OBJECTIVECoronary heart disease (CHD) is one of the most common causes of death in the world. Some studies suggested that CHD begins in childhood. Obesity and dyslipidemia are important risk factors of coronary heart disease. Apolipoprotein (apo)E gene associated with dyslipidemia and coronary heart disease. The present study was designed to investigate the expression status of apoE gene in peripheral blood monocyte and association of apoE gene expression with lipids in children with obesity.

METHODSAmong 32 children with obesity and 32 healthy children without obesity or overweight, ApoE gene expressions were determined by competitive reverse transcription-polymerase chain reaction in peripheral blood monocyte. The concentrations of plasma triglyceride, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, lipoprotein(a), apoA I, apoB(100) and apoE were measured.

RESULTSExpression of apoE gene was detected in peripheral blood monocyte. Expression of apoE gene was significantly reduced in children with obesity as compared with control group (0.29 +/- 0.14 moles/mole GAPDH mRNA vs. 0.36 +/- 0.10 moles/mole GAPDH mRNA, t = 2.15, P < 0.05). The more severe was the degree of obesity, the more significantly reduced the expression of apoE gene; the degree of obesity was negatively correlated with the levels of expression of apoE gene (correlation coefficient = -0.40, P < 0.05). Compared with control group, the levels of triglyceride, total cholesterol, low density lipoprotein-cholesterol, and apoB(100) were higher, and those of high density lipoprotein-cholesterol, apoA I and apoE were lower in children with obesity [(1.68 +/- 0.50) mmol/L vs. (0.99 +/- 0.54) mmol/L, (4.47 +/- 0.91) mmol/L vs. (3.33 +/- 0.90) mmol/L, (2.23 +/- 0.71) mmol/L vs. (1.13 +/- 0.96) mmol/L, (94.48 +/- 9.97) mg/dl vs. (83.81 +/- 15.64) mg/dl, (1.47 +/- 0.39) mmol/L vs. (1.73 +/- 0.36) mmol/L, (112.71 +/- 27.86) mg/dl vs. (134.80 +/- 45.36) mg/dl, (24.50 +/- 10.92) mg/L vs.(35.07 +/- 9.79) mg/L, respectively, P < 0.05]. ApoE gene expression was associated with plasma lipids metabolism in children with obesity. The quantity of apoE gene expression was inversely associated with low density lipoprotein-cholesterol, positively correlated with apoE (correlation coefficient = -0.33, 0.35, respectively, P < 0.05). The quantity of apoE gene expression was not associated with total cholesterol, triglyceride, high density lipoprotein-cholesterol, lipoprotein(a), apoA I, and apoB(100) (correlation coefficient = -0.19, -0.11, 0.16, 0.09, 0.18, 0.22, P > 0.05).

CONCLUSIONExpression of apoE gene was significantly reduced in peripheral blood monocyte in children with obesity. The quantity of apoE gene expression was associated with degree of obesity and abnormality of blood lipids.

Apolipoproteins E ; genetics ; Child ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Expression ; genetics ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; Obesity ; blood ; genetics ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Triglycerides ; blood

Adult ; Antigens, Neoplasm ; analysis ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Melanoma ; cerebrospinal fluid ; metabolism ; pathology ; Melanoma-Specific Antigens ; Melanosis ; cerebrospinal fluid ; metabolism ; pathology ; Meningeal Neoplasms ; cerebrospinal fluid ; metabolism ; pathology ; Meninges ; chemistry ; pathology ; Neoplasm Proteins ; analysis ; S100 Proteins ; analysis

Objective To investigate clinical symptoms,pathophysiology and brain imaging features of Chinese familial cerebral cavernous angiomas.Methods Head MRI examination,clinical and pathophysiological examination were performed in a Chinese family with one proband of cerebral cavernous malformation.The disease atlas of the family was drawn.The patients indicative of a surgery underwent resection of hemangioma whose pathophysiology and microstructure were observed.Results Nine familial cerebral cavernous angiomas patients were found to have multiple intracranial lesion in the 18 family members,the penetrance being 50%,conforming to the feature of autosomal incomplete dominance inheritance.Four patients with skin cavernous hemangioma had familial cerebral cavernous angiomas.MRI was the most sensitive modality for the diagnosis of cavernous angioma.With T_2-Weighted sequences,the lesion was typically characterized by an area of mixed signal intensity,with a central reticulated core and a peripheral rim of decreased signal intensity related to deposition of hemosiderin.Gradient-echo(GRE)MRI could find microcavernous hemangiomas that would not be found in other sequences.Cavernous angiomas were typically discrete multilobulated berrylike lesions that contained hemorrhage in various stages of evolution.Histological homogeneity and overlap with other vascular malformations such as capillary telangictasia was common.Cavernous angiomas were composed of endothelial-linked sinusoidal spaces not separated by significant amounts of neural tissue.Hemorrhagic residua were common.Clots at different stages of evolution within the lesion were seen.The basic membranes of sinus became thick and soft.Parts of it were layered.Conclusions Familial cerebral cavernous angiomas is an autosomal incomplete dominance inheritance disease.Cavernous angiomas are composed of endothelial-linked sinusoidal spaces not separated by significant amounts of neural tissue.There are more than one focus in every patients and the skin cavernous angiomas is the foundation of diagnosing familial cerebral cavernous angiomas.Gradient-echo imagine sequence MRI(3.0 T)could be the"golden standard".

The clinical study was conducted to further evaluation the effectiveness and safety of Fangfeng Tongsheng granule in the treatment of sub-acute eczema (superficial cold and interior heat syndrome, exterior and interior sthenic syndrome). In the block randomized, multi-centered study, totally 108 patients were enrolled and assigned to two groups: 72 patients in the test group and 36 patients in the placebo control group. Those in the test group took Fangfeng Tongsheng granule with the dose of 3 g, twice a day, while those in the control group were give simulated agent granules with the same dose. The therapeutic course lasted for 14 days. Their efficacies in TCM syndrome, dermal symptoms and adverse events were observed. According to the test results, except for the one exit case, all of the remaining 108 cases, including 71 in the test group, and 36 in the control group, completed the clinical trial. As for the efficacy of TCM syndrome, after the medication for 2 weeks, the cure rate was 33.81% (24/71) in the test group and 0% (0/36) in the control group (P < 0.01), with a statistical difference between the two groups. Regarding the TCM score, after the medication for 2 weeks, the test group decreased by (12.82 +/- 7.96), while the control group decreased by (3.67 +/- 4.12), indicating a statistical difference between the two groups. As for the efficacy of dermal symptoms, after the medication for 2 weeks, the cure rate was 25.35% (18/71) in the test group and 0% (0/36) in the control group, with a statistical difference between the two groups. Regarding the dermal symptom score, after the medication for 2 weeks., the test group decreased by (10.04 +/- 7.17), while the control group decreased by (2.33 +/- 3.57), indicating a statistical difference between the two groups. There was no significant adverse event caused by Fangfeng Tongsheng granule. In conclusion, Fangfeng Tongsheng granule was effective and safe in treating subcute eczema (superficial cold and interior heat syndrome, exterior and interior sthenic syndrome).
Adolescent ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Eczema ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the efficacy and safety of the comprehensive protocol of integrative medicine in preventing and treating perioperative delayed cerebrovasospasm (DCVS) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

METHODSUsing a prospective randomized controlled trial design, 63 aSAH inpatients were assigned to the treatment group (31 cases, 24 treated by intervention treatment and 7 by craniotomy) and the control group (32 cases, 26 treated by intervention treatment and 6 by craniotomy). All patients were treated with basic therapy and nimodipine. Those in the treatment group additionally took naomai jiejing decoction No. 1 and No. 2. The incidence and the mortality of DCVS, re-bleeding, hydrocephalus were compared on the 180th day. The middle cerebral artery mean flow velocity (Vm), PI value, linde-gard index on day 1, 3, 7, and 14 were compared. The Chinese medicine syndrome score, NIHSS, and revised Rankin questionnaire on day 1, 14, and 180 were compared.

RESULTSThe DCVS occurred in 9 cases (29. 0%) of the treatment group and 17 patients (53.1%) of the control group, showing statistical difference (P < 0.05). The occurrence of re-hemorrhage was obviously lower in the treatment than in the control group (3.2% vs. 6.2%), showing statistical difference (P < 0. 05). There was no statistical difference in the mortality (6.4% vs. 9.4%) or the occurrence of hydrocephalus (29.0% vs 25.0%, P > 0.05). The Vm, PI, and linde-gard index on day 7, the Vm and linde-gard index on day 14 were obviously lower in the treatment group than in the control group (P < 0.05). The Chinese medicine syndrome score and NIHSS on day 14 and 180 were lower in the treatment group than in the control group, showing statistical difference (P < 0.05).

CONCLUSIONThe comprehensive protocol of integrative medicine could reduce the incidence of aSAH patients' DCVS, the Chinese medicine syndrome score and NIHSS, and improve their clinical symptoms.

Adolescent ; Adult ; Aged ; Cerebrovascular Disorders ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Intracranial Aneurysm ; complications ; Intraoperative Period ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; Prospective Studies ; Subarachnoid Hemorrhage ; etiology ; therapy ; Treatment Outcome ; Young Adult

Objective To clarify the different prognostic characteristics between profound sudden sensorineural hearing loss (SSNHL) and total SSNHL. Methods The patients with SSNHL who visited Eye Ear Nose and Throat Hospital from June 2007 to September 2008 were reviewed retrospectively. All the 204 patients, with pure tone average (PTA) threshold more than 90 dB, were enrolled and divided into two groups, including total SSNHL and profound SSNHL groups. The relationship between recovery rate and prognostic factors including the age, complications, time period between onset and therapy was analyzed.Results There were 57 cases of total SSNHL and 147 cases of profound SSNHL in this series. Tinnitus was complained in more than 90% of the patients in both groups, which was higher than that of dizziness and ear fullness. Dizziness was present in 64. 9% (37/57) patient with total SSNHL group and 45.6% (67/147)patients with profound SSNHL, which had significant difference between the two groups (x2 = 5.72,P =0. 017). The PTA threshold improvement in total SSNHL group and profound SSNHL group was (36. 4 ±19.3) dB and (40. 2 ±21.3) dB respectively, which was no significant difference between the two groups (t = 1. 165 ,P =0. 245). The cured patients were all those received therapy within 1 week following the onset of SSNHL, which was of 2. 6% (1/38) patients in the total SSNHL group and 14. 3% (14/98) patients in the profound SSNHL group(P =0. 045). Furthermore, 3.5% (2/57) patients in total SSNHL group as well as 29. 9% (44/147) patients in profound SSNHL group obtained a good result with PTA threshold ≤50 dB after therapy(x2 = 15.92,P = 0. 001 ). In addition, the favorable prognosis was related with the onsettherapy time point( P = 0. 001 ), but not related to the patients' age. Conclusion Profound SSNHL and total SSNHL though both with PTA threshold > 90 dB had significant differences recovery rate and need to be studied separately.

OBJECTIVETo investigate the role of Th17 cells in immune thrombocytopenia (ITP) mice model.

METHODITP was induced by daily intraperitoneal injection of anti-platelet membrane CD41 antibody (MWReg30) into BALB/c mice, the mRNA expressions of Th17 cell associated transcription factors and cytokines in peripheral blood and spleen mononuclear cells were measured by real-time PCR, and the proportion of Th17 cells by FCM analysis.

RESULTSThe percentage of Th17 cell was significantly elevated in ITP mice both in splenocyte and peripheral blood as compared with that in normal controls (P<0.01). ITP mice had elevated mRNA expressions of IL-17F, IL-17A and IL-6 in splenocyte (P<0.05), and of IL-21 in peripheral blood (P<0.05). There was a positive correlation between IL-17A and IL-17F (r = 0.934, P = 0.000), and between IL-17A/IL-17F and IL-6 (r = 0.598, P = 0.001; r = 0. 619, P = 0.000).

CONCLUSIONSTh17 cell might play an important role in the pathogenesis of ITP, at least involving in the clearance of platelets.

Animals ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred BALB C ; Th17 Cells ; immunology ; Thrombocytopenia ; immunology

Objective To investigate the effect of preoperative portal venous thrombosis on liver transplantation for patients with end-stage liver cirrhosis.Methods Clinical data of 182 patients with end-stage liver cirrhosis undergoing liver transplantation at the Organ Transplantation Center of the Third Affiliated Hospital,Sun Yat-sen University from January 2007 to December 2011 were retrospectively studied.Thirteen patients complicated with portal venous thrombosis (3 patients were in Yerdel gradeⅠ,6 were in grade Ⅱ,2 were in grade Ⅲ and 2 were in grade Ⅳ)were divided into the portal venous thrombosis group.Other 169 patients without portal venous thrombosis were divided into the control group. The intra-operative and postoperative conditions of patients were compared between two groups.Results Compared with the control group,there were longer operation time,more intra-operative blood loss in the portal venous thrombosis group and the patient with Yerdel grade Ⅲ-Ⅳ.There was significant difference (both in P <0.05).At one month after transplantation,one patient (8%)in the portal venous thrombosis group and three patients (2%)in the control group developed portal venous thrombosis,and there was significant difference (P <0.05).Three-year survival rate of the portal venous thrombosis group was 46% (6 /13)and that of the control group was 84%(142 /169),and there was significant difference (P <0.05).Conclusions Portal venous thrombosis of gradeⅢ and Ⅳ may significantly increase the difficulty and risks of liver transplantation.However,the good curative effect may also be obtained only when the portal venous thrombosis is strictly assessed ,and the rational portal venous reconstruction method is used during the operation.

Objective To evaluate the influence of devascularization and shunt on liver transplantation in patients diagnosed with portal hypertension. Methods Clinical data of 182 patients diagnosed with cirrhosis,portal hypertension complicated with hemorrhages caused by esophageal and gastric varices rupture undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from January 2007 to December 201 1 were retrospectively analyzed. Nineteen patients undergoing splenectomy plus pericardial devascularization were assigned into the devascularization group,5 receiving distal spleen-renal vein shunt into the shunt group,and the remaining 158 cases with no history of devascularization or shunt into the control group. Preoperative incidence of pylethrombosis,operation time,intraoperative hemorrhage volume,the maximal blood flow velocity (Vmax )of portal vein anastomotic stoma at postoperative 1 month,postoperative incidence of pylethrombosis and 3-year survival rate were statistically compared among three groups. Results In the devascularization group,preoperative incidence of pylethrombosis was significantly higher compared with that in the control group(P<0.01).Compared with the control group,operation time of liver transplantation in the devascularization and shunt groups was significantly longer (both P<0.05 ). The incidence of pylethrombosis at postoperative 1 month was considerably enhanced in the devascularization group (P <0.05 ). The 3-year survival rates of devascularization group and shunt group were dramatically decreased compared with that of control group (both P<0.05 ). Intraoperative hemorrhage volume and Vmax of portal vein anastomotic stoma did not significantly differ among three groups (all P>0.05 ). Conclusions The medical history of devascularization or shunt will not cause severe difficulty or surgical risk to subsequent liver transplantation in patients with portal hypertension.

OBJECTIVETo observe the clinical effect and security of Sanqi Tongshu capsule in treating ischemic strkoe.

METHODA multicenter, no dummy, open labeled clincal trail was conducted. 1 753 patient were enrolled in this clinical trial. All patients were treated with the Sanqi Tongshu capsule (200 mg, three times a day) for 28 days. The score of Europe Stroke Score (ESS) and Barthel Index (BI) were evaluated before and after treatment. The adverse reaction occurred in the therapeutic course was also observed.

RESULTFinally, 1742 cases and 1676 cases were respectively assessable by Full analysis set (FAS) analysis and Full analysis set (FAS) analysis. Clinical symptoms markedly improved in patients after treatment, and the score of ESS and BI had significantly improved (P<0.05). According to the score of ESS and BI, the total effect analysis indicated that the total effective rate in FAS and PPS were 81.86% and 84.43% respectively. The rate of adverse reaction was 3.44%, and the raction was so slight that didn't need to receive therapy or withdral drug.

CONCLUSIONSanqi Tongshu capsule is effect and secure in treating ischemic stroke without obvious adverse reaction.

Aged ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Stroke ; drug therapy ; pathology ; Treatment Outcome