Adult ; Blood Viscosity ; Coronary Disease ; blood ; Diabetes Mellitus ; blood ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional

Objective To analyze the clinical data of patients with penicilliosis marneffei(PSM),summarize clinical characteristics of serosal involvement and provide experience to diagnose and treat serous effusion.Methods We retrospectively analyzed 61 patients with estabolished PSM infection in our hospital from March,2001 to March,2008.Patients were divided into positive groups while presented one or more abnormal serous effusion such as pleural effusion,ascites,pericardial effusion or cerebrospinal fluid.There were ten patients in positive groups finally,including nine male and one female whose ages ranging from 36yr to 67yr[mean(54.2?8.3)yr].Results(1)There were ten cases with pleural effusion,including two cases with pericardial effusion,five cases with ascites and two cases with abnormal cerebrospinal fluid.Ten cases were misdiagnosed as tuberculous pleurisy and accepted anti-tuberculosis treatment,two cases as tuberculous meningitis,two cases as tuberculous pericarditis,five cases as tuberculous peritonitis and five cases as malignant pleural effusion.(2)All patients manifested with fever,anemia,hypodynamia or emaciation,nine cases with cough,eight cases with chest pain,six cases with dyspnea,two cases with alvi profluvium,three cases with bellyache,five cases with necrotic papula,eight cases with subcutaneous abscess,nine cases with lymphadenectasis,nine cases with splenohepatomegalia and seven cases with moist rales.(3)Total white blood cells count increase in nine cases which mainly presented with significantly increase in neutrophil count[(17.6?5.3)?109/L]and ratio(0.841?0.048).Lymphocyte ratio was relatively low(0.976?0.035),but count was normal[(1.59?0.7)?109/L].(4)Human Immunodeficiency Viruses was negative in all patients and the CD4/CD8 ratio was 1.19?0.38.(5)Ratio of A/G was inversion in ten cases.Bilirubin,erythrocyte sedimentation rate and C-reactive protein increase in six cases,ten cases and ten cases respectively.Abnormal renal function appeared in five cases.(6)All cases were defined according to etiology including hemoculture(5 cases),medulloculture(2 cases),sputum culture(1 case),abscess secretion culture(4 cases) and histopathology(4 cases).(7)Imaging check demonstrated parenchymatous abnormality in lung(10 cases),splenohepatomegalia or abdominal para-aortic lymphadenectasis(9 cases)and osteolytic damage(6 cases).(8)The property of serous effusion which appeared cloudy yellow or uprightness was exudate.The cell count especially neutrophil count and protein content increased in it.(9)Anti-eumycete medicine were administered to four cases and achieved improvement.Three cases died of respiratory failure,cardiac failure,hepatic and renal failure.Two patient's condition aggravated and one patient voluntarily leaved hospital without treatment.Conclusion Penicilliosis marneffei often occurs in serous cavity of normal immune function crowd.Clinical characteristics manifest with chronic pyogenic and infected diseases which appear significant increase in neutrophil count.It invades lung,abdominal organ and might be complicated with pleural effusion,ascites and abnomal cerebrospinal fluid.The property of effusion is consistent with inflammatory efflusion which can be totally absorbed under effective anti-fungal treatment.Clinical prognosis relates with general body state.

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.

Objective To establish a time resolved fluoroimmunoassay (TRFIA) method for detecting Glypican 3 (GPC3) and to explore the diagnostic value of serum GPC3 for hepatic carcinoma (HCC). Methods Microplate coated with anti-GPC3 monoclonal antibody 7C8 and GP9 labeled with Eu3+ were used to establish TRFIA kit. The serum concentrations of GPC3 in 41 HCC patients and 44 chronic hepatitis (CH) patients were quantitatively analyzed. AFP was detected by with lowest limit of 2.06 μg/L. The CV of inter and intra assay were 12.25% and 12.91%, respectively. The average serum concentration of GPC3 in HCC patients was (86.68±110.39) μg/L (median: 56.98 μg/L). But in CH patients it was only (14.77±29.48) μg/L, which was significantly lower than that in HCC (Wilcoxon W=1335.00, Z=-4.99, P<0.001). With diagnostic cut-off value set at 42.94 μg/L, the diagnostic sensitivity and specificity of TRFIA GPC3 for HCC were 58.5% (24/41) and 95.5%(42/44) respectively. The diagnostic sensitivity of AFP was 46.3% (19/41) in 41 HCC patients, and was raised to 78.0% (32/41) when combined with GPC3. Conclusions Serum GPC3 assay by TRFIA is established and it could increase the diagnostic sensitivity for HCC when combined with AFP.

Objective Our previous study demonstrated that toll-like receptor 2(TLR2) can distinguish extraneous antigen and prevent the immunological response. This study was designed to detect the expression of toll-like receptor 2 (TLR2) mRNA in cornea and investigate the effect of steroid on TLR2 expression in rats cornea following allograft penetrating keratoplasty. Methods The penetrating keratoplasty models were established in SPF rats with the 108 SD rats as receiptors and 36 SPF Wistar rats as donors, and other 6 SPF SD rats worked as normal controls. The receiptor rats were divided randomly into autograft group, allograft group and steriod group. The clarity and neovascularization of corneas of experiment rats were examined under the slit-lamp microscope and the rejection index was calculated based on Holland criteria. Corneal histopathological examination was carried out by hemotoxylin and eosin staining under the light microscope, and real time-PCR was employed for the detect of TLR2 mRNA in the corneas at the fifth, seventh and ninth day after operation. The experimental animals were obtained from the Animal Experimental Center of Southern Medical University and the procedure followed the Statement of Association for Research in Vision and Ophthalmology. Results The rejection occurred in 7 days after operation in allograft group, and only mild edema, opacity and neovascularization of corneas were found at different degrees in 9 days after operation in autograft group and steriod group. Severe corneal edema, a lots of inflammatory cells infiltration and new vessels in stroma were seen in allograft group, and mild inflammatory response was found in autograft group and steriod group. Normal comeal structure was exhibited in normal control group under the light microscope. The fold differences of TLR2 mRNA expression in cornea after amplification was significantly different among three groups and different time points (F_(group) = 39. 46, P = 0. 00; F_(time) =35. 38, P = 0. 00 ; F_(interaction) = 45. 66, P =0. 00), and the evident enhance of TLR2 mRNA expression was revealed in allograft group compared with autograft group (P ＜ 0. 05) and declined in steriod group (P ＜ 0. 05). Conclusion Steriod may restrain the acute allograft rejection by down-regulating the expression of TLR2 in corneas and its signals transaction. This result suggests that steriod offer a protection from rejection of cornea after penetrating keratoplasty.

OBJECTIVETo evaluate the effect of nicotine on cell proliferation.

METHODSThe cells were cultured with DMEM medium containing 10% fetal bovine serum with 0, 1 x 10(-4) mol x L(-1), and 1 x 10(-3) mol x L(-1) nicotine for up to 3, 5, 7, 10, 14 days. The cell proliferation was evaluated by MTT. The alkaline phosphatase (ALP) activity was estimated by PNPP. The expression of collagen type I (COL1) and osteocalcin (OCN) were estimated by reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSNicotine suppressed the cell proliferation. ALP activity increased to peak on 10 days in control and 1 x 10(-4) mol x L(-1) nicotine. COL1 expression increased to peak on 10 days in control and 1 x 10(-4) mol x L(-1) nicotine, but there was decreased to the minimum on 10 days and increased on 14 days in 1 x 10(-3) mol x L(-1) nicotine. OCN expression increased to peak on 10 days in control, and increased in 1 x 10(-4) mol x L(-1) nicontine from 3 days to 14 days, but there wasn't significant change in 1 x 10(-3) mol x L(-1) nicontine.

CONCLUSIONNicotine suppresses osteogenesis through a decrease in ALP and COL1 production by osteoblasts.

