Objective To explore the expressions of hypoxia-inducible factor-1 alpha (HIF- lα)and nestin in the hippocampus of developing rats after pentylenetetrazol (PTZ)-induced starus epilepticus (SE),and the correlation between HIF-1α level and proliferation of neural stem cells (NSCs). Methods A total of 768 SD rats,including rats of postnatal 7 days (P7,n-192),rats of postnatal 14 days (P14,n=192),rats of postnatal 21 days (P21,n=192) and rats of postnatal 28 days (P28,n=192),were equally randomized into vehicle group (n=96) and control group (n-96),respectively; SE rat models of the vehicle group were induced by intraperitoneal injection of 1％ PTZ (80 mg/kg); and rats of the control group were received injection of normal saline (NS); 6 and 12 h,and 1,2,3 and 7 d after the inducement,the mRNA and protein expressions of HIF-1α in the hippocampus of rats in these 8 groups were examined by RT-PCR and immunohistochemistry, respectively. Another 48 21-d- old SD rats were equally randomized into vehicle I group (n=24) and intervention group (n=24); and rats in the intervention group received injection of HIF-lα antisense oligodeoxynucleotides (ASODN) into the right hippocampus and NS into the left hippocampus; 6 h after the injection,these 48 rats were induced into SE models by intraperitoneal injection of 1％ PTZ (80 mg/kg); 2 d after the inducement, the mRNA expression of HIF-1α in the hippocampus was examined by RT-PCR; and 7 and 14 d after theinducement, the protein expressions of HIF-1α and nestin in the hippocampus were examined by immunohistochemistry. Results The mRNA expression of HIF-1 α in the hippocampus of all the rats in the vehicle group after SE increased significantly with similar trend.Six h after SE,the HIF-1α mRNA expression significantly decreased with time prolongation (P＜0.05). Major HIF-1α positive cells were located in different areas at different time after SE. In intervention experiment, the HIF-1α mRNA expression 2 d after SE and the number ofnestin positive cells 7 and 14 d after SE in the vehicle I group and the left hippocampus of intervention group(being intervented with ASODN) obviously decreased as compared with those in the right hippocampus (being intervented with NS,P＜0.05). Conclusion The mRNA and protein expressions of HIF-1α in the hippocampus of developing rats are enhanced after SE with a correlation of age-in-days; correlativity between HIF-1α and proliferation of NSCs might exist after SE.

Objective To explore the pathological and imaging features of epithelioid angiomyolipoma(EAML). Methods A 47-year-old man presented with dull pain in left upper abdomen for 1 year admitted to hospital.Accompanied with several enlarged lymph nodes,a mass with the largest diameter of 28 cm in the left kidney was inhomogeneously enhanced on CT.The left kidney and the mass were radically resected with regional lymph node dissection after general anaesthesia. Results During the operation,a well-circumscribed,encapsulated mass with several paraaortic lymph nodes was found on the upper-middle left kidney.The gross cut surface showed fleshy texture with regions of necrosis.Microscopically and immunohistochemistrically,diffuse sheets of epithelioid cells were found with positivity for HMB-45 and negativity for EMA.CT features included higher pre-contrasted density,absent fat,enhanced mode of quick wash-in and slow wash-out.There was neither metastasis nor recurrence during the 1 year follow-up. Conclusion EAML with malignant potency is a rare tumor of mesenchymal tissue presenting with some specific radiopathological features and a good prognosis.

Acne Vulgaris ; therapy ; Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Needles

OBJECTIVE: To establish the diagnosis of amniotic fluid embolism with blood samples by liquid-based cytology technique and to study the validity of method. METHODS: The blood samples were collected from patients who suffered from amniotic fluid embolism. The components of amniotic fluid in blood samples were examined with blood smear by two direct smear methods (supernatant smear, sediment smear) and two liquid-based cytology methods (automatic smear, manual smear). The positive detection rate of each method was calculated. RESULTS: The positive detection rates of two liquid-based cytology methods (84.6% and 92.3%, respectively) were much higher than those of two direct methods (53.8% and 61.5%, respectively). CONCLUSION The liquid-based cytology technique could improve the positive detection rate of amniotic fluid embolism.
Amniotic Fluid ; Cytological Techniques/methods* ; Embolism, Amniotic Fluid/diagnosis* ; Female ; Humans ; Pregnancy

OBJECTIVETo analyze the characteristics of leptomeningeal carcinomatosis.

METHODSWe summarized the clinical presentation, magnetic resonance imaging (MRI) findings and cerebrospinal fluid (CSF) cytological findings in 4 cases of leptomeningeal carcinomatosis.

RESULTSAll the patients presented with signs of elevated intracranial pressure such as headache. Enlarged cerebral ventricles and dural enhancement were found by MRI, with also the presence of malignant cells in cytological slides.

CONCLUSIONCSF cytological examination is important for diagnosis of leptomeningeal carcinomatosis.

Aged ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Carcinomatosis ; cerebrospinal fluid ; diagnosis ; pathology ; Middle Aged

OBJECTIVETo evaluate the impact of preoperative biliary drainage on surgical morbidity in hilar cholangiocarcinoma patients underwent surgery.

METHODSOne hundred and eleven consecutive patients with hilar cholangiocarcinoma whose serum total bilirubin (TBIL) level > 85 micromol/L and underwent surgery in the period from June 1998 to August 2007 were enrolled. There were 67 male and 44 female patients, aged from 26 to 82 years old with a mean of 56 years old.

RESULTSFifty-five patients underwent preoperative biliary drainage with a mean of 11.4 d of drainage period (drainage group), the other (n = 56) were the non-drainage group. The preoperative TBIL level of drainage group was (154 +/- 69) micromol/L, which was significantly lower than the value of pre-drainage (256 +/- 136) micromol/L (P = 0.000) and the value of non-drainage group (268 +/- 174) micromol/L (P = 0.005). ALT and GGT levels could be lowered by preoperative biliary drainage. The postoperative complications of these two groups were comparable (36.3% vs. 28.6%, P = 0.381). Four patients in drainage group and 5 patients in non-drainage group died of liver failure. Multivariate logistic regression indicated that hepatectomy (OR = 0.284, P = 0.003) was the independent risk factor associated with postoperative morbidity. Bismuth-Corlette classification (OR = 0.211, P = 0.028) was the independent risk factor linked to postoperative mortality.

CONCLUSIONSPreoperative biliary drainage could alleviate liver injury due to hyperbilirubin, but it could not decrease the surgical morbidity and postoperative mortality. Concomitant hepatectomy and Bismuth-Corlette classification were independent risk factors linked to surgical risks.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; surgery ; Drainage ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Preoperative Care ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the expression of MMP-2, TIMP-2, TGF-beta1 and TGF-betaRI and the relationship among them in breast cancer.

METHODSThe protein expression of MMP-2, TIMP-2, TGF-beta1 and TGF-betaRI was detected on tissue chips by S-P immunohistochemical staining in 160 cases of breast carcinoma.

RESULTSThe positive rates of TGF-beta1, TGF-beta1 mRNA, MMP-2, MMP-9, TIMP-1 and TIMP-2 expression were 73.7%, 56.2%, 96.9%, 95.0%, 87.5% and 89.4%, respectively. Axillary lymph node metastasis and TNM staging (P < 0.01 and P < 0.01, respectively) were positively correlated to the expression of TGF-beta1. Relase-free survival of TGF-beta1 positive group was lower than that of TGF-beta1 negative group (P = 0.023). The expression of MMP-2 or MMP-9 was positively correlated to that of TGF-beta1 (r = 0.170, P < 0.05; r = 0.221, P < 0.01) and was negatively correlated to that of TGF-beta1 mRNA (r = -0.126, P > 0.05;r = 0.019, P > 0.05).

CONCLUSIONThe expression of TGF-beta1 may be closely correlated with the invasion and metastasis of breast cancer. TGF-beta1-induced invasiveness and metastasis of breast cancer cells are mediated by MMP-2 and MMP-9.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Matrix Metalloproteinase 2 ; metabolism ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Protein-Serine-Threonine Kinases ; metabolism ; RNA, Messenger ; metabolism ; Receptors, Transforming Growth Factor beta ; metabolism ; Survival Rate ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism ; Tissue Inhibitor of Metalloproteinase-2 ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

OBJECTIVETo study the surgical treatment for distal humeral fractures in adults according to the follow-up results.

METHODSTwenty-one cases (16 males and 5 females) of distal humeral fracture were included in this study. The average age was 42.5 years (range: 37-52 years). Fractures were classified according to the AO classification system. Nine cases of C1, 8 C2 and 4 C3-type fractures were identified. Open reduction and internal fixation were performed in all cases. A tricep-reflecting approach was adopted, and either the AO orthogonal plating or parallel plating technique was chosen, based on the fracture type. The plaster cast was removed 3 weeks after operation. Rehabilitation was encouraged during this period and afterwards. The average follow-up time was 12.2 months (range: 8-28 months). The outcome was scored according to Aitken and Rorabeek system.

RESULTSNo nerve injury, nonunion or failure of fixation was encountered during the operation and follow-up. However, ossifying myositis occurred in one case.

CONCLUSIONSA triceps-reflecting approach can provide adequate exposure to the joint. The use of AO orthogonal plating or parallel plating techniques based on the type of fractures can provide rigid fixation for the fracture.

