OBJECTIVETo observe the effect of Tetramethyl pyrazine (TMP) on the cytokines and inflammatory mediators in the serum and the synovial fluid of collagen-induced arthritis (CIA)rats, and further to investigate its possible mechanisms for treating rheumatoid arthritis (RA).

METHODSType II CIA rat model was established. Rats in the TMP group were administered with TMP at 50 mg/kg and 100 mg/kg, once daily. Dexamethasone at 2.0 mg/kg was intramuscularly injected to those in the Dexamethasone treated group, once daily. Normal saline at 2 mL/kg was given to those in the normal control group and the model group, once daily. All medication was started from the 7th day, lasting to the 35th day. CIA rats' foot swelling degree was observed. Contents of serum IL-1, IL-6, IL-2, NO and PGE2in the synovial fluid were detected by radioimmunoassay and nitrate reduction method.

RESULTSCompared with the normal group, the foot swelling obviously increased, contents of NO and PGE2 in the synovial fluid were obviously elevated in the model group (P < 0.01). Compared with the model group, the foot swelling could be obviously inhibited by 100 mg/kg TMP and Dexamethasone; serum levels of IL-1 and IL-6 obviously decreased, serum IL-2 level obviously increased, contents of NO and PGE, decreased (P < 0.01). TMP 50 mg/kg could obviously inhibit the foot swelling of CIA rats (P < 0.01). There was no statistical difference in other indices (P > 0.05).

CONCLUSIONSTMP at 100 mg/kg showed obvious inhibition on CIA rats. Its inhibitory effect might be correlated to inhibiting activities of endogenous cytokines and the generation of inflammatory mediators in inflammation local regions, improving contents of anti-inflammation cytokines, and inducing the balance of the inflammatory cytokine network.

Animals ; Arthritis, Experimental ; blood ; metabolism ; Dinoprostone ; metabolism ; Female ; Interleukin-1beta ; blood ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Male ; Nitric Oxide ; metabolism ; Pyrazines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Synovial Fluid ; metabolism

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

Objective To describe the clinical characteristics of a patient with Gitelman syndrome,and to identify the associated SLC12A3 gene mutations.Methods A suspected case of teenager-onset Gitelman syndrome was observed in our hospital.It was further confirmed by clinical manifestations and auxiliary examination.In addition,direct sequencing for the exons of SLC12A3 gene and CLCNKB gene region was conducted to identify the probable disease-associated mutations.Results The case showed characteristics of hypokalemia,hypomagnesemia,and low level of urinary calcium and onset by age of 18.By excluding the possibilities of long-term use of thiazide diuretics,laxatives,chronic vomiting and diarrhea,he was finally diagnosed as a case of Gitelman syndrome.Furthermore,by Sanger direct sequencing,2 coding variations were identified in SLC12A3 gene region,including T304M and L488P.L488P was a new heterozygous mutation.Conclusion Detection of SLC12A3 gene mutation could facilitate the diagnosis of Gitelman syndrome and improve prognosis.

Objective To investigate the relationship of the levels of peroxisome proliferator- activated receptor-?(PPAR-?)mRNA,MMP-9 with the severity of coronary artery lesions in patients with coronary heart disease(CHD).Methods One hundred and fifty three patients with CHD who underwent coronary angiography were admitted.The expression of PPAR-?mRNA in lymphocytes of peripheral blood was detected by using RT-PCR,the level of MMP-9 enzyme was measured by enzyme-linked immunosorent assay,and the severity of coronary artery lesions were analyzed. Results As compared with control(0.624-0.13),PPAR-?mRNA expression was significantly lower in CHD patients(0.4+0.12).Negative correlation was found between PPAR-?mRNA and the classification(r=-0.56,P＜0.01)of coronary artery lesions,so was the number of coronary artery lesions(r=-0.42,P＜0.01).MMP-9 level was significantly higher in CHD patients(1.27?0.16)?g/L than that in controls(1.21?0.05)?g/L.Positive correlation was found between MMP-9 level and the classification(r=0.36,P＜0.01)of coronary artery lesions,so was the number of coronary artery lesions(r=0.30,P＜0.01).Negative correlation was also found between PPAR-?mRNA expression and MMP-9 level.Conclusions PPAR-?is a negative regulator of coronary artery lesions and PPAR-?inhibits the activation of MMP-9.It may be a valuable method for protecting patients from the incident of coronary artery disease to activate the expression of PPAR-?and decrease the level of MMP-9.

OBJECTIVETo analyze the rationale and feasibility of maxillary reconstruction using free fibula-flexor hallucis longus myofascial flap.

METHODSNine consecutive cases of maxillary reconstruction using free fibula-flexor hallucis longus myofascial flaps from August of 2002 to August of 2003 were reviewed. Data concerning the operation included description of maxillary defect, design of the fibula flaps, recipient vessel and complications.

RESULTSOne flap experienced venous thrombosis after operation, and the flap was salvaged after exploration. All the flaps survived completely with the overall success rate of 100%, as well as the 100% survival of all fibula-flexor hallucis longus myofascial flaps.

CONCLUSIONSMaxillary reconstruction using free fibula-flexor hallucis longus myofascial flap without skin paddle is feasible and reliable.

Adult ; Female ; Humans ; Male ; Maxilla ; surgery ; Middle Aged ; Surgical Flaps

OBJECTIVETo evaluate the reliability and effectiveness of free flap transfer with double vein anastomosis for reconstruction of head and neck defects.

