Objective The levels of Thl cytokines(IL-10 and IL-13)and Th2 cytokines(INF-? and TNF-?)were determined in the sera of patients with Schistosomiasis japonica in order to find the relationship between cytokines and severe hepatic fibrosis(HF)in schistosomiasis.Methods A total of 358 patients with advanced Schistosomiasis japonica were examined by ultrasound.68 HBsAg negative patients were chosen randomly as experimental control.Among them,39 patients were found to have mild HF and 29 were severe HF.The sera levels of Thl and Th2 cytokines were determined with ELISA.Results Among these 358 patients,83(23.2%)were HBsAg positive.Neither earlier nor severer hepatic fibrosis was noted in the patients who had been simultaneously infected with HBV than those only infected with schistosomiasis. There was a significant difference between mild[ 1.60(1.30-12.14)ng/L]and severe[ 4.20(1.43- 52.07)ng/L]HF patients in the level of IL-10(Z=-3.907,P0.05)was found in level of IFN-?,between severe[3.12(1.38-66.14)ng/L]and mild[5.87(1.33-216.33)ng/ L]HF subjects.Our observation did not reveal any obvious difference of TNF-? between severe[ 2.48(0.79 -19.86)ng/L]and mild[ 2.28(0.67-15.72)ng/L]HF groups.Conclusions Patients infected with advanced shistosomiasis may become more susceptible to HBV.The results of the present investigation showed that a high level production of IL-13 was associated with severe HF.

OBJECTIVETo evaluate the surgical therapeutic strategy and prognostic factors for non-small cell lung cancer (NSCLC) with mediastinal lymph node metastasis (N2).

METHODSThe survival rate of 117 patients with N2 NSCLC treated surgically from January 1999 to May 2003 were analyzed. There were 88 male cases and 29 female cases, aged from 29 to 79 years. The procedure of operation (lobectomy, pneumonectomy and palliative resection), histological classification (squamous cell carcinoma, adenocarcinoma, mixed carcinoma, and large cell carcinoma and others), T primary tumor status, and adjuvant therapy were analyzed to determine their impact on the 5-year survival rate.

RESULTSThe median survival time was 22 months, and the over-all 3- and 5-year survival rate was 28.1% and 19.0%. Survival was higher in patients with lobectomy than with palliative resection, with T1 and T2 than with T4. The 5-year survival rate had no deference in age, sex and different histological classification. The 5-year survival rates of lobectomy and pneumonectomy (22.2% and 25.0% respectively) was higher than palliative resection (9.1%).

CONCLUSIONSSurgical procedures (especially lobectomy) is the best choice for N2 NSCLC patients with T1 or T2. But it can not prolong T4 patients' life significantly.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Mediastinum ; pathology ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Prognosis ; Retrospective Studies ; Survival Analysis

OBJECTIVETo evaluate the method and effectiveness of rigid-bronchoscopic cryosurgery for advanced central lung cancer.

METHODSForty-eight patients were enrolled in this study from June 2002 to December 2008, including 33 male and 15 female. The average age was 70 years (ranged from 45 to 83 years old). For the 48 patients, 38 cases were patients with advanced central lung cancer who were not suitable for surgery, and the remaining 10 cases were patients with local recurrence in trachea or main bronchus postoperatively. Cryosurgery was performed 120 times for all patients, 2.5 times per patient on average. The trachea or bronchus station, symptom such as dyspnea, hemoptysis, respiratory function and quality of life were observed.

RESULTSThe unblocked ratio of trachea and bronchi was 97%. All patients got satisfied improvement ratio of symptoms, 87.5% for dyspnea, 72.9% for cough, 93.8% for hemoptysis and 62.5% for chest pain. Respiratory function tests showed that both the mean forced expiratory volume in first second and forced vital capacity got an improvement from (1.03+/-0.05) L to (1.85+/-0.13) L and from (1.69+/-0.18) L to (2.96+/-0.14) L respectively (P<0.01). Karnofsky score also got no less than 20 scores improvement. The Follow-up time was 6 to 62 months. The longest survival was 62 months. The median survival time was 20 months. There was no severe perioperative complications and mortality except for 3 cases of moderate exeduation.

