BACKGROUND: As the selective susceptible region following cerebral injury, hippocampus was found to be more sensitive to the extrinsic stimulation which would stimulate hippocampus region, then result in post-traumatic excessive expression of some immediate early genes, over release of excitatory amino acid and delayed death of nerve cells.OBJECTIVE: To study the relationship between the expression of nitrogen monoxide (NO) and endothelin and the apoptosis of nerve cell in cerebral hippocampus region following brain laceration.DESIGN: A comparative study based on paired t test and multiple linear correlative analysis.SETTING:Neurosurgery Department of Kailuan Hospital Affiliated to Northern China Coal Medical College.MATERIALS:This study was carried out at Molecular Biological Laboratory of Northern China Coal Medical College, from February to June 2003. Totally 126 healthy male Wistar rats, grade two, with body mass of 250-350 g,were randomly divided into three groups: experimental group and control group of 60 rats, normal group of 6 rats, moreover the experimental group and control group were subdivided into 0.5 hour, 1 hour, 3 hours, 6 hours,12 hours, 24 hours, 72 hours, 120 hours, 168 hours, 240 hours time point subgroups with 6 rats in each subgroup.METHODS: Left parietal lobe laceration model was established on experimental rats by modified Feeney's free-drop traumatic method; rats in control group were only subjected to parietal skull opening without injury; rats in normal group were received no treatment. The level of Serum NO and endothelin, as well as the number of apoptosis nerve cell at hippocampus region were detected at each time point by using nitric acid deoxidase method, ELISA and in situ terminal labeled technique(TUNEL).MAIN OUTCOME MEASURES: Level of serum NO and endothelin,apoptosis of nerve cells in hippocampus region following brain laceration.RESULTS: Data of 126 rats were statistically analyzed without loss. ① The expression of serum NO, endothelin and apoptosis of nerve cells in hippocampus region of experimental rats: All amounted to the peak level at post-Iaceration 6 hours [(81.45±2.41) mmol/L, (20.29 ±1.63) ng/L], which began to decline from onset of 12 hours [(66.11±1.97) mmol/L, (20.14±1.63)ng/L]. The level of NO at each time point from post-laceration 0.5 hour to 120 hours, and the level of endothelin of from 0.5 hour to 168 hour were significantly higher in experimental group in contrast with normal group and control group (t=3.33-27.91, P ＜ 0.01). ② The apoptosis of nerve cells in hippocampus region of experimental rats: The apoptosis reached to the top at post-laceration 168 hours (27.33±l.86)x102/mm2, which began to decline at 240 hours (21.67±2.07) ×l02/mm2. No apoptosis cells could be observed in normal hippocampus, and less in control group. ③ The correlation of the level of NO and endothelin with the number of apoptosis of nerve cells in hippocampus region: There was obviously positive correlation (r=0.838, P ＜ 0.01; r=0.281, P ＜ 0.05).CONCLUSION: There are definite correlation between the level of NO and endothelin and the number of nerve cells of apoptosis at hippocampus following cerebral laceration. NO and endothelin interacted each other,which involved in the pathophysiological process of cerebral laceration, and consequently resulted in the apoptosis of nerve cells in hippocampus region.

Objective To evaluate the changes in the expression of NRF-1 in the spinal cord during remifentail-induced hyperalgesia in a rat model of incisional pain.Methods Forty-eight Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C); incisional pain group (group Ⅰ); remifentanil group (group R); incisional pain + remifentanil group (group Ⅰ + R).All the rats were anesthetized with sevoflurane.A 1-cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hindpaw in I and I + R groups.In C and I groups,normal saline was subcutaneously infused for 30 min.In group I + R,remifentanil (0.04 mg/kg,0.4ml) was subcutaneously infused for 30 min starting from the onset of skin incision.Paw withdrawal threshold to mechanical stimulation (PWMT) was measured at 24 h before operation and at 2,6,12,24 and 48 h after operation.After measurement of PWMT at 48 h,the rats were sacrificed and L4,5 segments of the spinal cord were removed rapidly to detect the expression of nuclear respiratory factor 1 (NRF-1) by immunofluorescence and Western blot.Results Compared with group C,PWMT was significantly decreased at each time point after operation,and the expression of NRF-1 in the spinal cord was up-regulated in I and I + R groups (P ＜ 0.05).Compared with group I,PWMT was significantly decreased at each time point after operation,and the expression of NRF-1 in the spinal cord was up-regulated in group I + R (P ＜ 0.05).Conclusion Up-regulation of NRF-1 expression in the spinal cord may be involved in the development of remifentail-induced hyperalgesia in a rat model of incisional pain.

Adult ; Femur Head Necrosis ; chemically induced ; drug therapy ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Paraquat ; poisoning

Objective To evaluate the association between R353Q polymorphism of the coagulation factor Ⅶ gene and cerebral infarction in Chinese Han people. Methods Restriction fragment length polymorphism(PCR-RFLP) methods was adopted to detect FⅦR353Q genotype and R、Q allelomorphie gone frequency of 100 cerebral infarction(CI) patients and 106 healthy people. Results There was FⅦR353Q polymorphism in the CI patients and healthy subjects. RR and RQ genotype could be found in the control group and CI group. RR and RQ genotype dis-position consistented with Hardy-weinberg equilibrium. In CI group,RR genotype was in 91 cases,RQ was in 9 cases and QQ in 0 case(the distribution frequencies were 91.00% ,9.00% and 0), and in the healthy subjects, those are 94 cases, 12 cases and 0 case(88.70% ,11.30% and 0). In the control group and CI group,R allele genotype fre-quencies were 94.33% and 95.50%, and Q were 5.67% and 4.50%. There was not significantly different in the R353Q polymorphism (χ20.3027, P=0.5822);Q allele genotype was not significantly different between the cases of control group and CI patients(χ20.2865, P=0.5925). Conclusion There are the FⅦR353Q polymorphism in Han population,however,the idea that the Q allele is a protective factor in CI is not supported.

Objective To explore the effects of adriamycin-loaded immuno-nanoparticles on multidrug resistance (MDR) of hepatoma cell line SMMC-7721/ADM. Methods The cytotoxicity of the adriamycin-loaded immuno-nanoparticles on the bepatoma cell line SMMC-7721/ADM in vitro and the tumor cell-binding ability of adriamycin-loaded immuno-nanoparticles were detected. Results The effect of the cytotoxicity of adriamycin-loaded immuno-nanoparticles on the hepatoma cell line SMMC-7721/ADM was significantly better than that of adriamycin-loaded nanoparticles. Adriamycin-loaded immuno-nanoparticles had the specific binding ability with the hepatoma cell line SMMC-7721/ADM. Conclusions Adriamycin-loaded immuno-nanoparticles can overcome the MDR of the tumor in vitro. The mechanism may be that immuno-nanoparticles could adhere to the tumor cell membrane, and the release of the loaded adriamycin creates a high local concentration in the extracellular medium. The increased concentration gradient improves the diffusion of adriamycin from the extracellular medium to the intracellular medium.

Objective To evaluate the value of ultrasonographic measurement of the antral crosssectional area (CSA) in assessing the preoperative gastric content volume in preschool pediatric patients.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged ＜7 yr,undergoing elective non-gastrointestinal surgery,were fasted according to the preoperative fasting guidelines recommended by American Society of Anesthesiologists.Sedation was performed with intravenously injected midazolam or with intravenously injected midazolam and propofol after admission to the operating room.The antral CSA in the supine and right lateral decubitus positions was measured using bedside ultrasonography and free tracing method.A gastric tube was inserted after gastric sonography to collect the gastric fluid,and the total volume of the gastric fluid was considered to be the gastric content volume.Results Six pediatric patients were excluded due to the unsatisfactory ultrasound image,and 44 pediatric patients were included.Gastric content volume and gastric content volume per kilogram of body weight were positively correlated with the antral CSA in the right lateral decubitus position,and the Spearman correlation coefficients were 0.48 (P＜0.01) and 0.37 (P＜0.05),respectively.There was no correlation between gastric content volume and gastric content volume per kilogram of body weight and the antral CSA in the supine position (P＞0.05).Conclusion Ultrasonographic measurement of the antral CSA in the right lateral decubitus position can be used to assess the preoperative gastric content volume in preschool pediatric patients.