METHODSOne hundred and sixty-eight cases of free flap transfers with double vein anastomosis for head and neck reconstruction from September 1999 to April 2003 were reviewed. There were 92 males and 76 females. The age range was 11 to 79 years old, with the average of 44.6 years old. Data concerning the operation included site, stage and histology of tumor, defect description, design of free flap, recipient vessel free flap survival and complications.

RESULTSAmong 168 free flaps, there were 126 free fibula flaps, 32 radial forearm flaps, 7 rectus abdominis flaps, one scapular flap, one jejunal flap, and one anterolateral thigh flap. The overall success rate of free flap was 99.4%. One fibula flap was lost because of arterial thrombosis. No venous thrombosis occurred in this group.

CONCLUSIONFree flap transfer with double vein anantomosis for head and neck reconstruction improves the outflow of free flap, reduces the venous thrombosis rate, and ensures a high success rate of free flaps.

Adult ; Aged ; Female ; Free Tissue Flaps ; Head ; Head and Neck Neoplasms ; Humans ; Male ; Middle Aged ; Neck ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Surgical Flaps

OBJECTIVETo establish a predicting model of survival rates and to evaluate the weighted contributions of each key prognostic factor of the patients with salivary adenoid cystic carcinoma (SACC).

METHODSOne hundred and eighteen follow-up cases with SACC were analyzed for the survival study with retrospective cohort method. Ten possible clinical and pathologic factors were selected. A multivariate analysis was performed by Cox proportional hazard model and prognostic index (PI) was calculated. According to the PI, all cases were divided into three risk subgroups respectively: lower, intermediate and higher risk subgroups. Ten-year survival rate and median survival time were calculated and the predicting models of survival rates were established.

RESULTSThe significant prognostic factors influencing the survival rate were age at diagnosis, clinical presentation, TNM clinical stage, treatment, surgical margins (P < 0.05). The predicting formula was PI = 0.031X(2) + 0.665X(5) + 0.420X(6)-0.576X(7) + 0.999X(10). According to the value of PI, the prognosis of the patients was significantly different among the three subgroups (P < 0.05). In the three risk subgroups, 10-year survival rates were 83.56%, 31.45% and 11.20% respectively, the median survival time was 18 years, 7 years and 4 years respectively.

CONCLUSIONSThe established predicting model of survival rates can predict the prognosis of the patients with SACC.

Adolescent ; Adult ; Aged ; Carcinoma, Adenoid Cystic ; mortality ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Salivary Gland Neoplasms ; mortality ; surgery ; Survival Rate ; Young Adult

OBJECTIVETo compare the impact of various types of neck dissection on postoperative shoulder function.

METHODSThe shoulder functions of 66 patients with oral squamous cell carcinoma (OSCC) and cN0 necks who underwent various types of neck dissection were evaluated by Constant's shoulder function test and neck dissection impairment index at least 12 months after surgery.

RESULTSThe patients with accessory spinal nerve reserved had better shoulder function than those with accessory spinal nerve resected. In the group with accessory spinal nerve reserved, the patients receiving selective neck dissection (SND) showed better shoulder function than those with modified radical neck dissection (MRND). The shoulder dysfunction and pain arising from SND were minor in patients with selective neck dissection.

CONCLUSIONSThe shoulder function after SND was superior to those after RND and MRND.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; physiopathology ; surgery ; Neck Dissection ; methods ; Shoulder ; physiopathology

OBJECTIVESTo investigate the difference of BPH incidence in two groups.

METHODS309 cadres and 314 farmers over 60 years old in district of Wannan have been investigated. The investigation included prostate volume (V), IPSS, L, Qmax, residual urine (R) and dietary constituents.

RESULTSThe intake of animal protein in cadres is more than that in farmers (u = 24.10, P < 0.01), and the incidence rate of BPH is significantly higher (91.1% vs 11.8%, chi 2 = 24.64, P < 0.001). Logistic regression shows that the intake of animal protein has a parallel relationship with BPH.

CONCLUSIONSIn the district of Wannan, the incidence of BPH in cadres is significantly higher than that of farmers, and it may be correlated with the amount of animal protein intake.

Aged ; China ; epidemiology ; Diet ; Humans ; Incidence ; Male ; Middle Aged ; Prostatic Hyperplasia ; epidemiology ; Rural Population ; Urban Population

OBJECTIVETo analyze the rate of postoperative vessel thrombosis and its management after free tissue transfers in head and neck region.

METHODSEight hundred and forty-nine consecutive free flap transfers were performed from May 1999 to September 2004. Among them, the flaps with postoperative vessel thrombosis were selected and reviewed. Data concerning each case included time of vessel thrombosis, kind of thrombosis, time of emergent exploration, and salvage of free flaps.

RESULTSAmong the 849 free flaps, postoperative vessel thrombosis occurred in 28 free flaps, between 8 to 120 hours after operation. There were 5 arterial thrombosis, and 23 venous thrombosis. Thirteen flaps were salvaged after emergent exploration, and 15 flaps were lost. The rate of postoperative vessel thrombosis was 3.3% in this group, the salvage rate of flap was 46.4%, and the overall successful rate was 98.2%.

CONCLUSIONClinical monitoring after free flap transfer in head and neck region is very important and effective. In case of vessel thrombosis, emergent exploration is the only effective way to salvage the flap.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Free Tissue Flaps ; adverse effects ; Head ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Microsurgery ; Middle Aged ; Neck ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; Tissue Transplantation ; adverse effects ; Vascular Surgical Procedures ; Venous Thrombosis ; etiology ; Young Adult