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged

Objective To evaluate the diagnostic value of brain SPECT imaging with a novel Aβ plaque probe,131 I-2-(4'-dimethylaminophenyl) -6-iodoimidazo[ 1,2-α ] pyridine ( 131 I-IMPY) in early AD.Methods Thirteen patients with AD (3 males,10 females,age ranged 52 - 79 y),11 with mild cognitive impairment (MCI,4 males,7 females,age ranged 48 - 67 y) and 14 normal controls (6 males,8 females,age ranged 42 - 67 y) were enrolled in this study.131I-IMPY SPECT imaging was acquired in 2 -3 h after the agent injection.ROIs were drawn on cerebral lobes and cerebellum.The ratios of mean radioactivity of cerebral lobes over cerebellum (Rcl/cb) were calculated.The t-test was used for data analysis.Results In patients with MCI,Rcl/cb ratios were increased in parietal gyrus,temporal gyrus and frontal gyrus (right:1.15±0.18,1.18±0.12,1.14±0.14; left:1.16±0.11,1.19±0.18,1.15±0.09)compared with those in normal control group ( right:1.02 ± 0.12,1.05 ± 0.14,1.01 ± 0.12 ; left:1.03 ±0.13,1.05 ±0.13,1.01 ±0.14; t:2.1642 to 2.8757,all P ＜0.05).Rcl/cb ratios of basel ganglia and occipital gyms in MCI group (right:0.92 ±0.18,1.12 ±0.15; left:0.94 ±0.15,1.13 ±0.17) showed no statistical difference compared with those in normal control group (right:0.82 ±0.15,1.06 ±0.18;left:0.85 ±0.16,1.08 ±0.15; t:0.7805 to 1.4344,all P＞0.05).In patients with AD,Rcl/cb ratios were increased in parietal,temporal,basal ganglia and occipital lobes (right:1.16 ±0.19,1.24 ±0.17,1.16 ±0.13,1.14±0.11,1.23±0.10; left:1.17±0.21,1.25±0.15,1.18±0.08,1.17±0.16,1.25±0.11)compared with those in normal control group( t:2.1001 to 6.2789,all P ＜0.05).Rcl/cb ratios of parietal,temporal and frontal lobes in AD group showed no statistical difference compared with those in MCI group (t:0.1316 to 0.9806,all P ＞ 0.05 ),while Rcl/cb ratios of basal ganglia and occipital lobes in AD group were increased compared with those in MCI group ( t:2.0850 to 3.6772,all P ＜ 0.05 ).Conclusion 131 I-IMPY as a β- amyloid plaque probe for brain SPECT imaging may be potentially helpful for early diagnosis of AD.

OBJECTIVETo analyze the clinical characteristics and effects of rehabilitation treatment on hemophiliacs with iliopsoas hemorrage.

METHODSThe hemophilia patients with iliopsoas bleeding treated in Peking Union Medical College Hospital between January 2006 to December 2010 were enrolled. The clinical characteristics including symptoms, signs, complications, and rehabilitation treatment were analyzed retrospectively.

RESULTSAll of the forty-one hemophiliacs with iliopsoas bleeding were male, 20 cases wee the left bleeding, 18 the right, and 3 the bilateral. The median median age was 18 (6 - 61) years old(y). The median age of the iliopsoas bleeding for the first time was 17 (6 - 20) y. 34 patients accompanied with femoral nerve injury, 19 of them had secondary knee bleeding on the same side. 20 patents had quadriceps atrophy. Pelvic pseudotumor developed in 2 patients and permanent abnormal posture in 2 patients. The main finding of the ultrasound image was low-echo mass in iliopsoas muscles or inguinal region. 34 patients received rehabilitation therapy for 8 - 12 weeks under the support of factor replacement, complete hematomas absorption in 33 of them, with hip range of motion recovering back to baseline. 27 of 32 (84.4%) cases with femoral nerve injury got quadriceps strength above 4/5 grade, 20 cases of femoral nerve injury (62.5%) still had numbness on front of their thigh after treatment.

CONCLUSIONSIn this cohort of iliopsoas bleeding, most of the patients are adolescent. High prevalence of the femoral nerve injury and the secondary knee bleeding are found. Rehabilitation treatment under the support of factor replacement is safe and effective on hematoma absorption and neurological function recovery.

Adolescent ; Adult ; Child ; Hematoma ; etiology ; rehabilitation ; Hemophilia A ; complications ; rehabilitation ; Hemorrhage ; etiology ; rehabilitation ; Humans ; Male ; Middle Aged ; Muscular Diseases ; diagnosis ; etiology ; rehabilitation ; Psoas Muscles ; physiopathology ; Retrospective Studies ; Young Adult