ABSTRACT
Objective:To investigate the influence of effects of transarterial chemoembo-lization (TACE) before liver transplantation on the prognosis of hepatocellular carcinoma.Methods:The retrospective cohort study was conducted. The clinicopathological data of 311 hepatocellular carcinoma patients undergoing TACE before liver transplantation who were admitted to the Third Medical Center of Chinese PLA General Hospital from January 2005 to December 2012 were collec-ted. There were 276 males and 35 females, aged from 47 to 59 years, with a median age of 52 years. All the 311 patients underwent TACE before liver transplantation. Observation indicators: (1) effects of hepatocellular carcinoma patients undergoing TACE and its relationship with clinicopathological factors; (2) follow-up; (3) influencing factors for prognosis of hepatocellular carcinoma patients after liver transplantation. Follow-up was conducted using outpatient examination or telephone interview to detect recurrence and metastasis of tumor and survival and graft loss of patients up to December 2017. The patients were followed up every 2 to 4 weeks within 3 months after liver transplantation, and once every 1 to 3 months thereafter. Measurement data with normal distri-bution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the nonparametric rank sum test. The COX regression model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to draw survival curves and calculate survival rates, and the Log-rank test was used for survival analysis. Results:(1) Effects of hepatocellular carcinoma patients undergoing TACE and its relationship with clinicopathological factors. Of the 311 patients undergoing TACE, 57 cases had pathologic complete response (pCR) and 254 cases had pathologic partial response (pPR), respectively. Cases with alpha fetoprotein (AFP) <20 μg/L,20?400 μg/L, >400 μg/L, cases with microvascular invasion, cases with tumor number as single nodule, cases with tumor distribution at right lobe of liver, cases with tumor caliber of feeding artery (CFA) >1 mm were 26, 26, 5, 51, 6, 43, 46 in patients with pCR, versus 87, 64, 103, 158, 59, 125, 159 in patients with pPR, showing significant differences in the above indicators ( Z=3.35, χ2=4.54, 15.71, 12.89, 6.79, P<0.05). (2) Follow-up. All the 311 patients were followed up for 47.0 to 59.0 months, with a median follow-up time of 44.6 months. There were 11 cases undergoing tumor recurrence and 11 cases undergoing tumor metastasis in the 57 patients with pCR, and there were 96 cases undergoing tumor recurrence and 66 cases under-going tumor metastasis in the 254 patients with pPR. The 1-, 3-, 5-year tumor recurrence free rates were 98.2%, 91.1%, 80.3% in the 311 patients, respectively. The 1-, 3-, 5-year tumor recurrence free rates were 100.0%, 91.1%, 80.3% in the 57 patients with pCR, versus 82.0%, 68.4%, 59.4% in the 254 patients with pPR, showing significant differences in the above indicators ( χ2=13.47, P<0.05). Cases with graft loss were 11 and 96 in the 57 patients with pCR and the 254 patients with pPR, respectively, showing a significant difference ( χ2=7.06, P<0.05). (3) Influen-cing factors for prognosis of hepatocellular carci-noma patients after liver transplantation. Results of univariate analysis showed that gender, basic diseases as viral hepatitis C, AFP (20?400 μg/L, >400 μg/L), Milan criteria, microvascular invasion, tumor number, tumor distribution, tumor CFA, times of TACE, effects of TACE were related factors influencing prognosis of hepatocellular carcinoma patients after liver transplantation ( hazard ratio=0.49, 3.97, 1.78, 1.84, 2.41, 1.96, 3.00, 1.76, 0.19, 2.01, 3.07, 95% confidence interval as 0.30?0.81, 2.23?7.05, 1.03?3.06, 1.18?2.85, 1.63?3.56, 1.28?3.01, 2.04?4.40, 1.20?2.59, 0.13?0.28, 1.28?3.14, 1.63?5.76, P<0.05). Results of multi-variate analysis showed that AFP >400 μg/L, exceeding Milan criteria, tumor number as multiple nodule,effects of TACE as pPR were independent risk factors influencing prognosis of hepatocellular carcinoma patients after liver transplantation ( hazard ratio=1.59, 2.06, 1.99, 2.05, 95% confidence interval as 1.22?2.07, 1.35?3.13, 1.29?3.07, 1.02?4.10, P<0.05) and tumor CFA >1 mm was an independent protective factor influencing prognosis of hepatocellular carcinoma patients after liver transplantation ( hazard ratio=0.10, 95% confidence interval as 0.05?0.19, P<0.05). Conclusions:The effects of TACE are related to AFP, microvascular invasion, tumor number, tumor distribution and tumor CFA. AFP >400 μg/L, exceeding Milan criteria, tumor number as multiple nodule,effects of TACE as pPR are independent risk factors influencing prognosis of hepatocellular carcinoma patients after liver transplantation and tumor CFA >1 mm is an independent protective factor influencing prognosis of hepatocellular carcinoma patients after liver transplantation.