OBJECTIVE: To investigate the clinical effects of the combined modality therapy for the patients with difficult-to-treat rhinosinusitis (DTRS). METHOD: The clinical data involving 42 patients with DTRS were analyzed retrospectively. All patients received revision endoscopic sinus surgery (ESS) and combined modality therapy systematically and individually. The clinical effects of all patients were observed 6- and 12-month following revision ESS. RESULT: Forty-two patients were followed up for 6 months, whereas 35 patients were followed for 12 months post operation. VAS scores of the patients significantly improved (P < 0.01) 6- and 12-month after revision ESS, but there was no statistic difference (P > 0.05) between 6- and 12-month post operation. Moreover, Lund-Kennedy scores by endoscopy significantly improved (P < 0.01) 6- and 12-month following ESS. Similarly, there was no statistic difference (P > 0.05) between 6- and 12-month postoperatively. Additionally, within 6 months follow-up, 16 of 42 patients (38.1%) were cured, 19 of 42 patients (45.2%) were improved, and 7 of 42 patients (16.7%) were ineffective. The total effective rate in all patients was 83.3% 6 months postoperatively. While within 12 months follow-up, 11 of 35 patients (31.4%) were cured, 15 of 35 patients (42.9%) were improved, and 9 of 35 patients (25.7%) were ineffective. Hence, the total effective rate in 35 patients was 74.3% after 12-month follow-up. There was no statistic difference (χ² = 1.019, P > 0.05) between 6- and 12-month postoperatively. CONCLUSION Appropriate revision ESS plus the combined modality therapy has been proven to be an effective method for the treatment of DTRS. The clinical effects in this study are significant and stable, and thus it is worthy of further clinical applications.
Combined Modality Therapy ; Endoscopy ; Humans ; Nasal Surgical Procedures ; Paranasal Sinuses ; surgery ; Postoperative Period ; Reoperation ; Retrospective Studies ; Rhinitis ; surgery ; therapy ; Sinusitis ; surgery ; therapy ; Treatment Outcome

AIM:To study the relationship between expression of p53 protein and AgNORs count and histological grade in pancreatic adenocarcinoma.METHODS:Fifty-six patients with pancreatic adenocarcinoma and 25 normal pancreatic tissue were examined for mutant P53 protein by immunohistochemistry,silver binding nucleolar organizer regions(AgNORs)were counted in cancer cells,and histological grade was observed in pancreatic adenocarcinoma.RESULTS:P53 protein positive expression was 50% in pancreatic adenocarcinoma,P53 protein expression was negative in all normal pancreatic tissue.There is a significant difference in P53 expression between normal pancreatic tissue and pancreatic adenocarcinoma tissue.The mean AgNORs count was 9.14?2.08 in group with P53 protein positive expression,and 5.99?1.84 in group with P53 protein negative expression group.The P53 expression was associated with AgNORs significantly.The P53 expression was significantly related with histological grade,and AgNORs count was also significantly related with histological grade.CONCLUSION:P53 may be closely related to carcinogenesis and development of pancreatic adenocarcinoma.P53 protein expression and AgNORs count might be a useful prognostic factor in pancreatic adenocarcinoma.

Objective To investigate the prognostic relevant factors of hepatocellular carcinoma (HCC) in recipients following liver transplantation (LT).Methods The clinical data of 147 cases of HCC undergoing LT between Aug. 2004 and Feb. 2011 in Nanfang Hospital were studied retrospectively.Those of significance in 14 relevant factors involving gender,age,blood-type,CTP,model of end-stage liver disease (MELD),alpha-fetoprotein (AFP),tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and microvascular invasion (MVI),HCC histology differentiation,which were based on univariate analysis with Log-Rank,were analyzed by means of Multivariate Cox proportional hazard regression model to screen out independently relevant ones.Results 143 cases were followed up.The follow-up duration ranged from 6 to 84 months.The 1- and 3-year cumulative survival rate was 75.2％ and 54.7％ respectively.The tumor free 1- and 3-year cumulative survival rate was 70％ and 59％ respectively.Univariate ananlysis revealed that age,AFP,tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and MVI had significant difference, In a Cox model,MVI,macrovascular invasion and AFP≥ 400 μg/L were independent prognostic factors.Conclusion MVI,macrovascular invasion and AFP are the main prognostic risk fators.Intervention and non-tumor technique should be performed preoperatively and intraoperatively,respectively.

Objectives To evaluate the predictive value of the revised model for end-stage liver disease in the clinical early stage after liver transplantation.Methods The clinical data of 218 patients were retrospectively analyzed.After calculating the MELD score,ReFit MELD score and ReFit MELDNa score before transplantation,we compared the predictive accuracies of these scoring systems using the area under curve (AUC) of the receiver operating characteristic.The groups were categorized with the cut-offs of the MELD,ReFit MELD and ReFit MELDNa,and the early-stage complications and mortality in the different groups were analyzed.Results The AUC for the MELD,ReFit MELD and ReFit MELDNa were 0.737 (95％CI 0.621～0.854),0.727 (95％CI 0.663～0.785) and 0.735 (95％CI 0.671～0.792),respectively.There was no statistical difference is the AUC among the MELD,ReFit MELD and ReFit MELDNa.Elevated scores in the 3 models predicted higher rates of pulmonary infection,abdominal infection and acute renal dysfunction,as well as a higher mortality.Conclusions The ReFit MELD score and ReFit MELDNa score were relatively useful predictors of short-term survival rates after liver transplantation.The predictive accuracy was similar to the MELD score.Values of the score above the cutoff values indicated higher rates of complication and poorer prognosis.