Objective:To evaluate the clinical outcome of botulinum A toxin(BTX-A)injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia(DESD)after spinal cord injury(SCI). Methods:A total of 38 urodynamic examination-confirmed DESD patients,male 31 and female 7,with an average age of (36.5?17.8)years old,were included in this study.200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites(1 ml per site)of the external sphincter via a 5F flexible cystoscopic needle.On the second day,9 patients(BTX-A+baclofen group)were randomly selected for baclofen oral administration,3/d for 3 months; the other 26 patients were taken as control.Urodynamic examination was repeated in all patients 4 weeks later;the voiding diary and urodynamic outcomes were compared before and after treatment.The adverse and toxic effects were observed in the patients who were followed up for 2-9 months.Results:One month after treatment the voiding and storing functions of bladder were improved to different degrees,with the mean maximum uroflow rate(Qmax),the mean urine volume,the mean maximal cystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly(all P

OBJECTIVETo investigate the regulation of Cha Gan Beng Ga on the activity of biomarker PGC-1α in vivo and in vitro, and lay the foundation for studying the efficacy result of Cha Gan Beng Ga on xenograft tumor model and extracting active constituents.

METHOD(1) The coarse powder of Cha Gan Beng Ga was extracted with 70% ethanol solution through heating and refluxing, and finally was used to freeze dry powder. (2) 50 mg x kg(-1) of freeze-dried power was orally administrated to KM and C57BL/6J mice once daily, lasting for 5 consecutive days; different concentrations of extracted materials was given to non-small cell lung cells A549. (3) The expression level of PGC-1α mRNA was quantitatively determined in lung tissue of mice and non-small cell lung cells A549.

RESULTThe expression levels of PGC-1α in lung tissue of different mice strains had an increasing tendency. Furthermore, the expression levels of PGC-1α in non-small cell lung cells A549 also had an increasing tendency, showing dose and time-dependent relationships.

CONCLUSIONMongolian Medicine Cha Gan Beng Ga could induce the over-expression of PGC-1α mRNA in lung tissue of mice and in non-small cell lung cells A549. The present results will lay foundation for studying the efficacy result of antitumor and active constitutes in future.

Aconitum ; chemistry ; Animals ; Biomarkers, Tumor ; genetics ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Lung ; drug effects ; metabolism ; Lung Neoplasms ; genetics ; pathology ; Male ; Medicine, Mongolian Traditional ; Mice, Inbred C57BL ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Plant Extracts ; pharmacology ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors ; Transcription Factors ; genetics

Objective To evaluate the effect of modified bowel preparation-Polyethylene Glycol Electrolytes Powder (SF-PEG, Shu Taiqing) in combination with magnesium sulfate in patients with constipation undergoing colonoscopy. Methods Sixty cases from mild to moderate constipation were randomly divided into two groups:Group A: SF-PEG (438.4 g, 4 L), 30 cases; Group B: received low-dose SF-PEG (219.2 g, 2 L) and 50.00%magnesium sulfate 50 ml, and then 250 ml water, 30 cases. Boston Bowel Preparation Scale scores (BBPS) and bubbles in bowel lumen score were assessed by the same endoscopist blindly to the preparation regimen, and the time of colonoscopy and the tolerability was recorded. Results All patients underwent completely the bowel preparation and colonoscopy. The time of colonoscopy of group B was shorter than that of group A (P < 0.05). The BBPS score of group B was higher than that of group A (P < 0.05). The bubbles in bowel lumen were less in Group B than in Group A (P < 0.05). The willingness to retake in Group B were superior to those in Group A (P < 0.05). No significant difference was found in score of total adverse effects and taste score between the two groups (P > 0.05). Conclusion SF-PEG in combination with magnesium sulfate in patients with constipation for colonoscopy can improve tolerance to bowel preparation, cleanliness and effects of examination. It's safe to be recommended in clinical practice.

Objective To investigate the association between essential hypertension(EH)and nonalcoholic fatty liver(NAFL).Methods Four hundred and nine patients of EH underwent liver uhrasonographic examina- tion during 2006-2007 year were enrolled.Patients were categorized as MS(n=312)or non-MS(n=97)ac- cording to the criteria by CDA.Body mass index(BMI),blood pressure,the profiles of blood lipid,liver func- tion,renal function,plasma sugar were determined.Results 1)The prevalence of fatty liver in EH+MS group (66.0%)was significantly higher than that of EH without MS group(41.2%,P

Objective To evaluate the prognostic significance of carbonic anhydrase IX (CA IX) expression in patients with clear cell renal cell carcinoma (ccRCC). Methods CA IX expression in a cohort of 120 patients with ccRCC was evaluated by P-V immunohistochemistry with a rabbit CA IX polyclonal antibody. Twenty-five normal kidney tissues were used as a control. The relationship between CA IX expression and prognosis was analyzed by univariate and multiple-factor analysis (Cox regression model). The primary end point was cancer specific survival. Results One hundred and twelve (93.3%) patients were followed up with the median follow-up time of 45 months (range, 6 to 94 months). Seventy-five patients survived without evidence of tumor recurrence, 3 patients survived with tumor recurrence, and 34 patients died, 28 of the 34 died of cancer. CA IX expression was negative in all normal renal tissue. High CA IX expression was observed in 89 (74.2%) patients, among which 82 patients were followed up, and the disease free survival was 75.6% (62/82). Two (2.4%) patients survived with tumor recurrence, and 18 (22.0%) patients died, of which 13 (15.9%) died of cancer. Tumor recurrence and (or) metastasis occurred in 9 (11.0%) patients, with a median survival of 92 months in this high expression group. Low CA IX expression was observed in 31 (25.8%) patients, among which 30 patients were followed up, and the disease free survival was 43.3% (13/30). One (3.3%) patient survived with tumor recurrence, and 16 (53.3%) patients died, of which 15 (50.0%) died of cancer. Tumor recurrence and (or) metastasis occurred in 8 (26.7%) patients with a median survival of 53 months in this low expression group. Cancer specific survival between CA IX high expression group and low expression group was significantly different (P=0.000, χ2=15.950), and tumor relapse and (or) metastasis rates were significantly different (P=0.040, χ2=4.200). The 1, 3, 5 and 7 year cancer specific survival rates were 95.2%, 83.9%, 81.2% and 78.2% respectively in the high CA IX expression group, and 89.5%, 63.9%, 46.8% and 40.1% respectively in the low expression group. Multivariate analysis with Cox regression model showed that CA IX expression was a prognostic factor (RR=0.186). Conclusions High CA IX expression is negatively correlated with postoperative mortality, relapse and (or) metastasis in ccRCC. CA IX expression could be used as a prognostic biomarker in ccRCC.

BACKGROUNDThe most appropriate surgical approach for patients with post-infarction left ventricular (LV) aneurysm remains undetermined. We compared the efficacy of the linear versus patch repair techniques, and investigated the mid-term changes of LV geometry and cardiac function, for repair of LV aneurysms.

METHODSWe reviewed the records of 194 patients who had surgery for a post-infarction LV aneurysm between 1998 and 2010. Short-term and mid-term outcomes, including complications, cardiac function and mortality, were assessed. LV end-diastolic and systolic dimensions (LVEDD and LVESD), LV end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) and LV ejection fraction (LVEF) were measured on pre-operative and follow-up echocardiography.

RESULTSOverall in-hospital mortality was 4.12%, and major morbidity showed no significant differences between the two groups. Multivariate analysis identified preoperative left ventricular end diastolic pressure > 20 mmHg, low cardiac output and aortic clamping time > 2 hours as risk factors for early mortality. Follow-up revealed that LVEF improved from 37% pre-operation to 45% 12 months post-operation in the patch group (P = 0.008), and from 44% pre-operation to 40% 12 months postoperation in the linear group (P = 0.032). In contrast, the LVEDVI and LVESVI in the linear group were significantly reduced immediately after the operation, and increased again at follow-up. However, in the patch group, the LVEDVI and LVESVI were significantly reduced at follow-up. And there were significant differences in the correct value changes of LVEF and left ventricular remodeling between linear repair and patch groups.

CONCLUSIONSPersistent reduction of LV dimensions after the patch repair procedure seems to be a procedure-related problem. The choice of the technique should be tailored on an individual basis and surgeon's preference. The patch remodeling technique results in a better LVEF improvement, further significant reductions in LV dimensions and volumes than does the linear repair technique. The results suggest that LV patch remodeling is a better surgical choice for patients with post-infarction LV aneurysm.

Aged ; Female ; Heart Aneurysm ; etiology ; mortality ; surgery ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; mortality ; surgery ; Ventricular Remodeling

Objective To investigate the operative methods and clinical significance of the treatment for large acoustic ncuroma with microsurgery by retrosigmoid approach.Methods 15 cases of large acoustic neuroma treated with microsurgery by retrosigmoid approach were systematic analyzed,including the operative approach,microsurgical technique,disposal after operation,prevention and cure of complications.Results Tumors were totally removed in 12 cases and were subtotally removed in 3 cases.Facial nerve was kept ana- tomic intact in 13 cases(86.7%) and acoustic nerve was kept anatomic intact in 6 cases(40.0%).The short period complications happened in 3 cases and no patient died in this series.Conclusion Treatment for large acoustic neuroma with microsurgery by retrosigmoid approach is a safe method,which give small hurt brain tissue and benefit to increase the total removal rate and protect effectively the function of facial nerve and acoustic nerve.

OBJECTIVE Programmed death ligand-1 (PD-L1) and indoleamine 2, 3-dioxygenase 1 (IDO1) are immune checkpoints which can be induced by interferon-γ(IFN-γ) in the tumor microenvironment, leading to immune escape of tumors. Myricetin (MY) is a flavonoid distributed in many edible and medicinal plants. The aim of this study is to clarify the effect and the mechanism of MY on inhibiting IFN-γ-induced PD-L1 and IDO1 in lung cancer cells. METHODS Expressions of PD-L1 and major histocompatibility complex-I (MHC-I) were evaluated by flow cytometry and Western blotting, and the expression of IDO1 was measured by Western blotting. qRT-PCR was used to detect their mRNA levels. The function of T cells was evaluated using a co-culture system consist of lung cancer cells and the Jurkat-PD-1 T cell line that overexpressing PD-1. Molecular docking analysis, Western blotting and immunofluorescence were used for mechanism study. RESULTS MY potently inhibited IFN-γ-induced PD-L1 and IDO1 expression in human lung cancer cells, while didn't show obvious effect on the expression of MHC-I. In addition, MY restored the survival, proliferation, CD69 expression and interleukin-2 (IL-2) secretion of Jurkat-PD-1 T cells suppressed by IFN-γ-treated lung cancer cells in the co-culture system. Mechanistically, IFN-γ up-regulated PD-L1 and IDO1 at the transcriptional level through the JAK-STAT-IRF1 axis, which was targeted and inhibited by MY. CONCLUSION Our research revealed a new insight into the anti-tumor effects of MY which inhibited IFN-γ-induced PD-L1 and IDO1 expression, supporting the potential of MY in anti-tumor immunotherapy.

Animals ; Global Health ; History, 20th Century ; Humans ; Influenza A virus ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; mortality ; virology ; Orthomyxoviridae Infections ; epidemiology ; veterinary ; virology ; Swine ; Swine Diseases ; epidemiology ; virology

OBJECTIVETo investigate the therapeutic effects of multiple level surgery in treating obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODSOne hundred ninety two patients with OSAHS diagnosed by polysomnography were treated through uvulopalatopharyngoplasty (UPPP). Thirty patients were combined with sub-mucous resection of the nasal septum. Forty four patients received sub-mucous resection of the nasal septum and partial inferior turbinectomy. Two patients received sub-mucous resection of the nasal septum and partial resection of the tongue base. Two patients received genioglossus advancement and partial resection of the tongue base. Three patients received partial resection of the tongue base. In addition, the patients with the nasal disease and/or the lingual fat, AHI > 40 times/h, LSaO(2) < 0.64 and/or BMI > 30 kg/m(2) received tracheotomy before general anaesthesia.

RESULTSOne hundred ninety two patients were treated through UPPP. One hundred ninety one patients were successful, one patient died of pneumothorax and cardiac arrest during the incision of the trachea. All patients were followed-up for 6-37 months, among them, 132 patients showed therapeutic effect, with the effective rate as 68.7%. Fifty five patients were cured (AHI < 5 times/h); 39 patients had significant effect (AHI < 20 times/h and decreased > or = 50%); 38 patients were effective (AHI decreased > or = 50%). However, 60 patients did not have any therapeutic effect, with the ineffective rate as 31.3%. Fifty four patients had palatopharyngeal and nasal cavity emphasis, 24 patients had palatopharyngeal and oropharyngeal emphasis, 96 patients had palatopharyngeal and nasal cavity and oropharyngeal emphasis. Some patients were treated with UPPP, which made effective rate as 15 (68.2%), 12 (63.2%), 29 (55.8%). The others were treated with multiple level operations, which made effective rate as 25 (78.1%), 5 (5/5), 33 (75.0%). The effective rate was 60.2% (56/93) by simple UPPP and it was 77.8% (63/81) by multiple level treatment in patients with multiple level obstruction. There was statistical significance between them (chi(2) = 6.2, P = 0.01).

CONCLUSIONSThe effective rate was improved through multiple level operations in OSAHS patients. The serious complications could be prevented through tracheotomy before general anaesthesia in patients with severe OSAHS who needed multiple level surgery.

Adult ; Aged ; Apnea ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; surgery ; Tongue ; surgery ; Treatment Outcome ; Uvula ; surgery