Adult ; Calcinosis ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma ; metabolism ; pathology ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Male ; Stomach Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism

Objective To observe the effects of mild hypothermia hemofiltration on cerebral blood flow (CBF) and intracranial pressures (ICP) in patients with severe brain injury. Methods 65 patients with severe brain injuries were divided into control group (n=30) and observation group (n=35). The control group accepted the routine treatment only while the observation group accepted mild hypothermia hemofiltration additionally. CBF was detected by Transcranial Doppler (TCD) and ICP was monitored by ICP monitor. Glasgow Coma Scale (GCS) was assessed every day. Results 5 d after treatment, the scores of GCS were higher in the observation group than in the control group (P<0.05) as well as the CBF (P<0.05), but the ICP was in the observation group significantly lower than in the control group (P<0.01). Conclusion Compared with the traditional mild hypothermia, mild hypothermia hemofiltration can improve hemodynamic changes caused by severe brain injury, reduce ICP and improve the outcomes.

Animals ; Apoptosis ; physiology ; Cell Proliferation ; Epithelial Cells ; transplantation ; Female ; Ki-67 Antigen ; analysis ; Kidney Tubular Necrosis, Acute ; pathology ; Male ; Mesenchymal Stem Cell Transplantation ; ethics ; Rats ; Rats, Sprague-Dawley

Background The filtration surgery is the main method of treating glaucoma,which usually fails due to postoperative scarring.The study about application of anti-scarring agents in filtration surgery is a hotspot.Objective This study was to investigate whether topical administration of hydroxycamptothecin (HCPT) could be used to prevent postoperative scarring in after experimental glaucoma filtration surgery,and explore its optimal dose.Metbods Trabeculectomy was performed on the right eyes of 40 New Zealand white rabbits to establish the trabeculectomy animal models.The rabbits were then randomized into normal saline solution group,0.3 g/L mitomycin C(MMC) group,0.3 g/L HCPT group and 1.0 g/L HCPT group based on the intraoperative topical drugs using randomized number table method.The different drugs above-mentioned were put beneath the conjunctival flap and scleral flap for 5 minutes during the surgery.The intraocular pressure (IOP) was measured before and day 1,4,7,14,21 and 28 after the surgery with Icare tonometer,and the filtering area and height were measured under the slit lamp microscope to assess the efficacy of various drugs.The adverse effects were evaluated by examining the responses of the ocular anterior segment and retinal change.The specimens at operative zone were obtained in 7,14 and 28 days after surgery with the size 5 mm×5 mm for the hematoxylin-eosin staining and Masson trichrome staining to estimate the anti-fibrosis effect of various drugs,and to evaluate the survival time of functional bleb.Kaplan-Meier analysis was used to compare the survival time of functional bleb of different groups.The use and care of the animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Committee.Results The IOP was significantly different in the rabbits from different groups among various time points (Fgroup =20.79,P =0.00 ; Ftime =85.34,P =0.00 ; Fiion =2.13,P =0.01).From 1 day through 28 days after operation,the IOPs in MMC group and 1.0 g/L HCPT group were significantly lower than those before operation (all at P＜0.05).The survival time of functional bleb of different groups was (11.3 ±2.8),(19.5 ±2.4),(13.3 ±2.2) and (20.2 ± 4.5) days,respectively,showing a significant difference (log rank =11.92,P ＜ 0.01),with a considerable prolong in the 1.0 g/L HCPT group.No significant change was found in the bleb area and height among the four groups within 7 days after operation,but postoperative 7,14,28 days,the area and height values of bleb were significantly smaller in the normal saline solution group and 0.3 g/L HCPT group compared with the MMC group and 1.0 g/L HCPT group (all at P ＜ 0.05).Histopathological examination showed loosen subconjunctival tissue,less inflammatory cells and weaker collagenous fibrillary staining in the MMC group and 1.0 g/L HCPT group in comparison with the normal saline solution group and 0.3 g/L HCPT group.Conclusions The topical administration of 1.0 g/L HCPT inhibit the inflammatory response and collagen fibrosis and therefore prolong the survival time of functional bleb after glaucomatous filtering surgery.

ADAM Proteins ; genetics ; ADAM17 Protein ; Animals ; Gene Library ; Genetic Vectors ; Male ; Mice ; Two-Hybrid System Techniques

