Bone Neoplasms ; Female ; Humans ; Middle Aged ; Waldenstrom Macroglobulinemia

Objective To explore the application value of CT perfusion imaging for predicting the tiny lymph nodes metastasis and micrometastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.Methods The clinical data and CT perfusion parameters of 46 patients with cervical squamous cell carcinoma who underwent neoadjuvant chemotherapy followed by surgery were enrolled in the study.Based on the surgical pathology findings and short-term follow up,the cases were divided into without tiny lymph nodes metastasis (short axle diameter of lymph nodes＜10 mm) group (n=32) and with tiny lymph nodes metastasis group (n=14).All perfusion data were analyzed retrospectively and the diagnostic value were investigated.Results Blood flow (BF),blood volume (BV) and the maximum diameter of tumor per-chemotherapy in with tiny lymph nodes metastasis group were higher than those in without tiny lymph nodes metastasis group (all P＜0.05).The differences of the maximum diameter of tumor after chemotherapy,permeability,time to peak (TTP) between two groups were not statistically significant (all P＞0.05).Multivariate Logistic regression analysis showed BF and the maximum diameter of tumor per-chemotherapy were independent predictors of the tiny lymph nodes metastasis in cervix after neoadjuvant chemotherapy.ROC showed BF (AUC=0.86,P＜0.001,95％CI [0.75,0.96]) had higher predictive value than maximum diameter of tumor per-chemotherapy (AUC=0.70,P=0.02,95 ％ CI [0.54,0.88]).Conclusion CT perfusion imaging shows the significant predictive value for the tiny lymph nodes metastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.

Objective To study changes of serum endotoxin and its receptor CD14 gene expression in lung, liver, intestines, kidney tissues in model of acute forebrain ischemia complicated by multiple organ dysfunction syndrome(MODS), and to investigate the pathogenesis of cerebrogenic MODS. Methods 54 Wistar rats were randomly divided into seven groups: normal control group(n=6)、sham-operative group(n=8) and 5 ischemia groups(n=40)including 12 h, 24 h, 36 h, 48 h, 72 h five time points. Model of cerebral infarction was established. The content of endotoxin in plasma was evaluated with a test kit. The area density and optical density of positive staining of CD14mRNA expressing were analyzed for the relative content of CD14mRNA using in-situ hybridization and CMIA medical imaging analysis system. Results Plasma endotoxin level were markedly high at 12 h (0.184?0.055)Eu/L after acute forebrain ischemia, peaking at 24 h (0.639?0.064)Eu/L and it was somewhat decreased at 72 (0.117?0.024)Eu/L. The CD14mRNA expression in lung, liver, intestines, kidney tissues increased after brain ischemia, reaching the peak at the 24~36 h, and decreased after 48 h. The highest change of CD14mRNA expression was found in lung(P

