Prevalence and risk factors of deep venous thrombosis of lower extremity in patients with stage Ⅲ and Ⅳ pressure ulcers on admission / 中华烧伤杂志

Objective: To investigate the incidence and risk factors of deep venous thrombosis (DVT) of lower extremity in patients with stage Ⅲ and Ⅳ pressure ulcer on admission. Methods: A retrospective case series study was conducted. A total of 241 patients with stage Ⅲ and Ⅳ pressure ulcers who met the inclusion criteria and were discharged from the Department of Wound Repair of the First People's Hospital of Zhengzhou from January 1, 2015 to December 31, 2019 were enrolled in this study, including 134 males and 107 females, aged 22 to 93 years, with a median age of 68 years; 37 patients were with stage Ⅲ pressure ulcers and 204 patients were with stage Ⅳ pressure ulcers. The DVT occurrence of patients was recorded. According to whether DVT of lower extremity veins was diagnosed by color Doppler ultrasound within 48 h after admission or not, the patients were divided into DVT group (n=37) and non-DVT group (n=204). Data of patients in the two groups were collected and compared, including gender, age, duration of pressure ulcer, time in bed, and combination with diabetes, hypertension, coronary heart disease, cerebral infarction, pneumonia, sepsis/septic shock, and paraplegia, and the plasma D-dimer level and Caprini score within 24 h after admission. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test, and Fisher's exact probability test. The indicators with statistically significant differences between the two groups were analyzed with multivariate logistic regression analysis to screen the independent risk factors influencing the DVT of lower extremity in 241 patients with stage Ⅲ and Ⅳ pressure ulcers on admission. Results: The incidence of DVT of lower extremity was 15.4% (37/241), of which 86.5% (32/37) were asymptomatic DVT. Among the DVT of 46 lower limbs, only 29 involved the inferior genicular veins, accounting for 63.0%. There were no statistically significant differences in gender, duration of pressure ulcer, combination with diabetes, hypertension, coronary heart disease, cerebral infarction, pneumonia, and sepsis/septic shock of patients between the two groups (P>0.05), while there were statistically significant differences in age, time in bed, combination with paraplegia, the plasma D-dimer level and Caprini score of patients between the two groups(t=-3.19, Z=-2.04, χ2=4.44, Z=-3.89, t=-2.14, respectively, P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age and plasma D-dimer level were independent risk factors influencing the DVT of lower extremity in 241 patients with stage Ⅲ and Ⅳ pressure ulcers on admission (with odds ratios of 1.03 and 1.18, respectively, with 95% confidence intervals of 1.00-1.06 and 1.05-1.33, respectively, P<0.05 or P<0.01). Conclusions: The patients with stage Ⅲ and Ⅳ pressure ulcers have a higher incidence of DVT on admission, with age and plasma D-dimer level being the independent risk factors for DVT of lower extremity. It is necessary to pay attention to the targeted screening of DVT and education of its prevention.

Innovation and exploration in medical immunology experiment lessons that aiming on clinical practice / 中国免疫学杂志

As a frontal subject of life science, the medical immunology lessons are verification and complementary to theory lessons, and students need it to train their scientific ability and spirit. Therefore, some adjustments and explorations is needed in the experiments, for example, the data analysis of ELISA has been imported to the lessons to make them more closer to the practice. It' s shown that our lessons got welcomed by almost all students and is more helpful to them. The results playing an important role in improving our teaching effects in future.

Effect of SOX7 promoter methylation on proliferation and apoptosis of bladder cancer / 医学研究生学报

Objective　The SOX7 gene plays a tumor-suppressive role in a variety of tumors, but there are few reports on whether it plays a role in bladder cancer. This study aims to investigate the expression of SOX7 gene in bladder cancer as well as to investigate the regulation and significance of SOX7 promoter methylation on bladder cancer.　Methods　GEPIA, Oncomine, MethHC, and cBioPortal databases were used to speculate the SOX7 expression and promoter methylation in bladder cancer tissues. 40 urine samples were collected from January 2017 to October 2017 in the Department of Urology, Tenth People's Hospital of Shanghai City, including 20 samples from bladder cancer patients and the rest 20 from regular patients as a control group. The methylation difference of SOX7 gene was detected by methylation-specific PCR. The bladder cancer cell line was cultured. The medium containing the methylated drug 5-aza-2’ deoxycytidine (5-aza-dc) was added to the Taza cells as the 5-aza-dc group, while T24 cells were added the same volume of DMSO as the control group. The bladder cancer cell line was transfected with the SOX7 plasmid as the plasmid group, and the transfected with the unloaded plasmid was the empty group. Western blot was used to detect the expression of SOX7 in bladder cancer cell lines, and the proliferation, clone formation, and apoptosis of bladder cancer cells after demethylation were detected by CCK-8 experiments, plate cloning experiments, and flow cytometry, respectively.　Results　The level of methylation in bladder cancer was significantly higher than that in healthy tissues (P<0.005). The higher levels of SOX7 methylation were observed in the urine of 15 bladder cancer patients (75%), compared with only 7 patients (35%) in normal urine, and the proportion was statistically different (P<0.05). The expression of SOX7 protein in the 5-aza-dc group was up-regulated compared to the control group. The expression of SOX7 protein was relatively high when the concentration reached 20 μmol/L. The expression of SOX7 protein in the plasmid group was significantly higher than that in the unloaded group. CCK-8 results showed that the A value of the 5-aza-dc group was statistically lower than that of the control group on the fifth day (P<0.05), and the A value of T24 cells in the plasmid group was significantly lower than that in the unloaded group. The colony formation experiment showed that the number of colony formation per well in the 5-aza-dc group (167.33 ± 13.65) was significantly lower than that in the control group (328.00 ± 20.81) (P<0.05). The number of clone formation per well in the plasmid group (136.00 ± 15.00) was significantly lower than that in the unloaded group (280.67 ± 13.43) (P<0.05). The apoptosis rate of T24 cells in the 5-aza-dc group (27.89%) was significantly higher than that of the control group (3.79%) (P<0.05), and the apoptosis rate of the plasmid group (21.28%) was higher than that of the no-load group (9.90%).　Conclusion　SOX7 is lowly expressed in bladder cancer, which is regulated by promoter methylation. It is a potential biological marker of bladder cancer and plays a vital role in the occurrence and development of bladder cancer.

Observations on the Efficacy of Scalp Acupuncture with Strong Stimulation in Treating Intractable Hiccup / 上海针灸杂志

Objective To investigate the efficacy of scalp acupuncture with strong stimulation plus oral hiccup decoction in treating intractable hiccup. Method One hundred patients with intractable hiccup were allocated, using a random number table, to treatment and control groups, 50 cases each. In addition to oral hiccup decoction in the two groups, the treatment group received scalp acupuncture with strong stimulation at the stomach and chest areas and the control group, electroacupuncture, for two courses of treatment. The times to produce the effect and the symptom frequency scores were compared between the two groups. Result After one course of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 42％, 66％ and 78％, respectively, in the treatment group and 24％, 40％ and 68％, respectively, in the control group. There were statistically significant difference in the cure rate and the cure and marked efficacy rate (P<0.05) but no in the total efficacy rate (P>0.05) between the two groups. After two courses of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 68％, 78％ and 88％, respectively, in the treatment group and 40％, 60％ and 74％, respectively, in the control group. There were statistically significant difference in the cure rate (P<0.05) but no in the cure and marked efficacy rate and the total efficacy rate (P>0.05) between the two groups. After one and two courses of treatment, there was a statistically significant difference in the hiccup frequency score between the treatment and control groups (P<0.05). The time to produce the effect was 2-5 hrs in the treatment group and 5-8 hrs in the control group. Conclusion The total efficacy rate of scalp acupuncture with strong stimulation for intractable hiccup is not significantly different from that of electroacupuncture, but the cure rate of the former was significantly higher than that of the latter. Scalp acupuncture with strong stimulation can produce a quick effect, reduce the frequency of hiccups and relieve symptoms accompanying hiccup.

Mechanism of antitumor effect of ursolic acid on T (8;21) leukemia cell kasumi-1 / 中国实验血液学杂志

This study was purposed to investigate the anti-tumor effect of ursolic acid (UA) on t(8;21) leukemia cell line kasumi-1 and its possible mechanisms. The kasumi-1 cells were treated with UA at different concentration for different duration of time. The growth inhibition of kasumi-1 treated with UA was detected by using CCK-8 test, and the morphological changes of kasumi-1 cells were observed by Wright's staining. Furthermore, the apoptosis rate of kasumi-1 was examined by flow cytometry. Lastly, the expression of AML1-ETO, KIT, MYC, CCND1, BCL-2, P53, BAX, MDM2 and protein were detected by using real-time quantitative PCR and Western blot respectively. The results showed that the UA obviously inhibited the growth of kasumi-1 cells in dose- and time-dependent manners. The apoptotic morphological changes of cells were presented when kasumi-1 cells were treated with UA for 48 hours. The apoptotic rate of kasumi-1 cells increased in a dose- and time-dependent ways, and the mRNA levels of AML1-ETO, KIT, MYC, CCND1, BCL2, MDM2 decreased in kasumi-1 cells treated with UA, as well as the protein levels. Meanwhile, UA up-regulated the mRNA and protein levels of P53 in the same manner. It is concluded that UA can exert its anti-tumor effect by inhibiting the proliferation and inducing the apoptosis of kasumi-1 cells in a dose-and time-dependent manners, that may provide the clues for a new targeting therapy to t(8;21) leukemia.

Mechanism concerning antitumor effect of oridonin on multiple myeloma cell line U266 / 中国实验血液学杂志

This study was purposed to investigate the antitumor effect of oridonin on human multiple myeloma cell line U266 and its possible mechanism. The CCK-8 test was used to determine the inhibitory effect of oridonin on proliferation of U266 cells. The morphological changes of U266 cells were observed under optical microscope. The apoptosis rate of U266 cells was detected by flow cytometry. The mRNA levels of FGFR3, BCL2, CCND1 and MYC genes were quantified by using real-time quantitative PCR method, and the protein levels of BCL2, MYC, CCND1, FGFR3 and P53 were detected by Western blot. The results showed that the oridonin obviously inhibited the growth of U266 cell in dose-and time-dependent manners. As for morphological changes, characteristic apoptotic cells presented in U266 cells treated with 10 µmol/L oridonin for 24 hours. The apoptotic rate of U266 cells increased in dose and time dependent manners; after treatment of U266 cells with oridonin the mRNA levels of FGFR3, BCL2, CCND1 and MYC as well as the their protein levels decreased. Occasionally, the oridonin up-regulated the protein levels of P53 in the same manner. It is concluded that the oridonin can exert its anti-tumor effect by inhibiting proliferation and inducing apoptosis of U266 cell in dose dependent and time dependent manners, that maybe give the clues about new program of target therapy for multiple myeloma.

Association of single nucleotide polymorphism in untranslated region of EGFR gene with genetic susceptibility of gastric cancer / 肿瘤

Objective: This population-based study is aimed to investigate the association of SNP (single nucleotide polymorphism) in untranslated region of EGFR (epidermal growth factor receptor) gene with genetic susceptibility of gastric cancer in Jiangsu province, China. Methods: The peripheral blood samples from 387 patients with gastric cancer and 392 healthy volunteers (as normal controls) were collected. Four SNPs including rs6965469, rs884225, rs884904 and rs763317 in untranslated region of EGFR gene were detected by polymerase chain reaction-ligase detection reaction assay. The associations of these SNPs with the genetic susceptibility of gastric cancer were evaluated. Results: The SNP allele frequencies of rs6965469, rs884225, rs884904 and rs763317 were not significantly different between the patients with gastric cancer and the normal controls (P > 0.05). The frequency of genotype rs6965469 TC was significantly different between the patients with gastric cancer and the normal controls (P < 0.05). The haplotype TGA (rs6965469, rs884225 and rs884904) was associated with a significant increase in risk for gastric cancer [OR (odds ratio) = 3.52, 95% CI (confidence interval): 2.34-5.29] while the haplotype TAG was associated with a significant decrease in risk for gastric cancer (OR = 0.41, 95% CI: 0.26-0.64). Conclusion: The T allele polymorphism in untranslated region of EGFR gene may be associated with the genetic susceptibility of gastric cancer. Combined analysis of SNPs including rs6965469, rs884225 and rs884904 may be useful to predict the risk of gastric cancer in Jiangsu province, China. Copyright © 2013 by TUMOR.

Effects of electroacupuncture on muscle state and electrophysiological changes in rabbits with lumbar nerve root compression / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture on force-displacement value (FDV) of muscle state and electrophysiology of the muscle in rabbits with lumbar nerve root compression.</p><p><b>METHODS</b>Thirty New Zealand white rabbits were randomly divided into a control, a model, an electro-acupuncture acupoints (EAA), a medication, and an electro-acupuncture un-acupoints (EAU) group. All rabbits except those in the control group were subject to modeling (surgical lumbar nerve root compression). The control group was sham-operated without nerve root compression. The EAA group received electro-acupuncture at bilateral Shenshu (BL23) and Dachangshu (BL25) that were located 1.5 cun lateral to the posterior midline on the lower border of the spinous process of the 2nd and 4th lumbar vertebra, respectively. The EA was 15 mm deep and the frequency was 2 Hz. Each session lasted for 20 min per day for a total of 14 times. The medication group was treated with Loxoprofen sodium by gastrogavage at 4 mg/kg per day for 14 days. The EAU group received electro-acupuncture identical to the EAA group with regard to the treatment frequency and duration except a different acupoint at the tip of rabbit tail. Muscle states were determined by measuring FDVs of the bilateral biceps femoris using the Myotonometer® fast muscle state detector. Meanwhile, the prolonged and non-prolonged insertion potentials were measured by electromyography before and after modeling and after treatment. Latency, amplitude (Amp) of evoked potential, motor nerve conduction velocity (MNCV) were also determined after treatment.</p><p><b>RESULTS</b>(1) After modeling, FDVs of right side activation (RSA, P=0.003) and right side relaxation (RSR) in the model group (P=0.000) were significantly decreased in comparison to the control group. The number of rabbits with non-prolonged insertion potentials in the model group was also significantly decreased (P=0.015) in comparison to the control group. (2) After treatment, FDVs of RSR were significantly increased in the EAA (P=0.000) and medication groups (P=0.018) in comparison to the model group. The increase in FDVs of RSR in the EAA group was significantly higher than that in EAU (P=0.000) and medication groups (P=0.002). MNCV in the model group was reduced compared with the control group (P=0.000). The reduction in MNCV after modeling was reversed in the EAA group (P=0.000) and medication group (P=0.008) after treatment and the increases were significant in both treatment groups in comparison to the model group. The EAA group had a greater MNCV recovery than the medication group (P=0.022).</p><p><b>CONCLUSION</b>Electro-acupuncture could improve the rehabilitation and regeneration of FDVs and the electrophysiology index of the muscle with nerve control impairment.</p>

Correlation study on effects of electroacupuncture on the muscle condition and MNCV in rabbits with lumbar nerve root compression / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture on the muscle condition and electrophysiology of the muscle in rabbits with lumbar nerve root compression and to explore potential mechanisms.</p><p><b>METHODS</b>Twenty-four New Zealand white rabbits were randomly divided into a normal group, a model group, a medication group and an electroacupuncture group. The rabbit model with lumbar nerve root compression was established in the model group, the medication group and the electroacupuncture group. The model and the treatment were not produced in the normal group. The medication group was treated with oral administration of Loxoprofen tablets at a dose of 30 mg each day for 14 days. The electroacupuncture group was treated with electroacupuncture at "Jiaji" (EX-B 2) of L5 and L6 for 14 days. The hibateral muscle condition before and after making model and after treatment was detected and the electromyogram and the nerve conduction velocity (NCV) were observed.</p><p><b>RESULTS</b>The spontaneous potential and the insertion potential were increased in the model group, the medication group and the electroacupuncture group after making model. The value of the activation and the relaxed condition of the strength-creep (ARCSC) in the right muscle was significantly decreased. The motor nerve conduction velocity (MNCV) and the wave amplitude of evoked potential (WAEP) were significantly decreased in the model group, the medication group and the electroacupuncture group after treatment, but the value of MNCV and WAEP in the electroacupuncture group, and ARCSC in the right muscle in the electroacupuncture group and the medicine group were closed to those level in the normal group, among them, the relaxed condition in the electroacupuncture group was more close to the level in the normal group.</p><p><b>CONCLUSION</b>Electroacupuncture can improve the strength-creep condition of the muscle that damage nerve place controls and the electrophysiology of the muscle can recover the MNCV and the wave amplitude of evoked potential in the compression nerve root.</p>

Effect of glutamate on vascular endothelial growth factor mRNA and protein expressions in hypoxic rat astrocytes in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of glutamate on the expression of vascular endothelial growth factor (VEGF) mRNA and protein in cultured rat astrocytes under hypoxia.</p><p><b>METHODS</b>Cultured rat astrocytes were randomly divided control group, glutamate group, hypoxia group and hypoxia+glutamate group. The cells in the control and glutamate groups were cultured under nomoxic condition (95% air and 5% CO(2)), and those in the other two groups under hypoxic condition (94% N(2), 5% CO(2) and 1% O(2)). The total RNA was extracted from the cells at different time points of hypoxic exposure for real-time FQ-PCR and ELISA to detect the expression of VEGF mRNA and protein in cultured astrocytes, respectively.</p><p><b>RESULTS</b>The expressions of VEGF mRNA and protein underwent no significant changes in the control glutamate groups, but increased obviously in both hypoxia and hypoxia+glutamate groups at 2, 4, 6, 8 and 12 h of hypoxic exposure. At these time points, VEGF expressions at both the mRNA and protein levels were significantly higher in hypoxia+glutamate group than in hypoxia group.</p><p><b>CONCLUSION</b>Glutamate at 1 micromol/L can further increase the expression of VEGF mRNA and protein in astrocytes exposed to hypoxia, which may result from the adaptive changes of glutamate receptors in hypoxic astrocytes.</p>

