Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.

Objective To assess the feasibility and clinical results of video-assisted high anterior transcervical approach (Smith-Robinson) in treatment of spinal lesions of the craniovertebral junction. Methods Between April 2007 to October 2009, nineteen consecutive patients with spinal lesions of the craniovertebral junction were included in the study. There were 9 males and 10 females aged from 16 to 62 years old with a mean of 32 years. The primary pathologies included 4 cases with chronic odontiod fracture, 2 cases with purely irreducible atlantoaxial dislocation, 6 cases with os odonteideum, 1 case with Marfan synd rome, 1 case with primary basilar invagination from Kippel-Feil syndrome, 3 case with axis tumor and 1 case with irreducible rheumatoid atlantoaxial dislocation. All of the patients underwent combined video-assisted high anterior transcervical procedure and posterior fixation at one-stage. The anterior procedure included atlantoaxil release and reduction (8 cases), odontoidectomy (8 cases), and intralesional extracapsular excision and reconstruction (3 tumor cases). The posterior technique were C1-C2 pedicle screw fixation (13 cases), C1-C3 pedicle screw fixation (2 cases), and occipitalcervical fusion (4 cases). Results Anatomical reduction was achieved in eight cases with anterior release and reduction. Tumors were completely removed in three cases with axial tumor. The mean follow-up was 14 months (6-36 months). All of them achieved solid bone fusion. In the 14 patients with symptoms of spinal cord dysfunction, the average Japanese Orthopaedic Association (JOA)score had improved from 9.1±3.3 preoperatively to 14.1±2.9 postperatively. The improvement rate was excellent for 7 cases, good for 5 cases, fair for lcase and poor for 1 case. One patient experienced leakage of cerebrospinal fluid which was resolved by bioprotein gelatin blocking and lumbar subarachnoid continuous drainage within 1 week. Dysphagia which occurred in 3 cases responded well to dexamethason and mannitol.No infection and hardware failure were observed. Conclusion Video-assisted high anterior transcervical procedure is a safe and effective alternative for treating spinal lesions in the craniovertebral junction.

OBJECTIVETo investigate the role of p38 MAPK on ischemic postconditioning (IPO) attenuating pneumocyte apoptosis after lung ischemia/reperfusion injury (LIRI).

METHODSForty adult male SD rats were randomly divided into 5 groups based upon the intervention (n = 8): control group (C), LIR group (I/R), LIR + IPO group (IPO), IPO + solution control group (D), IPO + SB203580 group (SB). Left lung tissue was isolated after the 2 hours of reperfusion, the ratio of wet lung weight to dry lung weight (W/D), and total lung water content (TLW) were measured. The histological structure of the left lung was observed under light and electron transmission microscopes, and scored by alveolar damage index of quantitative assessment (IQA). Apoptosis index (AI) of lung tissue was determined by terminal deoxynuleotidyl transferase mediated dUTP nick end and labeling (TUNEL) method. The mRNA expression and protein levels of and Bax were measured by RT-PCR and quantitative immunohistochemistry (IHC).

RESULTSCompared with C group, W/D, TLW, IQA, AI and the expression of Bax of I/R were significantly increased, the expression of Bcl-2 and Bcl-2/Bax were significantly decreased (P < 0.05, P < 0.01), and was obviously morphological abnormality in lung tissue. Compared with I/R group, all the indexes of IPO except for the expression of Bcl-2 and Bcl-2/ Bax were obviously reduced, the expression of Bcl-2 and Bcl-2/Bax were increased (P < 0.05, P < 0.01). All the indexes between D and IPO were little or not significant( P > 0.05). The expression of Bcl-2 and Bcl-2/Bax of SB were significantly increased and other indexes were reduced than those of IPO (P < 0.05, P < 0.01).

CONCLUSIONIPO may attenuate pneumocyte apoptosis in LIRI by inactivation of p38 MAPK, up-regulating expression of Bcl-2/Bax ratio.

Alveolar Epithelial Cells ; cytology ; Animals ; Apoptosis ; Disease Models, Animal ; Ischemic Postconditioning ; Lung ; blood supply ; enzymology ; pathology ; Male ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; enzymology ; pathology ; prevention & control ; bcl-2-Associated X Protein ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo investigate the effect of siRNA silencing the role of C-Jun N-terminal Kinase (JNK) gene in excessive endoplasmic reticulum stress on lung ischemia/reperfusion injury.

