OBJECTIVETo explore the expression of polymorphonuclear leucocyte adhesive molecules CD11b/CD18 and to study the possible mechanism of Chinese herbal medicine (TCM) for activating blood circulation to remove stasis in preventing vascular diseases.

METHODSForty-nine patients with diabetes mellitus (DM) but with no complications of hypertension and nephropathy were randomly divided into the treated group (26 patients treated by TCM) and the control group (23 patients treated by conventional treatment). They were treated for 3 months. The changes of urinary albumin excretion rate (UAER), CD11b/CD18 expression and tumor necrosis factor-alpha (TNF-alpha) concentration before and after treatment were observed.

RESULTSThe CD11b/CD18 expression and TNF-alpha concentration in DM patients were higher than those of normal range (P < 0.01). After treatment, the UAER, CD11b/CD18 expression and TNF-alpha concentration lowered significantly in the treated group (P < 0.01), but unchanged in the control group. Correlation analysis showed that the lowering of UAER was positively correlated with decreasing of CD11b/CD18 (r = 0.64, P < 0.01) and TNF-alpha (r = 0.56, P < 0.01).

CONCLUSIONExpression of CD11b/CD18 increases in patients with DM type 2. The mechanism of Chinese herbal medicine for activating blood circulation to remove stasis in preventing vascular disease in possibly related with its effect in inhibiting CD11b/CD18 expression.

Aged ; CD11b Antigen ; biosynthesis ; blood ; CD18 Antigens ; biosynthesis ; blood ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective Despite regular treatment,antineutrophil eytoplasmie antibodies(ANCA)asso- ciated systemic vasculitis(AASV),in which the role of Fc?Rs has been established,are still associated with significant long-term mortality and remain an important cause of end-stage renal failure.ANCA plays an im- portant role in the pathogenisis of primary systemic small vessel vasculitis(PSV)by their potential to activate neutrophils.Because the interaction between ANCA and its receptors on the Fc portion of immunoglobulins (Fc?R)on neutrophils is essential in the activation process,we investigate the inhibitory,effect of tg19320 on ANCA induced activation of neutrophils,which is a tetrameric tripeptide that interferes with IgG/Fe?Rs in- teraction.Methods We prepared tg19320 by solid-phase peptide syntbesis.The binding between tg19320 and human IgG was assessed by enzyme-linked immunosorbent assay.The biological activity of tg19320 to intefere with FcF?receptor recognition was identified by rosette formation assay.ANCA IgG was prepared from the sera of active Wegener's granulomatosis(WG)and microscopic polyangiitis(MPA)patients.Neu- trophils isolated from the blood of healthy volunteers were primed with TNF-?(2 ng/ml)and then incubated with ANCA IgG(200?g/ml),or pretreated with tg19320(2.5 mg/ml)and then added with ANCA IgG.Su- peroxide burst of neutrophils was determined by Ferri-cytochrome reduction assay.Results We found that tg19320 bound tightly to human IgG in a dose dependent manner and the inhibition of the rosette formation between SRBC-IgG and U937 cells was statistically significant(20.3% vs 53.2%,P

OBJECTIVETo investigate the inhibitory effects of OMT on TGF-β1-induced CFBs proliferation, and then explore the mechanism.

METHODThe experiment was randomly divided into 6 groups as following: control group (serum free DMEM), model group (20 μg x L(-1) TGF-β1), OMT low dose group (1.89 x 10(-4) mol x L(-1) + 20 μg x L(-1) TGF-β1), OMT medium dose group (3.78 x 10(-4) mol x L(-1) + 20 μg x L(-1) TGF-β1), OMT high dose group (7.56 x 10(-4) mol x L(-1) + 20 μg x L(-1) TGF-β1), SB203580 group (p38MAPK blocking agent, 1 x 10(-5) mol x L(-1) + 20 μg x L(-1) TGF-β1). Vimentin of CFBs was identified by immunocytochemical methods, α-SMA of myFBs as well. Inhibitory effects of OMT on CFBs proliferation was detected by the MTT assay. Picric acid Sirius red staining was analyzed collagen type I and collagen type III deposition. Western blot was determined the expression of p38MAPK, p-p38MAPK, collagen type I and collagen type III.

RESULTMTT results showed that OMT significantly inhibited CFBs proliferation induced by TGF-β1 (P < 0.01) α-SMA immunocytochemical experiments suggested that OMT could protect against the CFBs proliferation. OMT could significantly decrease the deposition of collagen type I and collagen type III by Western bloting and picric acid Sirius red staining. Western blot results showed that TGF-β1 enhanced p38MAPK phosphorylation, however OMT attenuated the phosphorylation of p38MAPK induced by TGF-β1 (P < 0.01).