BACKGROUND: There is much clinical datum analysis on multi-organ dysfunction syndromes induced by cerebral hemorrhage, but there is lack of experiment on dysfunction of peripheral organs induced by acute cerebral vascular disease.OBJECTIVE: Collagenase of two dosages together with proper amount of heparin were used to duplicate animal model of multi-organ dysfunction syndromes induced by cerebral hemorrhage so as to probe into the best experimental prerequisite.DESIGN: Complete randomized control experiment.SETTING: Departments of Dermatology, Neurology and Cardiac Surgery of Qilu Hospital Affiliated to Shandong University and Department of Neurology of Jinan Railway Center Hospital.MATERIALS: The experiment was performed in Institute of Basic Medicine of Shandong Medical Scientific Academy from September to December 2002. Totally 96 adult healthy male Wistar rats were employed and randomized into normal control (6 rats), sham-operation group (6 rats), first hemorrhage group (42 rats) and second hemorrhage group (42 rats). Seven sub-groups of 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours successively were divided in first and second hemorrhage groups respectively, 6 rats in each sub-group.INTERVENTIONS: In the first hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.4 U and heparin sodium 3.2 IU was infused slowly to the brain. In the second hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.8 U and heparin sodium 3.2 IU was infused slowly to the brain. In sham-operation group, physiological saline of same volume was injected. The general situation of animals at every phasic point was observed after operation, including consciousness, mental state and limb movement, as well as the alternations on body temperature, respiration and heart rate. Examinations were done on blood routine, liver function (alanine aminopherase, ALT;aspartic acid translocase, AST), kidney function (urea nitrogen, BUN; creatinine CRE) and myocardial zymology (creatine kinase, CK; lactic dehydrogenase, LDH). Modified matrix coloration method was used to determine endotoxin content in plasma. Pathological alternations were observed optic microscopically on brain, lung, liver, small intestine and kidney.ternations on main organs of experimental animals.experimental animals after operation: In the first and second hemorrhage groups, body temperature, respiration, heart rate and leukocyte content were all higher remarkably than normal group and sham-operation group (P ＜ 0.05).Those in the first hemorrhage group were higher than second group [(39.56±0.59)C, (37.98±0.52)C;(124.23±4.12) times/minute, (92.56±2.95)times/minute; (325.96±84.53) times/minute, (258.16±75.42) times/minute,(P ＜ 0.05)], and the difference in peripheral leukocyte content was specially nation of ALT activity, AST activity, BUN content, CRE content, CK activity,LDH activity and endotoxin content in plasma: Those in the first and second hemorrhage groups were higher than normal group and sham-operation group (P ＜ 0.05 -0.01). Those in the first hemorrhage group were higher than second hemorrhage group [(35.04±7.54) μkat /L, (24.25±5.42) μkat/L;(51.61±10.47) μkat/L, (33.77±7.44) μkat/L; (21.12±2.93) mmol/L,(9.78±1.45) nmol/L; (68.57±5.24) μnol/L, (40.54±3.95) μmol/L; (706.44±44.92) μkat/L, (189.23±25.08) μkat/L; (357.96±40.95) μkat/L, (149.60±19.10)(P ＜ 0.05)] and the difference was especially remarkable in endotoxin content logical alternations on main organs of experimental animals: Inflammatory damage of various degrees presented in all of animal organ tissues at various phasic points during cerebral hemorrhage in rats. In the first hemorrhage group, pathological change of organs reached the peak in 24-36 hours, which recovered to be normal in 72 hours. In the second hemorrhage group, the inflammatory damage was more remarkable and persistent compared with first group, in which, pathological change of organs reached the peak in 24-48hours and inflammatory damage was still visible in 72 hours.CONCLUSION: It is indicated that 0.8 U collagenase model is a successful model of multi-organ dysfunction syndromes induced by cerebral hemorrhage. Such model is in conformity with the common induced factors in clinic and various index changes of functions in every organ and can reflect dynamically the occurrence of multi-organ dysfunction syndromes.