METHODSMouse model of pulmonary ischemia reperfusion injury (PIRI) in situ was established with unilateral lung in vivo. Seventy experimental mice were randomly allocated into seven groups (n = 10): Sham group (Sham group), ischemia reperfusion group (I/R), PBS+ Lipofectamine2000TM transfection reagent group (I/R + PBS+ Lipo group), negative control group (I/R+ SCR group), JNK-siRNA group (I/R + siRNA(JNK1), siRNA(JNK2), siRNA(JNK3)). Mice were euthanized after experimental time out, and left lung tissue was extracted. Wet/dry lung weight ratio (W/D) and total lung water content (TLW) were tested. Light microscope, alveolar damage quantitative evaluation index (IQA) and electron microscope were observed. The expression levels of JNK and glucose regulatex protein(GRP78) were detected by RT-PCR and Western blot. Apoptosis of lung tissue was determined by TUNEL.

RESULTSCompared with Sham group, all indicators above of I/R + PBS + Lipo group and I/R + SCR group were significantly increased (P < 0.01), and compared with I/R group, those indicators of the three groups all had no notable difference; those indicators were not statistically different between I/R + PBS + Lipo group and I/R + SCR group, and compared to the three groups, the above indicators in JNK-siRNA group were lower (P < 0.05, P < 0.01) except that the expression levels of GRP78 was not statistically different.

CONCLUSIONI/R induces excessive ERS in lung tissue, in which JNK pathway participates in apoptosis, leading to lung tissue injury.

Animals ; Apoptosis ; Endoplasmic Reticulum Stress ; Heat-Shock Proteins ; metabolism ; JNK Mitogen-Activated Protein Kinases ; genetics ; Lung ; physiopathology ; Lung Injury ; genetics ; MAP Kinase Signaling System ; Mice ; RNA, Small Interfering ; Reperfusion Injury ; genetics

OBJECTIVETo investigate the role and significance of ATP-sensitive K+ channels in the pathological process of hypoxia hypercapnia-induced pulmonary vasoconstriction (HHPV) and the relationship with ERK1/2 signal pathway in rats.

METHODSWe made the third pulmonary artery rings of SD rats, used the model of pulmonary artery rings perfusion in vitro. Under acute hypoxia hypercapnia condition, and observed the effects of the three stages of HHPV incubated by glybenclamide(Gly) and the combined application of Gly and U0126. At the same time, the values of rings' tension changes were recorded via the method of hypoxia hypercapnia conditions reactivity.

RESULTSUnder the normoxia condition, the values of the third pulmonary artery rings tension were relatively stable, but under the hypoxia hypercapnia condition, we observed a biphasic pulmonary artery contractile response compared with N group (P < 0.05, P < 0.01). When the third pulmonary artery rings incubated by Gly, it's phase II persistent vasoconstriction was enhanced compared with the H group (P < 0.05, P < 0.01), and the phase I vasoconstriction was also heightened. Moreover, under the hypoxia hypercapnia condition, U0126 could significantly relieve the phase II persistent vasoconstriction compared with HD group (P < 0.05, P < 0.01) induced by Gly, but the phase I acute vasoconstriction and the phase I vasodilation had no changes (P > 0.05).

CONCLUSIONGly may mediate HHPV via activating ERK1/2 signal transduction pathway.

Animals ; Glyburide ; pharmacology ; Hypercapnia ; metabolism ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; In Vitro Techniques ; MAP Kinase Signaling System ; physiology ; Male ; Pulmonary Artery ; drug effects ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley ; Vasoconstriction ; drug effects

OBJECTIVETo explore the effect of curcumin (CUR) on cycteinyl aspirate specific protease-12 (Caspase-12) and pneumocyte apoptosis in pulmonary ischemia/reperfusion (I/R) injury mice.

METHODSThe in vivo unilateral in situ pulmonary I/R injury mouse model was established in C57BL/6J mice. Sixty experimental mice were randomly divided into six groups by random digit table, i. e., the sham-operation group (Sham), the I/R group, the I/R + dimethyl sulfoxide group (I/R + DMSO), the I/R + low dose CUR pre-treated group (I/R + CUR-100), the I/R + middle dose CUR pre-treated group (I/R + CUR-150), the I/R + high dose CUR pre-treated group (I/R + CUR-200), 10 in each group. Mice were euthanized and their left lungs were excised. Wet lung weight to dry lung weight (W/D) and the total lung water content (TLW) were tested. The morphological changes of the lung tissue were observed and index of quantitative evaluation for alveolar damage (IQA) detected under light microscope. The ultra-microstructure of the lung tissue was observed under electron microscope. The mRNA and protein expression levels of Caspase-12 and glucose regulated protein (GRP78) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. Apoptosis index (AI) of the lung tissue was determined by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.

RESULTSCompared with the Sham group, expression levels of Caspase-12, GRP78 mRNA and protein all significantly increased in the I/R group (P < 0.05); W/D, TLW, IQA, and AI were all notably higher (P < 0.05, P < 0.01); the morphological and ultrastructural injury of the lung tissue were notably observed in I/R group. Compared with the I/R + DMSO group, expression levels of GRP78 mRNA and protein were increasingly higher in the I/R + CUR-100 group, the I/R + CUR-150 group, and the I/R +CUR-200 group (P < 0.05), expression levels of Caspase-12 mRNA and protein were lower (P < 0.05); W/D, TLW, IQA, and AI also decreased (P < 0.05, P < 0.01); the morphological and ultrastructural injury of the lung tissue were gradually alleviated in the I/R + CUR groups.

CONCLUSIONCUR had better effect on the lung protection against I/R injury, which might be related to inhibition for pneumocyte apoptosis associated with Caspase-12 in excessive unfolded protein response (UPR).

Animals ; Apoptosis ; drug effects ; Caspase 12 ; metabolism ; Curcumin ; pharmacology ; Heat-Shock Proteins ; metabolism ; Lung ; blood supply ; Male ; Mice ; Mice, Inbred C57BL ; Reperfusion Injury ; metabolism ; pathology ; prevention & control

OBJECTIVETo study the mechanism of Ca(2+) on the apoptosis induced by hyperthermia in neonate rat hippocampal neurons to provide the applicative evidence of dantrolene for preventing brain injuries.

METHODSDantrolene, Ca(2+) specific blocking agent, was used in the hyperthermia-induced apoptosis of primary hippocampal neurons in vitro to observe its effect on the apoptosis, fluorescent intensity, and dynamic change of Ca(2+) by flowcytometry and laser confocal microscopy.

RESULTSThe rate of apoptosis was decreased significantly after hyperthermia treatment by dantrolene sodium. The intracellular Ca(2+) fluorescent intensity in 42 degrees C treatment group (107.35 +/- 6.0) was significantly lower than that in control group (159.12 +/- 33.8). The concentration of Ca(2+) began to decrease 20 approximately 25 s after adding dantrolene sodium, and reached the lowest level about 50 s later, and then kept lower than the basal level.

CONCLUSIONDantrolene sodium has an important protective effect on hippocampal neurons apoptosis induced by hyperthermia and may have some applicative value of preventing heat-induced brain injury.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Calcium ; metabolism ; Calcium Channel Blockers ; pharmacology ; Cells, Cultured ; Dantrolene ; pharmacology ; Female ; Hippocampus ; cytology ; drug effects ; Male ; Neurons ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Temperature

OBJECTIVETo investigate the safety and efficiency of the disposable circumcision suture device (DCSD) in the surgical treatment of phimosis and redundant prepuce.

METHODSWe randomly assigned 249 outpatients with phimosis or redundant prepuce to be treated with DCSD (n = 129) and by conventional circumcision (CC, n = 120), respectively. Then we compared the safety and efficiency of the two strategies.

RESULTSComparisons between DCSD and CC showed that the operation time was (4.02 +/- 0.69) vs (30.8 +/- 4.05) min, blood loss was (1.07 +/- 1.29) vs (8.72 +/- 2.15) ml, intraoperative pain score was 0.81 +/- 0.81 vs 2.42 +/- 1.15, 24-hour postoperative pain score was 1.84 +/- 1.02 vs 4.99 +/- 1.36, postoperative complication rate was 13. 95% (18/129) vs 9.17% (11/120), wound healing time was (13.99 +/- 9.06) vs (17.48 +/- 3.49) d, satisfaction with the penile appearance was 98.4% (127/129) vs 95% (109/120), and treatment cost was (2215.62 +/- 17.67) vs (576.47 + 15.58) Y RMB. DCSD exhibited obvious superiority over CC for shorter operation time, less blood loss, milder intraoperative pain, sooner wound healing, and better penile appearance, but it also had a higher rate of postoperative complications (P > 0.05) and involved more treatment cost than the latter (P < 0.05).

CONCLUSIONThe disposable circumcision suture device affords ideal clinical effects and therefore deserves clinical popularization.

Circumcision, Male ; instrumentation ; Disposable Equipment ; Follow-Up Studies ; Humans ; Male ; Phimosis ; surgery ; Surgical Staplers ; Treatment Outcome

OBJECTIVETo study how CCR5delta32, CCR5m303, CCR2-64I, SDF1-3'A gene polymorphisms affect the prognosis of Chinese HIV-1 carrier.

METHODSEpidemiologic survey was done to the HIV-1 carriers who were found in Shenzhen area. PCR/RFLP technology was applied to analyze CCR5delta32, CCR5m303, CCR2-64I, SDF1-3'A gene polymorphisms of the HIV-1 carriers. The plasma virus load and CD4+ cell counting was assayed. The incubation period of some carriers was estimated. SPSS11.0 software was used to analyze the data.

RESULTSNo persons with CCR5delta32 and CCR5m303 mutation genotype were found from 189 HIV-1 carriers. SDF1-3'A allele frequency was 26.14% and CCR2-64I allele 19.82%. The carriers were divided into high virus load group (virus load < 20,000 copies/ml) and low virus load group (virus load > or =20,000 copies/ml). It was found by one-way ANOVA analysis on the logarithm of virus load that there was no significant difference between CCR2-64I wild genotype and cross bred genotype (P=0.272). One-way ANOVA analysis on delitescence of some carriers showed that there was not significant difference between CCR2-64I wild genotype and cross bred genotype (P=0.662). One-way ANOVA analysis on the logarithm of virus load showed that there was significant difference among SDF1-3'A wild genotype, cross bred genotype and pure mutation genotype (P=0.001).

CONCLUSIONCCR2-64I gene mutation may not significantly affect virus load of Chinese HIV-1 carriers, nor it affect the incubation period of HIV-1 carriers. SDF1-3'A gene mutation can decrease virus load, but it may not prolong the incubation period of HIV-1 carriers.

Acquired Immunodeficiency Syndrome ; genetics ; pathology ; virology ; Carrier State ; Chemokine CXCL12 ; genetics ; China ; Gene Frequency ; Genotype ; HIV-1 ; Heterozygote ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Prognosis ; Receptors, CCR5 ; genetics

OBJECTIVETo evaluate the early operative treatment and clinical results of pelvic fractures associated with urethra disruption.

METHODSFrom January 1995 to January 2005, 25 patients suffered from pelvic fractures combined urethra disruption treated by operation were retrospectively analyzed. According to Tile's classification, 1 case was stable pelvic fracture, 17 rotational unstable fractures, and 7 rotational combined vertical unstable fractures. The complete urethra rupture were in 23 cases and incomplete in 2 cases. The operative methods included: (1) emergency open reduction and internal fixation of the pelvis combined primary urethra suturing in 2 cases, partial suturing after realignment in 4 cases, realignment in 2 cases, and urethrovaginal penetrating wound repairing in 1 case; (2) primary urethra realignment only and delayed (range, 7 to 21 days) pelvic internal fixation in 10 cases; (3) early cystostomy and delayed (range, 3 to 21 days) urethra realignment and pelvic internal fixation in 6 cases.

RESULTSThe mean follow-up time of all patients was 34 months (range from 6 to 120 months). According to Majeed's evaluation, 17 cases of pelvic injury showed excellent results, 5 good, and 3 fare. After urinary catheter removed, the mean maximal urine flow rate of 19 (76%) patients was 18.6 ml/s and the mean scar length between both disrupted ends on the film of excretion urethrography was 0.51 cm. Five (20%) cases suffered in dysuria needed urethral dilatation or further surgery. One (4%) female could not control urination who need a second-look operation. The primary suprapubic soft tissue avulsion wound infection secondary to retropubic abscess was found in 1 case, posterior urethra-stenosis in 5 cases, sexual impotence in 3 cases, and incontinence in 1 case.

CONCLUSIONSThe satisfactory reduction and effective fixation of the pelvic fractures is an anatomical basis for receiving "tension-free urethral anastomosis".

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Urethra ; injuries