Objective This present study explores and evaluates the effect of preliminary implementation in the clinical therapy programs for patients with chronic Keshan disease (CKD) in the disease seriously-affected endemic areas.Methods In 2010,seventy-six CKD patients with heart failure were chosen from Huangling and Xunyi Counties in Shaanxi Province,where incidences of CKD were high.Besides taking sodium selenite,all patients were given treatment with fixed prescription,which included angiotensin-converting enzyme inhibitor (captopril),β-blocker (propranolol),diuretics (hydrochlorothiazide,spironolactone) and cardiac (digoxin) for 4 months.The changes before and after treatment were analyzed,which included the changes of heart function by the United States of America New York Heart Association(NYHA) fractionation,cardiothoracic ratio,electrocardiogram,left ventricular ejection fraction(EF) and fractional shortening(FS).The therapeutic effect was subsequently evaluated.Results Seventy-four cases of the seventy-six CKD patients completed the treatment observation.The improvement rate of heart function was 81.1％ (60/74) after treatment.The elimination rates of ectopic rhythm,conduction block and ST-T changes were 37.5％ (9/24),2.7％ (1/36) and 26.9％ (7/26),respectively.The cardiothoracic ratios of heart function NYHA Ⅱ,Ⅲ and Ⅳ were 0.504 ± 0.051,0.572 ± 0.054 and 0.632 ± 0.063 before treatment.After treatment,the cardiothoracic ratios were 0.486 ± 0.048,0.538 ± 0.046 and 0.607 ± 0.048,which were reduced in all groups (t =2.643,6.641,3.005,all P ＜ 0.05),while the D-value of cardiothoracic ratio changes before and after treatment was not significantly different(F =3.005,P ＞ 0.05).Both the mild reduction group(35％≤EF ＜ 50％) and the moderate-severe group(EF ＜ 35％) EF were (43.62 ± 4.58)％,(27.57 ± 3.69)％ before treatment and were (48.21 ± 10.01)％,(36.57 ± 6.60)％ after treatment,EF were increased in the two groups,while the changes before and after treatment were significantly different(t =-2.911,-3.334,all P＜ 0.05).The EF D-value of the two groups was (4.59 ± 8.48)％ before treatment and was (9.00 ± 7.14)％ after treatment,which were not significantly different(P ＞ 0.05).FS was higher compared with pre-treatment in FS reduction group(FS ＜ 25％) and the changes before and after treatment[(19.75 ± 2.88)％,(21.92 ± 5.67)％] were significantly different(t =-2.297,P ＜ 0.05).Conclusions This study shows that the feasibility of clinical treatment of patients with CKD is very promising.The treatment of fixed prescription is effective.

Objective To explore the analgesic effect of intra-articular botulinum neurotoxin type A (BoNTA) injection in rats with adjuvant-arthritis pain,to quantify the expression of calcitonin gene-related peptide (CGRP) in the dorsal root ganglia (DRG) associated with arthritis pain,and to investigate the retrograde axonal transport of BoNT-A into the DRG after peripheral injection.Methods Ninety Sprague-Dawley rats were randomly divided into groups A,B,C,D and E,each of 18.A murine model of adjuvant-arthritis pain was established by injecting 50 μL of complete Freund's adjuvant into the left ankle in all the mice except those in group A.The control group A was treated with intra-articular injection of 50 μL of saline solution.Three weeks later,groups A and B were treated with a 20 μL intra-articular saline injection,while groups C,D and E received an intra-articular injection of BoNT-A at 1 U/20 μL,3 U/20 μL or 10 U/20 μL respectively.Pain threshold and muscle strength were graded before and 1,5,15 and 21 days after the modelling,as well as at 1,3,5 and 14 days after the BoNT-A treatments.Protein expression and the CGRP-positive cell number were observed,as well as any BoNT-A-cleaved synaptosomal-associated 25 kDa protein (cl-SNAP-25) in the DRG using Western blotting and immunofluorescence.Results Compared with group A,there was a significant decrease in the average mechanical withdrawal threshold and muscle strength and a significant increase in the protein expression and the CGRP-positive cell number in the other 4 groups.Compared with group B,the mechanical withdrawal threshold had increased significantly more in groups D and E at 5 days after the BoNT-A injection and in group C at 14 days after the treatment.Compared with group B,the protein expression and the number of CGRP-positive cells were significantly lower in groups D and E at 3 days after the BoNT-A injection.The decrease in group C was significant after 14 days.No significant differences were found between groups D and E in any measurement at any time point.There was no significant difference among groups B,C and D in terms of muscle strength.Five days after the BoNT-A injection,significantly decreased muscle strength was observed in group E.In addition,BoNT-A cleaved-SNAP-25 was detected in the DRG.Conclusion BoNT-A can reduce arthritis pain through inhibiting the expression of CGRP in the DRG.Its analgesic effect has a dose response.A peripheral injection of BoNT-A can arrive at the DRG through retrograde axonal transport.

Cognitive impairment is a common complication of diabetes. Hippocampus plays an important role in cognitive function. In hyperglycemia, synaptophysin, a crucial synaptic vesicle membrane protein in hippocampus neuron is found to be down-regulated. Recent evidences have shown that angiotensin IV can facilitate memory acquisition and recovery. However, whether it can also improve cognitive functions of diabetic rats with cognitive disorder, and the possible mechanisms are uncertain. Hence, the objectives of this study. Forty fi ve Sprague Dawley male rats were randomly divided into three groups: Control, diabetic group and diabetes with angiotensin IV treatment group. The cognitive functions, mainly learning and memory of the rats were evaluated using Morris water maze task. The synapses ultrastructure, relative mRNA concentrations and protein expression levels of synaptophysin in hippocampus CA1 area were estimated using transmission electron microscope, RT-PCR, immunohistochemistry and western blotting, respectively. Our study showed that in the diabetic rats with angiotensin IV treatment, the cognitive impairment as measured by Morris water maze task improved, the ultrastructure of synapses in hippocampus reversed, the relative mRNA concentrations and protein levels of synaptophysin in hippocampus signifi cantly increased, when compared with diabetic rats. We conclude that angiotensin IV plays an important role in improving cognitive function of diabetic rats. The possible mechanisms are up-regulating the expression of synaptophysin and normalizing the ultrastructure of synapses in hippocampus.

OBJECTIVETo investigate the antitumor effect of recombinant IFN-alpha-2b-BCG on mouse bladder cancer MB49 cells in vitro, and to explore its antitumor mechanisms.

METHODSMB49 cells were co-cultured with recombinant BCG or wild BCG, and than were examined by light and transmission electron microscopy. The cell growth was assessed by MTT assay, and apoptosis rate and MHC-I of the MB49 cells was detected by flow cytometry using AO and Hoechst33258 fluorescence immunostaining.

RESULTSThe hIFN-alpha-2b-BCG-treated tumor cells showed slow growth, detachment of some cells, and various degree of degeneration. Light microscopy revealed organelle disorganization, chromatin aggregation, nuclear pyknosis, and cytolysis in some cells. Cellular membrane bulged and some bubbles were seen under fluorescence microscope using AO staining. Hoechst33258 assay also depicted frequent apoptosis in the tumor cells. The MTT assay showed that rBCG more actively than the wild BCG inhibited the proliferation of MB49 cells. The apoptosis rate of the recombinant BCG group was 19.7% and 46.6% at the time point of 24 h and 48 h, respectively, significantly higher than 10.8% and 20.9%, respectively, in the wild BCG group. The results of flow cytometry indicated that both types of BCG enhanced the expression of MHC-I in the MB49 cells, but more effective in the recombinant BCG group.

CONCLUSIONThe recombinant hIFN-alpha-2b-BCG has more strong immuno-modulatory properties, anti-tumor effect on MB49 cells and induces apparent cytotoxicity in the bladder cancer cells in vitro.

Adjuvants, Immunologic ; pharmacology ; Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; BCG Vaccine ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytotoxicity, Immunologic ; Histocompatibility Antigens Class I ; metabolism ; Interferon-alpha ; pharmacology ; Mice ; Recombinant Proteins ; pharmacology ; Urinary Bladder Neoplasms ; metabolism ; pathology

OBJECTIVETo investigate the effect of Shenmai Injection (SMI) on immunologic function in patients with dilated cardiomyopathy (DCM).

METHODSFifty-six patients were divided into two groups, the control group treated with conventional western medicine, and the SMI group treated with conventional western medicine plus SMI. The indices including red blood cell (RBC) C3b receptor rosette (RBC-C3bRR) and immune complex rosette (RBC-ICR), T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were determined before and after treatment.

RESULTSThe level of RBC-C3bRR, CD4, CD8 and CD3 in patients with DCM were significantly decreased (P <0 .01, P < 0.05), RBC-ICR and CD4/CD8 were significantly increased than those in the normal control group (P < 0.01); While the level of RBC-C3bRR, CD4, CD8 and CD3 in the SMI group after treatment were significantly higher, and the level of RBC-ICR and CD4/CD8 were significantly lower (P < 0.01, P < 0.05) than those in the control group.

CONCLUSIONThe RBC immune adherence and cellular immune function are lower in patients with DCM, and SMI has the effect in regulating immune function in patients with DCM.

Cardiomyopathy, Dilated ; drug therapy ; immunology ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Erythrocytes ; immunology ; Female ; Humans ; Immune Adherence Reaction ; Male ; Phytotherapy ; Plant Extracts ; therapeutic use ; Receptors, Complement 3b ; blood ; Rosette Formation ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo improve the life quality of cancer patients with metastasis to long bone and to select suitable surgical treatment.

METHODSFifty two patients with metastasis 27 men and 25 women, were treated from 1990 to 1999. Their average age was 56.8 years (33 - 74). In 16 patients with multiple lesions, underwent surgery at bone shaft (29 patients) and bone epiphysis (26). Thirty patients were treated for pathologic fracture and the rest for impending fracture. Operations included limb-salvage (51 patients) and amputation (4) Limb salvage consisted of intralesional curettage (3 patients), intramedullary nailing reconstruction (29), endoprosthesis (18), and temporary spacer (1). 21 patients accepted postoperative chemotherapy or radiotherapy.

RESULTSFollow-up of 52 patients for a mean of 28.2 months (2 - 122 months) showed pain relief (41 patients), (75%) and full or part weight-bearing stability (36) 69%. Local tumor recurrence occurred in 11 patients.

CONCLUSIONSSurgical treatment can effectively improve the life quality of patients with metastasis to long bone. The metastatic lesions should be resected with wide or radical margin for the patients with kidney, breast, prostate and thyroid cancer.

Adult ; Aged ; Bone Neoplasms ; pathology ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Limb Salvage ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the surgical treatment and outcome of autogenous bone grafting and internal fixation in management of bone nonunion after massive allograft transplantation.

METHODSFrom January 1994 to December 2006, 41 of 176 patients underwent bone nonunion after massive allograft transplantation. Twenty-two of 41 patients received autogenous bone grafting. Complete clinical and follow-up data was available for 15 cases. The average age at secondary autogenous bone grafting was 24 years old (ranging from 15 to 34). The primary diseases included osteosarcoma (5 cases), giant cell tumor (4 cases), parosteal osteosarcoma (2 cases), hemangioendothelioma (2 cases) and primitive neuroectodermal tumor (2 cases). Tumor was located at distal femur in 7 patients, middle of humerus in 3, middle of femur in 2, proximal tibia in 2 and proximal humerus in 1. Eight of 15 patients with simple bone nonunion received autogenous bone grafting. Another 7 patients with bone nonunion and fracture of primary internal fixation underwent autogenous bone grafting and re-internal fixation.

RESULTSAt a mean follow-up of 46.8 months (ranging from 18 to 148 months), bone union was observed in 13 of 15 patients (86.7%) with the mean healing time 13.3 months (ranging from 5 to 20). Bone union could be observed in all 8 patients with simple bone nonunion and 5 of 7 patients with bone nonunion and internal fixation fracture, similar healing time 14 and 12 months respectively. There was no infection or any other complications. Two patients underwent re-nonunion received prosthesis replacement at last. The mean MSTS score of 13 patients was 25.1, with 8 simple bone nonunion patients and 5 combined with internal fixation fracture patients 25.4 and 24.6 respectively, also basically no difference.

CONCLUSIONSAutogenous bone grafting and internal fixation in management of nonunion after massive allograft transplantation have the advantage of easy operation, less complications, high rate of bone healing and good function result with obvious superiority to prosthesis replacement. For management of nonunion after massive allograft transplantation, autogenous bone grafting and internal fixation is mostly recommended.

Adolescent ; Adult ; Bone Neoplasms ; surgery ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Reoperation ; Retrospective Studies ; Transplantation, Homologous ; Young Adult

OBJECTIVETo investigate the effect of 1, 2-dichloroethane (1, 2-DCE) on blood brain barrier.

METHODSAcute toxic encephalopathy model was copied with the consecutive static inhalation of 1, 2-DCE. The water content of brain tissue was measured, and the blood brain barrier permeability was detected with lanthanum nitrate. The brain microvascular endothelial cells and neuroglial cells were cultured in vitro, which were administrated with 1, 2-DCE. The cell morphologic structures were observed under light microscope and electron microscope.

RESULTS(1) The extracellular edema was most found in the cerebral tissue and the leakage of lanthanum particles through the barrier were found with the lanthanum tracking method. (2) The water content in cerebral cortex in the moderate and high dose groups was significantly higher than that in the control group and became severer with the increases of the intoxicated time. The water content in cerebral medulla was significantly increased only at 6 hours after the intoxication. (3) The normal morphological structure of brain microvascular endothelial cells and neuroglial cells could be injured by 1, 2-DCE, and the injury to neuroglial cells caused by 1, 2-DCE occurred earlier and severer than that to brain microvascular endothelial cells.

CONCLUSION1, 2-DCE can damage blood brain barrier and induce cerebral edema.

Administration, Inhalation ; Animals ; Blood-Brain Barrier ; drug effects ; Brain ; pathology ; Brain Edema ; chemically induced ; pathology ; Cells, Cultured ; Dose-Response Relationship, Drug ; Endothelial Cells ; drug effects ; pathology ; Ethylene Dichlorides ; toxicity ; Female ; Male ; Rats ; Rats, Sprague-Dawley

Objective To investigate whether alpha-lipoic acid (ALA) possesses neuroprotective effects against high glucose-induced damage in vitro.Methods The cultured human lens epithelial cells (HLEC-B3 cells) were divided into normal control group,high glucose group and ALA group.Normal control group left untreated,ALA group was pretreated with different concentrations of ALA (25 μmol · L-1,50 μmol · L-1,100 μmol · L-1) for 1h,and then ALA group and high glucose group were cultured under high glucose conditions for 48h.After above treatment,the activity of lens epithelial cells in each group was detected immediately by MTT,and the changes in intracellular reactive oxygen species (ROS) were detected by flow cytometry.In addition,the expression of manganese superoxide dismutase (MnSOD) was detected by Western blot and RT-PCR in all groups.Results The activity of HLEC-B3 cells in high glucose group was 53.60％ ±4.10％,which was significantly lower than that in normal control group (P ＜ 0.01).The cell viability in 25 μmol · L-1,50 μmol · L-1,100 μmol · L-1 ALA group was 65.30％ ± 3.70％,72.70％ ± 4.90％ and 83.40％ ± 3.60％,respectively,all which were higher than those in the high glucose group (all P ＜ 0.05).Flow cytometry showed that intracellular ROS level in the high glucose group was significantly higher than that in the normal control group (P ＜ 0.01),but ROS levels were decreased to 14.70％ ±0.70％,8.70％ ±0.87％,5.20％ ±0.53％ after25 μmol· L-1,50 μmol· L-1,100 μmol · L-1 ALA treatment,respectively,with significant difference (all P ＜ 0.01).RT-PCR and Western blot results indicated that the relative expression of MnSOD mRNA and protein in the high glucose group was significantly lower than that in the normal control group (all P ＜ 0.01).Compared with the high glucose group,MnSOD mRNA and protein relative expression levels were significantly increased to 0.63 ± 0.06,0.71 ± 0.06,0.84 ± 0.04,and 0.25 ± 0.03,0.31 ± 0.02,0.45 ± 0.04,respectively (all P ＜ 0.05).In addition,the protective effects of ALA (25-100 μmol · L-1) on HLEC-B3 cells induced by high glucose was in a dose-dependent manner.Conclusion ALA has a protective effect on human lens epithelial cell line HLEC-B3 cultured in high glucose condition,and this protective effect may be achieved by increasing the expression level of intracellular MnSOD.

Objective:To investigate the clinical efficacy of laparoscopic resection of retrorectal cystic lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 patients undergoing laparoscopic resection of retrorectal cystic lesions in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2012 to August 2019 were collected. There were 5 males and 53 females, aged from 15 to 70 years, with a median age of 38 years. All the 58 patients underwent laparoscopic resection of retrorectal cystic lesions and the combined operation through the transsacral approach was chosen according to the patient condition. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative histopathological examination; (4) follow-up. Patients were followed up regularly using outpatient examination once every 6 months during the first postoperative year and once every 12 months after the first postoperative year. The recurrence of cysts was evaluated by computed tomography or magnetic resonance imaging examinations during the follow-up up to August 2020. Measurement data with normal distribution were represented as Mean± SD and measurement data with skewed distribution were described as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: of the 58 patients, 54 cases underwent laparoscopic resection of retrorectal cystic lesions and 4 cases underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation. One of the 58 patients who had a huge cyst surrounding the rectum underwent transverse colostomy after repairing the damage of separated posterior wall of rectum. Two cases underwent preventive transverse colostomy because the external rectal wall heat injury could not be excluded after separation of the tight adhesion between cyst and rectum. The operation time and volume of intraoperative blood loss were (123±56)minutes, 20 mL(range, 5?500 mL) of 54 cases who underwent laparoscopic resection of retrorectal cystic lesions and (232±38)minutes, 90 mL(range, 30?800 mL) of 4 cases who underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation, respectively. (2) Postoperative situations: 7 of the 58 patients had complica-tions. Of the 7 patients, 2 cases had postoperative rectal fistula and were cured after the treatment of transverse colostomy combined with pelvic drainage, 2 cases had postoperative urinary tract infection and were relieved after anti-infection treatment, 2 cases had urinary retention after removal of catheter and were recovered after 3 weeks of re-indwelling catheter, and 1 case had poor incision healing of transsacral and was healed after wound dressing change. The duration of postoperative hospital stay of the 58 patients was (7±4)days. (3) Postoperative histopathological examination: results of the postoperative histopathological examination showed that there were 26 of 58 patients with epidermoid cyst, 20 patients with teratoma (2 cases with mature teratoma accompanied by mucinous adenocarcinoma and 1 case with mature teratoma accompanied by neuroendocrine carcinoma), 10 patients with dermoid cyst, and 2 patients with tailgut cyst. (4) Follow-up: 57 of the 58 patients were followed up for 2-85 months, with a median follow-up time of 51 months. Of the 57 patients who were followed up, 1 patient was diagnosed with buttock subcutaneous cyst at postoperative 8 months and treated with local excision, 1 patient was diagnosed with a small presacral cyst recurrence by pelvic magnetic resonance imaging at postoperative 6 months and continued follow-up as the cyst without obvious enlargement, and the other 55 patients had no cyst recurrence.Conclusion:The laparoscopic resection of retrorectal cystic lesions is safe and feasible.