Objective To explore the correlation between heart rate variability ( HRV ) and multiple system atrophy( MSA) .Methods HRV was performed in 34 MSA patients and 32 healthy controls.The parameters of HRV study was compared, parameters studied included time domain and frequency domain.Single factor analysis andreceiver operating characteristic ( ROC ) curves were used to analyze the detection of parameters of HRV. ResultsThe HRV of MSA showed significant decreased from the health controls: root mean square successive difference of intervals (rMSSD) [(51.6 ±29.4)ms vs (70.1 ±34.1)ms,P=0.023],percentage of interval differences of successive N-N intervals greater than 50 ms(pNN50%) [ 4.2% (1.8%,9.5%) vs 9.6%(5.1%, 16.2%),P=0.005], coefficient of variation(CV) [(0.06 ±0.01) vs(0.08 ±0.02),P=0.005],very low frequency(VLF) [1003.4(586.5,1702.9)ms2vs1825.5(1407.2,2670.1)ms2,P=0.000],lowfrequency(LF) [162.9(90.6,337.4) ms2 vs 375.5(210.4,559.5) ms2,P=0.001], high frequency(HF) [164.9(77.5,470.7) ms2 vs 349.1(209.7,738.5)ms2,P=0.005].The areas under ROC in patients with MSA for VLF was 0.703(S=0.053), while the areas for CV, LF, HF and pNN50%were 0.667(S=0.054), 0.660 (S=0.055), 0.650( S=0.055) and 0.640( S=0.055) ,the results all have statistical significance(all P<0.05).The cutoff value of VLF for diagnosing MSA in the early stage was 1240.85, the sensitivity and specificity were 86.7 and 55.4(95%CI:0.599-0.807,P=0.002) .Conclusion MSA has sympathetic and vagus nerve involvement at the early stage disease, resulting dysfunction of cardiovascular autonomic system,VLF may have high drgree of assessing accuracy of its dysfunction.

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Radiation Dosage ; Radiosurgery ; Treatment Outcome

Objective To explore and evaluate the clinical value of MRI for status of axillary lymph node after neoadju-vant chemotherapy (NAC) in patients with breast cancer. Methods Forty-four patients with 1ocally advanced breast cancer (LABC) were underwent NAC for four cycles. The longest diameter of axillary lymph node (ALN) measured by MRI scan. Val-ue of apparent diffusion coefficient (ADC) and their correlation were compared before NAC and four cycles after NAC. Re-sults of MRI and pathological data for ALN were compared between two groups of patients. Results All patients finished four cycles of NAC. The total response rate (CR+PR) was 72.7% (32/44), and the total non-response rate (SD+PD) was 27.3%(12/44). The longest diameter of ALN was significantly shortened in response group. The longest diameter was (1.37± 1.06) cm before NAC and (0.90±0.76) cm after NAC (P<0.01). The ADC value of the tumor was significantly increased in re-sponse group [(0.91±0.28) ×10-3 mm2/s before NAC and (1.01±0.32)×10-3 mm2/s after NAC, P<0.01)]. There was no signifi-cant correlation between ADC value change (△ADC) and the longest diameter change of ALN (△L, r=0.131, P=0.413). The sensitivity, specificity and Kappa value of ALN evaluation after NAC were 100%, 62.5%and 0.68 measured by MRI. Con-clusion The change of tumor longest diameter reflects the effect of chemotherapy directly. The tumor ADC value of MRI can not be used as an independent indicator of chemotherapy effect of ALN, eventhouth MRI was the sensitive index for eval-uating the status of axillary lymph node after neoadjuvant chemotherapy for breast cancer.

Background Research showed that the morbidity rate of primary angle closure glaucoma (PACG) in Mongolian population is 3.02 times more than Han nationality population.To understand the cause and mechanism of PACG in Mongolia is of an important significance.Objective This study was to investigate the pathogenesis of Mongolian PACG.Methods Thirty-two eyes of 32 PACG patients in Mongolia and 40 eyes of 40 PACG patients of Han peoples were included in Inner Mongolia Autonomous Region People's Hospital according to the diagnosis criteria of glaucoma group of Chinese Medical Ophthalmology Association (version 1987),and 13 eyes of 13 normal Mongolia and 17 eyes of 17 normal Han peoples who suffered with ocular truma were recruited as controls.Intraocular pressure(IOP) was measured before surgery.The trabecular meshwork tissue was obtained from all the eyes during the operation.Annexinv-FITC/PI double staining was performed and the apoptosis rate of trabecula cells was tested with flow cytometry.Written informed consent was obtained initial of the study.Results The IOP value in Mongolia PACG group,Han PACG group,Mengolia normal group and Han normal group was (35.97±7.11)mmHg,(38.70± 6.82) mmHg,(14.69 ± 2.91) mmHg and (13.59 ± 2.91) mmHg,respectively,showing a significant difference among the 4 groups(F=106.144,P=0.000),and the IOP was significantly higher in the Mengolia PACG group and Han PACG group than the normal groups(P＜0.05).The apoptosis rate of the cells was (7.14±0.67)％,(5.40±0.69) ％,(5.86±0.91) ％ and(2.29±0.65) ％ in the Mongolia PACG group,Han PACG group,Mongolia normal group and Han normal group,respectively,with a significant difference among them (F =174.888,P =0.000),and apoptosis rate of the Mongolia PACG group was significantly higher than that of the Han PACG group and the Mongolia normal group (P＜0.05).No significant difference was found between the Mongolia PACG group and the Han PACG group or between the Mongolia normal group and Han normal group (P＞0.05).The cell apoptosis rate was increased with the elevation of IOP (b =0.990,F=10.209,P =0.009) with the regression equition Y =2.788 +0.092X.Conclusions The apoptosis rate of trabecula cells in Mongolian is higher than Han people.If these results are associated with the high incidence of Mengolia PACG is worth of study.

Objective To evaluate the immune response triggered by an in-house constructed hu-man metapneumovirus multi-epitope antigen ( MEA) in a mouse model .Methods Female SPF BALB/c mice at age 4-6 weeks were used in the study and divided into 7 groups.Mice in the five groups including MEA+oligodeoxynucleotides containing CpG motifs ( CpG ODN) intraperitoneal injection ( i.p.) treatment group, MEA+Alum i.p.treatment group, MEA+Alum+CpG ODN i.p.treatment group, MEA+CpG ODN intranasal (i.n.) treatment group and MEA+Alum+CpG ODN i.n.treatment group were immunized three times on days 0, 14 and 21, and those in the other experimental group were immunized intramuscularly with MEA+Quickantibody5W on days 0 and 21.A control group without treatment was set up accordingly .All mice were sacrificed two weeks after the last immunization .Antibodies including IgG , IgG1, IgG2a and IgA in serum samples were detected by ELISA .MTS assay was performed to analyze the proliferation of lympho-cytes.The cytotoxicity of cytotoxic T lymphocytes (CTL) was measured by LDH assay.Flow cytometry was used to detect T lymphocyte subsets .The cytokines secreted by T helper cells ( Th1 and Th2) were analyzed with Bio-Rad Liquid Chips.Results High titers of IgG, IgG1 and IgG2a antibodies were produced in MEA treated mice except for those in intranasal treatment groups .Serum samples from three groups including the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups were positive for IgA antibody .The highest titer of IgA antibody was detected in mice from the MEA+Alum+CpG ODN i.p.treatment group, which was 2.15×103.Compared with the control group, significantly enhanced proliferation of lymphocytes was observed in the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups (P<0.05).Enhanced cytotoxic activities of CTL were observed in mice with ip.and i.m.treatments as compared with those in control group (P<0.05).The levels of CD4+/CD8+T cells were slightly increased in mice from the MEA+CpG ODN i.p., MEA+Alum+CpG ODN i.p. and MEA+Quickantibody5W i.m.treatment groups as compared with those in control group (P<0.05).In-creased secretion of IL-2, IFN-γand Th2-type cytokines including IL-4, IL-5 and IL-10 were detected in mice from the MEA+CpG ODN i.p.treatment group.The MEA+Alum i.p.treated mice showed a slightly increased secretion of IFN-γand significantly increased secretions of IL-4, IL-5 and IL-10.Significantly in-creased secretions of IFN-γ, IL-4, IL-5 and IL-10 were detected in mice from the MEA+Alum+CpG ODN i.p.treatment group.Significantly increased secretions of IFN-γ, IL-5, IL-10 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were detected in mice from the MEA+Quickantibody5W i.m.treatment group.Conclusion MEA together with different adjuvants could stimulate high titers of specific antibodies , increase the proliferation of lymphocytes and enhance the cytotoxic activities of CTL .CpG ODN could bal-ance the Th1/Th2-mediated immune responses , and the balance could be enhanced when using CpG ODN in combination with Alum .A similar effect could be achieved by using the commercial adjuvant Quickanti -body5w.This study has paved the way for further investigation on the development of hMPV epitope vaccines and diagnostic reagents for hMPV as well as the epidemiological study of hMPV .

Objective To evaluate the safety and efficacy of the endoscopic resection of large nonampullary duodenal adenomas.Methods Twenty cases with large nonampullary duodenal adenomas(≥ 1.0 cm) were referred for EMR.After submucosal injection of the mixture of glycerin fructose solution and methylene blue,either en bloc or piecemeal snare polypectomy was performed.All resected specimens were retrieved for pathologic study.Follow-up gastroscopy was performed in patients after EMR.Results Among 20 lesions,six were found located in the 1st part(30％),13 were in the 2nd part(65％),and one in the 3rd part(5％)of the duodenum.The mean diameter of the lesions was 1.9 ± 1.1 cm.Endoscopic ultrasonography (EUS) was performed in 12 patients,and all lesions were originated from the mucosa.EMR was performed successfully in 20 patients.The en bloc resection rate was 75％ (15/20),and the mean time for EMR was 33.8 ± 16.7 min.The perioperative complication rate was 20％ (4/20).Bleeding occurred within 24 hours after EMR in 4 cases.There were no perforations.The complete resection rate was 100％.Of these 20 adenomas,14 adenomas were tubulous and 6 was tubulovillous.During the follow-up period (2-39 months),1 patient showed recurrence within 6 months after EMR.Conclusion Endoscopic resection of large nonampullary duodenal adenomas is safe and effective treatment.

Objective To investigate the clinical characteristics and surgical treatment of gastrointestinal stromal tumors (GIST) of the duodenum.Methods The clinical data of 39 patients with duodenal GISTs from 1992 to 2010 were analysed retrospectively.Results The most common symptoms of duodenal GISTs were alimentary tract hemorrhage,occuring in 18 cases of the 39 cases (46％).Clinical diagnosis established by CT in 22 cases (69％).Duodenoscopy performed in 18 cases established the definite diagnosis of GIST in 15 (83％).Duodenal GISTs were most commonly located in the descending portion of the duodenum in 27/39 cases (69％).All 39 cases received surgical treatment,with R0 resection in 34 cases,including partial resection of the duodenum in 47％ (16/34),pancreaticodenectomy in 35％(12/34),segmental resection of the duodenum in 3 cases,subtotal gastrectomy in 3 cases; One died perioperatively and postoperative complications developed in 9 cases,which were cured by conservative therapy.The 1,3,5 year survival rate was 90％,72％,41％ for those receiving R0 resection.Conclusions The abdominal CT scan with contrast and duodenoscopy are helpful to establish the diagnosis of duodenal GISTs.Surgical procedures depend on the size and site of the lesion for R0 resection.To decrease postoperative recurrence and prolong survival adjuvant therapy with Imatinib is necessary.

This article dealed with the effects of processing method and duration on the major bioactive components (sinigrin and sinapine thiocyanate) in Brassica juncea. The contents of sinigrin and sinapine thiocyanate in decoctions of raw and processed B. juncea were determined and compared by high performance liquid chromatography on a Alltima C18 column (4.6 mm x 250 mm, 5 microm) at 35 degrees C with the acetonitrile-0.1% phosphoric acid as the mobile phrase in gradient elution. The detection wavelength of sinigrin and sinapine thiocyanate was set at 227 nm and 326 nm, and the flow rate was 1.0 mL x min(-1). It was found that with the extended processing duration, the contents of sinigrin and sinapine thiocyanate first increased and then decreased: i.e., 0-2 minutes they increased gradually (for sinigrin, by 9.65% in processed products and 356. 10% in powder; for sinapine thiocyanate, by 12.82% in processed products and 3.41% in powder), and achieved their highest content at 2 min; then, decreased during the next 5 minutes (for sinigrin, by 80.35% in processed products and 82.09% in powder; for sinapine thiocyanate, by 14.29% in processed products and 17.54% in powder), suggesting that processing duration could significantly affect the contents of bioactive components in B. juncea, enzymatic hydrolysis of sinigrin when the seed is crushed in the present of moisture may be responsible for the content change. It is recommended that the slow fire should be the best processing method and the raw seed could be used directly in the water extracts related industrial production.
Brassica ; chemistry ; Choline ; analogs & derivatives ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Glucosinolates ; chemistry ; Powders ; chemistry ; Thiocyanates ; chemistry

Objective To evaluate the diagnostic value of US, ECT, CT and MRI in primary hyperparathyroidism (PHPT). Methods Data of 34 PHPT patients with diagnosis confirmed by postoperative pathology were retrospectively reviewed from January 1, 1990, through March 31, 2004. Results The preoperative diagnosis in 22 out of 25 cases (88%) undergoing preoperative ultrasonography of the neck with a positive result was verified by intraoperative findings. For 99m Tc-MIBI, CT and MRI, the positive results were 95%, 69% and 100% respectively. Conclusion Ultrasonography and 99m Tc-MIBI should be considered as the first choice for preoperative loci localization in patients with PHPT. Ultrasonography and 99m Tc-MIBI in combination is more sensitive and accurate for the localization of PHPT.

Objective To explore the diagnosis and treatment of primary hyperparathyroidism (PHPT). Methods Clinical data of 35 cases of PHPT were retrospectively analyzed. Results 23 out of 26 cases (88.5%) undergoing preoperative ultrasonography with a positive result were verified by intraoperative (findings). For ECT, the positive rate was 21 out of 23 cases (95.5%). Unilateral neck explorations (UNE) was performed in 27 cases of parathyroidoma. Two cases of parathyroid hyperplasia were treated by UNE and the other two cases by bilateral neck exploration (BNE). The procedure for 3 cases of parathyroid carcinoma was the same as that for papillary thyroid carcinoma. Unilateral resection of thyroid and parathyroid was done in a case of parathyroidoma with malignant change. Emergency excision of parathyroidoma, after (emergency) medical management, was performed in a patient with parathyroid storm, and the symptoms (subsided) postoperatively. All cases developed hypocalcemia in various degrees after surgery, but the symptoms were relieved with the use of calcium gluconate. Conclusions PHPT could be diagnosed according to (co-elevated) calcemia and PTH. Ultrasonography and ECT should be considered as the methods of first choice for preoperative localization. UNE of parathyroidoma could be feasible if accurate image localizations are (available). Radionuclear guided parathyroid resection could be performed in the patients with ectopic parathyroid disease or lesions without accurate localization. Aggressive surgical exploration after medical control of (symptoms) is the first choice of treatment when parathyroid storm is diagnosed.