Adult ; Cytokines ; metabolism ; Female ; Gene Expression ; Humans ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Male ; Semaphorins ; genetics ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism ; Thrombocytopenia ; genetics ; metabolism

Electrocardiography ; methods ; Heart Conduction System ; physiopathology ; Heart Diseases ; diagnosis ; Humans

Objective To study the effects of transient cerebral ischemic reperfusion(IR) and flunarizine on the expression of plasminogen activator inhibitor-1(PAI-1) protein in brain tissue of gerbils.Methods A cerebral transient ischemic-reperfusion model in gerbils was established by clamping both common carotid.The gerbils were fed with flunarizine before experiment in flunarizine treatment group.The expression of PAI-1 protein in brain tissue was detected by immunohistochemistry technique at the 1,3 and 7 days after IR.Results There was slight expression of PAI-1 protein in the brain tissue of gerbils in the normal control group and sham operation group.Compared with normal control group,the expression of PAI-1 protein in neurons and gliacytes of ischemic gerbils was evidently increased at the 1,3 and 7 days in the cerebral ischemia group(all P

Humans ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Reconstructive Surgical Procedures

ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.

Objective To analyze the demands and to evaluate training effect on the knowledge and technology of prevention and treatment about hypertension among doctors in county and countryside hospitals of Xinjiang.Methods 336 doctors were trained about knowledge of prevention and treatment of hypertension and technology of useful therapeutic regimen,and were investigated for demands of the knowledge and technology and self-evaluation of training effect by questionnaire.Results The knowledge of prevention and treatment about hypertension and the technology of useful therapeutic regimen were needed urgently by 94.8％ subjects.91.3％ trained doctors thought that the technology suited practically in county and countryside hospitals,and 96.7％ hospitals had condition of carrying out the technology.97.9％ trained doctors expected this kind of technology on hypertension prevention and treatment to be trained again.74.1％ trained doctors comprehended the technology,and the percent of doctor practically using the technology increased from pre-training 12.3％ to post training 62.1％.Conclusion The knowledge of prevention and treatment about hypertension and technology of useful therapeutic regimen were needed urgently and were comprehended with training for the most doctors in county and countryside hospitals of Xinjiang.

BACKGROUND: Ischemic stroke has a younger tendency; hence to explore the risk factors of stroke in the middle-aged and youth for primary rehabilitation has extremely important clinical significance.OBJECTIVE: To investigate the risk factor-of stroke in the middle-aged and youth.DESIGN: A case-control analysis based on diagnose.SETTING: Department of neurology in a university hospital.PARTICIPANTS: Totally 100 hospitalized patients including the middle-aged and youth ( ＜ 44 years old, n = 63 ) and the pre-elderly (45 - 49years old, n = 37) with mean age of(42. 91 ±6.8) were selected into stroke group from the Department of Neurology, Xiangya Second Hospital, Central South University between July 1997 and December 2000. Another 100 surgical patients without history of cerebrovascular diseases aged(42.70 ± 2.98) including the middle-aged and youth( n = 61 ) and the pre-elderly( n = 39) were collected randomly from the same corresponding period as control gruop.METHODS: A comparative study of 12 risk factors between two groups was studied and compared the middle-aged group and youth, the pre-elderly group with control group.MAIN OUTCOME MEASURES: Morbidity comparison of each risk factor in each group.RESULTS: Hypertension, hyperlipemia, abnormal electrocardiogram (ECG),family history of stroke, arteriosclerosis of the eyeground, diabetes, and rheumatic heart disease are risk factors of ischemic stroke in the middle-aged.CONCLUSION: It is extremely important significance to reduce blood pressure and blood-fat level in the prevention of ischemic stroke.

BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological changes of mandibular condyle specimens under light microscope.RESULTS: The articular disc was adhered to the mandibular condyle after 3months. Temporal fossa adhered to the articular disc and mandibular condyle could still be observed in one specimen. Bifid condylar deformity was found in two specimens and no disc perforation was found. The adhesions became more severe after 6 months and bifid condylar deformity was formed in all the 3 specimens, with distinctly thickened discs. Light microscope observation:Three months after fracture, the adhesion between disc and condyle was obvious. There was no clear boundary between the surrounding tissues. The adhesion was composed of fibro-connective tissues, with a large number of chondrocytes in it. Fibro-connective tissues tightly adhered to the trabeculae were found in some adhesions. The fiber of disc became deranged and blood vessels and fatty cells were seen. Six months after fracture, blood vessels, a large number of fibroblasts and sparse chondrocytes were seen in the adhesions. The collagen fibers of the discs were arranged in whirlpool shape. There were a large number of fatty cells and blood vessels within it. The fiber-cartilage of the condylar surface was found thickened and the fiber deranged in the unadhered tissues. Proliferative changes were seen on disc surfaces.CONCLUSION: Childhood longitudinal fracture of the mandibular condyle causes severe secondary injury to TMJ, suggesting a close correlation between longitudinal fracture of the mandibular condyle and TMJ ankylosis.

Objective To observe the changes in cytokines, oxygen free radicals, acidulous production in serum and to investigate the effectiveness of monitoring metabolism of cells and the method for evaluating cell injury in patients with severe trauma. Method The detailed data of 117 patients rescued and managed carefully from May 2005 to February 2007 were assessed and stratified with ISS and APACHE Ⅱ , and the serum levels of arterial blood lactate(ABL) ,base deficit(BD) ,superoxide(SOD) ,lipid peroxide(LPO) ,TNF-α and IL-6 were measured in real-time according to the condition of the patient. Results The monitoring biomarkers obviously changed with injury severity which endangered the situation of patients after trauma (P < 0.05) , especially in the patients with ischemia , hypoxia, shock, iniection, SIRS, and MODS (P < 0.01). The persistence of extremely elevated levels of biomarkers meant the organ failure and fatality of patients after trauma, and there was a obvious differece between those cases and cases without elevation of biomarkers ( P < 0.01). Conclusions The outcome of patients after trauma is closely correlated with injury severity,infection and MODS,and the levels of biomarkers including ABL, SOD, IPO, TNF-a and IL-6 are useful indicators of outcome measure.

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.