Abscess ; Cysts ; Female ; Humans ; Maxillary Sinus ; Tooth Diseases ; Young Adult

Objective To investigate the probability of assessment of hepatic fibrosis for liver transplantation using model for end-stage liver disease(MELD) by comparing the correlation of MELD score with Ishak pathological grading method. Methods Fifty-eight patients who underwent liver transplantation because of end-stage liver disease from February 2006 to September 2006 were performed quantitative hepatic fibrosis evaluation using computer-assisted digital image analysis. Pathological diagnosis according to the Ishak modified score was also performed. MELD scores were calculated using the original formula based on the clinical examination data collected on the admission days. The correlations among the image analysis method, Ishak grading and MELD scoring method were analyzed using the Spearman's rank correlation analysis. The linear relationship between the MELD scores and the degree of hepatic fibrosis shown from linear regression analysis was used to define the reference criterion. Results The hepatic fibrosis area ratios of the 58 patients were between 23.2 % and 88.4 % with average of 56.7% by computer-assisted digital image analysis. The MELD scores on the admission clays were between 11 and 38 with average of 22.85±9.32. The semi-quantitative Ishak classification showed that there were 0, 2, 7, 12, 18, 12, and 7 cases in each of the 7 grades respectively, the higher the grade the higher the hepatic fibrosis area ratio and the higher the MELD scores. Spearman rank correlation test indicated that there was significant correlation among these three methods(P ＜ 0.01). Linear regression analysis showed that there was a linear relationship between the MELD scores and the degree of hepatic fibrosis. Conclusions Computer-assisted digital image analysis can evaluate objectively the hepatic fibrosis degree and it is significantly correlated to the MELD system. Hepatic fibrosis degree can be evaluated by MELD scores.

Objective To clarify the clinical features,therapeutic strategy and prognosis of lipid storage myopathy (LSM).Methods The clinical data and therapeutic effects of 42 LSM patients were summarized retrospectively.All patients were followed up to evaluate their prognosis.Results Data of short-term therapeutic results of all the 42 patients were available.Thirty-three cases were placed in low- doses prednisone and 9 cases in riboflavin.All patients showed marked and quick improvement of symptoms within one month.Among thirty-two patients followed up for more than one year,26 cases had a full recovery and 6 remained to have intolerance to heavy exercise.Thirteen patients had relapses of muscle weakness in various degrees and most of which were induced by exertion,exposure to coldness and upper respiratory tract infection.In 5 patients the symptoms were recurred for more than one time.Among 13 cases with relapses, 7 had family history.Conclusions Our data suggest that LSM is a treatable disease and well responsive to low-doses prednisone.The disease tends to recur,especially in patients with family history.Glutaric aciduria type Ⅱ should be considered in LSM patients who are responsive well to riboflavin,indicating drug therapeutic strategy for LSM should be based on the etiology of the disease.

Autopsy ; Eye Injuries ; Forensic Medicine ; Humans

OBJECTIVE: To screen the differential expression of apoptosis-related protein and stress response protein(APR-SRP) genes after human brain injury by cDNA microrarray. METHODS: The total RNAs were isolated from normal and injured brain tissues of a car-accident victim, and were purified to obtain mRNAs by Oligotex. Both mRNAs from the tissues of the injured and the normal tissue were reversely transcribed to cDNAs with the incorporation of fluorescent dUTP to prepare the hybridization probes. The probes from normal tissue was labeled with Cy3-dUTP, that from the injured tissue with Cy5-dUTP. The mixed probes were hybridized to the BioDoor Chip ARP-SRP-1.0S, a cDNA microarray which contains 77 apoptosis related protein genes and 23 stress protein related genes. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and showed differences between two tissues. RESULTS: Among the 100 target genes, Only CLN2 gene (Homo sapiens lysosomal pepstatin insensitive protease gene) showed distinct deference in expression level between the brain injury and normal tissues. CONCLUSION cDNA microarray analysis indicated that CLN2 gene, which is correlated to a fatal childhood neurodegenerative disease, might be related to the brain injury. The expression level of CLN2 gene was significantly decreased in brain injured tissue in comparison to normal tissue. Further analysis of this gene will be helpful to understand the molecular mechanism of brain injury and utilization in forensic medicine.
Apoptosis ; Brain/metabolism* ; Brain Injuries/pathology* ; Gene Expression/genetics* ; Gene Expression Profiling ; Genetic Markers ; Humans ; Oligonucleotide Array Sequence Analysis/methods* ; RNA, Messenger/metabolism* ; Tripeptidyl-Peptidase 1

OBJECTIVETo evaluate a retro-grade auricular flap for repairing large alar defects.

