Objective To investigate the stabilization of betaine on the enzyme activity of ALT in human serum at different temperatures, and to evaluate the matrix effects of human serum with betaine among different analytical systems. Methods The enzyme activity of ALT in human serums with l mol/L betaine stored at 37 ℃, 25 ℃, 4 ℃ and - 20 ℃ respectively were measured. The matrix effect experiment was carried out according to the procedures specified in Clinical and Laboratory Standards Institute (CLSI)document EP14-A. Four analytical systems were the candidates for evaluation, and Roche Diagnostics (Roche)-Hitachi analytical system served as the reference system. The enzyme activity of ALT of 40 patient specimens and 3-level specimens ( high, medium and low) with 1 mol/L betaine were measured using the evaluated methods and the reference method respectively. The linear regression analysis was performed to compare the mean y value of 3-level specimens with the statistically defined limits ( the two-tailed 95% prediction interval) derived from 40 patient specimen data. Results The enzyme activity of ALT could be stabilized with betaine in serum, which remained to be 99% for 48 h at 37 ℃, 98% for4 d at 25 ℃, 97%for 4 weeks at 4 ℃, and 99% for 4 months at - 20 ℃. The enzyme activity of control serum decreased to 42%, 86%, 71%, 79% respectively. The mean y values of three specimens with the betaine were within the 95% prediction interval of the estimated mean y values, which suggested no obvious matrix effects in serum. Conclusion Betaine can be used in the development of enzyme ALT calibrator as its stabilizer.

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

China ; Coltivirus ; Encephalitis, Tick-Borne ; virology ; Humans

OBJECTIVETo observe the supplementary effect of moxibustion and Guben Yiliu III (GBYL), a Chinese herbal compound preparation, in combination with chemotherapy.

METHODSEighty-one patients of mid-late stage malignant tumor were randomly divided into 3 groups: 16 in Group A treated with chemotherapy and placebo; 35 in Group B treated with chemotherapy and GBYL and 30 in Group C treated with chemotherapy and GBYL plus moxibustion. The short-term effect of treatment, changes of blood picture, cell mediated immune function and blood coagulation in patients were observed.

RESULTSAfter chemotherapy, the lymphocyte count was significantly lowered in Group A and B (P < 0.01), but not in Group C (P > 0.05); lymphocyte subset T3 raised significantly in Group B; the average level of T-lymphocyte subsets was reduced in Group A while it increased in the other two groups; and a bi-directional regulation on plasma fibrinogen concentration was shown in Group C (P < 0.05).

CONCLUSIONMoxibustion prevented dropping of lymphocyte count caused by chemotherapy. Combination of GBYL and moxibustion could prevent the lowering of T-lymphocyte subsets caused by chemotherapy, and moxibustion could regulate bi-directionally the patients' abnormality in part of blood coagulation mechanism.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Blood Coagulation ; Carboplatin ; administration & dosage ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Drugs, Chinese Herbal ; therapeutic use ; Etoposide ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Humans ; Lung Neoplasms ; blood ; immunology ; therapy ; Lymphocyte Count ; Male ; Mitomycin ; administration & dosage ; Moxibustion ; Phytotherapy ; Stomach Neoplasms ; blood ; immunology ; therapy ; T-Lymphocyte Subsets

Objective To investigate the changes of plasma lysephosphatidic acid (LPA) or acidic phospholipids (AP) levels in patients with nonvalvular atrial fibrillation(NVAF) or NVAF associated with silent brain infarction (SBI) and to provide biochemistry evidence to antithrombotic therapy. Methods Plasma LPA/AP levels was examined in blood freshly sampled in 235 cases of NVAF who were not receiving any antithrombotic therapy, 116 cases SBI who were not with NVAF and 120 cases healthy volunteers as control enrolled in the LPA and stroke prevention study. Plasma LPA was assayed by measuring its inorganic phosphorus after separation by chromatograph. Meanwhile, the platelet activation in NVAF or (and) SBI were observed. Results SBI was found in 31.5% of the participants with NVAF, and in 37.6% of the elderly NVAF subjects (age60 years old). LPA/AP levels were significantly increased in NVAF with SBI group((3.78±0.61) μmol/L) compared with controls ((2.66±0.49) μmol/L, 95% CI 3.47-4.21,P = 0.000), NVAF without SBI group ((3.29±0.57) μmol/L, 95 % CI 3.01-3.76, P = 0.008), SBI without NVAF group((3.17±0.54) μmol/L, P=0.004). The platelet activation was significantly higherin NVAF with SBI group, the odds ratio (95% CI) was 21.39(10.17 to 45.02),than those in NVAF without SBI group (P<0.01). Conclusion The plasma LPA/AP levels were significantly elevated in NVAF or NVAF with SBI, NVAF contributes to the risk of SBI. Platelet activation may play an important role in the pathogenesis of thromboembolism in NVAF and the measurement of LPA reflects activation of platelets in vivo and may be a useful marker for the diagnosis of thrombosis or prothrombotic states.Consideration of the role of antiplatelet therapy should be given when choosing antithrombotic therapy to NVAF-associated ischemic stroke.

Objective To observe the effects of different antithrombotic interventions on the changes of plasma lysophosphatidic acid (LPA) level in patients with nonvalvular atrial fibrillation (NVAF) and to provide the basis for clinical antithrombotic therapy. Methods A total of 235 patients with NVAF who did not receive antithrombotic therapy diagnosed by clinical and auxiliary examinations were randomly allocated to receive aspirin (100 mg/d) plus dipyridamole (100 mg/d) (n =76), aspirin (100 mg/d) plus fixed-dose warfarin (1.25 mg/d) (n =79), and dose-adjusted warfarin (international normalized ratio (INR) range of 1.5 to 2. 1) (n =80). They gore redivided into <60, 60-75, and ≥76 year-old groups according to their age. The plasma LPA levels were measured and compared before treatment and 2 and 6 weeks after treatment. Results 1he plasma LPA levels were decreased more significantly in the aspirin plus fixed-dose group than those in the aspirin plus dipyridamole and dose-adjusted warfarin groups (all P < 0.01). Two and 6 weeks after treatment with aspirin plus dipyridamole in the < 60 year-old group, the plasma LPA levels were significantly lower than those before treatment (all P<0. 01). Two and6 weeks after treatment with aspirin plus fixed-dose warfarin in the < 60 year-old group, the plasma LPA levels were significantly lower than those before treatment (all P <0. 01). Two and 6 weeks after treatment with aspirin plus fixed-dose warfarin in the 60-75 year-old group, the plasma LPA levels were significantly lover than those before treatment (all P <0.01). Two and 6 weeks after the treatment with dose-adjusted warfarin (INR 1.5-2. 1) in patients in each age group, the plasma LPA levels were significantly lower than those before treatment. Conclusions 1he different antithromhotic therapeutic modalities have different effects on platelet activation in patients with NVAF in different age groups. The patients in the < 60 year-old group can receive aspirin plus dipyridamole, the patients in the < 75 year-old group can receive aspirin plus fix-dose warfarin, and the patients > 75 year-old, dose-adjusted warfarin (INR 1. 5-2. 1) should he recommend.

Objective To report the therapeutic effect of free dursum flap lnbule grafting to repair soft tissue defects in two or three fingers result from electric bum in just one operation.Methods Seven patients with electric injuries in two or three fingers were treated by the dorsum flap (or composite flap) lohule graft- ing.The procedure is followed:after dehridement,a trifoliated flap composed of medial pedal,first dorsal met- atarsal and lateral pedal flaps or a bifoliated flap composed of first dorsal metatarsal and lateral pedal flaps was designed.The combined flap contained anterior tihial artery and dorsal pedal artery as the stem vessel for anas- tomosing with the supplying vessel.The three tributaries of dorsal pedal artery:medial tarsal artery,first dor- sal metatarsal artery and lateral tarsal artery were enntained in the three leaves respectively.They could contain extensor digitorum longus tendons and cutaneous nerves and be used to cover the skin defect of two or three fin- gers,reconstruct the flexor tendons and finger arteries and nerves at the same time.Results All the flaps were survived completely,the wounds in all fingers healed primarily,however,skin graft in two feet necrosised partly,one got to healing required wound dressing for three weeks,another required further operation of trans- ferring medial supramalleolar flap due to tendon exposure.The patients were followed up from 3 to 24 months, all the flaps were of appropriate thickness,good texture and satisfactory sensation,all the fingers recovered good function of flection and extension except two fingers existing little limitation.Conclusion Free dorsum flap lohule grafting is an ideal way to treat electric injuries of multiple fingers because it can recnnstruct the skin,tendons,blood vessels and nerves in two or three fingers in just one operation.

OBJECTIVETo develop a mouse model of acute lung injury induced by cigarette smoke (CS) and to investigate inflammatory changes with the model.

METHODSICR mice exposed to CS for 20-min, 3/d. Bronchoalveolar lavage fluid (BALF) and lung tissue were harvested at d 0, d 1, d 3 and d 7 after CS exposure. Neutrophil count in BAFL, TNF-alpha and MMP-12 levels, the activity of MPO in lung tissue were determined.

RESULTNeutrophil count in BALF, MMP-12 and MPO levels in lung tissue were increased after CS exposure in a time-dependent manner with a peak at d3. TNF-alpha level sharply increased at d1, and remained high level until d7.

CONCLUSIONICR mice are tolerant and sensitive to CS exposure, which may be used as an appropriate animal model for acute lung injury induced by cigarette smoke.

Acute Lung Injury ; chemically induced ; pathology ; Animals ; Bronchoalveolar Lavage Fluid ; cytology ; Disease Models, Animal ; Male ; Matrix Metalloproteinase 12 ; metabolism ; Mice ; Mice, Inbred ICR ; Smoke ; adverse effects ; Tobacco ; adverse effects ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo investigate the association between cigarette smoking and cancer mortality in urban men in Shanghai and its impact when smoking habit changed during the follow-up period.

METHODSA total of 18 244 male residents aged 45 to 64 years in urban Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and was actively followed up on annual visits. Cox proportional hazards model was used to estimate relative risks (RR).

RESULTSBy the end of follow-up program in 2002, 235 762 person-years, averaged 12.9 years per subject in the cohort was reached. 3365 deaths including 1381 cancer deaths were registered during the follow-up period. The mortality rates for cancers of lung, stomach, liver, pancreas, esophagus, head and neck etc. increased significantly among smokers. Compared with data of nonsmokers at the baseline survey, the adjusted RR was 1.49 for all-causes mortality among current smokers at the baseline survey. After excluding subjects who changed their smoking habit during the follow-up period, the RR became 1.78 compared with lifelong-nonsmokers. The corresponding RRs rose from 2.05 to 2.58 for all cancer deaths and from 6.40 to 8.77 for lung cancer deaths. The age-adjusted all-causes and cancer death rates among current smokers at the baseline survey were 1695.6 and 782.0 per 100 000 person-years, respectively. After exclusion of those with smoking habit changed during the follow-up period, the rates among persistent smokers were 2353.7 and 1144.6 per 100 000 person-years, respectively.

CONCLUSIONCigarette smoking is an important predictor for risk of all-causes of death as well as for cancer deaths. The change of smoking habit during the follow-up period could result in underestimating the deleterious effect of cigarette smoking on health.

Adult ; Cause of Death ; China ; epidemiology ; Cohort Studies ; Follow-Up Studies ; Humans ; Liver Neoplasms ; mortality ; Lung Neoplasms ; mortality ; Male ; Middle Aged ; Neoplasms ; mortality ; Proportional Hazards Models ; Prospective Studies ; Smoking ; adverse effects ; Stomach Neoplasms ; mortality ; Urban Health

OBJECTIVETo examine the association between body mass index (BMI) and mortality as well as the effect of age on it among middle-aged and elderly men in urban area of Shanghai.

METHODSA total of 18,244 male subjects aged 45-64 years resided in urban area of Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and were actively followed under annual visits. 'Cox proportional hazards model' was used to estimate the relative risks (RR).

RESULTSBy the end of the follow-up process in 2002, a total number of 235,762 person-years was accumulated in the cohort, with an average of 12.9 years per subject. A total number of 3365 deaths including 1381 from cancer and 1165 from cardio- and cerebro-vascular diseases (CVD), was identified during the follow-up period. Compared with those under normal BMI (BMI 18.5-23.9), the RRs of death for all causes of death among groups at low BMI (BMI < 18.5), overweight (BMI 24-27.9) and obesity (BMI > or = 28) were 1.20, 1.12 and 1.61, respectively, among non-smokers after adjustment for age, alcohol consumption and level of education. After excluding the numbers observed during the first 5 years of follow-up, the corresponding RRs became 1.01, 1.12, and 1.75, respectively. The risk of deaths from colon cancer or CVD increased along with the increase of BMI, while the risk of non-cancer and non-CVD deaths, mostly deaths from infectious diseases, increased significantly in the group of low BMI. Among those aged > or = 55 years at baseline survey, the risk for all causes of death increased more significantly with those having obesity. However, among those who were younger than 55 years of age, no significant correlation between BMI and overall mortality was noticed.

CONCLUSIONA positive relationship between obesity and total mortality was observed in the middle-aged and elderly men in urban Shanghai. The association was more obvious among the elderly while the risk of deaths from colon cancer or CVD rose along with the increase of BMI. The risk of death from infectious disease increased significantly in the group with low BMI.

Aged ; Body Mass Index ; Cardiovascular Diseases ; mortality ; Cause of Death ; China ; epidemiology ; Cohort Studies ; Colorectal Neoplasms ; mortality ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Overweight ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Urban Health