OBJECTIVETo analyse the diagnostic and therapeutic aspects of carotid body tumor (CBT).

METHODSSeven patients with CBT had been hospitalized between 2003 and 2006. The clinical data was analyzed retrospectively. The preoperative evaluation included angiography in 7 patients. Most of them had an asymptomatic cervical lateral mass. Only one patient had the hoarseness and buckling and was given radiation therapy alone. Six of seven patients with carotid body tumour underwent surgery. Simple tumor excision was accomplished in 4. Carotid artery resection with the tumor was required in 2 patients and in the both, interposition of a 7 mm polytetrafluoroethylene graft was performed . During the resection, temporary carotid shunt was required in the two patients.

RESULTSAll tumors by surgery were identified as carotid paragangliomas without evidence of malignancy. There was no mortality and no hemiplegia. After surgery, temporary cranial nerve dysfunction was noted in one case. In the follow-up period of 2 months to 2 years, no recurrent disease occurred. The patient's tumor who accepted radiotherapy was in the stable stage under the half year follow up, and the follow up would be further continued.

CONCLUSIONSWith non-invasive investigation and arteriography it was possible to obtain an early and precise diagnosis. The surgical management was the major treatment of these tumors. The pattern of operation should be chosen according to the relation of tumor and carotid. The decision to perform simple tumor excision or additional arterial resection was based on diagnostic preoperative and after the arterial resection the polytetrafluoroethylene graft would be used for carotid reconstruction.

Adult ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Carotid Body Tumor ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo analyze the surgical complications in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and discuss the risk factors and preliminary strategies for prevention of complications.

METHODSFrom September 1998 to March 2007, 653 OSAHS patients confirmed by polysomnography were treated by different surgical approaches according to their obstructive sites, which included uvulopalatopharyngoplasty (UPPP) in 586 cases, nasal surgery in 104 cases/times, hyoid suspension surgery in 53 cases/times, respectively or at the same time. Local anesthesia was used in 294 cases and general anesthesia in 359 cases. Two hundreds and seventeen cases were treated by continuous positive airway pressure (CPAP) 3 to 7 days pre-operation and 2 to 3 days post-operation.

RESULTSPerioperative complications were found in 57 OSAHS cases (93 times), the incidence of peri-operative complications was 8.7% (57/653), including respiratory problems in 19 cases/times and 1 death occurred during inducing stage in general anesthesia. Profuse bleeding was encountered in 9 cases/times during operation and primary and secondary bleeding in 27 cases/times, cardiopathy and hypertension crisis in 31 cases/times and cerebral stroke and hemiplegia in 1 case, reactive somnolence in 3 cases/times and reactive hyperglycemia in 3 cases/times. Data were analyzed by the multivariate logistic regression model. The results showed that the complications were significantly reduced after CPAP treatment during peri-operative stage and increased accompanied with patients' hypertension, choice of general anesthesia, BMI and AHI. All patients were followed-up more than 1 year. After UPPP, 23.9% cases (140/586) had sensation of foreign body in pharynx and alleviated in 6 to 12 months. Scar tissues in oropharynx in 7 cases, nasopharyngeal stenosis in 1 case, atrophy rhinitides and atrophy pharyngitis in 3 cases, nasopharyngeal un-closure and long-term nasopharyngeal reflex in 3 cases. Conclusions Peri-operative complications are more common in obese and severe OSAHS patients, especially when they accompanied with hypertension. The corresponding strategies should be taken to reduce complications in OSAHS surgery, which include controlling the hypertension effectively, performing CPAP treatment actively, cooperating with interdisciplinary doctors, monitoring closely after operation. It is important to reduce surgical sequelae through improving surgical skills and not enlarging the surgical scale blindly.

Adult ; Aged ; Female ; Humans ; Intraoperative Complications ; etiology ; prevention & control ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; methods ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Postoperative Complications ; etiology ; prevention & control ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery ; Young Adult

Objective To assess the effective length of jejunal graft when the 3~(rd) intestinal artery is u- tilized as vascular pedicle and afford a reliable theoretic base for clinical esophageal reconstruction.Methods In 32 formalin preserved and 21 fresh cadaver specimens,the diameter of 1st to 5th intestinal arteries and diameter of arterial arches are measured with linear calibre.Measure the length of jejunum that can be harves- ted as graft when the arches are extended.In the 21 fresh specimens,the 1st,2nd,4th and 5th intestinal ar- teries are ligated,acetic ester stained with red dye were injected into the lumen of 3rd intestinal artery via catheter.Extent of distribution of the arteries to the jejunum was observed.And then red ABS solution was in- jected into the 3rd intestinal artery to make into cast specimen.The blood supply distribution of jejunum through 3rd intestinal artery-arterial arch and communicating system were observed again.Results The di- ameter of the 3rd intestinal artery was the largest among the 1st to 5th intestinal arteries.The length of jejunum vascularized by 3rd intestinal artery can be as long as (142.2?62.3) (69.0～206.60cm) in acetic ester in- filtrated specimens.While in ABS east specimen,the average available extent of donor jejunum was(30.8?7.3) (23.0～37.3cm).Conclusion As observed by this applied anatomy study,the jejunum graft vascu- larized by 3rd intestinal artery alone has sufficient length to meet the need of esophageal reeonstrution.

The purpose of study was to investigate the feasibility of the application of cationic propyl gallate (C-PG) as inducer of platelet aggregation for evaluating the platelet function of single-donor plateletpheresis and identifying the incidence of defective platelet function among donors. Experiments were as follows: 3 healthy volunteers' platelet aggregation induced by 100-300 micromol/L C-PG was determined by LG-PABER analyzer to observe the effect of C-PG concentration on platelet aggregation; 30 healthy volunteers' platelet aggregation before and 24 hours after administration of 200-400 mg acetylsalicylic acid (ASA) was examined after induction by 200 micromol/L C-PG for determining the cut-off value to discriminate platelet dysfunction donors; the platelet aggregation of 483 platelet donors was detected and the activated plasma clotting time (APCT) of donors who have deficiency in platelet aggregation was examined for investigating the incidence of defective platelet function among donors. The results showed that platelets were activated by C-PG induction in a dose dependent manner, when concentration of C-PG reached 200 micromol/L, the percentage of platelet aggregation was highest. It significantly decreased after 24 hours with ASA than that before the administration (P < 0.001), especially in 180 seconds induced by C-PG. If cut-off point was fixed on the platelet aggregation < 20% in 180 seconds, donors of platelet dysfunction can be selected effectively. 25 of defective platelet aggregation function among 483 donors were detected, and 11 out of 25 platelet dysfunction donors had the deficiency in procoagulant activity with prolonged APCT. It is concluded that C-PG as inducer of platelet aggregation is feasible to screen the platelet function of donors. Five percent of platelet donors has function defect examined by C-PG as inducer of platelet aggregation.
Antioxidants ; chemistry ; pharmacology ; Aspirin ; administration & dosage ; Blood Donors ; Blood Platelets ; cytology ; drug effects ; physiology ; Cations ; chemistry ; Humans ; Platelet Activation ; drug effects ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; administration & dosage ; Platelet Function Tests ; Platelet Transfusion ; Propyl Gallate ; administration & dosage ; chemistry ; Whole Blood Coagulation Time

This study aimed to examine whether ophiopogonin D (OP-D) is capable of protecting cardiomyocytes against DOX-induced injury and the mechanisms involved. H9c2 cells were cultured. MTT assay was used to evaluate cell viability and toxicity. Mito-tracker as fluorescence probe was used to measure ROS content raised from mitochondria. The mRNA and protein expression of ATF6alpha, GRP78 and CHOP were analyzed using real-time PCR and Western blotting, respectively. The results showed that a significant endoplasmic reticulum stress (ERS) was induced upon exposure of H9c2 cells to DOX as indicated by the increase in the expression of ERS related proteins, which was paralleled with the accumulation of reactive oxygen species (ROS) and decrease in the viability of H9c2 cells. Whereas, DOX-induced ROS accumulation and up-regulation of ERS related proteins were partially abolished by pretreatment with OP-D. Consequently, a DOX-induced ERS was mitigated by application of OP-D. Similarly, DOX-induced decrease in cell viability was partially attenuated by either inhibiting CHOP or pretreatment with N-acetylcysteine (NAC), an antioxidant. Moreover, cardiac ultrastructural abnormalities seen in mouse receiving DOX injections were obviously ameliorated by pretreatment of OP-D. Taken together, the present study proved that OP-D protects cardiomyocytes against DOX-induced injury, at least in part, through reducing ROS accumulation and alleviating ERS.
Acetylcysteine ; Activating Transcription Factor 6 ; metabolism ; Animals ; Antioxidants ; Cell Line ; Cell Survival ; Doxorubicin ; adverse effects ; Endoplasmic Reticulum Stress ; drug effects ; Heat-Shock Proteins ; metabolism ; Mice ; Mitochondria ; metabolism ; Myocytes, Cardiac ; drug effects ; Rats ; Reactive Oxygen Species ; metabolism ; Saponins ; pharmacology ; Spirostans ; pharmacology ; Transcription Factor CHOP ; metabolism ; Up-Regulation

Objective To evaluate the advantages and short term clinical results of arthroscopic release with radiofrequeney vaporization for knee joint stiffness.Methods Arthroscopic release with ra- diofrequency vaporization was done in 32 cases with knee joint stiffness resulted from various causes be- tween January 2002 and June 2005.According to degree of stiffness,32 cases were divided into three groups,ie,Group A(18 cases with suprapatellar bursa adhesions)treated with confectioning at suprapa- tellar bursa and lateral grooves;Group B(eight cases with joint compartment adhesions)managed with debridement at suprapatellar bursa and lateral groove and intereondyloid fossa,bending the knee with pressure and abscising the adhesion part in the joint compartment with radiofrequency vaporization;and Group C(six cases with most part of the joint adhered)treated by making small incision at the lateral or medial upper pole of the patellar as well as a space at the suprapatellar bursa by blunt dissection when it was difficult to insert arthroscope.After that,release combined with massage manipulation and thorough hemostasis by radiofrequency vaporization were carried out.There was no drainage after operation.Pas- sive and active flexion and extension exercises with pressure began two days after operation.Results Pre-operative limitation of flexion was 35?-75?that was increased to 115?-125?three weeks after opera- tion,with mean improvement of 78?in Group A.Pre-operative limitation of flexion was 40?-60?that was increased to 95?-120?three weeks after operation,with mean improvement of 72?in Group B.Pre-opera- tive limitation of flexion was 25?-45?that was increased to 90?-110?three weeks after operation,with mean improvement of 64?in Group C.No haematocele occurred postoperatively,with only slight swelling of the knee.Conclusion Arthroscopic release with radiofrequency vaporization for knee joint stiffness is characterized by less bleeding,minor trauma and reliable release and can be applicable especially for the eases with only adhesion at suprapatellar bursa,lateral groove or joint compartment.

Abstract?AIM: To investigate mechanism of bradykinin ( BK) on inflammations of retinal pigment epithelium ( RPE) cells.?METHODS: ARPE -19 cells were cultured in vitro, stimulated by 100nM BK for 24h. Cell morphology changes were observed by microscope, and BK receptor localization was detected through cell immunofluorescence. Changes of Ca2+in BK and BR antagonist stimuli were detected by laser scanning confocal microscopy.The expressions of COX-1, COX-2, eNOS and iNOS protein in control group and BK group were detected by Western Blot.?RESULTS: After the stimulation of BK, there was no significant changes of ARPE-19 cells in morphology.Kinin B1 receptors ( B1R ) and B2 receptors ( B2R ) could be detected in ARPE-19 cells.Compared with control group, Ca2+concentrations significantly increased in BK group; in B1R antagonist group and B2R antagonist group Ca2+concentrations increased less than BK group; B1R and B2R antagonist group showed no obvious changes in Ca2+concentrations.Compared with control group, COX-2 and iNOS protein concentrations were significantly increased in BK group (P<0.001).?CONCLUSION:BK induces the increasing expression of COX-2 and iNOS in the cultured ARPE cells through binding with either B1R or B2R.

Objective Studing the main influencing risk factors to provide evidence for improving the quality of life among people living with HIV. Methods The quality of life on 758 patients with HIV was evaluated by the Medical Outcomes Study Short-Form Health Survey (SF-36) and some potential risk factors as personal characteristics and disease condition were studied. Means and standard deviations of data were calculated and differences among groups and variances were tested using Student's t test, followed by step-wise multivariate regression. Results The SF-36 two summary scores of 758 patients with HIV appeared to be 45.34±8.77 and 41.92±12.01 respectively. The physical component surmmary scores (PCS) had a gradual decrease with the increase of age. However, mental component summary scores (MCS) had a gradual decrease with the increase of time receiving the treatment. Male patients reported having a better quality of life (QOL) than female, and patients who were infected through injecting drug use and sexual transmission reported to have had better QOL than patients who were infected through paid blood plasma donation. Compare to patients having low CD4+ count, those having higher CD4+ count reported to have better QOL. Conclusion Patients being young, female, infected through paid blood plasma donation, having low CD4+ count, or treated for longer period, would have unsatisfactory QOL.

The attenuating effect of daidzein (DAI) on oxidative toxicity induced by Aroclor 1254 (A1254) was investigated in mouse testicular cells. Cells were exposed to A1254 alone or with DAI. The oxidative damage was estimated by measuring malondialdehyde (MDA) formation, superoxide dismutase (SOD) activity and glutathione (GSH) content. Results show that A1254 induced a decrease of germ cell number, an elevation in thiobarbituric acid reactive substances (TBARS) but a decrease in SOD activity and GSH content. However, simultaneous supplementation with DAI decreased TBARS level and increased SOD activity and GSH content. Consequently, dietary DAI may restore the intracellular antioxidant system to attenuate the oxidative toxicity of A1254 in testicular cells.
Animals ; Chlorodiphenyl (54% Chlorine) ; toxicity ; Hypoxanthine ; toxicity ; Isoflavones ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Mice ; Mice, Inbred ICR ; Oxidation-Reduction ; Testis ; drug effects ; metabolism ; Xanthine Oxidase ; toxicity

OBJECTIVETo study the clinicopathologic features and immunophenotype of centrally necrotizing carcinoma (CNC) of breast; and to study its relationship with basal-like breast cancer.

METHODSThe clinical and pathologic characteristics of 35 cases of CNC were analyzed. Immunohistochemical study for estrogen receptor, progesterone receptor, HER2, CK8/18, 34betaE12, CK5/6, CK14, CK17, smooth muscle actin, p63, vimentin and epidermal growth factor receptor was performed using EnVision method. The surival information of 10 case were obtained.

RESULTSThe age of patients with CNC ranged from 30 to 82 years (mean = 54.2 years). Macroscopically, all tumors were relatively circumscribed, with a mean diameter of 2.4 cm. Histologically, there was a prominent central, necrotic or acellular zone surrounded by a narrow rim of viable tumor cells. The central necrotic foci had the following morphologic patterns: (1) coagulative tumor necrosis associated with various degree of fibrosis or hyaline degeneration (24 cases), (2) predominance of fibrous and scar tissue, with small amount of necrotic debris (8 cases), and (3) infarction (3 cases). The peripheral zone of tumor cells showed features of grade 3 invasive ductal carcinoma in 32 cases and grade 2 in 3 cases. Twenty cases of CNC were associated with ductal carcinoma in-situ. A component of invasive micropapillary carcinoma was identified in 5 cases. Peripheral lymphocytic infiltrates were seen in 17 cases. Immunohistochemical study of 31 cases showed that the expression rate of basal-like markers (83.9%, 26 cases) was higher than that of myoepithelial markers (38.7%, 12 cases). The percentage of basal-like subtype (64.5%, 20 cases) was higher than luminal-A (9.7%, 3 cases), luminal-B (9.7%, 3 cases), HER2 over-expression (12.9%, 4 cases) and null (3.2%, 1 case) subtypes. In 20 cases of basal-like carcinoma, the expression ratio of CK5/6 was highest amongst basal-like markers (18 cases), the other markers ratios of CK17, CK14 and epidermal growth factor receptor were 8/10, 14/19 and 8/16, respectively. Follow-up data were available in 10 patients. The follow-up duration ranged from 15 to 42 months (mean = 21.5 months). The median disease-free and overall survivals were 14.0 and 18.0 months, respectively. Disease progression (as defined by the presence of recurrence, metastasis or tumor-related death) occurred in 9 patients. The mean and median time to disease progression was 16.6 and 13.0 months, respectively.

CONCLUSIONSCNC is a rare subtype of breast carcinoma and has distinctive, easily discernible morphologic features. The majority of CNC exhibits basal-like immunophenotype and carries a poor prognosis. CNC is the typical representative of basal-like breast cancer.

Actins ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma in Situ ; metabolism ; pathology ; surgery ; Carcinoma, Basal Cell ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Immunophenotyping ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local ; Survival Rate