Objective To study the clinical pathological features of Wegener's granulomatosis (WG) in middle-aged and elderly patients,and enhance understanding of this disease.Methods Totally 21 patients with WG (11 males,10 females,aged 45 to 76 years,mean age 58.1 years) in our hospial from February 1999 to July 2012 were selected.The clinical and pathological data of WG patients were retrospectively analyzed.34 biopsies including 2 autopsies from different organs were paraffin embedded and stained by hematoxylin and eosin and histochemistry.13 renal biopsies were all examined by immunofluorescence and electron microscope.Results The average time from the onset of clinical symptoms to the diagnosis was 5.3 months (from 24 days to 11.0 months).Eyes,nose and salivary glands were the most commonly involved parts at the beginning of Wegener's granulomatosis (52.4％,11 cases).The percentages of the skin,lung and renal involvement were 14.3％ (3 cases),81.0％ (17 cases) and 71.4％ (15 cases),respectively.Among 21 patients,18 patients were examined with anti-neutrophil cytoplasmic antibody (ANCA).c-ANCA was positive in 72.2 ％ patients (13 cases,13/18),p-ANCA was positive in 16.7％ patients (3 cases,3/18),and ANCA was negative in 11.1％ patients (2 cases,2/18).3 major pathological manifestations were observed:7 kinds of vasculitis including capillaritis,acute vasculitis,chronic vasculitis,fibrinoid necrosis in vasculitis,necrotizing granulomatous vasculitis,non-necrotizing granulomatous vasculitis and cicatricial vascular changes; 4 kinds of granulomatous inflammation including scattered giant cells,palisading histiocytes,poorly formed granulomas and microabscess surrounded by granulomatousinflammation;2 kinds of parenchymal necrosis including geographic necrosis and microabscess.13 kinds of histopathologic features in 3 major manifestations were found from 2 autopsies,but various kinds histopathologic features presented in small biopsy samples.Minor manifestations such as diffuse pulmonary hemorrhage were found at the periphery of WG.Conclusions The wide variation and broad spectrum of pathologic features can occur in WG.Vasculitis,granulomatous inflammation and parenchymal necrosis are the most important histopathological features.The correct diagnosis of WG requires careful correlation of pathology with complicated clinical features.

Acupuncture Therapy ; Aged ; Female ; Humans ; Radiotherapy ; adverse effects ; Tonsillar Neoplasms ; radiotherapy ; Xerostomia ; etiology ; therapy

Objective To explore the stability of unilateral external fixator for tibial fracture in its middle in condition of different distribution and number of screws. Methods The experiment model was made when eighteen human corpse tibial transverse fractures had been fixated with unilateral external fixation, which were divided into six groups. In each group, resistance fragments were adhered to be close to the transverse tibial fracture and near the screw-bone interface(SBI), including three screw distribution models, which were well distributed, close to and far off the fracture site distribution. Each model had also been accomplished according to the conditions of four and six screws before compression load of the same magnitude, the same direction and the same loading position. This method was used to observed the values of strain of SBI and axial displacement at the fracture site at grade load. Results ① Under compression condition, the models displacements and the force at Y-axial were the smallest when screw distribution was even in four or six screws and much better than those of four screws. ② The stability at the condition of six screws was stronger than that of four screws. Conclusion The even distribution of four screws is reasonable when tibial fractures are treated with unilateral external fixation, and six screws can be choosen if conditions permit.

italic>γ-Aminobutyric acid (GABA) is a crucial inhibitory neurotransmitter found in various cells in the human body. While the GABAergic system is typically associated with the nervous system, recent research has revealed that immune cells and tumor cells also express components of this system. In the tumor microenvironment (TME), GABA is secreted to act extracellularly on other cells. GABA is metabolized via the GABA shunt and is involved in the tricarboxylic acid (TCA) cycle by generating succinate, which can provide energy for tumor cells. Activation of GABA receptors (GABARs) is a major pathway through which GABA participates in the regulation of antitumor immune responses. The activation of GABA type A receptors (GABA_ARs) can inhibit the activation and proliferation of T cells, elicit anti-inflammatory macrophages, and promote tumor cell growth and migration, while activation of GABA type B receptors (GABA_BRs) is generally considered to inhibit cancer cell migration and induce cancer cell apoptosis. In general, receptor activation inhibits immune cells, but the effect on tumor cells varies. Additionally, the downregulation of the expression levels of GABA transporters (GATs) is involved in tumor progression. Although antagonists of GABA metabolism and drugs that act on GABA receptors are considered therapeutic drugs for tumors, there have been few clinical studies conducted on them.

Acute Kidney Injury ; diagnosis ; etiology ; Biomarkers ; Early Diagnosis ; Humans ; Liver Cirrhosis ; complications ; diagnosis

?-arbutin is biosynthesized by whole cell method with Xanthomona maltophilia BT-112.The conditions for cell biosynthesized ?-arbutin are investigated as follows:temperature,25℃;concentration of hydroquinone,30mmol/L;mol ratio of sucrose and hydroquinone,20∶1;time course of ?-arbutin biosynthesis,45 hours;rotational speed,160r/min;concentration of Xanthomona maltophilia BT-112,85g/L;concentration of K-2HPO-4-KH-2PO-4 buffer solution,25mmol/L;pH of K-2HPO-4-KH-2PO-4 buffer solution,8.0.Under the above optimal conditions,the maximum of molar conversion yield based on the amount of hydroquinone supplied reaches 86.7%.

