Adult ; Burnout, Professional ; Female ; Humans ; Life Change Events ; Middle Aged ; Occupations ; Professional Competence ; Work ; psychology ; Young Adult

Objective To investigate the safety and efficacy of retroperitoneal laparoscopy for adrenal tumor and report the experience with this procedure for adrenal surgery.Methods From June 2003 to March 2007,we performed 24 laparoscopic tumorectomy via the retroperitoneal approach.Results All procedures were successful. The average operative time was 1.7 hours(ranging from 1 to 3.5 hours).All patients had no need of transfusion and no complication.All patients recovered.The average hospital stay was 4.5 days(ranging from 3 to 8 days).Patholog- ic diagnosis:10 cases of nonfunctional adenoma,6 cases of primary aldosteronism,4 cases of adrenal cyst,2 cases of pheochromocytoma,2 cases of Cushing's adenoma.Conclusions Retroperitoneal laparoscopic surgery for adrenal oc- cupying lesion had such advantages as minimal invasive,safe and effective,early recovery and shorter stay in hospital. It should be the flint choice of treatment for adrenal occupying lesion.

This study was aimed to clone human intercellular adhesion molecule-1 (ICAM-1) gene, to transfect the constructed eukaryotic expression vector ICAM-1-GFP into CHO cells, as well as to detect ICAM-1-GFP expression in CHO cells binding with Molt-4 cells. ICAM-1 cDNA gene was amplified by RT-PCR and inserted in PMD(18)-T vector. Then ICAM-1 cDNA from pMD18-ICAM-1 vector was subcloned into eukaryotic expression vector pEGFP-C1 to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing were used to confirm the recombinant vector. After stable transfection of CHO-K1 cells with the recombinant vector, the expression and subcellular localization of ICAM-1-GFP were detected by RT-PCR, flow cytometry and fluorescence microscopy. The function of ICAM-1-GFP fusion protein was assessed by the binding of ICAM-1-GFP/CHO cells to Molt-4 cells. The results showed that 1622 bp full-length ICAM-1 cDNA obtained and was successfully ligated with pMD(18)-T-vector, subcloned to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing indicated that recombinant ICAM-1-GFP was successfully constructed and ICAM-1-GFP was expressed stably in CHO cells. ICAM-1-GFP expression was only observed in the cytoplasm of ICAM-1-GFP/CHO cells by fluorescence microscopy. The ICAM-1-GFP/CHO cells were bound to PMA-treated Molt-4 cells. The expression of MEM-148 was very weak in PMA-treated Molt-4 cells. It is concluded that the ICAM-1-GFP eukaryotic expression vector has been constructed successfully and expresses stably in CHO cells. PMA can increase the binding of Molt-4 cells to ICAM-1-GFP/CHO cells by inducing specialized form of ICAM-1 clustering.
Animals ; CHO Cells ; Cricetinae ; Cricetulus ; DNA, Complementary ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; Recombinant Proteins ; genetics ; Transfection

Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

OBJECTIVEThis study aims to conduct a survey of the oral health status of disabled individuals in Liangshan Autonomous Prefecture in Sichuan province. This study was also conducted to prepare caries prevention planning in the region.

METHODSOn the basis of the Oral Health Surveys: Basic Methods of WHO and the Third National Oral Health Epidemiological Sample Survey Scheme, we investigated caries infecting disabled individuals who live in one big city (Xichang city), three counties (Bhutto county, Muli Tibetan autonomous county, and Huili county), and 46 towns and villages of Liangshan Autonomous Prefecture in Sichuan province, by multi-stage stratified and cluster sampling.

RESULTSAmong 3,439 disabled individuals, 2,085 were males and 1,354 were females; among these individuals, 815 live in the city and 2,624 live in rural areas. Furthermore, 2,177 were Han natives and 1,262 were Yi natives (ethnic). The caries prevalence rate and mean DMFT of disabled individuals in Liangshan Autonomous Prefecture in Sichuan province were 87.1% and 9.53, respectively. In Yi, the caries prevalence rate and mean DMFT of disabled individuals in Liangshan Autonomous Prefecture in Sichuan province were 85.8% and 9.93, respectively; in Han, the caries prevalence rate and mean DMFT of disabled individuals in Liangshan Autonomous Prefecture in Sichuan province were 87.9% and 9.29, respectively. No significant difference was found in the two groups of native (P > 0.05). A very low filling rate of 0.2% was also recorded.

