BACKGROUNDHyperostosis is a common pathological change among people more than 50 years old; it is connected with many risk factors, which are all indefinite. The aim of this study was to prospectively investigate the correlation between obesity and female hyperostosis.

METHODSTotally 4326 females were included in this study and their basic information including their age, stature, body weight, course of disease, symptoms, medical complications, frequency of exercise and smoking, and X-ray and bone mineral density (BMD) examination results, was carefully collected for a statistical analysis. The t test or chi(2) test was used to evaluate the differences between two groups; an analysis of variance (ANOVA) was used to evaluate the differences among several groups; the relationship between hyperostosis and body mass index (BMI), age, medical complications, exercise, average BMD was analyzed using Logistic regression.

RESULTSThe incidence rate of hyperostosis in obese patients was higher than that in patients with normal weight (P = 0.000). Obesity was relevant to hyperostotic sites (P = 0.000), and the incidence of hyperostosis in one or several sites of the lumbar vertebrae, knee joints, and other sites was higher in obese patients than in patients with normal weight. There was also a difference in the extent of hyperostosis between these two groups. BMI had positive effects on the incidence and degree of hyperostosis, which were also relative to the sites of hyperostosis, and the BMI of patients without hyperostosis were much lower than those of the patients with hyperostosis in their lumbar vertebrae, knee joints, or multiple sites. Obesity, age, and exercise had positive effects on the incidence of hyperostosis (P = 0.002, 0.000, 0.018).

CONCLUSIONSObesity is a significant potential stimulant of hyperostosis, especially hyperostosis in knee joints and multiple sites; keeping fit might be an important way to prevent it.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Humans ; Hyperostosis ; etiology ; Middle Aged ; Obesity ; complications ; Prospective Studies

Apoptosis ; Caspase 3 ; Caspases ; physiology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Isotretinoin ; pharmacology ; Melanoma ; pathology ; Receptors, Retinoic Acid ; physiology ; Retinoid X Receptors ; physiology ; Tretinoin ; pharmacology

Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.

BACKGROUNDHistone deacetylase inhibitors (HDACIs) have been reported to induce apoptosis in cancer cells. The effects of trichostatin A (TSA) on gastric cancer cells have not been well characterized. This study was aimed to explore the effects and mechanisms of TSA on human gastric cancer SGC-7901 cells.

METHODSThe cells were treated with TSA and analyzed by cell proliferation assay, Western blot, TUNEL assay, flow cytometry by fluorescein isothiocyanate (FITC) conjugated with Annexin V and PI staining, immunofluorescence analysis, analysis of subcellular fractionation, gene chips and real time polymerase chain reaction (PCR).

RESULTSTSA could inhibit cell growth and induced apoptosis in gastric cancer SGC-7901 cells through the regulation of apoptosis-related genes, such as Bcl-2, Bax and survivin. Further study indicated that the pan-caspase inhibitor z-VAD-fmk did not inhibit the apoptosis induced by TSA, and we did not observe the cleavage of poly ADP ribose polymerase (PARP) after TSA treatment too. In addition, apoptosis inducing factor (AIF) and EndoG were found to translocate from mitochondria to nucleus in the immunofluorescence assay and the Western analysis of subcellular fractionation confirmed the result of immunofluorescence assay.

CONCLUSIONSThe apoptosis induced by TSA in gastric cancer SGC-7901 cells involves a caspase-independent pathway.

Apoptosis ; drug effects ; Caspases ; physiology ; Cell Line, Tumor ; Enzyme Inhibitors ; pharmacology ; Gene Expression Profiling ; Histone Deacetylase Inhibitors ; Humans ; Hydroxamic Acids ; pharmacology ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; analysis ; Neoplasm Proteins ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Stomach Neoplasms ; drug therapy ; pathology ; Tumor Suppressor Protein p53 ; analysis ; physiology ; bcl-2-Associated X Protein ; analysis

Objective To establish a HPLC-MS/MS method to deter-minate the concentration of sitagliptin in human plasma .Methods The samples were treated by protein precipitation method .The chromato-graphic column was Venusil ASB C 18(2.1 mm ×50.0 mm,3.0 μm), mobile phase was 100% water contained with 0.1% formic acid -100%acetonitrile contained with 0.1%formic acid, flow rate was 0.40 mL· min-1, column temperature was 50 ℃, injection volume was 20.0 μL, mobile phase.The specificity, standard curve and lower limit of quantitation, precision and recovery , matrix effect and stability of the method were investigated.Results The standard curve of metformin was y=4.73×10 -3x+7.32×10 -4( r=0.998 8 ), and sitagliptin had good linear relationship in 1.00 -800.00 ng· mL-1.The limit of quantifica-tion was 1.00 ng· mL-1.The intra-day RSD and inter-day RSD were less than 12.0%, respectively.The recovery rate of extraction was over 95.9%.Conclusion The method is simple, rapid, accurate and sensi-tive, which is suitable for the determination of sitagliptin in human plasma.

Background Little information is available regarding the effect of angiotensin Ⅱ (Ang Ⅱ) on the bumetanide-sensitive sodium-potassium-2 chloride cotransporter (NKCC2), the thiazide-sensitive sodium-chloride cotransporter (NCC), and the Cl- channel (CLC)-K2 at both mRNA and protein expression level in Ang Ⅱ-induced hypertensive rats. This study was conducted to investigate the influence of Ang Ⅱ with chronic subpressor infusion on nephron-specific gene expression of NKCC2, NCC and CLC-K2. Results Ang Ⅱ significantly increased blood pressure and up-regulated NKCC2 mRNA and protein expression in the kidney. Expression of CLC-K2 mRNA in the kidney increased 1.6 fold (P<0.05).There were no changes in NCC mRNA or protein expression in AngII-treated rats versus control. Conclusions Chronic subpressor Ang Ⅱ infusion can significantly alter NKCC2 and CLC-K2 mRNA expression in the kidney, and protein abundance of NKCC2 in kidney is positively regulated by Ang Ⅱ. These effects may contribute to enhanced renal Na+ and Cl- reabsorption in response to Ang Ⅱ.

BACKGROUNDThe use of traditional techniques (such as landmark techniques, paresthesia and peripheral nerve stimulator) for upper-limb anesthesia has often been restricted to the expert or enthusiast, which was blind. Recently, ultrasound (US) has been applied to differ blood vessel, pleura and nerve, thus may reduce the risk of complications while have a high rate of success. The aim of this study was to determine if the use of ultrasound guidance (vs. peripheral nerve stimulator, (PNS)) decreases risk of vascular puncture, risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block.

METHODSA search strategy was developed to identify randomized control trials (RCTs) reporting on complications of US and PNS guidance for upper-extremity peripheral nerve blocks (brachial plexus) in adults available through PubMed databases, the Cochrane Central Register of Controlled Trials, Embase databases, SinoMed databases and Wanfang data (date up to 2011-12-20). Two independent reviewers appraised eligible studies and extracted data. Risk ratios (OR) were calculated for each outcome and presented with 95% confidence intervals (CI) with the software of Review Manager 5.1.0 System (Cochrane Library).

RESULTSSixteen trials involving 1321 adults met our criteria were included for analysis. Blocks performed using US guidance were more likely to be successful (risk ratio (RR) for block success 0.36, 95%CI 0.23 - 0.56, P < 0.00001), decreased incidence of vascular puncture during block performance (RR 0.13, 95%CI 0.06 - 0.27, P < 0.00001), decreased the risk of complete hemi-diaphragmatic paresis (RR 0.09, 95%CI 0.03 - 0.52, P = 0.0001).

CONCLUSIONSUS decreases risks of complete hemi-diaphragmatic paresis or vascular puncture and improves success rate of brachial plexus nerve block compared with techniques that utilize PNS for nerve localization. Larger studies are needed to determine whether or not the use of US can decrease risk of neurologic complications.

Brachial Plexus ; Humans ; Nerve Block ; methods ; Peripheral Nerves ; Randomized Controlled Trials as Topic ; Ultrasonography, Interventional ; methods

ObjectiveTo compare the clinical results between minimally invasive transforaminal lumbar(mini-TLIF) and posterior open surgery in treatment of lumbar spondylolisthesis.MethodsFrom March 2008 to August 2010,a total of 49 cases with lumbar spondylolisthesis underwent surgical intervention were retrospectively analyzed,including 23 cases with mini-TLIF and 26 with open surgery.Operation time,intra-operative bleeding,and radiation exposure times were recorded.Pre- and postoperative back pain was assessed by visual analogue scale(VAS),and lumbar function was evaluated by Oswestry disability index (ODI).The clinical results were assessed by Macnab criterion,and the pre and postoperative radiologic parameters were compared.ResultsThe mean follow-up time was 11 months(ranged,9-22).Both groups got good clinical results and satisfactory radiologic parameters.The group of mini-TLIF was superior to the group of open surgery in intra-operative bleeding,VAS of the second day postoperatively and the willingness of reoperation(P＜0.05).The ODI in the patients with open surgery were decreased from 31.2％±8.2％ to 16.1％±6.8％ corresponding to the pre-oporation and the final follow-up.The ODI in the patients with mini-TLIF were decreased from 34.4％±11.7％ to 15.3％±4.3％ corresponding to the pre-operation and the final follow-up.There is no significant difference of the change of ODI between two groups (t=0.673,P=0.412).The group of mini-TLIF need more operation time and were exposed to more X-ray when compared to the open surgery group(P＜0.05).ConclusionMini-TLIF and open surgery can both get satisfactory clinical outcomes in treatment of lumbar spondylolisthesis.Mini-TLIF was superior to open surgery in intra-operative bleeding and VAS of the second day postoperatively,but it needs more operation time and radiation exposure.

Background The use of traditional techniques (such as landmark techniques,paresthesia and peripheral nerve stimulator) for upper-limb anesthesia has often been restricted to the expert or enthusiast,which was blind.Recently,ultrasound (US) has been applied to differ blood vessel,pleura and nerve,thus may reduce the risk of complications while have a high rate of success.The aim of this study was to determine if the use of ultrasound guidance (vs.peripheral nerve stimulator,(PNS)) decreases risk of vascular puncture,risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block.Methods A search strategy was developed to identify randomized control trials (RCTs) reporting on complications of US and PNS guidance for upper-extremity peripheral nerve blocks (brachial plexus) in adults available through PubMed databases,the Cochrane Central Register of Controlled Trials,Embase databases,SinoMed databases and Wanfang data (date up to 2011-12-20).Two independent reviewers appraised eligible studies and extracted data.Risk ratios (OR)were calculated for each outcome and presented with 95％ confidence intervals (CI) with the software of ReviewManager 5.1.0 System (Cochrane Library).Results Sixteen trials involving 1321 adults met our criteria were included for analysis.Blocks performed using US guidance were more likely to be successful (risk ratio (RR) for block success 0.36,95％ CI 0.23-0.56,P ＜0.00001),decreased incidence of vascular puncture during block performance (RR 0.13,95％ CI 0.06-0.27,P ＜0.00001),decreased the risk of complete hemi-diaphragmatic paresis (RR 0.09,95％ CI 0.03-0.52,,P=0.0001).Conclusions US decreases risks of complete hemi-diaphragmatic paresis or vascular puncture and improves success rate of brachial plexus nerve block compared with techniques that utilize PNS for nerve localization.Larger studies are needed to determine whether or not the use of US can decrease risk of neurologic complications.

OBJECTIVETo preliminarily investigate the relationship between serum apelin level and pulmonary artery pressure in children with congenital heart disease.

METHODSOne hundred and twenty-six children with congenital heart disease undergoing surgical treatment were enrolled as subjects. The serum level of apelin was determined before surgery and at 7 days after surgery. The ratio of pulmonary artery systolic pressure to aortic systolic pressure (Pp/Ps) was calculated before extracorporeal circulation. According to the Pp/Ps value, patients were classified into non-pulmonary arterial hypertension (PAH) group, mild PAH group, moderate PAH group, and severe PAH group. Pulmonary artery mean pressure was estimated by echocardiography at 7 days after surgery.

RESULTSThe non-PAH group had the highest serum level of apelin before and after surgery, followed by the mild PAH group, moderate PAH group, and severe PAH group (P<0.05). All groups had significantly increased serum levels of apelin at 7 days after surgery (P<0.05). The serum level of apelin was negatively correlated with pulmonary artery pressure before surgery (r=-0.51, P<0.05) and at 7 days after surgery (r=-0.54, P<0.05).

CONCLUSIONSThe decrease in serum apelin level is associated with the development of pulmonary hypertension in children with congenital heart disease. The significance of serum apelin in predicting the development and degree of pulmonary hypertension in children with congenital heart disease deserves further studies.

Apelin ; Blood Pressure ; Child, Preschool ; Female ; Heart Defects, Congenital ; blood ; physiopathology ; Humans ; Hypertension, Pulmonary ; blood ; Infant ; Intercellular Signaling Peptides and Proteins ; blood ; Male ; Pulmonary Artery ; physiopathology