Objective To compare the efficacy of mechanical ventilation (MV) with low tidal volume (LTV) plus positive expiratory end pressure (PEEP) and conventioal MV in the treatment of traumatic acute respiratory distress syndrome(ARDS). Methods From Oct 1997 to Oct 2003, 26 cases of traumatic ARDS patients were treated by conventioal MV(group A, n=11) or MV with LTV plus PEEP(group B,n=15), and clinical data of the patients were recorded and compared. Results There were no statistical difference in the PaO 2 of blood gas analysis and hemodynamic indices between the two groups, while the PaCO 2 was higher in group B than that in group A(P

Animals ; Beverages ; Macrophages ; drug effects ; metabolism ; Mice ; Mice, Inbred Strains ; Receptors, Complement 3b ; metabolism

OBJECTIVETo explore the therapeutic efficacy of a combined treatment modality using transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) to treat hepatocellular carcinoma (HCC) complicated with main branch intraportal vein tumor thrombosis (PVTT).

METHODSClinical data was collected retrospectively for patients diagnosed with and treated for HCC plus main branch PVTT at our hospital between January 2007 and January 2010. The total study population (n = 51) consisted of 38 males and 13 females, with an average of 50.1 years (range: 24-73). Among these patients, 26 had been treated with TACE + PEI (group A) and 25 had been treated with TACE alone (group B). Short-term changes in PVTT (i.e. disappearance, shrinkage, and/or stability) and tumor (i.e. complete response, partial response, and/or stable disease) were assessed by using the t-test (continuous variables) or the Chi-squared or Fisher's exact tests (categorical variables). Between-group differences in survival time were assessed by the Kaplan-Meier analysis and log-rank test.

RESULTSThe follow-up time ranged from 3-24 months after treatment, and no serious treatment-related complications were recorded for any of the patients (0/51). The time of TACE treatment was significantly longer for the patients receiving the combination therapy (group A: 3.21.4 vs. group B: 2.40.9, t = 2.22, P = 0.032). The patients in group A received between 2-8 PEI treatments. The TACE + PEI combined treatment showed significantly better therapeutic efficacy for PVTT (group A: 19/26 vs. group B: 10/25, X2 = 5.685, P = 0.019). The tumor response was significantly better in patients treated with TACE + PEI at post-treatment month 3 (group A: 20/26 vs. group B: 18/25, X2 = 0.163, P = 0.705) and month 6 (group A: 17/20 vs. 10/19, X2 = 2.58, P = 0.027). Finally, the average survival time was significantly better in patients treated with TACE + PEI (group A: 12.856.02 months (range: 5-23) vs. group B: 8.653.39 months (range: 4-16), t = 3.051, P = 0.004).

CONCLUSIONTACE + PEI combination therapy for main branch PVTT in HCC patients is more efficacious than TACE alone, and is associated with a longer survival time.

Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; pathology ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Injections, Subcutaneous ; Liver Neoplasms ; complications ; pathology ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein ; pathology ; Retrospective Studies ; Thrombosis ; complications

OBJECTIVETo discuss the effect of Drynariae Rhizoma's naringin on osteoclasts induced by mouse monocyte RAW264.7.

METHODRAW264.7 cells were induced by 100 μg x L(-1) nuclear factor-κB receptor activator ligand (RANKL) and became mature osteoclasts, which were identified through TRAP specific staining and bone resorption. MTT method was sued to screen and inhibit and the highest concentration of osteoclasts. After being cultured with the screened medium containing naringin for 5 days, positive TRAP cell counting and bone absorption area analysis were adopted to observe the effect of naringin on the formation of osteoclast sells and the bone absorption function. The osteoclast proliferation was measured by flow cytometry. The effects of RANK, TRAP, MMP-9, NFATc1 and C-fos mRNA expressions on nuclear factor-κB were detected by RT-PCR.

RESULTNaringin could inhibit osteoclast differentiation, bone absorption function and proliferation activity of osteoclasts, significantly down-regulate RANK, TRAP, MMP-9 and NFATc1 mRNA expressions in the osteoclast differentiation process, and up-regulate the C-fos mRNA expression.

CONCLUSIONNaringin could inhibit osteoclast differentiation, proliferation and bone absorption function. Its mechanism may be achieved by inhibiting the specific gene expression during the osteoclast differentiation process.

Acid Phosphatase ; metabolism ; Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Flavanones ; pharmacology ; Isoenzymes ; metabolism ; Matrix Metalloproteinase 9 ; genetics ; Mice ; NFATC Transcription Factors ; genetics ; Osteoclasts ; cytology ; drug effects ; Tartrate-Resistant Acid Phosphatase

OBJECTIVETo investigate the expression of programmed cell death 5 (PDCD5) in tissues of normal human prostate (NP), benign prostatic hyperplasia (BPH), and prostate cancer (PCa) in order to assess the clinical role of PDCD5 in PCa.

METHODSPDCD5 expression was determined by EnVision immunohistochemical staining in formalin-fixed and paraffin-embedded specimens obtained from 12 subjects with NP, 22 with BPH, and 22 with PCa. In addition, PCa cases were classified as low/middle-risk (Gleason sum < or = 7) and high-risk (Gleason sum >7) on the basis of Gleason grade. Positive expression rates and intensity of PDCD5 protein were observed under light microscope and analyzed with computer imaging technique. Expression of PDCD5 was compared among different prostatic tissues.

RESULTSThe expression of PDCD5 was significantly lower in tissue of PCa than in tissues of NP and BPH (P<0.01). However, there was no significant difference in PDCD5 expression between tissues of NP and BPH. In addition, the expression of PDCD5 was further downregulated with the increase of Gleason sum in PCa.

CONCLUSIONSBy downregulating apoptosis, low PDCD5 expression may play an important role in the occurrence and development of PCa. PDCD5 is supposed to have a potential clinical value to be a new predictor of progression and target of gene therapy in PCa.

Aged ; Apoptosis ; Apoptosis Regulatory Proteins ; analysis ; physiology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Proteins ; analysis ; physiology ; Prostate ; chemistry ; Prostatic Neoplasms ; chemistry ; etiology ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; analysis

Objective To assess the therapeutic effect of arterial embolization with ONYX-18 for treatment of tentorial dural arteriovenous fistula (DAVFs). Methods The clinical data (including the disease history, radiographic examination, surgical record, and follow-up data) of 4 patients with DAVF treated between March and July, 2008 were retrospectively analyzed. Of the 4 patients, one had acute subaraclmoid hemorrhage, and 3 exhibited progressive neurological deficits. The fistula orifice was located on the top of the tentorium in 2 cases, on the left tentorium in one case and in the posterior tentorium in the other. Type Ⅱ b DAVF was found in 2 cases, type Ⅲ in one case and type IV in the other ease. All the 4 patients underwent arterial embolization with ONYX-18, with ONYX-18 dose of 1.5, 3.5, 9, and 12 mL, respectively. One patient underwent ventricuioperitoneal shunt after the embolization because of obstructive hydrocephalus. Results The fistulae were embolized completely in 3 cases, and in one patient, a small quantity of blood supply to the fistula orifice was present fi'om the occipital artery, but the blood flow velocity was obviously reduced. Follow-up of the patients for 3 months revealed no occurrence of the former symptoms after the embolization. Conclusion ONYX-18 injection through one single feeding artery after placement of the micro-catheter at the appropriate position allows effective embolization of the fistula orifice, the supplying arteries and the venous ends to achieve safe and effective embolization of DAVF.

OBJECTIVETo investigate the genetic diversity of main germplasm of Atractylodes macrocephala in China and the genetic differentiation of the germplasm of A. macrocephala.

METHODA molecular marker ISSR was used to analyze the genetic diversity of 7 populations of A. macrocephala and a population of A. lancea.

RESULTTwelve primers were used in the PCR amplification of 86 samples of A. macrocephala and 5 samples of A. lancea. Sixty-three bands with sizes ranged from 100 to 2500 bp were generated from 12 primers. Of all the 63 bands, 55 bands were polymorphic among 86 individuals of A. macrocephala, the percentage of polymorphic bands were 87.30% at the species level. The percentage of polymorphic bands (PPL) for a single population ranged from 58.73% to 71.43% (mean, 64.85%). Among the 7 populations, a population from Panan, GM exhibited highest variability (PPL =71.43%; HE = 0.2835; I = 0.4267). A dendrogram constructed by an unweighted pair group method of cluster analysis showed that populations from Panan constructed one branch and separated from other populations. In the AMOVA analysis, low level of genetic differentiation among populations was detected, 90.52% of the variability existed in population.

CONCLUSIONThe genetic diversity of cultivated A. macrocephala in China is high, which is good for the production of high quality herb medicine.

Atractylodes ; classification ; genetics ; Genetic Variation ; Phylogeny ; Plants, Medicinal ; genetics ; Polymorphism, Genetic

OBJECTIVETo investigate the pathogenic and clinical characteristics of chemical burns in recent years, so as to provide reference for its prevention and treatment.

METHODSMedical records of patients with chemical burns out of 6299 burn patients admitted to our unit from January 1992 to December 2011 were screened and retrospectively analyzed, including gender, age, onset time of the injury, pre-hospital management, injury cause, injury-causing chemicals, body site of wound, burn area and depth, complications, treatment and follow-up results. The data of age distribution and incidence of complications were processed with chi-square test.

RESULTSInvestigation showed that 605 out of 6299 burn patients (accounting for 9.60%) were chemically injured. (1) Among the patients with chemical burns, the ratio of male to female was 5.11:1.00, with the mean age of 37.6 years, and the highest incidence occurred in patients aged from 20 to 29 years (29.42%, 178/605). The difference in the numbers of patients among different age groups was statistically significant (χ(2) = 207.298, P < 0.01). (2) Chemical burns mainly occurred in summer (28.43%, 172/605) and autumn (38.35%, 232/605). About 72.07% (436/605) of patients received irrigation before admission. (3) In 453 (74.88%) patients, injury occurred during industrial production. The main injury-causing chemicals were acid (46.61%, 282/605) and alkali (20.66%, 125/605), and among them the sulfuric acid accounted for the highest ratio (18.18%, 110/605). (4) The main wound positions of chemical burns were the limbs (289 patients) and the head, face, and neck region (263 patients). The mean burn area was 5.98% TBSA. The depth ranged from superficial partial-thickness to full-thickness. (5) Three hundred and forty-eight patients with chemical burns suffered common complications, including inhalation injury (154, 44.25%), ocular burns (113, 32.47%), and poisoning (81, 23.28%). There was statistically significant difference in the incidence of the three complications (χ(2) = 23.086, P < 0.01). (6) Five hundred and twenty-one patients were cured, with the cure rate of 86.12%, and 76.20% out of them healed with scars (397/521). Three patients died of poisoning, with a mortality of 0.50%.

CONCLUSIONSThe patients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period. The chemical burns mainly involved young males with the relatively close time of onset, and acid and alkali were the main causative factors in the process of industrial production. Most patients had the clinical features of deep wound, high incidence of complications, and liability of scar formation after wound healing.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Burns, Chemical ; epidemiology ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Sex Distribution ; Young Adult

OBJECTIVETo study the clinical implications of changes in plasma tissue factor (TF), tissue factor pathway inhibitor (TFPI) and factor VII (FVII) after the onset of acute myocardial infarction (AMI) and acute cerebral infarction (ACI).

METHODSSixty-nine patients with AMI, 71 with ACI and 50 age-matched healthy volunteers were enrolled in this study. Blood samples were obtained from the healthy subjects and from the patients at the early stage of AMI and ACI onset for examination of plasma TF and TFPI activity using chromogenic assay, and the plasma TF and TFPI antigens were measured by enzyme-linked immunosorbent assay (ELISA). The plasma FVII coagulation activity (FVII:C) was also measured, and the plasma FVIIa determined using soluble TF assay.

RESULTSCompared with the healthy control group, AMI patients had significantly enhanced plasma TF and TFPI activities and elevated TF and TFPI antigen levels (P<0.05), with also markedly increased FVIIa (P<0.05) but comparable FVII:C (P>0.05). In ACI patients, the plasma TF activity and antigen were obviously increased in comparison with the control group (P<0.05), but plasma TFPI activity and antigen were lowered (P<0.05), and both the FVII:C and FVIIa were markedly higher (P<0.05). Significant differences were noted in plasma TF and TFPI activities and their antigen levels as well as in FVII:C, but not in FVIIa between AMI and ACI patients.

CONCLUSIONV Following the onset of AMI and ACI, TF pathway is initiated and the risk of thrombogenesis increases, and the assessment of TF pathway is therefore of value for understanding the development of the condition.

Aged ; Aged, 80 and over ; Case-Control Studies ; Cerebral Infarction ; blood ; Factor VII ; analysis ; Female ; Humans ; Lipoproteins ; analysis ; Male ; Middle Aged ; Myocardial Infarction ; blood ; Thromboplastin ; analysis

OBJECTIVETo detect the expression of apoptosis gene PDCD5 in tissues of normal human kidney, renal clear cell carcinoma, normal bladder and bladder carcinoma, and explore the role of PDCD5 gene in renal clear cell carcinoma and bladder carcinoma.

METHODSIndirect immunohistochemistry was employed to detect PDCD5 expression in 63 kidney specimens and 42 bladder specimens. Positive expression rates and intensity of PDCD5 protein expression in the kidney tissue were investigated microscopically and by computerized image analysis. Positive expression rate in the bladder tissue was investigated by microscopic observation.

RESULTSThe results of immunohistochemical staining showed PDCD5 protein overexpression in the renal tubule of normal human kidney tissues and downregulation with the stage increase of renal clear cell carcinoma. PDCD5 protein expression showed statistical significance in tissues of normal kidney and renal clear cell carcinoma in all stages. No obvious PDCD5 expression was detected in the tissues of normal human bladder and bladder carcinoma.

CONCLUSIONPDCD5 is an important apoptosis-regulating factor in the occurrence of renal clear cell carcinoma, and its expression is extremely low in tissues of normal human bladder and bladder carcinoma.

Adult ; Aged ; Apoptosis Regulatory Proteins ; biosynthesis ; Carcinoma, Renal Cell ; metabolism ; Carcinoma, Transitional Cell ; metabolism ; Female ; Humans ; Immunohistochemistry ; Kidney ; metabolism ; Kidney Neoplasms ; metabolism ; Male ; Middle Aged ; Neoplasm Proteins ; biosynthesis ; Urinary Bladder ; metabolism ; Urinary Bladder Neoplasms ; metabolism