CONCLUSIONDisabled individuals from Liangshan Autonomous Prefecture in Sichuan province exhibited a high prevalence of caries in permanent teeth. The oral health status of this special group of disabled individuals should be provided intensive care.

China ; Dental Caries ; Female ; Humans ; Male ; Oral Health

OBJECTIVETo explore the pathologic types, prognostic factors and effective treatment of PGI-NHL.

METHODSClinical data of 110 PGI-NHL patients were analyzed retrospectively, and so did prognostic factors and each treatment outcome.

RESULTSOf the 110 patients, the male-female ratio was 1.56:1 with a median age of 58.5 years. Stomach was the most common site and small intestine was the second. The main histological subtypes were diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) NHL. Among the 75 patients followed up, the 5-year overall survival (OS) rate was 62%, the median survival time was 36 months. Univariate analysis showed a similar prognosis between PG-NHL and primary bowel NHL (P > 0.05), and PGI-MALT had better prognosis than PGI-DLBCL. Among PGI-DLBCL, the ratio of germinal center (GC) sub-type to non-GC was 1:2.82. Among three main treatments, chemotherapy combined with surgery had the lowest mortality rate, compared with each alone. Disease progress mortality was 51.7% of overall mortality.

CONCLUSIONThe percent of non-GC in PGI-DLBCL is higher than that of in non PGI-NHL. The 5-year OS rate is lower than the 5-year OS rate of DLBCL. Combined chemotherapy is the first line treatment. Surgery is important in the control of the complications of GI tract. Maintenance treatment is important even in those who had systemic treatments.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo study and compare the anti-inflammatory effect and molecular mechanism of artemisinin and dihydroartemisinin.

METHODMouse mononuclear macrophage RAW264.7 cells were stimulated to release inflammatory mediators such as TNF-alpha, IL-6 and NO, in order to assess the drugs' inhibitory effect on macrophage's release of above inflammatory mediators. The levels of TNF-alpha and IL-6 were determined by ELISA and the cytotoxicity was determined by MTT method. The protein expression of iNOS, COX-2 and beta-actin were tested by Western blot. The enzymatic activity of COX-2 was determined by colorimetric method.

RESULTDihydroartemisinin significantly inhibited LPS-induced release of TNF-alpha, IL-6 and NO from RAW264.7 in mice with the concentration range of 12.5 - 100 micromol x L(-1), and showed good dose dependence. Artemisinin only inhibited the IL-6 release to a certain extent.

CONCLUSIONDihydroartemisinin inhibits macrophages from releasing inflammatory factors TNF-alpha and IL-6 and inflammatory mediators NO by down-regulating iNOS protein. Artemisinin may help dihydroartemisinin to show its anti-inflammatory effect through metabolism.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Artemisinins ; pharmacology ; Cell Line ; Gene Expression ; drug effects ; Inflammation Mediators ; immunology ; Interleukin-6 ; genetics ; immunology ; Macrophages ; drug effects ; immunology ; Mice ; Nitric Oxide ; immunology ; Tumor Necrosis Factor-alpha ; genetics ; immunology

CD4+ T cells mainly interact with Sphingosine 1-phosphate (S1P) to regulate immune function through Sphingosine 1-phosphate receptor 1 (S1P1). This study was aimed to investigate the effects of recombinant human granulocyte-colony-stimulating factor (rhG-CSF) mobilization on S1P1 expression in CD4+ T cells of donor's peripheral blood. The CD4+T cells of peripheral blood were isolated by magnetic beads from 17 allo-hematopoietic stem cell transplantation (allo-HSCT) donors before and at fourth day of mobilization with rhG-CSF. The S1P1 expression was detected by real time quantitative PCR in the RNA extracted from CD4+ T cells collected before and after rhG-CSF mobilization. The results showed that the expression of S1P1 was found in CD4+ cells before and after rhG-CSF mobilization, but the expression level of SIP1 in CD4+ cells after rhG-CSF mobilization was significantly lower than that before rhG-CSF mobilization (p<0.01). It is concluded that the mobilization with rhG-CSF obviously down-regulates the expression of S1P1 in CD4+ T cells of donor's peripheral blood.
CD4-Positive T-Lymphocytes ; drug effects ; metabolism ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; methods ; Hematopoietic Stem Cell Transplantation ; Humans ; Receptors, Lysosphingolipid ; metabolism ; Recombinant Proteins

OBJECTIVETo approach the long term safety and efficacy of transmyocardial laser revascularization (TMLR, holmium: YAG) combined with off-pump coronary artery bypass (OPCAB) compared with OPCAB alone in patients with ischemic cardiac disease.

METHODSBetween 1999 and 2005, 80 patients with diffusely diseased target vessels from two centers in Beijing were enrolled to the study and randomized to receive either TMLR/OPCAB (n = 40) or OPCAB (n = 40) operation. Baseline demographics and operative characteristics were similar between groups. Follow-up (mean 3.4 +/- 1.7 years) included CCS angina class and NYHA classification assessments, 6 minutes walking test (6MWT) and echocardiography.

RESULTSPerioperative mortality was 5% in both groups. No death occurred during follow up. At the end of follow-up, patients at both groups experienced significant improvement on angina score compared with baseline, and angina score was also significantly lower (1.21 +/- 0.42 vs. 1.57 +/- 0.87, P = 0.03) and 6MWT-distance significantly increased (518.0 +/- 65.5 m vs. 473.8 +/- 65.8m, P = 0.006) in OPCAB/TMLR group than that in the OPCAB group. Fewer patients developed recurrent severe angina and received re-CABG/PCI in OPCAB/TMLR group than that in the OPCAB (1 vs. 6 cases, P = 0.113). NYHA and LVEF were similar between the groups at the end of follow up.

CONCLUSIONOur study showed that the addition of TMLR to OPCAB is superior in improving angina and exercise tolerance, but there is no further improvement in cardiac function compared to OPCAB alone.

Aged ; Angioplasty, Laser ; Combined Modality Therapy ; Coronary Artery Bypass, Off-Pump ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Revascularization ; methods ; Prospective Studies ; Retrospective Studies

BACKGROUND: Ischemia-reperfusion injury in the myocardium after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) is an important pathologic basis of post-cardiac arrest of syndrome (PCAS), and apoptosis is one of the major mechanisms in myocardial ischemia-reperfusion injury. To lessen myocardial ischemia-reperfusion injury after cardiac arrest and CPR, it is important to reduce energy consumption and to increase energy supply in the myocardium. This study aimed to observe changes of cell apoptosis and expression of Bcl-2 and Bax protein on the myocardium after CPR in rats, and the protective effects of different doses of exogenous phosphocreatine (creatine phosphate, CP) on them. METHODS: A total of 32 male adult Sprague-Dawley rats were randomly divided into 4 groups: control group (group A), CPR group (group B), low-dose CP group (group C, CP 0.5 g/kg at beginning of CPR and 1.0 g/kg at 2 hours after CPR) and high-dose CP group (group D, CP 1.0 g/kg at beginning of CPR and 2.0 g/kg at 2 hours after CPR). Cardiac arrest was induced by asphyxiation and CPR started at 7 minutes after asphyxiation in groups B, C and D. Myocardium samples were taken at 24 hours after CPR. Cardiomycytic apoptosis was detected by the TdT-mediated dUTP-biotin nick end labeling (TUNEL) method. The expression of Bcl-2 and Bax protein was measured by immunohistochemistry. RESULTS: Cardiomyocytic apoptosis index (AI) and expression of Bcl-2 and Bax protein increased more significantly in groups B, C and D than in group A (P<0.01), but Bcl-2/Baxratio significantly decreased (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in groups C and D than in group B (P<0.01), but Bcl-2/Bax ratio increased more significantly (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in group D than in group C (P<0.05), but Bcl-2/Bax ratio increased more significantly (P<0.05). CONCLUSION: Exogenous phosphocreatine, especially at a large dose, could inhibit cardiomyocytic apoptosis and alleviate myocardial injury after CPR in rats.