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Objective:To investigate the changes and clinical significance of high mobility group protein B1 (HMGB1) in condyloma acuminatum (CA).Methods:Sixty four patients with initial CA(initial group) and 48 patients with recurrent CA(recurrent goup) treated in the Second Affiliated Hospital of PLA Air Force Military Medical University Hospital from January 2019 to November 2020 were included. In the same period, 31 patients who underwent circumcision and 19 female underwent sexual organ cosmetic plastic surgery were taken as the control group, and the normal foreskin and healthy vulva were collected. The expression of HMGB1 in wart was detected by real-time quantitative polymerase chain reaction(RT-PCR), and the expression of soluble apoptosis related factor ligand (sFasL), cell lymphoma-2 gene (Bcl-2), soluble apoptosis related factor (SFAS) and Survivin, caspase-3 were detected. At the same time, serum interleukin (IL) - 6, IL-17, IL-23 and tumor necrosis factor - α (TNF- α) were detected by enzyme-linked immunosorbent assay(ELISA).Results:The expression of HMGB1 mRNA in the warts of patients in the initial group, recurrence group and control group were 1.96 ± 0.20, 1.53 ± 0.14, 1.05 ± 0.11, there was statistical difference ( F = 15.20, P<0.05) ; the expression of HMGB1 mRNA in the warts of patients in the initial group was significantly higher than that in the recurrence group and the control group ( P<0.05), and the recurrence group was also significantly higher than that in the control group ( P<0.05). The mRNA expressions of sFas, Bcl-2, sFasL and caspase-3 in the warts of patients in the initial group were significantly lower than those in the recurrence group and the control group: 0.52 ± 0.08 vs. 0.82 ± 0.16, 1.10 ± 0.19; 0.50 ± 0.05 vs. 0.79 ± 0.13, 1.08 ± 0.21; 0.47 ± 0.06 vs. 0.81 ± 0.15, 1.01 ± 0.19; 0.35 ± 0.04 vs. 0.68 ± 0.09, 0.91 ± 0.16, P<0.05; and the recurrence group were also significantly lower than those in the control group ( P<0.05). The expression of Survivin mRNA in the warts of patients in the initial group was significantly higher than those in the recurrence group and the control group: 2.14 ± 0.40 vs. 1.60 ± 0.27, 0.99 ± 0.18, P<0.05, and the recurrence group was also significantly higher than that in the control group ( P<0.05). The serum levels of TNF-α and IL-6 in the initial group were significantly lower than that in the recurrence group and the control group: (20.08 ± 1.95) μg/L vs. (26.93 ± 2.74), (37.65 ± 3.83) μg/L; (31.05 ± 3.24) μg/L vs. (38.13 ± 3.76), (45.98 ± 4.69) μg/L, P<0.05; and the recurrence group were also significantly lower than those in the control group ( P<0.05). The serum levels of IL-17 and IL-23 in the primary group were significantly higher than those in the recurrence group and the control group: (423.71 ± 28.68) ng/L vs. (384.26 ± 21.70) and (335.43 ± 19.65) ng/L; (289.50 ± 18.53) ng/L vs. (251.07 ± 15.96) and (214.67 ± 13.20) ng/L, P<0.05; and the recurrence group were also significantly higher than those in the control group ( P<0.05). The results of correlation analysis showed that the mRNA expression of HMGB1 in the warts of CA patients were negatively correlated with the mRNA expression of caspase-3, sFas, Bcl-2 and sFasL in the warts ( r = - 0.602, - 0.734, - 0.692, - 0.717, P<0.05), and was positive correlation with Survivin mRNA expression ( r = 0.645, P<0.05); and were positive correlation with the contents of IL-17 and IL-23 in serum ( r = 0.673, 0.685, P<0.05), and negatively correlated with the contents of TNF-α and IL-6 ( r = - 0.698, - 0.764, P<0.05). Conclusions:HMGB1 is obviously abnormal in the warts of patients with condyloma acuminatum, and is closely related to apoptosis, immune and inflammation-related factors, and may be jointly involved in the occurrence and recurrence of CA.
