Objective To investigate MRI features of heat stroke (HS) and 1H-MRS in monitoring clinical outcome.Methods Six cases(4 males,2 females) of HS patients,aged 43-75 years old were retrospectively studied.The patients were divided into 4 severe cases (2 cases with coma for 4 hours,2 patients with persistent coma) and 2 moderate cases according to initial Glasgow coma scale (GCS) at the time of hospital admission.All patients underwent T1WI,T2WI,FLAIR,DWI,SWI,multi voxel 1H-MRS scans and the ratios of NAA/Cr,Cho/Cr,and NAA/Cho were calculated.One case of severe coma died on the next day.Follow-up imaging and brain 1H-MRS were performed on other 5 patients on the 7th and 15th day after the first examination.The imaging results were compared with clinical outcome.Results MRI features of HS for severe coma patients were iso-intensity on T1WI,hyper-intensity on T2WI,FLAIR and DWI,heterogeneous signal intensity on ADC.The infratentorial lesions distributed in the cerebellum,dentate nucleus and cerebellar arm (3 cases),and the supratentorial lesions distributed in the parahippocampal gyrus (2 cases),parietal lobe (2 cases),and temporal lobe (1 cases).The lesions could be multiple,and the cerebellum and the parahippocampal gyrus were most common involved.SWI showed focal hemorrhage in 2 cases,which located in the brainstem and parietal lobe.No obvious MRI abnormality was found in 2 cases of moderate coma patients.The ratios of NAA/Cr,Cho/Cr,and NAA/Cho for severe coma patients were 0.67 ±0.09,0.94 ±0.16 and 0.70±0.12,respectively,which for moderate coma patients were 0.87±0.12,0.95±0.13,and 0.94±0.08,respectively.The NAA/Cr and NAA/Cho ratios decreased and Cho/Cr mild decreased in the severe coma patients when compared with the moderate coma patients.One patient with persistent coma had expanded lesions on follow-up study.NAA/Cr,NAA/Cho and Cho/Cr were 0.63± 0.07,0.67 ±0.10,and 0.96 ±0.05,respectively.Two cases had smaller lesions on follow-up study with NAA/Cr and NAA/Cho ratio increased,which were 1.02±0.13 and 0.96±0.11,respectively.GCS was turned to 14.NAA/Cr and NAA/Cho for moderate coma patients were 1.17±0.10 and 1.21 ±0.07,respectively.Conclusions Severe HS patients present with cerebral edema and hemorrhage.1H-MRS can be an important index for monitoring the severity of HS.The longer the duration of coma,the worse prognosis may happen.

Airway Remodeling ; physiology ; Animals ; Asthma ; metabolism ; Disease Models, Animal ; PPAR gamma ; biosynthesis ; Rats

Objective To investigate whether pantoprazole (PPZ), a proton pump inhibitor,could reverse the transmember pH gradient by inhibiting vacuolar H+-ATPase so as to increase the sensitivity of human gastric adenocarcinoma cell line SGC7901 to antitumor drugs and to evaluate the optimal time of drug administration, dosage of PPZ and the possible mechanism. Methods Western blotting and immunofluorescent staining were used to determine the expression and intracellular distribution of vacuolar H+-ATPase in human gastric adenocarcinoma cell line SGC7901 with or without PPZ pretreatment. 2', 7'-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein, acetoxymethyl ester (BCECF-AM) fluorescent probe was used to measure the intracellular pH value of human gastric adenocarcinoma cell line SGC7901 which pretreated with different dose and time of PPI. Methyl thiazolyl tetrazolium (MTT) assay and annexin V-fluorescent isothiocyanate-propidium iodide double staining were performed to evaluate the cytotoxic effects and apoptosis of cells treated with antitumor drugs combined with PPZ. Adriamycin (ADR) was used as probe to estimate drug accumulation and retention with PPZ pretreatment. Results After 24 hours, the expression of vacuolar H+-ATPase in cells pretreated with PPZ of 10 μg/ml (1.19±0.03) or 100 μg/ml (0. 70±0.03) was significantly lower than that in blank control (1.53±0. 05), but this expression was increased by pretreatment with PPZ of 1 μg/ml (2.29 +0.06, P<0.05). The inhibitory effects of PPZ (10 μg/ml) on vacuolar H+-ATPase was observed at 6 hours (0.32±0.02)and 12 hours (0. 13±0.02). And it could alter the intracellular distribution of vacuolar H+-ATPase at 24-hours. The intracellular pH value in cells pretreated with PPZ of 10 μg/ml (7.44±0. 09 ) or 100 μg/ml (7.31 ± 0. 06) was significantly decreased in comparison with untreated cells (7.51±0.05, P< 0. 01). After administration of anti-tumor drugs, the viability in SGC7901 cells pretreated with PPZ for 24 hours (58.71%±1.18 %) was significantly lower than that in cells untreated with PPZ (74. 33% ± 1.77%, P<0.05), while thetotal and early apoptotic rates in former cells(80.81% ±1. 16% and 77.52 %±1.13 %, respectively) were significantly higher than those in later cells (26. 42%±1.19% and 23. 18% ±0.92%,respectively,P < 0. 01). And the ADR releasing index in cells treated with PPZ (20, 50 and 100 μg/ml) for 24 hours was obviously lower than that in the blank control (0. 164±0. 013, 0. 162±0.015, 0. 152±0. 012 vs 0. 277±0. 011, respectively, P<0. 01). Conclusion The sensitivity of human gastric adenocarcinoma cell line to antitumor drugs may be increased by pretreatment with PPZ.

Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.

treated with heat shock and OK-432 demonstrated enhanced biological activities,and could induce host lymphocytes to highly effective and specific eytotoxieity against PANC1 cells.

Objective To investigate the ideal dosage of dexmedetomidine( DEX) with 1?0 μg/kg fentanyl for monitored anesthesia care ( MAC) during endoscopic variceal ligation ( EVL) . Methods A total of 60 patients scheduled for elective EVL were randomly divided into 3 groups ( n=20) . After fentanyl was infused intravenously at the dosage of 1?0 μg/kg, the loading dosage of DEX at 1?0 μg/kg ( group D1 ) , 1?5 μg/kg ( group D2 ) , or 2?0μg/kg ( group D3 ) was continuously infused in 10 min, respectively. When the modified OAA/S score reaching≥3 point, EVL was carried out. The change in modified OAA/S score, the operation duration time, recovery time, satisfaction rates of patient and doctor, and complications were recorded. Results There were no significant differences in regarding of general status, operation duration time and satisfaction score of patients between the 3 groups ( P>0?05 ) . Before endoscope insertion, the OAA/S score in group D3(4?4±0?2)was higher than that in D1(3?4±0?5)or D2 groups(3?8±0?3)(P<0?05), and there was no significant difference between the scores of D1 and D2(P>0?05).At the time?point of 5 mins after endoscope insertion, the OAA/S score in group D3(4?5±0?3)was significantly higher than that in D1(3?5±0?6)or D2 groups(3?7±0?4)(P<0?05),there were no significant differences between D1 and D2( P>0?05) . At the end of the procedure,there was no significant difference in OAA/S score between the 3 groups(P>0?05).Compared with group D1(3?1±0?9)min and D2(3?8±0?8)min, the recovery time in group D3(6?6±1?2)min was significantly longer (P<0?05), while there was no significant difference between D1 and D2(P>0?05). The satisfaction score of endoscopist in group D1(8?0±0?8) was significantly lower than that in group D2(9?4±0?6)or D3(9?5±0?5)(P<0?05), there was no significant difference between groups D2 and D3 ( P>0?05 ) . No tachycardia, hypertension or hypoxemia occurred during the procedure. There was no significant difference in rate of hypotension among the three groups ( P>0?05) . The incidences of nausea(30%) and body movement(15%) in group D1 were significantly higher than those in group D2 and D3(P<0?05).There were no differences between D2 and D3(P>0?05). The incidence of bradycardia in group D3(40%) was significantly higher than those in group D1(0) and D2(10%)(P<0?05).There were no differences between those in D1 and D2(P>0?05). Conclusion Combined with 1?0 μg/kg fentanyl, 1?5 μg/kg DEX is more efficient and safer for EVL in the status of MAC.

Objective To evaluate the clinical value of susceptibility?weighted imaging(SWI) in detecting intramedullary hemorrhage of traumatic acute spinal cord injury. Methods From October 2012 to December 2014, 37 TSCI (traumatic spinal cord injuries) patients undergone the MRI scans including routine MRI and SWI were enrolled. Further according to ASIA classification standard, all patients were evaluated as ASIA A (n=4), ASIA B (n=4), ASIA C (n=19) and ASIA D (n=10). Referring to axial T2WI images at the same slice, the manifestations of hemorrhage in amplitude image, phase image and SWI were evaluated. At the slice with maximal size of hemorrhage area and its neighboring slices, the hemorrhage regions were manually drawn; and the total area was automatically calculated. The number of hemorrhage lesions was defined as the number of hemorrhage lesions at single slice × slice number. One?way ANOVA was used to compare the differences among different grading ASIA in terms of hemorrhage area and number. Meanwhile, the relations between hemorrhage area and ASIA grade; hemorrhage number and ASIA grade were evaluated by Spearman rank correlation. Results The hemorrhage was detected by SWI in 15 patients, including 4 ASIA A, 4 ASIA B, 7 ASIA C. Hemorrhage represents as isointense in T1WI and a slightly low signal intensity or isointense in the center companied by high intensity at circus in T2WI. In magnitude image and SWI hemorrhage appears as low signal intensity and low signal intensity in the center companied by high intensity at circus in phase image. In detecting the hemorrhage, SWI (98 lesions were detected) was 5.4 times of T2WI (19 lesion were detected). As for the number of hemorrhage, significant differences were found among ASIA grading A, B and C (grading A:22.5 ± 1.3, grading B:19.5 ± 1.3, grading C:4.0 ± 1.1;F=38.720, P<0.01); Further the pairwise comparison showed statistical significance (P<0.05); besides, the number of hemorrhage lesions closely related with the ASIA grade (r=0.864, P<0.01). For the hemorrhage area, the calculated results of grading ASIA A, B and C were (23.5 ± 0.6), (21.8 ± 1.9), (3.9 ± 0.7) mm2, respectively; there were significant differences among the different ASIA grades (F=29.987, P<0.001);furthermore the hemorrhage area also showed closely relation with the ASIA grade (r=0.778, P<0.01). Conclusions SWI is more sensitive in detecting the hemorrhage in traumatic acute spinal cord injury. The more number and area of bleeding area suggest the more severe of the damage level.

