OBJECTIVE: To summary and analyze the bleeding causes after uvulopalatopharyngoplasty(UPPP) with endotherm knife, and preventive measures will be given to effectively reduce postoperation hemorrhage. METHOD: Two hundred and twenty-six cases of obstructive sleep apnea hypopnea syndrome (OSAHS) adult patients, were carryed out UPPP under general anesthesia with endotherm knife to observe postoperation hemorrhage. RESULT: Eight cases out of 226 patients or 3.5% occurred postoperation hemorrhage, 2 cases after 1 or 2 days, 6 cases after 6 or 12 days. The postoperation hemorrhage stopped by local compression hemostasis or bi-polar coagulation hemostasis, and no more bleeding occurred. CONCLUSION The minimal trauma, quick operation and less-bleeding will be caused by UPPP with endotherm knife. Few patients 3.5% had a small amount of bleeding after operation, but no serious bleeding occured. Hemorrhage often happened during pseud mucosa falling off period. The bleeding was related with using skill of endotherm knife during operation, postoperation pse-ud mucosa falling off, local inflammation, improper eating and emotional stress of patients.
Adult ; Hemorrhage ; etiology ; Humans ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; instrumentation ; Palate ; surgery ; Pharynx ; surgery ; Postoperative Period ; Pressure ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery

Multiple sclerosis (MS) is an autoimmune disease. The etiology and pathogenesis of MS remain unclear. At present, there are substantial evidences to support the hypothesis that genetics plays a crucial role. The people who have genetic predisposing genes easily develop immune-mediated disorder, probably in conjunction with environmental factors. The aim of this review is to describe recent observations regarding the immunologic pathogenesis of MS.
Animals ; Autoantibodies ; immunology ; Humans ; Models, Biological ; Multiple Sclerosis ; etiology ; immunology ; pathology ; Myelin Basic Protein ; metabolism

Anti-Bacterial Agents ; pharmacology ; Child ; Humans ; Macrolides ; pharmacology ; Microbial Sensitivity Tests ; Mycoplasma pneumoniae ; drug effects

Background Eicosapentaenoic acid(EPA)function as the critical lipid mediators involved in several biological events in human body and play important role in suppressing the genesis of vascular endothelial growth factor (VEGF),migration and proliferation of vascular endothelial cells.Many ocular diseases were proved to be associated with neovascularization.Objecfive The purpose of this study was to investigate the inhibitory effect of EPA on the proliferation of human umbilical vein endothelial cells (HUVEC) indueed by VEGF. Methods HUVEC strain was cultured and passaged,and difierent concentrations of EPA were added to the medium with and without VEGF.The cultured cells were identified by antiofactor Ⅷ polyclonal antibody.The suppressing role of different concentrations of EPA on the proliferation of VEGF-induced or-uninduced HUVEC was assessed by MTT method.The influence of difierent concentrations of EPA on the cellular cycle of VEGF-induced HUVEC was assayed using flow eytometry.The expression of Flk-1,a receptor of VEGF,in the HUVEC Was detected by immunohistochemistry. Results Cultured HUVEC showed the ftlsiform in shape and presented with the cobblestone-like arrangement with the positive response for Ⅷ factor-related antigen.Various concentrations of EPA showed obviously inhibitory effect on VEGF-induced or-unindueed HUVEC at a dose-dependent manner (F=23.072.P=0.000).The inhibitory ability of EPA on VEGF-induced HUVEC was stronger than VEGF-uninduced HUVEC(F=41.417,P=0.000).In 24,48 and 72 hours,the action of EPA on the proliferation of HUVEC was gradually enhanced with the prolong of time(F=1.495,P=0.236).Cell cycle analysis indicated that EPA arrested VEGF-induced HUVEC in G0/G1 phase.The ratio of HUVEC in G0/G1 phase in EPA group was(75.83±1.56)%,and that in control groups was(68.62±1.44)%,showing a significant difference between them(t=-5.88,P=0.00),and no apoptosis of HUVEC was found in both groups.Flk-1 was strongly expressed in the cellular nucleus and cytoplasm in control group.However,the positive expressing intensity of Flk-1 in the HUVEC weakened,and the positive cell number was evidently less in EPA group. Conclusion EPA can inhibit the proliferation of VEGF induced HUVEC through arresting the synthesis of DNA of HUVEC and downregulate the expression of Flk-1 in HUVEC.These results suggest that EPA might exert an antiangiogenic effect.