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Objective:To explore the causal associations of two blood pressure phenotype and four lipid fractions with type 2 diabetes mellitus(T2DM) in European and East Asian populations using Two-Sample Mendelian randomization analysis.Methods:Blood pressure phenotype, lipid fractions and T2DM genetic loci from two ethnics were matched and combined according to single nucleotide polymorphisms(SNPs) numbering. With SNPs closely related to the exposure phenotype as instrumental variables, the inverse variance weighting method was used to analyze the causal effects of blood pressure phenotype and lipid fractions on T2DM in different ethnic groups. The sensitivity analysis was conducted using MR-Egger regression model, Weighted Median method, MR-PRESSO, MR-robust Adjusted Profile Score, and leave-one-out method.Results:Among European populations, systolic blood pressure( OR=1.40, 95% CI 1.23-1.59, P<0.001) and diastolic blood pressure( OR =1.24, 95% CI 1.08-1.42, P=0.002)were associated with increased risk of T2DM while high density lipoprotein-cholesterol( OR=0.68, 95% CI 0.62-0.76, P<0.001) reduced the risk of T2DM. In East Asian ethnicity, elevated diastolic blood pressure( OR=0.75, 95% CI 0.59-0.95, P=0.007) reduced the risk of T2DM. Sensitivity analysis confirmed the results. Conclusion:There are differences in the effects of blood pressure phenotype and lipid composition on T2DM in different ethnic groups, which may be related to population heterogeneity and exposure sensitivity. It should be taken into consideration in extrapolation.
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Objective:To explore the changes of neuron-specific enolase (NSE) and S-100β protein (S-100β) during perioperative period in infants undergoing living liver transplantation and examine the effect of brain injury.Methods:From January 2015 to January 2016 in Department of Anesthesiology First Central Clinical College Tianjin Medical University, study group was composed of forty infants of congenital biliary atresia with an age range of (4-12) months, a body weight of (4-10) kg and American Society of Anesthesiologists (ASA) class Ⅲ/Ⅳ. Another 40 infants undergoing general surgery were selected as control group. In study group, blood samples were harvested from central vein pre-operation (T0), before skin incision (T1), 30 min after anhepatic phase (T2), 1 h of neohepatic phase (T3) and 24h after hepato-reperfusion (T4). In control group, blood samples were collected at pre-operation (T0) and 24 h post-operation (T4). Serum levels of S-100β, NSE, heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and bispectral index (BIS) were monitored at T1-4 and end of surgery. All children were assessed by Bayley Scale of Infant Development (BSID) at Day 1 pre-operation and 2/4 weeks post-operation for observing mental and motor development status. The results were described with mental development index (MDI) and psychomotor development index (PDI). Pediatric anesthesia emergence delirium (PAED) was employed for evaluating the severity of delirium during the recovery stage at 30 min and 2/4h post-extubation.Results:In study group, serum levels of S-100β and NSE changed significantly during non-hepatic and neohepatic reperfusion phases. After inferior vena cava occlusion, serum concentrations of S-100β and NSE spiked ( P<0.05) and gradually recovered during neohepatic reperfusion period ( P<0.05). No significant inter-group difference existed in serum S-100β or NSE at T4 ( P>0.05). In study group, as compared with Day 1 pre-operation, MDI/PDI decreased at Week 2 post-operation ( P<0.05) and increased from Month 1 post-operation ( P<0.05). Both MDI and PDI were lower than control group before and at Week 2 post-operation ( P<0.05). MDI/PDI of study group basically reached the preoperative level at Month 1 post-operation ( P<0.05). In control group, no significant difference existed in MDI/PDI at Day 1 pre-operation and Week 2/4 post-operation ( P>0.05). In study group, the delirium rate was up to 30% post-extubation and decreased at 2/4h post-extubation. In control group, the incidence of delirium was low at 30 min and 2/4h post-extubation ( P<0.05). Conclusions:Perioperative evaluations of serum levels of NSE and S-100β are significant for predicting the postoperative onsets of delirium and cognitive impairment in children with living donor liver transplantation.
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Objective:To investigate the extent of statistics anxiety and explore its influencing factors among university students majoring in medicine.Methods:The statistics anxiety rating scale (STARS) was first translated into Chinese and modified until the reliability and validity were acceptable. Through online questionnaire, the Chinese version of STARS was used to measure the level of statistics anxiety for students enrolling in the course of Medical Statistics during autumn term 2018 to spring term 2019 in the medical college of a university. The collected data were managed and analyzed by SPSS 25.0.Results:A total of 562 students took part in the survey, and 500 questionnaires were eligible and included in the final analysis. The measurement of Chinese version of STARS showed quite good reliability and validity, with item score of the whole scale being (2.31 ± 0.65) points. The proportions of students with mild, moderate and severe statistics anxiety were 41%, 56% and 3% respectively. Female students had higher extent of anxiety than male students, and undergraduates had higher extent of anxiety than postgraduates. The extent of anxiety of students with different majors from high to low were nursing > (dentistry, basic medicine and pharmacology) > (clinic medicine and public health) respectively. When controlling other factors, the influence of gender, student level and major on statistics anxiety was still statistically significant.Conclusion:Statistics anxiety is prevalent in medical college students. Professional teachers should pay more attention to students' psychological status, conduct targeted counseling to alleviate students' anxiety and help them to improve self-efficacy in statistics learning.
