This research explored the synergistic effects and the potential mechanisms of RCE-4 and various nonsteroidal anti-inflammatory drugs (NSAIDs) on the proliferation of cervical cancer Ca Ski cells. The MTT assay and CalcuSyn V2.0 software were used to detect cell proliferation and calculate the combination index (CI); the expression levels of various proteins were analyzed using Western blot assay; mitochondrial membrane potential (MMP) was assessed using JC-1 staining; acridine orange/ethidium bromide (AO/EB) double-fluorescence staining was used to detect the apoptosis of Ca Ski cells; a co-immunoprecipitation (Co-IP) assay was used to analyze the relative content of Bcl-2-Beclin 1 complex in Ca Ski cells. The results demonstrate that the combination of RCE-4 and NSAIDs increases the inhibition of Ca Ski cells compared to the single-RCE-4 group, and celecoxib provided the best synergistic effect among the four NSAIDs tested, with a CI of 0.32. The combination of RCE-4 and celecoxib significantly down-regulated the expression of cyclooxygenase-2 (COX-2) and nuclear transcription factor-κB (NF-κB), and promoted the expression of non-steroidal anti-inflammatory drugs activity gene-1 (NAG-1). In addition, autophagy induced by RCE-4 was markedly inhibited in combination with celecoxib, which was associated with down-regulation of the expression of microtubule-associated protein 3 (LC3)-II, Beclin 1, p62 and autophagy-related gene (ATG) 3/4B/5/7/14. RCE-4-induced apoptosis was significantly enhanced by altering the depolarization of mitochondrial membrane potential and the expression of B cell lymphoma-2 (Bcl-2), B cell lymphoma-xl (Bcl-xl), Bcl-2 associated X protein (Bax), Bcl-2/Bcl-xl-associated death promoter (Bad) and cleaved cysteinyl aspartate specific proteinase (cleaved-caspase) 3/7/9. Furthermore, the formation of the Bcl-2-Beclin 1 complex was significantly inhibited in Ca Ski cells treated with RCE-4 in combination with celecoxib. Taken together, this research shows that the combination of RCE-4 and celecoxib has a significant synergistic effect on the proliferation of Ca Ski cells by promoting apoptosis, inhibiting autophagy and disturbing the formation of the Bcl-2-Beclin 1 complex, which may be a novel strategy to increase the sensitivity of anti-cervical cancer drugs.

Objective To study the effects of dexamethasone (DEX) and/or hyperbaric oxygen (HBO) on the subdermal vascular network (SVN).Methods SVNs were selected on dorsal skin flaps of 40 Wistar rats.The animals were divided randomly into a control group,a DEX group,a HBO group and a HBO+DEX group.Cranially based,2.5 cm?10 cm dorsal SVN skin flaps were sharply incised and elevated between the dartos and SVN,then sutured to their beds.On the 7th postoperative day,the surviving flap area was measured along with the number of new capillary,the thickness of meat tissue and the number of infiltrated neutrophilie granulocytes in the SVN skin flap.Results The mean surviving flap area for the control group was 7.90 cm~2,for the DEX group it was 10.48 cm~2,for the HBO group 15.53 cm~2,and for the DEX+HBO group it was 15.58 cm~2.The improvement in surviving flap area was highly statistically signifieant compared with the control.The improvement was also statistical- ly significant when the HBO group or HBO+DEX group was compared with the DEX group.However,no statistically significant difference was found between the HBO group and HBO+DEX group.Conclusion In a rat dorsal skin flap model,DEX or HBO improved skin flap viability,but DEX alone is not as efficacious as HBO or as DEX+ HBO.DEX plus HBO showed no additive beneficial effect over HBO alone.

