Objective To investigate static closure functional characteristics of lower urinary tract in continence in late pregnancy of primigravida through perineal ultrasound and urodynamieal measurement. Methods From January of 2003 to December of 2005,83 primigravida undergoing antenatal health care in Shanghai Jiaotong University Affiliated Shanghai Sixth People's Hospital were randomly enrolled in the study, while 28 nulliparous women were recruited as control.The perineal ultrasound and urodynamical measurement were performed at the gestation age of 36-40 weeks,in both groups.We analysed the parameters of lower urinary tract function in late pregnancy compared with nullipara,such as maximal urethral closure pressure(MUCP),functional urethral length(FUL),maximal urethral pressure(MUP), valsalva leak point pressure(VLPP),postvoid residual bladder volume(PVRBV)and volume of first desire to voiding(VFDV).Results The average weight of 83 neonates was(3504?404)g.In all of 83 primigravida PVRBV was less than l0 ml.MUP(110 + 22)cm H_2O(1 cm H_2O=0.098 kPa),MUCP (96?22)cm H_2O and FUL(44?9)mm were significantly increased in the third trimester compared with nullipara(P0.05). There were 33 pregnant women suffering from urinary leakage throughout the terms.The data showed that MUCP was significantly lower in the pregnant women with symptoms of leaking than without leaking. Conclusion The static closure function increased significantly compared with nulliparous women.The VLPP was decreased and had relationship with symptoms of leakage.The results suggest that the function of lower urinary tract in continence in late pregnancy of primigravida is complex.

Aim To study the anti-oxidative and mitochondria-protective effects of estract of astragalus (EA ) on focal cerebral ischemia-reperfusion injury and its mechanism in rats.Methods Middle cerebral artery occlusion(MACO) was used to induce focal cerebral ischemia-reperfusion model. After 24 h reperfusion,MDA, LD content and SOD activity of brain homogenate were tested. MDA content,SOD and ATPase activity in mitochondrion were also tested.Transmission electron microscopy was used to assess the ultrastructure dstruction. Results EA(20, 40, 80 mg?kg -1) significantly inhibited the increase of MDA, LD after cerebral ischemia-reperfusion. EA (40, 80 mg?kg -1) also inhibited the decrease of activit of SOD in rats. EA(20, 40, 80 mg?kg -1) inhibited the increase of MDA and inhibited the decrease of activities of SOD, Na+,K+-ATPase, Ca 2+,Mg 2+-ATPase in mitochondrion. The examination by transmission electron microscopy showed that EA (20, 40 mg?kg -1) protected the ultrastructure destruction. Conclusion EA had protective effects against focal cerebral ischemia reperfusion injuries via attenuating cerebral oxygen free radical(OFR)lipid peroxidation and protecting mitochondria.

OBJECTIVETo observe the efficacy of Zaozhu Yinchen Recipe (ZZYCR) on non-alcoholic steatohepatitis (NASH) patients, and to explore its effect on serum free fatty acid (FFA) and tumor necrosis factor alpha (TNF-alpha).

METHODSTotally 120 patients with NASH were randomly assigned to the treatment group (60 cases, treated with ZZYCR, one dose per day) and the control group (60 cases, treated with Silibin Meglumine Tablets, 20 mg each time, thrice per day). The therapeutic course for all was 24 weeks. Serum levels of ALT and AST activities, TC and TG levels were detected before and after treatment. Peritoneal CT was performed in all patients, and CT ratios of liver and spleen calculated. NAFLD activity score (NAS) and degree of hepatic fibrosis were assessed using pathological examinations of liver tissue, and efficacy also evaluated. Serum contents of FFA and TNF-alpha were also detected.

RESULTSCompared with before treatment in the same group, activities of ALT and AST, serum levels of TC, TG, FFA, and TNF-alpha, NAS, scores of symptoms and signs all obviously decreased, degree of hepatic fibrosis was obviously improved in the two groups (P < 0.05, P < 0.01). These changes were more obviously seen in the treatment group (P < 0.05). After 24-week treatment, the total effective rate and total clinical efficacy were 80.00% (48/60 cases) and 85.00% (51/60 cases) in the treatment group, obviously higher than those in the control group [60.00% (36/60 cases) and 73.33% (44/60 cases) respectively], with significant difference (P < 0.05, P < 0.01).

CONCLUSIONZZYCR could improve the clinical efficacy of NASH patients, and its mechanism might be associated with inhibiting serum levels of FFA and TNF-alpha.

Drugs, Chinese Herbal ; therapeutic use ; Fatty Acids, Nonesterified ; blood ; Humans ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo establish osteoblast apoptosis model induced by gingipains, and to examine the expression of pro-apoptotic protein Bcl-2 interacting mediator (Bim), Bcl-2 associated X protein (Bax) and Bcl-2 antagonist/killer (Bak).

METHODSGingipain and gingipain acticity were extracted and measured. Mouse osteoblast cell line MC3T3-E1 cells were cultured in the presence of 0.453, 0.906, 1.812 U/L gingipains for 0, 16, 24 and 48 h. Apoptosis was examined by 4',6-diamidino-2-phenylindole (DAPI) staining or annexin V/propidine iodide (PI) staining.Protein expression of Bim, Bax and Bak was determined by Western blotting after osteoblasts were cultured with 1.812 U/L gingipain for 0, 4, 8, 16, 24 and 48 h. Osteoblasts were cultured with 1.812 U/L gingipain which had been inhibited with N-alpha-tosyl L-lysyl-chlorom ethylketone (TLCK). Western blotting was used to detect Bim expression and DAPI staining to measure apoptosis.

RESULTSArginine-specific proteinases (Rgp) activity was (18.11 ± 2.11) U/L and specific proteinases (Kgp) was (1.02 ± 0.25) U/L. Percentage of osteoblast apoptosis induced by 1.812 U/L gingipain rose to (6.31 ± 0.37)% after 16 h, and reached (11.20 ± 0.35)% at 24 h and (10.80 ± 0.46)% after 48 h with DAPI staining. Annexin V/PI staining supported the result from DAPI staining.Bim protein level increased during osteoblast apoptosis, the relative fold rose to (0.31 ± 0.03) after 4 h (about 2 fold compared to control), peaking at 24 h (0.57 ± 0.05, 3-4 fold compared to control). Proteinase inhibitor TLCK effectively blocked the activity of gingipain and inhibited up-regulation of Bim induced by gingipains from (0.58 ± 0.04) to (0.14 ± 0.03). The percentage of osteoblast apoptosis decreased from (11.20 ± 0.35)% to (4.31 ± 0.38)% in the presence of TLCK. Expression of Bax remained unchanged when cells were cultured with or without gingipains. Bak was under the detectable level in MC3T3-E1.

CONCLUSIONS1.812 U/L gingipains induced osteoblast apoptosis. Protein expression of Bim was up-regulated during cell apoptosis and was down-regulated when gingipain inhibited with TLCK, suggesting that Bim was involved in osteoblast apoptosis induced by gingipain. Inhibition of Bim protein expression protected osteoblast from apoptosis.

Adhesins, Bacterial ; pharmacology ; Animals ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Bcl-2-Like Protein 11 ; Cell Line ; Cysteine Endopeptidases ; pharmacology ; Humans ; MCF-7 Cells ; Membrane Proteins ; metabolism ; Mice ; Osteoblasts ; cytology ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Tosyllysine Chloromethyl Ketone ; pharmacology ; bcl-2 Homologous Antagonist-Killer Protein ; metabolism ; bcl-2-Associated X Protein ; metabolism

In recent years, the impact of meteorological factors on health and injury has been paid more and more attention. Severe weather events were considered to be an important risk factor for traffic accident injuries. Evidence from a large number of epidemiological studies suggests that meteorological factors, including high temperatures, rainfall, snowfall, wind and visibility, might be related to the occurrence of traffic accidents. This systematic review attempts to summarize the current research status of meteorological factors on traffic accident injury, systematically review the relationship between meteorological factors and traffic accident injury, and discuss how to further carry out related research.

OBJECTIVETo investigate one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft for temporomandibular diseases combined with dental-maxillofacial deformities.

METHODSThe preoperative measurement and model surgery was performed. The patients underwent arthroscope assisted condylar reconstruction with costochondral graft combined with bimaxillary surgery or mandibular surgery.

RESULTSFrom Sept. 2003 to Dec. 2005, 15 cases were treated successfully with no bleeding, nerve injury and infection. The patients were followed up for 29 to 52 months (mean, 31.8 months). The appearance was markedly improved. TMJ function was good with no pain. The average maximum interincisal opening was 33.6 mm.

CONCLUSIONCompared with traditional operation, one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft has its advantages. Indication selection and preoperative design are very important.

Adult ; Cartilage ; transplantation ; Endoscopy ; Female ; Humans ; Male ; Mandibular Condyle ; surgery ; Reconstructive Surgical Procedures ; methods ; Ribs ; transplantation ; Temporomandibular Joint Disorders ; surgery ; Young Adult

OBJECTIVETo identify the causes of respiratory complications following liver transplantation (LT) and to discuss the management of these complications.

METHODSOne hundred and twenty four cases with pulmonary complications in the first two weeks after LT were identified among 163 patients admitted to the First Affiliated Hospital, College of Medicine, Zhejiang University from February, 1999 to March, 2003.

RESULTSThe incidence rate of complications was 76%(124/163) with the total cure rate of 92%(114/124). The cure rates of the various complications were as follows: pleural effusion 100%(113/113), pneumonia 92%(76/83), respiratory insufficiency 91%(59/65), pulmonary hypertension 98%(101/103), pulmonary edema 98(58/59), atelectasis 100%(4/4) and pneumothorax 100%(2/2).

CONCLUSIONTo drainage the pleural effusion with an unicameral venous catheter is safety and effective. To cure or prevent pneumonia and atelectasis, aseptic manipulating, aspiration of sputum and keeping respiratory channel open were the key measurements of treatment. Restrictive ventilatory functional disturbance (RVFD) and dysfunction of ventilation are two major types of respiratory insufficiency in early stage of post-transplantation. The causes of pulmonary hypertension and edema are associated with pulmonary angiotasis and blood flow volume, and the vasodilator and diuretic often introduced in the therapy.

Female ; Humans ; Hypertension, Pulmonary ; etiology ; therapy ; Liver Transplantation ; adverse effects ; Male ; Pleural Effusion ; etiology ; therapy ; Pneumonia ; etiology ; therapy ; Postoperative Complications ; etiology ; therapy ; Pulmonary Atelectasis ; etiology ; therapy ; Pulmonary Edema ; etiology ; therapy ; Respiratory Insufficiency ; etiology ; therapy ; Respiratory Tract Diseases ; etiology ; therapy

OBJECTIVEThis is a preliminary study of the endoscopic technique on open surgery. The purpose of this study is to introduce the use of endoscopic technique for the reconstruction of the condyle with costochondral graft through a preauricular incision.

METHODS33 patients of temporomandibular joint diseases (n=49) underwent reconstruction of mandibular condyle with costochondral graft. After preparation of the recipient site through a preauricular incision, maxillo-mandibular fixation, and preparation of the costochondral graft, the graft was fixed to the lateral side of the mandible ramus under the supervision of arthroscope.

RESULTSAll the patients had successful reconstruction of the condyle with costochondral graft without any severe bleeding or craniocerebral injury.

CONCLUSIONThis case series demonstrates the feasibility of endoscopic technique for the reconstruction of the condyle through a preauricular incision. It has the advantage of high efficiency, minimal postoperative morbidity, great patient comfort, and little appearance impairment. The endoscopic technique has a promising future.

Adult ; Arthroscopes ; Endoscopy ; Female ; Humans ; Male ; Mandible ; Mandibular Condyle ; Reconstructive Surgical Procedures ; Temporomandibular Joint Disorders

OBJECTIVETo study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis (CAG), and evaluate the possible mechanisms.

METHODSRats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis (CAG) models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin (H-E) and alcian blue (A-B) stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer (microm) and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope (SEM). The levels of PGE(2), EGF (epiderminal growth factor) and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR (EGF receptor), C-erbB-2, p53, p16 and bcl-2 in gastric tissue.

RESULTSUnder SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infiltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower (P<0.05). Compared with normal level of (0.61+/-0.28) microg/L, EGF in CAG (2.24+/-0.83) microg/L was significantly higher (P<0.05). The levels of PGE(2) and gastrin in serum were significantly lower in CAG rats than that in normal rats (P<0.05). Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group (P<0.05). Immuno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue. bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue.

CONCLUSIONThe pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.

Animals ; Chronic Disease ; Epidermal Growth Factor ; blood ; Gastric Mucosa ; chemistry ; pathology ; Gastrins ; blood ; Gastritis, Atrophic ; metabolism ; pathology ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Rats ; Rats, Sprague-Dawley ; Receptor, Epidermal Growth Factor ; analysis ; Tumor Suppressor Protein p53 ; analysis

The aim of this study was to determine the dynamic expression profile of hepatitis B surface antigen (HBsAg) according to hepatic parenchyma cells' volume at different stages of liver fibrosis during the immune clearance phase. Eighty-nine patients with HBeAg-positive chronic hepatitis B (CHB) in the immune clearance stage were recruited for study. Each patient's serum HBsAg levels were detected by electrochemiluminescence. The serum HBsAg levels were apportioned according to hepatic parenchyma cells' volume at liver fibrosis stages 1, 2, 3, and 4 and compared by ANOVA. The unapportioned serum HBsAg levels (IU/mL) at liver fibrosis stages 1 (227.2+/-237.7), 2 (211.0+/-131.4), 3(300.1+/-144.6), and 4 (278.7+/-148.8) were not significantly different (all comparisons, P range: 0.061 to 0.759). However, when the serum HBsAg levels were apportioned by the same hepatic parenchyma cells' volume at liver fibrosis stages 1 (343.9+/-359.8), 2 (336.4+/-209.5), 3 (508.7+/-245.1), and 4 (525.2+/-274.8), the levels were significantly different (all comparisons, F = 3.045 and P = 0.033; stage 1 vs. 3, P = 0.041; stage 1 vs. 4, P = 0.046; stage 2 vs. 3, P = 0.028; stage 2 vs. 4, P = 0.034). During the immune clearance phase of chronic hepatitis B, increased HBsAg expression is associated with increased hepatic parenchyma cells' volume and progressive liver fibrosis stage.
Adolescent ; Adult ; Cell Size ; Child ; Female ; Hepatitis B Surface Antigens ; blood ; Hepatitis B, Chronic ; metabolism ; pathology ; Humans ; Liver ; cytology ; metabolism ; Liver Cirrhosis ; metabolism ; pathology ; Male ; Middle Aged ; Young Adult