BACKGROUNDPercutaneous microballoon compression (PMC) for trigeminal neuralgia is an important therapeutic method. The aim of this study was to review the effects of PMC for trigeminal neuralgia in 276 patients.

METHODSFrom December 2000 to May 2003, 276 patients with trigeminal neuralgia were treated with PMC. The course of the disease ranged from 3 months to 38 years. Under the guidance of C-arm X-ray, 14# needle was placed into the foramen ovale using the classical Hakanson's technique. Fogarty balloon catheter was navigated into the Meckel's cave tenderly. A small amount of Omnipaque was slowly injected to inflate the balloon and compress the trigeminal ganglion for 3 to 10 minutes.

RESULTSA total of 290 PMC were performed on the 276 patients. Among them, 252 had immediate relief from pain. The patients were followed up for a mean of 18.7 months (range, 4 to 32), 14 of them had a recurrence. Of the 14 patients, 12 were re-operated with PMC, and the pain was all controlled successfully.

CONCLUSIONSPMC is an effective and technically simple method for trigeminal neuralgia. For older patients with trigeminal neuralgia, it may be the first choice.

Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; Catheterization ; methods ; Female ; Follow-Up Studies ; Heart Rate ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; physiopathology ; therapy

OBJECTIVETo study the roles of platelet (PLT) and its regulating factors, megakaryocyte, thrombopoietin (TPO) and transforming growth factor beta1 (TGF-beta1), in immune vasculitis in young rabbits.

METHODSAn experimental model of Kawasaki disease (KD) of weanling rabbits was reproduced by bovine serum. PLT count, total number and differentiating count of megakaryocyte, and serum TPO and TGF-beta1 levels were measured 0, 4, 8, 12, 16, 20, 24 and 28 days after KD induction. Pathological analysis of coronary artery, liver, spleen, kidney and brain was performed 17 and 28 days after KD induction.

RESULTSIn the KD group, PLT count, the total number of megakaryocyte, and the middle board megakaryocyte percentage increased 12, 16, 20, 24 and 28 days; serum TPO level increased 8, 12, 16, 20, 24 and 28 days; serum TGF-beta1 level increased 16, 20, 24 and 28 days after KD induction compared with those in the normal control group (p<0.05). The pathological examinations of coronary artery, liver, spleen, kidney and brain showed severe inflammatory injuries of tiny arteries and small/medium-sized arteries 17 and 28 days after KD induction, respectively in the KD group. The aortas were showed as mild inflammatory injuries.

CONCLUSIONSPLT, megakaryocyte, TPO and TGF-beta1 participate in the pathogenesis of KD, and they may play an important role in the injuries of immune vasculitis. This suggests that they may serve as markers for the assessment of severity in KD.

Animals ; Blood Platelets ; physiology ; Disease Models, Animal ; Humans ; Megakaryocytes ; physiology ; Mucocutaneous Lymph Node Syndrome ; etiology ; Rabbits ; Thrombopoietin ; physiology ; Transforming Growth Factor beta1 ; physiology ; Vasculitis ; etiology ; immunology ; pathology

OBJECTIVETo evaluate the toxicity of chicken calamus keratin (CCK) conduit as a tissue-engineered scaffold material.

METHODSThe chemical composition of the leaching solution of CCK was determined by means of ultraviolet spectrometry, and the toxic effects of the solution was evaluated by skin sensitization test in rats, intracutaneous stimulation test in rabbits, acute systemic toxicity test in mice, and cytotoxicity test in L929 cells.

RESULTSThe leaching solution of CCK consisted mainly of middle-molecular-weight peptides with a small quantity of macromolecular proteins. Skin sensitization test in rats showed that application of the CCK leaching solution caused no obvious skin reddening, regional edema, or skin necrosis. Intracutaneous injection of the leaching solution in rabbits did not induce obvious skin stimulation manifested by intradermal erythema or edema. In acute systemic toxic test, administration of the leaching solution in mice caused no death, organ dysfunction, cyanosis, tremor, severe peritoneal irritation, ptosis, or dyspnoea. In vitro cytotoxicity test indicated that the cell toxicity of the CCK leaching solution was approximately at 0 level.

CONCLUSIONCCK contained in the treated chicken calamus easily undergoes hydrolysis to release mainly some peptides which do not induce obvious toxic effects, suggesting the safe potential applications of CCK conduit as a tissue-engineering biomaterial.

Animals ; Cell Line ; Cell Proliferation ; drug effects ; Chickens ; Feathers ; chemistry ; Female ; Keratins ; chemistry ; toxicity ; Male ; Mice ; Rabbits ; Rats ; Skin Irritancy Tests ; Solutions ; Tissue Engineering ; Tissue Scaffolds ; chemistry ; Toxicity Tests ; methods

BACKGROUND: Bioabsorbable biomaterials are of crucial importance in tissue engineering applications, and various factors affect their degradation. OBJECTIVE: To compare the degradation characteristics of concentrated growth factor (CGF) clot and CGF membrane in simulated body fluid (SBF) and simulated saliva fluid (SSF). METHODS: Fifteen volunteers were selected, and human blood samples were collected for the preparation of CGF clot or CGF membrane. All specimens from each subject were averagely divided into four groups: group A, CGF clot in SBF; group B, CGF clot in SSF; group C, CGF membrane in SBF; group D, CGF membrane in SSF. The specimens were subjected to the immersion test. The average daily rate of degradation of each group was calculated after the samples were thoroughly degraded, and weight loss ratio per unit time was also determined. RESULTS AND CONCLUSION: (1) The mean degradation time in groups A-D were (14.0±0.7), (9.7±0.9), (9.9±1.2) and (7.2±0.7) days, respectively. (2) By comparing CGF membrane with CGF clot in the same simulated fluid, the average daily degradation rate of CGF clot (groups A, B) was statistically significantly lower than counterparts of CGF membrane (groups C, D) (P < 0.05). By comparison between SBF and SSF, the average daily degradation rate in the SBF (groups A, B) was significantly lower than counterparts in the SSF (groups C, D) (P <0.05). Overall, the degradation rate of CGF membrane is higher than that of CGF clot under the same degradation environment; for CGF membrane or CGF clot, the degradation rate in SSF is higher than that in SBF.

OBJECTIVETo improve the histocompatibility of chicken calamus keratin (CCK) graft by collagen-gel coating or using of cyclosporine A (CsA).

METHODSThirty SD rats were equally randomized into 5 groups, and in 4 of them, CCK implantation into the bilateral erector spinae was performed on different treatment protocols. In group A, the rats received daily intraperitoneal injection of CsA (5 mg/kg) for two consecutive weeks after CCK implantation; in group B, CCK was soaked in CsA (2.5 mg/ml) solution at 4 degrees Celsius; for 48 h before grafting; in group C, CCK coated with collagen gel was grafted; and in group D, only CCK was implanted. Rats in the fifth group received only cutaneous incision as well as muscular dissection to serve as the blank control. CCK degradation and its effect on the surrounding tissues were observed at 2, 4 and 8 weeks after grafting. Immunohistochemistry was performed to identify T lymphocyte infiltration in the host tissues.

RESULTSAll the rats survived the operation. Numerous macrophages, especially multinucleated giant cells occurred on the peripheral of the CCK grafts, and small degraded CCK pieces were observed in their cytoplasm. Only a few inflammatory cells were seen in the host tissues. At 2, 4 and 8 weeks after CCK implantation, only a few CD3-positive cells were found in all the groups, and in group A and B, the density of T lymphocytes was significantly lower than that in group D, and there was no significant difference between group A and the blank control group.

CONCLUSIONSCsA significantly improves the histocompatibility of CCK material, and short-term systemic CsA administration achieves the best results. Macrophages, especially multinucleated giant cells participate in CCK degradation in vivo.

Animals ; CD3 Complex ; analysis ; Chickens ; Coated Materials, Biocompatible ; administration & dosage ; chemistry ; Collagen ; chemistry ; Cyclosporine ; administration & dosage ; chemistry ; Feathers ; chemistry ; Female ; Gels ; Histocompatibility ; drug effects ; Immunohistochemistry ; Immunosuppressive Agents ; administration & dosage ; chemistry ; Implants, Experimental ; Injections, Intraperitoneal ; Keratins ; chemistry ; Male ; Muscle, Skeletal ; chemistry ; drug effects ; surgery ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spine ; T-Lymphocytes ; chemistry ; cytology ; Tissue Engineering ; methods

OBJECTIVETo observe the unique structural features of chicken calamus keratin (CCK) conduit as a candidate scaffold material for tissue engineering and its in vivo degradation and histocompatibility after its implantation into living tissues.

METHODSChicken calami were taken from healthy chickens and treated through sequential, controllable physical and biochemical procedures for preparation of three types of CCK conduits, namely CCK-I (mildly treated), CCK-II (moderately treated) and CCK-III (intensely treated). Light microscopy (LM) and scanning electron microscopy (SEM) were performed for morphological observation. Each of these three types of CCK pieces (experimental group) and the untreated ones (control group) was implanted into the dorsal muscular tissue on both sides of SD rats, respectively. Routine tissue sectioning and HE stain were performed to identify the morphological changes under light microscope. Each of the CCK threads (experimental group) and the untreated chicken calamus threads (control group) was also grafted within the sciatic nerve bundles of SD rats, respectively.

RESULTSThe wall of the chicken calamus was composed of 4 compact parts from inside to outside on cross sections, namely the innermost basophilic homogenous coarse line, 3-5 layers of acidophilic corneum, 60-100 layers of circular keratin tracts containing massive pigment granules, and 10-20 outmost layers of keratin tracts with only a few pigment granules. The three-dimensional surface features of chicken calamus identified by SEM, as compared with untreated chicken calamus, was characterized by loose arrangement containing horizontal and vertical keratins with obvious pores of different sizes and depths on its surface. At 8 weeks after implantation into the muscular tissue in experimental groups, the CCK grafts were degraded into thin filaments or/and dispersed pieces and fine granules with the appearance of blood vessels, which facilitated the absorption of the degradation products; at 12 weeks, the grafts were markedly degraded into tiny fragments. In the control group, in contrast, the grafts remains intact throughout the experiment. After implantation of the material into the nerve bundles, similar cell infiltration and tissue responses to the grafts were observed as compared to those occur in intramuscular grafting. The degradation products did not seem to cause nerve tissue degeneration or necrosis.

CONCLUSIONSFresh chicken calamus is a natural tube composed of multi-layered compact keratin tracts with pigment granules and small amount of matrix, and is non-absorbable in vivo, and therefore does not favor the purpose for use directly as a candidate biological scaffold. After proper treatment, the chicken calamus becomes loosely arranged porous material, and can be degraded and absorbed in vivo without resulting in tissue degradation or necrosis, suggesting its potential for applications in tissue engineering.

Animals ; Biocompatible Materials ; chemistry ; Chickens ; Female ; Implants, Experimental ; Keratins ; chemistry ; ultrastructure ; Male ; Microscopy, Electron, Scanning ; Muscles ; innervation ; physiology ; surgery ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

OBJECTIVETo explore the changes of CD(14)(+) monocyte human leucocyte antigen DR (HLA-DR) and their relationship with multiple organ dysfunction syndrome (MODS) in severe sepsis.

METHODSNinety-one patients with a definite diagnosis of severe sepsis in the intensive care unit (ICU) were included. CD(14)(+) monocyte HLA-DR levels were detected by flow cytometry on the first, 4th and 7th days of the study, and Marshall scores and prognosis on day 28 were evaluated.

RESULTSThirty-four patients died within 28 days following the onset with a mortality rate of 37.4%. Persistently lowered levels of HLA-DR were detected and significantly increased Marshall scores were found in the fatal cases at all the time points (P<0.001). In the surviving patients, the levels of HLA-DR were significantly increased (P<0.01) and Marshall scores were gradually decreased (P<0.001). During the observation period, the levels of HLA-DR decreased significantly as the number of dysfunctional organs and Marshall scores increased (P<0.001). The levels of HLA-DR were significantly increased in severe sepsis patients with 2-4 dysfunctional organs and Marshall score of 5-12 (P<0.05 or P<0.001). No changes in HLA-DR levels in severe sepsis patients with 5-6 dysfunctional organs and Marshall scores of 13-22. The levels of HLA-DR showed a significant inverse correlation to Marshall scores (r=-0.368, P<0.001).

CONCLUSIONIn patients with severe sepsis, persistent low CD(14)(+) monocyte HLA-DR levels predicts high mortality. The levels of HLA-DR are significantly correlated to the severity of organ dysfunction.

Adult ; Aged ; Aged, 80 and over ; Female ; HLA-DR Antigens ; metabolism ; Humans ; Lipopolysaccharide Receptors ; Male ; Middle Aged ; Monocytes ; immunology ; metabolism ; Multiple Organ Failure ; pathology ; Sepsis ; immunology ; metabolism

OBJECTIVETo evaluate the therapeutic efficacy of intensity-modulated radiation therapy(IMRT) combined with Delisheng injection for treatment of nasopharyngeal carcinoma (NPC).

METHODSSixty-six patients with pathologically confirmed NPC (stage II and III) were randomized into therapeutic group and control group. Patients in the therapeutic group were treated with Delisheng injection in addition to IMRT and those in the control group with IMRT alone.

RESULTSNo significant difference in the response rate occurred between the two groups. The incidence of adverse effects was significantly lower in the therapeutic group than in the control group, and the humoral immunity was improved in the former.

CONCLUSIONDelisheng injection can decrease the side effects of IMRT and improve humoral immunity in NPC patients.

Adult ; Aged ; Carcinoma, Squamous Cell ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; therapy ; Phytotherapy ; Radiotherapy, Intensity-Modulated ; methods ; Treatment Outcome

OBJECTIVETo develop a composite material containing human hair keratin (HHK), collagen sponge (inner layer) and poly 2-hydroxyethyl methacrylate (PHEMA) film that allows sustained release of polydatin and test its effect as a biological dressing in promoting burn wound healing in SD rats.

METHODSThree HHK materials with fast, moderate, and low degradation rates were mixed at the ratio of 4:3:3 to prepare a reticular structure, which was processed into a composite material with bovine tendon-derived collagen sponge, and further complexed with HEMA film containing PD prepared by polymerization. Degree II burn wound was induced in SD rats by scalding and within postburn day 2-5, the wounds were cleansed and covered with the composite material or with glutaraldehyde-treated porcine skin (positive control). At week 1, 2, 4, 6 and 8 following wound dressing, 6 full-thickness skin samples were harvested from the wounds for histological observation and immunohistochemical detection of collagen and elastic fibers, and the wound healing time and healing rate were recorded.

RESULTSThe prepared collagen sponge film was transparent and porous (50-300 microm in diameter) and allowed sustained PD release into normal saline within 48 h. Compared with the porcine skin, the composite material reduced exudation and maintained ideal moisture of the wound, and significantly shortened the wound healing time (P=0.000). On day 7, 14, and 21 following dressing, the composite material and porcine skin significantly increased the wound healing rate as compared with the negative control group (P=0.000), and on day 14, the composite achieved significantly greater healing rate than the porcine skin (P<0.05).

CONCLUSIONHHK-collagen sponge-PHEMA/PD composite as a dressing material promotes burn wound healing in rats by allowing in vivo construction of tissue engineered epidermis. PHEMA is feasible for sustained drug delivery in this composite.

Animals ; Biological Dressings ; Burns ; drug therapy ; Cattle ; Collagen ; therapeutic use ; Drug Delivery Systems ; Drugs, Chinese Herbal ; pharmacology ; Glucosides ; pharmacology ; Humans ; Keratins ; therapeutic use ; Polyhydroxyethyl Methacrylate ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Stilbenes ; pharmacology ; Swine ; Tissue Engineering ; Wound Healing

OBJECTIVE: To investigate the relationship between MICA*008/A5.1 allele and human cytomegalovirus (HCMV) infection in kidney transplanted donees of Hunan Han nationality. METHODS: The MICA*008/A5.1 allele based on 91 kidney transplanted donees and 81 unrelated normal individuals of Han nationality in Hunan Province were analyzed by PCR/SSP assay. At the same time, anti-HCMV antibody IgM was detected in the serum by ELISA method. RESULTS: The positive rate of MICA*008/A5.1 allele was significantly higher in the control group (56.79%) than that in the kidney transplanted donee group (34.07%) (P <0.05). The infection rate of HCMV in those individuals whose genotype was MICA*008/A5.1 (-) was significantly higher than that in the MICA*008/A5.1(+). CONCLUSION The individual whose genotype is MICA*008/A5.1 (+) is not liable to HCMV infection, but the individual whose genotype is MICA*008/A5.1 (-) is liable to HCMV infection.
Alleles ; Antibodies, Viral ; blood ; China ; Cytomegalovirus ; isolation & purification ; Cytomegalovirus Infections ; genetics ; Female ; Genotype ; Histocompatibility Antigens Class I ; genetics ; Humans ; Immunoglobulin M ; blood ; Kidney Transplantation ; adverse effects ; Male