CONCLUSIONOMT can inhibit the CFBs proliferation induced by TGF-β1, and its mechanism may be involved in inhibiting p38MAPK phosphorylation.

Alkaloids ; pharmacology ; Animals ; Cell Proliferation ; drug effects ; Collagen ; metabolism ; Down-Regulation ; Female ; Fibroblasts ; drug effects ; Heart ; drug effects ; In Vitro Techniques ; Male ; Phosphorylation ; Quinolizines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; antagonists & inhibitors ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

OBJECTIVETo observe the effect of Cordyceps sinensis (CS) powder on renal oxidative stress and mitochondria functions in 5/6 nephrectomized rats, and to primarily explore its possible mechanisms.

METHODSTotally 30 male Sprague-Dawley rats were divided into the sham-operation group, the model group, and the treatment group by random digit table, 10 in each group. A chronic kidney disease (CKD) rat model was prepared by one step 5/6 nephrectomy. Rats in the treatment group were intragastrically administered with CS powder solution at the daily dose of 2 g/kg, once per day. Equal volume of double distilled water was intragastrically administered to rats in the sham-operation group and the model group. All medication lasted for 12 weeks. The general condition of rats, their body weight, blood pressure, 24 h proteinuria, urinary N-acetyl-β-D-glucosaminidase (NAG), serum creatinine (SCr) , and blood urea nitrogen (BUN) were assessed before surgery, at week 2, 4, 6, 8, 10, and 10 after surgery. Pathological changes of renal tissues were observed under light microscope. Morphological changes of mitochondria in renal tubular epithelial cells were observed under transmission electron microscope. Activities of antioxidant enzymes including reduced glutathione (GSH), manganese superoxide dismutase (MnSOD), and malondialdehyde (MDA) in fresh renal tissue homogenate were detected. Mitochondria of renal tissues were extracted to detect levels of mitochondrial membrane potential and changes of reactive oxygen species (ROS). And expressions of cytochrome-C (Cyto-C) and prohibitin in both mitochondria and cytoplasm of the renal cortex were also measured by Western blot.

RESULTS(1) Compared with the sham-operation group, body weight was significantly decreased at week 2 (P <0. 01), but blood pressure increased at week 4 (P <0. 05) in the model group. Compared with the model group, body weight was significantly increased at week 12 (P <0. 01), but blood pressure decreased at week 8 (P < 0. 01) in the treatment group. (2) Compared with the sham-operation group, 24 h proteinuria, urinary NAG, blood SCr and BUN significantly increased in the model group (all P <0. 01). Compared with the model group, blood and urinary biochemical indices all significantly decreased in the treatment group (all P <0. 01). (3) Results of pathological renal scoring: Glomerular sclerosis index, scoring for tubulointerstitial fibrosis, degree of tubulointerstitial inflammatory infiltration were all obviously higher in the model group than in the sham-operation group (all P <0. 01). All the aforesaid indices were more obviously improved in the treatment group than in the model group (all P <0. 01). (4) Compared with the sham-operation group, activities of MnSOD and GSH-Px were significantly reduced, but MDA contents obviously increased in the renal cortex of the model group (all P <0. 01). Compared with the model group, activities of MnSOD and GSH-Px obviously increased (P <0. 05, P <0. 01), but MDA contents obviously decreased in the renal cortex of the treatment group (P <0. 01). (5) Compared with the sham-operation group, the mitochondrial membrane potential significantly decreased, but ROS levels significantly increased in the model group (all P <0.01). Compared with the model group, mitochondrial transmembrane potential increased in the treatment group, thereby inhibiting the tendency of increased production of ROS (both P < 0. 01). (6) Results of Western blot showed that, compared with the sham-operation group, expression levels of mitochondrial Cyto-C and Prohibitin were significantly reduced in the renal cortex (P <0. 01), but significantly elevated in the cytoplasm of the model group (P <0. 01). Compared with the model group, each index was obviously improved in the treatment group with statistical difference (P <0. 05, P <0. 01).

CONCLUSIONCS powder had renal protection, and its mechanism might partially depend on in- hibition of oxidative stress and protection for mitochondria.

Acetylglucosaminidase ; metabolism ; Animals ; Blood Urea Nitrogen ; Cordyceps ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; Kidney Cortex ; Kidney Diseases ; Kidney Function Tests ; Male ; Malondialdehyde ; metabolism ; Mitochondria ; Nephrectomy ; Oxidative Stress ; drug effects ; Proteinuria ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

