in the danger of high-arsenic exposure. Urgent attention shall be paid for the endemic arsenic including investigation, prevention and control.

Antagonistic Effect of N-acetyI-L-cysteine and ?-Lipoic Acid to Oxidative Damage in Liver and Kidneys of Rats Induced by Condensate of Cooking Oil Fume / 环境与健康杂志

Objective To study the antagonistic effect of N-acetyl-L-cysteine(NAC)and ?-lipoic acid(LA)to the oxidative damage in the liver and kidney of rats induced by the condensate of cooking oil fume(COF).Methods SD rats were randomly divided into 4 groups,8 in each,the blank control,COF group(10 ml/kg,subcutaneous injection),COF plus NAC(2 mmol/kg, intraperitoneal injection)and COF plus LA(0.35 mmol/kg,intraperitoneal injection).Forty-eight hours after treatment,the activity of SOD,GSH-Px and MDA level in the livers and kidneys were determined.Results In the kidney,compared with the COF group, both of NAC and LA could increase the activity of kidney SOD and GSH-Px and decreased the MDA level significantly,the same results were seen in the liver.Conclusion Both of N-aeetyl-L-cysteine and ?-lipoic acid has an obvious antagonistic effect to the oxidative damage in the liver and kidney of rats induced by the condensates of cooking oil fume.

Antagonistic Effect of Grape Procvanidin or Linoic Acid to Rat laver Cell Peroxidative Damage Induced bv ~(60)Co ? Radiation / 环境与健康杂志

Objective To study the antagonistic effects of grape procyanidin(GPC)or lipoic acid(LA)to the rat liver cell peroxidative damage induced by~(60)Co ? radiation.Methods The cultured rat liver cells(1?10~9/L)were prepared from 10 rats aged 1 week,the survival rate was above 85%.The cultured liver cells were divided into the negative control group(without radiation), GPC group(75 mg/L),LA group(100 mg/L)and the positive control group(containing no antioxidants),which were radiated by (60)~Co ? radiation(2.5 Gy,90 cm,10 s).The SOD,GSH-Px activity,MDA level and comet assay were determined.Results Compared with the positive control group,in the GPC group and LA group,the activity of hepatic SOD and GSH-Px were significantly higher (P

Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function.</p><p><b>METHOD</b>From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed.</p><p><b>RESULTS</b>MEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis (H-B grade 3), and 5 had mild facial paralysis (H-B grade 2). In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal.</p><p><b>CONCLUSIONS</b>Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.</p>

Establishment of 2-dimensional electrophoresis maps of peripheral blood mononuclear cells / 中南大学学报(医学版)

OBJECTIVE@#To establish the 2-dimensional electrophoresis(2-DE) profiles of peripheral blood mononuclear cells(PBMC) in patients with hepatocellular carcinoma(HCC) and health adults.@*METHODS@#The total proteins from PBMC in patients with HCC and healthy adult were separated by immobilized pH gradient-based 2-DE. The differential expression proteins were analyzed by PDQuest analysis software.@*RESULTS@#The well-resolved, reproducible 2-DE patterns of PBMC in patients with HCC and healthy adults were obtained. For HCC, the average spots of 2-DE maps were 1 206 +/- 48, and the average matching rate was 90.8%. For normal adults, the average spots were 1 123 +/- 37, and the average matching rate was 92.6%.@*CONCLUSION@#The well-resolved, reproducible 2-DE patterns of PBMC in patients with HCC and healthy adults are established. These proteomic analysis methods are useful to screen the potential biomarkers in the early diagnosis, treatment and prognosis monitor in patients with malignant tumor.

Mutation analysis of the checkpoint kinase 2 gene in colorectal cancer cell lines / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Checkpoint kinase 2 (CHK2) is a DNA damage-activated protein kinase which is involved in cell cycle checkpoint control. CHK2 gene could be a candidate gene for colorectal cancer susceptibility. But there are few systematic reports on mutation of CHK2 in colorectal cancer.</p><p><b>METHODS</b>The mutations of all 14 exons of CHK2 in 56 colorectal cancer cell lines were screened systematically, using denaturing high-performance liquid chromatography (DHPLC) to screen the mismatches of the CHK2 exons amplified products, and then the suspected mutant cell lines were scanned by nucleotide sequence analysis.</p><p><b>RESULTS</b>VACO400 in CHK2 exon 1a was suspected to have mutation by DHPLC and confirmed by sequence, but this was nonsense mutation. C106, CX-1, HT-29, SK01, SW480, SW620 and VACO400 in CHK2 exon 1b were confirmed to have the same nonsense mutation in 11609 A > G. DLD-1 and HCT-15 in CHK2 exon 2 were confirmed to have missense mutation R145W, which was heterozygous C > T missense mutation at nucleotide 433, leading to an Arg > Trp substitution within the FHA domain.</p><p><b>CONCLUSIONS</b>The CHK2 mutation in colorectal cancer is a low frequency event. There are just 10 cell lines to have sequence variations in all the 14 exons in 56 colorectal cancer cell lines and only DLD-1/HCT-15 had heterozygous missense mutation. These findings may give useful information of susceptibility of colorectal cancer as single nucleotide polymorphysim.</p>

Surgical intervention for advanced valvular heart disease in 227 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although the results of surgical treatment in cardiac valve disease continue to improve, the postoperative mortality rate and the rate of complications in patients with advanced valvular heart disease (AVHD) are still very high. We did this retrospective study to summarize the surgical experience of heart valve replacement for patients with AVHD and discuss effective ways to improve the surgical outcome.</p><p><b>METHODS</b>From January 1994 to October 2003, surgical procedures of heart valve replacement were performed on 227 (136 men and 91 women) patients with AVHD in our Department of Cardiothoracic Surgery. The clinical data of all patients were collected and analysed. Patients' age ranged from 10 years to 77 years. In preoperative cardiac function grading, 157 cases were NYHA III and 70 cases NYHA IV. Fifty-one patients had had cardiac operations. The ultrasonic cardiac graphs showed that 145 patients suffered from moderate or severe pulmonary hypertension and 73 had combined giant left ventricle. Mitral valve replacement was performed in 32 cases, aortic valve replacement in 90, tricuspid valve replacement in 1, combined mitral and aortic replacement in 103 and combined mitral and tricuspid replacement in 1. Nineteen patients also received surgical corrections for other minor abnormalities during the operations. A logistic model was established to evaluate the influence of perioperative factors on the mortality rate.</p><p><b>RESULTS</b>The operative mortality rate was 13.2% (30/227). The main causes of death included multiple organ dysfunction syndrome (MODS), low cardiac output syndrome and ventricular fibrillation. From the results of the binary noncounterpart multivariate logistic regression, the following statistically significant factors were found to influence the operative mortality rate: redo operation, age >/= 55 years, preoperative NYHA cardiac function grading, extracorporeal circulation time >/= 120 minutes and postoperative usage of GIK (glucose, insulin and potassium) solution. All factors were risk ones except postoperative application of GIK. The Hosmer-Lemeshow goodness of fit coefficient of this model was 0.976.</p><p><b>CONCLUSIONS</b>The risk factors associated with postoperative mortality rate in the patients with AVHD were redo operation, age >/= 55 years, preoperative NYHA cardiac function grading and extracorporeal circulation time >/= 120 minutes. Postoperative usage of GIK acted as a kind of metabolic therapy and will improve the recovery for patients with AVHD. Active perioperative management and care will play a very important role in reducing the operative risk and improving the short term outcome of surgical treatment for the patients with AVHD.</p>