Objective: To analyze the related risk factors for esophageal variceal bleeding (EVB) in patients with hepatocirrhosis and portal hypertension, so as to provide clinical evidences for establishing preventive measures for EVB. Methods: Using "* esophag *", "varice *", "bleeding", "hemorrhage", and "risk factor *" as the key words, we searched the clinical studies (1986-2006) about the risk factors of EVB in hepatocirrhosis patients in PubMed, Medline, Chinese Biomedical Database, Elsevier Database, OVID Database, etc. for Meta-analysis. The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI] was calculated. Results: Totally 19 papers met our criteria and were included in this Meta-analysis. The 19 papers involved 995 EVB patients and 1 854 controls. Meta-analysis revealed that a hepatic function of Child C, decreased prothrombin activity, hypoalbuminemia, severe esophageal varices, positive red-color sign, extended portal vein width and splenic vein width, thrombopenia, leucopenia and anemia were the risk factors of EVB; a hepatic function of Child A and mild esophageal varices were the protective factors of EVB. The gender, age, hepatic function of Child B, ascites, hepatic encephalopathy, hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion: Improvement of poor hepatic function, blood coagulation status, hypoalbuminemia and treatment & prevention of severe esophageal varices (by endoscopic variceal ligation, devascularization and shunt) can help to reduce the incidence of EVB.

Objective:To analyze the related risk factors for esophageal variceal bleeding(EVB)in patients with hepatocirrhosis and portal hypertension,so as to provide clinical evidences for establishing preventive measures for EVB. Methods:Using"*esophag*","varice*","bleeding","hemorrhage",and"risk factor*"as the key words,we searched the clinical studies(1986-2006)about the risk factors of EVB in hepatocirrhosis patients in PubMed,Medline,Chinese Biomedical Database,Elsevier Database,OVID Database,etc.for Meta-analysis.The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI]was calculated.Results:Totally 19 papers met our criteria and were included in this Meta-analysis.The 19 papers involved 995 EVB patients and 1854 controls.Meta-analysis revealed that a hepatic function of Child C,decreased prothrombin activity,hypoalbuminemia,severe esophageal varices,positive red-color sign,extended portal vein width and splenic vein width,thrombopenia,leucopenia and anemia were the risk factors of EVB;a hepatic function of Child A and mild esophageal varices were the protective factors of EVB.The gender,age,hepatic function of Child B,ascites, hepatic encephalopathy,hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion:Improvement of poor hepatic function,blood coagulation status,hypoalbuminemia and treatment & prevention of severe esophageal varices(by endoscopic variceal ligation,devascularization and shunt)can help to reduce the incidence of EVB.

Objective To evaluate the diagnostic evaluation of isotropic scanning and Lung Care soft- ware in solitary pulmonary nodules,and to improve the diagnostic accuracy.Methods 52 patients suffered from SPN were included in our study.Two experts in CT analyzed the films.First,they read the axial images and made diagnosis.Then isotropic scanning and lung care software approaches were used on 16 spiral CT and another analysis were made again.The results were compared with pathological diagnosis respectively. Results Spiculated sign,lobulated sign,vessel convergence were found more on isotropic scanning approach, that had significant difference with axial images analysis(P

Objective To explore the application value of MSCT 3D reconstruction technique in flexible ureteroscopy and holium laser lithotripsy (FURL) for subrenal calyx calculus. Methods Data of 67 subrenal calyx calculus patients treated with FURL were analyzed retrospectively. The anatomic difference between surgically cured group and uncured one was compared by measuring the renal pelvis subrenal calyx infundibulopelvic angle (IPA), the calyx width and length, as well as the minimum ratio of subrenal calyx neck width and calyx transverse diameter (minN/T) with MSCT 3D reconstruction technique. The anatomic structure factors that may impact the operative success rate were discussed. Results Among the 67 patients, 52 patients were cured and in cured group, and 15 patients were in uncured group. The average IPA value in cured group was significantly higher than that in uncured group:(54.12 ± 21.32)° vs. (42.12 ± 22.68)° , and there was significantly difference (P<0.05). Twenty-six patients performed CT 3D reconstruction and IVU examination at the same time. The level of IPA in CT 3D reconstruction was significantly higher than that in IVU examination : (53.12 ± 10.16)° vs. (47.67 ± 11.25)° , and there was significant difference (t=1.676, P<0.05). Logistic regression analysis showed that IPA and minN/T levels were the influencing factors of FURL for subrenal calyx calculus. Conclusions The MSCT 3D reconstruction technique can better describe the anatomical relationship of the subrenal calyx. The success rate of FURL relates to the IPA value and the min N/T, which is significant in preoperative indication evaluation.

OBJECTIVETo explore the effect of Salvianolate on myosin heavy chain (MHC) in cardiomyocytes of congestive heart failure (CHF) rats.

METHODSSixty male SD rats were divided into 6 groups according to random digit table, i.e., the normal control group (NCG), the model group, the Captopril group (CAG), the low dose Salvianolate group (LSG), the high dose Salvianolate group (HSG), the Captopril and high dose Salvianolate group (CSG), 10 in each group. CHF rat model was established with peritoneal injection of adriamycin in all rats except those in the NCG. Equal volume of normal saline was peritoneally injected to rats in the NCG, once per week for 6 successive weeks. Corresponding medication was started from the 5th week of injecting adriamycin. Rats in the CAG were administered with Captopril solution at the daily dose of 10 mg/kg by gastrogavage. Rats in the LSG and the HSG were administered with Salvianolate solution at the daily dose of 24.219 mg/kg and 48.438 mg/kg respectively by gastrogavage. Salvianolate was dissolved in 2 mL 5% glucose solution and administered by peritoneal injection. Rats in the CSG were peritoneally injected with high dose Salvianolate solution and administered with Captopril solution by gastrogavage. Two mL normal saline was peritoneally injected to rats in the model group, once per day for 8 successive weeks. Eight weeks later, the cardiac function and myocardial hypertrophy indices were detected by biological signal collecting and processing system. mRNA expression levels of alpha-MHC and beta-MHC in cardiac muscle were detected by fluorescence quantitative PCR. Expressions of protein kinase C (PKC) in cardiac muscle were detected by Western blot.

RESULTSCompared with the normal control group, heart mass index (HMI) and left ventricular mass index (LVMI) obviously increased in the model group (P < 0.01). Compared with the model group, HMI and LVMI decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). It was more obviously lowered in the CSG group than in the CAG group (P < 0.05). Compared with the NCG, the mRNA expression level of alpha-MHC in cardiac muscle decreased, the mRNA expression level of p-MHC and the expression of PKC in cardiac muscle increased in the model group (P < 0.01). Compared with the model group, the mRNA expression level of alpha-MHC in cardiac muscle was increased, and the mRNA expression level of beta-MHC and the expression of PKC in cardiac muscle were decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). There was statistical difference between the CSG group and the CAG group (P < 0.05).

CONCLUSIONSSalvianolate could up-regulate the mRNA expression level of alpha-MHC, and down-regulate the mRNA expression level of beta-MHC in cardiac muscle. Its mechanism might be related to decreasing the expression of PKC.

Animals ; Captopril ; Doxorubicin ; Drugs, Chinese Herbal ; Heart Failure ; metabolism ; Male ; Myocardium ; Myocytes, Cardiac ; drug effects ; metabolism ; Myosin Heavy Chains ; metabolism ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To investigate the relationship between the promoter of IL-12B gene polymorphism and the susceptibility and clinical features of chronic gastritis and duodenal ulcer with or without Helicobacter pylori(Hp) infection in children and adolescent.Methods Mucosal biopsies were obtained from 132 children and adolescent (patient group),including 100 children with chronic gastritis and 32 children with duodenal ulcer,undergoing an upper gastrointestinal endoscopy for dyspeptic symptoms.Biopsy specimens were stained with hematoxilin and eosin (HE),and gastritis was graded according to the Sydney system.Serology,urease test and histology were taken to assess Hp status.Genomic DNA was obtained from peripheral blood or gastric biopsies of patients and 102 healthy children as normal control group.The promoter of IL-12B +1188A/G gene polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing.The genotype distributions and allele frequencies were compared between the study group and the normal control group,and the association of genotypes with clinicopathological features was studied.IL-12B mRNA level expressions in gastric mucosa were confirmed by reverse transcription PCR biopsy-based tests.Results The genotype distributions and allele frequencies of IL-12B +1188A/G gene polymorphisms were similar in gastric upper gastrointestinal diseases and healthy subjects.The IL-12B +1188A/G gene polymorphisms were not associated with Hp status.IL-12B+1188A/G gene polymorphisms did not affect IL-12B mRNA level expressions and were not associated with the degree of antrum chronic inflammation.Conclusions These data suggest that IL-12B+1188A/G gene polymorphisms are not associated with susceptibility to chronic gastritis and duodenal ulcer in children and adolescent.

Objective To study the immunologic and pathologic features of an accelerated rejection model of renal allotransplantation in presensitized monkeys.Methods The accelerated rejection model of renal allotransplantation was established in presensitized monkeys,which received donor skin transplantation in advance(n=3).The changes of donor specific antibody(DSA)levels in the recipient monkeys before/after skin and kidney transplantation were measured.The kidney grafts were examined for routine pathology,antibody and complement depositions,various lymphocyte subsets infiltration by HE staining,immunofluorescence,or immunohistochemistry.Results All renal allografts in 3 presensitized monkeys developed accelerated rejection within 4 days.In 2 presentized monkeys,the levels of DSA and their mediated complement-dependent cytotoxicity(CDC)were significantly increased after skin transplantation,and further markedly elevated at the time of kidney graft rejection.In the rejected renal grafts,massive C3,C4,C5b-9 and IgG deposits with few lymphocytes infiltration were found.Typical pathologic changes included severe arterionecrosis,thrombosis,interstitial hemorrhage,and infiltration of neutrophils.In the rest one presentized monkey,the levels of DSA and CDC were only marginally increased,and the pathological changes of the rejected renal graft were characterized mainly by the injury of renal tubules.Conclusion Presensitization by donor skin transplantation could elevate the levels of DSA and CDC in recipient monkeys,which resulted in severe antibody-mediated acute humoral rejection in most of the following renal transplants.

OBJECTIVETo investigate the expression of interleukin-10 (IL-10) mRNA in gingival tissue of active and stable stage in patients with adult periodontitis.

METHODS12 patients with acute abscesses of the periodontium, 12 patients after periodontal initial treatment and 6 periodontal healthy patients having extraction of impacted wisdom tooth were randomly divided into group A (active stage group), group B (stable stage group) and the control group. Biopsies of gingival tissues were collected from every subject of three groups. Technique of in situ hybridization was applied to observe the expression of IL-10 mRNA in the biopsies from three groups semi-quantitatively.

RESULTSIL-10 mRNA was positively expressed in lymphocytes, macrophages and fibroblasts. The quantity of IL-10 mRNA of group A was the lowest in the three groups and was significantly lower than that of control group and group B respectively (P < 0.01). The quantity of IL-10 mRNA of group B was the highest in the three groups and was significantly higher compared with the control group and group A (P < 0.01).

CONCLUSIONThe quantities of IL-10 mRNA expression are closely related with various clinical states of periodontitis.

Case-Control Studies ; Chronic Periodontitis ; metabolism ; Gingiva ; metabolism ; Humans ; Interleukin-10 ; metabolism ; RNA, Messenger ; metabolism

OBJECTIVEIn order to investigate the characterization of mother to children transmission, the sequences of HBV were analyzed to offer the information about the effect of interrupt.

METHODSThe sera of 75 mother with positive HBsAg are collected from 2003, and the ELISA was performed to determine the HBV infection of the child. The Large S sequence of HBV including preS and S gene are amplified and sequenced. The genotype was determined with the standard genotype sequence. The mutation ratios of group successfully interrupted and failed compared.

RESULTSThe sera of 4 pairs mother-children were HBsAg positive, including one twins. The virus genes are successful amplified. Four of HBV genotype is B and one is C. Gene of twins has mutation of T143M. 43 HBV of successfully interrupted group were sequenced. There are 37 of genotype B and 6 of genotype C. Three have the mutation in "a" dominant, and the percentage is 7%.

CONCLUSIONMost failed interrupted child have the same sequence with their mother, and the ratio is higher than the mother of successful group, however there have no statistical significance.

Adult ; Female ; Hepatitis Antibodies ; blood ; Hepatitis B ; immunology ; prevention & control ; transmission ; virology ; Hepatitis B Surface Antigens ; genetics ; immunology ; Hepatitis B Vaccines ; administration & dosage ; immunology ; Hepatitis B virus ; genetics ; immunology ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; immunology ; Infectious Disease Transmission, Vertical ; prevention & control ; Male ; Mutation ; Vaccination

OBJECTIVETo investigate the effects of a new anticoagulant, annexin V derivative (AND) on anticoagulation and antithrombosis.

METHODSHigh and low doses of AND were given to rabbits (groups 1 and 2 respectively) by intravenous (iv) bolus injections followed by half the respective AND doses by iv infusion over 2 hours. Control groups were iv given heparin (group 3) and saline (group 4) of the same volume and procedure as that in group 1 and 2. Blood cell count, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen level were examined before and 15, 30 and 60 min after iv bolus and 2 hours after the end of iv infusion. A 3.0 mm x 15 mm balloon was put into femoral artery to induce endothelial denudation 15 min after IV bolus and the blood pressure of femoral artery was monitored until the pulse pressure recorded 0 mm Hg when the vessel was occluded completely by a thrombus. The femoral arteries were collected and the thrombi were stripped off for measuring their lengths, wet and dry weights.

RESULTSAnticoagulation parameters: APTT at 15 min after iv bolus in AND group was significantly longer than that in group 4 (P < 0.05) but shorter than that in group 3 (P < 0.05); APTT and TT in group 3 were significantly longer than those in groups 1, 2 and 4. Fibrinogen: 0.70 mg/kg AND may decrease fibrinogen. Antithrombosis values: the wet and dry weights in AND groups were significantly lighter than those in group 3 and 4 (P < 0.05). The dry weight in high-dose AND group was remarkably lighter than that in low-dose group (P = 0.029). The length of thrombus in low-dose AND group was remarkably shorter than that in group 4 (P = 0.013), but not for group 3 (P > 0.05). It was remarkably shorter in high-dose AND group than in both group 3 (P < 0.001) and 4 (P = 0.015). The time when pulse pressure equaled to 0 was longer in AND group than in group 4 (P < 0.05), but not in 3.

CONCLUSIONAND is an effective anticoagulant and antithrombosis agent, the highest anticoagulation effect occurs at 15 min after IV bolus. Its anticoagulation effect is not more potent than that of standard heparin, while antithrombosis capacity is more effective. AND in treating thrombosis clinically might be promising.

Animals ; Annexin A5 ; administration & dosage ; pharmacology ; Anticoagulants ; administration & dosage ; pharmacology ; Blood Coagulation ; drug effects ; Disease Models, Animal ; Fibrinogen ; analysis ; Humans ; Injections, Intravenous ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Rabbits ; Random Allocation ; Thrombin Time ; Thrombosis ; prevention & control