Objective To explore the expression and significance of p53 and p21_(WAF1)proteins in hep- atocellular carcinoma(HCC).Methods Immunohistochemical(S-P)method was used to detect the expression of p53 and p21~(WAF1)proteins in the 41 patients with HCC and 30 cases of paracancerous tissues.Results The positive rates of p53 and p21~(WAF1)proteins were 43.9 % and 75.6 % respectively.The expression of the proteins was significantly higher in tumor than that in corresponding paracancerous tissue(P0.05). p53 ex- pression showed significant difference in different pathologic grades and cases with or without intrahepatic metastasis and thrombus in the portal veins(P

Objective To quantify the expressions of collagen metabolic markers carboxy terminal propeptide of type I procollagen(PICP),nitrogen terminal propeptide of type I procollagen (PINP),nitrogen terminal propeptide of typeⅢprocollagen(PⅢNP),type I collagen carboxy terminal telopeptide (ICTP), matrix metalloproteinases(MMPs)and the tissue inhibitor of metalloproteinases(TIMPs)in the serum of atrial fibrillation patients by enzyme linked immunosorbent assay(ELISA),and to discuss the atrial structural remodeling during atrial fibrillation(AF).Methods 71 elderly patients were enrolled,24 patients had permanent AF,24 patients had paroxysmal AF,and 23 patients were in sinus rhythm.The serum levels of all markers were measured by ELISA. Results PICP was increased in permanent AF group versus the paroxysmal AF group and sinus rhythm group by 25.4%and 42.8%(all P<0.05),respectively.PⅢNP was increased in permanent AF group versus the paroxysmal AF group and sinus rhythm group by 17.9a% and 35.6%(all P<0.05),respectively,and was increased in the paroxysmal AF group versus the sinus rhythm group by 15.0%(P<0.05).PINP and ICTP did not differ significantly between the 3 groups(all P >0.05).MMP-1 was significantly increased by 25.6%(P<0.05)in the paroxysmal AF group versus the sinus rhythm group.MMP-2 was also significantly increased in permanent AF group versus the paroxysmal AF group and sinus rhythm group by 54.9%and 37.9%(all P<0.05),respectively.MMP-7,MMp-9 and TIMP-1 did not differ significantly between the 3 groups(P>0.05).TIMP-2was significantly decreased in the permanent AF group and paroxysmal AF group versus the sinus rhythm group by 21.8%and 11.8%(P<0.05),respectively. Conclusions Disturbance in the balance of MMP/TIMP system may perturb the balance of collagen synthesis and degradation during atrial fibrillation.This may be a contributing mechanism to atrial structural remodeling in atrial fibrillation,and may correlate with the initiation and maintenance of AF.

The leading cause of drug withdrawal from market and clinical trials failure is drug-induced liver injury (DILI). Varying clinical, histological and laboratory features of DILI, as well as undefined underlying mechanisms, hinder patients to be diagnosed in the early-stage of the disease and receive effective treatments. Conventional indicators, like serum transaminases and bilirubin, have inevitable limitations referring to sensitive prediction and specific detection of DILI. In order to reduce the occurrence of DILI, researchers have attempted to discover potential biomarkers with higher specificity and sensitivity from blood and urine in recent years. This article aims to review recent advances in biomarkers of DILI.
Biomarkers ; blood ; urine ; Chemical and Drug Induced Liver Injury ; diagnosis ; Humans ; Sensitivity and Specificity

Abstract?AlM:To discuss the feasibility of using the visual quality analyzer KR - 1W to guide the relatively personalized aspheric intraocular lens ( lOL ) implants to make the whole eye spherical aberration close to 0. 1μm.?METHODS: ln this prospective case series study, the corneal spherical aberration with 6mm aperture of 73 patients (100 eyes) was measured with KR-1W Visual Function Analyzer 1d before surgery. For the sake of the whole postoperative spherical aberration were close to 0. 1μm, 9 cases ( 16 eyes ) with corneal spherical aberration <0. 15μm were implanted Sofport Advanced Optic lOL, named AO group;45 cases ( 57 eyes ) with corneal spherical aberration 0. 25~0. 3μm were implanted AcrySof lQ lOL, named lQ group;19 cases (27 eyes) with corneal spherical aberration > 0. 35μm were implanted Tecnis ZA9003 lOL, named Tecnis group. Aspherical lOL was implanted after phacoemulsification through a cornea 2. 75mm incision without suture. Uncorrected visual acuity, beat corrected visual acuity, spherical aberration of the whole eye and jnternal optics (mainly lOL) at 6mm pupil diameter were examined at 3mo postoperatively. The relevant data were analyzed using t-test and variance analysis.?RESULTS: The whole ocular spherical aberration at 6mm pupil diameter in all postoperative were 0. 084 ± 0. 032μm;in Tecnis group, the data were 0. 091 ± 0. 021μm;in AO group, the data were 0. 0814-0. 013μm;lQ group were0. 093 ± 0. 042μm. There was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter in all postoperative ( t = 1. 932, P = 0. 061 ) and in the three groups. The difference value in the predicted values of the preoperative spherical aberrations of the whole eye and the actual values after surgery was 0. 013±0. 041μm; there was no statistically significant difference ( F=2. 537, P=0. 091 ) . Respectively compared the uncorrected visual acuity and besta corrected visual acuity among three groups of postoperative, no significant difference were found (F=0. 897, P=0. 421;F=1. 423, P=0. 097).?CONCLUSlON: Personality selection of aspheric lOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration.

