OBJECTIVETo explore the scientificity of Yunqi theory based on incidence of disease related recognitions such as year evolutive phase, host climatic qi, six climatic factors, celestial manager qi, qi in the earth by analyzing data of hypertension incidence.

METHODSA total of 1,265 inpatients with confirmed first diagnosis as hypertension were recruited at Dongzhimen Hospital, Beijing University of Chinese Medicine from February 4, 1999 to February 4, 2011. Each period (including year evolutive phase, host climatic qi, guest climatic qi) was deducted based on Yun-qi theory. Their ratios of different phases and qi in the total number of hypertension inpatients number were calculated and statistically tested.

RESULTSThere was statistical difference in ratios at year evolutive phase, celestial manager qi, and qi in the earth (P < 0.05).

CONCLUSIONThe incidence of hypertension has certain difference in each period, which is consistent with Yun-qi theory.

Beijing ; epidemiology ; Humans ; Hypertension ; epidemiology ; Incidence ; Medicine, Chinese Traditional ; Qi ; Research

Objective To analyze the relationship between different rectal volume,bladder volume and dose of organs at risk (OARs) in intracavitary brachytherapy for cervical cancer.Methods A total of 47 patients with cervical cancer were selected.All of them were treated with high dose rate (HDR) intracavitary brachytherapy with a 600 cGy dose for the dosage point.The effects of different volume of rectum bladder and small intestine for corresponding exposure dose under the standard planning were evaluated using a dose-volume histogram (DVH).According to bladder volume,patients were divided into three groups,＜ 80 cm3 group,80-120 cm3 group and ＞ 120 cm3 group.And according to rectum volume,patients were divided into ＞ 60 cm3 group and ≤ 60 cm3 group.The relationship between the volume and dosage were analyzed.The ANOVA test and t test were used for analyzing D1 cm3,D2 cm3,D30％ and D50％.Results Compared with the group with ＜ 80 cm3 bladder volume,D30％,D50％ value of bladder in groups with 80-120 cm3 and ＞ 120 cm3 of bladder volume increased (F =5.074,5.088,P ＜ 0.05).The difference of D1 cm3 and D2 cm3 value of the small intestine between 80-120 cm3 and ＞ 120 cm3 bladder volume groups were not statistically significant (P ＞ 0.05).D1 cm3 of rectum in groups with ≤ 60 cm3 rectum volume was decreased than that of ＞ 60 cm3 group (t =-2.045,P ＜ 0.05).Conclusions Keeping an appropriatly full bladder and reducing rectal volume in cervical cancers treated with intracavitary brachytherapy can make the exposure dose of bladder,rectum and small intestine relatively small,and reduce the adverse reactions of radiotherapy.

Objective: To investigate the value of serum hepcidin in assessment of liver inflammation activity among patients with chronic hepatitis B ( CHB ), so as to provide insights into the assessment of liver inflammation activity among CHB patients. Methods: A total of 79 CHB patients who were admitted to the Affiliated Hospital of Hangzhou Normal University were selected as the experimental group, while 40 healthy volunteers were randomly sampled as controls. Subjects'demographic data, liver function tests and iron metabolism parameters were collected from medical records, and serum hepcidin was measured using enzyme-linked immunosorbent assay ( ELISA ). In addition, ultrasound-guided liver biopsy was performed in CHB patients, and mild and moderate-to-severe CHB were classified according to liver inflammation activity and degree of liver fibrosis. Serum hepcidin levels were compared between the experimental and control groups and between patients with mild and moderate-to-severe CHB. The value of serum hepcidin in assessment of liver inflammation activity was examined among CHB patients using the receiver operating characteristic ( ROC ) curve analysis. Results: Subjects in the experimental group included 54 men ( 68.35% ) and had a mean age of ( 39.06±10.67 ) years, while the controls included 24 men (60.00%) and had a mean age of ( 42.43±11.44 ) years. Lower hepcidin levels were measured in the experimental group than in the control group [( 11.70±5.64 ) vs. ( 17.82±3.63 ) μg/L; P<0.05 ]. There were 54 patients with mild CHB ( 68.35% ) and 25 cases with moderate-to-severe CHB ( 31.65% ), and lower hepcidin levels were detected in patients with moderate-to-severe CHB than in those with mild CHB [ ( 6.92±2.21 ) vs. ( 13.95±5.36 ) μg/L; P<0.05 ]. The area under the ROC curve, optimal cut-off, sensitivity and specificity of serum hepcidin were 0.903 ( P<0.05 ), 10.365 μg/L, 100.0% and 72.2% for assessment of moderate-to-severe CHB, respectively. Conclusion Serum hepcidin is feasible to evaluate the liver inflammatory activity among patients with CHB.

