Objective To improve the understanding and diagnosis of primary hypertrophic os-teoathropathy(PHO).Methods A case of PHO was reported.The clinical data and the process of the diagno-sis and treatment was analyzed retrospectively,and the related literature were reviewed.Results The patient was a young man without family history of PHO.He had symptoms since age 16.He had clubbing fingers and toes,hypertrophic skin,joint swelling,hyperhidrosis and radiographic evidence of periostitis.Thus the disease was diagnosed as PHO.The patient was treated with NSAIDs and the symptoms relieved very quickly.Conclusion Radiographic examination should be taken in time when young males have the general characters of clubbing fingers and toes,hypertrophic skin changes.If the periostitis presents,the final diagnosis of PHO can be confirmed.

Objective To summarize the diagnostic and therapeutic experience of a patient with chronic graft versus host disease (cGVHD) related polymyositis (PM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods A patient with acute lymphocytic leukemia in com- plete remission received sibling allo-HSCT,and cyclosporine and methotrexate were adopted to pre- vent GVHD.Results Eleven days after HSCT,WBC＞0.5?10~9/L,13 days after HSCT,PLT＞20?10~9/L;27 days after HSCT,chromosome analysis of bone marrow cells showed 99% donor type. Seventeen days after HSCT,Ⅰ~0 acute GVHD of skin occurred,and it was cured by intravenous injec- tion of dexamethasone and methotrexate.Eight months after HSCT,cGVHD of liver happened.Al- though treated by tacrolimus and azathioprine,enzymes of liver were still elevated.At last,tacrolimus combined with sirolimus were used,and enzymes of liver subsided gradually.However,the serum creatine phosphokinase (CK) began to rise from 9 U/L to 3010 U/L,and fatigue all over the patient occurred.Finally,the symptom relapsed,and disability involved with the origin of limbs appeared. The electromyogram and magnetic resonance imaging of concerned muscles confirmed the PM diagno- sis.Although treated with methylprednisolone and plasma exchange,the patient died due to asphyxia, while the CK as high as 21 010 U/L.Conclusion PM is a rare kind of manifestations of cGVHD. When the key muscle tissue was involved,the prognosis is poor.

OBJECTIVETo search for an effective method for treatment of chronic hepatitis B.

METHODSOne hundred and twenty-three cases were randomly divided into a treatment group (n = 63) and a control group (n = 60). The treatment group were treated with injection of Huangqi injectio and Danshen Injectio into Ganshu (BL 18) and Zusanli (ST 36), once every other day; and the control group were treated with oral administration of Gankangning tablet and fufang yiganling tablet. The clinical symptoms, hepatic function, hepatitis B e antigen (HBeAg), hepatitis B virus-desoxyribose nucleic acid (HBV-DNA) were compared between the two groups.

RESULTSThe total effective rate was 93.7% in the treatment group and 76.7% in the control group with significant difference between the two groups (P < 0.01); and the treatment group in hepatic function and the effects of turning negative for HBeAg and HBV-DNA was better than the control group (P < 0.01).

CONCLUSIONAcupoint-injection has a better therapeutic effect on chronic hepatitis B.

Acupuncture Points ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans

OBJECTIVETo follow up the cohort of a certain factory and analyze the death cause of the employees.

METHODSA dynamic cohort was adopted and the study population consisted of all workers stayed at the factory for more than 1 year. The cohort data was mainly from the personnel ministry in the factory,the death data provided by the personnel ministry,the labour union and the hospital. All cause of death of the all employee and the death condition of radiation group and no-radiation group were analyzed and compared.

RESULTSThe mortality of the workers in the factory was significantly lower than national population, the SMR of all cause of death in all employee, radiation group and no-radiation group were 0.41 (95% CI: 0.37-0.45), 0.24, 0.75 respectively; all cancer death in the three group was 0.59, 0.40 and 0.92. But the death order was different in radiation group and no-radiation group,the order of liver cancer was list first in radiation group, which was unlike that of the nation order and the no-radiation order.

CONCLUSIONThere have no excess death in the factory, but the order of liver cancer is precedence.

Cause of Death ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Radiation-Induced ; mortality ; Nuclear Reactors ; Occupational Exposure ; Power Plants ; Prospective Studies ; Workplace

OBJECTIVETo observe the association between angiotensin-converting enzyme (ACE) gene polymorphism and endothelial nitric oxide synthase (eNOS) gene polymorphism and risk of coronary artery disease (CAD) in Han Chinese.

METHODSThe polymorphism in the ACE and eNOS gene were detected by using polymerase chain reaction-restriction fragment length polymorphism analysis, blood pressure (BP), blood lipids, blood glucose (BS), body mass index (BMI) and left ventricle eject fraction (LVEF) were determined 236 patients with CAD and 190 healthy individuals.

