Objective:To investigate the relationship between hyper-homocysteinemia ( HHcy) and experiment autoimmune en-cephalomyelitis (EAE) mice,and to study the cause and effect of HHcy in multiple sclerosis (MS).Methods: Four groups were included in this study:healthy C57BL/6 mice and EAE mice fed with chow(HC and EAE group),healthy mice and EAE mice supple-mented with 4%(w/v) methionine in the drinking water (HC+Hcy and EAE+Hcy group).Clinical symptoms,the levels of Hcy and cytokines ( TNF-α,IFN-γand IL-17) were evaluated at different time points.Results:EAE group had no greater Hcy than HC group ( P>0.05 ).The clinical scores and weight loss of mice from EAE+Hcy group were more severe than those from EAE group during the course of EAE ( P<0.05 ).EAE+Hcy group had higher levels of TNF-αand IFN-γthan EAE group ( P<0.05 ) ,while IL-17 was about the same.Conclusion:Mice do not have gradually increased Hcy during the course of EAE.HHcy worsen the symptoms of EAE by pro-moting the production of TNF-αand IFN-γ,but not IL-17.

Objective To explore the effects of p38 mitogen-activated protein kinase (MAPK) on apoptosis of small intestinal epithelial cells after transplantation in rats. Methods Small intestinal transplantation was performed in SD and Wistar rats. The recipients were divided into three groups: isograft group (Wistar→Wistar group), allograft group (SD→Wistar group) and allograft+cyclosporine A group (SD→Wistar+CsA group). The grafts were harvested on day 1, 3, 5 and 7 after operation. All graft samples were subjected to histological examination. The apoptosis of graft epithelial cells was detected by TUNEL method. p38 MAPK was measured by Western-blotting method and serum TNF-? was determined by ELISA. Results Mild, moderate and severe rejection reaction occurred in the SD→Wistar group, it was showed that the number of apoptotic cells increased with the severity of the rejection reaction by TUNEL. In SD→Wistar group, the numbers of apoptotic cells were significantly higher than those of the other two groups (P0.05). The expression of p38 MAPK and the level of serum TNF-? were positively correlated with apoptosis in small intestinal rejection after transplantation (r=0.875, P

0.05), but in Wistar→SD group and Wistar→SD+CsA group, the serum IL-1? (levels) (increased) as the number of apoptotic cells increased(P

Objective To investigate the surgical techniques and clinical efficacy of laparoscopic intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods A retrospective descriptive study was performed.The clinical data of 12 patients who underwent laparoscopic low rectal anterior resection combined with ISR at the First Affiliated Hospital of Dalian Medical University from May 2014 to October 2014 were collected.The patients underwent abdominal operation including total mesorectal excision (TME) + sphincter mobilization,then transanal intersphincteric resection,finally colinic anal-anal anastomosis.The operation time,volume of intraoperative blood loss,number of lymph node dissected,postoperative complications,time to anal exsufflation,duration of hospital stay,duration of postoperative hospital stay,pathological stage and follow-up were observed.The patients were followed up by outpatient examination and telephone interview at month 1,3 and 6 after operation up to April 18,2015.The follow-up included the prognosis of patients and the recovery of anal function.The function of defecation was evaluated by Wexner scoring system and Kirwan grading.Measurement data with normal distribution were presented as (x) ± s.Results All the 12 patients were completed laparoscopic surgery without conversion to open surgery.Eight patients underwent partial internal anal sphincter resection,and 4 underwent subtotal resection.Four patients in T3 stage underwent lateral lymph node dissection preserving the left colonic artery,hypogastric nerve and pelvic nerve.The operation time was (290 ± 35) minutes.The volume of intraoperative blood loss was (124 ± 80) mL.The number of lymph nodes dissected was 17 ± 8,and the number of positive lymph nodes was 0-4.The distance of the distal margin was (2.0 ± 0.5) crm,and the margin was negative.All the 12 patients were not complicated with infection,bleeding,anastomotic leakage,anastomotic stenosis and other complications.The time to postoperative anal exsufflation was (3 ± 1)days,duration of hospital stay was (20 ± 3) days,and duration of postoperative hospital stay was (12 ± 3) days.The results of TNM stage showed 3 cases of pT1 stage,5 cases of pT2 stage,4 cases of pT3 stage,10 cases of pN0 stage,1 case of pN1 stage,1 case of pN2 stage,8 cases of Ⅰ stage,2 cases of Ⅱ stage and 2 cases of Ⅲ stage.All the 12 patients were followed up for 6-11 months.The defection frequency and the Wexner score at month 1,3 and 6 after operation were 12 ±7,15 ±3,9 ±5 and 13 ±4,5 ±3,10 ±3,respectively.Of the 12 patients,the number of patients with satisfactory Kirwan score,flatus incontinence and loose stool was 1,3,8 at month 1 after operation,3,3,6 at month 3 after operation,10,2,0 at month 6 alter operation,respectively.Conclusion Laparoscopic ISR is effective in the treatment of low rectal cancer.

Reduced surgery for early gastric cancer has been actively performed because it can offer complete cure and a good postoperative quality of life.Pylorus-and vagus-preserving gastrectomy (PPG) is one form of function-preserving surgery.Laparoscopic surgery has been widely applied for the treatment of gastric cancer due to its advantages including low invasiveness,minimal bowel paralysis,earlier postoperative healing and nerve and gastric function preservation.Therefore,laparoscopic pylorus-and vagus-preserving gastrectomy (LAPPG) for the treatment of early gastric cancer is welcomed by surgeons.From May 2004 to April 2013,12 patients with early gastric cancer received LAPPG in the First Affiliated Hospital of Dalian Medical University.All the patients were followed up for 3-74 months.One patient died of gastric cancer liver metastasis at postoperative month 22.The 5-year cumulative survival rate was 86％.LAPPG preserves nerve function and limits surgical injury,it is one of the ideal surgical methods for the treatment of early gastric cancer.

Adult ; Carbodiimides ; poisoning ; Humans ; Male ; Methylamines ; poisoning ; Occupational Exposure ; Young Adult

BACKGROUND: Myasthenia gravis (MG) patients with thymoma were often neglected in clinical work and delayed the therapy.OBJECTIVE: To investigate the significance of the Ryanodine receptor (RyR) antibody on the assessment of MG.DESIGN: A case analysis.SETTING: Institute of neurology in a hospital of a university.PARTICIPANTS: This experiment was carried out in the Institute of Neurology, Fudan University from June 1999 to March 2002. There were 66 MG patients with thymoma(MGT group), 98 MG patients with non-thymoma (NTMG group), 50 patients with non-myasthenia gravis(NMG) and 123 normal persons (NC group).METHODS: Sarcoplasmic reticulum(SR) abounded in RyR was extracted with differential centrifugation, in order to establish a detecting system of ELISA-RyR-RyR antibody (RyR-ab).MAIN OUTCOME MEASURES: The levels of RyR-ab in serum of researched subjects.RESULTS: Positive rate of RyR-ab in MGT group was higher than that in NTMG and NMG groups(P ＜ 0.01), moreover, the sensitivity and the specificity were 81.8% and 94.5% respectively. The positive rates of MGT groups with different thymus histology were no significant difference(P＞ 0.05). Ages, clinical scores and levels of acetylcholine receptor antibody (AchR-ab) in patients with positive RyR-ab were higher than those in patients with negative RyR-ab( P ＜ 0.01 ) in MG group. The levels of RyR-ab was positive correlated with the severities of clinical symptoms in MG patients, especially the patients in MGT group( r = 0. 626, P ＜ 0.01) . And among the different histological types of MGT, thymoma of epithelioid cells has the highest correlation coefficient ( r = 0. 592, P ＜ 0. 01).CONCLUSION: The detection of RyR-ab has better sensitivity and specificity for the diagnosis of MGT and the levels of RyR-ab is positive correlatied with the severities of MG patients.

Child ; Diabetes Mellitus, Type 1 ; genetics ; Female ; Humans ; Infant ; Male ; Siblings

Objective To evaluate the significance to detect the Ryanodine receptor (RyR) antibody in the sera of myasthenia gravis (MG) patients.Methods Sarcoplasmic reticulum abound with RyR was extracted by centrifugation,and levels of antibodies in 66 MG patients with thymoma (MGT),98 non-thymoma MG (NTMG) patients,50 non-myasthenia gravis (NMG) patients and 123 normal persons were examined by ELISA-RyR method.Results RyR antibody positive rate of MGT was the highest among MGT,NTMG and NMG groups ( P 0.05).Ages,clinical scores and levels of acetycholine receptor antibodies of patients with RyR antibody positive sera were higher than those with RyR antibody negative sera ( P

Objective To investigate the percentage of Th17 cells and regulatory T cells in patients with myasthenia gravis (MG) and observe the effects of methylprednisolone infusion on these cells.Methods The circulating Th17 cells and CD4+ CD25highT cells of 66 MG patients and 35 healthy controls were detected using four colour cytometry. The relationship between these cells and MGFA score in 18 MG patients and in 8 MG patients after methylprednisolone was infusion were also analyzed in this study. Results There was significant difference in the percentage of circulating Th17 cells between MG patients (2. 61% ±0. 28% ) and the healthy controls (0. 94% ± 0. 12%, Z = 4. 059, P = 0. 0001 ). Methylprednisolone therapy significantly reduced the percentage of circulating Th17 cells from 4. 72% ± 1.21% to 1.81% ± 0. 69%(Z = 1. 995,P = 0. 0460). In addition, the percentage of Th17 cells showed a positive correlation with MGFA score(r =0. 5359, P =0. 0219). Conclusions Circulating Th17 cells are elevated in MG patients.Methylprednisolone therapy can reduce such elevation, and this may be important in mediating symptomatic improvement in MG patients.