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Objective:To evaluate the role of transient receptor potential melastatin 2 (TRPM2)-calcineurin A (CnA)-dynamin-related protein 1 (Drp1) pathway in propofol-induced reduction of renal injury induced by hepatic ischemia-reperfusion (I/R) in mice.Methods:Twenty-four SPF male C57BL6 mice, aged 8 weeks, weighing 20-23 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (group S), hepatic I/R group (group IR), propofol group (group P) and TRPM2 agonist (ADPR) combined with propofol group (AP group). Hepatic I/R injury was induced by occluding the portal vein and hepatic artery supplying the left and middle lobes of the liver for 60 min followed by reperfusion in anesthetized rats.In group P, 0.2 ml normal saline was injected intraperitoneally at 1 h before establishing the model and 1% propofol 30 mg/kg was injected intraperitoneally at 30 min before establishing the model.In group AP, ADPR 10 mg/kg (in 0.2 ml of normal saline) was injected intraperitoneally at 1 h before establishing the model, and 1% propofol 30 mg/kg was injected intraperitoneally at 30 min before establishing the model.The equal volume of normal saline was given intraperitoneally at 1 h and at 30 min before establishing the model in group S and group IR.Blood samples were taken from the eyeballs for determination of the levels of serum urea nitrogen (BUN), creatinine (Cr), aminotransferase (ALT) and aspartate aminotransferase (AST) at 6 h of reperfusion.The animals were then sacrificed and the kidney tissues were taken, the ultrastructure of myocardial mitochondria was observed using transmission electron microscopy, the average diameter of mitochondria was calculated, and the expression of TRPM2, CnA, phospho-Drp1 Ser637 (p-Drp1 Ser637) and cleaved caspase-3 was detected (by Western blot). Results:Compared with group S, the concentrations of serum BUN and Cr were significantly increased, the expression of TRPM2, CnA and cleaved caspase-3 in kidney tissues was up-regulated, the expression of p-Drp1 ser637 was down-regulated, and the average diameter of mitochondria was shortened in IR, P and AP groups ( P<0.05). Compared with group IR, the concentrations of serum BUN and Cr were significantly decreased, the expression of TRPM2, CnA and cleaved caspase-3 in kidney tissues was down-regulated, the expression of p-Drp1 Ser637 was up-regulated, the average diameter of mitochondria was prolonged ( P<0.05), mitochondrial injury was attenuated, and no significant change was found in the serum ALT and AST concentrations in group P, and no significant change was found in concentrations of BUN and Cr in serum in group AP ( P>0.05). Compared with group P, concentrations of BUN and Cr in serum was significantly increased, the expression of TRPM2, CnA and cleaved caspase-3 in kidney tissues was up-regulated, the expression of p-Drp1 Ser637 in kidney tissues was down-regulated, and the average diameter of mitochondria was shortened ( P<0.05), and mitochondrial injury was accentuated in group AP. Conclusion:The mechanism of propofol-induced reduction of renal injury induced by hepatic I/R is related to inhibiting the expression of TRPM2 in kidney tissues, decreasing the level of intracellular CnA and inhibiting dephosphorylation of Drp1 Ser637 in mice.
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Objective@#To investigate the imaging diagnosis, treatment and prognosis of primary hepatic neuroendocrine tumors.@*Methods@#The clinical features, imaging manifestations, histopathological and immunohistochemical findings and interventional therapy of 6 patients identified with pathologically confirmed primary hepatic neuroendocrine tumors were retrospectively analyzed, and the related literatures were reviewed.@*Results@#All 6 patients presented with symptoms of abdominal pain. 4 patients had solitary hepatic mass and 2 patients had multiple hepatic masses. Magnetic resonance imaging showed low signal intensity on T1 weighted imaging, high signal intensity on T2 weighted imaging and clear boundary; the arterial phase of enhancement scan was uneven and enhanced, and portal venous phase or delayed phase showed continuous enhancement, surrounded by ring enhanced capsule. A pathological diagnosis was primary neuroendocrine tumor of the liver. After interventional treatment, 6 patients had some therapeutic effects. Among them, 4 patients underwent multiple interventional therapies, followed by 4 years of follow-up has shown satisfactory results.@*Conclusion@#Primary hepatic neuroendocrine tumors are very rare and their imaging manifestations are specific. Eventually, relies on pathological and immunohistochemical diagnosis. Transarterial chemoembolization therapy can bring satisfactory results in the treatment of primary hepatic neuroendocrine tumor.
