Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

Objectives To explore the relationship of orthostatic hypotension in elderly hypertensive patients with left ventricular structure and function.Methods 101 cases of elderly patients with hypertension were selected from July 2013 to June 2015.After blood pressure measurement in vertical and decubitus position,all patients were divided into non-orthostatic hypotension and orthostatic hypotension groups,received the echocardiography and the accurate calculation of left ventricular mass index.Results Compared with non-orthostatic hypotension,orthostatic hypotension in patients with left ventricular diastolic diameter,left ventricular posterior wall thinckness and interventricular septum thickness.Left ventricular mass index significantly increased(48.13±5.54)mm vs.(52.45 ± 1.48)mm in left ventricular diastolic diameter,(10.08± 1.87)mm vs.(11.29± 1.98)mm in left ventricular posterior wall thickness,(10.18± 1.88)mm vs.(11.61±1.66) mm in interventricular septum thickness,and (114.59 ± 22.72) g/m2 vs.(131.98 ± 23.43)g/m2 [t=4.386、2.985、4.397、8.672,in left ventricular mass index(BMI),all P＜0.05].Left heart ventricular ejection fraction and mitral peak early/late diastolic blood flow decreased [(60.81 ± 4.73)vs.(53.60±2.58)and(0.93±0.23)vs(0.76±0.26)t=4.298、3.654,all P＜0.05].Conclusions There is relationship of orthostatic hypotension with left ventricular structure and function in elderly hypertension patients,and it is essential not only to control blood pressure effectively,but also to focus on controlling orthostatic hypotension.

Objective To provide experimental evidences for developing a safe and effective re- combinant fowlpox virus which can prevent the infection of HIV-2.Methods A fowlpox virus(FPV) transferring vector was constructed by inserting HIV-2 gag gene to the downstream of a synthetic complex promoter ATI-p7.5?20 of vector pUTA2.Transfection was then carried out,and recombi- nant FPV(rFPV)was screened by 5'-bromo-deoxyuridine(BrdU),genome PCR and western blot detection.Balb/c mice were immunized with rFPV by muscular injection.Anti-HIV-2 antibody, CD4~+ and CD8~+ T-cell count and specific target-killing activity of spleen CTL in immunized mice were analyzed by ELISA,FACS and LDH release assay,respectively.Results A transferring vector pA- gag was constructed and confirmed by amplifying a fragment of 766 bp from the rFPV genome.Mean- while,HIV-2 multi-antibody-specific protein blot(55 000)was detected from the recombinant virus and the HIV-2 specific antibody was detected from the immunized Balb/c mice.HIV-2 specific target- killing activity of spleen CTL was observed in immunized mice.Conclusion A recombinant fowlpox virus expressing HIV-2 structural protein Gag has been obtained,and it can stimulate HIV-2-specific eelluar and humoral immune reactions in mice.

Objective To evaluate the diagnostic procedures and treatment choice of primary malignant tumor of the duodenum.Methods The clinical data of 54 cases with primary malignant tumor of the duodenum at Peking University People's Hospital from 1995 to 2005 were analyzed retrospectively.Resuits Tumors located in the first,second,third and fourth parts in 6 cases(10%),44 cases(82%),2 cases(4%),and 2 cases(4%)respectively,and among them,tumors within papillary area accounted for 86%(38 cases)of all cases.Fifty cases(92%)were of adenocarcinoma,2 cases(4%)of mucinous adenoearcinoma carcinoid and undifferentiated carcinoma for 1 case each(2%)respectively.The main clinical presentations included jaundice,upper abdominal pain,weight loss,abdominal distention,nausea and vomiting.gastrointestinal obstruction and abdominal mass.The accuracy rate of duodenoscopy and ERCP in preoperative diagnosis was 94%,and 78%respectively.Preoperative associated cholecystopathy accounted for 37%.Panceaticoduodenectomy was performed in 38 cases,duodenectonmy in 1 ease,palliative resection of tumor in 9 cases,and tumor was inoperable in 6 cases.Resection rate was 89%,and radical resection rate was 72%.The postoperative 3-and 5-year survival rate was 41%and 22%respectively.Patients after palliative resection died from 3 months to 24 months and all patients who did not undergo a surgery died within 6 months.Conclusions Tumors located in papillary region account for the majority of primary malignant tumors of the duodenum and are mainly of adenocarcinoma.Specific signs on abdominal examination are few.The symptoms of advanced stage are complicated,associated cholecystopathy is relatively frequent.Endoscopy and ERCP examination are the main diagnostic tools.the pancreatoduodenectomy is the first choice of therapy for patients with primary duodenal carcinoma.

Objective To investigate the effect of thalidomide on the proliferation of as well as the expression and secretion of vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α) by the human keratinocyte cell line HaCaT.Methods Cultured HaCaT cells were divided into several groups to be treated with dimethyl sulfoxide (negative control group) and various concentrations (0.01nmol/L-100 μmol/L) of thalidomide (experimental groups) respectively for 20 to 24 hours.Subsequently,water soluble tetrazolium-1(WST-1) assay was performed to estimate cellular proliferation,real time quantitative PCR to detect the mRNA expression of VEGF and TNF-α in HaCaT cells,and enzyme-linked immunosorbent assay (ELISA) to quantify the protein expressions of VEGF and TNF-α in the culture supernatants of HaCaT cells.Statistical analysis was done by one-way analysis of variance with least significant difference post hoc test.Results The survival rate of HaCaT cells was 74.3％,82.9％ and 90.8％ after 24-hour treatment with thalidomide of 100,10 and 1 μmol/L respectively,significantly lower than that in the negative control group (100％,all P ＜0.01).A significant decrease was induced in the mRNA expression (0.439-to 0.634-fold change,all P ＜0.01) and supematant level ((0.587-to 0.923-fold change,P ＜0.05) of VEGF in HaCaT cells by thalidomide of 0.01-100 nmol/L,as well as in the mRNA expression (0.493-to 0.587-fold change,P ＜0.05) and supernatant level (0.408-to 0.617-fold change,P ＜0.01) of TNF-α by thalidomide of 0.1-100 nmol/L.Conclusion Within a certain range of concentration,thalidomide could suppress the proliferation of,as well as the expression and secretion of VEGF and TNF-α by,HaCaT cells.

Objective To evaluate the relationship of serum levels of interleukin (IL)-36α,IL-36β and IL-36γas well as their receptor antagonist IL-36Ra with disease severity in patients with psoriasis.Methods Venous blood samples were collected from 45 patients with generalized pustular psoriasis (GPP),34 patients with psoriasis vulgaris (PV),and 37 healthy human controls.Enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum levels of IL-36α,IL-36β,IL-36γ and IL-36Ra.Nonparametric Mann-Whitney test was conducted to compare the levels of IL-36 and IL-36Ra among these groups,and Spearman's rank correlation analysis to assess the relationship between the serum levels of IL-36 and IL-36Ra and disease severity.Results No statistical difference was observed in the serum levels of IL-36 or IL-36Ra among the patients with GPP,patients with PV,and healthy human controls.The serum levels of IL-36β and IL-36γ (given as the median ± interquartile range) were significantly higher in 27 patients with GPP during episodes of pustules ((12.101 ± 11.315) ng/L and (34.541 ± 15.580) ng/L respectively) and in 7 patients with severe GPP ((11.218 ± 9.318) ng/L and (38.536 ± 17.332) ng/L respectively) than in the healthy human controls ((5.355 ± 9.020) ng/L and (23.052 ± 22.410) ng/L respectively,P ＜ 0.05 or 0.01).The serum level of IL-36γwas positively correlated with that of IL-36β in patients with GPP,patients with PV,and the healthy human controls (r =0.85,0.86,0.91,respectively,all P ＜ 0.01),and both IL-36β and IL-36γserum levels were lowly and positively correlated with the severity of GPP (r =0.33,0.41,respectively,both P ＜ 0.05).A positive correlation was also observed between the serum level of IL-36β and psoriasis area and severity index (PASI) scores in patients with PV (r =0.54,P ＜ 0.01).Conclusions The serum levels of IL-363 and IL-36γ are lowly and positively correlated with disease severity in patients with GPP,suggesting that IL-36β and IL-36γplay an important role in the pathogenesis of GPP.

Purpose To study the clinicopathologic features, immunophenotype and differential diagnosis of solid papillary carcinoma (SPC) of breast.Methods 73 cases of breast SPC with or without invasive carcinoma were collected, and the clinical data and histopathologic features were analyzed with further investigation of transmission electron microscopy and immunohistochemical staining (EnVision method). Selected antibodies included cytokeratin (CK), myoepithelial markers, neuroendocrine markers, proliferation marker Ki-67 and ER,PR,c-erbB-2,etc.Results All the patients were females with mean age of 64.7 years.The presenting symptoms were either a palpable breast mass or nipple discharge.Metastasis was observed in 43 cases who had undergone axillary lymph node dissection. Histologically, the tumor displayed a solid-papillary growth pattern, with mucin production demonstrated in 25 cases. Intraductal papilloma was not uncommon at the peripheral area of the tumor. The tumor cells were polygonal, oval, spindled or signet ring-like and contained abundant eosinophilic to granular cytoplasm and mildly to moderately pleomorphic nuclei. More than 5 mitotic figures/10 HPF were observed in 51 cases. 43 cases contained foci of invasive carcinoma which showed similar cytologic features as those of in-situ component. Immunohistochemical study showed that the tumor cells were negative for basal cell cytokeratin; positivity for smooth muscle actin-alpha and p63 were demonstrated in the myoepithelial layers of fibrovascular cores, as well as around the expanded ductolobular units.Most cases also showed cytoplasmic positivity for chromogranin A (89.0%), synaptophysin (86.3%) and neuron-specific enolase (95.9%).The proliferatiing index, as highlighted by Ki-67 imnunostaining, was 9.2%.The tumor mainly expressed estrogen receptor and progesterone receptor. The staining for c-erbB-2 oncoprotein was negative in the most cases. Neuroendocrine granules were seen under transmission electron microscope in the cytoplasm.Conclusions SPC represents a subgroup of low-grade ductal carcinoma in situ.SPC predilection in older women is associated with mucinous and neuroendocrine components. Follow-up data suggest that SPC has a good prognosis.

Objective To study the possible relationships between expression of matrix metalloproteinase(MMP)2,9 and the pathogenesis of preeclampsia in which trophoblast invasion is impaired. Methods MMP-2,9 expression were detected by immunohistochemistry streptavidin-biotin complex (SABC)method in 20 normal term placentae and 20 preeclampsia placentae,respectively.In addition, mRNAs for MMP-2,9 were analyzed by real time PCR in both groups.Results The intensities of both MMP-2 and MMP-9 immunostaining in preeclampsia placentae were significantly declined compared to those of normal term placentae(P

Objective To investigate the features of MR imaging of acute high voltage electric injury in forearm muscle. Methods Nine patients (17 forearms, 8 males and 1 female, 15～36 years of age) with clinically and pathological proved acute high voltage electric injury were studied on MRI retrospectively. MRI studies were obtained within 72 hours on Siemens 1 0 T MR scanner. 2 forearms were examined with body coil, and 15 with head coil. The severe area was placed as near as possible to the isocenter in the magnet and was used as the center of the MR imaging acquisition. Spin echo T 1 weighted images, spin echo and fast spin echo T 2 weighted images were acquired in all patients. 14 out of 17 were performed with Ⅳ administration of Gd DTPA. Results All 17 forearms had fascistomy after MRI. 11 had only debridement. The lesions were mainly observed in the flexor digitorum supericialis or profunduds muscle appearing as isointense on T 1 weighted images, hyperintense on T 2 weighted images, and strongly enhanced after Ⅳ administration of Gd DTPA in 8. The proximal aspect of the lesion appeared as sharp knife in 11. There was a weaker twitch response to electrocauterization in the injury muscle than in healthy muscle. It was variably necrotic in histopathology. Two transitional zones accompanied with the suffered forearm in 2, and one transitional zone in 6. Both of them had well defined margin. 6 forearms had amputation after debriding. There was Ⅰ,Ⅱ,and Ⅲ mixture signal all over the forearms. The proximal lesions showed type Ⅰ changes. Distal to the zone of forearm showed type Ⅱ and Ⅲ pattern appearing as isointense on T 1 weighted images, hyperintense and hypointense on T 2 weighted images. It was hardly enhanced after Ⅳ administration of Gd DTPA. There was no twitch response to electrocauterization in the injury muscle. It was almost completely necrotic in histopathology. ALL amputated forearms had two transitional zones and ill defined margin. The second transitional zone was enhanced something like flower border. Conclusion MR imaging of acute high voltage electric injury in forearm appeared as three kinds of signal mode, which was closely related with histopathology. MRI was useful in dealing with clinic problem and in judging the prognosis.

AIM To study the therapeutic effects of Deketoprofen trometamol (D KPT) on adjuvant arthritis (AA) and its side effects on gastroduodena. METHEDS The change of primary and secondary inflammatory and the injury effect of gastroduodena treated with D KPT were observed. The effect of D KPT on prostaglandin E 2 (PGE 2) produced by peritoneal macrophage (PM) on AA rats in vitro was also observed. RESULTS D KPT (2 5, 5, 10 mg?kg -1 ) significantly inhibited primary inflammatory, secondary inflammatory and multiple arthritis of AA rats. D KPT(10 -8 ,10 -7 ,10 -6 ,10 -5 ,10 -4 mol?L -1 )inhibited the elevated PGE 2 released from PM of AA rats in vitro . D KPT (10 mg?kg -1 ) significantly injured gastroduodena on AA rats, but the degree of injuries was less than that of ketoprofen (KP) (10 mg?kg -1 ). CONCLUSION D KPT has therapeutic effects on AA rats, and its injury effect on gastroduodena is less than that of KP.