OBJECTIVETo compare the effect of transurethral resection of the prostate combined with endocrine therapy (TURP + ET) with that of αlA-blockers combined with ET ((αlA-b + ET) in the treatment of bladder outlet obstruction (BOO) in patients with advanced prostate cancer (PCa), and to investigate the safety of the TURP + ET for the treatment of PCa with BOO.

METHODSWe retrospectively analyzed 63 cases of PCa with BOO, 28 treated by αlA-b + ET and the other 35 by TURP + ET. We obtained the residual urine volume (RV), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and quality of life score (QoL) before and after treatment along with the overall survival rate of the patients, followed by comparison of the parameters between the two methods.

RESULTSAt 3 months after treatment, RV, IPSS, and QoL in the TURP + ET group were significantly decreased from (137.8 ± 27.6) ml, (22.3 ± 3.6), and (4.2 ± 0.8) to (29 ± 13.6) ml, (7.8 ± 2.1), and (1.6 ± 0.5) respectively (P < 0.05), while Qmax increased from (5.6 ± 2.1) ml/s to (17.6 ± 2.7) ml/s (P < 0.05); the former three parameters in the αlA-b + ET group decreased from (133.6 ± 24.9) ml, (21.5 ± 3.2), and (4.7 ± 1.1) to (42 ± 18.3) ml, (12.8 ± 2.6), and (2.5 ± 0.7) respectively (P < 0.05), while the latter one increased from (6.3 ± 2.4) ml/s to (11.7 ± 2.3) ml/s (P < 0.05), all with statistically significant differences between the two groups (P < 0.05). The overall survival rate of the TURP + ET group was not significantly different from that of the αlA-b + ET group (51.4% vs 46.4% , P > 0.05).

CONCLUSIONTURP + ET is preferable to αlA-b + ET for its advantage of relieving BOO symptoms in advanced PCa without affecting the overall survival rate of the patients.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; methods ; Humans ; Male ; Prostatic Neoplasms ; complications ; drug therapy ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; etiology ; surgery

Objective To evaluate the acute and delayed killing effect of high intensity focused ultrasound (HIFU) on Echinococcus granulosus(E. granulosus)protoscolices in vitro.Methods E. granulosus protoscolices were treated with different dosage of effective power(0,25,50,100,200,250 W)and time(5,10,20,30,40,50,60 s)of HIFU in vitro to obtain the dosage-effect curves.Then the survival pmtoscolices were incubated,and the mortality of each group was counted daily.The protoscolicidal effects were investigated by trypan blue exclusion assay.Results Compared with the untreated group,the Vitality of E.granulosus protoscolices significantly decreased immediately after treated by HIFU of different dosage(F=5201.59 vs 1865.65,P＜0.05),there were the interaction both different dosage and time(F=214.50,P＜0.05).The protoscolices were broken into pieces by HIFU of 250 W×40 s,whereas the growth of the surviving protoscolices after exposed to HIFU was obvious suppressed.Both the acute killing effect and the delayed inhibitory effect showed a dosage-dependant manner.The inhibitory effect increased along with the increased dosage of HIFU(P＜0.05).The inhibitory effect in 50 W×10 s group was stronger than 25 W×20 s group(P＜0.05).The mortality was increased in parallel with the increase of HIFU dosage.Conclusions HIFU show an effective immediately killing effect,as well as a growth-inhibiting effect on the E.granulosus protoscolices in vitro.

Adolescent ; Child ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Killer Cells, Natural ; pathology ; Leukocyte Common Antigens ; analysis ; Lymphoma, T-Cell ; genetics ; immunology ; Male ; Microtubule-Associated Proteins ; genetics