Objective To determine the effect of iron deficiency on hemoglobin A2(HbA2) expression in patients with β-thalassemia.Methods The participants were recruited from the out-patient clinics of the Pediatrics Department and Obstetrics Department of Affiliated Hospital of Guilin Medical College and from some β-thalassemia major families.Blood samples from the participants were used for blood smear tests and hemoglobin electrophoresis and to analyze serum ferritin (SF),3 alpha-globin gene deletions,and 17 beta-globin point mutations.Results Of the 408 individuals,304 were assigned to group A (normal controls),26 to group B (iron deficiency),56 to group C (β-thalassemia),and 22 to group D (β-thalassemia combined with iron deficiency). The results for the comparison of the mean HbA2 values among pairs of groups were as follows: group A vs group B,q=5.074 7,P<0.05; group A vs group C,q=37.650 8,P<0.05; group A vs group D,q=16.043 0,P<0.05;group C vs group D,q=7.682 9,P<0.05; Group B vs group D,q=15.806 6,P<0.05. There were no significant correlation between SF and HbA2 in all 4 groups.Conclusions Iron deficiency decreased the HbA2 level in both controls and individuals with β-thalassemia. HbA2 levels decreased significantly in individuals with both β-thalassemia and iron deficiency as compared with β-thalassemia group alone. However,they remained significantly higher than both the control and iron-deficient groups. Therefore,the elevation of HbA2 could be used to diagnose β-thalassemia reliably even in the presence of iron deficiency.

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

OBJECTIVETo investigate the effects of valsartan on cyclooxygenase-2 (COX-2) in cultured human umbilical vein endothelial cells (HUVECs) stimulated by ox-LDL.

METHODSHUVECs were cultured in endothelial basal medium and divided into four groups (n = 5 each): group I, control group without any treatment; group II: HUVECs stimulated with ox-LDL (100 mg/L) in endothelial basal medium for 24 hours; group III: HUVECs treated with ox-LDL (100 mg/L) and valsartan (10 µmol/L) in endothelial basal medium for 24 hours; group IV: HUVECs treated with ox-LDL (100 mg/L) and valsartan (30 µmol/L) in endothelial basal medium for 24 hours. Expression of COX-1 and COX-2 mRNA were determined by reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSExpression of and COX-2 mRNA was significantly higher in ox-LDL-treated HUVECs than in control group (1.478 ± 0.104 vs. 0.366 ± 0.104, P < 0.05), while expression of COX-1 mRNA was similar between the 2 groups (P > 0.05). Valsartan dose-dependently decreased the COX-2 mRNA expression (group III vs. group II: 1.074 ± 0.112 vs. 1.478 ± 0.104, P < 0.05; group IV vs. group II: 0.664 ± 0.104 vs. 1.478 ± 0.104, P < 0.05). Expression of COX-1 mRNA in ox-LDL-treated HUVECs was not affected by valsartan.

CONCLUSIONSCOX-2 mRNA expression in ox-LDL-treated HUVECs could be reduced by valsartan suggesting valsartan might attenuate atherosclerosis by reducing ox-LDL-induced inflammatory responses.

Cells, Cultured ; Cyclooxygenase 2 ; metabolism ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Lipoproteins, LDL ; adverse effects ; Tetrazoles ; pharmacology ; Valine ; analogs & derivatives ; pharmacology ; Valsartan

Objective To study the effect and prognosis of percutaneous coronary intervention(PCI) for pa- tients with coronary artery disease(CAD).Methods Selected coronary angiography was performed in 31 patients with CAD.PTCA and stent implantation were performed in the patients of coronary stenosis(≥75 % in diameter). The effect and prngnosis of coronary interventionary therapy in patients were observed.Results The results of coro- nary angiongraphy suggested there were 18 patiens of coronary stenosis(≥75 % in diameter),PTCA and stent im- plantation were performed in 13 patients.Symptom was relieved greatly after the operation.There were 2 patients of coronary stenosis again,and 5 patients died.Conclusion Selected coronary angiography was an effective way to di- agnose CHD.The coronery interventioned therapy was not only effective in relieving symptom,but also in improving the quality of life of patients with CAD.

OBJECTIVETo investigate the feasibility of treatment for calculous pyonephrosis with first stage percutaneous nephrolithotomy under the standard access.

METHODSThirty-six cases of calculous pyonephrosis and 36 cases of urolithiasis with no pyonephrosis were treated by percutaneous nephrolithotomy. In the nephrostomy, the caliber was dilated to F24. All the operations were preformed through the EMS lithotrity system. The intrapelvic pressure was detected in the operation. The hemoculture before and after operation, the germi culture of urine, and the temperature and blood leucocyte changes after operation were recorded. All the patients were treated by antibiotics before and after the operation.