Objective To analyze the effects of-γ-knife treatment with different dosages on level of prolactin (PRL) in patients with different sizes of functional pituitary prolactinomas, and determine an index to guide hormone replacement therapy and the prognosis of -γ-knife treatment in patients with functional pituitary prolactinomas through comparing the changes of tumor sizes and the levels of PRL before and after -γ-knife treatment. Methods A retrospective analysis of the clinical data of 248 patients with functional pituitary prolactinomas was performed; gamma knife treatment was performed on these patients from September 2004 to March 2008. We divided the patients into 3 groups: group Ⅰ (50 Gy≤central dose<60 Gy, 20 Gy＜marginal dose<30 Gy), group Ⅱ (40 Gy≤ central dose＜50 Gy, 15 Gy＜marginal dose<25 Gy) and group Ⅲ (30 Gy ≤ central dose<40 Gy, 12 Gy＜marginal dose<20 Gy). The irradiation dose on optic nerves in the 3 groups was under 9 Gy. Radioimmunoassay was employed to detect the serum PRL level before and 1, 3 and 12 months after γ-knife treatment. The changes of the tumor sizes were observed and compared with cranial MRI 1 and 2 years after -γ-knife treatment.Results Significant differences on the PRL level were noted before -γ-knife treatment between each 2 groups (P<0.05); the PRL level in group Ⅲ was lower as compared with that in group Ⅰ and Ⅱ before γ-knife treatment; however, the PRL level in group Ⅲ was higher as compared with that in group 112 months after -γ-knife treatment; the PRL level in all the 3 groups after γ-knife treatment was significantly lower as compared with that before γ-knife treatment (P<0.05). MRI showed that the tumor had 80% partial response rate (198/248) in the 1st year, 82% complete response rate (203/248) in the 2nd year, increased volume in 19 patients (7.7%) and no change in 26 patients (10.4%). Conclusion Different treatment doses of Gamma knife on functional pituitary prolactinomas has great influences on postoperative recovery of endocrine; the higher doses of the center and edge (especially center), the higher normal rate of postoperative PRL level. Whether it will cause long-term hypopituitarism needs continue follow-up.

Objective To study the dynamic air quality of clean ICU so as to provide evidence for hospital infection management in clean ICU.Methods Flat natural sedimentation method,six percussive determination of planktonic bacteria and dust particle counting method were used to get samples at three different time periods,different regions for four consecutive days in 100 000 air clean ICU.Results The counts of 0.5μm,5 μm dust particles at different time ( morning,afternoon,evening) were significantly different( F =78.85,89.94 ;P ＜ 0.01 ) and the monitor results of different regions( single rooms,double rooms,hall) were significantly different( F =20.21,16.17; P ＜ 0.01 ).The number of planktonic bacteria at different time (morning,afternoon,evening) were significant different(F =14.21,P ＜0.01 ),while there was no difference in different regions ( single rooms,double rooms,hall) ( F =0.98,P ＞ 0.05 ).There was significant difference of depositing bacterial counts at different time and regions( F =5.68,17.05,P ＜ 0.01 ) and there was a positively correlation between planktonic bacterial counts and depositing bacterial counts ( r =0.612,P ＜ 0.05 ).Each level of bacterial average counts of six percussive samplers measured was significantly different (F =8.35,P ＜ 0.01 ),with fifth grade most and fourth grade following.Conclusions Air quality of ICU is not good especially when making ward round; Less than 5 μm particles dominant; the counts of planktonic bacteria and depositing bacteria is increasing when dust particles counts increase,and the air quality of single rooms and double rooms is better than that of the hall.

Objective To investigate the effect of employers' respirator and hat wearing method on class 100 000 clean ICU air quality,in order to provide basis for hospital infection management in ICU.Methods For the control group,the first day (d1) and third day (d3),every employer was demanded to wear a respirator and a hat before entering the ICU.For the observation group,the second day (d2) and forth day (d4),employers were demanded not to wear any respirator or hat.During all four days,they must wear respirator and hat before any nursing operation.Air quality was sampled by class 100 000 clean air using flat panel natural settlement method,dust planktonic bacteria method and particle counting method.The amount of dust,plankton bacterium and descending bacteria were monitored for 4 days and compared between two groups.Results The difference of 0.5 μm dust particles in ICU between the control group and the observation group were statistically significant ( F =40.95,P ＜ 0.05 ).As to 5.0 μm dust particles,there was no significant difference between two groups (F =2.86,P ＞ 0.05 ).0.5 μm dust particles in ICU was lower at d1 and d3,and the difference was statistically significant ( F =40.95,P ＜ 0.05).The number of 0.5 μm dust particles had significant difference between different periods of a day:the morning time segmcnt＞ evening ＞ afternoon ( F =80.72,P ＜0.05 ).The number of 0.5 μm dust particles in the observation group was higher than that in the control group,and the difference was statistically significant ( F =68.84,P ＜ 0.05 ).The number of 5.0 μm dust particles had significant difference between different time periods of a day:the morning time segment ＞afternoon ＞ evening ( F =98.17,P ＜ 0.01 ).The number of dust particles at hall was larger than that at single and double rooms (P ＜0.01 ),but the number had no difference between single room and double room.More subsidence bacteria and floatingbacteria was detected during dl and d3 in the control group,and the difference was statistically significant ( P ＜ 0.01 ).Besides,the difference of the number of subsidence bacteria and floating bacteria in ICU between different time periods was also statistically significant ( P ＜ 0.05 ).Conclusions The number of 0.5 μm dust particles in ICU is smaller when workers wear hats and respirators,while the number of 5.0 μm dust particles remains the same.Under the other conditions remain unchanged,the mainly cause of number increase of dusts,planktonic bacteria and sedimentation bacteria in the morning rounds is the increasing number of working staff.ICU staff has no apparent effect on dynamic class 100 000 clean ICU air quality whether they wear respirators or hats.This kind of behavior is not the key management elements in clean ICU environment.

OBJECTIVETo analyze the reasons of the complications,and the measures taken for the prevention and treatment by percutaneous vertebroplasty (PVP) for osteoporotic thoracolumbars vertebral compressive fractures.

METHODSFrom May 2004 to June 2008, 204 patients with 286 diseased vertebrae underwent PVP under the guidance of C-arm fluoroscopy, and 56 patients with complications included 18 males, 38 females, ranging in age from 58 to 93 years, with an average of 72 years. The condition of leakage of bone cement and complications was observed.

RESULTSThe complications related to the leakage of PMMA found in 60 vertebrae in 49 cases: vertebral canal in 5 cases, intervertebral foramina in 3 cases, soft tissue besides vertebrae in 20 cases,intervertebral discs in 15 cases, venous plexus besides vertebrae in 6 cases. The complications no related to the leakage of PMMA found in 7 cases: the nerve roots injuried in 3 cases; the pain of the patient worsened temporarily in 2 cases; the blood pressure of the patient descent temporarily in 2 cases.

CONCLUSIONThe main reasons of complications are no-integrated of the compressived vertebrae,unstandard skills of injecting,unsuitable opportunity and quantity of injecting PMMA, unsufficient monitoring of C-arm fluoroscopy, the toxicity of PMMA. The measures of prevention and treatment is strict indication, standard skills of injecting, sufficient monitoring of C-arm fluoroscopy, suitable opportunity and quantity of injecting PMMA, electrocardio-monitoring in operation.

Aged ; Aged, 80 and over ; Bone Cements ; adverse effects ; Female ; Fractures, Compression ; complications ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Polymethyl Methacrylate ; adverse effects ; Postoperative Complications ; prevention & control ; Spinal Fractures ; complications ; surgery ; Vertebroplasty

Objective to explore the current situation and related influencing factors on the retention time of patients receiving methadone maintenance treatment (MMT). Methods Information on basic situation and daily treatment of the patients were collected from the 7 MMT clinics opened in the pro-two batch in Hunan province. Retention rate and influencing factors were analyzed. Results (1) The retention rates after 6 and 12 months of MMT became 72.06% and 49.65% respectively. (2) The retention rates of high-dosage group and low-dosage group were 85.03% and 68.03% after 6 months on MMT program while became 60.48% and 46.28% after 12 months of MMT respectively. (3) The mean retention time of HIV+ patients and HIV- patients were 9.46 months and 8.62 months respectively during the 12 months follow-up observation, showing a significant difference. (4) Patients who took large dose methadone, did not share needles, at older age or HIV+ , were prone to keep MMT at a long period. Conclusion The retention rates for 6 months and 12 months in the MMT program in Hunan province were similar to the national data. Dose, type of drug abuse, age and HIV status were related to the period of retention.

BACKGROUNDPatients with pelvic fractures are often treated in hospitals without the capacity to implement an open reduction internal fixation (ORIF). This often leads to pelvic malunion in patients with unstable pelvic fracture, shock or even death due to uncontrollable pelvic hemorrhage and unstable hemodynamics. This study explored the role of early external fixation (within 7 days) for patients with unstable pelvic fractures.

METHODSA retrospective analysis was conducted on 32 patients with unstable pelvic fractures treated with early external fixation from January 2005 to January 2010 (Tile type B: 18 cases; C: 14 cases). The study comprised 28 males and 4 females, with a mean age of (32 ± 8) years (range, 21-56 years). Of these patients, 22 were treated with emergency pelvic external fixation and 10 were treated with external fixation within 1-7 days. Fifteen cases suffered traumatic hemorrhagic shock. A statistical analysis was conducted to compare fluid infusion and blood transfusion volumes within the first 24 hours of these shock patients with another cohort of patients treated without early external fixation from January 1993 to January 1998.

RESULTSThe average follow-up was (34.7 ± 14.6) months (range, 6-66 months). Six to eight weeks after external fixation, patients could walk with crutches; by 12 weeks, external fixation was removed and all fractures had healed. Seven patients presented with sequelae, including 3 patients with long-term lumbosacral pain, 3 patients with erectile dysfunction and 1 patient with Morel-Lavallee lesion and other complications. The 15 shock patients in this study (2005-2010 group) required significantly lower volumes of fluid infusion and blood transfusion (P(fluid) = 0.000; P(transfusion) = 0.000) as compared to the 1993-1998 cohort.

CONCLUSIONSThe early application of external fixation in unstable pelvic fracture patients positively affects hemodynamic stability, with outstanding efficacy as a final fixation option for unstable pelvic fractures.

Adult ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Hemodynamics ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies

OBJECTIVETo study the effect of ex vivo expansion on the adhesion activities of umbilical cord blood hematopoietic stem and progenitor cells (HSPC).

METHODSFresh UCB CD(34)(+) cells were cultured in a serum and stroma-free culture system. At day 7, day 10 and day 14, CD(34)(+) cells were re-selected from the expanded products. The expression of adhesion molecules (CAMs) such as VLA-4, VLA-5, LFA-1, ICAM-1, HCAM, L-selectin and PECAM-1, and the adhesion activity of the expanded CD(34)(+) cells were evaluated and compared with those of precultured fresh CD(34)(+) cells.

RESULTS(1) The CD(34)(+) cells expressing homing-related CAMs were increased (from 15-fold increase for CD(34)(+) CD(54)(+) subset to 72-fold increase for CD(34)(+) CD(49e)(+) subset at day 14). (2) The expressions of CD(49d), CD(44), CD(11a) and CD(49e) on the expanded CD(34)(+) cells were increased or sustained the same levels as those on fresh UCB CD(34)(+) cells, while the expression of CD(62L), CD(54) and CD(31) on expanded CD(34)(+) cells declined with the cultivating. (3) Spontaneous adhesion and SDF-1-induced adhesion tended to be increased in the course of the first 10 day's culture.

CONCLUSIONSThe culture system used in this study could substantially support the expansion of HSPCs expressing the above CAMs, and the expanded HSPCs would sustain their intrinsic adhesion potentials.

Antigens, CD ; analysis ; Antigens, CD34 ; analysis ; Cell Adhesion ; Cell Adhesion Molecules ; biosynthesis ; Cell Division ; Fetal Blood ; cytology ; immunology ; metabolism ; Flow Cytometry ; Hematopoietic Stem Cells ; cytology ; immunology ; metabolism ; Humans ; Receptors, Lymphocyte Homing ; biosynthesis

OBJECTIVETo investigate the efficacy and feasibility of duodenojejunal bypass(DJB)on non-severe obese patients with type 2 diabetes mellitus(T2DM).

METHODSThe body mass index (BMI), fasting plasma glucose(FPG), 2h-postprandial plasma glucose(2hPG), fasting insulin(F-ins), fasting c-peptide(F-CP), glycated hemoglobin and hypoglycemic agents dose changes were tested in 7 patients with non-severe obese T2DM undergoing DJB, preoperatively and within 24 weeks after surgery during the follow-up. Data were collected and the clinical outcomes of T2DM were analyzed.

RESULTSIn 7 cases of non-obese T2DM who underwent DJB, one patient was weaned off hypoglycemic agents with normal FPG, 2hPG and HbA1c postoperatively. Five required significantly lower dosage. No significant improvement in 1 case. Complete remission rate of hyperglycemia was 1/7, effective rate was 6/7, and effective rate of HbA1c was 5/7. No significant changes in BMI were observed between the preoperative and postoperative phases.

CONCLUSIONPlasma glucose level can be markedly reduced by duodenojejunal bypass in non-obese T2DM, independent of weight loss, and the mechanism remains unclear.

Adult ; Aged ; Bariatric Surgery ; methods ; Diabetes Mellitus, Type 2 ; surgery ; Duodenum ; surgery ; Female ; Follow-Up Studies ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Obesity ; Treatment Outcome