The chemical ingredients of sediments from single Radix Aconiti Lateralis (Fuzi, in Chinese) decoction and Radix Aconiti Lateralis-Radix Glycyrrhizae (Gancao, in Chinese) decoction were evaluated separately by HPLC-MS for exploring their ingredients difference and discussing the mechanism of toxicity reduction of Fuzi-Gaocao herb-pair, even providing the experimental basis for extracting and purifying process of TCM preparations containing Fuzi-Gancao herb-pair. The sediments samples from single Fuzi decoction (FD) and Fuzi-Gaocao decoction (FGD) were prepared separately firstly. Then these samples were analyzed in the same chromatographic and mass spectrometry condition, estimating their HPLC-MS fingerprint and identifying their compounds by Q-TOFMS. As a result, 28 compounds in sediments samples from FD were obtained, among which 25 compounds and structures were confirmed. Besides, 36 compounds in sediments samples from FGD sample were obtained including 34 confirmed compounds and structures, among which there were 11 compounds from Gancao and 25 compounds from Fuzi. However, according to these confirmed compounds, alkaloids compounds in sediments samples from FGD were significantly different from that in sediments samples from FD. This result showed the fact that there would be some influences on alkaloid compounds in decoction after the combination of Gancao. In this study, the experiment basis of the mechanism of toxicity reduction of Fuzi-Gaocao herb-pair is provided. It also showed that much attention should be paid to the fact that there were great amount of alkaloid compounds, the effective compounds, in the sediments for which a comprehensive utilization in clinic and pharmaceutical process should be noted.

Objective To investigate the inducing effects of selenium dioxide(SeO2 ) on the apoptosis in human cervical carcino-ma cell line Hela and its influence on the expression of apoptosis-related proteins caspase-3 and P53 .Methods Hela cells were trea-ted with different concentrations of SeO2 for 24 h in vitro ;the morphological changes of Hela cells were observed by the optical mi-croscope;the influence of SeO2 on the cell proliferation and vitality was examined by the MTT assay ;the flow cytometry was em-ployed to detect the cell apoptosis rate ;the expressions of caspase-3 and P53 proteins in Hela cells were determined by the Western blot analysis .Results Under the optical microscopy ,SeO2 generated the obvious influence on the cell growth morphology ,a large number of cells became rounded and shrunken ,and lost the normal form ,while the adherence cell number was evidently decreased and the proliferation was slowed down ;the MTT results showed that SeO2 markedly inhibited the cell proliferation and viability in a dose-dependent manner ,in which ,the cell apoptosis rates induced by the 0 ,1 .875 ,3 .750 ,7 .500 ,15 .000 and 30 .000 μmol/L con-centrations of SeO2 were 3 .12% ,30 .56% ,33 .42% ,37 .50% ,45 .43% and 69 .38% respectively ,which revealing the obviously in-creasing trend;the Western blot assay revealed that SeO2 could up-regulate the caspase-3 and P53 levels ,and reached the peak value at the concentration of 7 .500μmol/L .Conclusion SeO2 could induce the cervical cancer cell apoptosis possibly by up-regulating the expressions of caspase-3 and p53 in Hela cells .

OBJECTIVETo study the feasibility of multi-slice spiral computed tomography (MSCT) 3-dimensional reconstruction technique in assisting cervical pedicle screw fixation (PSF) and double-door laminoplasty to treat multi-segmental degenerative spinal stenosis with traumatic instability (MDSTI) of lower cervical spine.

METHODSFrom September 2006 to August 2007, PSF combined with double-door laminoplasty was performed in 9 patients with MDSTI of lower cervical spine. MSCT 3-dimensional reconstruction techniques, including volume rendering (VR) and multi-planar reconstruction (MPR), were used to assist preoperative diagnosis and measurement to guide the procedure. MPR was performed after operation. In coronal view, the degree of screw perforation was measured precisely and the different positions of pedicle screws were divided into three grades according to Richter's method. In axial view, the canal sagittal diameter and transverse area of every laminoplasty level were measured.

RESULTSNine patients with MDSTI of lower cervical spine underwent PSF (total 44 screws). According to the classification of Richter, 72.7% (32/44) was in Grade 1 and 27.3% (12/44) was in Grade 2. No screw perforation occurred in Grade 3 and no screw revision was done for misplacement. No iatrogenic damage was observed. Double-door laminoplasty was performed in total 42 volumes. The postoperative sagittal diameter and transverse area of cervical spinal canal were significantly increased (P<0.05). The confidence intervals of mean increased ratio were 23.43%-40.65% in sagittal diameter and 23.18%-42.07% in transverse area. Six months after laminoplasty, based on MSCT axial view, complete union between "open door" and allograft bone was obtained in 76.19% of volumes (32/42), and allograft bone was absorbed partly in 23.81% (10/42). A solid union in bilateral gutters was achieved in all cases. They were followed up from 6 months to 1 year (mean 7.8 months). Postoperative neural function recovery in two cases improved 2 ASIA grade, 5 cases improved 1 grade and 2 cases remained the same as preoperative grade. No cases had lower ASIA grade.

CONCLUSIONAssisted with MSCT 3-dimensional reconstruction technique, PSF combined with double-door laminoplasty can be performed more safely and effectively to treat patients with MDSTI of lower cervical spine.

Aged ; Cervical Vertebrae ; injuries ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Spinal Stenosis ; diagnostic imaging ; surgery ; Tomography, Spiral Computed ; methods

Objective To investigate the relationship between acute radiation proctitis and radiation dose,volume as well as radiation time,in the process of intensity-modulated radiation therapy (IMRT) for the cervical cancer patients.Methods A total of 51 patients with locally advanced cervical cancer were enrolled from January 2011 to December 2013.Those patients were then classified into grade 1 to 4 groups,according to the RTOG/EORTCtoxicity grading standard.The exposure dose volume and the average dose of rectum under the standard plan were evaluated with dose-volume histogram (DVH).The ANOVA test was used for analyzing Dmax,D mean,D1 cm3,D2cm3,D40 and V40 values of rectum and the average exposure dose of rectum.Results The average time of acute radiation proctitis with clinical symptoms was (23.06 ± 12.01) d after radiotherapy.Dmaxvalues of rectum in grade 2 group was lower than those in grade 3 and 4 groups (F =5.268,P ＜ 0.05).Moreover,D1 cm3 and D2 cm3 values of rectum in grade 1 and 2 groups were also lower than those in grade 3 and 4 groups (F =4.893,4.406,P ＜ 0.05).There was no statistically significant difference between D40 and V40 values.Conclusions The acute radiation proctitis could be frequently found around 20 days during the IMRT for cervical cancer patients.Mild and moderate acute radiation proctitis are more common,while severe acute radiation proctitis is rare.Minimizing Dmax,D1 cm3 and D2 cm3 values of rectum might reduce the incidence of severe acute radiation proctitis in cervical cancer patients receiving IMRT.

