Six cases of Paget′s disease of bone, including 5 males and 1 female, aged (57. 7 ±11. 8) years old, were recruited. Mean duration of disease was (7. 5±6. 5) years. Clinical manifestations were bone pain and bone deformity. The lesions mainly reside in the pelvis and femur. X-ray film showed typical lesion of Paget′s disease of bone, such as impaired bone trabecular structure with coarseness and disorder, cortical thickening, medullary cavity narrowing and skeletal deformation. Bone scan revealed abnormal radionuclide concentration in the involved bone. Serum alkaline phosphatase ( ALP) in 6 patients was increased ( median 235 U/ L). 5 patients received zoledronic acid sodium intravenous infusion therapy. Bone pain was relieved obviously in 5 patients after treatment for 2-3 months. Physical activity was greatly improved, and serum ALP levels significantly decreased.

A 47-year-old Chinese man with hypophosphatemic osteomalacia suffered from bone pain, difficulty in walking and pseudo-fractures. Biochemical examination showed a lowered serum phosphorus level and an elevated alkaline phosphatase level. The X-ray examination showed pseudo-fractures of multiple ribs, low bone density, biconcave deformities of the lumbar vertebrae, and pseudo-fracture of the right superior ramus of the pubis. A diagnosis of hypophosphatemic osteomalacia was made. The case was treated with oral neutral phosphate solution, calcitriol and Caltrate D. After treatment for two years, biochemical indicators were improved, and pseudo-fractures healed. Clinically, hypophosphatemic osteomalacia is often overlooked or misdiagnosed. In addition, the duration and dosage of these drugs should be appropriate, in order to avoid tertiary hyperparathyroidism or poor response to treatment.

BACKGROUND: In the clinical therapy for orthopedic diseases, the traditional administration easily induces the great fluctuation of drug concentration and side effect, and implanted drug carrier material hydroxyapatite (Hap) cannot be used in human's load bearing parts due to its poor mechanical performances, and poly-L-lactic acid (PLLA) is effortlessly degraded to acid byproducts. Drug carriers made from Hap/PLLA are supposed to not only persist releasing drug onto the lesion and reduce the side effect,but also obtain strength enhancement and eliminate tissue inflammatory reaction in favor of bone regeneration.OBJECTIVE: To observe the preparation of absorbable target control-release drug carrier and simulate the application of drugs.DESIGN: Observation trial.SETTING: Chongqing Institute of Technology and Wuhan University of Technology.MATERIALS: Tails of albino rats and PLLA (offered by Biological Center of Wuhan University of Technology), pepsin (1:10 000, Sigma company), Ca(OH)2, strong phosphoric, NaOH, glacial acetic acid, phosphate buffer (pH=7.4), 1,4-dioxane, absolute alcohol (Analytical reagent available on market).METHODS: The experiment was carried out in Chongqing Institute of Technology and Wuhan University of Technology. ①Type Ⅰ collagen (Col)was prepared by acid dissolution and alkali purification methods. Hap/Col bone-like biomimetic composite was synthesized through self-assembly mechanism of materials simulating in vitro biomineralization process of nature bone. X ray diffraction analysis and transmission electron microscope were applied to observe the characterization of composite's structure and morphology. ②The resultant product of HAP/Col composite was further synthesized with PLLA to prepare the three-dimensional porous reservoir type carrier for controlled release of drug employing thermal-induced phase separation technique. Scanning electron microscope, material test machine and specific gravity test method were used to investigate the pore structure and mechanical property of carrier material. ③The prepared Hap/Col/PLLA drug carrier was loaded with bromothymol blue to investigate in vitro control-release characteristic in simulated body fluid.MAIN OUTCOME MEASURES: ①Characterization of structure and morphology of Hap/Col bone-like biomimetic composite; ②Evaluation on the property and preparation technique of Hap/Col/PLLA drug carrier; ③Assessment on results of in vitro control-release trail of model composite.RESULTS: ①Hap nanocrystals formed as slender needles aligning with its crystalline c-axis preferentially oriented.②Hap/Col/PLLA drug carrier possessed apt pore configuration and physical properties for drug controlrelease.③In vitro release test by model compound revealed an approximate zero-orderslow release prior to its 80% release percentage.CONCLUSION: Hap/Col composite material is similar with natural bone, and Hap/Col/PLLA reservoir carrier can control drug release.

On the basis of understanding acupuncture method of inducing resuscitation (xing nao kai qiao) and training methods of modern rehabilitation medicine, new training methods were developed and could be used at different stages of stroke patients with upper-limb motor dysfunction, including acupuncture method of Jiquan acupoint (HT01) and rehabilitation training.

Objective To investigate the concurrent application value of indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA) in systemic lupus erythematosus (SLE).Methods A retrospective study.All patients who took anti-double stranded DNA (dsDNA) antibody test from June 1 2011 to September 30 2011 in our department were recruited in this study.The patients' anti-dsDNA antibody results and clinical diagnosis were collected and analyzed retrospectively.The consistence,sensitivity and specificity of IIF and ELISA tests were calculated and the consistence was compared by Kappa test.Results The positive rates of detecting anti-dsDNA antibodies by ELISA and IIF tests were 16.3％ and 13.1％ respectively.The consistency between these two tests was 90.8％,and showed good correlation by Kappa test (Kappa =0.641,P ＜ 0.05 ).Of 9.2％ of inconsistent results between IIF andi ELISA,most cases ( 6.2％ ) were ELISA positive and IIF negative.Taking the clinical diagnosis of lupus as a golden standard,the accuracy of IIF and ELISA was 84.8％ and 84.4％ respectively and the difference was no significant (x2 =0.25,P ＞ 0.05 ).The sensitivity and specificity for diagnosing lupus by IIF were 46.1％ and 99.2％,and 51.3％ and 96.7％ by ELISA.Conclusions Our results suggested that anti-dsDNA antibodies in samples should be detected by both ELISA and IIF tests simultaneously.If ELISA was used first and the positive samples were further tested by IIF,at least 3％ of ELISA negative and IIF positive samples would be misdiagnosed as anti-dsDNA antibodies negative.IIF negative and ELISA positive samples should be further analyzed the affinity of anti-dsDNA antibodies in order to help the diagnosis and evaluation of SLE.

The effects of tetrandrine (Tet) on blood pressure, plasma renin activity (PRA) and the contractility of the papillary mascle and portal vein were studied in rats. After 4 d administration of Tet 30 mg/kg, 2/d, ig, blood pressure was decreased markedly in anesthetized male SD rats, but there were no effects on heart rate and PRA. A single dose of Tet 15 mg/kg iv reduced blood pressure and heart rate significantly, while did not change PRA. This single dose produced similar hypotensive effect in rats with and without pretreatment of Tet 30 mg/kg, 2/d, 4d, indicating the absence of tolerance. Tet inhibited the paced papillary muscle contractility and the spontaneous portal vein contractility, and the EC50 were 5.33?10-6mol/L and 4.25?10-5 mol/L, respectively. So the vascular selectivity of Tet is 0.12.

OBJECTIVE To investigate the effect of overexpression of vascular cell adhesion molecule-1(VCAM-1)on the migration in vitro of the murine mesenchymal stem cells(MSCs)and its possible mechanism. METHODS The migration ability of normal mouse MSC (C3) ,empty vector-transfected MSC(C3+N) and VCAM-1 transfected MSC(C3+VCAM-1)was assessed by Transwell culture system in vitro after incubation for 8 and 12 h,respectively. The fetal bovine serum (FBS) was used as the chemotactic agent to induce MSC migration. The transmigrated cells were detected with methylosaniliam chloride(crystal violet)as well as DAPI staining.Furthermore,the specific chemical inhibitors of mitogen-activation protein kinase (MAPK) pathway ( SB203580,PD98059 and JNK inhibitorⅡ)were added to the Transwell system for 12 h and the alteration of the MSC migration ability was evaluated. RESULTS After incubation with FBS for 8 and 12 h,the absolute migrated cell number(7467 ± 485 and 8795 ± 255)and migration rate〔(14.9 ± 1.0)% and(17.6 ± 0.5)%〕of MSC in C3+VCAM-1 group were significantly increased compared with C3 group〔2731±562 and 4779±224, (5.5 ± 1.1)%and(9.6 ± 0.4)%〕and C3+N group〔2539 ± 321 and 5645 ± 1080,(5.1 ± 0.6)%and(11.3 ± 1.1)%〕(P<0.05,P<0.01),but there was no significant difference between C3 and C3+N groups. Moreover,the MSC migration ability of C3+VCAM-1 group was partially suppressed by addition of JNK inhibitorⅡ. The transmigrated cell number(4843 ± 167)and migration rate〔(9.7 ± 0.3)%〕were decreased compared with those of C3+VCAM-1 group without JNK inhibitorⅡ(P<0.01). SB203580 and PD98059,as specific chemical inhibitors of MAPK pathway,had no effect on MSC migration. CONCLUSION VCAM-1 can enhance mouse MSC migration in vitro and th4e mechanism may be related to JNK/MAPK pathway activation.

Objective To investigate the overall survival prediction of the Bolondi substaging model for patients in intermediate-stage of Barcelona clinic liver cancer (BCLC) after hepatectomy.Methods The retrospective cohort study was adopted.The clinical data of 343 patients with intermediate-stage hepatocellular carcinoma (HCC) who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University between February 2008 and January 2010 were collected.All the patients received the detailed medical history collection,physical examination,laboratory and imaging examinations after admission,and then hepatectomy was performed according to the results of above examinations.Research methods:(1) patients were allocated into the B1,B2 and B3/4 groups based on the Bolondi's substaging model,and the prognostic analyses among groups were conducted.(2) The related factors affecting the prognosis of patients in the B1 and B2 groups were analyzed.(3) The patients in the B1 and B2 groups were allocated into the 4 groups [patients of B1 group with negative microvascular invasion (MVI) were divided in the M1 group,patients of B1 group with positive MVI in the M2 group,patients of B2 group with negative MVI in the M3 group and patients of B2 group with positive MVI in the M4 group] according to the situations of MVI,and stratified analysis was conducted.Observation indicators:basic clinical and pathological features and survival of patients in the B1,B2 and B3/4 groups were observed.Risk factors analysis affecting the prognosis of patients and stratified analysis of MVI in the B1 and B2 groups were conducted.All the patients were followed up by outpatient examination and telephone interview up to February 2014,and the abdominal ultrasound,liver function and serum alpha-fetoprotein (AFP) tests was performed once every 3 months within 2 years postoperatively and once every 6 months after 2 years postoperatively.The continuous variables and categorical variables were respectively represented as M(Qn) and percentage.The comparisons of continuous variables and categorical variables among groups were analyzed by ANOVA or Kruskal-Wallis test and chi-square test or Fisher exact probability,respectively,and one-way ordinal categorical variables were analyzed by the Kruskal-Wallis test.The survival curve was drawn using the KaplanMeier method.The univariate analysis and multivariate analysis were done using the Log-rank test and COX regression model.Results (1) The basic clinical pathological features:of 343 patients with HCC,143,183 and 17 patients (12 in the B3 substaging and 5 in the B4 substaging) were respectively allocated into the B1,B2 and B3/4 groups.There were statistically significant differences in the age,peritoneal effusion,total bilirubin (TBil),albumin (Alb),alanine transaminase (ALT),prothrombin time (PT),platelet (PLT),alpha-fetoprotein (AFP),extent of liver resection,surgical margin ivasion,tumor diameter,number of tumor,Edmondson-Steiner grade,Up-to-7 score,Up-to-7 standard and Child-pugh score among the 3 groups (F =3.377,NA,11.245,32.616,6.884,11.564,33.100,12.902,NA,NA,239.089,10.357,x2=8.906,F =251.508,x2 =343.000,106.790,P ＜ 0.05).(2) Survival of patients:all the patients were followed up for 2.8-70.8 months with a median time of 38.7 months.The 1-,3-,5-year survival rates and median survival time in the B1,B2 and B3/4 groups were 85.8％,72.8％,52.9％ and 63.2％,47.5％,16.8％ and 45.5％,30.4％,8.4％ and 55.1 months,35.1 months,12.2 months,respectively,showing a statistically significant difference (x2 =22.800,P ＜ 0.05).(3) Risk factors analysis:the results of univariate analysis showed that the peritoneal effusion,Alb,Hb,AFP,esophagogastric varices,surgical margin invasion,tumor diameter,MVI and Edmondson-Steiner grade were related risk factors affecting the prognosis of patients with HCC after hepatectomy [HR =2.04,2.46,2.50,1.78,1.55,3.54,1.71,1.76,1.69,95％ confidence interval (CI):1.13-3.69,1.20-5.02,1.51-4.15,1.29-2.45,1.06-2.25,1.65-7.61,1.23-2.38,1.23-2.51,1.08-2.64,P＜0.05].The results of multivariate analysis showed that the Alb ＜ 35 g/L,Alb ＜ low limit of normal,tumor invading to surgical margin,tumor diameter ＞ 5 cm and positive MVI were independent risk factors affecting the overall survival of patients with HCC after hepatectomy (HR =2.82,2.16,2.93,1.48,1.53,95％ CI:1.37-5.80,1.27-3.69,1.33-6.44,1.05-2.09,1.06-2.22,P＜0.05).(4) There were 61,82,57 and 126 patients in the M1,M2,M3 and M4 groups,and M2 and M3 groups were merged into the M2/3 group because of being similar survival situations of patients.The 1-,3-,5-year survival rates and median survival time in the M1,M2/3,and M4 groups were 90.0％,83.2％,67.7％ and 68.8％,59.9％,41.6％ and 52.7％,42.1％,23.6％ and 69.0 months,49.2 months,24.9 months,respectively,with a statistically significant difference among the 3 groups(x2=20.200,P ＜ 0.05).Conclusions The Bolondi substaging model produces an optimal survival prediction for patients in intermediate stage of BCLC after hepatectomy.The patients in the B1 and B2 substaging have better long-term survival outcomes after hepatectomy.

OBJECTIVETo study the injection of NKG5SV gene to inhibit growth and metastasis of hepatocellular carcinoma (HCC).

METHODSNKG5SV gene was inserted into retroviral vector pLXSN by normal methods. LacZ gene was used as control. LCI-D20 tumor together with saline, pLXSN-LacZ DNA or pLXSN-NKG5SV was subcutaneously inoculated to the nude mice. Tumor formation rate and tumor size were noted 35 days after inoculation. LCI-D20 tumor was inoculated subcutaneously. Saline, pLXSN-LacZ DNA or pLXSN-NKG5SV was intratumorally injected respectively 10 days after inoculation. Tumor growth was observed 35 days after inoculation. Liver cancer was resected 22 days after intrahepatic inoculation. Saline, pLXSN-LacZ DNA or pLXSN-NKG5SV was respectively injected at incisal margin or intraspleen. Mice were killed 35 days after inoculation to observe tumor recurrence at incisal margin, intrahepatic metastasis and extrahepatic metastasis.

RESULTSTumor formation rate and tumor diameter(cm) were 1.76 +/- 0.11, 1.51 +/- 0.34, 0.33 +/- 0.04 in the control group, LacZ group, NKG5SV group respectively when tumor and different cDNA were inoculated together. Tumor diameter(cm) and weight(g) were 0.87 +/- 0.08, 0.83 +/- 0.05, 0.26 +/- 0.04; 0.43 +/- 0.06, 0.38 +/- 0.04, 0.08 +/- 0.06 in the control group, LacZ group, NKG5SV group respectively when different cDNA were injected into the LCI-D20 tumor. Sites with extrahepatic metastasis nidi, incisal margin recurrence tumor size(cm), intrahepatic metastasis nidi, metastasis involved hepatic lobes in the control group, LacZ group, NKG5SV group were 4.25 +/- 1.48, 4.25 +/- 1.04, 0.63 +/- 0.51; 1.51 +/- 0.27, 1.35 +/- 0.17, 0.81 +/- 0.17; 2.50 +/- 1.41, 2.38 +/- 1.06, 1.25 +/- 0.71; 2.13 +/- 0.99, 2.00 +/- 0.75, 1.38 +/- 0.74 respectively when NK cells were injected at incise margin. They were 4.38 +/- 1.85, 4.25 +/- 1.48, 1.00 +/- 0.75; 1.13 +/- 0.23, 0.97 +/- 0.29, 0.76 +/- 0.16; 2.50 +/- 1.41, 2.05 +/- 1.12, 0; 2.13 +/- 0.83, 1.75 +/- 0.88, 0 respectively when NK cell were injected intrasplenicly.

CONCLUSIONSNKG5SV gene can inhibit HCC growth and postoperative metastasis and recurrence.

Animals ; Antigens, Differentiation, T-Lymphocyte ; Cell Division ; drug effects ; Genetic Therapy ; methods ; Genetic Vectors ; administration & dosage ; genetics ; Humans ; Injections ; Liver Neoplasms, Experimental ; genetics ; pathology ; therapy ; Male ; Mice ; Mice, Nude ; Neoplasm Metastasis ; prevention & control ; Receptors, Immunologic ; genetics ; physiology ; Tumor Cells, Cultured ; Xenograft Model Antitumor Assays

OBJECTIVE: To detect the effect of p38 mitogen activated protein kinase (p38MAPK) and cyclooxygenase-2 (COX-2) on the expression of mucin5AC (MUC5AC) in human nasal mucosa induced by histamine in vitro, and to investigate the pathogenesis of mucus hypersecretion in allergic rhinitis (AR). METHOD: Western blot was performed to detect the protein expressions of p38MAPK, COX-2 and MUC5AC in nasal mucosa induced by histamine or blocked by selective inhibitors of p38MAPK and COX-2 of different concentration gradient. RESULT: Weak expressions of p38MAPK. COX-2 and MUC5AC were detected in normal nasal mucosa in vitro. The protein expressions of p38MAPK. COX-2 and MUC5AC increased in nasal mucosa induced by histamine in a dose-dependent manner. The histamine induced protein expressions of COX-2 and MUC5AC were dose-dependently attenuated by selective inhibitor of COX-2, namely NS-398. No apparent influence of NS-398 on the expression of p38MAPK was observed. The histamine induced protein expressions of p38MAPK, C()X-2 and MUCbAC dose-dependently decreased after nasal mucosa was treated by selective inhibitor of p38MAPK, namely SB203580. And no significant change of MUC5AC protein expression induced by NS-398 or SB203580 was observed. CONCLUSION Our findings indicated that the histamine-induced increased expression of MUC5AC by activated p38MAPK/COX-2 may be a possible pathogenesis of mucus hypersecretion in AR.
Adult ; Female ; Humans ; Male ; Middle Aged ; Mucin 5AC ; metabolism ; Nasal Mucosa ; metabolism ; Rhinitis, Allergic, Perennial ; metabolism ; Signal Transduction ; p38 Mitogen-Activated Protein Kinases ; metabolism