Alkaline Phosphatase ; Bone Neoplasms ; Cell Line ; Cell Proliferation ; Collagen Type I ; Humans ; Nicotine ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteosarcoma

OBJECTIVETo investigate the regularity of traditional Chinese compound prescription by observing the clinical effect of the compatibility and dismantlement of Xuefu Zhuyu decoction on blood stasis and stagnation of qi syndrome of angina.

METHOD123 outpatients were randomly divided into Xuefu Zhuyu group(XF), Jingzhi Xuefu Zhuyu group(JZ), Yaodui group(YD) and placebo group and treated.

RESULTThe array of angina effect and blood stasis and qi stagnation of syndrome effect was XF group, JZ group, YD group, placebo group( P < 0.01). The levels of blood viscosity, platelet adhesiveness, RED transfigure were significantly different before and after treatment in XF group (P < 0.05). The levels of blood viscosity, platelet adhesiveness were significant different before and after treatment in JZ group ( P < 0.05). The levels of blood plasma viscosity, platelet adhesiveness were significantly different before and after treatment in YD group ( P < 0.05). The levels of platelet adhesiveness, RED transfigure were significantly different before and after treatment in placebo group (P < 0.05). There are no difference among levels of blood lipoprotein and ET of four groups ( P > 0.05). Significant difference was found among four groups in increase of NO and t-PA and decrease of IL-6 (P < 0.05).

CONCLUSIONThe clinical effect and indexes amelioration are correlated to the combination of prescription and the corresponding degree of prescription to syndrome. There are same material foundation in the series of Xuefu Zhuyu dismantle decoction, but the function degree and targets are different with the change of herbs. The method of conjugating disease and syndromes, and prescription to syndromes are a practical pattern to expound the relationship between disease and syndrome.

Aged ; Angina Pectoris ; blood ; drug therapy ; Blood Viscosity ; drug effects ; Double-Blind Method ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Hematocrit ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Nitric Oxide ; blood ; Plants, Medicinal ; chemistry ; Platelet Adhesiveness ; drug effects ; Tissue Plasminogen Activator ; blood

OBJECTIVETo gain insight into the role of Toll-like receptor 2 (TLR2) in graft rejection following penetrating keratoplasty, and investigate the expression of TLR2 mRNA in the corneal graft.

METHODSPenetrating keratoplasty was performed in 3 groups of rats for orthotopic autologous corneal transplantation (group A), allograft corneal transplantation (group B), or allograft corneal transplantation with hormone treatment (C). The transparency and neovascularization of the cornea were observed using a slit-lamp microscope and scored according to the rejection index, with normal cornea serving as the control. The corneal tissues were sampled at 5, 7, and 9 days after the transplantation for histopathological examination and detection of TLR2 mRNA expression using RT-PCR.

RESULTSWith the passage of time, edema, opacities and neovascularization of the corneal graft occurred after the operation in all the groups. Seven days after the operation, the rejection index of group B, but not that of groups A and C, met the diagnostic criteria for graft rejection with also support by histopathological evidence. The expression of TLR2 mRNA was detected in normal corneas and augmented in the corneal grafts in the 3 transplantation groups. TLR2 mRNA expression in group B was significantly higher than that of group A, and the expression in group C decreased significantly in comparison with that in group B (P<0.05).

CONCLUSIONAs the recognition receptors of native immune system, TLR2 in the rejected corneal grafts may recognize the allograft antigen and play a role in acute graft rejection after penetrating keratoplasty.

Animals ; Cornea ; metabolism ; Female ; Graft Rejection ; immunology ; Keratoplasty, Penetrating ; Postoperative Complications ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 2 ; genetics ; metabolism

OBJECTIVETo develop a single-tube multiplex polymerase chain reaction (mPCR) technique to detect three common deletional alpha-thalassemias (alpha-Thal) in Chinese, and to perform genetic diagnosis and prenatal diagnosis for an alpha-Thal family from Hebei province, China.

METHODSFourty-two blood samples including samples from one alpha-Thal family from Hebei province were assayed. The mPCR containing 7 primers, gel electrophoresis and DNA sequencing were used for the genetic diagnosis and prenatal diagnosis.

RESULTSThe gene types of the fourty-two DNA samples analyzed by the mPCR-gel electrophoresis technique were in accordance with the results by Southern blot and three separate PCR techniques. A HbH child and a fetus of the alpha-Thal family were diagnosed as--(SEA)/alpha(cs)alpha and alpha alpha/alpha alpha respectively by using the mPCR and DNA sequencing. The result of postnatal analysis of the cord blood was consistent with the prenatal result (alpha alpha/alpha alpha).

CONCLUSIONThe developed mPCR technique can be used for genetic diagnosis and prenatal diagnosis of the 3 deletional alpha-Thal in Chinese.

Adult ; Child, Preschool ; Family Health ; Female ; Fetal Diseases ; diagnosis ; genetics ; Gene Deletion ; Genetic Testing ; Humans ; Male ; Molecular Diagnostic Techniques ; methods ; Point Mutation ; Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; Sequence Analysis, DNA ; alpha-Thalassemia ; diagnosis ; genetics

OBJECTIVETo investigate the correlation between pro coagulation factors and anti-coagulation factors synthesized by the liver, and the correlation between fibrin degradation products (FDP) and D-dimer (D-D) concentration and coagulation proteins synthesized by extra-hepatic tissues, in different liver diseases; to explore the relationship between coagulation and bleeding in hepatic diseases.

METHODSChronic hepatitis B (CHB) patients, CHB-related liver cirrhosis patients, CHB-related liver failure patients and healthy (normal) controls were selected for study and provided blood samples for analysis. The activity of coagulation factors (F) II, V, VII, VIII, IX, X, XI, and XII was detected using the one-stage clotting method. Coagulogram analysis, including activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT), was conducted by the solidification method. Antithrombin III (AT-III) and protein C (PC) activities were measured by chromogenic substrate assay. FDP concentration was detected using immunoturbidimetry. Tissue factor pathway inhibitor (TFPI), thrombomodulin (TM), von Willebrand factor (vWF), and tissue factor (TF) concentrations were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTSWith the exception of FVIII, coagulation factors and anticoagulant proteins synthesized by the liver were decreased and the coagulogram was extended for all patients. Likewise, the FDP and D-D concentrations were increased in blood. CHB patients, however, presented with increased levels of FVIII, TFPI, TM, vWF, and TF. Pairwise comparison indicated statistical differences existed among CHB, CHB-related liver cirrhosis, and liver failure patients: TFPI: 239.3+/-206.4, 315.0+/-258.6, and 319.5+/-298.1 -- higher than normal control: 104.0+/-87.1, F = 5.453, P less than 0.05; vWF: 70.3+/-29.5, 105.5+/-58.0, and 179.3+/-61.7 -- higher than normal control: 21.9+/-7.2, F = 20.104, P less than 0.05; TF: 85.9+/-85.7, 234.2+/-202.9, and 344.7+/-214.6 -- higher than normal control: 12.8+/-8.1, F = 8.619, P less than 0.05; FVIII: 157.2+/-53.4, 206.9+/-86.9, and 335.7+/-117.7 -- higher than normal control: 105.5+/-46.2, F = 13.418, P less than 0.05.

CONCLUSIONIn parallel to the progression of liver diseases, pro coagulation and anti-coagulation elements synthesized by the liver were reduced. In contrast, fibrinolysis activity was enhanced, which is expected to lead to an imbalance between blood clotting and anti-clotting factors. This may be an important cause for the bleeding that occurs in end-stage liver disease. Expressions of TFPI, TM, vWF, and TF significantly change in the early stage of liver diseases, as compared to normal (healthy) levels, and may represent a sensitive indicator of vascular injury.

Adult ; Aged ; Antithrombin III ; metabolism ; Blood Coagulation Factors ; metabolism ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Hepatic Insufficiency ; blood ; physiopathology ; Hepatitis B, Chronic ; blood ; physiopathology ; Humans ; Hydrocarbons, Chlorinated ; metabolism ; Lipoproteins ; metabolism ; Male ; Middle Aged ; Young Adult ; von Willebrand Factor ; metabolism