Objective To investigate the effects of transplantation of bone marrow mesenchymal stem cells (BMSCs) transfected with adrenomedullin (ADM) on cardiac function in heart failure rats and the mechanism.Methods BMSCs were isolated from femur and tibia marrow of 10 rats,20 days old,body weight 30-50 g,and in vitro cultured.The third passage of BMSCs were tuansfected with adenovirus containing ADM and labeled with green fluorescent protein(GFP).Before transplantation,BMSCs were labeled with 4',6-diamidino-2-phenylindole (DAPI).Eighty healthy male Wistar rats weighted 180-200 g were randomly divided into 2 groups according to body weight:control group (n =10) was injected with normal saline (NS); diffuse myocardial injury heart failure rat model(n =70) was established by subcutaneous injection of isoproterenol (ISO,170 mg/kg) every day for 4 consecutive days.Four weeks after administration of ISO,heart function was assessed by echocardiography,the 39 rats with left ventricle ejection fraction(LVEF) ＜ 70％ of global heart failure model were randomly divided into three groups in accordance with the level of heart function:untransfected group,transfected group and NS group.DAPI labeled untransfected BMSCs suspension,ADM gene transfected BMSC suspensions (3 × 106/150 μl) and equal volume of NS were injected into the left ventricular anterior wall in 4 places in each goup.Control group received thoracotomy only.Four weeks after transplantation,rats were examined by ultrasound echocardiography,then were sacrificed and left ventricular were dissected.The myocardium was stained with Massons trichrome to analyze myocardial tissue fibrosis.The transplanted cells were observed by fluorescence microscopy and matrix metalloproteinase-2 (MMP-2) expression of myocardial tissue was detected in each group by Western blotting.Results After in vitro culture for three days,the BMSCs began to grow adherently,tended to be fused about 10 days,in the fusiform shape.Four weeks after transplantation,ultrasound echocardiography results showed that rat cardiac left ventricular end systolic diameter (LVDs),LVEF,and left ventricular cardiac fractional shortening (LVFS) were different between groups,and the difference were statistically significant(F =5.838,32.983,51.714,P ＜ 0.05 or P ＜ 0.01).Compared with the control group[(86.50 ± 1.54)％,(50.66 ± 1.87)％],the LVEF and LVFS of NS groups[(56.67 ± 6.86)％,(26.27 ± 4.01)％],the transfected group[(79.40 ± 1.70)％,(43.48 ±2.15)％] and untransfected group[(69.24 ± 7.30)％,(34.59 ± 5.13)％] were significantly lower(all P ＜ 0.05);compared with the NS group,the LVEF and LVFS of the transfected groups and the untransfected group were significantly increased(all P ＜ 0.05) ; compared with the untransfected group,the LVEF and LVFS of the transfected group were increased (all P ＜ 0.05).Compared with the control group [(3.16 ± 0.22)mm],the LVDs of the NS group[(5.35 ± 1.57)mm] was significantly increased (P ＜ 0.01); compared with the NS group,the LVDs of the transfected group and the untransfected group[(3.95 ± 0.55),(4.24 ± 0.92)mm] were significantly decreased (all P ＜ 0.05).There was no statistically significant difference between the control group,the transfected group and the untransfected group in LVDs (P ＞ 0.05).It can clearly be seen that there was GFP and DAPI labeled transplanted cells under a fluorescence microscope in the myocardial tissue transplanted area.There was significant difference in myocardial fibrosis area and the myocardial tissue protein expression of MMP-2 between groups(F =533.75,32.777,all P ＜ 0.01).The area ratio of the NS group[(15.200 ± 0.356)％,0.584 ± 0.013],the transfected group[(8.530 ± 0.573)％,0.386 ± 0.017] and the untransfected group [(10.670 ± 0.369)％,0.438 ± 0.015] and the MMP-2 protein expression were significantly higher than that of the control group[(1.070 ± 0.113)％,0.319 ±0.013,all P ＜ 0.01)]; compared with the NS group,the two index of the transfected group and the untransfected group were decreased (all P ＜ 0.05).Compared with the untransfected group,the two index of the transfected group was decreased (all P ＜ 0.05).Conclusion Transplantation of ADM gene transfected BMSCs can improve heart function of rats with heart failure significantly and reduce myocardial fibrosis.