RESULTSThe frequencies of DD genotype of ACE were higher and the II genotype were lower in CAD patients than in controls (P < 0.05). CAD patients with DD genotypes were related with higher serum TG, lower HDL-C, higher BS levels, higher BWI and lower LVEF compared to CAD patients with II and ID genotypes of ACE (all P < 0.05), while SBP, DBP, TC and LDL-C levels were similar among CAD patients and controls with different genotypes of ACE (P > 0.05). The genotype distributions of ACE and eNOS were also similar among CAD patients with or without diabetes mellitus/ACS, with single or multiple vessel diseases (P > 0.05). The frequency of GT genotype of eNOS was higher in CAD patients than in controls (P < 0.01) while the frequency of GG genotype in CAD patients and controls was similar (P > 0.05) and eNOS genotypes were not related to TC, TG, HDL-C, LDL-C, BS, BMI, SBP, DBP and LVEF levels among CAD patients and controls (P > 0.05). The risk of suffering from CAD in population with ACE DD genotype is 1.74 times higher than that with II genotype (P < 0.01) and 1.73 times higher in population with eNOS GT genotype than that with GT genotype (P < 0.05). The risk of suffering from CAD is 37.9% with II and GG genotypes and 77.8% with DD and GT genotypes.

CONCLUSIONThe ACE and eNOS genotype polymorphisms were associated with risk of CAD and persons with DD and GT genotypes take higher risk of suffering from CAD.

Aged ; Case-Control Studies ; Coronary Artery Disease ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type III ; genetics ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Single Nucleotide

OBJECTIVETo study the effect of interferon-gamma (IFN-gamma) on the proliferation of mesangial cells (MsC) and transforming growth factor (TGF)-beta/Smad signal pathway, the mRNA and protein expression of matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of matrix metalloproteinase-2 (TIMP-2), and to provide an experimental basis for IFN-gamma treatment of renal fibrosis.

METHODSCultured MsC were treated with IFN-gamma at different concentrations and the proliferation of MsC was examined by MTT. Protein and RNA samples were extracted from MsC at 0, 0.5, 1, 2, 4, 6, 12, 24 h after treated by 100 IU/ml IFN-gamma. The mRNA and protein expression of Smad3, Smad7, MMP-2 and TIMP-2 were analyzed by real-time RT-PCR and Western blot, respectively.

RESULTSThe expression of Smad7 mRNA and protein were promptly elevated at 0.5 hour after the IFN-gamma treatment and lasted for 6 hours, but the proliferation of MsC was not altered. The elevated expression of Smad3, MMP2 mRNA and proteins persisted after 6 hours, whereas the expression of TIMP-2 mRNA and protein decreased.

CONCLUSIONThe therapeutic effect of IFN-gamma of renal fibrosis may be mediated by TGF-beta/smads signal pathway through up-regulation of MMP-2 expression, coupled with down-regulation of TIMP-2 expression.

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Interferon-gamma ; pharmacology ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Mesangial Cells ; cytology ; metabolism ; RNA, Messenger ; metabolism ; Rats ; Recombinant Proteins ; Signal Transduction ; Smad3 Protein ; genetics ; metabolism ; Smad7 Protein ; genetics ; metabolism ; Tissue Inhibitor of Metalloproteinase-2 ; genetics ; metabolism ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo evaluate the changes of plasma levels of the excitatory amino acid neurotransmitter aspartic acid (Asp), inhibitory neurotransmitter glycine (Gly) and asparagine (Asn) in patients with major depressive disorder (MDD).

METHODSPlasma samples were collected from 15 MDD patients (9 males and 6 females, aged 32-64 y) and 14 healthy subjects (7 males and 7 females, aged 30-65 y); and also collected from 7 MDD patients (5 males and 2 females) 2 months after antidepressant treatment. The plasma levels of amino acids were determined by high performance liquid chromatography with fluorescence detection method.

RESULTSPlasma Asp and Gly levels were significantly lower in MDD patients than those in controls (P<0.04). There were positive correlations between plasma levels of Gly and Asp, and between Gly and Asn (P<0.005) in the control group; while in MDD patients, a significant positive correlation was found only between plasma levels of Gly and of Asp (P<0.001). MDD patients did not show significant changes in plasma Asp, Asn and Gly levels after antidepressant treatment compared to those before treatment.

CONCLUSIONThe reduced plasma Asp and Gly levels may serve as a clinical biomarker for MDD.

Adult ; Aged ; Antidepressive Agents ; therapeutic use ; Asparagine ; blood ; Aspartic Acid ; blood ; Depressive Disorder, Major ; blood ; drug therapy ; Female ; Glycine ; blood ; Humans ; Male ; Middle Aged

AIMTo study the protective effect of Quinacrine(QA) on rat striatum neurons from the injury caused by heat environment treatment, to probe the relationship between cell membrane injury and cellular injury protection, and to seek the possibility of QA as a preventive agent to heat injury.

METHODSPrimary cultured striatum neurons from newborn rats were pretreated with QA at different concentration for 1 h, and then heat-treated at 43 degrees C for another 1 h. Cell necrosis was detected by Trypan blue staining, and apoptosis was evaluated through Activated Caspase-3 dye and TdT dye.

RESULTSHeat treatment effected the survival of striatum neurons and resulted in great number of cell death, which was mainly mediated by cell necrosis process. It was shown that treatment of QA itself had little effect on the survival of striatum neurons, while QA pretreatment decreased cellular necrosis caused by following heat treatment.

CONCLUSIONQA protects striatum neurons from heat environment injury at about 20 pmol/L, and the protection may mediated by reduction of necrosis.

Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Death ; drug effects ; Cells, Cultured ; Corpus Striatum ; cytology ; Heat-Shock Response ; Neurons ; drug effects ; Quinacrine ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVETo evaluate the roles of oxidative stress in the generation and development of aneurysms.

METHODSFive terminal aneurysms and 8 lateral aneurysms were rebuilt on rabbits, and 6 normal artery vessels were prepared as control. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), and anti-reactive oxygen species unit (anti-ROS unit) were measured with chemical methods.

RESULTSThe levels of MDA in terminal and lateral aneurysms were (33.85 +/- 8.66) and (27.87 +/- 5.78) nmol/mg prot, respectively, which were significantly higher than (10.91 +/- 2.72) nmol/mg prot in control group (P < 0.01). The levels of SOD in terminal and lateral aneurysms were (28.30 +/- 3.58) and (33.00 +/- 8.09) U/mg prot, respectively, which were significantly lower than (127.27 +/- 38.72) U/mg prot in control group (P < 0.01). The levels of anti-ROS unit in terminal and lateral aneurysms were (47.86 +/- 5.00) and (62.64 +/- 13.87) U/ mg prot, respectively, which were significantly lower than (116.94 +/- 9.22) U/mg prot in control group (P < 0.01). No significant differences were shown between terminal aneurysm and lateral aneurysm in MDA and SOD except anti-ROS unit (P = 0.014). MDA had negative correlations with both SOD and anti-ROS unit, and the correlation coefficients were -0. 830 and -0. 852, respectively.

CONCLUSIONOxidative stress may play an important role in the development of aneurysms. Oxidative stress seems similar among various aneurysms.

Aneurysm ; classification ; metabolism ; Animals ; Disease Models, Animal ; Malondialdehyde ; metabolism ; Oxidative Stress ; Rabbits ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the incidence of lymph node metastasis (LNM) in the right para-tracheal triangle (RPT) of esophageal carcinoma patients and the technique of dissection.

METHODSOn the top of double mediastinal and abdominal lymphadenectomy, 333 esophageal carcinoma patients received RPT lymphadenectomy through the right pleural apical approach from 1990 to 2001.

RESULTSIn these 333 patients, the lymph node metastasis (LNM) rate in the RPT was 36.40%. A total of 457 nodes among 2 159 nodes removed gave a metastasis degree of 24.96%. The LNM rates in RPT for cervical, upper third, middle third, and lower third segments of esophagus were 66.67%, 45.45%, 34.19% and 15.79% (P < 0.05), while their respective metastasis degrees were 44.44%, 27.04%, 24.32% and 18.92% (P > 0.05). The frequency of positive nodes in the RPT for PTI, PT1, PT2, PT3 and PT4 was 0, 17.24%, 28.7%, 45.16% and 53.57%, while those of metastasis degree were 0, 8.77%, 17.62%, 33% and 41.17% (P < 0.01). The frequency of LNM in the RPT in papillary, erosive, patch-like and covert type of early tumor was 40%, 3.85%, 0 and 0 (P < 0.05), while those of the metastasis degree were 29.41%, 1.82%, 0 and 0 (P < 0.01). Higher rate of LNM in progressive stenotic esophageal carcinoma was observed compared with those of the other gross types (56.52%, P < 0.05), so was the degree (P < 0.01). The frequency of LNM in the RPT for mono-focal and multi-focal tumor was 34.98% and 70% without significant difference (P > 0.05), while the degree was 24.29% and 53.33% (P < 0.05). Postoperative complications were: leak (0.6%), and recurrent laryngeal nerve injury (1.2%). No injury of vein or infra-clavicular artery, tracheal damage or mortality occurred.

CONCLUSION1. The lymph node metastasis from esophageal carcinoma has a tendency of wide spread and right para-tracheal triangle is an important region to be doomed. 2. With location, depth of tumor invasion and differentiation of tumor as major factors affecting LNM of esophageal carcinoma, dissection of this region should be paid more emphasis. 3. In early lesions, higher frequency of LNM in the RPT is found in papillary and erosive lesions than in the other macroscopic types. 4. Exposing the RPT, lymph node by dissection through a right pleural apical approach is very important and significant.

Adult ; Aged ; Cardia ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; methods ; Esophagus ; pathology ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neck ; Neoplasm Invasiveness