Adult ; Aged ; Aged, 80 and over ; Brachytherapy ; adverse effects ; methods ; Digestive System Neoplasms ; radiotherapy ; Esophageal Neoplasms ; radiotherapy ; Female ; Fever ; etiology ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Nausea ; etiology

AIM: To investigate the variation of ?-AR in pulmonary microvascular endothelial cells and variation of GRK2 in lung and to explore the therapeutic effect of methlyprednisolone in severe acute pancreatitis-associated lung injury model in rats.METHODS: 36 rats were divided into three groups randomly: the control group,the experimental group,and the intervention group.In the experimental group,severe acute pancreatitis-associated lung injury model was induced in SD rats by retrograde injection of 5% sodium taurocholate into biliopancreatic duct.In the control group,laparotomy was performed,duodenum and pancreas were flipped only.In the intervention group,methlyprednisolone(30 mg/kg) was injected into rump muscle of rats after model developed.At 6 and 12 h after model was developed,the maximum binding capacity(Bmax) and the Kd value of ?-AR were detected in lung by means of radioactive ligand binding assay.GRK2 expression was detected in lung by means of immunofluorescence.RESULTS: The scores of the severity of pancreatitis and the severity of lung injury in the experimental group were obviously higher than those in control group.In the experimental group,Bmax was obviously lower,Kd and GRK2 were obviously higher than those in control group and the intervention group.CONCLUSION: The ?-AR in lung is lower down and GRK2 expression in lung is up-regulated in severe acute pancreatitis-associated lung injury model in rats.The therapeutic effect of methlyprednisolone to severe acute pancreatitis-associated lung injury is positive.

? AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.?METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13. 27 ± 7. 77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15. 43 ± 8. 42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17. 0.?RESULTS:In the exotropia patients, the conversions of circular degree(°) and prism degree(△) were:1°=0. 29△ ~1. 78△, which was statistically significant with intermittent strabismus (P=0. 001). While in the esotropia patients, the conversions were:1°=2. 01△ ~2. 15△.?CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7. 00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Objective To evaluate the relevant causes of neurologic complications following liver transplantation.Methods 155 adult patients (131 males, 24 females) who received liver transplantation for the first time at Tongji Hospital between January 2005 and September 2009 were identified.Case notes were reviewed and demographic data, details of the liver disease, neurologic complications, MELD score and discharge information were recorded.Results Neurologic complications occurred following 36 transplants (23.2 %), The complications included mental symptoms in 15 cases (41.7 %), disorder of consciousness and action in 9 cases (25 %), and coma in 12 cases (33.3 %).Twelve percent patients with liver cancer experienced a neurologic complication, which was lower than for other transplant indications, like acute and chronic hepatic failure because of HBV infection (33.3 %, P＜0.01), inborn/metabolic disease (40 %, P＜0.05), and HCV Infection (25 %, P = 0.36).Patients who experienced a neurologic problem had significantly higher MELD score (for non-cancer patients:22.93 ± 8.21; for cancer patients:17 ± 5.4) than the other Patients (for non-cancer patients:18.33 + 8.47, P＜0.05; for cancer patients:13 ±3.4, P＜0.01).The rate of infection (36.1 %) and mortality (30.5 %) were significantly higher in patients with neurologic complications (P＜0.01).The levels of ALT, TBil, ALB, PT and the concentrations of serum sodium and chlorine had no impact on neurologic complications.Conclusion Neurologic complications are common in liver transplant recipients.These complications are related to primary disease and liver function before the operation, and increase the rate of infection and mortality.

