Objective To evaluate the pathophysiology of paraplegia during transarterial chemoembolization in liver cancer and investigate effective management and prevention for improving clinical situation and relieve major symptoms.Method 2758 patients accepted TACE procedure because of liver cancer(and/or combined with remote metastasis),demonstrated 4 cases suffering from paraplegia(3 males,1 female)since Mar.2003 to Feb.2005,with mean age of(51?14)years old,The operative records and the clinical features after chemoembolization were summarized in detail.Results The incidence of paraplegia was 0.145%,with major symptoms of dysesthesia and hypokinesise emerging within 4 hours after TACE,and most symptoms aggravating gradually within 24-48 hours untill paraplegia appeared,and then turned to stabilization about 5-7 days,with their body functions partial recovery in 2 months.Conclusion More attention should be paied to prevent ectopic embolization of spinal cord vessels originating from extrahepatic collateral arteries during TACE or TAE.

AIM: To construct a recombinant vector containing gloverin and express it in vitro by Rapid Translation System(RTS500). METHODS: The gloverin cDNA was amplified by PCR and inserted into the prokaryotic expression vector pIVEX2.3. The recombinant product was identified by PCR and enzyme digestion. The positive reconstructed expression plasmid pIVEX2.3-G was expressed by RTS500 in vitro. The expressed protein was identified by SDS-PAGE and western blotting. RESULTS: Positive recombinant plasmid pIVEX2.3-G was successfully constructed. Target protein of 13.8 Kda with 6-his tag was detected by SDS-PAGE and western blotting. CONCLUSION: Gloverin polypeptide is successfully expressed in inactive E.coli in vitro.

Objective To explore the impact of total parathyroidectomy(tPTX)on carotid-femoral pulse wave velocity(cfPWV)in hemodialysis patients. Methods A total of 35 patients undergoing hemodialysis with refractory secondary hyperparathyroidism and treated with tPTX were studied. Before tPTX and 1 year after the oper-ation,cfPWVwas measured and hepatic and renal function,serum calcium,serum phosphorus,intact parathyroid hormone and hemoglobin were measured. The impact of tPTX on cfPWV in hemodialysis patients was analyzed. Results Serum calcium,serum phosphorus and intact parathyroid hormone decreased(P < 0.01),while hemo-globin and serum albumin increased(P < 0.01)and cfPWV decreased 1 year after the operation,which showed statistical significance(P<0.01). The cfPWV of the patients with tPTX was still higher than that of healthy indi-viduals(P<0.01). Conclusion tPTX can effectively reduce cfPWV in hemodialysis patients with refractory sec-ondary hyperparathyroidism.

Objectives By Oxford pathological classification and analysis of circulating complement complement 3 (C3),renal C3 deposition,and clinical laboratory tests,we discussed the correlation between complement C3 and immunoglobin A nephropathy (IgAN) in pathogenesis.Methods A retrospective study of 558 IgAN cases at Xinhua Hospital from January of 2000 through December of 2013 was performed.All 558 IgAN diagnoses were made and confirmed by renal needle biopsy.Results Compared to patients who had circulating C3 ＜ 0.9,patients with circulating C3 level ＞ 0.9 showed statistically significant decreases in serum creatinine [(100.92 ± 105.31) μmol/L vs (157.58 ± 208.39) μmol/L,t =-2.283,P =0.025],blood urea nitrogen [(5.69 ± 2.88) mmol/L vs (7.69 ± 5.90) mmoL/L,t =-2.81,P =0.006];besides,other parameters like IgA,body weight,body mass index (BMI),cholesterol,triglyceride,serum IgA/C3 ratio,albumin,and estimated glomeruli filtrate rate (eGFR) also presented statistically significant differences between two patient groups;no statistically significant differences were observed between two groups in glomerular mesangial cell proliferation,capillary endothelial proliferation,segmental glomerular sclerosis or adhesions,renal tubule atrophy,tubulointerstitial fibrosis,and formation of glomerular crescent;meanwhile,no statistically significant differences were observed between two groups in mesangial depositions of IgA,IgG,IgM,and complement C3;meanwhile the blood level of C3 between C3 deposition negative group,deposition 2 + and 3 + subgroup showed statistically significant differences (2.493 and 2.782;0.013 and 0.006),nevertheless,prognostic indices in Oxford classification,such as mesangial cell proliferation,capillary endothelial proliferation,segmental glomerular sclerosis or adhesions,renal tubule atrophy and tubulointerstitial fibrosis,were also statistically different between two patient groups (Pearson Square test result was 50.782,35.141,21.105,30.182,respectively;P ＜0.01).Conclusions Renal deposition of complement C3 or decrease in circulating C3 level may be associated with a poor prognosis of IgA nephropathy,and alteration in C3 dynamics may be implicated in the pathogenesis of IgAN through its involvement in humoral immunity.