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Objective To understand the use of mycobacterial and fungal blood culture bottle and the prevalence of Mycobacterium and fungus in the bloodstream infections in AIDS patients.Methods Blood samples were collected from hospitalized AIDS patients for culture of Mycobacterium and fungus.Results Of the 3 012 blood samples submitted for culture,425 (14.1％) were positive,including195 strains of fungal pathogens,mostly Talaromyces mnarneffei (129) and Cryptococcus (62),172 strains of Mycobacterium spp,and 58 strains of other pathogens.Conclusions The mycobacterial and fungal blood culture bottle is useful for detection of bloodstream infection in AIDS patients.The prevalence of fungal bloodstream infection is 6.5％ (195/3 012) and the prevalence of mycobacterial bloodstream infection is 5.7％ (172/3 012).The top three pathogens are Mycobacterium spp,Talaromyces marneffei and Cryptococcus neoformans.Our finding is inconsistent with the reports of other authors.
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Objective@#To investigate the prognosis of osteosarcoma patients with lung metastases and its correlated factors.@*Methods@#The clinical data of 104 osteosarcoma patients with lung metastasis from April 2007 to September 2015 were retrospectively analyzed. Univariate analysis was performed using Kaplan-Meier and Log rank test. Multivariate Cox regression was applied to analyze independent prognostic factor for patient survival.@*Results@#The one-year, two-year and five-year survival rates of the 104 osteosarcoma patients with lung pulmonary metastasis were 93.3%, 61.5% and 11.5%, respectively, and the median survival time was 33 months. The univariate analysis revealed that number of lung metastases, objective response of first-line chemotherapy and therapeutic methods for lung metastases were significant prognostic factors for patient survival, whereas gender, age, time to lung metastasis and time to other metastasis were not (P>0.05). The multivariate analysis indicated that number of lung metastases, objective response of first-line chemotherapy and therapeutic methods for lung metastases were independent significant prognostic factors for patient survival.@*Conclusions@#The prognosis of osteosarcoma patients with advanced lung metastases and active treatment is better. Surgery and adjuvant chemotherapy could effectively prolong survival time for osteosarcoma patients with pulmonary metastasis.
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Objective To detect different animal erythrocyte hemolysins titer,and compare the application of these hemolysins in immunological experimental teaching,for selecting the better method of preparing high titer hemolysin for experimental teaching of medical immunology.Methods A total of 40 experiment rabbits were divided into 4 groups in this study,and immunized by sheep red blood cell(SRBC) and porcine red blood cell(PRBC) through different immunization procedures to prepare the hemolysin,detect and compare these 4 groups hemolysins titer by the complement hemolysis test.Results Rabbit Anti-SRBC in the group A was 1∶4 800,rabbit Anti-PRBC in the group B was 1∶1 200,rabbit Anti-SRBC in the group C was 1∶1 000,rabbit Anti-PRBC in the group D was 1∶200.Conclusion The hemolysin titer of the rabbit Anti-PRBC was lower than that of the rabbit Anti-SRBC by the same immunization procedures,and the immunization procedure by intradermal multi-point and auricular vein injection is the better method of preparing high titer hemolysin,so PRBC could replace SRBC as antigen,and immunize the rabbits for preparing hemolysin,which could be used in experimental teaching of medical immunology.
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Objective To investigate the effect of split-bolus spectral computed tomography(CT) on the portal venography and radiation dose.Methods The prospective study was adopted.The clinical data of 119 patients who underwent spectral CT at China-Japan Union Hopital from September 2014 to March 2015 were collected.Patients were randomly divided into the portal venography with split-bolus spectral CT single-phase enhanced scan group and portal vein multi-phase scan group by random sequence method.In the portal venography with split-bolus spectral CT single-phase enhanced scan group,the spectral CT was used with the method of split-bolus single phase imaging,and in the portal vein multi-phase scan group,standard spiral CT was used to perform three-phase scan.Two observers evaluated CT portal venography subjectively and objectively,measured CT values,contrast to noise ratio (CNR),signal noise ratio (SNR),and calculated radiation dose.Observed indices included (1) choice of optimal monochromatic images.(2) CT values of portal veins,measurement of CNR and SNR.(3) Subjective scoring of portal venography quality.(4) Comparison of radiation dose.Measurement data with normal distribution were presented as x ± s,comparison between groups was analyzed by independent sample t test.Comparison of count data was analyzed by chi-square test.Results The 113 patients were screened for eligibility,including 59 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 54 in the portal vein multi-phase scan group.(1) Choice of optimal monochromatic images:optimal monochromatic images were abstracted at 60 keV from spectral CT portal venography.(2) CT values of portal veins and measurement of CNR and SNR:the CT values of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were (319 ± 44) HU,(328 ± 53) HU,(294 ± 45) HU in the reconstructed images at the energy level of 60 keV in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (213 ±41)HU,(228 ±49)HU,(210 ±41)HU in the portal vein multi-phase scan group,with significant differences between the 2 groups(t =8.04,6.34,6.82,P ＜ 0.05).The CNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 15 ± 5,24 ± 8,22 ± 7 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 13 ± 4,20 ± 6,19 ± 6 in the portal vein multi-phase scan group,respectively,with no significant difference (t =-1.13,-1.89,-1.51,P ＞ 0.05).The SNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 31 ± 6,29 ± 6,27 ± 6 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 29 ± 7,28 ± 9,26 ± 6 in the portal vein multi-phase scan group,respectively,with no significant differences (t =-0.688,0.615,0.600,P ＞ 0.05).(3) Subjective scoring of portal venography quality:the subjective score of image quality of portal venography was 14.3 ± 1.0 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 12.5 ± 1.8 in the portal vein multi-phase scan group,with a significant difference (t =12.43,P ＜ 0.05).(4) Comparison of radiation dose:the radiation dose was (8.1 ± 1.1)mSv of patients in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (17.4 ± 7.5) mSv in the portal vein multiphase scan group,with a significant difference (t =24.14,P ＜ 0.05).Conclusion Spectral CT portal vein imaging combined with split-bolus protocol can achieve better manifestations of portal vein and its branches,and reduce radiation dose in the scanning process.
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<p><b>OBJECTIVE</b>To observe the clinical efficacy of BO's abdominal acupuncture for obese type-2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>Sixty patients of obese T2DM were randomly divided into an acupuncture group and a medication group, 30 cases in each one. Patients in the medication group were treated with basic treatment combined with oral administration of regular antidiabetics, three weeks as one session. Patients in the acupuncture group, based on the medication group, were treated with abdominal acupuncture at Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanguan (CV 4)], Fusiguan [Huaroumen (ST 24), Wailing (TE 5)], Tianshu (ST 25), Daheng (SP 15), Qixue (KI 13), etc.; the treatment was given three times per week, 3 weeks as one session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, waist circumference (WC), hip circumference, body mass index (BI) were observed before and after treatment in the two groups, and fasting plasma glucose (FPG), fasting insulin (FINS), 2-hours postprandial blood glucose by oral glucose tolerance test (OGTT) and insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), HOMA-IR of insulin resistance index were calculated and adverge events were recorded.</p><p><b>RESULTS</b>Compared before the treatment, SBP, WC, body weight, BMI, FPG, OG-TT2hBG, FINS, GTT2h insulin, HOMA-IR, TC and LDL-C in the acupuncture group were all significantly reduced (all P <0. 05), while FPG, OGTT2H insulin and TG were increased in the medication group (all P<0. 05)'. The differences of reducing SBP, WC, FPG, OGTT2H insulin, HOMA-IR, TC, TG and LDL-C were statistically significant between the two groups (all P<0. 05). The total effective rate was 93. 3% (28/30) in the acupuncture group, which was significantly superior to 23. 3% (7/30) in the medication group (P<0. 01).</p><p><b>CONCLUSION</b>BO's abdominal acupuncture has obvious clinical efficacy for obese type-2 diabetes mellitus, featuring in lowering blood pressure, reducing weight, decreasing blood glucose, im- proving insulin resistance and lowering lipid, which has no adverse effects and is worthy of clinical popularization and application.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontos de Acupuntura , Terapia por Acupuntura , Glicemia , Metabolismo , Índice de Massa Corporal , Peso Corporal , Colesterol , Sangue , Diabetes Mellitus Tipo 2 , Metabolismo , Terapêutica , Insulina , Sangue , Metabolismo , Lipoproteínas LDL , Sangue , Metabolismo , Triglicerídeos , Sangue , Circunferência da CinturaRESUMO
Objective To investigate any correlation between cognition and auditory event-related potential (ERP) after traumatic brain injury (TBI),and to explore the diagnostic value of the P300 ERP for TBI patients.Methods Thirty TBI patients and 28 healthy subjects were recruited.Their P300 auditory event-related potentials were measured and the Montreal cognitive assessment (MoCA) was administered.Results The TBI patients' total MoCA scores and their scores on most of the sub-item components were significantly lower than those of the control subjects,though their naming and speech showed no significant difference.The TBI patients had abnormal P300 responses.Their N1,P2,N2 and P3 latencies were significantly longer and their P2 and P3 amplitudes were significantly lower than those of the control group.Stepwise regression and multivariate analysis showed that the P300 latency was significantly associated with delayed memory,impaired visual spatial executive functioning and total MoCA score.Conclusion P300 can be used as a quantitative electrophysiological index for detecting cognitive impairment in patients with TBI.
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Objective To study the relationship between the expression of Mycobacterium tuberculosis small heat shock protein Hsp16.3 and the apoptosis of infected mouse alveolar macrophages.Methods The laboratory mice were infected with bacterial suspension of the international standard virulent strain of Mycobacterium tuberculosis H37Rv strains (H37Rv),Hsp16.3 gene deletion mutants of the international standard virulent of Mycobacterium tuberculosis H37Rv strains(△H37Rv),or sterile saline solution (normal control)by the tail vein. After successful replication of mouse infection model in each group,we cleaved the alveolus of each group of mice and collected lavage fluid to obtain alveolar macrophages of the infected mice at days 1 ,3 ,5 ,7 ,9 ,1 1 ,1 3 and 1 5 .Then the infection status of macrophages was observed with confocal laser scanning microscopy;flow cytometry was used to detect the apoptosis rate of alveolar macrophages of the infected mice;Caspase-3 and Bcl-2 expressions were examined by Western blot.Results The apoptosis rate of Hsp16.3 gene was higher in deletion strain (△H37Rv)group and H37Rv strains (H37Rv)group than in control group.The apoptosis rate of alveolar macrophages in △ H37Rv group gradually increased,peaked at day 7 ,and then gradually decreased.It was significantly higher in H3 7 Rv group than in H3 7 Rv strain group from day 1 to 7 and from day 1 3 to 1 5 (P<0 .0 5 ).Caspase-3 and Bcl-2 protein expressions in the macrophages of△H37Rv group and H37Rv group were higher than those of control group.Caspase-3 expression in the microphages of △H3 7 Rv group and H3 7 Rv group gradually increased from day 1 to 7 and peaked at day 7;it peaked again at day 13 in H37Rv group.However,Caspase-3 expression remained significantly higher in△H37Rv group than in H3 7 Rv group (P<0 .0 5 ).Bcl-2 expression in △H3 7 Rv group did not change much at the early stage of infection (P<0 .0 5 ),but gradually increased after day 9 .Bcl-2 expression in H3 7 Rv group did did not change much from day 1 to 7 (P<0.05),but gradually increased after day 7.However,it remained lower in△H37Rv group than in H37Rv group,especially after 7 days(P<0.05).Conclusion Mycobacterium tuberculosis small heat shock protein Hsp16.3 can inhibit the apoptosis of macrophages during the early and late stages of infection,and this inhibition may be achieved by inhibiting the expression of apoptotic protease Caspase-3 and promoting the expression of Bcl-2 protein.
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Objective To analyze the risk factors of esophageal and gastric variceal bleeding (EGVB) in patients with cirrhosis.Methods A retrospective study was conducted in 638 hospitalized patients with cirrhosis from 2002 to 2009,who were divided into study group as having EGVB (n =286) and control group as not having EGVB (n =352).Differences between 2 groups were analyzed with univariate analysis and multivariate logistic regression.Results Child-pugh classification,serum albumin,prothrombin time,portal vein diameter and spleen thickness were significantly different between 2 groups (P ＜ 0.05).Univariate analysis showed that serum albumin(OR =0.944,P =0.000),prothrombin time (OR =1.067,P =0.007),portal vein diameter (OR =3.423,P =0.007) and spleen thickness (OR =1.276,P =0.007) were correlated with EGVB.Multivariate logistic regression analysis showed that serum albumin (OR =0.936,P =0.000),portal vein diameter (OR =4.098,P =0.013) and spleen thickness (OR =1.275,P =0.000) were independent risk factors for EGVB in patients with cirrhosis.Conclusion Low serum albumin level,increased portal vein diameter and spleen thickness are the risk factors for EGVB in patients with cirrhosis,which can be important predictors.To some extent,increasing serum albumin might reduce the risk of EGVB.
