· AIM: To study the inhibitory effect of pyrrolidine dithiocarbamate (PDTC) on the inflammatory reaction in an experimental proliferative vitreoretinopathy (PVR)model with laser flare cell meter (LFCM).· METHODS: A total of 20 pigmented rabbits were divided into two groups randomly, with 10 rabbits in each group. After the creation of retinal holes, 0.1mL PDTC was injected intravitreally into the right eyes of Group 1(A1) and the left eyes of Group 1 (A2), and 0.1mL balanced saline solution (BSS) into the right eyes of Group2 (B1). One hour later, 0.1mL BSS into the eyes of A1,and 5000U IL-1 β in 0.1mL BSS was injected intravreally into the eyes of A2 and B1. Clinical evaluation and LFCM examination were performed before retinal injury (PO)and at 4h, 24h, 1, 2 and 4wk after the second injection(P4h, P24h, Plwk, P2wk and P4wk). Histopathologic and immunohistochemical examination were also performed at these time points.· RESULTS: PDTC could inhibit the inflammatory reaction obviously from P24h to P2wk. The eyes of A1 and A2 recovered earlier than those of B1. Although inflammatory reaction in the 3 groups resolved completely by the end of P2wk measured with the slit-lamp microscope,the eyes of the B1 still showed obvious aqueous flare judged by the LFCM compared with those of A1 and A2.Histopathologic and immunohistochemical examination showed that nuclear factor- κ B (NF- κ B) was activated by IL-1 β and the PDTC had inhibitory effect on it without obvious toxicity to retina.· CONCLUSION: Inflammatory reaction involves in the rabbit model of PVR induced by injecting intravitreally IL-1 β and the PDTC can relieve it significantly. The LFCM provides a new, sensitive, objective and noninvasive method to quantify the inflammatory reaction in the PVR model.

The genes of maltooligosyl trehalose synthase (MTSase) and maltooligosyl trehalose tetrahydrolase(MTHase) from Sulfolobus solfataricus ATCC 35092 were amplified using PCR. The expression plasmids, pTrc99a-MTSase and pTrc99a-MTHase, were constructed by inserting these two DNA fragments into E. coli expression vector pTrc99a. The specific activity of MTSase and MTHase in E. coli BL21(DE3) at optimal fermentation conditions reached 31.3U/g (wet cell) and 403U/g (wet cell), respectively. The biotransformation of partially hydrolyzed starch to trehalose catalyzed by MTSase and MTHase was carried out at 75℃ and pH 5.0. The highest yield of trehalose (ca. 53.6%) was gained when the original starch concentration was 15%(w/v) and the DE value was 10.

OBJECTIVETo compare the efficacies of portal vein stenting and transcatheter arterial chemoembolization (TACE) combined therapy performed with or without endovascular implantation of iodine-125 (125I) seeds strand in patients with hepatocellular carcinoma (HCC) and main portal vein tumor thrombus (MPVTT).

METHODSOne-hundred-and-six patients with HCC complicated by MPVTT who were treated with portal vein stents and TACE, either with (Group A, n=56) or without (Group B, n=50) endovascular implantation of 125I seeds strand, between July 2005 and April 2011, were retrospectively analyzed. Overall survival, stent patency, and procedure-related adverse events were compared between the two groups.

RESULTSThe technical success rate was 100% for placement of 125I seeds strands and stents in the obstructed main portal vein. No serious procedure-related adverse events were recorded. Group A had significantly higher median survival (335 days vs. group B: 146 days; P=0.001, hazard ratio (HR)=2.244). Additionally, group A had significantly higher median stent patency (400 days vs. group B: 190 days; P=0.005, HR=2.479).

CONCLUSIONThe combination therapeutic strategy of portal vein stenting and TACE with endovascular implantation of 125I seeds strands improves the survival of HCC patients with MPVTT complication.

Carcinoma, Hepatocellular ; complications ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein ; physiopathology ; surgery ; Retrospective Studies ; Stents ; Treatment Outcome ; Venous Thrombosis ; complications ; therapy

OBJECTIVETo discuss the efficacy of the myogenic elephant skin cream combining with VSD for treating severe bedsores.

METHODSTwenty-nine cases of III and IV degree bedsores were treated from June 2009 to June 2013. Among them, 15 cases were treated by myogenic elephant skin cream combined with VSD (VSD group) including 7 males and 8 females with an average age of (69.0±5.3) years old ranging from 17 to 96 years;other 14 cases were treated by the treatment of conventional dressing change (control group) including 6 males and 8 females with an average age of (71.0±4.2) years old ranging from 40 to 86 years. At 7, 14, 21, 28 d after treatments, specimens of wound two groups were respectively taken to examine immunohistochemical CD34 adopted SABC, the number of wild vascular cross were observed as capillary density value under high magnification microscope. It was used to assess the hyperplasia of granulation tissue of wound. The capillary density value and the visual wound observation were indicators for evaluation of clinical efficacy.

RESULTSSeventeen of 19 cases got complete data of specimens of wound at 7, 14, 21, 28 d,included 9 cases of VSD group,8 of control group. In the microscope view, the capillary density of VSD group was higher than that of control group significantly (P<0.05), it showed the application of VSD technology improved hyperplasia of granulation tissue much faster than conventional dressing change. In VSD group, 13 cases with 15 wounds healed, 2 cases with 3 wounds improved; in control group,3 cases with 3 wounds healed,7 cases with 9 wounds improved, 4 cases with 5 wounds were unhealed.