ABSTRACT
Objective@#To explore the effects of vitamin D3 on intestinal mucosal barrier of mice with severe burns.@*Methods@#Forty-two C57BL/6C male mice aged eight to twelve weeks were divided into vitamin D3 vehicle+ sham injury group of seven mice, vitamin D3 vehicle+ burn injury group of fourteen mice, vitamin D3+ sham injury group of seven mice, and vitamin D3+ burn injury group of fourteen mice according to random number table. Mice in vitamin D3 vehicle+ sham injury group and vitamin D3 vehicle+ burn injury group were injected with vehicle of vitamin D3 at a dose of 0.1 mL intraperitoneally at 1, 24, and 48 h before burn experiment. Mice in vitamin D3+ sham injury group and vitamin D3+ burn injury group were injected with vitamin D3 at a dose of 100 ng/kg dissolved in 0.1 mL vehicle intraperitoneally at the same time points. Mice in vitamin D3 vehicle+ burn injury group and vitamin D3+ burn injury group were inflicted with 30% total body surface area full-thickness dermal scald (hereinafter referred to as burn) on the back by 98 ℃ hot water for 3 to 4 seconds. And mice in vitamin D3 vehicle+ sham injury group and vitamin D3+ sham injury were treated with 37 ℃ water on the back for 3 to 4 seconds to simulate injury. Seven mice in vitamin D3 vehicle+ sham injury group and seven mice in vitamin D3+ sham injury group at post injury hour (PIH) 24, and seven mice in vitamin D3 vehicle+ burn injury group and seven mice in vitamin D3+ burn injury group at PIH 6 and 24 were sacrificed respectively to collect mesentery lymph nodes, spleens, livers, and intestinal tissue. The mesentery lymph nodes, spleens, and livers of mice in each group were collected to observe growth of bacteria, and number of bacteria was counted. Intestinal tissue of mice in each group was collected to detect protein expressions of zonal occludin 1 (ZO-1) and occludin by immunohistochemistry staining method, distribution of ZO-1 by immunofluorescence staining method, and expression of occludin by Western blotting. Data were processed with Kruskal-Wallis H test, Nemenyi test, one-way analysis of variance, t test, and Bonferroni correction.@*Results@#(1) At PIH 6 and 24, bacterial counts of mesentery lymph nodes, livers, and spleens of mice in vitamin D3 vehicle+ burn injury group were significantly higher than those of mice in vitamin D3 vehicle+ sham injury group (P<0.05). At PIH 6, bacterial counts of livers and spleens of mice in vitamin D3+ burn injury group were significantly lower than those of mice in vitamin D3 vehicle+ burn injury group (P<0.05). At PIH 24, bacterial counts of mesentery lymph nodes and livers of mice in vitamin D3+ burn injury group were significantly lower than those of mice in vitamin D3 vehicle+ burn injury group (P<0.05). (2) At PIH 6 and 24, expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D3 vehicle+ burn injury group were significantly lower than those of mice in vitamin D3 vehicle+ sham injury group, and expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D3+ burn injury group were close to those of mice in vitamin D3+ sham injury group. At PIH 6 and 24, expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D3+ burn injury group were significantly higher than those of mice in vitamin D3 vehicle+ burn injury group. (3) At PIH 6 and 24, compared with that of mice in vitamin D3 vehicle+ sham injury group, distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D3 vehicle+ burn injury group was discontinuous. Distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D3+ sham injury group was normal, and the distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D3+ burn injury group was with good continuity. (4) At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D3 vehicle+ burn injury group were 0.720±0.003, 0.638±0.052 respectively, significantly lower than 0.918±0.003 of mice in vitamin D3 vehicle+ sham injury group (t=57.33, 5.36, P<0.05). At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D3+ burn injury group were 0.994±0.058, 1.064±0.060, close to 0.938±0.023 of mice in vitamin D3+ sham injury group (t=0.91, 1.96, P>0.05). At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D3 vehicle+ burn injury group were significantly lower than those of mice in vitamin D3+ burn injury group (t=4.75, 5.35, P<0.05).@*Conclusions@#Intestinal bacterial translocation can occur in the early stage of severe burn. And vitamin D3 plays a protective role in the intestinal mucosal barrier post severe burn to reduce the bacterial translocation by protecting tight junction proteins of intestinal epithelium.