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Purpose To explore the ADC value in distinguishing prostate cancer (PCa) and benign prostatic hyperplasia (BPH) by reviewing related articles. Materials and Methods The studies about the diffusion-weighted images in distinguishing the prostate cancer and benign prostatic hyperplasia were enrolled from the websites of Elsevier Science, PubMed, Springer-Link, Wiley Online Library, Medline and CNKI from 2000 to 2011, with DWI, prostate, cancer, carcinoma and hyperplasia as search terms. According to the uniform inclusion and exclusion criteria, the correct studies were chosen and the parameters including the mean values and standard deviations of ADC value were extracted. Meta-analysis was done by using Stata 11 software. Results A total of 7 studies met the inclusion criteria, including 4 English articles and 3 Chinese articles. The fixed-effect model was used due to no heterogeneity. The standardized mean difference (SMD) was-1.357 and 95%confidence interval (95%CI) was (-1.604,-1.109, P=0.000). Conclusion DWI can be helpful in distinguishing the prostate cancer from the benign prostatic hyperplasia, and the ADC value of PCa is lower than that of BPH.
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Objective To observe the therapeutic effect of treating cervical spondylosis of vertebral artery type (CSA) mainly by needling EX-B2 point & Tui na,and to investigate the advantage of needling EX-B2 point to treat CSA.Methods 60 patients with CSA were divided into a trial group (30cases) and a control group (30cases) by the sequence of visit.Patients in the trial group were treated by needling EX-B2 point combined with electro-acupuncture and Tui na,other patients in the control group were treated by Tui na,with 2 weeks as a therapeutic course.Then,the change of therapeutic effect,symptoms index,mono-symptomatic therapeutic effect and average blood flow velocities of vertebral artery and basilar artery were observed in both groups before and afer the treatment.Results The therapeutic effect constitution & cure rate showed significant differences between the two groups (P＜0.05),but there was no difference in total efficacy.Significant differences were found in both groups in symptoms index before and after treatment,and after the treatment the symptoms index was lower.There was significant difference between the two groups in symptoms index difference (P＜0.05),and the trial group was better.The mono-symptomatic therapeutic effect of vertigo,nausea and vomiting showed significant difference between the two groups (P＜0.05),and the trial group was better.No marked differences were observed in avenge blood flow velocities of vertebral artery and basilar artery between groups and in each group.Conclusion The therapeutic effect of CSA mainly treated by needling EX-B2 point & Tui na was much better than just treated by Tui na,and this method showed obvious advantage in relieving vertigo.
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Objective To investigate the effects of ulinastatin on the myocardial injury in patients undergoing live donor liver transplantation.Methods Forty patients (AHA classification grade A or B),aged 40-64 yr,with a body mass index of 18-25 kg/m2,scheduled for live donor liver transplantation,were randomly divided into 2 groups ( n =20 each):control group (group C) and ulinastatin group (group U).Anesthesia was induced with midazolam,sufentanil,and cisatracurium besilate.The patients were tracheal intubated and mechanically ventilated.Ulinastatin 300 000 IU in 100 ml of normal saline was infused intravenously over 30 min after anesthesia induction and then the infusion was repeated at 4 h interval until the end of operation in group U,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein immediately before skin incision (T0,baseline),at 30 min of anhepatic phase (T1),at 30 min of neohepatic phase (T2),and at 0,4 and 24 h after operation (T3-5) for determination of the concentrations of serum cardiac troponin Ⅰ (cTnI),creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP).The changing rates of cTnI and CK-MB at T1-5 were calculated.The use of cardiovascular drugs and cardiovsscular accidents were recorded during operation.Results The serum cTnI,CK-MB and NT-proBNP concentrations were significantly higher at T2-5 than at T0 in the two groups ( P ＜ 0.05).Compared with group C,the serum cTnI,CK- MB and NT-proBNP concentrations at T2-5 were significantly deceased in group U ( P ＜ 0.05).The maximal changing rates of cTnI,CK-MB and NT-proBNP concentrations were 4.71 ± 1.62,6.85 ± 1.53 and 4.96 ± 1.23 respectively in group C,decreased to 3.26 ± 1.51,4.56 ± 1.62 and 3.67 ± 1.02 respectively in group U.There was no significant difference in the incidence of cardiovascular accidents and the use of dopamine between the two groups.Conclusion Intravenous infusion of ulinastatin can attenuate the myocardial injury to some extent in patients undergoing live donor liver transplantation.
