Aim To monitor the whole blood trough concentration of cyclosporine A (CsA) in renaltransplant recipients reciving triple therapy with mycophenolate mofetil, cyclosporine andprednisone and to establish an optimal therapeutic window of CsA. Methods Sampleswere measured by specific fluorescence polarization immunoassay. According to the timeafter operation and different therapy plan, the whole blood trough concentration of CsA ineach group was compared with that in control group.Results The optimal therapeuticwindow of CsA with MMF plan was 150~300 ?g? L-1 (less than one month after op-eration), 120~260?g?L-1 (1~

OBJECTIVE: To explore the effects of curcumin on the content of malondialdehyde (MDA) and the expression level of c-fos protein following hypoxia ischemia brain damage (HIBD) in rats. METHODS: Sprague-Dauley (SD) rats were randomly divided into four groups as the following: sham group, hypoxia ischemia brain damage group, curcumin group and solvent control group. The content of MDA in the brain was measured by colorimetry. The expression level of c-fos protein in the cortex tissue was detected by immunohistochemistry. Morphologic and structural changes of neuron cells of the cortex were observed by electron microscopy. RESULTS: The content of MDA was clearly lower in curcumin group than that in the other groups at the same time after HIBD. The expression level of c-fos protein was higher in the curcumin group than that in the other groups (P<0.05). Electron microscopy showed that the morphologic and structural changes of neuron cells of cortex in the curcumin group were reduced. CONCLUSION Curcumin could significantly decrease the content of MDA, increase the expression level of c-fos protein and reduce the damage of the neuron cells.
Animals ; Curcumin/pharmacology* ; Forensic Pathology ; Hypoxia-Ischemia, Brain/pathology* ; Male ; Malondialdehyde/metabolism* ; Neurons/pathology* ; Neuroprotective Agents/pharmacology* ; Proto-Oncogene Proteins c-fos/metabolism* ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To analyze the significance of forensic autopsy in medical tangle. METHODS: Ninety autopsy cases of medical legal dispute were retrospectively analyzed from the database of our department from 2001 to 2008. All cases were analyzed and classified based on age, sex, cause of death, clinic diagnosis and forensic diagnosis. RESULTS: The age ranged from 1 day to 72 years, and the ratios of male to female is 1:1. The most common healthcare facilities involved were county hospitals (30 cases, 33.33%). The coincidence rate between clinical diagnoses and pathological diagnoses was 33.33%. CONCLUSION The forensic autopsy is valuable to solve or even avoid the occurrence of medical legal dispute.
Adult ; Aged ; Autopsy ; Cardiovascular Diseases/pathology* ; Cause of Death ; Child ; Child, Preschool ; Female ; Forensic Pathology ; Humans ; Infant ; Infant, Newborn ; Male ; Malpractice/legislation & jurisprudence* ; Middle Aged ; Respiratory Tract Diseases/pathology* ; Young Adult

Aminopyridines ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Benzamides ; therapeutic use ; Clinical Trials as Topic ; Depsipeptides ; therapeutic use ; Histone Deacetylase Inhibitors ; therapeutic use ; Histone Deacetylases ; metabolism ; Humans ; Hydroxamic Acids ; therapeutic use ; Indoles ; therapeutic use ; Neoplasms ; drug therapy ; enzymology ; Sulfonamides ; therapeutic use

OBJECTIVETo evaluate therapeutic effects for reconstruction of anterior cruciate ligament(ACL)with hamstring tendon autografts and bioabsorbable interference screws fixation under arthroscopy.

METHODSThirty-one patients with ACL rupture were verified through arthroscopy. There were 27 patients were male and 4 patients were female, ranging in age from 17 to 40 years,with an average of 25 years. Among the patients, 26 patients combined with meniscus injuries, 3 patients with injuries of articular cartilage and 16 patients with I to II degree degeneration of articular cartilage. All the patients were performed ACL reconstruction with hamstring tendon autografts under arthroscopy and the reconstructed ligaments were fixed with bioabsorbable interference screws.

RESULTSNo severe complications occurred at early stage after operation. Thirty patients were followed up and ranged from 9 to 39 months,with an average of (19 +/- 9.0) months. Lysholm score significantly increased from average of 54.6 +/- 16.6 preoperatively to average of 92.5 +/- 5.7 at the end of follow-up period (t = 11.84, P < 0.01). Twenty-six patients restored to normal activity.

CONCLUSIONACL reconstructed with hamstring tendon autografts under arthroscopy has advantages of minimal trauma and satisfactory outcomes.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Tendons ; surgery ; transplantation ; Transplantation, Autologous ; Treatment Outcome

Background: Congenital myasthenic syndromes (CMSs) are a group of clinically and genetically heterogeneous disorders caused by impaired neuromuscular transmission. The defect of AGRN was one of the causes of CMS through influencing the development and maintenance of neuromuscular transmission. However, CMS reports about this gene mutation were rare. Here, we report a novel homozygous missense mutation (c.5302G>C) of AGRN in a Chinese CMS pedigree. Methods: We performed a detailed clinical assessment of a Chinese family with three affected members. We screened for pathogenic mutations using a disease?related gene panel containing 519 genes associated with genetic myopathy (including 17 CMS genes). Results: In the family, the proband showed limb?girdle pattern of weakness with sparing of ocular, facial, bulbar, and respiratory muscles. Repetitive nerve stimulation showed a clear decrement of the compound muscle action potentials at 3 Hz only. Pathological analysis of the left tibialis anterior muscle showed predominance of type I fiber and the presence of scattered small angular fibers. The proband's two elder sisters shared a similar but more severe phenotype. By gene analysis, the same novel homozygous mutation (c.5302G>C, p.A1768P) of AGRN was identified in all three affected members, whereas the same heterozygous mutation was found in both parents, revealing an autosomal recessive transmission pattern. All patients showed beneficial responses to adrenergic agonists. Conclusions: This study reports a Chinese pedigree in which all three children carried the same novel AGRN mutation have CMS only affecting limb?girdle muscle. These findings might expand the spectrum of mutation in AGRN and enrich the phenotype of CMS.

OBJECTIVETo investigate the influence of escharectomy at different time-points after burn injury on the lymphocyte apoptosis and the antigen presentation function of monocytes in peripheral blood of scalded rats.

METHODSOne hundred and thirty-six Wistar rats were randomly divided into normal control ( C,n = 8 ), scald ( S, n = 64,without treatment after scald) , A ( n = 40, with escharectomy at 36 post-burn hour( PSH) ) , B ( n = 24, with escharectomy at 72 PSH ) groups. The rats in A , B, S groups were inflicted with 30% TBSA full-thickness scald. The rats in S group were sacrificed on 6,12,24,72,120,168,216, 288 PSH, while those in A and B groups were sacrificed at 72 -288 PSH, 168 -288PSH, respectively. The rats in C group were also sacrificed as control. The apoptotic rate of peripheral lymphocytes, the positive expression rate of MHC- II in mononuclear cells, the changes in concentration of IL-4 and gamma-IFN were determined in each group. The correlation of above indices were also analyzed.

RESULTS(1) The apoptotic rate of peripheral lymphocyte in S group were increased dramatically at 6PSH, peaking at 24 PSH( 18. 19+/-1.42% ) , then decreasing gradually, reaching the lowest level at 72 PSH(8. 25+/-0.56% ) , then it increased gradually again, approaching almost the peak value at 288 PSH( 17.81 +/- 1.99% ). The values were all obviously higher than those in C group( P <0.05). The apoptotic rates of peripheral lymphocyte in A and B groups were evidently lower than that in S group ( P <0. 01). (2) The positive expression rate of MHC-II in monocyte was decreased sharply at 6 PSH, and it was 20% lower than that in C group (37. 2 +/- 2. 4% ) at 24 PSH. It then increased gradually, but it was significantly lower than that in A, B groups at 288 PSH (18. 8 +/-2. 8, P <0.01). (3) The plasma level of y-IFN in S group increased gradually from 6 PSH on, peaking at 24 PSH(440. 8 +/-25. 1 )ng/L,then decreasing gradually , and it reached the lowest level at 288 PSH (51.3 +/-37.0) ng/L. The IL-4 level in S group was increased gradually ,peaking at 288 PSH (78. 1+/-2. 8) ng/L. (4) There was negative correlation between the expression rate of MHC- II in S group and IL-4/gamma-IFN ratio in escharectomy groups during 72 - 288 PSH ( r = - 0. 96, P < 0. 05).