BACKGROUND: Leukoaraiosis is a group of changes in image. Since the firm pathogenic mechanism on leukoaraiosis has been unknown, the evaluation at the earlier stage of the disease has not been emphasized commonly and there is rather less recognition of the alternations on its electrophysiological system.OBJECTIVE: To probe into the clinical characteristics and alternations on image and evoked potential in simple leukoaraiosis and subcortical arteriosclerotic encephalopathy(Binswanger' s disease) and carry on the comparison with healthy people.DESIGN: Retrospective comparative study based on patients and healthy people.SETTING: Department of neurological internal medicine of one university hospital and department of neurological internal medicine of one railway central hospital.PARTICIPANTS: Outpatients or inpatients with cerebral vascular disorders in Qilu Hospital Affiliated to Shandong University were collected from August 1995 to March 2000. Totally 114 cases were leukoaraiosis, of which, 79 cases were males and 35 cases females. And 41 cases were Binswanger' s disease,of which, 28 cases were males and 13 cases females. Fifty healthy aged people who received routine physical check were randomized from the clinic of the hospital as the control.METHODS: The analysis was carried on the risk factors, clinical characteristics and CT exam in 114 cases of leukoaraiosis and 41 cases of Binswanger' s disease, of which, 74 leukoaraiosis cases and 35 Binswanger' s disease cases had received cranial MRI exam. Of those, 43 cases of simple leukoaraiosis associated with hypertension, 30 cases of Binswanger' s disease and 50 cases in the normal control were selected to carry on the examinations of body-sensory evoked potential, brain stem auditory evoked potential and visual evoked potential.coronary heart disease, diabetes, hyperlipemia, smoke, cerebral apoplexy,evoked potential and visual evoked potential.RESULTS: According to practical management analysis, 114 cases of leukoaraiosis, 41 cases of Binswanger' s disease and 50 cases in the control were diversification, mainly characterized as slightly declining of memory and loss of gait stability. Hypertension is predominated anong risk factors in Binswanger' s disease group (95.1% ), mainly characterized as physical signs of local neural focus, obvious cognitive disturbance and cerebral in CT exam that 70.2% (80/114) of cases presented brain whiter-matter abnormity in type Ⅰ. It was indicated in MRI exam that 72% (53/74) of cases presented brain whiter-matter abnormity, type Ⅰ, 27% (20/74) presented type Ⅱ and 1% (1/74) presented type Ⅲ. For Binswanger's disease patients, it was indicated in MRI exam that 54% (19/35) of cases presented brain white-matter abnormity, type Ⅲ, and 46% (16/35) presented type Ⅳ.Symmetrical extension of bilateral ventricles presented in Binswanger' s disbody-sensory evoked potential was 84% (36/43), of which, the mild abnormity occupied 60% (26/43) and moderate abnormity 23% (10/43); The abnormity rate of brain stem auditory evoked potential was 63% (27/43) and that of visual evoked potential was 54% (23/43). In Binswanger' s disease group, the abnormity rate of body-sensory evoked potential was 97% (29/30),of which, mild abnormity was 7% (2/30), moderate abnormity was 47%(14/30) and severe abnormity was 43% (13/30); The abnormity rate of brain stem auditory evoked potential was 87% (26/30) and that of auditory evoked potential was 83% (25/30).CONCLUSION: The risk factors of simple leukoaraiosis are diversified,without obvious physical signs of local neural focus. The diagnosis of it is mainly depended on abnormity Ⅰ of brain white matter described in images,manifested as remarkable dysfunction of cerebral eletrophysiology. Binswanger' s disease patients are mainly characterized as hypertension, relevantly obvious cognitive disturbance and common seizure of cerebral apoplexy. Abnormity Ⅲ of brain white matter indicated in CT exam, abnormity Ⅲ or Ⅳ of that in MRI exam are the image evidence for diagnosis. Remarkable abnormity also presents in cerabral electrophysiology, in which, abnormal body-sensory evoked potential is especially significant.

Objective: To observe the influence of electroacupuncture with different frequencies on rats swimming endurance and sift out the optimal frequency parameter.Methods: Wistar rats were randomly allocated to control group, non-acupoint group and electroacupuncture with low frequency group (EA with 2 Hz group), electroacupuncture with medium frequency group (EA with 15 Hz group), and electroacupuncture with high frequency group (EA with 100 Hz group), acupoints Zusanli (ST 36) and Taichong (LR 3) were punctured and rats load swimming time was used as an index, and the change of swimming endurance time before and after acupuncture was observed. Results: After electro-acupuncture, swimming time was increased in 15 Hz and 100 Hz groups respectively, with the significant differences between before and after acupuncture (P＜0.05). There was also a significant difference in the percentage of increase in swimming time between 15 Hz group and other groups (P＜0.05).Conclusion: It is suggested that electroacupuncture at acupoints Zusanli (ST 36) and Taichong (LR 3) with a frequency of 15 Hz could enhance rats's swimming endurance, and 15 Hz might be an optimal frequency parameter during the electrical stimulation.