Interleukin-18-induced transdifferentiation in renal proximal tubular cells is mediated by activation of p38MAPK pathway / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To explore the effect of p38MAPK signaling pathway in interleukin-18-induced transdifferentiation in renal proximal tubular cells.</p><p><b>METHODS</b>Human proximal tubular epithelial cell line (HK-2 cells) was cultured in vitro. After preincubated with SB203580 (0, 5, 10, 20 micromol/L) for 30 minutes, cells were exposed to IL-18 (100 ng/ml) for 24, 48 and 72 hours respectively. The expressions of a-smooth actin (alpha-SMA) in cultured HK-2 cells were assessed by RT-PCR and ELISA.</p><p><b>RESULTS</b>IL-18-induced expressions of a-SMA mRNA and protein were inhibited obviously by a dose-dependent manner when HK-2 cells were incubated with SB203580 (0, 5, 10, 20 micromol/L) and IL-18 (100 ng/ml) for different time (P < 0.05).</p><p><b>CONCLUSION</b>IL-18-induced transdifferentiation of renal tubular epithelial cells (RTECs) is suppressed obviously by blocking p38MAPK signaling pathways. IL-18-induced transdifferentiation of RTECs is probably mediated, at least in part, through the activation of p38MAPK signaling pathways.</p>

Absence of gender disparity in short-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing sirolimus-eluting stent based primary coronary intervention: a report from Shanghai Acute Coronary Event (SACE) Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Randomized, controlled trials have demonstrated the superiority of sirolimus-eluting stent (SES) implantation during primary percutaneous coronary intervention (PCI), as opposed to bare-metal stents, in patients with ST-elevation myocardial infarction (STEMI). This study aimed to test the hypothesis that clinical benefits of SES treatment were independent of gender in this setting.</p><p><b>METHODS</b>A total of 2042 patients with STEMI undergoing SES-based primary PCI were prospectively enrolled into Shanghai Acute Coronary Event (SACE) registry (1574 men and 468 women). Baseline demographics, angiographic and PCI features, and in-hospital and 30-day major adverse cardiac events (MACE) were analyzed as a function of gender.</p><p><b>RESULTS</b>Compared with men, women were older and more frequently had hypertension, diabetes, and hypercholesterolemia. Use of platelet glycoprotein IIb/IIIa receptor inhibitor (GPI, 65.5% vs. 62.2%, P = 0.10) and procedural success rate (95.0% vs. 94.2%, P = 0.52) were similar in both genders. In-hospital death and MACE occurred in 3.8% and 7.6%, and 4.5% and 8.1% in the male and female patients, respectively (all P > 0.05). At 30-day follow-up, survival (94.3% vs. 93.8%, P = 0.66) and MACE-free survival (90.2% vs. 89.3%, P = 0.52) did not significantly differ between men and women. After adjustment for differences in patient demographics, angiographic and procedural features, there were no significant difference in either in-hospital (OR = 0.77, 95%CI of 0.48 to 1.22, P = 0.30) or 30-day mortality (OR = 1.28, 95%CI of 0.73 to 2.23, P = 0.38) between women and men.</p><p><b>CONCLUSION</b>Despite more advanced age and clustering of risk factors in women, female patients with STEMI treated by SES-based primary PCI had similar in-hospital and short-term clinical outcomes as their male counterparts.</p>

Outcomes of two temperature maintenance strategies during radical resection for carcinoma of oesophagus and their effects on postoperative shivering / 上海第二医科大学学报

Objective To compare the outcomes of two temperature maintenance strategies during radical resection for carcinoma of oesophagus and their effects on postoperative shivering. Methods Thirty ASA Ⅰ-Ⅱ patients undergoing radical resection for carcinoma of oesophagus were randomly assigned to hypothermia group (HT group, patients were not wanned perioperatively, n=10), intraoperative normothermia group (INT group, patients were warmed only intraoperatively, n=10) and perioperative normothermia group(PNT group, patients were warmed before induction of anesthesia and during anesthesia, n=10). The tympanic temperature began to be recorded 20 min before induction of anesthesia at intervals of 10 min. Results There was no significant difference in the decrease velocity of tympanic temperature during the first hour after induction of anesthesia between HT group and INT group, while both were significantly higher than that of PNT group (P<0.05). There was no significant difference in the tympanic temperature within 70 min after induction of anesthesia between HT group and INT group, while both were significantly lower than that of PNT group (P<0.05). The tympanic temperature of HT group continued to decrease 70 min after induction of anesthesia, while that of INT group and PNT group began to increase. There were significant differences in the tympanic temperature 80 min to 180 min after induction of anesthesia among these three groups(P<0.05). The incidences of postoperative shivering were 8, 5 and 2 in HT group, INT group and PNT group, respectively. The scores of thermal comfort scale were 19±10, 41±7 and 51±11 in HT group, INT group and PNT group, respectively, and there were significant differences among these three groups(P<0.05). Conclusion Compared with INT, PNT can more effectively maintain perioperative normothermia, reduce the incidence of shivering and relieve the patients' cold thermal discomfort in radical resection for carcinoma of oesophagus.

Model for end-stage liver disease-sodium predicts prognosis in patients with chronic severe hepatitis B / 中华外科杂志

<p><b>OBJECTIVES</b>To study the practical use of the serum sodium incorporated model for end-stage liver disease (MELD-Na) on clinic and to assess its validity by the concordance-statistic in predicting the prognosis of the patients with chronic severe hepatitis B.</p><p><b>METHODS</b>Adult patients with a diagnosis of chronic severe hepatitis B between January 2007 and December 2007 in a single center were analyzed. The serum sodium, MELD, MELD-Na, and Delta MELD-Na (Delta MELD=MELD score at 14 days after medical treatment-MELD score at admission) scores of 426 patients with chronic severe hepatitis B were calculated. The 3-month mortality in patients was measured, and the validity of the models was determined by means of the concordance-statistic.</p><p><b>RESULTS</b>The area under the receiver-operating characteristic curves of Na, MELD and MELD-Na for the occurrence of death in 3 month were 0.718, 0.875 and 0.922. The 3-month mortality of the MELD-Na scores group <25, 25-30, >30-35, >35- <40 and > or = 40 were 2.0%, 5.4%, 35.4%, 53.8% and 86.9% respectively. There was a significant difference of 3-month mortality between the five groups (P<0.05). The 3-month mortality of Delta MELD-Na> 0 group was 65.9%, and the Delta MELD-Na < or = 0 group was 15.8%. There was a significant difference of 3-month mortality between the two groups (P<0.05).</p><p><b>CONCLUSIONS</b>MELD-Na score is a valid model to predict 3-month mortality in patients with chronic severe hepatitis B. Delta MELD-Na is clinically useful parameters for predicting the therapeutic effect of chronic severe hepatitis B.</p>

Risk factors predicting the prognosis of orthotopic liver transplantation in hepatopulmonary syndrome / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the effect of orthotopic liver transplantation (OLT) on hepatopulmonary syndrome (HPS) and investigate risk factors predicting the prognosis of OLT.</p><p><b>METHODS</b>Twenty-six cases of HPS and 30 cases of non-HPS were analyzed treated from April 2004 to January 2006. Survival rates after OLT were compared and risk factors predicting the prognosis of OLT in HPS were researched by univariant and COX analysis.</p><p><b>RESULTS</b>The 28 days survival rate in HPS after OLT was 76.9% (20/26), half a year survival rate and one year survival rate were both 61.5% (16/26). Whereas the one year survival rate of patients without HPS was 100%(P < 0.05). By univariant analysis, shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs, PaO2 and PaO2/FiO2 in room air before operation were relative to the prognosis of peri-operative period and half a year outcome after OLT in HPS (P < 0.05). Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs (OR = 1.182, P = 0.001), and mechanical ventilation time (OR = 1.003, P = 0.053) after OLT were independent risk factors predicting the prognosis of OLT in HPS by COX analysis. Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs > or = 28.4%, or PaO2 < or = 56 mm Hg (1 mm Hg = 0.133 kPa) before OLT predicted the poor outcome of OLT in HPS. The sensitivity were 83.3% and 85.0% respectively, and the specificity were 95.0% and 83.3% respectively.</p><p><b>CONCLUSIONS</b>OLT is an effective treatment for HPS.Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs before OLT and mechanical ventilation time after OLT were independent risk factors for the prognosis of OLT in HPS.</p>