It is now thought that atherosclerosis,although due to enhanced lipid deposition,is mainly the result of a series inflammatory process.Total saponins of Aralia elata (Miq)Seem(TASAES)from the Chinese traditional herb Longya Araliachinensis L.,a folk medicine used for treating various diseases, increasing energy and improving the body′s ability to prevent hypoxia in Asian countries has attracted widespread attention. However, the ability of TASAES on inflammation-triggered vascular endothelial cell injury, a key early event in the pathogenesis of atherosclerosis, and its potential mechanisms of this protection have never been demonstrated. The present study determined the anti-inflammatory and anti-apoptoticactivities and protective mechanisms of the total aralosides of Araliaelata(Miq)Seem (TASAES) ameliorate tumor necrosis factor-α (TNF-α)-induced human umbilical vein endothelial cells (HUVECs) injury. Our results indicate that TASAES pretreatment provided cytoprotective effects by suppressing TNF-α-induced HUVECs apoptosis, mitochondrial membrane depolarization, caspase-3 activation, and modulation of inflammatory factors (IL-6, MCP-1 and VCAM-1), meanwhile inhibiting NF- κB transcription. Furthermore, the effect was correlated with the activation of the PI3K/Akt signal pathway. Blocking Akt activation with the PI3K inhibitor LY294002 effectively reversed the protective effect of TASAES against TNF-α-induced cell apoptosis.Moreover,the PI3K inhibitor partially blocked the effects of TASAES on the increasing of Bcl-2 and Bcl-xl protein expression,and inactivation of Bax protein expression. In conclusion, the results showed that TASAES decreased the inflammation and apoptosis of HUVECs caused by TNF-α treatment,and PI3K played a crucial role in enhancing cell sur-vival during this process.

OBJECTIVETo search for the best acupuncture and moxibustion treatment program for stroke.

METHODSOne hundred and eighty-three cases of stroke were divided into a scalp-body acupuncture group of 62 cases, a scalp acupuncture group of 60 cases and a body acupuncture group of 61 cases. They were treated for 2 months and then their therapeutic effects were compared.

RESULTSIn the scalp-body acupuncture group, 13 cases were basically cured, 32 cases improved obviously, 15 cases improved, 2 cases was ineffective, and corresponding figures in the scalp acupuncture group were 8, 21, 24, 7, and in the body acupuncture group were 11, 28, 19, 3, with a significant difference between the scalp-body acupuncture group and the scalp acupuncture group (P<0.05) , and with no significant differences between the scalp-body acupuncture group and body acupuncture group, and between the body acupuncture group and the scalp acupuncture group.

CONCLUSIONScalp acupuncture combined with body acupuncture has a better clinical therapeutic effect than that of simple scalp acupuncture for the patient of stroke.

Acupuncture Therapy ; Humans ; Moxibustion ; Scalp ; Stroke ; therapy

OBJECTIVETo explore the therapeutic effect and mechanism of Aitongping capsule (ATP) in treating cancerous pain.

METHODSSixty cancer patients were randomly divided into two groups, 30 patients in the treated group took ATP and 30 patients in the control group took diclofenac, 1 week of treatment was applied. The relevant clinical conditions of cancerous pain, the content of plasma beta-endorphin (beta-EP) and c-AMP, hemorheological index, improuement of life quality of patients, occurrence rate of adverse reaction were observed before and after treatment.

RESULTSThe total effective rate in the treated group and in the control group was 90.0 % and 83.3%, respectively, difference between them showed no significance. However, there were significant difference between the two groups in such aspects as the degree of pain relieving, the decrease of pain episodes, the shortening persistent time of pain and the initiation time of analgesic action and prolonged analgesic duration, the decrease of tenderness and percussion pain, the increase of plasma beta-EP content and the decrease of cAMP (P< 0.05 or P< 0.01). The evidences also showed that it was better in improving quality of life, ameliorating hemorheologic indexes and reducing incidence of adverse reaction in the treated group than in the control group (P <0.05 or P <0.01).

CONCLUSIONATP has affirmative effect on cancerous pain, its analgesic effect may be associated with the increasing of plasma beta-EP content, decreasing of cAMP level and ameliorating of hemorheologic indexes.

Capsules ; Cyclic AMP ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Liver Neoplasms ; blood ; complications ; Lung Neoplasms ; blood ; complications ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Phytotherapy ; Quality of Life ; beta-Endorphin ; blood

Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Cafe-au-Lait Spots ; diagnosis ; pathology ; Child ; Diagnosis, Differential ; Female ; Fibroma ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Neurofibromatosis 1 ; diagnosis ; Radiography ; Syndrome

Background and purpose: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new minimally invasive method in the dignosis for mediastinal lymph nodes. This study was to evaluate the diagnostic yield of EBUS-TBNA for mediastinal lymph nodes. Methods: Twenty patients with mediastinal lymph nodes found by CT underwent the dignosis by EBUS-TBNA form April 1st 2009 to July 16th 2009. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were evaluated. Results: Twenty patients with 37 lymph node groups were studied. Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EBUS-TBNA for diagnostic were 84.62%, 100%, 100%, 77.78% and 90.00%, respectively. The diagnostic accuracy for cancer was 100%. The operation time was 11.9min per group in average with no serious complication. The median length of hospital stay was 1 (range from 1 to 17 days) day after operation. There were significant differences in the average operation time between the first three patients and the others (36.25 min vs. 7.76 min; z=3.247, P=0.001). Conclusion: Endobronchial ultrasound-guided transbronchial needle aspiration proved to be a safe procedure with a high yield for the diagnosis of mediastinal lymph nodes.

Objective To explore the clinical efficacy and safety of transcatheter absolute ethanol injection treatment on varicose veins of lower extremity.Methods twenty-there patients with 25 varicose veins of lower extremity were treated by puncture of great saphenous vein above 1—2 cm of complicated inner ankle,perforating catheter to the point below the 3—4 cm of the conjunction of great saphenous vein and Femoral vein and pressing the conjunction of these two veins.Under the monitor of DSA,inject the absolute ethenal slowly while retrieve the catheter little by little(one limb with varicose veins injected total volume 15—20 ml),in the mean time,using contrast agent to monitor the level of embolism until the formation of total embolism in the all great saphenous veins.Results All the cases were retrospectively followed up with CDFI examination after 3—12 months of the surgery,No blood flow were seen in the 25 embolismic great saphenous vein.Clinical symptom were alleviated obviously after 2—3 weeks of treatment;varicose veins were collapse after 3 to 7 days.Two eases of leg ulceration were healed after 4 to 6 weeks of operation.20 limbs were found mild swelling in the 2 day after the surgery.However,all the cases were disappeared after 1 to 2 weeks;4 treated limbs developed delayed paresthesia in the 3 day after the surgery,and recovered totally in the 2 weeks.No complications of deep vein thrombosis,lung thrombosis etc al,were found after operation.Conclusions Using transcatheter injection of absolute ethanol to treat varicose veins of lower extremity has the advantage of less invasion,more safety and low appearance of complications.The short term efficacy is solid while the long term effect needs further evaluation.