Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.

Psychrotrophs were isolated by using four media from low-temperature sewage of sewage treatment plant in Urumqi, Xinjiang. Totally, 154 strains were obtained including 12 filamentous fungi, 46 yeasts, 6 actinomycetes and 90 bacteria. The results of tolerance tests of the isolates to salt, phenol and SDS, and enzyme producing characters of amylase, proteinase and esterase were shown. Then 60 bacterial strains were chosen for 16S rRNA gene sequencing and analysis. The blasting results showed that the strains were assigned to 13 recognized genera , and the Strain 39 exhibited 96.6% similarity to Acinetobacter lwoffii(DSM2403), indicating that it might be a novel species. These results suggested that there were a lot of psychrotrophs and rich bacterial diversity in low-temperature sewage. In addition, which maybe an important and potential library of microbial resources.

Objective To summarize the technique and managements of complications in endovascular embolization on intracranial aneurysm with Guglielmi detachable coils(GDC),and to evaluate the effect of the treatment.Methods One hundred and thirty six cases with Aneurizym were treated using GDC to embolize the aneurismal sac via femoral artery approach.Results One hundred and thirty six aneurysms were cured.Of them 132 cases recovered clinically,4 patients died.The mortality was 2.9%. The sac of 123 aneurysms were embolizied at 100%,8 cases with 95% embolization,5 with 90% embolization.3 aneurysms reptured during the embolization,cerebral vasospasm happened in 7 eases. microcoil escaped in 2 case.Three recurring cases were cured after second GDC embolization.The technique-related complications occured in 13 cases.No re-bleeding occurred during the 6 to 54-month follow-up.Conclusion Endovascular embolization of intracranial aneurysm with coils is a safe and effective treatment for intracranial aneurysm.Advances in Techniques and treating the complications correctly would decrease the complications and improve future outcomes.

To silence the expression of K-RASAsn12 in human pancreatic cancer cell line by vector-based RNAi(RNA interference) technique,two single-strand DNA sequences encoding mutant-specific shRNA (short haipin RNA) for K-RASAsn12 were synthesized and then inserted into pSilenCircle. The recombinant plasmid was called pSC-K-RASAsn12. According to the same method, pSC-GFP encoding shRNA for GFP was gained. Both recombinant plasmids were transfected into human pacreatic cancer cell line AsPC-1 and BxPC-3. The expression level of K-RASAsn12 was detected by semi-quantitative RT-PCR and Western blot. The result indicated that the recombinant plasmid edcoding mutant-specific shRNA for K-RASAsn12 can inhibit significantly the expression of K-RASAsn12 without affection of wild-type K-RAS(K-RASWT)in Human Pancreatic Cancer Cell Line.

To investigate the influence of sodium valproate (VPA) on proliferation, apoptosis and differentiation of HL-60 cell line, effect of VPA in various concentrations on proliferation of HL-60 cells was detected by MMT; Wright-Giemsa staining was performed to observe the morphologic changes of HL-60 cells; NBT experiment was used to test the differentiation of HL-60 cells; flow cytometry was used to observe cell cycles and analyze the apoptosis. The results indicated that the changes of the growth curve showed inhibition of proliferation of HL-60 cells. After a 24-48 hours culture with 2 mmol/L VPA, the cells exhibited nuclear shrinkage, pyknosis fragmentation and appearance of apoptosis bodies. The percentage of the annexin V(+)/PI(-) cells which were apoptotic increased from 2.9% to 17.1%; hypodiploid peak was observed; the percentage of HL-60 cells in G(1) phase increased from 51.1% to 84.6% and the cells in S phase decreased from 37.9% to 14.4%. After a week culture with 0.25 mmol/L VPA, the cells exhibited characteristics of differentiation. The percentage of NBT positive cells was (47 +/- 2)%. It is concluded that VPA can inhibit the proliferation of HL-60 cells while inducing differentiation and apoptosis of these cells. The mechanism needs to be further studied.
Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; HL-60 Cells ; Humans ; Valproic Acid ; pharmacology

OBJECTIVEThis paper is to investigate the effects of steroid or IFN alpha-2b on apoptosis and cell pathway of fibroblasts from keloids, hypertrophic scars and normal skins and different responses of different fibroblasts.

METHODS6 samples from keloid, hypertrophic scar and normal skin were collected respectively and fibroblasts from different sources were cultured in vitro. After different fibroblasts were treated with dexamethasone (0.1 mg/ml) or IFN alpha-2b (1000 U/ml), Bax and Bcl-2 protein expressions were detected in situ by immunohistochemical staining; DNA ladders of different fibroblasts were observed by gel electrophoresis; and relative activated (phospho-) ERK1/2 and JNK pathways were detected by method of FACE ELISA.

RESULTSDexamethasone could induce apoptosis of fibroblasts from keloids, hypertrophic scars and normal skins through activating (phospho-) ERK1/2 and JNK pathways; IFN alpha-2b could not induce apoptosis of fibroblasts from different sources. IFN alpha-2b could inhibit (phospho-) ERK1/2 pathway and could not affect (phospho-) JNK pathways of fibroblasts from keloid and hypertrophic scar. IFN alpha-2b could affect neither (phospho-) ERK1/2 pathway nor (phospho-) JNK pathways of fibroblasts from normal skin.

CONCLUSIONSThe responses of different fibroblasts to steroid or IFN alpha-2b were different.

Adult ; Apoptosis ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; chemically induced ; metabolism ; pathology ; Female ; Fibroblasts ; metabolism ; pathology ; Hormones ; pharmacology ; Humans ; Interferon-alpha ; pharmacology ; Keloid ; chemically induced ; metabolism ; pathology ; Male ; Middle Aged ; Recombinant Proteins ; Signal Transduction

OBJECTIVETo explore the multi-differentiated capability of human periodontal ligament cell population (hPDLP), and provide a theoretical basis for the periodontal regeneration by tissue engineering technique.

