BACKGROUND: Alginic sodium diester (ASD) possesses neuroprotective function because of its selective calcium antagonist effects.OBJECTIVE: To compare the influences of ASD on intraneuronal Ca2+content and nerve cell apoptosis before and after reperfusion in focal cerebral ischemic rats.DESIGN: Randomized controlled observation.SETTING: Neurological Department of Xiangya Hospital Affiliated to South China University; Laser Orthopedic Surgery of the First Hospital Affiliated to Southern China University.MATERIALS: This experiment was carried out between November 2003and April 2004 at the Neurological Department of Xiangya Hospital Affiliated to South China University. A total of 65 male SD rats were recruited and randomized into 6 groups; 17 got lost during the experiment, and the other 48 rats completed the experiment with 8 rats in each group.METHODS: In sham operation group, an incision was made on rats' cervical skin and sutured. Right cerebral middle artery was occluded in rats of ischemic group, ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group, and ASD 10 mg/kg postischemic group. After that, rats in all but ischemic group were subjected to intraperitoneal injection of various dosage of ASD or excipient 30minutes before reperfusion and 5 hours after reperfusion. FCM was used to determine intraneuronal Ca2+ content and rate of nerve cell apoptosis;meanwhile, neurological dysfunction was scored.MAIN OUTCOME MEASURES: [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia. [2]Correlation of behavioral obstacle score with intraneuronal Ca2+ fluorescence intensity and neuronal apoptosis in rats with right cerebral middle artery ischemia.RESULTS: Totally 65 rats were enrolled in this study, 17 of which got lost and the other 48 rats entered the result analysis. [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia: The score was obviously reduced in ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group and ASD 10 mg/kg postischemic group as compared with ischemic group (1.80±0.21, 2.20±0.23, 1.20±0.11, 2.00±0.22, 3.40±0.65); moreover,functional improvement was more obvious due to pre-reperfusional administration than post-reperfusional administration. Intraneuronal Ca2+ concentration was reduced after ASD administration at different degrees and lower than that of ischemic group. Decrement of intraneuronal Ca2+ concentration was found most obvious due to 10 mg/kg ASD administration 30 minutes before reperfusion, approximately reduced by 70%; moreover, neuronal apoptosis rate on the ischemic side was obviously suppressed by ASD administration, displaying time-dependent manner, with apoptotic suppression effect more obvious in pre-reperfusional group than in post-reperfusional group (5.68%, 10.03%; 4.00%, 9.91%). [2] Correlation of behavioral obstacle score of right cerebral middle artery ischemic rats with intraneuronal Ca2+ fluorescence intensity and membrane associated protein/propidium iodide apoptosis: Obvious positive correlation was found between behavioral obstacle score and intraneuronal Ca2+ fluorescence intensity and detection rate of membrane associated protein/propidium iodide apoptosis (r=0.51,0.62, P ＜ 0.05); intraneuronal Ca2+ fluorescence intensity was also positively correlated with the detection rate of membrane associated protein/propidium iodide apoptosis (r=0.84, P ＜ 0.05).CONCLUSION: [1] ASD can exert anti-apoptosis effect by suppressing the increment of intraneuronal Ca2+ concentration, thus having neuroprotective function and ultimately improving neurological dysfunction. [2] Its effect displays time-dependent manner, and neurological functional improvement is more obvious by pre-reperfusional administration than by post-operational administration.

Objective To investigate clinical signifieances of serum levels of vascular endothelial growth factor (VEGF) in patients with diffuse large B-cell lymphoma (DLBCL) and to analyze the relationships with international prognostic index (IPI). Methods Serum levels of VEGF were measured by ELISA in 26 cases with newly diagnosed DLBCL and 9 cases with relapsed DLBCL. The clinical data of 26 patients were collected. According to the IPI, 26 patients were divided into two group: low risk group (IPI＜2) and moderate to high risk group (IPI≥2). Results Compared with the normal controls, newly diagnosed and relapsed DLBCL had significantly higher VEGF serum levels (P ＜0.01). In the patients responding to CHOP or RCHOP regimen a significantly decrease in VEGF serum levels occurred, while in the patients who did not achieve complete remission(CR) there was no significant decrease. Furthermore, pretreatment serum levels of VEGF were significantly lower in CR group than in partial remission (PR) and no remission (NR) group. In addition, serum levels of VEGF were significantly elevated in the high risk group than those at the low risk group(P＜0.01). Conclusion The serum levels of angiogenic factor VEGF are related to the development and progression of DLBCL. The VEGF combined with IPI can be used for evaluating the prognosis of DLBCL.

Objective To explore the significance of the suppressor of cytokine signaling-1 (SOCS-1)gene methylation in the genesis, development and prognosis of diffuse large B-cell lymphoma (DLBCL).Methods The methylation state of CpG island in SOCS-1 gene were detected by methylation-specific polymerase chain reaction (PCR) and the level of SOCS-1 gene was measured by the real-time PCR. The clinical data of 30 patients with DLBCL were collected, and according to the international prognosis index (IPI), they were divided into low risk group and high risk group. Results Aberrant methylation of SOCS-1 in 17 DLBCL patients (56.7 %) were positive, however, in control group aberrant methylation was negative(P ＜0.01).The methylation level of DLBCL patients with positive SOCS-1 methylation was higher than that of patients with negative (P ＜0.05). Combined with the clinical data, the positive rate of methylation in patients with high level of serum LDH or the numbers of extra-nodal lesions＞l were significantly higher than that in patients with normal LDH level or the numbers of extra-nodal lesions ≤ 1, respectively. Hence, the positive rate of methylation in the high risk group of DLBCL was higher than that in the low risk group (P ＜0.05). Conclusion There were aberrant methylations of the SOCS-1 gene in the patients with DLBCL. The methylations of SOCS-1 can silence the gene expression, which indicates that SOCS-1 and its methylations play some role on genesis and development of DLBCL and can evaluate the prognosis of the patients with DLBCL.

Objective To detect the significance of the SHP-1,p15 and SOCS-1 genes methylation status in the genesis and development of diffuse large B-cell lymphoma (DLBCL).Methods The methylation state of SHP-1,p15 and SOCS-1 genes CpG islands were measured by methylation-specific polymerase chain (MSP) reaction.Results The positive rates of aberrant methylation for SHP-1,p15 and SOCS-1 genes in 50 specimens of DLBCL were 96 ％ (48/50),52 ％ (26/50) and 56 ％ (28/50) respectively.In control group,however,15 specimens of benign lymph node proliferation showed no methylation in CpG island of SHP-1,p15 and SOCS-1 genes promoter.Conclusion Aberrant methylations of the SHP-1,p15 and SOCS-1 genes exist in the patients with DLBCL.The methylations of SHP-1,p15 and SOCS-1 genes may be associated with the occurrence and development of DLBCL.This study provides a theoretical basis of treatment methylation for DLBCL.

BACKGROUND AND OBJECTIVES: Acoustic neuroma (AN) is commonly encountered in the cerebello-pontine angle (CPA) and AN arises principally from the vestibular division of the nerve, which can show not only hearing disturbance but also various vestibular symptoms and laboratory findings by affecting central and peripheral vestibular system. Vestibular testing is reported not to be a useful screening test for AN, but can be helpful in defining whether the tumor arises from the superior or inferior division and identifying the cause of dizziness or vertigo. MATERIALS AND METHOD: We are presenting four patients with CPA tumors accompanied by various abnormal findings of vestibular function tests including head-shaking nystagmus, vibration-induced nystagmus, hyperventilation- induced nystagmus and vestibular evoked myogenic potential and subjective visual vertical, which can enable us to understand the pathomechanism of the abnormal results. RESULTS: All patients presented hearing loss and mild dizziness. Caloric test, head thrust test and vibration-induced nystagmus was helpful in localizing the disease, but head-shaking nystagmus and hyperventilation-induced nystagmus was less helpful. Otolith tests did not always show abnormal results. CONCLUSION: We should consider abnormal results of the vestibular function tests in a whole to estimate the status of vestibular compensation in patients with CPA tumors.
Caloric Tests ; Compensation and Redress ; Dizziness ; Head Impulse Test ; Hearing ; Hearing Loss ; Humans ; Mass Screening ; Neuroma, Acoustic ; Otolithic Membrane ; Vertigo ; Vestibular Function Tests*