METHODSTwenty-nine adult cadavers were anatomically used for vascular investigation of the frontal, nasal and temporal regions by injecting a dye into the main vessels. Based on the anatomical study in these regions, a retro-grade auricular flap was designed for repairing alar defects in 16 patients.

RESULTSThe blood supply of the auricle could be nourished by the inner carotid artery system from the supratrachlear artery and supraorbital artery through the frontal arterial anastomotical network into the frontal branch of the superficial temporal artery. It is then passing the main trunk of the superficial temporal artery into the ear area through the auricular branches of the superficial temporal artery. The retro-grade auricular island flap could be formed by basing the supratrachlear artery and the supraorbital artery through the vascular network between the superficial temporal artery and the supratrachlear artery or the supraorbital artery. Sixteen patients with large alar defects and half-sized nasal defects were successfully repaired by this technique.

CONCLUSIONSThe retro-grade auricular island flap, based on the inner carotid artery system, could be a good and safe flap for repairing a large alar defect or half-sized nasal reconstruction.

Adult ; Arteries ; Cadaver ; Carotid Artery, Internal ; Ear Auricle ; blood supply ; Humans ; Nose Deformities, Acquired ; surgery ; Ophthalmic Artery ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply ; transplantation ; Temporal Arteries

OBJECTIVETo measure the effect of atorvastatin on COX-2 expression in monocytes in patients with acute myocardial infarction (AMI).

METHODSForty patients with AMI (AMI group) and 18 patients with stable coronary heart disease (control group) were enrolled, and patients with AMI were randomly given routine therapy (n = 20) and routine therapy plus atorvastatin (20 mg/day, n = 20) for a week. Peripheral blood monocytes for each participant including patients with AMI were isolated and cultured for 24 hours. During the culture, monocytes in patients with pretreatment AMI were incubated with celecoxib in different concentration (0, 0.1, 1 and 10 micromol/L). COX-2 mRNA expression in monocytes was measured by reverse transcription polymerase chain reaction (RT-PCR); concentrations of interleukin-6 (IL-6) in supernatant from monocytes and plasma hs-CRP levels were measured by using enzyme-linked immunosorbent assay (ELISA).

RESULTSCOX-2 expression in monocytes in patients with AMI (0.92 +/- 0.13) was significantly higher than that in the control subjects (0.19 +/- 0.08), and decreased by 66% after atorvastatin (compared with that on routine therapy, P < 0.05); IL-6 secretions of monocytes in the AMI group (204.8 +/- 45.6 ng/L) increased dramatically compared with those in the control group (40.9 +/- 1.2 ng/L, P < 0.05), and reduced dramatically by 58% when incubated with 10 micromol/L celecoxib (P < 0.05) in a concentration-dependent manner; plasma levels of CRP in the AMI group (43.3 +/- 14.9 mg/L) significantly increased compared with those in the control group (1.7 +/- 0.8 mg/L), and reduced by 62% after atorvastatin (compared with those in the routine therapy group, P < 0.05). COX-2 expression in monocytes in the AMI group was positively correlated with both secretions of IL-6 and plasma level of CRP (r = 0.636 and 0.662, respectively, both P < 0.05).

CONCLUSIONSThere is an inflammatory activation in peripheral blood monocytes in patients with early AMI, and the monocytes-derived COX-2 may play an important role in promoting early inflammatory process. Atorvastatin may decrease COX-2 expression in peripheral blood monocytes in patients with AMI and cyclooxygenase-dependent pathway might be correlated with the anti-inflammation mechanism of statin.

Aged ; Atorvastatin Calcium ; Cyclooxygenase 2 ; metabolism ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Inflammation ; Interleukin-6 ; metabolism ; Leukocytes, Mononuclear ; drug effects ; metabolism ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; metabolism ; Pyrroles ; therapeutic use ; RNA, Messenger ; genetics

OBJECTIVESTo detect the expression of Cathepsin B (CatB) in the intracranial aneurysm wall and its effect to the apoptosis of vascular smooth muscle cells, aimed at clarifying the pathological formation mechanism of intracranial aneurysm.