OBJECTIVETo investigate the effect of Helicobacter Pylori lipopolysaccharide (Hp-LPS) on expression of Gli and Ptch-1 proteins in sonic hedgehog (Shh) signaling pathway of gastric mucosa GES-1 cells.

METHODSThe LPS was extracted from Hp by hot phenol water method, and then the concentration of LPS was detected by the kinetic turbidimetric assay. GES-1 cells were stimulated by different concentrations of Hp-LPS (0, 1, 10, 20, 30 and 40 μg/ml). The inhibition rates of cell growth were measured by MTT assay after treated with Hp-LPS for 24 h. The expression of Gli and Ptch-1 proteins were determined by Western Blot.

RESULTSMTT assay showed that the inhibition rates of GES-1 cell growth after treatment by different concentrations of Hp-LPS (1, 10, 20, 30 and 40μg/ml) were 25.8% ± 2.7%, 34.2% ± 3.1 %, 46.3% 3.4%, 60.8% ± 2.1% and 82.9% ± 2.8% respectively (r=0.985, P<0.001). Western blot showed that the expressions of Gli and Ptch-1 proteins were decreased after Hp-LPS treatment (0, 1, 10, 20, 30 and 40 μg/ml): the relative expression values of Gli were 1.286 ± 0.180, 0.963 ± 0.067, 0.850 ± 0.085, 0.566 ± 0.058, 0.549 ± 0.056 and 0.377 ± 0.047, respectively (r=-0.945, P<0.001); those of Ptch-1 were 1.688 ± 0.088, 1.466 ± 0.061, 1.170 ± 0.065, 1.042 ± 0.064, 0.648 ± 0.057 and 0.482 ± 0.074, respectively (r=-0.985, P<0.001).

CONCLUSIONHp-LPS can decrease the related protein expression of Shh signaling pathway, which indicates that Hp may interfere with the function of Shh signaling pathway in gastric mucosa via the effect of its LPS.

Cells, Cultured ; Epithelial Cells ; drug effects ; Gastric Mucosa ; cytology ; Hedgehog Proteins ; metabolism ; Humans ; Lipopolysaccharides ; administration & dosage ; pharmacology ; Patched Receptors ; Patched-1 Receptor ; Receptors, Cell Surface ; metabolism ; Signal Transduction ; Transcription Factors ; metabolism ; Zinc Finger Protein GLI1

OBJECTIVETo explore the clinical effects of external fixation associated with limited internal fixation on treatment of Gustilo grade III leg fractures.

METHODSFrom July 2006 to December 2008, 40 cases of Gustilo grade III leg fractures were emergently treated in our unit with external fixation frames. Soft tissue injuries were grouped according to the Gustilo classification as IIIA in 17 cases, IIIB in 13 cases, and IIIC in 10 cases. All the patients were debrided within 8 hours, and then fracture reposition was preformed to reestablish the leg alignment. Limited internal fixation with plates and screws were performed on all the Gustilo IIIA cases and 10 Gustilo IIIB cases at the first operation. But all the Gustilo IIIC cases and 3 Gustilo IIIB cases who had severe soft tissue injuries and bone loss only received Vacuum-sealing drainage (VSD). Broad-spectrum antibiotics were regularly used and VSD must be especially maintained easy and smooth for one week or more after operation. Limited internal fixation and transplanted free skin flaps or adjacent musculocutaneous flaps were not used to close wounds until the conditions of the wounds had been improved.

RESULTSThe first operations were completed within 90-210 minutes (170 minutes on average). The blood transfusions were from 400 ml to 1500 ml (those used for anti-shock preoperatively not included). All the 40 patients in this study were followed up for 6-28 months, 20.5 months on average. The lower limb function was evaluated according to the comprehensive evaluation standards of leg function one year after operation and the results of 28 cases were excellent, 9 were good and 3 were poor.

CONCLUSIONExternal fixation associated with limited internal fixation to treat Gustilo grade III leg fractures can get satisfactory early clinical therapeutic effects.

Adolescent ; Adult ; Debridement ; External Fixators ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged