Relationship between fragmented QRS wave with ventricular arrhythmia's incidence situation and heart rate variability in patients with old myocardial infarction / 中国综合临床

Objective:To explore the relationship between fragmented QRS complex and heart rate variability (HRV) and ventricular arrhythmia in patients with old myocardial infarction.Methods:From August 2018 to October 2019, 200 patients with old myocardial infarction were first treated in the Department of cardiac function examination of the First Affiliated Hospital of Hebei North University. The patients were divided into 99 cases of old myocardial infarction with fragmented QRS wave group and 101 cases of old myocardial infarction without fragmented QRS wave group according to the case bank data and conventional 12 lead ECG diagnosis in our hospital for the first time. Then, the 24-h ambulatory ECG reexamined within 1 year after discharge was retrospectively analyzed. The incidence of ventricular arrhythmia was compared between the two groups by χ 2 test. The difference of heart rate variability between the two groups was compared by rank sum test. Multiple logistic regression was used to analyze the value of different indexes of heart rate variability in the evaluation of fragmented QRS complex in old myocardial infarction. Drawing the receiver operating characteristic (ROC), and the area under the curve (AUC) was used to analyze the diagnostic accuracy of different indexes of heart rate variability in the broken QRS complex of old myocardial infarction. Results:According to the Lown classification of ventricular premature contraction, the number of positive ventricular arrhythmias in patients with Grade Ⅰ of ventricular premature contraction and Grade Ⅲ-Ⅴ of ventricular premature contraction in the old myocardial infarction fragmented QRS group was higher than that in the old myocardial infarction non fragmented QRS group (Grade Ⅰ of ventricular premature contraction: 54.5% (54/99)and 39.6%(40/101); χ 2=4.484, P<0.05;Grade Ⅲ-Ⅴ of ventricular premature contraction: 34.3% (34/99) and 9.9%(10/101); χ 2=17.406, P<0.05)). Ventricular premature contraction Grade 0 old myocardial infarction fragmented QRS group was lower than old myocardial infarction non fragmented QRS group (8.1% (8/99) and 48.5% (49/101); χ 2=37.995, P<0.05). The total number of positive cases of ventricular arrhythmia in the old myocardial infarction group with fragmented QRS wave was higher than that in the old myocardial infarction group without fragmented QRS wave (91.9% (91/99) and 51.5%(52/101); χ 2=57.146, P<0.05)). There was no significant difference in the number of positive ventricular arrhythmias between the old myocardial infarction fragmentation QRS group and the old myocardial infarction non fragmentation QRS group ( P>0.05). The standard deviation of NN intervals (SDNN) and the standard deviation of average NN intervals (SDANN) of HRV time domain indexes in the old myocardial infarction fragmented QRS group were higher than those in the old myocardial infarction non fragmented QRS Group (SDNN:143.00(122.00,166.00) vs. 110.00(95.00,130.50), Z=5.780, P<0.05; SDANN:112.00(100.00,136.00) vs. 96.00(76.00,118.50), Z=4.013, P<0.05). Multiple Logistics regression analysis results of HRV domain shows that HRV time domain SDNN and SDANN have diagnositic value in diagnosis fQRS after OMI(SDNN: OR=0.949, 95% CI:0.922-0.977, P<0.001; SDANN: OR=1.036, 95% CI:1.005-1.068, P=0.022). Area under ROC curve of HRV time domain SDNN and SDANN have particular diagnositic accuracy in diagnosis fQRS after OMI(SDNN: AUC 0.737, 95% CI 0.666-0.807, Sensitivity 0.818, Specificity 0.634; SDANN: AUC 0.664, 95% CI 0.587-0.741, Sensitivity 0.737, Specificity 0.673. 0.5<AUC<1). Conclusion:Fragmented QRS complex was positively correlated with the incidence and severity of ventricular arrhythmia in patients with old myocardial infarction, and positively correlated with time-domain indexes SDNN and SDANN of heart rate variability in patients with old myocardial infarction.

Effect of Quercetin on Proliferation and Apoptosis of Multiple Myeloma Cells and Its Related Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of quercetin (que) on proliferation and apoptosis of multiple myeloma cell line NCI-H929.@*METHODS@#NCI-H929 cells were routinely cultured, and cells in logarithmic growth phase were taken and used for experiments. After treatment of NCI-H929 cells with Que of 50, 100 and 200 µmol/ L for 24, 48 and 72 hours, the proliferation level of cells was detected by using MTT method; after treatment of NCI-H929 cells with Que of 100 and 200 µmol/ L for 24 hours, the cell apoptosis level was detected by Annexin V-FITC/PI double staining, the changes of cell cycle was analysis by flow cytometry with PI marking; the expression of apoptosis-related proteins caspase-3, caspase-8, caspase-9, PARP, BCL-2 and cell cycle-related proteins P53, P21, P27, CDK4, and the activiation of ERK and ATK were detected by Western blot.@*RESULTS@#Que of different concentration could inhibit cell proliferation with time and dose dependent manner. The flow cytometry showed that Que could significantly increase the cell apoptosis and arrest NCI-H929 cells in the G/M phase. In addition, Western blot analysis showed that Que could activate the apoptosis-related proteins, such as caspase-3, caspase-8, caspase-9 and PARP, and then inhibited the expression of BCL-2. Que could promote the expression of P53, P21 and P27, however, it could inhibited the CDK4 expression in NCI-H929 cells. Que could decrease the phosphorylation levels of p-ERK and p-AKT in NCI-H929 cells.@*CONCLUSION@#Quercetin mediates anti-myeloma effects through inducing apoptosis, cell cycle arrest and down-regulating ERK and AKT pathways in human myeloma cells.