ABSTRACT
Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.
ABSTRACT
Trauma is the leading cause of death for people under 40 years old in the world.At present,the rescue and treatment system of trauma patients in China is not yet well established,and the mortality of trauma patients is higher than those in the developed countries.Improving the treatment system is the key to reducing the trauma mortality.In order to innovate the service mode of trauma first aid,further promote the establishment of regional trauma first aid system,improve the ability of trauma treatment,reduce the mortality and disability rate of trauma patients in Jiangxi Province,recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center.In order to provide reference for the construction of trauma treatment system,the author analyzes the following aspects including functional positioning,basic requirements,organization management,and evaluation of core indicators.
ABSTRACT
Objective:To explore the effects of PPARγ on the cholesterol efflux of C57 mice peritoneal macrophage.Methods:Firstly constructing C57 mice model under different metabolic situation including high-fat diet and acute inflammation then isolate and culture its peritoneal macrophage,observing the expressions of PPARγ and IκB-α,identify the character of macrophage cholesterol efflux in every group.Then pretreat the normol C57 mice peritoneal macrophage with PPARγ ligand ciglitazone and PPARγ antisense oligonucleotide,observing the effect to cholesterol efflux after simulated with LPS in vitro.Results:The level of mice serum lipids of high fat diet group was significantly higher than that of normal diet group.The results of Western-blotting showed that the expression of PPARγ protein in groups of HFD and stimulated by LPS were significantly higher than that of control group.The expression in groups stimulated by LPS was all lower significantly than in control grouph.The determination of cholesterol efflux showed that this function of macrophage with HFD was more enhanced than that of control group but was inhibited in group stimulated by LPS.To normol peritoneal macrophage pretreat with PPARγ antisense oligonucleotide and stimulated by LPS,the expression of PPARγ protein was lower than that of control group but the expression of IκB-α was depressed obviously.Conclusion:The PPARγ ligand ciglitazone can increase the cholesterol efflux of C57 mice peritoneal macrophage and weaken the inhibition stimulated by LPS.The PPARγ antisense oligonucleotide can depress it and aggravate the inhibition.
ABSTRACT
Objective To investigate the characteristics of infection and risk factors after pediatric living donor liver transplantation (PLDLT).Method Form April 2005 to April 2014 the clinical data of 45 cases of PLDLT in General Hospital of Chinese People's Armed Police Forces were retrospectively investigated,and the difference between the patients after PLDLT with infection and those without infection was analyzed.Result Eighty-four infections occurred in 27 (60.0％) of 45 patients,including 25 cases of bacterial infections,14 cases of viral infections,and 3 cases of candida albicans infections.Most infections occurring within 3 months after PLDLT have been found to be caused by bacteria,viruses and fungi.The trough level of tacrolimus (Tac) was in target therapeutic window in 16/20 infected patients and more than 10 ng/mL in 4/20 infected patients within 3 months after PLDLT,and there were 12/16 infected patients with the trough level of Tac of more than 10 ng/mL 3 months post-PLDLT,with the difference being significant (P＜0.05).Multivariate analysis revealed that post-transplant infection was significantly related with the factors as weight＜10 kg,age ＜12 months,biliary intestinal anastomosis,pediatric end-stage liver disease (PELD) score,ChildPugh score,total bilirubin,blood loss per kg body weight and graft to recipient weight ratio (GRWR).Logistic regression analysis suggested that PELD score was independent risk factor of infection after PLDLT.Conclusion The infection after PLDLT has their special characteristics.The proper irnmunosuppressive protocol and control of above risk factors are helpful to decrease the incidence of infection after PLDLT.
ABSTRACT
Objective To analyse our clinical experience in pediatric living donor liver transplantation (PLDLT).Methods The clinical data of 45 patients who underwent PLDLT in our hospital from April 2005 to April 2014 were retrospectively studied and their preoperative,intraoperative and postoperative data were analyzed.Results All donors recovered well.The graft to recipient weight ratio (GRWR) ranged from 1.0％ ～ 6.4％ (2.5％ ± 1.2％).Size reduction of graft were performed in 2 patients.An interposition venous conduit from the confluence of the native right and left portal vein (PV) to the graft PV was carried out in 1 patient,venous grafts for revascularization of the tributaries of the middle hepatic vein from segment Ⅴ and Ⅷ were used in 3 patients,and a venous patch for revascularization of the left hepatic vein was used in 2 patients.Hepatic artery re-reconstruction was performed in 3 patients after hypoperfusion was detected on intraoperative Doppler ultrasound.The postoperative complications included acute rejection (n =2),vascular complications (n =7),biliary complications (n =11),and infectious complications (n =27).The 1-,2-and 5-year survival rates were all 84.4％.Seven of 45 recipients died within one year post transplantation,with 3 patients who died of vascular complications,and 4 patients who died of infection.The differences in age [(50.8 ± 49.8) months vs (12.6 ± 14.9) months],body weight [(16.2 ± 10.5) kg vs (7.3 ± 1.7) kg],serum total bilirubin [(177.0 ± 126.5) μmol/L vs (301.9 ± 110.6)μmol/L],Pediatric end-stage liver disease (PELD) score (16.1 ± 12.1 vs 26.2 ± 11.3) and GRWR (2.2％ ± 0.8％ vs 4.2％ ± 1.6％) between the survival and the dead groups were significant (P ＜ 0.05).Conclusions PLDLT is an effective method to treat children with end-stage liver disease.Using a multidisciplinary approach in the preoperative management,excellent surgical techniques,and proper postoperative management are extremely helpful to improve postoperative survival rate.
ABSTRACT
Objective To observe the effect of health education and installation of improved stove in control of coal-burning-borne endemic fluorosis in Pingba County of Guizhou Province.Methods Two towns(Shizi and Qibo) of Pingba County that had implemented the health education and installed the improved stoves for control of coal-burning-borne endemic fluorosis were selected as the investigation sites.Two villages in each selected town and 30 householders as well as all students of grade 4-6 were investigated.Questionnaires were made by survey of the fluorosis control knowledge,household investigations were used to know the use of household stoves,corn and peppers drying method,and the dental fluorosis of children aged 8-12 were examined by Dean methods before the intervention(2006) and after implementation(2009) of health education and improvement of stoves.Results The awareness of fluorosis control among students and households after the intervention was 97.36％ (405/416) and 86.46％(415/480),respectively,and the difference was statistically significant(x2 =658.86,163.10,all P ＜ 0.01) compared with that before the intervention [32.19％(1083/3364),43.33％(130/300)].Correct using rate of the household stoves was 95.42％ (229/240) after the intervention and 45.85％ (3976/8672) before the intervention,the difference was statistically significant(x2 =230.25,P ＜ 0.01).The correct rates of drying corn and chili were 91.67％ (110/120) and 97.50％ (117/120) before the intervention,and 20.00％ (12/60),26.67％ (16/60) after the intervention,the difference was statistically significant(x2 =94.07,104.02,all P ＜ 0.01).The incidences of dental fluorosis of children aged 8-12 were 31.21％(1305/4182) after the intervention and 87.71％(2856/3256) before the intervention,the difference was statistically significant(x2 =2371.91,P ＜ 0.01).Conclusions The measures of health education and intervention of stove improvement in Pingba County of Guizhou Province for prevention and control of coal-burning-borne endemic fluorosis is effective.
ABSTRACT
Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.
ABSTRACT
BACKGROUND: Performance of antibody screening and identification tests before blood transfusion is important because the unexpected presence of red cell antibodies may cause hemolytic transfusion reactions. Many patients with malignancy undergo transfusion in order to overcome pancytopenia due to disease itself or chemotherapy. We investigated the type distribution of unexpected red cell antibodies in cancer patients and compared our results with those of other institutions. METHODS: From January 2008 to June 2011, 30,989 serum samples were screened using a LISS/Coombs card and ID-DiaCell I, II (DiaMed AG, Morat, Switzerland). Data-Cyte Plus Reagent Red Blood Cells (Medion Diagnostics, Dudingen, Switzerland) were used in performance of antibody identification tests. RESULTS: Out of 30,989 serum samples, 180 cases (0.58%) showed screening-positive results, and unexpected antibodies were identified in 72 cases. The type of unexpected antibody observed most often in cancer patients was a member of the Rh antibody group, anti-E in 17 cases (29.8%), followed by anti-Lea in five cases (8.8%) and anti-e in three cases (5.3%). While Rh group antibodies were observed in the colon cancer group, non-Rh group antibodies were observed in the rectal cancer group. And, in the genitourinary cancer group, Lewis group antibodies were more frequently detected than others. CONCLUSION: Findings from our study demonstrated a type distribution of unexpected red cell antibodies that was similar to those reported in previous studies. Compared with non-cancerous patients, no difference in type distribution of unexpected red cell antibodies was observed in cancer patients. Some antibodies were frequently observed in certain cancer groups. Further comprehensive research on unexpected antibodies based on location or histologic type of cancer is needed.
Subject(s)
Humans , Antibodies , Blood Group Incompatibility , Blood Transfusion , Colonic Neoplasms , Erythrocytes , Mass Screening , Pancytopenia , Rectal Neoplasms , Urogenital NeoplasmsABSTRACT
Objective To investigate the usage of fluorine-proof iron stove in regions with coal-burning borne endemic fluorosis of Guizhou province and to provide scientific basis for the project management. Methods According to "the local prevention programs against coal-burning borne endemic fluorosis-Guizhou iron stove usage survey scheme", in the 18 counties implemented the project of improving the iron stove from 2005 to 2008, 2 townships were selected randomly in each county of each project annually, 2 villages were selected in each township randomly, and 10 households were checked in each village. The project households were investigated using questionnaire of the related health knowledge and awareness as well as the satisfaction of the households.Results ①The improvement rate of iron stove was 100.00%(1286/1286). ②The overall utilization rate of the improved stove was 94.09% (1210/1286), in which winter was 62.21% (800/1286) and annual was 31.88%(410/1286). ③Among the households that did not use the project stove, 46.05%(35/76) households was due to switch to other clean energy, in addition, 19.74%(15/76) was due to sell or send to other households, and 14.47%(11/76) was still used to use the open kitchen without the ventilating pipe, and still 13.16%(10/76) was due to high coal prices, and 6.58%(5/76) was due to that the improved stove can not meet the needs of life and no longer used. ④Amoag 1261 households investigated, households with damaged furnace was 24.58%(310/1261 ), and the parts damaged were mainly chimney (ventilating pipe) and the furnace core, accounting for 51.94%(161/310) and 29.03%(90/310), respectively. Repair rate of the damaged parts was 32.58%(101/310). ⑤The health knowledge rate was about 82.74% (1064/1286), and the satisfaction of the iron furnace was 88.65% (1140/1286).Conclusions The improved stoves for the prevention of endemic fluorosis in the diseased area meet the people's living habits, and meet their basic livelihood needs. Most project households are still using the improved furnace.But we still need to further strengthen the project management and the health education intervention, establish and improve stove maintenance network, and reach the goal of sustainable control of coal-burning borne endemic fluorosis.
ABSTRACT
Objective To study the follow-up management strategies after improving stoves for controlling coal-burning type endemic fluorosis in Guizhou and to provide a scientific basis for exploring the follow-up management measures.Methods In 2006 - 2009,three counties of Puding,Bijie and Liuzhi with improved stoves in 2005 and implemented follow-up management measures for subsequent three years were chosen,3 towns were chosen randomly in each chosen county,2 villages were selected randomly in each chosen town,10 households were investigated randomly in each chosen village,and 20 students were investigated of the knowledge of fluorosis control.The investigation included also the usage of the stoves,dehydration methods of grain and related conditions.Results ①The head of the family and student awareness of fluorosis control were 82.6％(743/900)and 91.7％ (1650/1800),respectively,and 35.0％ ( 385/1100 ) and 61.0％ (6605/10 835 ),respectively,before the test,and the difference was statistically significant( x2 =33.04,1189.12,all P ＜ 0.01 ).②The rates of chimney out of the house were 88.5％(69/78) and 100.0％(102/102),respectively,compared with those before the trial[74.4％(2125/2856) and 2.1％(104/4984),respectively],the difference was statistically significant(x2 =720.56,4295.38,all P ＜ 0.01).The iron stove and the table stove's airtight utilization rates were 85.9％(67/78) and 100.0％(102/102),respectively.③The corn and the hot pepper's correct drying rates were 100.0％(180/180).Compared with those[27.2％(49/180) and 32.2％(58/180),respectively]before the trial,the difference was statistically significant(x2 =26.68,37.38,all P ＜ 0.01 ).The corn and the hot pepper's washing rates before eating were 95.0％(57/60) and 98.3％(177/180),respectively.Compared with those[85.0％(153/180) and 77.8％(140/180)]before the trial,the difference was statistically significant(x2 =135.00,490.82,all P ＜ 0.01 ).Conclusions The target population's awareness and knowledge of fluorosis prevention and related behavior are significantly elevated and enhanced after implementation of the three years post-management,which has reached the desired goal.The strategies of the follow-up management suits Guizhou province and widespread application is suggested.
ABSTRACT
<p><b>BACKGROUND</b>Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.</p><p><b>METHODS</b>Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.</p><p><b>RESULTS</b>Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas-acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.</p><p><b>CONCLUSIONS</b>In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Acupuncture Points , Acupuncture Therapy , Magnetic Resonance Imaging , Magnetoencephalography , Methods , Pain , PsychologyABSTRACT
Background There are no noticeable symptoms in early stages of diabetic retinopathy(DR)and the detection of presymptomatic DR remains challenging. Therefore, data on the prevalence and progress of DR will help in prevention and treatment programs in China. Objective This study was to survey the prevalence and risk factors of diabetic retinopathy( DR ) in a population aged 40 years or older in the Shunyi district of Beijing city.Methods A cross-sectional study was designed. Cluster sampling was used to randomly select 4167 (91.6%)individuals aged ≥40 years in 24 clusters in the Shunyi district of Beijing city in China. The Questionnaire data,including general information, living habits, present history, past history, family history, education level etc., were obtained from each subjects. The height, body weight and blood pressure were examined, and slit-lamp examination, direct ophthalmoscopy,indirect ophthalmoscopy and nonmydriatic fundus photography were performed during the study duration. Diabetic mellitus (DM)was diagnosed and graded according to the criteria of Early Treatment Diabetic Retinopathy Study Research Group(ETDRS). The associated factors with DR were analyzed byx2 test,trend x2 test,and multivariate Logistic regression analysis. This protocol was approved by the Ethic Committee of Peking University. Informed consent was obtained from each individual prior to the survey. Results A total of 4167 ( 91.6% )individuals were examined from the 4549 samples with a response rate of 86. 4%. This study showed a prevalence of 29. 2% for DR, 5.4% for sight-threatening diabetic retinopathy ( STDR), and 1.3% for prolifrative retinopathy (PDR) in type 2 DM subjects. Of the type 2 DM subjects,0. 4% (4/445)had social blindness( VA＜0. 1 ) ,and 6. 3% (28/445) presented with visual impairment (VA ＜ 0. 3 )in bilateral eyes. Univariate Logistic regression analysis indicated that insulin therapy ( P = 0.011 ) and lower body mass index ( BMI, kg/m2 ) ( P = 0. 022 ) appeared to be significantly associated with DR, and the multivariate Logistic regression analysis demonstrated that longer duration of diabetes( P＜ 0. 01 ) , increased fasting glucose ( P ＜ 0.01 ) and lower education level ( P = 0. 031 ) were significant independent predictors of DR. Conclusion The prevalence of DR is lower among diabetic Chinese aged ≥ 40 years than those of matched population in Western countries. Lower BMI and insulin therapy were the significantly associated factors of DR, and a longer duration of disease and higher fasting glucose level are independent risk factors of DR. Education attainment is important for the DM patients as a protective factor of DR.
ABSTRACT
Background Visual impairment influent the life quality of patient and bring about the economical burden to their families and society.Epidemiology survey of the prevalence and main causes of visual impairment is the basis of the prevention of blindness.Objective The goal of this survey was to investigate the visual impairment in the subjects aged 40 years or older living in Shunyi district and assist in the design of intervention programs.Methods A cross-sectional survey was performed in this study.Cluster sampling was used to randomly select 4549 individuals aged ≥40 years in Shunyi district,and visual impairment was evaluated based on WHO criteria and analyzed based on the 10-year interval groups.The questionnaire,best corrected visual acuity (BCVA)and comprehensive eye examination were provided for eligible residents.To evaluate the independentassociation of significant sociodemographic variables with visual impairment,a regression model was constructed including age,sex and education level.This study was approved by the Ethic Committee of Peking University Medical Department.Written informed consent was signed by each subject before any medial survey.Results A total of 4167 subjects participated in this survey with the response rate of 91.6％.The age of the subjects ranged from 40-94 years(mean:56.61±11.10 years).The numbers of visual impairment was 161 with the prevalence 3.9％.Trend x2 test showed that the number and percentage of visual impairment were elevated as the increase of age,showing a significantly difference among different age groups(x2 =159.487,P＜0.01).The prevalence rate of visual impairment in 70 and older group was 15 times more than that of 60-69-year-old group(OR =0.114,95％ CI:0.056-0.234).No significant difference was found between gender and prevalence of visual impairment(OR =0.901,95％ CI:0.627 -1.295).The prevalence rate of visual impairment in illiterate group was 5.5 fold more than that of educated group (OR =2.743,95％ CI:1.830-4.111).Conclusions Ageing and low education degree are the important factors of visual impairment.Education attainment is an independent protective factor of visual impairment.
ABSTRACT
BACKGROUND: Studies of spinal biomechanics are conducted based on three-dimensional finite element model. The biomechanics of lower thoracic vertebra requires accurate and precise finite element models due to its structural characteristics. Currently, cervical and lumbar finite element models have been explored, but the studies of lower thoracic vertebra remains unclear.OBJECTIVE: Using reverse engineering software to reconstruct three-dimensional finite element model of lower thoracic vertebra, to lay a foundation for further biomechanical research. METHODS: imaging samples of one case with no spinal disease or osteoporosis were selected from Affiliated Hospital of Inner Mongolia Medical College. Informed content was obtained. Using non-spinal-disease CT data, three-dimensional finite element model Of lower thoracic vertebrae and intervertebral discs were reconstructed with Mimics, Gomagic and Ansys softwares. RESULTS AND CONCLUSION: Using reverse engineering software in combination with CT technique, the three-dimensional finite element model of lower thoracic vertebrae was reconstructed. The model accurately showed their anatomic characteristics and discrimination of inner structure. The lower thoracic vertebrae was divided into 112 540 tetrahedron elements. Results show that using reverse engineering software, a three-dimensional finite element model of lower thoracic vertebrae was successfully reconstructed, with high efficiency of establishment and simple operation.
ABSTRACT
Objective To explore the mechanism of skeletal fluorosis via observation on the expression of bone γ-carboxyglutamic acid-containing protein (BGP) and osteoprotegerin (OPG) in the residents of coal-burning fluorosis regions, and to provide a basical data for further monitoring and evaluating the effects of fluoride-reducing projects. Methods Stratified sampling was applied, the 6 villages of fluorosis were chosen as focusing areas for investigation. The residents of villages underwent clinical examination of the skeletal fluorosis. And according to the degree of skeletal fluorosis, villages were divided into three groups, namely light, moderate and severe villages. Radio-Immunoassay and Enzyme-linked immunosorbent assay were used to check the expression of BGP and OPG in the serum. Results The levels of serum BGP in the severe skeletal fluorosis cases[(6.78±4.43)μg/L] were significantly higher(P<0.05) than those in the normal, moderate and the severe groups [ (3.58±1.53), (3.44±2.66), (3.41±2.20)μg/L], respectively. The expression of OPG in the light, moderate and the severe groups [(1251.55±998.31), (1265.94±931.77), (1560.55±858.07)ng/L] were significantly higher (P<0.05) than those in the normal[(520.81±385.05)ng/L], respectively. The levels of BGP in mixed type[(6.09±2.62)μg/L] were much higher(P<0.05) than no mixed type[(3.97±1.53), (3.20±2.12)μg/L]. The levels of OPG in the osteosclerosis, osteoporesis and mixed type[(1321.63±1017.00), (1205.42±852.22), (1529.01±402.83)ng/L] were significantly higher(P<0.05) than those of the normal, respectively. The levels of OPG in the light villages [(452.06±338.10)ng/L] were significantly lower(P<0.05) than moderate and severe villages[(1266.30±899.14), (1851.80±956.08 )ng/L], respectively. The levels of OPG in the severe villages were significantly higher(P<0.05) than moderate villages. Conclusions It indicates that OPG can be used as an early indicator in coal-burning pollution endemic fluorosis results in biochemical changes in the composition of bone.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate whether the third-party dendritic cells (DC) incubated with donor's antigens possess the similar immune functions with donor derived immature DC.</p><p><b>METHODS</b>Female C57 BL/6, BALB/c and Kunming mice were used as skin transplant donors, recipients and third-party, respectively. Forty BALB/c mice were randomly divided into A (normal control), B (cyclophosphamide administration), C (CTX and donor derived immature DC), D (CTX and third-party immature DC), E (CTX and third-party DC loaded with donor's antigens) groups, with 8 mice in each group. The mice in group B, C, D and E were given CTX (200 mg/Kg) 4 days before operation, while those in group A were given equivalent amount of normal saline(NS). Then in group C, D and E, DC at a dose of 1 x 10(7)/ml were intraperitoneally injected with 2 days before grafting and 12 days after operation, but the mice in group A and B were given NS in the same manner. Mean survival time (MST) of skin grafts was recorded, and biopsies of grafts on 5 and 10 post-operation days (POD) were harvested for histologic examination.