Impact of different clinical pathways on outcomes of patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the RAPID-AMI study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Current guidelines support primary percutaneous coronary intervention (primary PCI) as the first treatment of choice (as opposed to thrombolytic therapy) for patients with acute ST-segment elevation myocardial infarction (STEMI) especially when delivered within 12 hours of symptom onset. We aimed to evaluate the impact of different clinical pathways on reduction of reperfusion delay and subsequent improvement in outcomes in patients with STEMI.</p><p><b>METHODS</b>From November 2005 to November 2007, 546 consecutive patients with definite STEMI, who upon arrival at the emergency room were triaged to undergo primary PCI, were included. Of them, 271 patients were brought directly to catheterization laboratory (rapid group), and 275 patients were admitted to the coronary care unit (CCU) or cardiac ward first, and then transferred to the catheterization laboratory (non-rapid group). Primary endpoint was door-to-balloon (D2B) time, and secondary endpoints included infarct size assessed by peak CK-MB level and rates of major cardiac adverse events (MACE) including death, reinfarction, or target-vessel revascularization during hospitalization and at 30-day clinical follow-up.</p><p><b>RESULTS</b>Baseline clinical characteristics, angiographic features and procedural success rates were comparable between the two groups, except that more patients received glycoprotein IIb/IIIa receptor inhibitors before angiography (84.0% and 77.1, P = 0.042) and had TIMI 3 flow in the culprit vessel at initial angiogram (17.1% and 9.2%, P = 0.007) in the non-rapid group. The D2B time was shortened ((108 +/- 44) minutes and (138 +/- 31) minutes, P < 0.0001), and number of patients with D2B time < 90 minutes was greater (22.6% and 10.9%, P < 0.0001) in the rapid group. The advantages associated with rapid intra-hospital transfer were enhanced if the patients presented to the hospital at regular hours. Peak CK-MB level was significantly reduced in the rapid group. In-hospital mortality (4.1% and 5.8%) and cumulative MACE rate (7.0% and 9.8%) did not significantly differ between rapid and non-rapid groups. At 30 days, cumulative death- and MACE-free survival rates were improved in the rapid group (94.5% and 89.5%, P = 0.035; 90.1% and 84.0%, P = 0.034, respectively).</p><p><b>CONCLUSIONS</b>Clinical pathway with bypass of CCU/cardiac ward admission was associated with rapid reperfusion, smaller infarct size, and improved short-term survival for patients with STEMI undergoing primary PCI. In the future, it is essential to reduce the time delay for patients presenting at off-hours.</p>

Immunization with dendritic cells infected with mTERT adenovirus vector effectively elicits immunity against mouse H22 hepatoma in vivo / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effects of dendritic cells (DCs) infected with adenovirus vector encoding mTERT on induction of mTERT antigen specific immunity against H22 hepatoma in vivo.</p><p><b>METHODS</b>Forty Bal B/c mice were subcutaneously immunized with Ad-mTERT infected DC. Cytotoxicity of mTERT specific CTL was determined by 51Cr release assay. IL-2 and IFN-gamma were tested by ELISA. IFN-gamma ELISPOT assays were performed for measuring antigen specific IFN-gamma production by T cells. Tumor size and survival of the immunized mice were recorded and evaluated whether preexisting hepatoma metastases could be supressed after immunization with mTERT-expressing DCs.</p><p><b>RESULTS</b>The lytic activity of CTL, IL-2 (871.25 pg/ml), IFN-gamma (169.15 ng/ml) and IFN-gamma secreting cells (378/10(6) spleen cells) elicited by the Ad-mTERT infected DCs were much stronger and higher than that by Ad-GFP group (131.6 pg/ml, 15.4 ng/ml, 36/10(6) spleen cells, P<0.05), DC group (71.3 pg/ml, 10.5 ng/ml, 21/10(6) spleen cells, P<0.05), PBS group (65.8 pg/ml, 7.4 ng/ml, 18/10(6) spleen cells, P<0.05). In prophylaxis and treatment experiment the Ad-mTERT/DCs immunized mice lived significantly longer than other groups, demonstrating that primary DCs were genetically modified to express the mTERT antigen and could suppress the tumor growth.</p><p><b>CONCLUSION</b>Adenovirus vector mediated mTERT infected DCs can effectively induce mTERT antigen specific antitumor activity, and can induce protective and therapeutic antitumor immunity.</p>