Cancer-associated-fibroblasts regulate the chemoresistance of lung cancer cell line A549 via SDF-1 secretion / 中华肿瘤杂志

Objective@#To investigate whether cancer-associated- fibroblasts (CAF), the key component of tumor microenvironment, regulate the chemoresistant capacity of lung cancer cell line A549 through SDF-1 secretion.@*Methods@#Primary cell isolation techniques was used to isolate cancer-associated-fibroblasts from lung cancer patients. MTT assay was applied to determine the proliferation and chemoresistance of A549 cells. Quantative PCR was used to detect the mRNA changes of Bcl-xL. Western blotting was used to detect the protein expression of Bcl-xL. ELISA was applied to detect the SDF-1 secretion from normal fibroblasts (NF) and CAF.@*Results@#CAF promoted the proliferation of A549 cells, while NF had no significant effect on them. After 72 hrs incubation, the absorbance value of A549+ CAF medium group was 0.814±0.006, significantly different from the 0.753±0.006 of the A549+ NF medium group (P<0.05). The Q-PCR assay indicated that mRNA expressions of Bcl-xL in the A549 group, A549+ NF medium group and A549+ CAF medium group were 1.00±0.11, 1.10±0.09 and 3.50±0.30, respectively, showing a significant difference between the A549+ NF medium group and A549+ CAF medium group (P<0.05). The Western blot showed that protein expressions of Bcl-xL in the A549 group, A549+ NF medium group and A549+ CAF medium group were 1.00±0.08, 1.10±0.12 and 3.10±0.25, respectively, with a significant difference between the A549+ NF medium group and A549+ CAF medium group (P<0.05). The ELISA results showed that the SDF-1 concentrations in the A549+ NF medium group and A549+ CAF medium group were 3.23±0.02 and 9.53±0.10, respectively, significantly different from each other (P<0.05). The MTT assay indicated that the absorbance values of OD of A549 group, A549+ AMD3100 group, A549+ NF medium group, A549+ NF medium+ AMD3100 group, A549+ CAF medium and A549+ CA Fmedium+ AMD3100 group were 0.43±0.03, 0.25±0.02, 0.48±0.03, 0.31±0.03, 0.72±0.06 and 0.45±0.03, respectively. The data of A549+ NF medium group was significantly different from that of A549+ CAF medium group (P<0.05).@*Conclusions@#Cancer-associated-fibroblasts enhance the drug resistance of A549 cells through SDF-1 secretion, upregulating the expression level of Bcl-xL through interaction with CXCR4. Our study not only illustrates that tumor microenvironment is able to enhance drug resistance of tumor, but also provides experimental evidence for the cancer-associated-fibroblasts as a potential therapeutic target for the treatment of lung cancer.

The design of home care platform and its application in the management of clinical nurse specialists in orthopedics in Jiangsu Province / 中华护理杂志

We constructed a home care platform for orthopedics,and clinical nurse specialists in orthopedics in Jiangsu Province opened online clinics on it.Patients with knee or hip joint replacement could be added to the platform,and the clinical nurse specialists provided patients with professional home care service when discharged.In the interviews of clinical nurse specialists,they said that the application of the platform was conducive to enhance their own values,and expressed their willingness to continue to use it.The joint function and quality of life scores of the intervention group were significantly higher than those of the control group (P＜0.001).The application of the home care platform is conducive to give full play to the role of clinical nurse specialists to provide professional home care services for patients.

Brain injury after induction chemotherapy in children with acute lymphoblastic leukemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes in brain injury after the induction chemotherapy in children with acute lymphoblastic leukemia (ALL) by cranial MRI.</p><p><b>METHODS</b>The clinical data and cranial MRI results of 62 children with ALL who were hospitalized from March 2014 to June 2015 were analyzed retrospectively.</p><p><b>RESULTS</b>Before chemotherapy, MRI showed bone marrow infiltration of the skull in 33 patients (53%); the children with WBC<20×10(9)/Lhad a significantly lower incidence rate of bone marrow infiltration of the skull than those with WBC≥20×10(9)/L (16 patients/42% vs 17 patients/71%; P<0.05), and the high-risk group had a significantly higher incidence rate of bone marrow infiltration of the skull than the non-high-risk group (71% vs 44%; P<0.05). Before chemotherapy, there were 4 cases (7%) of brain atrophy, and 2 cases (3%) of abnormal signals in the sensory conduction bundle. MRI reexamination in 28 patients after 3 months of chemotherapy showed 3 new cases (11%) of brain atrophy and 1 aggravated case of brain atrophy.</p><p><b>CONCLUSIONS</b>The children with ALL have bone marrow infiltration of the skull, brain atrophy, and abnormal signals in the sensory conduction bundle before chemotherapy, especially bone marrow infiltration of the skull, and some changes in brain injury disappear after treatment.</p>

Efficacy analysis of double-“U” embedding and pursestring suture and binding pancreaticojejunostomy for the prevention of pancreatic leakage / 中华消化外科杂志

Objective To investigate the efficacy of double-“ U” embedding and pursestring suture and binding pancreaticojejunostomy for the prevention of pancreatic fistula.Methods The retrospective cohort study was adopted.The clinical data of 208 patients who underwent pancreaticojejunostomy at the Hunan Provincial People's Hospital from March 2011 to March 2015 were collected.Of 208 patients,106 patients undergoing double-“ U” embedding and pursestring suture and binding pancreaticojejunostomy were allocated into the double-“ U” group and 102 patients undergoing Child pancreaticojejunostomy were allocated into the Child group.Observation indicators included (1) surgical effects:anastomosis time,postoperative pancreatic leakage,duration of hospital stay,(2) follow-up situations.The follow-up using telephone interview and outpatient examination was performed to detect postoperative long-term complications and recovery of patients by abdominal ultrasound or computed tomography (CT) at every 6 months postoperatively up to September 2015.Measurement data with normal distribution were represented as x ± s and comparison between groups was analyzed by t test.Count data were analyzed using the chi-square test.Results (1) Surgical effects:208 patients underwent successful surgery without occurrence of death.The anastomosis time was (13.0 ± 1.5) minutes in the double-“ U” group and (20.0 ± 1.6) minutes in the Child group,with a statistically significant difference between the 2 groups (t =4.713,P ＜ 0.05).Two patients in the double-“ U” group were complicated with grade A of pancreatic leakage,including 1 of 36 patients with normal pancreatic remnant and 1 of 70 patients with fibrotic pancreatic remnant.Nine patients in the Child group were complicated with pancreatic leakage,including 6 in grade A,1 in grade B and 2 in grade C,and there were 6 of 33 patients (4 in grade A,1 in grade B,1 in grade C) with normal pancreatic remnant and 3 of 69 patients (2 in grade A,1 in grade C) with fibrotic pancreatic remnant.There were statistically significant differences in the pancreatic leakage between the 2 groups and among the patients with normal pancreatic remnant in the 2 groups (x2 =2.951,4.994,P ＜ 0.05).The duration of postoperative hospital stay was (13.5 ± 1.2)days in the double-“U” group and (15.7 ± 2.6)days in the Child group,with a statistically significant difference (t =1.011,P ＜ 0.05).No readmission in the 2 groups occurred.(2) Followup situations:91 of 106 patients in the double-“U” group were followed up for 6-54 months with a median time of 30 months.During the follow-up,8 patients were dead,12 patients didn't undergo reoperation due to multiple metastases in the liver,lung and greater omentum,4 and 4 patients were respectively complicated with relapsing pancreatitis and refluxing cholangitis,and other patients had good conditions without the occurrence of diabetes,diarrhea,indigestion and hypopancreatism.Eighty-eight of 102 patients in the Child group were followed up for 6-54 months with a median time of 25 months.During the follow-up,10 patients were dead,11 patients didn't undergo reoperation due to multiple metastases in the liver,lung and greater omentum,6 and 6 patients were respectively complicated with relapsing pancreatitis and refluxing cholangitis,and other patients had good conditions without the occurrence of diabetes,diarrhea,indigestion and hypopancreatism.Conclusion Double“U” embedding and pursestring suture and binding pancreaticojejunostomy for the prevention of pancreatic fistula can reduce the suture time,incidence of pancreatic leakage and duration of postoperative hospital stay,and it is especially suitable for the patients with normal pancreatic remnant.

Risk factors of postoperative hemorrhage after pancreatoduodenectomy / 中华消化外科杂志

Objective To investigate the risk factors of postoperative hemorrhage after pancreatoduodenectomy (PD).Methods The retrospective case-control study was adopted.The clinical data of 857 patients with pancreatic diseases who were admitted to the First Affiliated Hospital of Hunan Normal University from January 2007 to December 2014 were collected.All the 857 patients underwent PD and digestive tract reconstruction using the Child method.The number of patients with postoperative hemorrhage,classification,bleeding sites,source and time of bleeding and method and effect of treatment after PD were observed.The correlations among the gender,age,concomitant diseases (diabetes and hypertension),malignancy degree of tumor,the preoperative levels of serum alanine transaminase (ALT),total bilirubin (TBil),albumin (Alb) and prothrombin time (PT),international normalized ratio (INR),operation time,volume of intraoperative blood loss,method of pancreatic and jejunal anastomosis and postoperative hemorrhage after PD were analyzed.The follow-up of outpatient examination and telephone interview was performed to observe postoperative recovery of patients for 2 months till February 2015.Univariate analysis and multivariate analysis were done using the chisquare test and Logistic regression model,respectively.Results Of 72 patients with postoperative hemorrhage,grade A,B and C hemorrhage were detected in 3,41 and 28 patients,respectively,and 41,29 and 2 patients had respectively enteral hemorrhage,parenteral hemorrhage and enteral and parenteral hemorrhage.After PD,38 patients had hemorrhage located at the gastrointestinal tract,9 at the common hepatic artery,proper hepatic artery and gastroduodenal artery (5 due to pseudoaneurysm),5 at the pancreatic section,3 at the jejunal mesenteric vessels,2 at the middle colic arterial branches,1 at the superior mesenteric artery,1 at the superior mesenteric vein and 13 at the ambiguous bleeding sites.The early and late stage hemorrhages (within postoperative hour 24 and after postoperative hour 24) were detected in 20 and 52 patients,respectively.Of 44 patients with grade A and B of hemorrhages,17 underwent conservative treatment,16 underwent reoperation,8 underwent hemostatic therapy under gastroscopy,3 underwent interventional treatment.All the 44 patients had good hemostasis effect.Of 28 patients with grade C of hemorrhage,interventional treatment,reoperation,hemostatic therapy under gastroscopy,conservative treatment,interventional treatment + reoperation and gastroscopy + interventional treatment were applied to 10,7,4,3,3 and 1 patients,respectively.Ten of 28 patients died and 18 had successful hemostasis.The gender and preoperative levels of ALT and TBil were related factors affecting postoperative hemorrhage after PD in the univariate analysis (x2 =4.516,7.585,7.209,P ＜ 0.05).Male,preoperative ALT ≥ 172 U/L and preoperative TBil ≥ 159 μmol/L were the independent risk factors affecting postoperative hemorrhage after PD in the multivariate analysis (HR =2.033,1.860,1.872,95％ confidence interval:1.237-3.341,1.135-3.047,1.060-3.307,P ＜ 0.05).Fifty of 62 patients were followed up for a median time of 2 months with a follow-up rate of 80.6％ (50/62),and no rehemorrhage was occurred.Conclusion Male,preoperative ALT≥172 U/L and preoperative TBil≥≥ 159 μmol/L are the independent risk factors affecting postoperative hemorrhage after PD.

Expression and implication of toll-like receptors TLR2, TLR4 and TLR9 in colonic mucosa of patients with ulcerative colitis / 华中科技大学学报（医学）（英德文版）

Toll-like receptors (TLRs) family may play important roles in inflammatory bowel disease. This study examined the expression of TLR2, TLR4 and TLR9 in the colonic tissues of patients with ulcerative colitis (UC) and explored their roles in the pathogenesis of UC. Colonic biopsies were taken from the colon of 30 patients with mild or moderate UC (at active phase) and 10 healthy controls during colonoscopy. TLR2, TLR4 and TLR9 protein expression levels were immunohistochemically detected. The mRNA expression levels of TLR2, TLR4 and TLR9 were assessed by reverse transcription polymerase chain reaction (RT-PCR). The disease activity index (DAI), colonoscopic and histologic grades and fecal microbial flora were determined. Histological examination showed that the intestinal mucous membrane of UC patients underwent acute inflammation changes. Immunohistochemistry exhibited that the expression levels of TLR2, TLR4 and TLR9 in colon epithelia and inflammatory cells were higher in UC patients than in control group (P<0.01). The mRNA expression levels of TLR2, TLR4 and TLR9 were increased in UC patients but were not detected in the normal controls. Expression levels of TLR2, TLR4 and TLR9 were positively correlated, and bore close correlation with DAI, colonoscopic and histologic grades and fecal microbial flora. An important mechanism of UC might be that abnormal activation of mucosal immunity by intestinal dysbacteriosis caused dysregulation of TLRS that mediates innate immunity.

Expression and implication of toll-like receptors TLR2, TLR4 and TLR9 in colonic mucosa of patients with ulcerative colitis / 华中科技大学学报（医学）（英德文版）

Toll-like receptors (TLRs) family may play important roles in inflammatory bowel disease. This study examined the expression of TLR2, TLR4 and TLR9 in the colonic tissues of patients with ulcerative colitis (UC) and explored their roles in the pathogenesis of UC. Colonic biopsies were taken from the colon of 30 patients with mild or moderate UC (at active phase) and 10 healthy controls during colonoscopy. TLR2, TLR4 and TLR9 protein expression levels were immunohistochemically detected. The mRNA expression levels of TLR2, TLR4 and TLR9 were assessed by reverse transcription polymerase chain reaction (RT-PCR). The disease activity index (DAI), colonoscopic and histologic grades and fecal microbial flora were determined. Histological examination showed that the intestinal mucous membrane of UC patients underwent acute inflammation changes. Immunohistochemistry exhibited that the expression levels of TLR2, TLR4 and TLR9 in colon epithelia and inflammatory cells were higher in UC patients than in control group (P<0.01). The mRNA expression levels of TLR2, TLR4 and TLR9 were increased in UC patients but were not detected in the normal controls. Expression levels of TLR2, TLR4 and TLR9 were positively correlated, and bore close correlation with DAI, colonoscopic and histologic grades and fecal microbial flora. An important mechanism of UC might be that abnormal activation of mucosal immunity by intestinal dysbacteriosis caused dysregulation of TLRS that mediates innate immunity.

Investigation of occupational health status of female workers in pharmaceutical industry of Shandong and Gansu provinces / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate occupational health status of female workers in pharmaceutical industries and to propose the protective measures for the occupational health.</p><p><b>METHOD</b>A total of 2816 female workers from 19 pharmaceutical industries in Shandong and Gansu provinces were investigated by a questionnaire.</p><p><b>RESULTS</b>73.1% of female workers exposed to occupational hazards, mainly to toxic chemicals. 63.2% of them suffered from dysmenorrhea; 38.5% of them have reproductive system diseases, i.e. mammary gland hyperplasia (44.1%), cervical erosion (26.5%), uterine annex inflammation (24.2%); 17.1% of them suffered from accidental work injuries; 34.7% of them complained about low back pain, and 29.7% of them perceived hearing loss. 94.9% of female workers hoped to get the occupational health and labor protection knowledge and skills.</p><p><b>CONCLUSION</b>Strengthening the supervision of labor protection for female workers, including technical measures occupational hazards control and health-related knowledge, and improving the occupational health status of female workers should be conducted.</p>

The occupational and procreation health of immigrant female workers in electron factory / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the occupational and reproductive health problems of migrant female workers in electron factory.</p><p><b>METHODS</b>A total number of 2000 female migrant workers were randomly sampled from three electronic factories for the study. All were investigated by questionnaire and data were input to EpiData 3.0 data base, SPSS17.0 statistical software and analyzed by Chi-square test.</p><p><b>RESULTS</b>1971 complete questionnaires were received, the recovery rate reached over 98.6%. The average age of interviewees is (21.1 ± 3.9) years. Junior employee between 16 and 18 years accounted for 19.04%. The average working age was (1.1 ± 2.2) years and about 90% were single including 0.11% of them were divorced. The main occupational hazards were: sodium hydroxide, sodium carbonate, formaldehyde, hydrochloric acid, stannic anhydride, benzene analogues, n-hexane methanol, glycol isopropanol, sulphuric acid, nitric oxide, noise, ultraviolet radiation, etc. Workplace monitoring indicated that benzene and noise levels and ultraviolet radiation were over the national OEL at fewer worksites. More than 50% female workers worked over 8 hours per day and 83% of them worked 22 days per month. The ergonomic problems: 63.86% of them worked with tedious repetitiveness and monotonous job task. About 42% of them need to be continuously with standing posture. As a consequence, there were 30% workers complain about LBP, 21% had experienced work injury; 15% ∼ 18% had some non-specific discomfort, such as insomnia, dysacusis, dizzy and headache. The incidence rate of reproductive system such as abnormal menstrual cycle (5.71%), dysmenorrhea (25.11%), congestion (8.91%), etc. The first four reproductive system disease were pelvic inflammation, adnexitis, cervical erosion, and vaginitis. There are significant differences between continuous and temporary standing work, and repeated and unrepeated job action in terms of dysmenorrheal and congestion related-discomfort(P < 0.05).</p><p><b>CONCLUSION</b>There are many occupational hazards in electronic industry. And there is somewhat a serious occupational and reproductive health problems among female migrant workers, that seem to be a matter of great concern.</p>

CTLA-4 gene polymorphism regulates CTLA-4 mRNA stability and protein level in patients with ulcerative colitis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the effect of (AT)n repeat polymorphism of the 3'untranslated region in cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) gene on CTLA-4 mRNA stability and full length (flCTLA-4) and soluble CTLA4 (sCTLA-4) expression in ulcerative colitis (UC).</p><p><b>METHODS</b>flCTLA-4 mRNA in colonic biopsies and sCTLA-4 mRNA stability in peripheral blood mononuclear cells of UC patients were measured by quantitative PCR and half-life, respectively. The protein expression of flCTLA-4 in colonic biopsies and sCTLA-4 in sera of UC patients were determined by immunohistochemistry and enzyme-linked immunosorbent assay, respectively. The polymorphism of CTLA-4 (AT)n repeats in 300 UC and 700 age and sex matched healthy controls was genotyped by fluorescent PCR.</p><p><b>RESULTS</b>Among the UC patients, sCTLA-4 mRNA expression levels were decreased in active disease compared to non-active disease (P= 0.004). Carriers of the longer alleles of the (AT)n repeats expressed lower levels of flCTLA-4 and sCTLA-4 mRNA and sCTLA-4 protein than those of the shorter alleles in UC (all P< 0.01), and mRNA with long (AT)n repeat alleles has shorter half-life than mRNA with short alleles and, hence, are unstable. The frequency of long allele carriers of CTLA-4 (AT)n repeats was significantly higher in UC patients than in the healthy controls (22.0% vs. 6.3%, P< 0.01, OR= 4.21, 95% CI: 2.79-6.33), and associated with extensive colitis (P= 0.008).</p><p><b>CONCLUSION</b>CTLA-4 gene expression levels were associated with (AT)n repeat polymorphisms in UC patients. The expression of CTLA-4 mRNA and protein were decreased in carriers of the longer alleles of the (AT)n repeats of CTLA-4 gene. This study suggests that CTLA-4 plays an important role in genetic risk and pathophysiology for UC in central China.</p>

The expression of Cyclin A and p21cip1 in fibroblast of hypertrophic scar / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the relation of the mRNA and protein expression of Cyclin A and p21cip1 in different stages hypertrophic scar fibroblast (FB) with its cell cycle, so as to provide theoretical evidence for intervention therapy of cell cycle gene being used in hypertrophic scar.</p><p><b>METHODS</b>The hypertrophic scar samples at different stages (the third month, the sixth month, the twelfth month, the twenty-fourth month) in 32 cases and the normal skin samples in 8 cases were used in this study. The expression of Cyclin A, p21cip1 mRNA and protein was detected by quantitative real-time PCR and Western Blot. And at the same time, the flow cytometer was used to detect the fibroblastic cell life cycle.</p><p><b>RESULTS</b>1) The expression of Cyclin A mRNA and protein in the third month group, the sixth month group, the twelfth month group, the twenty-fourth month group were 19.34 +/- 2.41, 0.99 +/- 0.11; 19.30 +/- 1.42, 0.96 +/- 0.09; 10.73 +/- 2.93, 0.66 +/- 0.58; 9.29 +/- 0.97, 0.65 +/- 0.14, respectively. And in corresponding stages, the expression of p21cip1 mRNA and protein were 2.80 +/- 0.69, 0.35 +/- 0.07; 4.95 +/- 1.82, 0.44 +/- 0.07; 9.98 +/- 1.19, 0.56 +/- 0.06; 10.25 +/- 1.46, 0.59 +/- 0.06, respectively. The expression intensity of Cyclin A mRNA and protein was no significantly different between the third month group and the sixth month group (P > 0. 05), but it was higher respectively than that in the twelfth month group, the twenty-fourth month group and normal group (P < 0.05). And the expression intensity was no different between the above three groups (P > 0.05). The expression intensity of P21cip1 mRNA and protein in the third month group was lower than that in the sixth month group, but that in the above two groups was lower respectively than that in the twelfth month group, the twenty-fourth month group and normal group (P < 0.05). And the expression intensity had no difference between the three later stage groups (P > 0.05). 2) Most FB were in S and G2/M stage (cycle) in 3rd month, 6th month group. And most FB were in G0/G1 stage (cycle) in 12th month, 24th month group and normal group.</p><p><b>CONCLUSIONS</b>The expression of mRNA and protein of Cyclin A in hypertrophic scar changes from high level to low level as the hypertrophic scar develops, while the expression of P21cip1 changes from low level to high level. The mRNA and protein expression of Cyclin A and p21cip1 respectively are basically corresponded to different stages of hypertrophic scar. The distribution of cell life cycle of fibroblastic are also corresponded to the expression intensity of Cyclin A and p21cip1 in different stages hypertrophic scar. An early stage intervention to the two gene can be effective to prevent from the genesis and development of hypertrophic scar.</p>

Clinical study on fludarabine combined with cytarabine regimen in the treatment of patients with refractory and relapsed acute myeloid leukemia / 中国实验血液学杂志

The aim of study was to evaluate the clinical efficacy and toxicity of fludarabine combined with cytarabine (FA) regimen in the treatment of patients with refractory and/or relapsed acute myeloid leukemia (AML). Nineteen cases with refractory/relapsed AML were treated with FA regimen in which fludarabine phosphate 25 mg/(m(2) x d), d1-5; cytarabine (Ara-C) 2 g/(m(2) x d), d1-5. Another 20 cases were treated with salvage chemotherapy (MAE regimen: mitoxantrone, Ara-C and etoposide or DAE regimen: daunorubicin, Ara-C and etoposide). All patients received at least 2 cycles chemotherapy. The results showed that 9 patients (47%) in FA regimen group achieved complete remission (CR), 8 cases (42%) obtained partial remission (PR), the clinical efficacy was superior to that of the MAE or DAE regimens (p < 0.05). Major toxicity of FA regimen was myelosuppression. Grade IV hematologic toxicity occurred in all patients received FA regimen. Nonhematologic complications consisted of gastrointestinal side effects, mucositis, liver toxicity, which were mild to moderate and could be alleviated with supportive therapy. In conclusion, FA regimen is an effective regimen for treatment of refractory and relapsed AML.

Arsenic trioxide induces socs-1 gene demethylation in myeloma cell lines / 中国实验血液学杂志

The aim of this study was to explore the effect of arsenic trioxide (As(2)O(3)) on the methylation status of socs-1 gene in multiple myeloma cell lines U266, RPMI8226. The cell viability was assayed by MTT method. The methylation status of socs-1 gene was detected by methylation specific PCR. The expression of socs-1 gene mRNA was determined with real-time PCR. The cell apoptosis was analyzed by flow cytometry. The results indicated that hypermethylation of CpG island of socs-1 gene was observed without expression of socs-1 in myeloma cell lines U266, RPMI8226. The expression of socs-1 gene mRNA in each myeloma cell line increased significantly after exposure to As(2)O(3) for 72 hours as compared with the cell lines of wild type (p < 0.05). And cell proliferation was significantly inhibited, both early apoptosis and later apoptosis ratios increased in dose-dependent manner. It is concluded that As(2)O(3) may induce socs-1 demethylation and up-regulate the expression of the gene. This study provides a new thought and direction for exploring possible mechanism of cell apoptosis induced by As(2)O(3) and multiple myeloma treatment by As(2)O(3).