Objective To evaluate the myocardial protective effect of dexmedetomidine in the pediatric patients undergoing total correction of tetralogy of Fallot.Methods Forty ASA physical status Ⅱ] or Ⅲ pediatric patients of both sexes,aged 9 months-5 yr,weighing 7-21 kg,scheduled for elective total correction of tetralogy of Fallot under cardiopulmonary bypass,were randomly divided into 2 groups (n =20 each):control group (C group) and dexmedetomidine group (D group).Anesthesia was induced with iv injection of midazolam,sufentanil,etomidate and rocuronium.The patients were endotracheally intubated and mechanically ventilated.After intubation,dexmedetomidine was infused intravenously at 0.6 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume normal saline was given instead of dexmedetomidine in group C.Venous blood samples were obtained before operation,at the end of operation and at 24 h after operation for determination of plasma TNF-α and IL-6 concentrations.The occurence of anoxic spells was recorded.Results The concentrations of plasma TNF-α and IL-6 were significantly lower at the end of operation and 24 h after operation in group D than in group C(P ＜0.05).The incidence of anoxic spells was 0 in group D,however it was 20％ in group C.Conclusion For the pediatric patients undergoing total correction of tetralogy of Fallot under cardiopulmonary bypass,dexmedetomidine infused at 0.6 μg· kg-1 · h-1 during operation can exert myocardial protective effect with clinical significance.

Objective To investigate the effects and possible mechanisms of platelet-activating factor (PAF) on the invasion of ovarian cancer cells and to provide a potential target for ovarian cancer therapy.Methods ( 1 ) Serous type ovarian cancer cell line OVCA429 with platelet-activating factor receptor (PAFR) positive and mucinous type cell line RMUG-L (PAFR negative) were treated with 100 nmol/L of the PAF,cell invasion ability was determined by transwell cell migration assay.(2) For determination of the optimal PAF concentration,ovarian cancer cell OVCA429 was treated by 0,0.1,1,10,100,and 1000 nmol/L of PAF for 10 minutes or 24 hour,respectively.To observe the different time point of protein changes,OVCA429 were treated by 100 nmol/L of PAF for 0,5 minutes,10 minutes,30 minutes,1 hour or 12 hours,respectively.The total proteins of treated cells were extracted according to standard protocol.The expression of p38 mitogen-activated protein kinase (p38 MAPK),phosphorylated p38 MAPK (p-p38 MAPK),transcription factor response element-binding protein (CREB),phosphorylated CREB (p-CREB) and matrix metalloproteinase-2 (MMP-2) were detected by western blot.(3) To verify the pathway involved in the PAF induction of the cancer cell invasion,we repeated the experiments by adding the inhibitors when treating cells with PAF.The inhibitors used were as follows,PAFR inhibitor-WEB2076 (50 μmol/L),pp38 MAPK inhibitor-SB203580 (10 μmol/L),CREB binding protein (CBP)-CREB interaction inhibitor217505(25 μ mol/L).All treated cells were divided into 6 groups:control group,PAF group,PAF + WEB2076 group,PAF + SB203580 group,PAF + 217505 group and PAF + SB203580 + 217505group.Results ( 1 ) By transwell assay,100 nmol/L of PAF could improve the invasion ability of OVCA429 cell significantly [ PAF:( 118 ± 23 ) cells vs.control:(36 ± 8 ) cells,P ＜ 0.0l ],while the same treatment had no effect on RMUG-L cells [PAF:(45 t 13) cells vs.control:(53 ±9) cells,P＞0.05].(2) Even a very low concentration of PAF (0.1 nmol/L) could increase the expression of p-CREB and MMP-2,while the most effective concentration of PAF was 100 nmol/L.The highest p-CREB protein expression was detected at 10 minutes after administration of 100 nmol/L PAF,as well as the expression of p-p38 MAPK protein.Even 12 hours after treatment the p-p38 MAPK protein could be detected,while there was no significant difference in the expression of CREB ( P ＞ 0.05 ).(3) As compared with PAF group,both in PAF + WEB2076 group and PAF + SB203580 group,the expressions of p-p38 MAPK,p-CREB and MMP-2 protein were decreased significantly; in PAF + 217505 group,although the expression of p-p38 MAPK and p-CREB protein was significantly higher than the control group,the expression of MMP-2 protein was significantly lower; in PAF + SB203580 + 217505 group,the expression of these three proteins were also significantly lower,but there was no significant difference as compared with that in the PAF + WEB2076 or PAF + SB203580 group.Conclusion PAF could induce MMP-2 expression and contributed to PAFR positive ovarian cancer cell invasion via activation of CREB by phosphorylating of p38 MAPK.

Objective To describe and examine the clinical characteristics and spectrum of tufted angiomas (TA) in infants so as to explore the therapeutic approaches to Kasabach-Merritt phenomenon (KMP).Methods The clinical and follow-up data of 24 patients with TA were retrospectively analyzed between Jan.2009 and Mar.2013.The median age of the patients was 7.5 months(ranged from 18 days to 2 years),including l0 male and 14 female.Surgical excision and observation were chosen according to the lesion and conditions of the patients.The mean follow-up period was 3.6 years (1.2 to 5.4 years).The changes in the patients' s condition were established by evaluating platelet counts,and the size of lesion.Results Common clinical features included dusky red or violaceous infiltrating cutaneous lesion,thrombocytopenia,pain or decreased function and hyperhidrosis or hypertrichosis.The following 3 clinical patterns of TA progress were described:spontaneous complete or partial regression (n =2,8.3％),TA without complications and persistence over the years(n =9,37.5％),and TA complicated by KMP(n =13,54.2％).The average interval of development of KMP for delayed cases was 45.2 days(ranged 0 d to 4 months).Each of the 13 patients who developed KMP subsequent to initial presentation was symptomatic at the time KMP was detected(enlarged lesion,n =8;increased lesion firmness with change in cutaneous stain,n =3 ;and respiratory distress,n =2).All of 13 patients were cured by surgery.Complete surgical resections were performed on 10 cases.The thrombocyte count was back to normal within 1-3 days post operation,and hemoglobin and blood coagulation function gradually returned to normal within 1 to 2 weeks.Other 3 cases received major resection surgery.The number of platelets in the patients were unstable,but significantly higher than that of preoperational stage.The platelet count remained above 60 × 109/L.The residue lesions in 2 cases disappeared gradually after the operation and medication were given within 3-6 months.And the other case died of multiple organ failure post-operation.Conclusions Surgical intervention can be applied to TA that severely makes damage to children's appearance or looks or may be complicated with KMP or functional abnormality.A closely monitored policy seems appropriate for the early small tumor without severe complications.And it is necessary to monitor the number of the platelet regularly and find the KMP by as early as possible.TA associated with KMP is vitol to infants.And surgical therapy after clear diagnosis should be done as early as possible.The surgical therapy is a reliable management with higher curative rate,short disease period and minimal side-effect.

Background Researches documented that retinal nerve fiber layer thickness (RNFLT) in unaffected carriers of Leber hereditary optic neuropathy (LHON) becomes thickened in different quadrants to different degrees.But the change of their macular thickness is still unclear.Objective This study was to clarify RNFLT and macular thickness by optical coherence tomography (OCT) in unaffected female carriers of LHON families.Methods Five female LHON patients (5 eyes) from 5 LHON families,eighteen unaffected female carriers (18eyes) from 18 LHON families and twenty-five age-matched healthy female controls (25 eyes) were included in this study.The patients and genetic carriers were diagnosed in PLA General Hospital from 2011 September to 2012 October.Regular ocular examination were performed followed by OCT measurement of retinas.The Optic Disc Cube 200×200 and Macular Cube 200×200 protocols were used during the OCT measurement.Average (360°) RNFLT,RNFLT at four quadrantic sections,cube average macular thickness and macular thickness of nine Early Treatment Diabetic Retinopathy Study (ETDRS) sub-areas were compared among the LHON genetic carriers,LHON patients and normal controls.Results Compared to the normal control group,significant reduced values were seen in temporal,superior,nasal and inferior side of sub-area macular thickness in the LHON female carriers (P=0.022,0.046,0.024,0.008).In addition,but no significant differences were found in cube average thickness,central subarea macular thickness,temporal,superior,nasal and inferior side of lateral sub-area macular thickness,average RNFLT,and temporal,superior,nasal and inferior quadrant RNFLT between the LHON female carriers and normal controls (P=0.102,0.051,0.238,0.663,0.1 10,0.104,0.419,0.371,0.158,0.063,0.563).Compared to the unaffected female carrier group,female patients showed significant reductions in cube average macular thickness,temporal,superior,nasal and inferior side of sub-area macular thickness,temporal,superior,nasal and inferior side of lateral sub-area mac ular thickness,average R NFLT and temporal,superior,and inferior quadrant RNFLT (P =0.000,0.000,0.000,0.007,0.002,0.002,0.000,0.000,0.040,0.000,0.016,0.000,0.000) except for the central subarea macular thickness and nasal quadrant RNFLT (P=0.388,0.580).Conclusions Unaffected LHON female carriers show a normal peripapillary RNFLT,but the macular thickness at medial sub-area is thinner.This first report offers an information of macular structure change in unaffected LHON female carriers,which suggest that macular damage appears prior to RNFLT change.

Objective:To observe the clinical efficacy of moxibustion with seed-sized moxa cone plus opioid drugs for moderate-to-severe cancer pain, and the effect on immune function in patients with cancer pain. Methods: A total of 80 patients with moderate-to-severe cancer pain were randomized into an observation group and a control group by the random number table method, with 40 cases in each group. Both groups were treated with opioid drugs for analgesia according to the standardized management principles for cancer pain. In addition, the observation group was given moxibustion with seed-sized moxa cone. The treatment was performed once a day, continuous 5-day treatment with a 2-day interval constituted a treatment course, and a total of 2 courses were performed. The score of numerical rating scale (NRS) and 24 h equivalent morphine consumption was compared between the two groups before treatment, after 1 treatment course and after 2 courses of treatment. The immune functions were compared between the two groups before and after 2 courses of treatment. Results: During the treatment, there were 3 dropouts in the control group, and 2 dropouts in the observation group. Before the treatment, there were no significant differences in the NRS score and 24 h equivalent morphine consumption between the two groups (both P＞0.05). The NRS scores of both two groups were quite stable during the whole treatment period, and there was no significant difference in the intra-group comparison after treatment (both P＞0.05), and there was no significant difference between the two groups at the same time point (both P＞0.05). In the control group, the 24 h equivalent morphine consumption showed an increasing trend. The dosage after 1 treatment course and 2 courses of treatment was statistically different from that before treatment in the control group (both P＜0.01). There was no significant change in the mean 24 h equivalent morphine consumption in the observation group compared with that before treatment (both P＞0.05). After 2 courses of treatment, the 24 h equivalent morphine consumption in the observation group was significantly lower than that in the control group at the same time point (P＜0.05). Before treatment, there was no significant difference in the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) between the two groups (all P＞0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the control group were lower than those before treatment (all P＜0.05), while the levels in the observation group were higher than those before treatment, and the levels of CD3+ and CD4+ were significantly different from those before treatment (both P＜0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) of the observation group were significantly higher than those of the control group at the same time point (all P＜0.05). Conclusion: Moxibustion with seed-sized moxa cone can reduce the dosage of opioid drugs used in patients with moderate-to-severe cancer pain and improve their immune functions.

Objective: The expression of WNT5A is associated with aggressive tumor biology and poor clinical outcomes of various types of cancer. However, its function in the cell migration of small cell lung cancer (SCLC) should be elucidated. Methods:The expres-sion of WNT5A in SCLC and normal lung tissues was detected by immunohistochemisty. The correlation between the expression and clinical characteristics of WNT5A was analyzed. The function of WNT5A in regulating cell migration was studied in DMS153 cell line in vitro. Small interfering RNA (SiRNA) was used to knock down WNT5A. Wound healing and Transwell tests were used to determine the migration rate of DMS153. The phosphorylated JNK expression was detected by Western blot analysis. Results:The WNT5A expression was higher in SCLC tissues than that of normal lung tissues. WNT5A was correlated with clinical stages, lymph nodes, and distance me-tastasis in SCLC. The high expression of WNT5A was accompanied by abnormal levels of NSE and Pro-GRP. The WNT5A phosphoryla-tion of JNK promoted cell migration in vitro. Conclusion:The expression of WNT5A in SCLC is high and correlated with tumor metasta-sis. The influence of WNT5A/JNK on the cell migration property of DMS153 supports the concept that WNT5A can initiate the cell mi-gration of SCLC, which suggested that WNT5A may be a marker and can be potentially used as an effective therapeutic target for the SCLC metastasis.