RESULTSAll the patients were treated successfully. The average intrapelvic pressure were 23.2 cmH(2)O in non-pyonephrosis group and 22.8 cmH(2)O in pyonephrosis group. Both of the groups had 1 case of transient bacteremia after the operation. No significant difference was found in the other indices between the two groups.

CONCLUSIONEMS lithotrity system is safe and feasible for treating calculous pyonephrosis with stage I percutaneous nephrolithotomy via the standard access.

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Pyonephrosis ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo establish an animal model of tumor-associated depression and observe their biological behaviors and biochemical indices.

METHODSFour groups of SD rats kept in separate cages were subjected to tumor cell inoculation with or without chronic unpredictable moderate stress administered before or after the inoculation. The depressive behaviors of the rats were examined by open-field test, and the concentration of 5-HT in the hippocampus was measured by spectrophotofluorometry. The body weight of the rats and volume of the implanted tumor were monitored and sugar water test was performed.

RESULTSThe rats subjected to chronic stress displayed significant depression, manifested by reduction in movement in the central area and total movement distance with prolonged resting time and shortened time of activity. These rats maintained high levels of depression even 12 days after withdrawal of chronic stress. Compared with the control group, the depressive rats showed obviously reduced sugar water consumption and hippocampal 5-HT level. Tumors of different sizes were observed in all rats in the 4 groups.

CONCLUSIONA rat model of tumor-associated depression is established, and the tumor-bearing rats exhibit obvious depressive behaviors and reduced level of neural substance (5-HT), which provides a good basis for studying the association of depression with tumorigenesis,progression and prognosis of tumor.

Animals ; Carcinoma 256, Walker ; complications ; psychology ; Depressive Disorder ; etiology ; Disease Models, Animal ; Female ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological ; complications

OBJECTIVETo find a way to discriminate operative reason from anaesthesia reason for the changes of intraoperative transcranial magnetic motor evoked potentials (MEPs).

METHODSIn 26 patients under Etomidate/Fentanyl anesthesia from February 2001 to June 2004, MEPs elicited by transcranial magnetic stimulation were recorded from tibialis anterior muscles, simultaneously bispectral index (BIS) and train-of-four stimulation (TOF) were used to monitor the anesthesia depth and neuromuscular blockade respectively. MEP, BIS and measurements of TOF at different anesthesia depth and muscular relaxation were recorded synchronously, statistical analysis of this data set was done in order to find the inherent relationship between these variables.

RESULTSUnder anesthesia, MEP amplitude was always positively correlated with the corresponding BIS and TOF value. A regression equation could be built, with which the MEP amplitude could be reckoned based on realtime BIS and T(1)/T(c). In case of spinal cord injury, the measured amplitude value would significantly deviate from predicted one, which suggested that the change of MEP was because of the operation, but not the anaesthesia or neuromuscular blockade. Each patient had his or her own regression equation, which was different from each other.

CONCLUSIONSThe establishment of regression equation from MEPs, BIS and TOF is very useful to distinguish reasons of the changes of transcranial magnetic MEPs during surgery, and with this technique, the intraoperative MEP monitoring should be more reliable and practicable.

Adolescent ; Adult ; Anesthesia, General ; Evoked Potentials, Motor ; physiology ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Regression Analysis ; Transcranial Magnetic Stimulation ; Young Adult

OBJECTIVETo assess the response of neoadjuvant chemotherapy and its influencing factors in the breast cancer patients.

METHODS171 patients with stage II or operable stage III breast cancers were treated with neoadjuvant chemotherapy before surgery between January 2004 and May 2005. Of these, 160 received and completed > or =3 cycles of neoadjuvant chemotherapy, 11 received only 2 cycles. The regimens of neoadjuvant chemotherapy were: CEF (CTX, Epirubicin, 5-Fu); NE (Navelbine, Epirubicin); TEC (Taxotere, Epirubicin, CTX). Response of neoadjuvant chemotherapy was evaluated in all patients by palpation, ultrasonography and pathological methods.

RESULTSComplete response rate and clinical objective response rate determined by clinical palpation (cCR, cOR), ultrasonography (sCR, sOR) and pathology (pCR) was 18.7% and 88.3%; 4.1% and 74.9%; 15.2%, respectively. The correspondence rate of the pCR with cCR and sCR was 43.8% and 42.9%, respectively. It was showed by univariate analysis that patient whose tumor was < or =3 cm in diameter, or ER negative or grade 3 were more likely to achieve a pCR than those whose tumor was >3 cm, or ER positive or grade 1. Logistic regression analysis showed that only tumor size was the significant predictive factor for response to neoadjuvant chemotherapy in patients with primary breast cancer.

CONCLUSIONPatient with small, or ER negative or grade 3 tumor may have better pathological response to neoadjuvant chemotherapy, particularly, the tumor size is more predictive of pCR. Palpation or ultrasonography may have a tendency either to under- or to overestimate pCR. Breast neoplasms/drug therapy;

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Cyclophosphamide ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Humans ; Logistic Models ; Mastectomy ; methods ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Receptor, Epidermal Growth Factor ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Remission Induction ; Taxoids ; administration & dosage ; Vinblastine ; administration & dosage ; analogs & derivatives

OBJECTIVETo study the effects of Liangge San to the expression of CD14 and scaverger receptor(SR) in the kupffer cells of liver and the pathological changes of liver tissue of endotoxemia-mice.

METHODThe model was established with intravenous injection of lipopolysaccharide (LPS) and at the same time different dose Liangge San were given. The expression of CD14 and scaverger receptor were detected with immunohigtochemistry at the 2nd, 4th, 8th hour ofter injury and analyzed with computer image system, and the pathological changes of liver tissue were also observed.

RESULTAt the three different hours, the expression of CD14 and scaverger receptor in macrophages of liver of LPS-injury group showed significant increase and significant decrease respectively, compared with that of the blank-control group (P < 0.01). The expression in dexamethasone group and Liangge San different dose groups were intermediate between those in injury group and those in control group. Compared with expression of LPS-injury group, those of dexamethasone group and Liangge San different dose groups showed significant differences (P < 0.01), especially that of Liangge San high dose group. Liver cells showed vacuole change. Changes of CD14 and SR expression were paralleled with the severity of liver damages of the mice.

CONCLUSIONLiangge San can inhibite the up-regulation of CD14 expression and down-regulation of scaverger receptor expression in a dosage-dependent manner and also alleviate the damages of liver induced by LPS.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Dexamethasone ; pharmacology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Endotoxemia ; chemically induced ; metabolism ; pathology ; Female ; Kupffer Cells ; metabolism ; pathology ; Lipopolysaccharide Receptors ; metabolism ; Lipopolysaccharides ; Liver ; metabolism ; pathology ; Mice ; Plants, Medicinal ; chemistry ; Receptors, Scavenger ; metabolism

OBJECTIVETo evaluate the practicability and validity of transcranial magnetic motor evoked potential monitoring (TMS-MEP) during spinal surgery.

METHODSFrom February 2001 to June 2004, 37 patients undergoing spinal surgery were involved, anaesthesia was maintained with volatile anesthetics in 11 operations and etomidate in 26. Analgesia was provided with fentanyl, and non-depolarizing muscle relaxant was given intermittently. MEPs elicited with transcranial magnetic stimulations were recorded from tibialis anterior muscles, simultaneously bispectral index (BIS) and train-of-four stimulation (TOF) were used to monitor the anesthesia depth and neuromuscular blockade respectively. The variety of MEP and its effect on surgical operation at different anesthesia depth and muscular relaxation were observed, and the muscle strength of the patients before and after operation were compared.

RESULTSThe 11 cases anesthetized with isoflurane or enflurane gave no response to TMS, the other 26 cases in which anaesthesia was maintained with etomidate and fentanyl gave satisfactory TMS-MEPs, but with significantly attenuated amplitudes and prolonged latencies (P < 0.05). Intraoperative MEP showed a grossly unchanged waveform, and its amplitude and latency had little fluctuation when anaesthesia and neuromuscular blockade maintained stable. When T(1) value of TOF at 40% - 60%, a steady MEP could be acquired and the muscular contraction after TMS should not interfere the operation.Seven of 26 cases had a MEP amplitude drop up to 50% or more during the operation, the surgical team was notified to avoid further spinal injury, at last only 1 case had a worsen muscle power after operation.

CONCLUSIONSMyogenic TMS-MEP is a valid and practicable technique for intraoperative monitoring, and the etomidate + fentanyl technique is adequate for its anesthesia. BIS and TOF monitoring are helpful to maintain the steadiness of the anesthesia and MEPs, which is very important for monitoring the changes of the MEPs.

Adolescent ; Adult ; Aged ; Anesthesia ; methods ; Evoked Potentials, Motor ; physiology ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Spinal Cord ; surgery ; Spine ; surgery ; Transcranial Magnetic Stimulation ; Young Adult