</p><p><b>RESULTS</b>Compared with group A [(16.1 +/- 3.5)d], MST of skin grafts in group C [(38.3 +/- 7.7) d] and E [(34.9 +/- 7.7) d] were significantly prolonged ( P < 0.01), while no obvious difference was observed between group C and E( P > 0.05), but there was statistically significant difference in MST between group D [(23.7 +/- 2.7) d] and E ( P < 0.05). In addition, clear epithelial structure and infiltration of inflammatory cells were observed in specimens from both groups C and E.</p><p><b>CONCLUSION</b>Both donor derived immature DC and third-party DC loaded with donor's antigens can partly induce donor specific transplantation tolerance.</p>
Subject(s)
Animals , Female , Mice , Cyclophosphamide , Pharmacology , Dendritic Cells , Allergy and Immunology , Mice, Inbred BALB C , Mice, Inbred C57BL , Mice, Inbred Strains , Random Allocation , Skin Transplantation , Allergy and Immunology , Transplantation Tolerance , Allergy and Immunology , Transplantation, Heterologous , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To explore the protective mechanisms of glycine (Gly) on lipopolysaccharides (LPS) induced liver injury.</p><p><b>METHODS</b>BABL/c mice were randomly divided into a LPS group, in which the animals were intraperitoneally injected with 10 mg/kg LPS, and a Gly group, in which the mice were pretreated with a 5% Gly-containing diet for 3 days before receiving the same dose of LPS. The livers of the mice were examined for histopathological changes. The TNF alpha and interleukin-10 (IL-10) levels in the blood plasma were measured using ELISA analysis. The mRNA expression of TNF alpha, IL-10 and Toll-like receptor 4 (TLR4) in hepatic tissues were detected using RT-PCR analysis. Protein expression of TLR4 in livers was detected using immunohistochemistry.</p><p><b>RESULTS</b>The Gly group mice had an improved survival rate and attenuated LPS-induced pathological changes in the liver tissues in comparison with those of the LPS group animals. The TNF alpha levels [(1,852.80+/-126.64) pg/ml vs (708.83+/-51.29) pg/ml, P<0.05] in plasma, as well as the expression of TNF alpha (A 1.59+/-0.14 vs. 0.91+/-0.11, P<0.05) and TLR4 (A 0.97+/-0.12 vs. 0.53+/-0.11, P<0.05) mRNA in liver tissues were decreased. However, the levels of plasma interleukin-10 [(344.09+/-31.70) pg/ml vs (418.64+/-38.86) pg/ml, P<0.05] were significantly increased and the peaking time left, shifted.</p><p><b>CONCLUSIONS</b>Gly pretreatment could attenuate LPS -induced liver injury in mice, which may be associated with its role in down-regulating TLR4 expression and up-regulating IL-10 production.</p>
Subject(s)
Animals , Female , Mice , Down-Regulation , Glycine , Pharmacology , Interleukin-10 , Blood , Metabolism , Lipopolysaccharides , Liver , Metabolism , Pathology , Mice, Inbred BALB C , Toll-Like Receptor 4 , Metabolism , Tumor Necrosis Factor-alpha , Blood , Metabolism , Up-RegulationABSTRACT
<p><b>OBJECTIVE</b>To explore the possible mechanism and optimal treatment phase of glycine for inhibition lipopolysaccharide (LPS) induced Kupffer cells (KCs) activation.</p><p><b>METHODS</b>The KCs were isolated from 40 BALB/c mice and divided into four groups: the endotoxin group, the prevention group, the early treatment group and the later treatment group (n = 10). The endotoxin group was treated with 10 mg/L LPS, and in the other three groups, glycine (1 mmol/L) was given 24 h before, or at 0 h or 4 h respectively after LPS stimulation. At 0 h, 1 h, 2 h, 6 h and 12 h after LPS stimulation, the mRNA levels and protein expression of interleukin-1 receptor associated kinase-4 (IRAK-4) were determined by reverse transcription polymerase chain reaction (RT-PCR) and Western blot respectively, and nuclear factor-kappaB (NF-kappaB) activities as well as tumor necrosis factor alpha (TNF-alpha) levels were also detected by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The climax values of IRAK-4, NF-kappaB and TNF-alpha were significantly higher in the endotoxin group and the later treatment group than that in the other two groups (t = 3.17, 4.33, 2.47, 126.73, P < 0.01).</p><p><b>CONCLUSION</b>The results indicated that prophylactic or simultaneous treatment with glycine could effectively inhibit LPS-induced KCs activation by inhibiting IRAK-4 expression.</p>