BACKGROUND: Researches indicate that interleukin-6 (IL-6) in blood has changed during the process of the edema and infection of spinal cord.It is found that IL-6 participates in the course of spinal cord lesion according to the further researches. It is also presumed that the IL-6 is correlated with the edema of spinal cord accompanied nervous system diseases.OBJECTIVE: To observe the effect of the receptor antagonist of the IL-6 on the traumatic edema of spinal cord, and explore the effect of IL-6 in the process of the edema of spinal cord.DESIGN: Randomized control experiment with animals as subjects.SETTING: Department of Orthopedic, Hospital Affiliated to Guangdong Medical College.MATERIALS: The experiment was completed from January to December 2004 in the Animal Experimental Center of Guangdong Medical College.Forty male Wistar rats were selected and randomly divided into the normal group, the wound group, the saline control group and the receptor antagonist of the IL-6 treated group with 10 rats in each group.METHODS: ① The receptor antagonist of the IL-6 treated group: Blast injury of the thoracic spinal cord was made by the sap pressure, and the injection with the receptor antagonist of the IL-6 was given at the injured region with microinjector. ② The wound group: There was not the procedure of administration and placement of the tube. ③ The saline control group: The IL-6 was replaced with the sterile-physiological saline solution (SPSS), and the other procedures were the same as those of the receptor antagonist of the IL-6 treated group. ④ The normal group: There was not any treatment. All rats in each group were detected with magnetic resonance. The water content in the spinal cord was determined with the dry and humid weight method, and the status of the edema of spinal cord was observed with the electron microscope and the pathological image analysis after dyeing with hematine-eosine.MAIN OUTCOME MEASURES: ① The results of the examination of the rats in each group with the magnetic resonance. ② The water content in the spinal cord of rats in each group. ③ The status of the edema of spinal cord was observed with the electron microscope and the pathological image analysis.RESULTS: All the 40 rats entered the result analysis. ① The edema of the T2 w eighting image in the receptor antagonist of the IL-6 treated group was relieved as compared with that in the wound group and the saline control group. ② The water content of the injured region in the receptor antagonist of the IL-6 treated group, the wound group and the saline control group was higher than that in the normal group [ (81.68±1.39)%, (79.72±1.49)%, (82.59±1.12)%, (77.19±0.64)% ,P ＜ 0.01].The water content of the injured region in the wound group was higher than that in the normal group(P ＜ 0.01), and the receptor antagonist of the IL-6 treated group was lower than that of the wound group (P ＜ 0.01). ③The cell body of the gray substance was contracted, the inter-space around the cell was enlarged and the nerve cells were lost in the wound group;The saline control group was not significantly different as compared with the wound group; The cellular edema, degeneration and the necrosis in the receptor antagonist of the IL-6 treated group was milder than that in the wound group.CONCLUSION: The receptor antagonist of the IL-6 has the therapeutical effect on the traumatic edema of spinal cord. The endogenous IL-6 participates in the development of the traumatic edema of spinal cord.

Acupuncture Therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Narcolepsy ; therapy ; Qi

OBJECTIVETo evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence.

METHODSWe searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software.

RESULTSSeven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials.

CONCLUSIONThe current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.

Asthenozoospermia ; drug therapy ; Carnitine ; adverse effects ; pharmacology ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Semen Analysis ; Sperm Count ; Sperm Motility

AIMTo elevate the encapsulation efficiency, decrease the burst release and improve the release of protein entrapped in poly (lactic-co-glycolic acid) (PLGA) microspheres. The bovine serum albumin (BSA) composite microspheres of alginate-chitosan-PLGA were prepared and the release characteristics of BSA from this composite microspheres were studied.

METHODSThe much smaller calcium alginate microcapsules were first prepared by a modified emulsification method in an isopropyl alcohol-washed way and coated with chitosan, then the alginate-chitosan microcapsules were further entrapped in PLGA to form the composite microspheres. The protein concentration was determined using a BCA protein assay kit. The release profiles were changed with various formulation factors.

RESULTSThe average diameter of the composite microcapsules was about 30 microm. Comparing with 60% to 70% of the conventional PLGA microspheres, the average encapsulation efficiency was more than 80%, and the burst releases in phosphate buffer solution of the composite microspheres decreased from 40% and 50% to 25% and further to 5% in saline solution.

CONCLUSIONThe novel composite microspheres were prepared, the drug encapsulation efficiency increased and the burst release decreased. The desired release profiles could be obtained by regulating the ratios of PLG and PLA in the composite microspheres.

Alginates ; chemistry ; Chitosan ; chemistry ; Drug Delivery Systems ; methods ; Lactic Acid ; chemistry ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Polymers ; chemistry ; Serum Albumin, Bovine ; chemistry

Adult ; Female ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; pathology

Objective To analyze risk factor of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). Methods A retrospective population-based cohort study was carried out on 13878 patients undergoing LC from Apr 1994 to Dec 2003. Patients were divided into BDI group and non-BDI group. Factors with statistically significant differences between groups in anivariable analysis were selected to construct a multivariate logistic regression mode. Result Among 13878 LC procedures 38 BDI (0.27%) were identified. Factors which were of significant differences between groups in anivariable analysis includ diameter of common bile duct(?~2=5.92, P

Objective To study the association between functional genetic polymorphisms of IL-1B(T-31C,C-511T),IL-1RN and the susceptibility to gastric cancers. Methods A case-control study was conducted in 180 gastric cancer cases and 308 age-and sex-matched cancer-free controls.Genotypes were detected by PCR-restriction fragment length polymorphism(PCR-RFLP) assays,and association between genotypes,environmental factors and risk of gastric cancers were determined. Results IL-1B T-31C was in strong linkage disequilibrium with IL-1B C-511T(D'=0.862,R2= 0.721,P=0.000).Multivariate logistic regression analysis revealed that the variant genotypes of IL-1B T-31C and C-511T were not significantly associated with risks for gastric cancers(adjusted OR,0.95 and 95% CI,0.62-1.47 for IL-1B T-31C;and adjusted OR,0.85 and 95% CI,0.55-1.31 for IL-1B C-511T).The variant genotypes(1/2,2/2) in IL-1RN were associated with a non-significantly increased risks for gastric cancers(adjusted OR,1.32 and 95% CI,0.71-2.36) in all subjects and with a significantly increased risks for gastric cancers in subjects with H.pylori infection(adjusted OR,2.03 and 95%CI,1.02-4.80).Conclusion The functional genetic polymorphisms of IL-1RN may contribute to the risks of gastric cancers in high-risk population,particularly in those with H.pylori infection.

Objective In this paper we analyzed the major risk factors of hemorrhagic fever with renal syndrome(HFRS) as well as its clinical manifestation,so as to provide a basis for clinical diagnosis and effective control of HFRS in Xi'an.Methods The method of retrospective study was used to collect clinical data of hospitalized patients with HFRS between 2005 and 2010 in the Hospitals for Infectious Diseases in Xi'an city,Zhouzhi and Huxian counties and then clinical manifestations of the patients with HFRS were analyzed and classified according to the national standards for clinical symptoms and test indicators of HFRS.HFRS patients matched by the ratio of 1 ∶ 2 healthy human controls were retrospectively investigated in order to obtain risk factors relevant to HFRS incidence using casecontrol study.Odds ratio(OR) method was used for single factor study.While for the multifactor study,we took the conditional Logistic regression approach.We also built models for both studies.Factor with OR ＞ 1 and P ＜ 0.05 was judged to be a risk factor.Results A total of 3090 cases information of patients with HFRS and 6018 healthy controls were collected.Of the 3090 cases of HFRS patients,sixty vaccinated patients showed atypical clinical manifestations and they were mild or moderate cases and no deaths.A total of 3030 nonvaccinated patients had obvious clinical symptoms.Severe or critical cases accounted for 39.07％(1184/3030)and 60 patients died and the fatality rate was 1.98％ (60/3030).The results of single factor Logistic regression analysis showed that of the 16 factors analyzed,the difference of 11 risk factors between the case group and the control group was statistically significant.Multivariate Logistic regression analysis showed that of the 11 factors,the difference of six factors between the case group and the control group was statistically significant.The main risk factors of suffering HFRS in the order were:exposure to rat pollutants,living in the affected areas,sitting or lying on grass fields in the affected areas,working in the affected areas,house rat infestation,and domesticated cats or dogs(OR =6.826,5.764,4.882,4.857,3.126 and 2.875; P ＜ 0.01 or P ＜ 0.05).Conclusions Vaccines are very useful in the sense that vaccinated HFRS patients tend to have mild symptoms and good prognosis.Health education in this area should be focused on the six risk factors in order to prevent the spreading of HFRS.

Objective To evaluate the diagnostic performance of a point-of-care testing for sensitive cardiac troponin Ⅰ (POCT-cTnI) in early diagnosis of chest pain patients who had a high pretest probability of acute myocardial infarction (AMI).Methods Total of 127 patients with new-onset chest pain at the emergency department were enrolled.Blood samples were drawn for the routine blood test,and determined POCT-cTnI and central laboratory testing for high sensitive cardiac troponin T (CLT-hscTnT) at admission,three and then at six hours after admission.All patients were divided into AMI group and non-AMI group according to the final diagnosis,which was adjudicated independently by two physicians who reviewed all available medical records for the 90-day follow-up period,and they were unaware of the results of the investigational assays of cardiac troponins.The receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performance of AMI of two cardiac troponin assays.The comparison of areas under the ROC curves (AUC) was performed by DeLong test,and the sensitivity,specificity,negative predictive values (NPV) and positive predictive values (PPV) for the target markers were calculated by applying a maker-specific cutoff value.Results The final diagnosis of AMI was made in 40 of 127 patients (31.5 ％).The diagnostic accuracy of the two assays oBtained at presentation,as quantified by AUC,was no statistically differences (AUC for POCT-cTnⅠ,0.901,95％ CI,0.901 to 0.947;and for CLT-hscTnT,0.907,95％ CI,0.842 to 0.951;Z =0.235,P =0.745).The AUC for POCT-cTnI at 3 hours after admission was significantly higher than that on admission (0.931 vs.0.858;Z =-2.038,P =0.042),while there was on further improvement at 6 hours after admission (0.931 vs.0.949;Z =-1.435,P =0.151).With use of POCT-cTnI (cutoff value 0.023 ng/mL,which was the 99th percentile upper reference limit) on adimission,the clinical sensitivity was 77.5％,and the specificity was 94.2％.A single sample of POCT-cTnI at 3 hours after admission improved the diagnostic accuracy,with a sensitivity of 96.4％,a specificity of 92.0％,and a NPV of 98.6％,a PPV of 81.8％.While,with use of CLT-hscTnT (cutoff value 0.014 ng/mL,was the 99th percentile upper reference limit) at 3 hours after admission,the NPV reached to 100％.Conclusions The use of a POCT-cTnI assay in chest pain patients can identify and exclude the AMI rapidly and exactly at three hours after admission,and the diagnostic performance is equivalent to CLT-hscTnT.