CONCLUSIONSCryosurgery is easy to perform with minimal complications. Not only could it provide an effective and rapid control of symptoms caused by central lung cancer, it could also unobstructed bronchus promptly and improve patients' quality of life.

Aged ; Aged, 80 and over ; Bronchoscopy ; Cryosurgery ; methods ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome

PURPOSE: The purpose of this study was to evaluate the usefulness of computed tomography(CT) and magnetic resonance imaging(MRI) in experimental bacterial meningitis. MATERIALS AND METHODS: CT and MR images of experimental bacterial meningitis were obtained after inoculation of 1ml suspension of 106/ml Staphylococcusaureus directly into the supratentorial arachnoid space of 18 New Zealand white rabbits. Each animal was studied with both Pre-enhanced and post-enhanced CT and MRI at 12, 24, 48 hours and 1 week. Cerebrospinal fluid of all of18 rabbits were sampled and cultured for bacterial growth. RESULTS: All of 18 rabbits had the clinical symptoms such as neck stiffness and anorexia within 24 hours after the inoculation. Cerebrospinal fluid cultures werepositive for Staphylococcus sureus growth. Gd-enhanced MRI exhibited diffuse enhancement along the thickened supratentorial meninges earlier than CT. in Gd-enhanced MRI, the mean contrast enhancement ratio(CER) at supratentorial meninges increased to 1.93 at 12 hours and 2.99 at 24 hours from 1.06 at 0 hour. Histologic evaluation demonstrated inflammatory cell infiltration into the meninges. MRI also identified the complications of mening it is such as ependymitis and hydrocephalus more effectively than CT. CONCLUSION: These results indicatedthat Gd-enhanced MRI detected earlier the abnormal findings of bacterial meningitis and evaluated more effectively the complications of mening it is compared with CT. MRI was more useful than CT in evaluation of the bacterial meningitis.
Animals ; Anorexia ; Arachnoid ; Cerebrospinal Fluid ; Hydrocephalus ; Magnetic Resonance Imaging* ; Meninges ; Meningitis ; Meningitis, Bacterial* ; Neck ; Rabbits ; Staphylococcus

OBJECTIVEThis paper presents a new method of skeleton reconstruction for oblique facial clefts using autogenous bone of the mandibular outer table.

METHODSIn the operation, the mandibular outer table was harvested through the intraoral approach. Assisted with internal rigid fixation technique, the mandibular outer table was used to reconstruct the naso-orbital framework as inlay or onlay bone graft.

RESULTSFrom 1993 to 2001, seven cases of oblique facial clefts were repaired with mandibular outer table bone graft. Postoperative follow-up for 6 months to 3 years demonstrated that the grafted bone healed well with the adjacent bones. No obvious bone resorption was observed. The facial appearance was improved greatly.

CONCLUSIONSThe mandibular outer table, with similar bone density to the calvarium, is easy to harvest without donor site scar. The method is quite ideal for skeleton reconstruction of oblique facial clefts.

Adolescent ; Bone Transplantation ; Child ; Facial Bones ; abnormalities ; Female ; Humans ; Male ; Mandible ; transplantation ; Nasal Bone ; abnormalities ; Orbit ; abnormalities ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome

OBJECTIVETo investigate the mechanism of silicosis by observing the effects of silica on the expression of plasminogen activator inhibitor-1 (PAI-1) and activator protein-1 (AP-1) in human alveolar epithelial cells type II (A549).

METHODSA549 cell and SiO(2) (200 microg /ml) were co-cultured for 0, 4, 8, 16 and 24 h respectively. The reverse transcriptase polymerase chain reaction (RT-PCR), Western blotting and SP immunocytochemistry were used for detections of the PAI-1 mRNA and protein expression. The nucleoprotein and total protein expression of AP-1 were investigated by Western blotting.

RESULTSThe expression levels of PAI-1 mRNA and protein were increased in a time-dependent manner(r(mRNA) = 0.911, r(protein) = 0.902, P < 0.05). The expressions of PAI-1 mRNA and protein in experimental groups were higher than that in control group (P < 0.05) and was the highest in 24 h group [(0.73 +/- 0.01) vs (0.36 +/- .03)]. The nucleoprotein expressions of c-jun/c-fos in experimental groups were also higher than in control group (P < 0.05), and the nucleoprotein expression level of c-jun was the highest in 4 h group [(1.54 +/- 0.02) vs (0.56 +/- 0.03)]; the nucleoprotein expression level of c-fos was the highest in 8 h group [(0.36 +/- 0.01) vs (0.15 +/- 0.01)]. Both c-jun and c-fos expression were decreased after 16 h, but the total protein expression of c-jun/c-fos had no difference in all experimental groups. The positive signal of PAI-1 was located in cytoplasm and nucleus.

CONCLUSIONSiO(2) could induce PAI-1 expression of A549 in a time-dependent manner, and AP-1 activation can be observed in early time.

Alveolar Epithelial Cells ; drug effects ; metabolism ; Cell Line ; Humans ; Plasminogen Activator Inhibitor 1 ; metabolism ; Silicon Dioxide ; toxicity ; Transcription Factor AP-1 ; metabolism

OBJECTIVETo explore the osteogenic potential of the nano-hydroxyapatite/collagen/calcium alginate composite implanted in animals.

METHODSEighteen 3-month-old New Zealand white rabbits were adopted to prepare 15 mm segmental defect model at the middle part of radius. Rabbit models were randomly divided into experimental group and blank control group. Nano-hydroxyapatite/collagen/calcium alginate was implanted into the defects of experimental group. Four, 8, and 12 weeks after operation, all specimens were examined by X-ray and histological methods.

RESULTSAll the 18 rabbit models entered the final analysis. X-ray showed that osteotylus was seen in the whole defect area in the experimental group 12 weeks after operation, during which osteogenesis was more obvious than in weeks 4 and 8 and the bridge grafting of defect area was obviously visible. In the blank control group, osteotylus was only observed at the two ends of the defects, and no osteogenesis was found in the central part of the defect area. Histological examination showed that new osteoid formation was seen in internal porous zone in the experimental group in weeks 4 and 8; in week 12, more woven bone-like tissues were visible and trabecular-like structure was formed.

CONCLUSIONThe nano-hydroxyapatite/ collagen/calcium alginate has good osteogenic potential.

Alginates ; chemistry ; Animals ; Collagen ; chemistry ; Durapatite ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Osteogenesis ; Rabbits ; Radius ; anatomy & histology ; Tissue Engineering ; Wound Healing

OBJECTIVETo investigate the role of MAPK signal transduction in TGF-beta1 induced phenotypic differentiation of human lung fibroblasts.

METHODHuman lung fibroblasts cell line (HLF-02) were cultured and then stimulated with 10 ng/ml TGF-beta1 for different time; SB203580 or PD98059 was added into culture medium to prevent p38 or Erk kinase pathway before incubating with TGF-beta1; the expression of alpha-smooth muscle actin (alpha-SMA) was detected by Western blotting and RT-PCR; Western blotting was used to assay phosphorylation of p38, Erk, and JNK kinase.

RESULTS(1) In the process of stimulation by TGF-beta1, the alpha-SMA mRNA expression levels of 24, 48 and 72 h groups were 1.87 +/- 0.11, 2.49 +/- 0.10, 3.02 +/- 0.15 respectively; and the alpha-SMA protein expression levels of 24, 48 and 72 h groups were 3.20 +/- 0.14, 3.96 +/- 0.21, 4.57 +/- 0.13 respectively. (2) TGF-beta1 induced p38, Erk kinase phosphorylation but not JNK kinase. (3) The inhibitors SB203580 and PD98059 suppressed TGF-beta1-induced p38 kinase and Erk phosphorylation respectively. (4) SB203580 significantly attenuated TGF-beta1-induced alpha-SMA mRNA and protein expression (inhibition rate: 30% and 40%); PD98059 also significantly inhibited TGF-beta1-induced alpha-SMA mRNA and protein expression (inhibition rate: 10% and 20%).

CONCLUSIONTGF-beta1 is capable of inducing the phenotypic differentiation of HLF-02, which is regulated by p38 and Erk kinase signal pathway.

Actins ; biosynthesis ; genetics ; Cell Line ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; metabolism ; Fibroblasts ; drug effects ; metabolism ; Flavonoids ; pharmacology ; Humans ; Imidazoles ; pharmacology ; Lung ; cytology ; Phenotype ; Phosphorylation ; Pyridines ; pharmacology ; RNA, Messenger ; genetics ; Transforming Growth Factor beta1 ; pharmacology ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

OBJECTIVETo evaluate the efficacy and safety of argon plasma coagulation (APC) in the treatment of large airway obstruction.

METHODSTotally 389 patients with treacheobronchial stenosis were treated with APC (ARCO3000 type) by bronchoscopy. The stenoses were caused by carcinomas (203 cases, 52.2%), metastatic tumors (67 cases, 17.2%), benign tumors (18 cases, 4.6%), granulomas (93 cases, 23.9%) and other lesions (8 cases, 2.1%). The rate of recanalization, relief of the symptoms, and complications were analyzed.

RESULTS1121 times of APC treatment were performed in the 389 patients. Complete recanalization was achieved in 138 cases (35.5%), partial in 143 (36.8%), mild in 55 (14.1%) and none in 53 (13.6%). The major complications included: super-ventricular tachycardia in 136 cases (34.9%), bleeding in 51 (13.1%), decrease in blood oxygen saturation in 48 (12.3%), asphyxia in 33 (8.5%), ventricular or super-ventricular arrhythmia in 24 (6.2%), short-term aggravation of airway obstruction in 18 (4.6%), and tracheal perforation in 3 (0.78%). All those complications were treated with various measures and no patient died of the complications during the procedure.

CONCLUSIONArgon plasma coagulation is effective and relatively safe in relieving the obstruction and dyspnea in patients with large airway obstruction caused by various reasons. However, for the patients with severe airway obstruction, argon plasma coagulation sometimes may cause severe or even lethal complications. Critical consideration of the indication, operators' skill and taking more precautions during the procedure are required to ensure the safety of argon plasma coagulation treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Argon ; therapeutic use ; Bronchial Diseases ; etiology ; surgery ; Bronchial Neoplasms ; complications ; Bronchoscopy ; Constriction, Pathologic ; Electrocoagulation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tracheal Neoplasms ; complications ; Tracheal Stenosis ; etiology ; surgery ; Young Adult

OBJECTIVETo evaluate the effectiveness of thymectomy for myasthenia gravis (MG) and the relative risk factors for postoperative myasthenic crisis.

METHODSThe clinic data of 78 cases with MG who underwent thymectomy from June 1985 to June 2005 were analyzed retrospectively. The relative risk factors of postoperative myasthenic crisis were analyzed and the differences between new and old region of perioperative management were compared.

RESULTSThe symptom of MG was complete remission in 21 cases, significantly improved in 38 cases, improved in 11 cases and unchanged in 8 cases, respectively. The symptom duration before operation, preoperative serum level of anti-acetylcholine receptor antibody, Osserman stage and pathological type of thymoma were independent relative risk factors for postoperative myasthenic crisis. The new region of perioperative management was significant better than the old one.

CONCLUSIONSurgical treatment shows significant clinical benefits for patients with MG.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle Weakness ; etiology ; prevention & control ; Myasthenia Gravis ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Thymectomy ; adverse effects ; methods ; Treatment Outcome