CONCLUSIONEacharectomy after scald can inhibit peripheral lymphocyte apoptosis, slow down the insertional tendency of IL-4/gamma-IFN , and ameliorate the antigen presentation function of monocytes. Moreover, escharectomy during shock stage can markedly promote the immune function of monocytes.

Animals ; Antigen Presentation ; Apoptosis ; Burns ; immunology ; pathology ; surgery ; Genes, MHC Class II ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Lymphocytes ; cytology ; immunology ; Male ; Monocytes ; immunology ; Rats ; Rats, Wistar ; Shock, Traumatic ; immunology ; pathology

OBJECTIVETo reconstruct a finite element model of human middle ear and measure characteristic dimensions of this model and calculate the mass properties of the ossicles.

METHODSThe proposed method starts with the histologic section preparation of human temporal bone. Through tracing outlines of the middle ear components on the sections in AutoCAD2005, a set of exterior contours of the components is obtained. The three-dimensional solid model of middle ear, including tympanic membrane, ossicular bones, middle ear suspensory ligaments/muscles, are reconstructed using these contours in Unigraphics (UG). To prepare for finite element analysis (FEA) of the middle ear, all surfaces of the solid model are translated into ADINA, a commercial FE model package. Based on these surfaces, FE meshes of the middle ear are created, and material properties and boundaries are set up. The characteristic dimensions of this model are measured and the mass properties of the ossicles are calculated to confirm the accuracy of the geometric model constructed following the proposed method.

RESULTSThe three-dimensional finite element model of the human middle ear that included tympanic membrane, ossicular bones and middle ear suspensory ligaments/muscles was reconstructed. The accuracy of this geometric model was confirmed with the outcome of the characteristic dimensions of this model and the mass properties of the ossicles.

CONCLUSIONSThe proposed method not only provides an effective, convenient, economic, accurate way to reconstruct the three dimensional finite element model of human middle, but also provides a detailed knowledge of middle ear geometry that is required for finite element analysis.

Ear, Middle ; Finite Element Analysis ; Humans ; Models, Anatomic

Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.
Antigens, CD20 ; metabolism ; Castleman Disease ; diagnosis ; immunology ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Mediastinal Diseases ; diagnosis ; immunology ; pathology ; radiotherapy ; surgery ; Mediastinum ; diagnostic imaging ; pathology ; Middle Aged ; Multimodal Imaging ; Positron-Emission Tomography ; Radiotherapy, Intensity-Modulated ; Tomography, X-Ray Computed

OBJECTIVESTo analyze the reason of revisions no more than 5 years after primary hip replacement, and to discuss the methods how to prevent and manage.

METHODSRetrospectively review 11 cases with revision no more than 5 years after primary total hip replacement from January 2002 to June 2007. The reasons for revision were as follows: 2 cases were recurrent dislocation due to malposition of acetabular prosthesis; 5 cases were loosening of acetabular prosthesis; 1 case was abrasion of the native acetabulum by bipolar femoral head; 2 cases were periprosthetic femoral fractures and 1 case was periprosthetic infection. The average follow-up time was 36 months. Each patient was assessed according to Harris hip score. The revision procedures including liner only, acetabular prosthesis only, or both acetabular prosthesis and femoral prosthesis depending on the reasons for revision, two-stage revision was performed on 1 case with periprosthetic infection.

RESULTSThe average of Harris hip score was increased from 46 (28 to 62) preoperatively to 86 (75 to 96) at follow up. The complication occurred in 2 cases: one was postoperative haematoma formation who was performed further surgery for clearance of haematoma, another was slight instability of the hip joint who was accepted skin traction for 3 weeks.

CONCLUSIONSThe main reason for revision after primary total hip replacement is related to uncorrected insert of acetabular prosthesis. Improving surgical technique of insert of acetabular prosthesis is important in primary total hip replacement.

Aged ; Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Prosthesis Failure ; Reoperation ; Retrospective Studies ; Treatment Outcome