OBJECTIVETo investigate the relationship between mild consciousness and mental disorders after arthroplasty and incomplete cerebral fat embolism.

METHODSA retrospective analysis of 12 patients with incomplete cerebral fat embolism after arthroplasty was performed from June 2004 to December 2011. There were 5 males and 7 females,ranging in age from 36 to 82 years old,averaged 56.8 years old. Four patients had femoral neck fractures; 3 patients had avascular necrosis of the femoral head; 3 patients had rheumatoid arthritis; 1 patient had ankylosed hip and 1 patient had knee osteoarthritis. The patients had consciousness and mental disorders after arthroplasty (femoral head replacement in 3 cases, total hip replacement in 7 cases, and knee joint surface replacement in 2 cases), changes of vital sign and abnormal brain MRI examination.

RESULTSTwelve patients had mild consciousness and mental disorders,and the NIHSS score was 1.92+/-3.78,which was correlated with incomplete cerebral fat embolism after arthroplasty. The patients recovered conscious within 24 to 72 hours after treatment with expansion of blood volume,dehydrating agent and neuroprotective drugs,improving respiratory and circulatory function, hormone protection and antibiotic application. The patients were followed up with a mean period of 18 months (ranging from 10 to 36 months). The patients had neurological function recovering to normal without sequelae, and the NIHSS score decreased to 0.

CONCLUSIONIncomplete cerebral fat embolism after arthroplasty is the main reason causing mild awareness and mental disorders, which is often to be misdiagnosed or ignored because of not typical clinical manifestations.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty ; adverse effects ; Consciousness ; Embolism, Fat ; etiology ; Female ; Humans ; Intracranial Embolism ; etiology ; Magnetic Resonance Imaging ; Male ; Mental Disorders ; etiology ; Middle Aged ; Retrospective Studies

Objective:To investigate the expression of Fas、FasL and the apoptosis of liver cancer cell line HepG2 transfected with LIGHT and IFN-? gene mediated by Cationic liposome.Methods:HepG2 cells were divided into two groups(the solo transfection of LIGHT gene and the combined transfection of LIGHT and IFN-? genes) and the control groups(no transfection).HepG2 cells were cellected at 12h,24h and 48h after transfection.The apoptosis of HepG2 cells and the expression of Fas and FasL of the HepG2 cells were investigated with flow cytometry.Results:After transfection,the apoptosis of HepG2 cells increased,and the apoptosis of combined transfection group was higher than the solo transfection of LIGHT(P

OBJECTIVETo study the clinical features and diagnosis of intrahepatic cholestasis of pregnancy (ICP).

METHODSDuring the last 10 years 1241 cases of ICP stayed in our hospital. Their clinical data were retrospectively reviewed.

RESULTS5.2% of all the maternity patients had ICP. It occurred more in winter and 3.5% of ICP occurred in multiple pregnancies. The recurrence rate of ICP was 30.2%. On the average, it occurred at gestational week 32.6. Skin pruritus was the characteristic manifestation and the presenting symptom in 1201 patients (96.8%). The other presenting features included elevated serum ALT and AST (2.3%), jaundice (8 patients), diarrhea (3 patients), deep yellow urine (2 patients) and right upper abdominal pain (1 patient). The serum transaminases levels were elevated, of which 60% were between 50-200 IU/L. Serum total bile acid (TBA) levels were elevated in 82.4% of the patients and bilirubin levels in 33.4%. The elevated bilirubin levels were 30 to 90 micromol/L in 85% of those patients with this condition, and it was never higher than 170 micromol/L.

CONCLUSIONThe basic diagnostic points of ICP are pruritus and abnormal liver function characterized by increased transaminases and TBA. Therefore paying attention to typical pruritus and other atypical features such as elevated serum transaminases, jaundice, diarrhea, deep yellow urine and right upper abdominal pain during antenatal care is important for an early diagnosis of ICP.

Adult ; Cholestasis, Intrahepatic ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; Retrospective Studies ; Young Adult

Objective · To study the effect of inhibitor of differentiation 1 (ID1) on ocular neovascularization. Methods · The oxygen-induced retinal neovascularization (OIR), laser-induced choroidal neovascularization (CNV) and over-expression of vascular endothelial growth factor (VEGF) (Rho-VEGF) transgenic mice were established. The localization and mRNA level of ID1 in retina of OIR mice and Rho-VEGF transgenic mice were determined by immunofluorescence staining and quantitative real-time PCR. Mice deficient in ID1 (ID1-/-) were used to induce retinal neovascularization in accordance with the above three models, and to compare the changes of ID1 on the number of retinal, subretinal and choroidal neovascularization areas. In order to explore the role ID1 in neovascularization, the numbers and areas of retinal, subretinal and choroidal neovascularization in the mice models with or without ID1 deficiency were compared. Its effect on the related factors, i.e. hypoxia-inducible factor-1α (HIF-1α), VEGF and vascular endothelial growth factor receptor 1/2 (VEGFR1/2) were also observed. Results · Mice deficient in ID1 showed a significant reduction in the area of neovascularization in these three models (P＜0.05). Mice lacking ID1 showed reduced levels of HIF-1α, VEGF and VEGFR 1. Conclusion · ID1 promotes the expression of HIF-1α, VEGF and VEGFR1 in the retina and choroidal neovascularization during hypoxia and oxidative injury.

OBJECTIVETo investigate the role of allograft inflammatory factor-1 (AIF-1) in colorectal cancer (CRC) progression and explore the possible mechanism.

METHODSThe expression levels of AIF-1 in 70 CRC tissues and paired adjacent tissues were detected using immunohistochemistry and Western blotting, and the correlation of AIF-1 expression with the clinicopathological features of the patients was analyzed. In the CRC cell line SW480, the functional role of AIF-1 in regulating tumor progression was investigated by transfecting the cells with an AIF-1-overexpressing plasmid (AIF-1) and a negative control plasmid (NC). EdU proliferation assay and flow cytometry were used to assess the cell proliferation and cell cycle changes; Transwell migration assay and Annexin V-APC/7-AAD apoptosis assay kit were used to analyze the cell migration and apoptosis. The changes in the biological behaviors of the cells were observed after application of SB203580 to block the p38 MAPK pathway. The expression levels of CDK4, cyclin D1, P21, P27, MMP2, MMP9, Bax, Bcl2, Bcl-xl, p38 and p-p38 were detected using Western blotting.

RESULTSAIF-1 was down-regulated in CRC tissues compared with the adjacent normal tissues, and its expression level was positively correlated with lymph node metastasis (P=0.008), TNM stage (P=0.003) and tumor size (P=0.023). Overexpression of AIF-1 in SW480 cells significantly reduced EdU-positive cells and caused obvious cell cycle arrest in G1 phase (P<0.05). AIF-1 overexpression resulted in significantly lowered protein expressions of CDK4 and cyclin D1, enhanced expressions of P21 and P27, attenuated cell migration ability (P<0.001), and decreased protein levels of MMP2 and MMP9. AIF-1 overexpression also induced obvious apoptosis of SW480 cells (P<0.01), significantly increased the protein levels of Bax and p-p38, and decreased the protein levels of Bcl-2 and Bcl-xl; SB203580 significantly attenuated the apoptosis-inducing effect of AIF-1 overexpression.

CONCLUSIONAIF-1 plays the role of a tumor suppressor in CRC by inhibiting cell proliferation, suppressing cell migration and inducing cell apoptosis. AIF-1 overexpression promotes the apoptosis of CRC cells by activating the p38 MAPK pathway.

This study was purposed to detect the expression of autophagy-related gene Beclin1 and microtubule-associated protein 1 light chain 3 (MAPLC3) in bone marrow mononuclear cells (BMMNC) isolated from acute leukemia (AL) patients, and to explore its significance. Transmission electron microscopy and RT-PCR were used to detect the autophagy activity and the expression level of Beclin1 and MAPLC3 mRNA in BMMNC isolated from 27 AL patients with de novo, refractory or relapse AL and completely remission and 31 normal persons respectively. The results showed that autophagy activity and expression levels of Beclin1 and MAPLC3 mRNA in BMMNC from de novo AL patients were 80%, 0.68 ± 0.18, 0.24 ± 0.06, respectively; those in BMMNC from refractory or relapse AL patients were 100%, 0.79 ± 0.09, 0.30 ± 0.07, respectively; those in BMMNC from CR patients were 40%, 0.52 ± 0.15, 0.16 ± 0.04, respectively, while those in BMMNC from normal persons were 20%, 0.57 ± 0.13, 0.16 ± 0.05, respectively. The autophagic activity and expression levels of Beclin1 and MAPLC3 mRNA in de novo and refractory or relapse AL patients were higher than those in normal persons, with statistical significance (p < 0.05), while the comparison between CR patients and normal control showed no statistical difference (p > 0.05). It is concluded that autophagy activity and Beclin1 and MAPLC3 mRNA expression level of in de novo and refractory or relapse patients are higher than those in normal control, and the up-regulation of autophagy activity and expression of Beclin1 and MAPLC3 mRNA in refractory or relapse patients is especially significant. This may be related to the genesis, development and drug resistance of AL.
Acute Disease ; Adolescent ; Adult ; Aged ; Apoptosis Regulatory Proteins ; metabolism ; Beclin-1 ; Bone Marrow Cells ; metabolism ; Child ; Female ; Humans ; Leukemia ; metabolism ; pathology ; Male ; Membrane Proteins ; metabolism ; Microtubule-Associated Proteins ; metabolism ; Middle Aged ; RNA, Messenger ; genetics ; Young Adult

OBJECTIVETo analyze experimental results of Graft-versus-host disease (GVHD) after liver transplantation.

METHODS13 cases of GVHD out of the 1013 liver transplantation between 2002-2008 were analysed. Routine blood test, liver function and microorganisms test were done in all of the 13 cases, bone marrow test was done in 5 cases, liver pathological test was done in 5 cases, cytokines were analyzed in 4 cases, chimerism test was done in 6 cases.

RESULTSLeukocytes were reduced to various degree in all 13 cases, and were extremely low in 8 cases. Hematopoiesis was repressed in 4 cases. Normal liver function was found in 9 cases. Bacterium were found in blood, bile, wound secrete juice, excrement, phlegm of 10 cases. The pathological characteristics was in accordance with GVHD in 5 cases. The levels of IL-1 alpha, IL-1 beta, IL-2, IL-4 were low or undetectable. IL-10 was decreased in 4 cases but increased in 1 case. MCP-1, VEGF, IL-6, EGF, IL-8 were increasing or remained at high level during GVHD. TNF alpha was slightly increased. IFN gamma was only slightly changed before GVHD.

CONCLUSIONChimerism is a reliable but not unique evidence of GVHD.

Acute Disease ; Adult ; Aged ; Bacterial Infections ; etiology ; Bone Marrow Diseases ; blood ; etiology ; Bone Marrow Examination ; Cause of Death ; Chimerism ; Cytokines ; blood ; Female ; Graft vs Host Disease ; blood ; diagnosis ; etiology ; mortality ; Humans ; Interleukins ; blood ; metabolism ; Leukopenia ; blood ; etiology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Transplantation, Autologous ; Tumor Necrosis Factor-alpha ; metabolism

Objective To determine the main genotype of hepatitis B virus(HBV) prevailed in Henan Luohe area. Methods Serum specimens were collected from 94 HBsAg positive individuals, and HBV S gene were obtained by PCR amplifying, and the gene sequences were analyzed and the polygenetic tree was drawn by the software MEGA3. Results About 75.7% samples of HBV S gene clustered in genotype C, about 20% samples clustered at genotype B in the HBV polygenetie tree, about 4.3% samples clustered at genotype D in the HBV pelygenetic tree. Conclusion The main genotype of hepatitis B virus prevalent in Henan Luohe is genotype C,genotype B is rarely seen, and genotype D is rarely seen.

Objective To find out the different features of deep gray matter lesions on magnetic resonance imaging (MRI) among patients with acute disseminated encephalomyelitis (ADEM),multiple sclerosis (MS),and neuromyelitis optica (NMO) in adults.Methods After searching the database,353 adult patients,admitted to our hospital from August 2004 to October 2012 and diagnosed as ADEM,MS,and NMO,were identified.Among them,95 adult patients with ADEM (n=12),MS (n=60) and NMO (n=23) had deep gray matter lesions on MRI were included in our study.Morphological features of deep gray matter lesions,including diameter,quantity and distribution among these patients,were compared.Results The percentage of lesions involved in the thalamus,caudate nucleus and globus pallidus was not significantly different among the three groups (P＞0.05).Putamen was more frequently involved in patients with ADEM than that in patients with MS and NMO (P=0.002 and 0.013,respectively).Hypothalamus was more frequently involved in patients with NMO than that in patients with ADEM and MS (P=0.033 and 0.001,respectively).The diameter of the thalamus lesion in patients with ADEM was significantly larger than that in patients with NMO (P=0.027),but was not significantly different from that in patients with MS (P=0.116); no significant difference between the lesion diameters of patients with MS and NMO was observed (P=0.209).The diameters of the lesions located in the caudate nucleus,globuspallidus,putmen,and hypothalamus were not significantly different among the three groups (P＞0.05).Furthermore,no significant difference was found among the three groups in respect of the symmetry of lesion distribution (P=0.335).Conclusions Thalamus involvement might not be helpful in differentiating ADEM from MS in adults.Putamen involvement might be helpful in differentiating ADEM from MS and NMO.Hypothalamus involvement is specific for NMO.Lesion size is not useful in the differential diagnosis of ADEM,MS,and NMO.

OBJECTIVETo investigate the safety of autologous bone marrow mononuclear cell (BM-MNCs) transplantation by intracoronary infusion in patients with acute myocardial infarction (AMI).

METHODSOne hundred and eighty-four patients with AMI treated with percutaneous coronary intervention (PCI) were randomized in a 1:1 way to either intracoronary transplantation of autologous BM-MNCs (n = 92) right after PCI or to sodium chloride concluding heparin (controlled, n = 92) via a micro infusion catheter. In the process of the intracoronary infusion of BM-MNCs, the complications should be recorded, which were aberration reflect (including of pale, syncope, nausea, hypotension and shock), deterioration of angina or heart failure, arrhythmias (including of bradycardia, sinus arrest or atrial ventricular block or ventricular fibrillation), embolism etc. Body temperature, blood pressure and heart rates should be monitored during the first week after transplantation. Holter, coronary angiography and ultrasonic cardiography were performed at the designed time points. Main heart accidents, restenosis and tumor were recorded during 2-years follow up.

RESULTSDuring the period of bone marrow puncture and intracoronary infusion of BM-MNCs, few patients occurred pale, dizziness, bradycardia and hypotension, which were transient and due to vagus reflect. No stem cell-related arrhythmias, deterioration of angina were noted. In BM-MNCs group one patient developed in-stent reocclusion in one week after transplantation, five developed in-stent restenosis during further follow-up 30 months, which were similar with control group. There were no deaths, major adverse cardiac events, tumor and other late adverse events during follow-up period in both groups.

CONCLUSIONIntracoronary transplantation of autologous BM-MNCs in the acute phase after AMI is feasible and seems safe in the 30 months of follow-up.

Adult ; Aged ; Bone Marrow Transplantation ; methods ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Middle Aged ; Myocardial Infarction ; surgery ; Transplantation, Autologous