Objective To investigate the effects of early rehabilitative training program on patients with acute myocardial infarction(AMI).Methods One hundred and twenty-two patients with AMI were randomly divided into early rehabilitation group(n=62)and control group(n=60).In addition to routine treatment,patients in rehabilitation group received early rehabilitative training mainly by walking exercise for two weeks.Results There were no significant differences in ventricular arrhythmia(Lown≥Ⅲ), extension of infarction and heart rate variability(HRV)between the two groups(P＞0.05).Forty of 62 patients(64.5%)in rehabilitation group had their left ventricular ejection fraction(LVEF)more than or equal to 50% in the 3~(rd)～4~(th)week after admission,significantly higher than that in control group(45.0%, 27/60 ;P＜0.01 ).By the end of the 4~(th)week after admission,25.8% of the patients in rehabilitation group showed positive in treadmill test,significantly lower than that in control group(38.3%,P＜0.01). Occurrence of angina pectoris and reinfarction and fatality in rehabilitation group were significantly lower than those in control group(P＜0.05)during their hospitalization and follow-up period.Patients in rehabilitation group stayed at hospital for(16?3)days in average,significantly less than that in control group[(27?4) days],with statistically significant difference(P＜0.05).Conclusion Early rehabilitative training for patients with uncomplicated AMI is not only safe and feasible,but also useful in improvement for their prognosis and quality of life.

BACKGROUND: Currently, the materials used in clinical practice to repair cruciate ligament of knee joint contain auto-graft bone- mid 1/3 patella tendon-bone (B-T-B), auto-semitendinous muscle, gracilis muscle and allogenic tissue graft. All of them are limited to a certain degree in clinical application. Therefore, people hope to consistently develop artificial ligaments to take the place of auto- and allografts. OBJECTIVE: To investigate the feasibility to construct artificial biological ligament (ABL) by applying a novel biochemical technique using porcine tendon as the raw material. DESIGN: Research of new biological material. SETTING: Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University. MATERIALS: Adult pigs of either gender were provided by the Animal Center of Sun Yat-sen University. Scanning electron microscope (SEM, S-520) was provided by Hitachi, Japan, and micro-controlled electron tension-testing device (Model LWK-10B) by Guangzhou Experimental Devices Factory. METHODS: The experiment was performed at the Animal Center of Sun Yat-sen University from January 2004 to June 2005. ABL was established by means of treating porcine tendon with epoxy cross-linking fixation, diversified antigen minimization process, mechanic enhancement modification and surface activating process. Under aseptic condition, a 6-month-old goat's bone marrow was abstracted, and then the bone marrow matrix stem cells were cultured in ABL stent for 3 weeks. Scanning electron microscope was used to observe structure and compatibility of artificial ligament, and mechanics test was used to analyze biomechanics characteristics of ABL. MAIN OUTCOME MEASURES: Structural features, cell compatibility and biomechanics characteristics of ABL.RESULTS: ① Structural features of ABL: The appearance of ABL was similar to that of the normal human ligament. Histological examination showed that the ABL was collagen fibers with no cells. Electron microscope examination revealed that the ABL was composed of hair-looking and fiber-like objects running uniformly in a certain direction and closely parallel-arranged. ② Cell compatibility: Three weeks after xenogenic marrow matrix cells were cultured on the surface of the ABL, it was noted that cells adhered and the matrix secreted by the cells precipitated around the cells. There were no cells found inside the ABL. ③ Mechanical strength of the ligament: The average diameter of ABL was 5 mm and the mechanical test at a speed of 100 mm/min showed that its averaged tensile limit was 927.19 N and the tension-resistant strength was 47.22 N/mm those were close to the corresponding parameters of the normal goat's ACL. The normal goat's ACL was 5 mm. The greatest tensile load was 807.50 N and the tension-resistant strength was 41.13 N/mm.CONCLUSION:As we used the unique biochemical technique and minimized the xenogenic protein immunogenicity of the porcine tendon, ABL has acceptable biomechanical properties and superior biocompatibility. As a substitute of the ligament in the reconstruction of the ACL, ABL has a promising prospect in clinical applications.

OBJECTIVETo study the genotoxicity of components of diesel engine exhausts with ethanol-diesel blending fuel. To provide scientific arguments to find more economical and less polluted fuels.

METHODSAmes test, comet assay and GC-MS technique were used to test the genotoxicity and 16 kinds of PAHs on diesel engine exhausts with different proportions of ethanol (E0, E5, E10, E20).

RESULTSBoth Ames test and comet assay were positive. It shows that diesel engine exhausts can lead to mutation and DNA damage, especially in pure diesel oil. But the content of 16 kinds of PAHs and DNA damage level decreased in exhausts of E5. With the increase of ethanol proportion in diesel oil, the content of 16 kinds of PAHs and DNA damage level increased.

CONCLUSIONCompared with pure diesel oil and high proportion of ethanol fuel, E5 can reduce the genotoxicity and the brake specific exhausts of PAHs.

Air Pollutants ; toxicity ; Air Pollution ; Carbon Monoxide ; Comet Assay ; DNA Damage ; Ethanol ; toxicity ; Gasoline ; toxicity ; Mutagenicity Tests ; Particulate Matter ; Vehicle Emissions ; toxicity

OBJECTIVETo sum up the clinical experience in the management of benign prostatic hyperplasia (BPH) with the prostate weighing over 80 ml by transurethral resection of the prostate (TURP) combined with 2 μm continuous-wave laser vaporesection (LVR).

METHODSWe retrospectively analyzed the clinical effects of TURP combined with 2 μm LVR in the treatment of 46 cases of BPH with the prostate volume > 80 ml.

RESULTSAll the operations were successfully accomplished. The operation time and intraoperative blood loss were (112.0 ± 20.0) min (range 86-176 min) and (77.9 ± 25.9) ml (range 50-200 ml), respectively. The catheters were withdrawn at 7 days after surgery. Transient urinary incontinence occurred in 6 cases and secondary hemorrhage was found in 2 postoperatively. Six-month follow-up revealed no urethral stricture or other complications. Compared with the baseline, the international prostate symptom score (IPSS) was significantly decreased at 6 months after operation (26.3 ± 1.8 vs 11.6 ± 1.7, P <0.05), and so were the quality of life (QOL) score (5.3 ± 0.7 vs 1.3 ± 1.1, P <0.05) and post-void residual urine (PVR) ([115.5 ± 55.6] ml vs [19.9 ± 11.6] ml, P <0.05). However, the maximum urinary flow rate (Qmax) was remarkably increased from (4.1 ± 2.6) ml/s to (16.2 ± 1.7) ml/s (P <0.05).

CONCLUSIONTURP combined with 2 μm LVR is safe and effective for the treatment of BPH with the prostate volume >80 ml.

Aged ; Blood Loss, Surgical ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Organ Size ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome ; Urethral Stricture ; Urinary Incontinence ; etiology ; Urinary Retention

OBJECTIVETo improve the X-ray diagnosis of cervical spondylosis of vertebral artery type (VCS).

METHODSA blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4 ± 12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations,the X-ray imaging features of VCS were further analyzed.

RESULTSThere was significant difference in cervical curvature between two groups in anteflexion X-ray films (P < 0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P < 0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P< 0.05). There was significant.difference in anteflexion degree of atlanto-axial joint angle between two groups (P < 0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness; and always accompanied with headache; tenderness mostly concentrated in the upper cervical area.

CONCLUSIONBoth X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; diagnostic imaging ; Radiography ; Spondylosis ; diagnostic imaging ; Vertebral Artery ; X-Rays

OBJECTIVETo study short-term results and clinical application of Tri-lock BPS in total hip arthoplasty.

METHODSFrom May 2010 to July 2011, 32 hips in 31 patients (18 males and 13 females, ranging in age from 50 to 77 years old, with an average of 60.5 years old) were treated by total hip arthroplasty with Tri-lock BPS, including 8 patients with osteonecrosis (ON), 13 patients with fresh femoral neck fracture, 10 patients with developmental dysplasia of the hip (DDH). The therapeutic effects were evaluated by self assessment form, preoperative and postoperative Harris hip score, radiographs, Engh score and bone in growth of femoral side described by Gruen. Based on the short-term results,its design characteristic and clinical properties were analyzed.

RESULTSAll the incisions healed well and there were no complications such as femoral fracture, infection, dislocation and neurovascular injuries. All the patients were followed up with an average time of 12.2 months (ranged, 10 to 14 months). All the joints had good or excellent clinical results. The Harris score increased from preoperative 38.3 +/- 4.9 to 92.5 +/- 11.2 at the latest follow-up (t = 27.53, P < 0.01). Radiographically, the positions of the prostheses were normal,the average limbs length and femoral eccentricity recovered to normal. X-ray of the hips showed that the femoral stem prosthesis was in line with good initial fixed standard. At 3 months after surgery, X-ray of the hips showed that bone in growth in Gruen II and VI of femoral side.

CONCLUSIONShort-term results show that the design of Tri-lock BPS is more in line with human anatomy, and has the advantages in rapid recovery of hip function and retains more bone mass. It offers a newly valuable technology for the treatment of osteonecrosis, femoral neck fracture and DDH and so on.

Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Recovery of Function ; Tomography, X-Ray Computed ; Treatment Outcome