Objective To explore integrated teaching based on small private online course (SPOC) in lymphoma clinical courses for medical undergraduates.Methods A total of 60 medical undergraduates in the department of hematology were randomly allocated to SPOC teaching group (n=30) and problem-based learning (PBL) teaching group (n=30) according to scores of the basic medical theoretical examination for lymphoma clinical courses education.After teaching activities,personal experiences were evaluated by anonymous questionnaires from medical undergraduates and instructors.Besides teaching efficacies assessed by objectively measurable score system including academic examination scores,clinical skill and capabilities in analyzing clinical problems of students,were systematically analyzed and compared between two groups by SPSS 19.0.Results The survey results showed that compared with PBL teaching group,SPOC teaching group had higher teaching feedback evaluation and better teaching experience,and SPOC were widely recognized by teachers and students.The SPOC teaching group's scores of the three items in the exam were better than those of the PBL teaching group,with the academic achievement [(84.03 ± 7.66) vs.(77.60 ± 8.22),P=0.005],the performance of practical skills [(87.83 ± 8.17) vs.(81.97 ± 6.13),P=0.001],and case analysis results [(88.17 ± 6.53) vs.(80.10 ± 6.91),P=0.000],and the difference was statistically significant.Conclusion Integrated teaching based on SPOC is feasible for lymphoma clinical courses,which can trigger interest of students,enhance learning abilities and their clinical capabilities.Moreover,this novel medical education approach may provide new ideas and theoretical basis in training qualified and talent doctors.

Objectives: This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals. Methods: We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals. Results: Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality. Conclusions Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

Cerebral fat embolism (CFE) combined with pulmonary fat embolism (PFE) is an extremely rare and serious complication after fat injection. In order to improve the understanding of the mechanism of this complication, this article reported the diagnosis, treatment and pathological results of a patient with CFE and PFE after facial autologous fat injection. A 34-year-old female underwent an injection of autologous fat in her right cheek at another institution in March 2021 and developed into a coma. 1.5 hours later, she was taken to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University. CT revealed a massive infarction in the right cerebral hemisphere and bilateral acute pneumonia. The patient was treated with dehydration, anti-infection, anticoagulation and microcirculation improvement in the intensive care unit. But the patient died due to the critical condition. Postmortem autopsy and histopathological examination, revealed ischemic stroke with hemorrhagic transformation, and pulmonary embolism with acute pneumonia. It was speculated that the fat embolus passed through the damaged main trunk or branch of the right facial artery, and then retrograde to the right external carotid artery, common carotid artery and internal carotid artery to cause middle cerebral artery occlusion. At the same time, the embolus returned to the right atrium along with the accompanying vein of the above artery, and reached the pulmonary vascular bed through the pulmonary circulation, resulting in pulmonary embolism. Plastic surgeons should have extensive knowledge with the anatomical structure of facial blood vessels, master the injection techniques, and improve the awareness of fat embolism when performing facial fat transplantation.

Cerebral fat embolism (CFE) combined with pulmonary fat embolism (PFE) is an extremely rare and serious complication after fat injection. In order to improve the understanding of the mechanism of this complication, this article reported the diagnosis, treatment and pathological results of a patient with CFE and PFE after facial autologous fat injection. A 34-year-old female underwent an injection of autologous fat in her right cheek at another institution in March 2021 and developed into a coma. 1.5 hours later, she was taken to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University. CT revealed a massive infarction in the right cerebral hemisphere and bilateral acute pneumonia. The patient was treated with dehydration, anti-infection, anticoagulation and microcirculation improvement in the intensive care unit. But the patient died due to the critical condition. Postmortem autopsy and histopathological examination, revealed ischemic stroke with hemorrhagic transformation, and pulmonary embolism with acute pneumonia. It was speculated that the fat embolus passed through the damaged main trunk or branch of the right facial artery, and then retrograde to the right external carotid artery, common carotid artery and internal carotid artery to cause middle cerebral artery occlusion. At the same time, the embolus returned to the right atrium along with the accompanying vein of the above artery, and reached the pulmonary vascular bed through the pulmonary circulation, resulting in pulmonary embolism. Plastic surgeons should have extensive knowledge with the anatomical structure of facial blood vessels, master the injection techniques, and improve the awareness of fat embolism when performing facial fat transplantation.