METHODSFrom November 2006 to February 2009, 20 intracranial aneurysm samples were collected as the experimental group, and 6 cases of normal pallium artery samples were collected as the control group. Immunohistochemical technique was used to evaluate the expressions of CatB, alpha-smooth muscle actin (alpha-SMA) and Caspase-3. The expression of CatB mRNA was evaluated by real-time PCR. The ultrastructure of intracranial aneurysms were observed by using the transmission electronic microscope.

RESULTSCompared with the normal pallium artery specimens, the expression of CatB and Caspase-3 both significantly increased in the intracranial aneurysm walls where alpha-SMA decreased (P < 0.05). The mean expression of CatB mRNA in intracranial aneurysm samples was about 3.8-folds than that in control group (P < 0.01). There were excessive apoptotic vascular smooth muscle cells (VSMCs) in the tunica median, and typical apoptotic body were observed in some aneurysm walls.

CONCLUSIONCathepsin B may be involved in the formation and the progression of intracranial aneurysm.

Adolescent ; Adult ; Aged ; Apoptosis ; Case-Control Studies ; Cathepsin B ; metabolism ; Female ; Humans ; Intracranial Aneurysm ; enzymology ; pathology ; Male ; Middle Aged ; Muscle, Smooth, Vascular ; pathology ; Young Adult

OBJECTIVETo explore the association between polymorphism in the ACE I/D gene and blood pressure-lowering response to hydrochlorothiazide (HCTZ) in 829 patients.

METHODSHCTZ 12.5 mg was taken once a day for six weeks. The blood pressure reduction and ratio reaching target blood pressure were compared in different ACE genotype groups.

RESULTSThe reduction in SBP of patients carrying DD was greater than that in other groups carrying II or ID (12.2 mmHg versus 5.4 mmHg, 12.2 mmHg versus 4.4 mmHg, respectively, P<0.05). The reduction in MAP of patients carrying DD was also greater than that in other groups carrying II or ID (6.9 mmHg versus 3.9 mmHg, 6.9 mmHg versus 3.6 mmHg, respectively, P<0.05). The ratio reaching target blood pressure in DD groups was significantly higher than that in II or ID groups (P<0.05). The pre-treatment SBP, DD genotype, aldosterone levels entered the multi-linear regression model significantly and might affect the reduction of SBP. The pre-treatment DBP, aldosterone levels, DD genotype entered the multi-linear regression model significantly and might affect the reduction of DBP. The pre-treatment MAP, DD genotype, aldosterone levels entered the multi-linear regression model significantly and might affect the reduction of MAP.

CONCLUSIONACE genotyping is associated with blood pressure-lowering response to HCTZ. Specific genotypes might be associated with the response to specific antihypertensive treatment.

Aged ; Alleles ; Antihypertensive Agents ; therapeutic use ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Hydrochlorothiazide ; therapeutic use ; Hypertension ; drug therapy ; genetics ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; genetics

OBJECTIVETo investigate whether Candida albicans-native phospholipomannan (PLM) induce an inflammation response through Toll-like receptor(TLRé2 in human acute monocytic leukemia cell line (THP-1) cells.

METHODSHuman THP-1 monocytes were challenged with PLM in vitro. The mRNA expressions of TLR2, TLR4, proinflammatory cytokine [interleukin(IL)-6], and chemokine (IL-8) were assayed by real time reverse transcription polymerase chain reaction. The secretions of IL-6 and IL-8 were measured by enzyme-linked immunosorbent assay. The expression of TLR2 was analyzed with Western blot.

RESULTSPLM increased the mRNA expressions and secretions of proinflammatory cytokines (IL-6) and chemokines (IL-8) in THP-1 cells (all P=0.0000). PLM up-regulated the mRNA and protein levels of TLR2 (P=0.0000), whereas the mRNA level of TLR4 was not altered. PLM hydrolyzed with β-D-mannoside manno hydrolase failed to induce gene and protein expressions of TLR2, IL-6, and IL-8. Anti-TLRS-neutralizing antibody blocked the PLM-induced secretions of IL-6 and IL-8 in THP-1 cells (P = 0.0003, P = 0.0010).

CONCLUSIONCanidada albicans-native PLM may contribute to the inflammatory responses during Candida infection in a TLR2-dependent manner.

Candida albicans ; chemistry ; Cells, Cultured ; Glycolipids ; pharmacology ; Humans ; Interleukin-6 ; metabolism ; Interleukin-8 ; metabolism ; Monocytes ; drug effects ; immunology ; metabolism ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism