Objective To evaluate the short-term efficacy and toxicity of perfusion in pleural cavity with bruceolic oil emulsion and cisplatin for malignant pleural effusion. Methods 64 patients with malignant pleural effusion received thoracentesis catheterization in pleural cavity and were devided into 2 groups:the treatment group and the control group. The treatment group(32 cases) were perfused with bruceolic oil emulsion 60 ～ 80ml every time and DDP 60mg/m2. The control group(32 cases) were perfused with DDP 60mg/m2 only,they used it once a week. All patients completed therapy 4 weeks. Results The response rate of treatment group was 81.3% and 56.3% for the control group(x2 =4.65,P＜0.05).There was no difference in toxicity between two groups(P＞0. 05). Conclusion The efficacy of perfusion with bruceolic oil emulsion and cisplatin in pleural cavity was of promise. It could improve the life quality of the patients. The toxicity is weak,it was worth of clinical application.

BACKGROUND: Tissue Doppler echocardiography (TDE) has been proved to evaluate general and local function of heart but less reported on adriamycin-induced cardiomyopathy following bone marrow stromal cell (BMS) transplantation.OBJECTIVE: To evaluate myocardial function of an adriamycin-induced cardiomyopathy rabbit model following BMS transplantation using TDE.DESIGN, TIME AND SETTING: A randomized animal control study was performed at Laboratory of Ultrasound, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from September 2002 to December 2003.MATERIALS: A total of 28 male adult Japanese rabbits weighing (2.0+0.2) kg were used in this study. Adriamycin was used to induce cardiomyopathy model in 20 rabbits.METHODS: Twenty-eight male Japanese rabbits were randomly divided into three groups: cell transplantation group (n=10),PBS group (n=10), and sham operation group (n=8). BMSs were isolated from cell transplantation group at the 8th day. On the 12th week, cells were labeled with 4, 6-diamidino-2-phenylindole (DAPI), and then epicardial directly injected into the myocardium of the same rabbits in thoracotomy surgery. Non-cell only culture fluid PBS was injected in PBS group. Sham operation group underwent thoracotomy surgery with the same volume of saline injection.MAIN OUTCOME MEASURES: Left ventricular function was assessed by conventional and tissue Doppler echocardiography before and 4 weeks after surgery. Histological examination including apotisis study and DAPI fluorescent were assessed after sacrificed.from (4.0+1.1) cm/s to (5.3+1.2) cm/s (P ＜ 0.05) around the inject site, but the improvement of global myocardial function was not found by conventional echocardiography. In PBS and sham operation group there were no differences in global and myocardium at 4 weeks after transplantation. Histological findings showed that the injury of the myocardium around the injection site was relieved with less apoptosis.

Objective To investigate the possible signaling mechanisms by which recombinant human platelet-derived growth factor (rhPDGF) accelerated healing of cutaneous wound in diabetic rats. Methods Four full-thickness skin wounds were incised in the back of 26 male Wistar diabetic rats. The wounded rats were divided into 3 groups (7 or 8 rats each group). One group without treatment was used as a control, and the other 2 groups were treated with rhPDGF at a dose of 7.0 μg/cm2 wound or vehicle ( DMSO/0.9%NaCl, vol/vol 1:1) from 1 to 14 days. The wound healing was evaluated by the measurements of the wound volume and area. Immunofluorescent and immunohistochemical staining were used to examine the phosphorylation of extracellular signal-regulated kinase 1/2(ERK1/2) and the expression of proliferative cell nuclear antigen (PCNA), respectively. Results Granulation tissue appeared in the bed of wound after injury. The number of blood capillary buds and fibroblasts was greater in the rhPDGF-treated group than that in the other 2 groups. A lot of inflammatory cells infiltration and collagen deposition were observed in the wound. The wound-volume in the rhPDGF-treated group was smaller than that in control group ( P ＜ 0.05). The reepithelialization rate in rhPDGF-treated group was higher than that in the other 2 groups at 7 days after injury ( P ＜ 0.05). The expression of PCNA in reparative cells was higher in rhPDGF-treated group than in control group or vehicle-treated group at 3,7 days after injury( P ＜ 0.05). The phosphorylation of ERK1/2 was stronger in rhPDGF-treated group than that in control group or vehicle group at 7 and 14 days after injury( P ＜ 0.05). Conclusion These results suggest that rhPDGF accelerates wound healing and improves healing quality by increasing the phosphorylation of ERK1/2.

The feasibility of bone marrow stromal cells autologous transplantation for rabbit model of dilated cardiomyopathy induced by adriamycin was studied. Twenty rabbits received 2 mg/kg of adriamycin intravenously once a week for 8 weeks (total dose, 16 mg/kg) to induce the cardiomyopathy model with the monitoring of cardiac function by transthoracic echocardiography. Marrow stromal cells were isolated from cell-transplanted group rabbits and were culture-expanded on the 8th week. On the 10th week, cells were labeled with 4,6-diamidino-2-phenylindole (DAPI), and then injected into the myocardium of the same rabbits. The results showed that viable cells labeled with DAPI could be identified in myocardium at 2nd week after transplantation. Histological findings showed the injury of the myocardium around the injection site was relieved with less apoptosis and more expression of bcl-2. The echocardiography found the improvement of local tissue movement from (2.12+/-0.51) cm/s to (3.81+/-0.47) cm/s (P<0.05) around the inject site, but no improvement of heart function as whole. It was concluded bone marrow stromal cells transplantation for dilated cardiomyopathy was feasibe. The management of cells in vitro, the quantity and the pattern of the cells transplantation and the action mechanism still need further research.

Objective To investigate the efficacy and safety of microsurgery for trigeminal neuralgia (TN) in elderly patients.Methods Totally 143 patients with intractable primary TN who received microsurgery were retrospectively analyzed.There were 92 cases in the elderly group with age of 65-82 years,and the other 51 cases in control group with age of 40-62 years.All the patients in both groups were classified as American Society of Anesthesiologists (ASA) Scale Grade 1 to 3.After suboccipital retrosigmoid craniotomy,microvascular decompression (MVD) was performed in 136patients and partial sensory trigeminal rhizotomy in 7 patients.The complications and efficacy were compared between the two groups.Results 87 cases in the elderly group and 49 cases in control group underwent MVD procedure,complete and part pain relief were achieved in 78 cases and 9 cases in the elderly group,45 cases and 4 cases in control group,respectively.After an average follow-up period of 2.6 and 2.1 years,4 cases (5.1％) among 79 follow-up cases and 3 cases (6.5％) among 46follow-up cases experienced TN recurrences in the elderly and control groups,respectively.No statistically significant differences existed in the efficacy and recurrence rate between the two groups (P＞0.05).There were 3 cases with aseptic meningitis,1 cases with hearing decrease,1 case with cerebrospinal fluid leakage,1 case with pulmonary infection and 1 cases with deliration in the elderlygroup,meanwhile,1 cases with aseptic meningitis,1 case with tinnitus and 1 case with cerebrospinal fluid leakage after surgery in control group (P＞0.05).No facial hypoesthesia appeared in the patients receiving MVD.5 cases in the elderly and 2 cases in control group underwent partial trigeminal rhizotomy with facial hypoesthesia,but the pain released,and no recurrence was found.There were no dead cases in both groups.Conclusions With cautious and proper treatment,microsurgical procedure can be performed safely and effectively in the elderly TN.

Objective To investigate the molecular mechanisms of effect of glycogen synthase kinase -3beta( GSK3β) on proliferation of human osteosarcoma cells .Methods Normal osteoblast hFO and osteosarcoma cell lines were examined for GSK 3βexpression and activity by Western blot and in vitro kinase assay ( NIRKA) . The effects of small molecule GSK3βinhibitors on cell proliferation and apoptosis were examined .Depletion of en-dogenous GSK3βby GSK 3βsiRNA detected the expression and phosphorylation of p 27 and its downstream cy-clinD1-CDK-Rb pathway factor by Western blot .Human osteosarcoma cell xenografts ,in athymic mice model , were treated with DMSO as control or with GSK 3βinhibitor SB-216763 or AR-A014418 by intraperitoneal in-jection,3 times a week.The tumor growth and body weight were observed in nude mice .Results Osteosarcoma cell lines showed increased GSK 3βexpression and decreased serine 9 phosphorylation compared with normal oste-oblast cells.Inhibition of GSK3βresulted in attenuated cell proliferation and increased apoptosis in most osteosar-coma cell lines in vitro and in vivo in MG 63 xenografts in rodents but not in hFOB cells .We decreased endoge-nous GSK3b activity,tumor growth was inhibited in SB216763,AR -A014418 group compared with control group.There was statistical significance(P<0.05).GSK3βinhibition in osteosarcoma cells was associated with decreased p27 expression, Rb expression and phosphorylation level of decline , CDK2, 4, 6 protein level de-creased,the upregulation of cyclin D1 expression but the phosphorylation level of no effect .Conclusion In this research,we demonstrate that deregulated GSK 3βsustains osteosarcoma cells survival through modulation of p27and cyclinD1-CDK-Rb pathway.The result will open up a potential target for clinical treatment of osteosar -coma.

OBJECTIVETo assess the results of 26 patients with tethered cord syndrome (TCS) after microsurgical operation.

METHODSTwenty-six patients with TCS were treated microsurgically and their clinical data were analyzed retrospectively.

RESULTS72% of the patients with TCS showed significant improvement. Surgical outcome was excellent in relieving pain and sensorimotor deficits, but bladder dysfunction.

CONCLUSIONEarly diagnosis and adequate surgical release are the keys to a successful outcome.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Male ; Microsurgery ; Neural Tube Defects ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVESTo evaluate clinical manifestations of 21 patients with subclinical pituitary apoplexy and their diagnosis and treatment.

METHODClinical data from 21 patients with subclinical pituitary apoplexy treated from October 1989 to November 2001 were analyzed retrospectively.

RESULTSTheir clinical manifestations included chronic headache, visual deficit and field cut. Three patients showed no clinical signs. Microsurgery was performed in 20 patients, of whom 3 were treated by emergency operation. Microsurgery included transsphenoidal decompression in 17 patients, and transpterioral approach in 3. One patient was given conservative therapy, and 12 were given endocrine replacement therapy. Nineteen patients recovered with marked visual improvement (7), partial improvement (8), no changes (4); deterioration was noted in 1.

CONCLUSIONSSubclinical pituitary apoplexy characterized by atypical clinical manifestations may be misdiagnosed or in appropriately treated. MRI is superior to CT scan for the diagnosis of subclinical pituitary apoplexy. Patients with persistent chiasmatic syndromes are indicated for emergency surgery. Endocrine replacement and transsphnoidal decompression are effective for the improvement of severe visual disturbance.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Apoplexy ; diagnosis ; surgery ; Tomography, X-Ray Computed

The feasibility of bone marrow stromal cells autologous transplantation for rabbit model of dilated cardiomyopathy induced by adriamycin was studied. Twenty rabbits received 2 mg/kg of adriamycin intravenously once a week for 8 weeks (total dose, 16 mg/kg) to induce the cardiomyopathy model with the monitoring of cardiac function by transthoracic echocardiography. Marrow stromal cells were isolated from cell-transplanted group rabbits and were culture-expanded on the 8th week. On the 10th week, cells were labeled with 4,6-diamidino-2-phenylindole (DAPI), and then injected into the myocardium of the same rabbits. The results showed that viable cells labeled with DAPI could be identified in myocardium at 2nd week after transplantation. Histological findings showed the injury of the myocardium around the injection site was relieved with less apoptosis and more expression of bcl-2. The echocardiography found the improvement of local tissue movement from (2.12±0.51) cm/s to (3.81±0.47) cm/s (P＜0.05) around the inject site, but no improvement of heart function as whole. It was concluded bone marrow stromal cells transplantation for dilated cardiomyopathy was feasibe. The management of cells in vitro, the quantity and the pattern of the cells transplantation and the action mechanism still need further research.