Background With the changes of diet and living style,the diabetes has become the major diseases affecting human health.Diabetic cataract is a common complication of diabetes. Objective The present study was to investigate the difference of lens proteomics between diabetic cataract and age related cataract using two dimensional electrophoresis (2-DE) and mass spectrometry in order to postpone happening of diabetic cataract and offer the effective approach to the prevention and therapy of diabetic cataract. Methods The lenses were obtained from 8 diabetic patients and 12 age-related cataract patients during the surgery to extract the protein by lysis and centrifugation.The lens proteins were separated using immobilized pH gradients 2-DE.Image analysis was carried out using PDQuest Advanced-8.0.1 software package.Significant difference of the crystallines was identified by matrixassisted laser adsorption/ionization time of-flight-mass spectrometry (MALDI-TOF-MS) and peptide mass fingerprint combined with protein database. Results The maps of 2-DE showed that lens proteins of diabetic cataract and age related cataract were in the section of pH 5-9 with the relative molecular weight 14000-97000;while relative molecular weight of more abundant crystalline was localized at 20000-31000.About 3 differential protein spots were detected by image analysis software.Two crystallines,αB and βB1 crystallin,were identified using MALDI-TOF-MS.Conclusions Proteomic analysis of lens can be accomplished and the proteins can be well separated,moreover,differential proteins can be analyzed using 2-DE and mass spectrometry between diabetic cataract and age related cataract.These results indicate that αB and βB1 crystallin proteins accelerate the development of diabetic cataract.This technique offers a new avenue for clarity of lens proteins of diabetic cataract other than age related cataract.

Objective To explore the endothelial cell markers,angiogenesis and proliferative activity ofcavemous malformation (CM) ofthe central nervous system by immunohistochemical study.Methods Ninety-seven patients with CM performed excision and confirmed by pathologic examination from April 2004 to August 2008 were chosen in our study.According to the MRI manifestations and their pathological features,they were divided into bleeding group (n=47) and non-bleeding group (n=50); and 20 normal brain samples from patients of open cranial-cerebral trauma were chosen as controls. All samples were stained by immunohistochemistry with CD34, α-smooth muscle actin (α-SMA), and vascular endothelial growth factor (VEGF),respectively. Results CD34 expressed in the endothelium of CM discontinuously; in CM with small lumen,thick layer of immunohistochemistry with CD34 was noted,while in CM with large lumen,thin layer of that was observed discontinuously; and the α-SMA expressed in the sub endothelium of CM with diffuse distribution. VEGF expressed obviously in endothelium,sub endothelium and intervascular spaces with diffuse distribution; significant differences of them were noted between each 2 groups (control group,bleeding group and non-bleeding group,P＜0.05).Ki-67 was negative in all samples. Conclusion Lack of vessel smooth muscle may relevant to bleeding tendency of CM; the up-regulation of VEGF may be the result of bleeding stimulation and absence of Ki67 indicates no proliferation in CM.

Objective To present a preliminary latest procedure for portal hypertension and evaluate the technical feasibility and efficacy of portacaval shunt creation through the percutaneous transhepatic approach in order to make a hemodynamic comparison with that of the classic TIPS.Methods Thirty-eight patients with portal hypertension(36 men;mean age 57 years,range 32～73)were referred for PTPS procedure because of bleeding varices(n=36),intractable ascites(n=1),and hepatopulmonary syndrome(n=1).The severity of liver disease was classified as Child-Pugh B in 27 and C in 11.The PTPS was created by a percutaneous transhepatic puncture into right portal vein and then through left portal vein to the hepatic segment of IVC followed by a prefabrication stress stent-graft placement at the very site.Results Technical and functional success of 100% was achieved in all patients,without related complications.The postprocedural portal vein-IVC gradients mean 13 cmH_2O was achieved with the follow-up period mean 493 days.No recurrence of variceal bleeding and controlled refractory ascites were achieved,and still more with primary patency rate of the involved vascular structure up to 94.8% at 365 days,much better than classic TIPS. Conclusions Portacaval shunt creation using the prefabrication stress stent via percutaneous transhepatic technique is safe and feasible.The compact coincidence was obtained between the stent and the involved vessel with restoration of intrahepatic portal venous bemodynamics together with partial lowering of portal venous pressure and guaranteeing intrahepatic perfusion through right portal vein.It is also obviously to have postoperative prevention of shunt restenoses and lowering postoperative incidence of hepato-encephalopathy.

BACKGROUNDThe presence of autoantibodies against multiple epidermal proteins is an important feature in paraneoplastic pemphigus (PNP). Circulating anti-desmoglein 3 autoantibody, the major pathogenic autoantibody in pemphigus vulgaris (PV), has been proved pathogenic in PNP. Because of many clinical differences between PNP and PV, we speculate about the involvement of other autoantibodies in the pathogenesis of PNP. Envoplakin (EPL) and periplakin (PPL) are recognized by most PNP sera. Their linker subdomains are highly homologous and necessary for the association of intermediate filaments.

METHODSWe characterized the autoantibodies against the linker subdomains of EPL and PPL in PNP patients' sera and their associated tumors by enzyme-linked immunosorbent assay (ELISA) and immunofluorence. We also applied the purified autoantibodies against EPL and PPL from PNP sera to cultured human epidermal keratinocytes (HEK), to evaluate the changes of cell-cell adhesion.

RESULTSAutoantibodies against EPL and PPL were detected in most PNP patients by ELISA, and the decrease of these autoantibodies after removal of the tumors was roughly comparable to the improvement of clinical symptoms. Cultured tumor cells from PNP patients secreted these autoantibodies. Specific immunoglobulin receptors for EPL and PPL were found on B lymphocytes in tumors from PNP. Furthermore, purified anti-EPL and anti-PPL autoantibodies from PNP sera were capable of dissociating cultured human epidermal keratinocytes.

CONCLUSIONAutoantibodies against EPL and PPL may also be pathogenic in PNP.

Adolescent ; Adult ; Autoantibodies ; immunology ; pharmacology ; Cell Adhesion ; drug effects ; Cells, Cultured ; Desmoglein 3 ; immunology ; Enzyme-Linked Immunosorbent Assay ; Epidermis ; cytology ; Female ; Humans ; Keratinocytes ; cytology ; drug effects ; Male ; Membrane Proteins ; immunology ; Middle Aged ; Paraneoplastic Syndromes ; immunology ; metabolism ; Pemphigus ; immunology ; metabolism ; Plakins ; immunology ; Protein Precursors ; immunology ; Young Adult

OBJECTIVETo probe the safe depth and angle of needling the point Yaotu for treatment of prolapse of intervertebral disc.

METHODSCT technique was used for scanning investigation of the depth and angle of needling the point Yaotu.

RESULTSWhen the acupuncture needle was inserted vertically to the external space of intervertebral foramen of human body with arrival of qi, the tip of needle could reach to 73 mm deep, which is the best needling depth and angle.

CONCLUSIONThe needle vertically inserting to the external space of intervertebral foramen at the point Yaotu is proper in treatment of prolapse of intervertebral disc.

Acupuncture Analgesia ; Acupuncture Points ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Medicine, Chinese Traditional ; Tomography, X-Ray Computed

OBJECTIVETo study the effect of multiglycosides of Tripterygium wilfordii (MTW) for treatment of proteinuria in kidney transplant recipients.

METHODForty-five kidney transplant recipients with proternuria were randomized into 3 groups (n=15) and received full daily dose (1 mg/kg) MTW, half dose (0.5 mg/kg) MTW or no MTW (control) in addition to immunosuppressant therapy. The 24-hour urinary protein (24 h Upro), blood urea nitrogen (BUN), serum creatinine (Scr), dose of ciclosporin and the adverse effects of MTW were recorded.

RESULTSMTW at both the full dose and half dose significantly reduced the 24 h Upro as compared to exclusive immunosuppressant therapy (P<0.05). The therapeutic dose of ciclosporin in patients with full and half dose of MTW was significantly lower than that in the control group (P<0.05), and the patients receiving full dose MTW showed greater adverse effects than those having half dose MTW (P<0.05).

CONCLUSIONSMTW can significantly ameliorate proteinuria, reduce the therapeutic dose of ciclosporin and protect the renal function in kidney transplant recipients. While producing similar therapeutic effect to routine full dose, long-term use of half dose MTW may reduce the adverse effect associated with MTW.

Adult ; Aged ; Female ; Glycosides ; therapeutic use ; Graft Survival ; immunology ; Humans ; Kidney Transplantation ; adverse effects ; immunology ; Male ; Middle Aged ; Proteinuria ; drug therapy ; etiology ; Tripterygium ; chemistry ; Young Adult

Dermophytosis is a common fungal disease that affects fast-growing antlers of sika deer (Cervus nippon)and red deer (Cervus elaphus),causing the so-called 'white-skin antlers'and 'crusted antlers'.Here we described the features of dermophytosis in deer antler observed from 20 affected deer from 8 farms in Jilin and Liaoning province by clinical findings,he-matology,pathological examination and fungal species distribution.The fungal infection in the antlers as indicated by HE stai-ning,affected only epidermis and the dermis layers,with the main lesion of necrosis of the dermis tissue and inflammatory in-filtrate.Hematologic profile suggested the insignificant cell count change of lymphocyte,neutrophil,white blood cell between dermophytosis and healthy deer(n=10).A total of 68 fungi isolates were then recovered from the antlers with dermophytosis, of which 64.7% (44/68)were identified as members within Deuteromycotina,the rest 35.3% (24/68)belonged to the Saccha-romycotina.Notably,the well-known opportunistic pathogen,including species within Trichophyton,Epidermophyton as well as Candida albican,might account for the dermophytosis of deer antler.In conclusion,'white-skin antlers'and 'crusted antlers'are high likely caused by opportunistic fungi.

BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insufficiency who had received sedation or no sedation. METHODS: The data of 91 patients who had received mechanical ventilation in the first 24 hours between November 2008 and October 2009 were retrospectively analyzed. These patients were divided into two groups: a sedation group (n=28) and a non-sedation group (n=63). The patients were also grouped in two groups: deep sedation group and daily interruption and /or light sedation group. RESULTS: Overall, the 91 patients who had received ventilation ≥48 hours were analyzed. Multivariate analysis demonstrated two independent risk factors for in-hospital death: sequential organ failure assessment score (P=0.019, RR 1.355, 95％CI 1.051–1.747, B=0.304, SE=0.130, Wald=50483) and sedation (P=0.041, RR 5.015, 95％CI 1.072–23.459, B=1.612, SE=0.787, Wald=4.195). Compared with the patients who had received no sedation, those who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and hospital, and an increased in-hospital mortality rate. The Kaplan-Meier method showed that patients who had received sedation had a lower 60-month survival rate than those who had received no sedation (76.7％ vs. 88.9％, Log-rank test=3.630, P=0.057). Compared with the patients who had received deep sedation, those who had received daily interruption or light sedation showed a decreased in-hospital mortality rate (57.1％ vs. 9.5％, P=0.008). The 60-month survival of the patients who had received deep sedation was significantly lower than that of those who had daily interruption or light sedation (38.1％vs. 90.5％, Log-rank test=6.783, P=0.009). CONCLUSIONS: Sedation was associated with in-hospital death. The patients who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and in hospital, and an increased in-hospital mortality rate compared with the patients who did not receive sedation. Compared with daily interruption or light sedation, deep sedation increased the in-hospital mortality and decreased the 60-month survival for patients who had received sedation.

BACKGROUND:Esophagectomy is a very important method for the treatment of resectable esophageal cancer, which carries a high rate of morbidity and mortality. This study was undertaken to assess the predictive score proposed by Ferguson et al for pulmonary complications after esophagectomy for patients with cancer. METHODS:The data of patients who admitted to the intensive care unit after transthoracic esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2008 and October 2010 were retrospectively reviewed. RESULTS:Two hundred and seventeen patients were analyzed and 129 (59.4％) of them had postoperative pulmonary complications. Risk scores varied from 0 to 12 in all patients. The risk scores of patients with postoperative pulmonary complications were higher than those of patients without postoperative pulmonary complications (7.27±2.50 vs. 6.82±2.67;P=0.203). There was no significant difference in the incidence of postoperative pulmonary complications as well as in the increase of risk scores (χ2=5.477,P=0.242). The area under the curve of predictive score was 0.539±0.040 (95％CI 0.461 to 0.618;P=0.324) in predicting the risk of pulmonary complications in patients after esophagectomy. CONCLUSION:In this study, the predictive power of the risk score proposed by Ferguson et al was poor in discriminating whether there were postoperative pulmonary complications after esophagectomy for cancer patients.

BACKGROUND:Readmission to intensive care unit (ICU) after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay (LOS). The objective of this study was to investigate whether ICU readmission are preventable in critical y il cancer patients. METHODS:Data of patients who readmitted to intensive care unit (ICU) at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between January 2013 and November 2016 were retrospectively collected and reviewed. RESULTS:A total of 39 patients were included in the final analysis, and the overall readmission rate between 2013 and 2016 was 1.32％ (39/2,961). Of 39 patients, 32 (82.1％) patients were judged as unpreventable and 7 (17.9％) patients were preventable. There were no significant differences in duration of mechanical ventilation, ICU LOS, hospital LOS, ICU mortality and in-hospital mortality between patients who were unpreventable and preventable. For 24 early readmission patients, 7 (29.2％) patients were preventable and 17 (70.8％) patients were unpreventable. Patients who were late readmission were all unpreventable. There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable (100％ vs. 66.8％, log rank=1.668, P=0.196). CONCLUSION:Most readmission patients were unpreventable, and all preventable readmissions occurred in early period after discharge to ward. There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.