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Objective To observe the changes of cognition and auditory event-related potential P300 on vascular cognitive impairment-no dementia (VCIND) patients before and after cognitive rehabilitation training,then further to explore the application value of P300 in early diagnosis of vascular cognitive impairment (VCI). MethodsA total of 57 patients with VCIND were randomly assigned to the treatment group ( n =30) and the control group ( n =27),and 30 healthy volunteers without cognitive deficits were recruited as normal group.Each patient was examined with auditory-P300 and scored with mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scale.The measurement indicators were analyzed and evaluated with the factors of education,age and so on. ResultsThe P300 latency in VCIND group was longer,and the amplitude lower than those in normal group before treatment (P＜0.05 ),the latency lengthening was more significant than the lowering of the amplitude ( P＜0.01 ).The cognitive assessment scale scores of MMSE,MoCA and ADL (Barther index,BI) in VCIND group were lower than those in normal group (P＜0.05),while no significant difference was revealed between the VCIND and normal groups with regard to naming and speech( P ＞ 0.05 ).A highly positive correlation between age and P300 latency as well as a significantly negative correlation between years of education and P300 latency were demonstrated( P＜0.05 ).After cognitive rehabilitation therapy the P300 latency in VCIND group was shortened,the amplitude increased (P＜0.05 ),scores of the items of cognitive scale raised(P＜0.05 ) and the change of each indicator was more statistically significant in treatment group(P＜0.05). ConclusionP300 could objectively reflect early cognitive dysfunction in VCIND patients.Early cognitive training could effectively promote cognitive function of VCI patients.
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Objective To analyze inhibitory effect on Wistar rattish hepatoma by endostatin, angiostatin,hyper-liquid hpiodol and a combination of these agents. Methods The rattish hepatoma models were randomly divided into 8 groups, including control group, lipiodol group, endostatin gene group, angiostatin gene group, endostaitin gene and angiostatin gene group, endostatin gene and lipiodol group, angiostatin gene and lipiodol group and endostatin gene, angiostatin gene and lipiodol group. Following treatment on Wistar rots with these agents or a combination of these agents, we measured the changes in tumor volume growth rate, metastases quantity rote, rattish life span, micmvessel density (MVD) value, apoptotic index(AI), vascular endothelial growth factor. Single factor variance test and Chi-square test were used for statistics. Results On the sixth day after treatment, the tumor volume growth rate of all the therapy groups were smaller than the control group. The therapeutic effect of the above mentioned two genes in combination with lipiodol was the best and the tumor volume growth rate was the smallest. On the eighteenth day after treatment, the numbers of pulmonary metastasis were(37.2±7.2)、(26.2±5.0)、(25.5±4.7)、 (26.2±3.9)、(14.9±2.6)、(19.1.4-2.8)、(20.2±2.7)and(6.1±1.2); the life span was(23.3± 4.4),(35.2±4.9),(28.2±3.6), (29.4±3.4), (38.3±6.7),(37.7±5.8), (36.4±5.5) and (59.8±9.4)days for each group respectively. The difference of the numbers of pulmonary metastases between the therapeutic groups and the control group was statistically significant(P<0.O1). The difference of the life span between the control group and the single gane group was not statistically significant, but the difference of the life span between the control group and the combination groups is statistically significant. MVD[(63.4±8.7)strip/high power field] in the lipiodol group was higher than the other therapeutic groups. However, the difference of MVD between the lipiodol group and the control group was not statistically significant. The apoptotie indexes in all the therapeutic groups were higher than the control group [(4.2±1.6)% ], the index in the two genes in combination with lipiodol group was the highest[ (19.6± 2.4)%]. The expression rate of VEGF in the control group was the highest(100%)and the rate in the two genes in combination with lipiodol group was the lowest(12.5%). Conclusions The inhibitory effect on Wistar rattish hepatoma of a combination of the above-mentioned two genes and lipiodol via transhepatic artery infusion is obviously superior to that of each individual agents.
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Objective To probe the value of clinical application of three dimensional contrast enhanced magnetic resonance angiography (3D CE MRA) for diagnosis of peripheral artery occlusive diseases (PAOD) and to assess its accuracy. Methods One hundred and three cases of PAOD received 3D CE MRA before operation. And 579 vascular segments were displayed. The diagnosis of 3D CE MRA before operation were compared with the results of vascular reconstruction surgeries of lower extremities. The image quality and how 3D CE MRA revealed the abnormal blood vessels were evaluated. Results Satisfactory images of the main arteries of the lower extremities were achieved by 3D CE MRA. In 579 vascular segments of 103 patients with PAOD,the sensitivity and specificity for detection of severe stenosis and occlusions were 97.6% and 95.4%,respectively. In 206 vascular segments of tibiofibula artery,the sensitivity was 100%. In 196 vascular segments of femoral artery,the specificity was 97%. Conclusion 3D CE MRA is accurate and reliable for determination of the degree of peripheral artery stenosis. The results of 3D CE MRA are concordant with that of operation.