Objective To evaluate the relationship between severity of airway obstruction and peripheral arterial stiffness in patients with chronic obstructive pulmonary disease (COPD).Methods 81 COPD patients [aged (78.32 ± 6.98)yrs,73 males,8 females] from Jan 2008 to Oct 2012 were enrolledin Geriatric Department of Peking University First Hospital.All patients underwent spirometry and Holter evaluation,while age,sex,BMI,smoking pack-years,medical history,blood levels of lipid profiles,glucose,high sensitivity C reactive protein (hsCRP)and arterial oxygen pressure (PaO2)were recorded.The severity of airway obstruction was evaluated by spirometry.The patients were divided into two groups:mild/moderate group [forced expiratory volume in one second (FEV1％) predicted ≥ 50 ％,n=51] and severe group (FEV1％ predicted ＜ 50％,n=30).24-hour average heart rate (HR)was assessed by holter.Arterial stiffness was assessed by the brachial ankle pulse wave velocity (baPWV).The baPWV increment was considered to be a direct witness of arterial stiffness increase.Blood levels of lipid profiles,glucose,arterial oxygen pressure (PaO2)and hsCRP were compared between the two groups.Results Age,gender,smoking index,medical history of the two groups were matched.BMI was less in severe group than in mild/moderate group [(22.8± 4.2) kg/m2 vs.(25.3± 3.2) kg/m2,t=3.017,P＜0.05].24-hour average HR was higher in severe group than in mild/moderate group [(77.4± 12.7)bpm vs.(70.8± 9.6)bpm,t=-2.602,P＜0.05].The PaO2 was lower in severe group than in mild/moderate group [(74.6±13.0)mmHg vs.(82.4± 13.1)mmHg,t=2.456,P＜0.05].There were no differences in blood lipid profile and glucose levels between the two groups.76 patients (93.4％)were detected with peripheral arterial stiffness by baPWV＞14.00 m/s.baPWV was significantly increased in severe group as compared with mild/moderate group [(20.77 ± 3.71) m/s vs.(18.84 ± 1.88) m/s,t=-2.109,P＜0.05].hsCRP was significantly higher in severe group than in mild/moderate group [[(6.51±5.66)mg/L vs.(3.27±3.34)mg/L,t=-2.658,P＜0.01].Conclusions The morbidity of peripheral arterial stiffness is increased in patients with COPD.Progression of arterial stiffness is related to the severity of airway obstruction,which may be related to chronic inflammation,hypoxia,or excessive sympathetic activation.

Objective To discuss the relationship betwee n chromosome abnormalities and disease progress and prognosis in chronic lymphocytic leukemia (CLL). Methods The karyotype of 56 patients with CLL were analyzed, and combined probe was applied to do fluorescence in situ hybridization (FISH) detection. Results Conventional cytogenetics detection found abnormal karyotype in 26 cases (46.4 %), by comparing the median overall survival (OS), the normal karyotype group (>31.9 months) and abnormal group (24.0 months) had statistically difference (χ2=6.60, P<0.05). FISH detected genetic abnormality in 38 cases (67.9 %), whose abnormal detection rate was significantly higher than the conventional chromosome group (χ2=9.874, P<0.01), RB1 was 33.9%(19/56), D13S25 was 46.4%(26/56), ATM was 16.1%(9/56), p53 was 12.5 % (7/56). 21 cases involved 1 kind of genetic abnormality, 12 cases involved 2 kinds of genetic abnormalities, 4 cases involved 3 kinds of genetic abnormalities, 1 case involved 4 kinds of genetic abnormalities. According to the modified installment Rai, involving genetic abnormality species distribution in the low risk and high risk group had statistically difference (χ2 = 11.77, P< 0.05). The median OS of D13S25, RB1 normal and abnormal patients had no difference (P>0.05), the OS of patients with p53 or ATM gene abnormality was significantly shorter than that of normal patients. Compared with the patients without genetic abnormality and with 1, 2 or 3 kinds of gene abnormalities, the patients with 4 kinds of gene abnormalities had minimum median OS. According to the modified installment Rai, the OS rate of low and intermediate risk group was higher than that of low risk group (χ2= 10.61, P< 0.05). According to the modified installment Binet stage,the OS rate of stage C was lower than that of stage B (χ2= 6.60, P< 0.05). Conclusion The prognosis of CLL patients in same risk group is very strong heterogeneity, cytogenetics changes and biological indicator are the important prognostic factors of CLL.

AlM:To investigate the effect of teaching mode of problem- based learning ( PBL ) in the teaching of medical students' clinical ophthalmology.
METHODS: Five classes ( total 148 students ) were randomly selected as experimental group, using PBL method, at the same time another 5 classes ( total 151 students) were also randomly selected as control group, using lecture-based learning ( LBL) mode in 2010 grade. The scores of the experimental group were compared with control at the end of term. ln addition, students and teachers were respectively interviewed using self -administered questionnaire to obtain their evaluation for PBL practice.
RESULTS:The mean scores of PBL group (78. 35±7. 63) were significantly higher than control group (71. 68±6. 37) (P<0. 001). Most of students thought that their ability of referring, synthesizing and analyzing information was enhanced by PBL, and their skills both in written and oral were also improved. PBL made it easier to understand the contexts of course. lt was the best way to improve the effect of teaching in ophthalmology based on the increase of quality in novitiate that gives more chance to students of contacting with practice, developing the ability of clinical thinking and verifying the theory in clinical novitiate. Lots of teachers considered that the classroom atmosphere was more active, students were becoming more and more proactive on their classes and the relationship between students and teachers were more harmonious when PBL was used.
CONCLUSlON:Using PBL teaching mode can highly improve the teaching effectiveness of clinical epidemiology, which is worth popularizing.