AIMTo investigate whether transplantation of neural stem cells can ameliorate learning and memory abilities in Alzheimer's disease (AD) rats.

METHODSNeural stem cells were isolated from dentate gyrus of hippocampus of newborn rats. After labeled with Hoechst33258, neural stem cells were grafted into the hippocampus of AD rats. 2 or 4 weeks post transplantation, the rats underwent behavioral testing using Y-maze trial. Fluorescence observation and immunohistochemistry were used after the rats were sacrificed.

RESULTSNeural stem cells grafted into hippocampus of AD rats could not only survive well, but also possessed the capacity of continuous proliferation and migrate along the hippocampus.

CONCLUSIONNeural stem cells grafted into hippocampus of AD rats can not only survive well, possess the capacity of continuous proliferation, but also ameliorate memory defects in Alzheimer's disease rats.

Alzheimer Disease ; surgery ; Animals ; Disease Models, Animal ; Hippocampus ; surgery ; Male ; Maze Learning ; Memory ; Neural Stem Cells ; transplantation ; Neurons ; transplantation ; Rats ; Rats, Sprague-Dawley ; Stem Cell Transplantation

CD40 and its receptor CD40L are a very important pair of co-stimulating molecule in immune response, which have extensive biological effects. After stimulating CD40 signal, it can exert corresponding function through MAPK (JNK, ERK, p38) pathway, PI3K cascade, as well as NF-κB and STAT. The CD40 signal is closely related to tumor immunity, this moleculer has already become targeted-molecule for cancer treatment. Recently, there have been many anti-CD40 monoclonal antibodies displaying good anti-cancer effect, among which CHIR-12.12, SGN-40 and CP-870, 893 developed rapidly and successively have entered clinical research stage. This review focuses the status of anti-CD40 monoclonal antibody, including distribution of CD40, physiological function of CD40, CD40 and tumor immunity, anti-CD40 monoclonal antibodies and so on.
Animals ; Antibodies, Monoclonal ; CD40 Antigens ; immunology ; Humans ; Neoplasms

OBJECTIVETo explore the treatment of chronic calcaneal osteomyelitis with bone defect after debridement and evaluate its clinical outcomes.

METHODSFrom June 2009 to June 2011, 52 patients with chronic calcaneal osteomyelitis were treated with stage-one compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone,including 12 females and 40 males with an average age of 43 years old ranging from 18 to 67. According to Cierny-Mader classification, there were 34 cases with stage III and 18 with stage IV. There were 32 cases on right side and 20 on left,with a course of 6 months to 3 years. The area of soft tissue wound ranged from 3.0 cm x l.5 cm to 23.0 cm x l2.0 cm. The clinical effects were evaluated according to infection controlling, calcium sulfate absorption,bone defect repair and heel functional recovery.

RESULTSAll patients were followed up for 2 to 3.8 years (averaged 2.8 years). Primary healing was achieved in 52 patients. Two cases of recurrence were found post-operatively, 1 case in 3 months and another in 5 months,which were cured after a second operation. Bone repair healing was gained in 1.5 to 3.5 months (averaged 2.5 months). Complete radiological absorption of calcium sulfate was found in 1.2 to 3 months(averaged 2.2 months). Local exudation after removal of drainage tube had been persisting in 10 patients for 2 to 3 months, which was consistent with the time when cacium sulfate were totally absorbed. Flap had partial necrosis in 4 cases,and the wounds were closed after appropriate treatment finally. The mean Maryland score was 88.15±7.70. There were excellent results in 32 cases, good in 14, fair in 6.

CONCLUSIONA satisfactory short-term clinical results can be gained by one-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone in chronic calcaneal osteomyelitis, but the long-term results need further follow-up. And much more study is also demanded to reduce the exudation of calcium sulfate.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Transplantation ; Calcaneus ; injuries ; surgery ; Calcium Sulfate ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteomyelitis ; drug therapy ; physiopathology ; surgery ; Surgical Flaps ; Wound Healing ; Young Adult

Objective To prospectively evaluate 3D time-of-flight magnetic resonance angiography (3DTOF MRA) and high resolution contrast enhanced volume scan magnetic resonance angiography (CEMRA) with sensitivity encoding in diagnosing craniocervical artery stenosis. Methods Forty-six patients suspected with craniocervical artery diseases underwent MRI, 3DTOF MRA of the head and also CEMRA of the neck. The images of MRA were reconstructed with MIP and VR. The degree of arterial stenosis demonstrated on MRA was compared with that showed on digital subtraction angiography(DSA), and the data were analyzed with Spearman rank correlation coefficient (Rs). Results Excellent correlation in determining the degree of craniocervical artery stenosis existed between MRA and DSA (Rs = 0.97). With DSA as a golden standard, the sensitivity, specificity and accuracy of MRA in detecting over 50% arterial stenosis were 100%, 99.4% and 99.4% respectively. Conclusion 3DTOF MRA and CEMRA with sensitivity encoding at 3.0T are reliable and effective examinations for evaluating craniocervical artery disease. These techniques can be used as the necessary exams before DSA and can even substitute for the conventional DSA in some instances.