Characteristics of infrasound and its influence on workers in working environment of certain thermoelectricity works and department / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the characteristics of infrasound and its effects on the workers at power plants.</p><p><b>METHODS</b>The audible noise and infrasound in three thermoelectricity plants were measured and by using Symptom Checklist 90 (SCL-90), the subjective sensation, and the physiological indices were compared between exposed workers and controls.</p><p><b>RESULTS</b>The infrasound levels were different at different measure sites of the three thermoelectricity works ranging from 40 to 98 dB. There was still 40 approximately 80 dB infrasound even when the soot blower stopped running. Different apparatus produced different infrasound levels with the highest ranging from 62 to 115 dB. A single frequency (16 Hz) infrasound was produced in certain department during working hour with sound pressure levels of 110 to 120 dB, but the audible noise sound pressure level was less than 70 dB. There was no significant difference in the indices representing vision fatigue and neurobehaviour function between exposed workers and controls. Workers at certain department experienced evident subjective sensation of neurobehavioral dysfunction, and the scores of somatization, depression, hostility, phobic anxiety, and psychotism in the SCL-90 were significantly higher in the exposed group than in the control and the norm in China (P < 0.05).</p><p><b>CONCLUSION</b>Infrasound is ubiquitous in the working environment, but usually, the noise levels are less than 120 dB. In some special production department, there is persistent infrasound above 110 to 120 dB. No obvious health effects are found among those who are exposed to infrasound below 100 dB. However, the workers who are chronically exposed to infrasound above 110 to 120 dB present notable subjective sensation of autonomic neurobehavioral dysfunction, and their psychological health status is not as good as those in the control and those in the domestic normal pattern.</p>

Helicobacter pylori infection and changes of cell gap junction of gastric epithelial cells in patients with gastric cancer and precancerous lesion / 中南大学学报(医学版)

OBJECTIVE@#To observe the changes of cell gap junction ultrastructure of gastric epithelial cells in patients with gastric cancer(GC) and precancerous lesion(PL),and to investigate the relation between these changes and H.pylori infection.@*METHODS@#Seventy patients with GC, 88 with PL, and 33 with chronic superfial gastritis (CSG) were studied. H.pylori was detected by rapid urease test,basic fuchsin stain and 14C-urea breath test. The CagA gene of H.pylori was determined by polymerase chain reaction(PCR).The cell gap junction ultrastructure was observed under transmission electronic microscope.@*RESULTS@#Length of junction/unit perimeter of gastric epithelial cells in patients with PL was smaller than that in CSG patients, and the smallest width of the intercellular space was bigger than that in CSG patients. The number of cell junction, the number of junction/unit perimeter, and the length of junction/unit perimeter in patients with GC were all smaller than those in patients with CSG or PL, and its smallest width of the intercellular space was bigger than that in patients with CSG. In patients with GC, the number of cell junction, the number of junction/unit perimeter and the length of junction/unit perimeter in CagA+ H.pylori group were smaller than those in CagA(-) H.pylori group, and its smallest width of the intercellular space was bigger than that in CagA(-) H.pylori group. In PL patients, the intercellular space decreased, and the length of cell junction of gastric epithelial cells became bigger after H.pylori eradication. The length of junction/unit perimeter in patients of H.pylori eradication was bigger than that in patients without eradication, and the smallest width of the intercellular space was smaller than that in patients without eradication.@*CONCLUSION@#The changes of cell gap junction of gastric epithelial cells in patients with GC and PL are associated with H.pylori infection especially CagA+ H.pylori infection. Eradication of H.pylori can promote the formation of cell junction.

Influence of carbachol on intestinal dysfunction after traumatic or burn injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of enteral administration of carbachol on the intestinal dysfunction of both severely burn patients and rabbits with partial intestinal ischemia/reperfusion (I/R) injury.</p><p><b>METHODS</b>Seventy-five white rabbits were inflicted with I/R injury and randomized into intestinal I/R (I, n=25), carbachol [C, n=25, with 3g/L carbachol (3 mg/kg) injection into duodenum 1 h after SMA occlusion] and sham operation (SO, n=25, with SMA isolation but no occlusion) groups, and 5 other as normal controls. The blood flow of intestinal mucosa was detected before and after SMA occlusion or admission of carbachol. Changes in diamine oxidase (DAO), D-lactate, xylopyranose absorption, blue dextran discharging time were measured at 2, 4, 6, 8, 24, 48, 72 h after SMA occlusion. In addition, eight severe burn patients with TBSA of 84 +/- 12% were enrolled in the study, and carbachol (15 microg/kg) was administered to patients when abdominal distension or bowel sound was lower than 2 times/min, then the number of abdominal distension and bowel sounds per minute were observed.</p><p><b>RESULTS</b>The blood flow in intestinal mucosa of rabbits without SMA occlusion was (102 +/- 5) PU, reduced to (48 +/- 6) PU after SMA occlusion, and increased to (77 +/- 3) PU after injection of carbachol. The plasma DAO activity and D-lactic acid content in I group began to increase 4 hours after SMA occlusion, and they reached the peak 24 hours after SMA occlusion (4.63 +/- 0.27 U/ml, 7.9 +/- 2.4 mg/L) , after that they decreased gradually, but still higher than the normal value (0.89 +/- 0.14 U/ml, 2.0 +/- 1.1 mg/L, P < 0.05). In carbachol group, data showed the same trends as that in intestine I/R group with lower values, while no obvious changes were in sham operation group (P > 0.05). The content of D-lactic decreased dramatically 2 hours after D-lactic administration in both I and C groups, increased 6 hours after SMA occlusion, then decreased gradually, but it in C group was always higher than normal values, and little fluctuation was in sham operation group. There was no blue dextran discharge 2 hours after SMA occlusion. The discharging distance increased 6 hours later, but it was obviously shorter than the normal value 24 hrs after operation (P < 0.05) , then it returned to normal 48 to 72 hrs after operation. In the C group, blue dextran discharge was found immediately after its injection, with obvious increase in the discharging distance to peak value (43 +/- 6 cm) 6 hours after injury, and returning to normal (28 +/- 3 cm) gradually. In severe burned patients, the bowel sounds was (1.6 +/- 1.1) per minutes before carbachol administration, then increased dramatically to (6.9 +/- 1.7) per minutes 10 mins after administration, reached to a higher level 30 minutes after administration (8.3 +/- 2.4 ) times/min, and it maintained to (6.1 +/- 1.3) times/min 1 hour after administration. Abdominal distension was ameliorated 2 hours after carbachol administration, six patients were able to defecate.</p><p><b>CONCLUSION</b>Enteral administration of Carbachol can increase the blood flow of intestine mucosa, help to improve the movement, absorption and barrier functions of intestine, and ameliorate intestinal dysfunction in patients with severe burns.</p>

The diagnostic value of FDG coincidence imaging combined with serum tumor marker assays for pulmonary lesions / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the performance of 18F-FDG three-head tomography with coincidence imaging and serum tumor marker assays in identifying lung lesions in 104 patients with abnormal findings on chest X-ray or computer tomography.</p><p><b>METHODS</b>A prospective evaluation of 18F-FDG coincidence imaging and the measurement of 3 serum markers for lung cancer ( carcinoembryonic antigen, CYFRA21-1 and neuron specific enolase) were performed within one week in 104 inpatients with suspected lung malignancy. All images were analyzed visually. It was considered positive for malignancy if the 18F-FDG uptake was increased relative to that in the adjacent lung tissue, and was focal. The serum tumor marker test was considered positive for malignancy if the serum level of at least one marker was elevated.</p><p><b>RESULTS</b>66 patients were proven to have lung cancer by pathology, and 38 patients had benign lung diseases. The sensitivity, specificity, accuracy of 18F-FDG coincidence imaging and serum tumor markers in assessing lung cancers were 80. 0% , 77. 2% , 77. 9% and 56. 0% , 60. 9%, 64. 4% , respectively. 18F-FDG coincidence images in assessing lung lesions showed significantly higher sensitivity, specificity and accuracy than serum tumor markers. Four patients with lung cancer had negative findings on 18F-FDG coincidence images but showed positive serum markers.</p><p><b>CONCLUSION</b>18F-FDG coincidence imaging is a powerful tool for evaluating patients with lung lesions suggestive of malignancy. Although the determination of serum marker levels is less accurate than 18F-FDG coincidence imaging, the combination of a positive 18F-FDG coincidence result and positive tumor markers may be helpful in improving the diagnosis of lung cancers.</p>

Significance of ~(99m)Tc-Diethyl Iminodiacetic Acid Hepatobliliary Planar and Tomographic Scintigraphy in Diagnosis on Biliary Atresia / 实用儿科临床杂志

Objective To evaluate the clinical value of 6 h 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) planar hepatobiliary scintigraphy (HBS),6 h tomographic HBS and 24 h planar HBS in diagnosis on biliary atresia(BA).Methods Seventy cases(32 male,38 female) with continuous jaundice received planar and tomographic HBS in Beijing Friendship Hospital from Jan.2005 to Dec.2007.The mean age was 48.7 d (29 d-4 months).According to final diagnosis,all cases were divided into BA group (45 cases) and non-BA group (25 cases).All cases fasted at least 4 hours before HBS.The equipment was 3 head IRIX from Philips company with low energy high resolution collimator.The tracer was 99mTc-EHIDA and the radiochemistry purity was more than 95 percent.The dosage was 7.4 MBq/kg.All diagnosis demonstrated by operation pathology and clinical follow-up.All cases received HBS at 5,10,15,20,30 min and 1,6 h after tracer injection.HBS would ended if radioactivity appeared in gallbladder or intestine.These cases would received tomographic HBS and 24 h HBS if radioactivity did not appear in gallbladder or intestine at 6 h post injection.All these images were analyzed by 2 or more nuclear medicine physicians.Results There were not radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 27 cases,which suggested the BA.There were radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 30 cases,which suggested the non-BA.Positive rate of 6 h tomographic HBS was significantly higher than that of 6 h planar HBS and there was significantly difference between the 2 methods.Positive rate of 6 h tomographic HBS was significantly higher than that of 24 h planar HBS and there was significant difference between the 2 methods.Conclusions 99mTc-EHIDA HBS is a noninvasive,safety,valuable examing method and has definitely clinical value in the diagnosis on BA.The clinical value of 6 h tomographic HBS is significantly higher than that of 6 h planar HBS and 24 h planar HBS.