Objective To explore the different operation modes for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.Method A retrospective analysis was performed on 48 cases of native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney,including 14 cases receiving open surgery (open surgery),22 cases receiving laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision (oblique incision group) and 12 cases receiving modified endoscope assisted Plunk technique (Plunk group).The operating time,amount of bleeding and blood transfusion during operation,recovery of intestinal function,time of indwelling drainage tube and wound suture,the total cost of hospitalization,the hospital stay and the incidence of complications were comparatively analyzed.Result The operating time in open group was shortest.Group of Pluck is better than other groups in the aspects of Time of wound suture and intestinal function time in shorter in Plunk group than the rest two group (P＜0.05),and amount of bleeding and incidence of complication in Plunk group were higher than oblique incision group (P＜0.05).The incidence of complications and amount of bleeding were decreased significantly as compared with the rest groups (P＜0.05).Conclusion The mode of the laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision has the advantages of high security,minimal invasion and satisfactory treatment effect.It is especially suitable for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.

Objective To evaluate if expression of serum retinol-binding protein 4 (RBP4) concentrations in cholesterol gallstone disease.Methods Serum RBP4 levels of 100 cholesterol gallstone disease patients (cholesterol gallstone disease group) and 147 healthy controls (healthy control group) were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics,including insulin resistance and renal function.The chemical composition of gallstones was determined by postoperative pathology.Results The level of RBP4 in cholesterol gallstone disease group was significantly lower than that in healthy control group [(30.57 ± 13.64 ) mg/L vs.(41.52 ± 20.25 ) mg/L](P＜ 0.01 ).The level of RBP4 was also associated with gallstone occurrence (OR =0.93,95％ CI:0.88 -0.96,P =0.004).Serum RBP4 levels of all subjects were positively correlated with total cholesterol,triglyceride,creatinine,insulin resistance and albumin ( P ＜ 0.05 or ＜ 0.01 ),and negatively correlated with aspartate aminotransferase (P ＜0.01).In multivariate analysis,cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (OR =2.97,95％ CI:1.15 -7.68,P =0.025 ).Both gallstone patients and controls were subdivided into two groups according to ceatinine:≥ 88.40 μ mol/L group and ＜ 88.40 μ mol/L group.Patients with gallstones were found to have significantly lower serum RBP4 levels than controls in both subgroups (P =0.012,0.045 ).According to GFR,both gallstone patients and controls were subdivided into ≥ 90 ml/(min· 1.73 m2) group,60 - 89 ml/(min· 1.73 m2) group and ＜60 ml/ (min· 1.73 m2) group.It showed that a lower GFR was associated with greater serum RBP4 level in healthy control group.This trend was not noted in cholesterol gallstone disease group.Conclusions Serum RBP4 decreases in cholesterol gallstone disease independent of renal function.The relationship between liver function and RBP4 level in these patients deserves further investigation.

Objective To explore the effects of a single bout of aerobic exercise on oxidative stress and total peripheral vascular resistance. Methods 36 prehypertensive patients were divided into aerobic exercise group (n=18) and control group (n=18). The aerobic exercise group performed cycle ergometry at 70% maximal oxygen consumption for 30 min. Total peripheral vascular resistance (TPVR), malondialdehyde (MDA), mean arterial pressure (MAP), vitamin C (VC) and vitamin E (VE) were measured before, immediately, 1 hour and 2 hours after the aerobic exercise. Results There was no significant difference in TPVR, MDA, MAP, VC and VE between two groups before exercise (P>0.05). TPVR was all significantly lower in the aerobic exercise group than in the control group immediately, 1 hour and 2 hours after exercise (P<0.001), and showed a rising trend of recovery. MDA was significantly higher in the aerobic exercise group than in the control group 1 hour and 2 hours after exercise (P<0.05), however there was no significant difference in MDA between two groups immediately after exercise (P>0.05). MAP was significantly lower immediately after exercise in the aerobic exercise group than in the control group (P< 0.001), but there was no significant 1 hour and 2 hours after exercise (P>0.05). There was no significant difference in VC and VE between two groups immediately, 1 hour and 2 hours after exercise (P>0.05). Conclusion The level of oxidative stress increases after a single bout of aerobic exercise, and the TPVR decreases.

Pregnancy ; Female ; Humans ; Lymphohistiocytosis, Hemophagocytic/complications*