Observation on therapeutic effect of acupuncture at pain points for treatment of myofascial pain syndrome / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of acupuncture at pain points and massage combined with medicine on myofascial pain syndrome (MPS).</p><p><b>METHODS</b>One hundred and fifty cases were randomly divided into an observation group (n=90) and a control group (n=60). The observation group was treated with needle-sticking method combined with single-finger meditation pushing therapy at pain points, and the control group with local application of Votalin Emulgel combined with Tuina. All the patients were treated for 1 course and followed up after 3 months and their therapeutic effects were compared.</p><p><b>RESULTS</b>There were significant differences in cumulative scores of symptoms before and after treatment in the two groups (both P < 0.01), and there were no significant differences in the pain and pressure pain between the two groups (P > 0.05), and there were significant differences in the muscle spasm and joint range of motion between the two groups (P < 0.05); after treatment, the markedly effective rate and the total effective rate in the observation group were 57.8% and 94.4% respectively, and were 31.7% and 73.3% respectively in the control group, with a significant difference between the two groups (both P < 0.05).</p><p><b>CONCLUSION</b>Needle-sticking method combined with single-finger meditation pushing therapy at pain points can effectively alleviate pain and pressure pain in the patients with MPS and it has better therapeutic effect in the markedly effective rate and the total effective rate as well as improvement of muscle spasm and joint range of motion than local application of Votalin Emulgel combined with Tuina.</p>

Neurons in the corpus callosum of rats: expression of Cav2.2 and their connection / 中南大学学报(医学版)

OBJECTIVE@#To prove the existence neurons in the rat corpus callosum, the potential function of these neurons and their connection.@*METHODS@#Immunohistochemistry was used performed to examine the expressions of NeuN, a mature neuron marker,and N-type voltage-dependent valcium channel alpha1-subunit (Cav2.2)in the section of the rat corpus callosum. Horseradish peroxidase (HRP) normal sodium solution (30%), the retrograde tracer,was injected under the frontal forceps of corpus callousm and HRP absorbed by the process of neurons in the brain slices was stained with tetramethyl benzidine.@*RESULTS@#There were some NeuN positive cells in the rat corpus callosum and Cav2.2 was detected in some of these NeuN positive cells.Neurons with positive HRP were found in the rat corpus callosum and some of these neurons connected to the cortex or corpus striatum.@*CONCLUSION@#There are a few neurons in the corpus callosum of adult rats and some of them express Cav2.2. Neurons in the corpus callosum have connections with the brain cortex or corpora striatum.

Early liver retransplantation versus late liver retransplantation: analysis of a single-center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Orthotopic liver retransplantation (re-OLT) is the only effective therapy for irreversible failure of a liver graft. Early and late graft failure gives way to two different clinical conditions that should be discussed separately. This study was designed to compare early and late re-OLT for patients with poor graft function after primary transplantation at our center and sum up our clinical experience in re-OLT.</p><p><b>METHODS</b>The clinical data of 31 re-OLTs at our center from January 2004 to February 2007 were analyzed retrospectively, consisting of the first group with 14 cases of early re-OLT and the second group with 17 cases of late re-OLT.</p><p><b>RESULTS</b>Biliary tract complications were the main indications for early re-OLT (57.1%) and late re-OLT (52.9%). Other common indications were vascular complications in early re-OLT and recurrence of primary diseases in late re-OLT. No significant differences were found between the groups with regard to the volume of bleeding during operation, cold ischemia time, operative duration, and perioperative mortality; except for the model of end-stage liver disease (MELD) score. Outcome was fatal for 7 patients in early re-OLT and 9 patients in late re-OLT. Two deaths were due to multiple organ failure with 3 deaths due to severe sepsis-related disease in early re-OLT, and 4 deaths were due to severe sepsis-related disease with 3 deaths due to recurrence of hepatocellular carcinoma (HCC) in late re-OLT. One and 2-year actuarial survival rates after re-OLT were 55.2% and 36.9%, respectively, for patients in early re-OLT, and 65.1% and 52% respectively, for patients in late re-OLT. No significant differences were found regarding survival rates between the two groups.</p><p><b>CONCLUSIONS</b>Similar clinical results can be achieved in early and late re-OLT. Proper indications and optimal operation timing, adequate preoperative preparation, experienced surgical procedures, and effective perioperative anti-infection strategy contribute to the improvement of overall survival rates of patients after re-OLT.</p>