Objective To investigate the effect of a newly developed photosensitizer—chlorophyll derivative combined with irradiation of 650 nm laser for PC3, an androgen independent cell line in vitro. Methods PC3 was cultured and designed to 4 groups,including blank control,laser irradiation,medication of photosensitizer and medication of photosensitizer with laser irradiation (treated).The medicated concentration of chlorophyll was 0.1 g/L and irradation fluence of 650 nm semiconductor laser was 6 J/cm2.Intracellular distribution of photosensitizer and cellular morphological alterations were studied through light microscopy, electron microscopy and laser confocal microscopy. Results It showed the shrinkage, round-up and membrane integrity of treated PC3 under light microscopy.Sable deposits were observed in cytoplasm of cells in both photosensitizer and treated groups.Transmission electron microscopy showed the fragmentation of DNA and condensation of chromatin beneath the karyolemma in treated cells.In cytoplasm,the endoplasmic reticulum and mitochondria swell to form vesicles and vacuoles.It showed the strong red fluorescence in the cytoplasm of treat cells compared with the red fluorescence indifferent to the background through laser confocal microscopy. Conclusions Chlorophyll derivative based photodynamic therapy is able to induce apoptosis of PC3 in vitro.Mitochondria is presumed to be the primary target of photodynamic therapy and trigger the apoptotic pathway.

Objective:To evaluate the clinical application of 64-slice spiral computer tomography pulmonary angiography (CTPA)in diagnosis of pulmonary embolism(PE).Methods:Sixty-two patients suspected of PE were examined by 64-slice spiral CTPA.The image findings combined with their clinical data were retrospectively analyzed.Results:Twenty-four of the 62 patients were confirmed to have PE by clinical data,laboratory examination and follow-up examination.64-slice spiral CTPA discovered 152 involved branches in the 24 PE patients,including 4 branches in left and right pulmonary trunk,52 in lobar pulmonary arteries,82 in segmental pulmonary arteries,and 14 in subsegmental arteries.Four types of PE were detected in our group,including eccentric filling defect in 58 branches,central filling defect in 49 branches,total occlusion of the pulmonary arteries in 21 branches,and mural embolism of host artery in 24 branches.The diagnosis accuracy of 64-slice spiral CTPA in the present group of patients was 100%,with no missed diagnosis and misdiagnosis.Besides,64-slice spiral CTPA could reflect the location,morphology,involvement and degrees of PE.Conclusion:64-slice spiral CTPA is a rapid,accurate and non-invasive diagnostic approach for PE.It is the first choice in clinical screening of PE and may serve as a gold standard for diagnosis of pulmonary embolism.

Objective To study the clinical significance of the mRNA expression level of a novel gene which encodes a kind of transmembrane prostate protein induced by androgen-PMEPA1, as it may predict the progress of prostate cancer from hormone-dependent to hormone-independent. Methods We used Real-time PCR to detect the mRNA expression of PMEPA1 and GSTP1 in prostate cancer cell lines (LNCaP, PC-3), epithelia cells of benign prostatic hyperplasia and tissues from 33 patients with prostate cancers and 16 cases of prostatic hyperplasia. Results We found the mRNA expression of GSTP1 and PMEPA1 were both down-regulated in prostate cancer cell lines. The mRNA expression of GSTP1 was up-regulated in 6.1% of cases, down-regulated in 81.8%, and showed no difference in 12.1%. While PMEPA1 was highly expressed in 27.3% of cases, lowly expressed in 27.3%, and not differently expressed in 45.4%. Statistical analysis showed that the mRNA expression of GSTP1 was relevant to ages, but had no relationship with PSA, TNM stage, osseous metastasis or tumor differentiation, while the mRNA expression of PMEPA1 was relevant to osseous metastasis and tumor differentiation, but had no relationship with age, PSA or TNM stage. Conclusions PMEPA1 is possibly a useful biomarker, as it can identify patients with unfavourable prognosis, however, this hypothesis needs to be further studied with large samples.

OBJECTIVETo study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.

METHODSFrom February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).

CONCLUSIONTreatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.