Objective To evaluate the clinical value and effectiveness of ultrasound screening for fetal chromosomal abnormalitie in the middle and late pregnancy. Methods Fetuses who were detected with abnormal ultrasound findings during the middle and late pregnancy, and high risk of maternal serum screening underwent amnioeentesis or eordocentesis for fetal chromosome karyotypes. Results (1) A total of 31 cases with fetal malformation diagnosed by ultrasound were analysed for fetal chromosome karyotypes, and 8 (25.8%) cases were proved with fetal abnormal chromosome karyotypes. There were 3 cases of cervical springwater cyst accompany with edema,and all were fetal abnormal chromosome karyotypes. There were 3 cases of cervical pachyderma,and 2 were fetal abnormal chromosome karyotypes. There was one case with multiple malformations, one with Dandy-Walker malformation and one with holoprosencephaly malformation,all were revealed fetal abnormal chromosome karyotypes. (2) A total of 516 cases with high risk of Down's syndrome and trisomy 18 by maternal serum screening were analysed for fetal chromosome karyotypes,and 14(2.710%) cases were proved with fetal abnormal chromosome karyotypes, which include 7 cases of Down's syndrome and 7 cases of other fetal abnormal chromosome karyotypes. (3) A total of 544 (516 + 28)cases with high risk by the combination of ultrasound and maternal serum screening were analysed for fetal chromosome karyotypes, and 21 (3.86%) cases were proved with fetal abnormal chromosome karyotypes, the rate of detection higher than only maternal serum screening 42.43%.Conclusions Fetal structure abnormalities were the effective ultrasound signs for fetus chromosomal abnormalities screening in the middle and late pregnancy. The combination of ultrasound and maternal serum screening can improve the rate of fetus chromosomal abnormalities screening and be an effective way to retrieve false-positive and lower risk of maternal serum screening.

OBJECTIVETo explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea.

METHODSOne hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group (group A), an starch-partitioned moxibustion group (group B) and an acupuncture group (group C), 57 cases in each one. In the group A, moxibustion isolated with herbal medicine was applied to Shenque (CV 8). In the group B, moxibustion isolated with starch was used at Shenque (CV 8). In the group C, acupuncture was given at Sanyinjiao (SP 6). The changes of estradiol (E2), progesterone (P) and prostaglandin levels (PGF2alpha) were observed before and after treatment, and the therapeutic effects were compared among the 3 groups.

RESULTSThe therapeutic effect in the group A was better than those in the other two groups [compared the cured rate: 89.8% (44/49) vs 60.0% (30/50), 60.4% (32/53), both P < 0.05]. In the group A, E2 level [(110.99 +/- 12.90) pg/mL vs (83.94 +/- 8.91) pg/mL, P < 0.05] and PGF2alpha level [(24.58 +/- 3.01) pg/mL vs (14.34 +/- 1.48) pg/mL, P < 0.01] were decreased and P level was increased [(4.65 +/- 0.68) ng/mL vs (6.68 +/- 0.95) pg/mL, P < 0.05]. In the group B and C, PGF2alpha level were reduced. Concerning to the regulating of E2 and PGF2alpha levels, the results in the group A were better than those in the group B and C [(-30.16 +/- 10.20) pg/mL vs (10.79 +/- 15.01) pg/mL, (22.81 +/- 12.22) pg/mL; (-13.10 +/- 2.40) pg/mL vs (-6.52 +/- 1.88) pg/mL, (-3.14 +/- 1.19) pg/mL, (see text) P < 0.05]. Concerning to the regulation of P level, the results in the group A and B were better than that in the group C (all P < 0.05).

CONCLUSIONThe herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea, which could be related to regulating the reproductive endocrinal level. It decreases E2 and PGF2alpha levels and increases P level.

Acupuncture Points ; Adult ; Dinoprost ; metabolism ; Dysmenorrhea ; metabolism ; therapy ; Estradiol ; metabolism ; Female ; Humans ; Moxibustion ; Progesterone ; metabolism ; Young Adult

Cardiac Catheterization ; Child ; Echocardiography, Three-Dimensional ; Heart Septal Defects ; diagnostic imaging ; Humans ; Prosthesis Implantation ; Time Factors

OBJECTIVETo investigate the advantages and disadvantages of dual energy with dual-source computed tomography (CT) in cerebral angiography by comparing those of neuro-digital subtraction angiography (Neuro-DSA) .

METHODSTotally 300 patients with normal CT angiography (CTA) images underwent dual energy CT angiography (DE-CTA groups, n=200) and Neuro-DSA scan (Neuro-DSA groups, n=100) using dual source CT. The comparison of two scan approaches was based on image quality, radiation does, post-processing methods, and duration of scanning and subtraction.

RESULTSThe image quality of intracranial blood vessels in DE-CTA group showed no significant difference with that in Neuro-DSA group (P>0.05) , while the number of Grade I images was significantly higher than those of other three grades (P<0.01) . However, the effect of the skull base bone removal with Neuro-DSA is superior to DE-CTA (P<0.01) . The duration of scanning was significantly longer in DE-CTA group than in Neuro-DSA group (P<0.01) . However, the radiation dose, time of entire examination, and time of subtraction were significantly lower/shorter in DE-CTA group than in Neuro-DSA group (P<0.01) . The radiation dose of DE-CTA group is 26.3% lower than Neuro-DSA group.

CONCLUSIONSThe image quality of intracranial blood vessels with head DE-CTA is same as Neuro-DSA, while head DE-CTA has lower radiation doses and higher inspection efficiency than Neuro-DSA. However, the effect of the skull base bone removal needs to be improved.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; methods ; Cerebral Angiography ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods ; Young Adult

Background Corneal neovascularization (CNV) is an important cause of visual impairment and graft rejection after allograft corneal transplantation in inflammatory corneal diseases. The mechanisms and therapy relating to CNV are intensely investigated at all times. Objective This study was to evaluate the effect of eicosapentaenoic acid (EPA) on CNV induced by alkali cauterization and its mechanism. Methods The animal models of corneal neovasculation were induced in the right eyes in 72 Sprayue-Dawley rats by putting a piece of 3 mmfilter paper with 1 mol/L NaOH at the center of the cornea for 30 seconds. The rats were then divided randomly into the 0.02 mg EPA treatment group (24 rats) ,0.03 mg EPA treatment group (24 rats) ,model group (24 rats) and normal group (6 rats). EPA of 0.04 ml with doses of 0.02 mg or 0. 03 mg or saline solution of 0. 04 ml was injected subconjunctivally in model rats and immediately after cauterization. The presence of CNV and corneal edema were observed daily by slit lamp biomicroscope. 1,4,7 and 14 days after operation, corneal histopathological examination was performed by hematoxylin and eosin staining. The vascular endothelial cells were stained with CD34 by immunohistochemistry,and the expression of IL-1α,IL-6 mRNA and the nuclear factor-κBp65 ( NF-κBp65 ) proteins was measured by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. The use of animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by Hebei Province( version 1998 ). Results Under the slit lamp, CNV grew slowly from days 2-4 with obvious corneal edema and defect of epithelium. Larger CNV area and less edema were seen from days 7-10. Maximal vessel growth was observed 14 days after injury with thinner vessels in the model group. Histological examination showed that part of the corneal epithelium was damaged;serious corneal edema, more inflammatory cells and a lot of CNV in the stroma were presented in the model group. However, repairing of the corneal epithelium without CNV ,light corneal edema and less inflammatory cells were found in both the 0. 02 mg EPA and 0. 03 mg EPA treatment groups 7 days after alkali cauterization. The relative area of CNV in the 0. 02 mg EPA treatment group was ( 15.80±6.43 )% and ( 11.06±2. 14)% ,and that in the 0. 03 mg EPA treatment group was (16. 10±7.41 )% and (11.06±2. 51 )%, showing significant reduction in comparison with the model group [ (84. 74±7.77)% and (89.63±7.50) % ] 7 days and 14 days after operation ( P＜0. 05 ). Stronger expression of CD34 in the vascular endothelial cells of the cornea stroma was observed in the model group and an absence of CD34 was observed in the EPA-treated groups on the 7th day. RT-PCR revealed that the expression of IL-1α mRNA and IL-6 mRNA was lower in the EPA treatment groups than the model group ( P＜0. 05 ), and Western blot analysis showed that the expression of NF-κB/p65 in the corneas in the EPA treatment groups was significantly lower than that in the model group on the 4th day after operation (P＜0.05).Conclusion Topical application of EPA suppresses CNV induced by alkali burn possibly by inhibiting the expression of NF-κB,IL-1α and IL-6.

The pol gene of HIV-1 encodes mainly three enzymes: reverse transcriptase (RT), protease (PR) and integrase (IN). Currently, FDA approved drugs targeting RT and PR are available and administered in various combinations, while no anti-IN drug was approved. HIV-1 integrase is an essential enzyme for the viral replication and an interesting target for the design of new pharmaceuticals for multi-drug therapy of AIDS. The 288 amino acids of IN (32kDa) recognizes specific sequences in the long terminal repeats (LTRs) of the retroviral DNA. The IN protein catalyzes the 3′-processing step and the 5′-strand transfer step reaction in vivo, which was called integration and this reaction could be analysed by ELISA Assay in vitro. It has been reported that F185K and C280S mutations of HIV-1 integrase would improve the enzyme solubility, and the catalytical activity of the enzyme was the same as that of the wild-type enzyme in vitro. In order to build the platform of screening inhibitor against integrase of HIV-1 virus, the IN enzyme was expressed and the function of integrase protein was assayed. The cDNA of clade B HIV-1 genome was used as a template, overlapped PCR was used to construct site mutagenesis of F185K/C280S and NdeI/Xho I restriction sites were brought in. The PCR product was cloned into the prokaryotic vector pET-28a(+) to form a recombined plasmid, transferred into the host cell E.coli(BL21 DE3). The recombined clones were identified by PCR and Nde I/Xho I digestion .The positive plasmid was sequenced, and the successfully recombined plasmid in the host cell was induced by IPTG. The expressed IN protein was puriied sy the Co+ affinity chromatography column and SDS-PAGE was used to analyze the molecular weight and specificity. In addition, ELISA assay was used to analyze the function of the recombined IN protein. The recombinant protein was soluble, and expressed highly and stably in E.coli. The molecular weight of the expression product was identical to the expectation. The IN protein was proved to be functional in 3′ processing and 5′strand transfer by ELISA. It will be helpful to build the platform of screening inhibitors against HIV-1 integrase.