CONCLUSIONUsing the VSD technology with continuous high pressure suction to clean the drainage of wound and lacuna thoroughly can effectively control infection,promote the growth of granulation tissue, and then applying myogenic elephant skin cream to improve partial blood supply while prompting rapid growth of new granulation tissue and epithelial cell. The risk of this treatment is low,and the course of treatment is short, this provides a safe and effective method for treating bedsores.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; therapy ; Skin Cream ; therapeutic use

OBJECTIVETo investigate the clinical effects of close reduction and minimally invasive percutaneous plate osteosynthesis in treating proximal humerus fractures in the aged.

METHODSFrom February 2012 to December 2013,39 patients with proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO group, 21 cases) and open reduction internal fixation (ORIF group, 18 cases). Including 17 males and 22 females in the study, and aged from 67 to 88 years old with an average of (71.8 ± 5.2) years old. In MIPPO group, there were 11 males and 10 females with an average age of (70.0 ± 5.3) years old;and in ORIF group, there were 10 males and 8 females with an average age of (72.0 ± 4.2) years old. Operation time, blood loss during operation, fracture healing time and postoperative complications were recorded. The functions of the shoulder joints were assessed according to Constant-Murley score at final follow-up.

RESULTSAll the patients were followed up from 11 to 27 months with an average of 18.1 months. The mean blood loss of the MIPPO group was (176.0 ± 57.4) ml,while the ORIF group was (356.0 ± 66.9) ml (t = 7.22,P = 0.01). The operation time of the MIPPO group was (47.4 ± 14.9) min, while the ORIF group was (92.7 ± 15.8) min (t = 0.79, P = 0.03). Fracture healing time in the MIPPO group and ORIF group was (17.6 ± 5.8), ( 21.7 ± 4.9) weeks, respectively (P < 0.05). The mean Constant-Murley score at final follow-up was 89.7 ± 14.5 in MIPPO group, and 81.8 ± 13.2 in ORIF group (P < 0.05).

CONCLUSIONMIPPO has advantages of little trauma, less blood loss, rapid recovery, less vascular damage and so on and can effectively treat the proximal humerus fracture in the aged.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Shoulder Fractures ; surgery

Air ; analysis ; Cyclohexanones ; analysis ; Electrophoresis, Capillary ; Reproducibility of Results ; Workplace

OBJECTIVETo explore the expression of Ghrelin and high mobility group protein B1 (HMGB1) in the serum and the intestinal tissue of sepsis model rats, and to evaluate the effect of electro-acupuncture (EA) at Zusanli (ST36) on the expression of HMGB1 and Ghrelin.

METHODSForty-eight male Wistar rats were randomly divided into four groups, i.e., the sham-operation (sham), the cecal ligation and puncture group (CLP), the CLP + EA at Zusanli (ST36) group (EA), and the CLP + Ghrelin receptor blocking agent + EA group (GHSRA), 12 in each group. A sepsis rat model was prepared by CLP. The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group. In the EA group EA at Zusanli (ST36) was performed 20 min after CLP surgery with the constant voltage (2 - 100 Hz, 2 mA) for 30 min. In the GHSRA group, Ghrelin receptor blocking agent, [D-Arg1, D-Phe5, D-Trp79, Leu11]-substance P (700 nmol/kg), was administered through intravenous injection immediately after CLP, and 20 min later, EA at Zusanli (ST36) was performed in the same way as for rats in the EA group. Blood samples were withdrawn 12 h after CLP. The serum levels of Ghrelin and HMGB1 were detected using ELISA. Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry. HMGB1 contents of the jejunum tissue were detected by Western blotting.

RESULTSCompared with the Sham group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group (P < 0.05). Compared with the CLP group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased, but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group (P < 0.05). Compared with the EA group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group (P < 0.05), but there was no statistical difference in levels of Ghrelin between the two groups (P > 0.05). The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group, the CLP group, and the EA group (r = -0. 528, P < 0.01).

CONCLUSIONSEA at Zusanli (ST36) could inhibit the expression of HMGB1 in the jejunum of septic rats, and promote the expression of Ghrelin. The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent, which suggested that the anti-inflammation of EA at Zusanli (ST36) might be associated with Ghrelin.

Animals ; Disease Models, Animal ; Electroacupuncture ; Ghrelin ; metabolism ; HMGB1 Protein ; metabolism ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Sepsis ; metabolism

0.05).Conclusion The PAI-1 genotype perhaps may not be one of independent risk factors for both T2DM and FA-IMT in T2DM patients.

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To define the incidence and perioperative risk factors of new-onset atrial fibrillation for patients with preoperative sinus rhythm after successful mitral valve replacement.Methods Retrospective analysis was performed on 586 patients with preoperative sinus rhythm who underwent successful mitral valve replacement in our hospital from 1998 to 2008.The cases were classified into postoperative atrial fibrillation (AF group) or postoperative sinus rhythm (SR group).Twenty-nine risk factors including clinical and echocardiography data were selected into univariate analysis by using student' s t test or chi-squared test according to the data type.The factors with a value of P ＜ 0.1 in univariate analysis were assessed by multivariate logistic regression.A value of P ＜ 0.05 (two-sided) was considered to be statistically significant in multivariate logistic regression. ResultsOne hundred and eighteen patients had atrial fibrillation postoperatively. The incidence was 20.1％.Univariate analysis revealed that the factors including age,chronic lung disease,left ventricular mass,left atrial volume,right atrial volume,tricuspid valve regurgitation,heart failure,valvular pathology,postoperative prosthetic mitral effective orifice area index,postoperative mechanical ventilation time,serum levels of potassium and magnesium significantly increased the risk of postoperative atrial fibrillation.However,in multivariate logistic regression,age,left atrial volume and postoperative prosthetic mitral valve effective orifice area index and serum of potassium had significant statistically significances between AF group and SR group.Conclusion Age,left atrial volume,postoperative prosthetic valve effective orifice area index and serum of potassium were significant predictors of postoperative new-onset atrial fibrillation for patients with preoperative sinus rhythm after mitral valve replacement.