Craniocerebral Trauma ; Earthquakes ; Head ; Humans

BACKGROUND: Resistin has been shown to play an important role in the pathogenesis and progression of osteoarthritis. OBJECTIVE: To investigate the correlation between resistin level in serum and synovial fluid and the severity of knee osteoarthritis. METHODS: Seventy-four patients with knee osteoarthritis and 79 healthy individuals were recruited. The Noyes score method was used to assess articular cartilage damage arthroscopically. The severity of knee osteoarthritis was evaluated according to the Western Ontario McMaster University Osteoarthritis (WOMAC) score. The radiographic severity of knee osteoarthritis was assessed by the Kellgren-Lawrence (K-L) grading system. The levels of resistin and cross linked C-telopeptide of type Ⅱ collagen (CTX-Ⅱ) in serum and synovial fluid were determined by ELISA. RESULTS AND CONCLUSION: The resistin level in the synovial fluid was positively correlated with the radiographic severity of knee osteoarthritis, WOMAC pain, WOMAC function, and WOMAC total scores, but showed no correlation with the WOMAC stiffness score. There were no significant correlations between the serum level of resistin and WOMAC total scores, subscale or K-L Grading system in the the osteoarthritis patients. Multiple regression analysis showed that the correlation between the synovial fluid level of resistin and WOMAC scores was of significance after removal of other confounding factors, and the resistin level in the synovial fluid was positively correlated with Noyes scores and CTX-Ⅱ level. These results suggest that the resistin level in the synovial fluid can serve as a potential biomarker reflecting the severity of knee osteoarthritis and cartilage degenerative degree in patients with osteoarthritis.

Objective To analyze the pathological and clinical characteristics of patients with idiopathic IgA nephropathy accompanied by vasculitic/crescentic lesion (IgA-V/C). Methods Data of 222 patients diagnosed as idiopathic IgA nephropathy by renal biopsy, among them 87 cases with vasculitic/crescenlic (V/C)lesion, from our department in 2004 were analyzed retrospectively. Clinical and pathological data from patients with IgA-V/C were compared to those of non-IgA-V/C patients and of lupus nephritis (LN) patients with V/C lesion. Results Vasculitic/crescentic lesion was found in 39.19% (87/222) patients with idiopathic IgA nephropathy.And about( 14.08?12.75)% of the glomeruli was affected. It should be taken into account that there was no significant differences of clinical manifestations including blood pressure, urinary protein excretion between IgA-V/C group and non-IgA-V/C group .except serum creatinine(Scr)level which was significantly higher in IgA-V/C group. In addition, only 37.9% of IgA-V/C patients presented high Scr level,thus the lesion of V/C in idiopathic IgA nephropathy was easily overlooked. Patients with idiopathic IgA nephropathy were found to have higher percentage of glomerular sclerosis (64.86% vs 40.00%) and ratio of sclerostic glomeruli to total glomeruli [ (26.98 ?24.68)% vs (16.10 ?18.80)% ]as compared to LN group, which further predicated the progressing characteristics of IgA nephropathy. Conclusions Vasculitic/crescentic lesion is a quite common finding in idiopathic IgA nephropathy and often associated with no dramatically symptoms. It is possible for vasculitic/crescentic lesion to induce unmarked lose of nephron slowly and continually, so as to accelerate IgA nephropathy progression to end-stage renal failure.

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.

Objective To investigate the features of familiar facial palsy,ophthalmoplegia and dysphagia characterized by autosomal dominant inheritance in a family and to discuss the classification and pathogenesis of the disease.Methods Clinical,electrophysiological,pathological examinations were performed and blood samples were obtained from 5 patients and 26 family members.PCR protocol was used to identify a certain gene. Results In the 5 patients receiving physical examination,all had ptosis,external ophthalmoplegia,facial paralysis,dyphagia,hoarseness,decreased pharyngeal reflex;4 had amyotrophy of muscle of tongue,temporal nuscle,masseter and muscles of distal lower limbs;3 had proximal limb asthenia and distal limbs amyotrophy.Compared to those of oculopharyngeal muscular dystrophy(OPMD)with similar symptoms and signs,both electrophysiological manifestation and pathological findings of the family members supported the diagnosis of muscular dystrophy,but the(GCG)6(GCA)3GCG in the first exon of PABPN1 mutated neither in normal family members nor in patients.Conclusions This family presents clinical manifestations somewhat resembling to those of OPMD and distinctive to other disorders,but has a totally different genetic background from OPMD.It may be a new subtype of muscular dystrophy.