METHODShPDLP was cultured from periodontium of human tooth by the outgrowth method. STRO-1 and CD 146 expression were investigated by flow cytometry. hPDLP was induced to odontogenic/osteogenic-like and adipogenic-like cell. The multilineage differentiation capacities of hPDLP were evaluated by alizarin red stain, oil red O stain, anti-CD146 and STRO-1 immunocytochemistry, and reverse-transcriptase polymerase chain reaction analysis.

RESULTShPDLP was isolated from human periodontium and most of the cells retained their fibroblastic spindle shape. hPDLP can be induced into osteoblast-like cells and adipocyte-like cells, and calcium deposition and lipid droplets were detected perspectively. And the eighth generation of hPDLP had weaker potential into adipocyte-like cells than the first passage, however, there was no difference to the aspect of calcification ability between the two passages.

CONCLUSIONhPDLP cultured in vitro can differentiate into adipocytes and osteoblasts, and the first to third passage cells may have the predominance of differentiation potential.

Adipocytes ; Cell Differentiation ; Cells, Cultured ; Fibroblasts ; Flow Cytometry ; Humans ; In Vitro Techniques ; Odontogenesis ; Osteoblasts ; Periodontal Ligament ; Regeneration ; Tissue Engineering

Objective To develop a new isotope dilution gas chromatography mass spectrometry method (ID/GC/MS) for the measurement of serum cholesterol.Methods Serum was mixed with an isotope labeled internal standard ([3,4-~(13)C]-cholesterol) and treated with alcoholic sodium hydroxide to hydrolyze cholesterol ester to cholesterol.Cholesterol and internal standard was extracted and derived by N, O-Bis(trimethylsilyl) trifluoroacetamide to trimethylsilyl ethers.The derivation products were analyzed by capillary column GC combined with electron impact MS using scan and selected ion monitor (SIM) modes. Signals of cholesterol internal standard were corrected for the contributions from cholesterol and the signal ratio of cholesterol to internal standard for the calibrators were linearly regressed against cholesterol concentrations.The resulted regression equation was used for the calculation of serum cholesterol concentrations.Results The new ID/GC/MS method showed a mean within-run coefficient variance (CV) of 0.04%-0.81%.Comparison with two levels of standard reference material (SRM1951a) of National Institute of Standards and Technology (NIST) displayed a bias of 0.19% and 0.90% respectively.Conclusion A time-gaining ID/MS method has been established that is highly precise and accurate and can be used for the measurement of serum cholesterol.

OBJECTIVETo discuss the early diagnostic methods and therapeutic principles of aneurysmal subarachnoid hemorrhage (SAH), and evaluate the therapeutic efficacy objectively.

METHODSUsing neuro-imaging examinations combined with case history and clinical symptoms to make the early diagnosis of 96 case with aneurysmal SAH, and Guglielmi detachable microcoil (GDC) was utilized for early intracapsular embolization in the ruptured aneurysms. Efficient symptomatic treatment was done early after operation.

RESULTSAll of 96 cases were early diagnosed and successfully embolized; Among them, the aneurysmal lumen was 100% occluded in 83 cases, 95% in 8 cases, 90% in 5 cases. There were 3 cases complicating with aneurysms rupture during operation, 5 cases with cerebral vasospasm. One case was affected by microcoil terminal escape after operation, 3 recurrent cases were all cured with secondary GDC embolization. There were 9 complications associated with embolization techniques and 13 cases (13.5%) occurring permanent sequelae associated with SAH. According to the Glasgow prognosis score, 77 patients got grade I, 7 grade II, 6 grade III, 3 grade IV, and 3 grade V. The mortality rate was 3.1%.

CONCLUSIONSTo make early etiological diagnosis of the SAH patients, using GDC to embolize the aneurysms, and earlier efficient symptomatic treatment are important methods to improve the curative rate and reduce the mortality rate.

Adult ; Aged ; Aneurysm, Ruptured ; complications ; diagnosis ; therapy ; Angiography ; methods ; Early Diagnosis ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; complications ; diagnosis ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Subarachnoid Hemorrhage ; diagnosis ; etiology ; therapy ; Tomography, X-Ray Computed ; Treatment Outcome

This study was aimed to detect the gene expression profile changes between human acute leukemia cell line HL-60 and VCR-resistance HL-60, and to investigate the underlying mechanisms of MDR by using genechip technology. In experiments, mRNA were harvested using TrizoL reagent from these two cell lines, through RT-PCR, the biotinylated nucleotide were incorporated into the cRNA during the in vitro transcription reaction. The high quality RNA was hybridized to the gene expression array--human genome U133A developed by Affymetrix. It was scanned by G2500A GeneArray Scanner and the acquired image was analysed by a series of softwares. The results showed that 5,507 genes were differentially expressed between human acute leukemia cell line HL-60 and VCR-resistant HL-60. Compared with HL-60, 3,100 genes were up-regulated and 2,407 genes were down-regulated in VCR-resistant cell line. These genes were involved in different cell activities such as growth regulation and signal transduction. Among the genes with remarkable differential expression between the two cell lines, 435 were up-regulated and 605 were down-regulated. It is concluded that many different kinds of genes are involved in the mechanism of MDR and there is an intricate molecular network that controls the sensitivity of leukemia cells to the chemotherapeutic agents. Genechip is an efficient tool for parallel gene expression analysis.
Drug Resistance, Neoplasm ; genetics ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Genome, Human ; HL-60 Cells ; Humans ; Oligonucleotide Array Sequence Analysis ; Vincristine ; pharmacology