Objective To investigate the composition of the disease spectrum of hospitalized children in Anhui Provincial Children's Hospital, so as to provide scientific basis of the strategy to refine pediatric medical resources and health care. Methods Totally 268809 patients from 2013 to 2017 was analyzed and compared with the 2003-2007 data. Results Compared to 2003-2007, the number of hospitalized children and involved diseases increased significantly in 2013-2017. The proportion of common diseases such as respiratory system (28.73% vs 26.49%), digestive system (12.68% vs 10.78%), and nervous system (6.22% vs 3.72%)) significantly decreased; while the proportion of injury and poisoning (2.13% vs 7.4%), infectious diseases, parasites (7.15% vs 10.69%), tumors (2.65% vs 4.12%), and blood immunity (1.42% vs 3.19%) increased. Respiratory diseases remain the first ranking disease in hospitalized children (26.49%), with pneumonia as the first ranking single disease among it. The top 5 hospitalized children in 2013-2017 were pneumonia, bronchitis, hernia, respiratory infections, and neonatal pneumonia. Conclusions The absolute number and capacity of services have been greatly improved in the hospital. While constantly improving the level of diagnosis and treatment of common diseases, we should pay more attention to the injury poisoning, mental and behavioral diseases and infectious diseases in children.

ObjectiveTo investigate the value of 18F-FDG SPECT myocardial imaging in evaluating haemodynamic change,treatment outcome and prognosis for idiopathic pulmonary arterial hypertension (IPAH).MethodsAll 24 patients with IPAH underwent 18 F-FDG SPECT myocardial imaging.Right ventricle/left ventricle (RV/LV)-FDG uptake was calculated by ROI method drawing over the central areas of left and right ventricular free walls.All patients underwent right heart catheterization within 3 days after imaging studies.Mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) were recorded.After six month pharmaceutical treatment,15 IPAH patients were re-examined with 18F-FDG SPECT myocardial imaging followed by repeated right heart catheterization within 3 days.Plasma N-terminal pro-brain naturetic peptide (NT-proBNP) and endothelin-1 ( ET-1 ) were measured in 17 patients using electrochemiluminescent immunoassay and enzyme immunoassay respectively.All patients were followed up for 12 months at least.Correlations between RV/LV-FDG uptake and mPAP and PVR were determined by simple linear regression analysis.Change of RV/LV-FDG before and after treatment was calculated using Student's t-test.Survival in groups with RV/LV FDG uptake ≥ 1.15 and RV/LV-FDG uptake ＜ 1.15 were compared using Log-rank test.ResultsSignificant correlations were found between RV/LV-FDG uptake and mPAP (r =0.562,P ＜ 0.01 ),and between RV/LV-FDG uptake and PVR ( r =0.574,P ＜ 0.01 ).There were no significant correlation between RV/LV-FDG uptake and NT-proBNP( r =0.18 1,P ＞ 0.05 ),but a significant correlation between RV/LV-FDG and ET-1 was observed (r =0.669,P ＜ 0.01 ).The RV/LV-FDG uptake in patients with positive treatment outcome ( n =6) decreased from 1.38 ± 0.52 to 0.92 ±0.26 (t =4.018,P ＜ 0.05) after 6 months treatment.In contrast,no significant change of RV/LV-FDG uptake was seen in those patients (n =9) with negative treatment outcome ( t =1.861,P ＞ 0.05 ).The mean follow-up time was (21 ±8) months.Mean survival time for the patients with RV/LV- FDG uptake ≥ 1.15was 28 months (95％ confidence interval:24-32 months),which was significantly lower than 34 months survival (95％ confidence interval:33-35 months) for the patients with RV/LV-FDG ＜ 1.15 (x2 =3.956,P ＜0.05 ).Conclusions Detection of right ventricle myocardial glucose metabolism level with 18F-FDG SPECT may be a practical method for evaluating haemodynamic change,treatment outcome and prognosis of IPAH.

Objective To investigate the safe time of sterile equipments used in laminar flow operating room.Methods In ten operations ( Class Ⅰ ) which last 8 or more hours,we sampled preoperative air,surgery equipments 4 h,6 h,8 h pre and intra-operatively,and surgical personnel' s hands for bacterial culture.Results There was no growth of bacteria in the sampling of preoperative air,surgical personnel's hands and surgical instruments during operation,pass rate was 100％.Conclusions The sterile equipments used in the same operation could be used safely for 8 hours in operating room where the condition of Level 100 laminar flow reached.

OBJECTIVETo investigate the clinical characteristics of children with critical hand-foot-mouth disease (HFMD) who were treated with mechanical ventilation and to explore the risk factors for poor prognosis.

METHODSThe clinical data of 63 children with critical HFMD who were admitted to the pediatric intensive care unit between April 2012 and September 2013 and needed mechanical ventilation were retrospectively analyzed.

RESULTSAmong the 63 children, 43 were boys and 20 were girls, and their mean age was 25 ± 18 months, with 81% under 3 years old. The four death cases were all under three years old. Compared with the cured cases, the death cases had a significantly lower mean age (8 ± 3 months vs 25 ± 18 months; P<0.05). Poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung field, and pulmonary hemorrhage were all closely related to death (P<0.01). The death cases and cured cases had significantly different peripheral white blood cell counts, blood lactic acid, and blood glucose (24 ± 11× 10⁹/L vs 12 ± 5×10⁹/L; 6.6 ± 1.8 mmol/L vs 3.6 ± 1.7 mmol/L; 16.4 ± 2.5 mmol/L vs 10.0 ± 3.0 mmol/L). The cases with critical illness score <90 had a significantly higher death risk (P<0.01).

CONCLUSIONSChildren with critical HFMD are mainly under 3 years old. The children face extremely high risk of death when they suffer from poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung field, and pulmonary hemorrhage. Significant increases in peripheral white blood cell counts, blood lactic acid, and blood glucose are risk factors for poor prognosis. Critical illness score is also related to poor prognosis.

Blood Glucose ; analysis ; Child ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; blood ; mortality ; therapy ; Humans ; Infant ; Lactic Acid ; blood ; Leukocyte Count ; Male ; Prognosis ; Respiration, Artificial ; Retrospective Studies

OBJECTIVETo explore the efficacy of anterior percutaneous screw fixation in the treatment of odontoid process fractures in aged people.

METHODSFrom February 2001 to April 2009, 15 elderly patients with odontoid fracture were treated with anterior percutaneous screw fixation,including 13 males and 2 females; the average age was 69.3 years (ranged, 60 to 86 years). According to Anderson classification, there were 10 patients with type II fractures (type II A in 7 cases, type II B in 3 cases, based on Eysel and Roosen classification), 4 patients with shallow type III fractures, 1 patient with deep type III fractures. Thirteen patients were fresh fractures, 2 patients were obsolete fractures. All patients had varying degrees of neck or shoulder pain, and limit activity of neck. There were 4 patients with neural symptoms including 2 grade D and 2 grade C according to Frankel classification. All the patients were followed up and were assessed by radiology. Clinical examination included neck activity, neurological function and the degree of neck pain. Radiology examinations including anteroposterior, lateral, open mouth position and flexion-extension radiographs of cervical vertebra were performed.

RESULTSAfter surgery, all patients were followed up,and the duration ranged from 6 to 60 months (averaged 31.3 months). Two patients died of other diseases during the follow-up period (18 and 22 months after surgery respectively). All patients got satisfactory results, and all screws were in good position. As the screw was too long, esophagus was compressed by screw tail in one case. One case showed fibrous union, 12 cases had achieved solid bony union, 2 cases showed nonunion without clinical symptoms. The rotation of neck in 3 cases was mildly limited,the neck function of the remaining patients were normal. Four patients with symptoms nerve injuries improved after operation (Frankel E in 3 cases, Frankel D in 1 case). The symptom of neck pain had a significant improvement after surgery (P < 0.001). The VAS score decreased from preoperative (6.07 +/- 1.44) (4 to 8 scores),to postoperative (1.13 +/- 0.92) (0 to 3 scores). And there were no severe postoperative complications.

CONCLUSIONThe anterior percutaneous screw fixation is less traumatic than conventional approaches for aged people in dealing with odontoid process fractures. Most patients will achieve satisfactory clinical results, as long as the general conditions of them are comprehensively assess. However, this procedure should not be used in patients with comminuted odontoid fractures or severe osteoporosis.

Aged ; Aged, 80 and over ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Odontoid Process ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Skin ; Tomography, X-Ray Computed

OBJECTIVESTo investigate the mechanical properties of bilateral atlantoaxial trans-articular screws and atlas laminar hooks instrumentation with finite element method.

METHODSThere was a volunteer with age of 28 years old, body height 172 cm, body weight of 60 kg and without cervical deformity by X rays. The ligamentous, nonlinear, three-dimensional finite element models of normal upper cervical spine (C0-3) was developed and validated. The destabilized model with bilateral atlantoaxial trans-articular screws and atlas laminar hooks was evaluated for quasistatic loading.

RESULTSThe finite element model of upper cervical spine consists of 229,047 nodes and 152,475 elements, and correlated well with experimental data for all load cases and could be used for experiment. The finite model with bilateral atlantoaxial trans-articular screws and atlas-laminar hooks predicted that the maximum Von Mises Stress was in the region in which screws penetrated the atlantoaxial articular facet. The novel instrumentation resulted in sufficient stability.

CONCLUSIONThe bilateral atlantoaxial trans-articular screws and atlas laminar hooks instrumentation is useful and effective for atlantoaxial arthrodesis.

Atlanto-Axial Joint ; surgery ; Biomechanical Phenomena ; Bone Screws ; Cervical Vertebrae ; diagnostic imaging ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Internal Fixators ; Joint Instability ; surgery ; Male ; Radiography ; Spinal Fusion ; instrumentation ; methods