Objective To summarize the clinical experience of one stage hybrid operation for aortic arch replacement and explore the indication. Methods From July,2009 to March,2010, 22 consecutive patients received one stage hybrid operation in our hybrid suite for aortic dissection or aortic aneurysm involving aortic arch. Two operative methods are used. (1)Bypass from ascending aorta to brachiocephalic arteries using midstemotomy and normothermia with antegrade aortic arch endovascular stented graft implantation. (2) Ascending aorta replacement and/or aortic valve replacement and/or coronary artery bypass grafting using midstemotomy and cardiopulmonary bypass with antegrade aortic arch endovascular stented graft implantation. Results All patients were technically successful. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleak of the stents. One patient in the first group died on sixth day after operation due to distal dissection rupture. There was one case of mediastinal lymph effusion in the second group and one case of death due to renal failure and respiratory failure 12 days after operation in the second group. The ICU stay and hospital stay were obviously shorter in hybrid open chest group than that in traditional open chest operation group(P ＜0.05). The blood product consumption and expenditure were also obviously less in hybrid open chest group than that in traditional open chest operation group (P ＜0.05). All the patients were followed up with a mean period of (14.45 ±2.33) months (range: 12 -20 months). All other patients were recovered with normal social life. CT showed neither endoleak nor translocation of the stented grafts. Faulse lumen closure rate at stented-graft segment is 100%. There was no obvious change of distal part of the dissection three months after operation except some thrombosis formation in some of the false lumen. Conclusion One stage hybrid operation for aortic arch replacement is safe and effective in shortening the duration of the operation and reducing the surgical trauma and risk of interval between procedures, shortening the hospital stay and reducing the blood product consumption compared with conventional operation with satisfactory early results. The midterm and long term results are still needed to be followed up.

AIM:To investigate the gene expression profile of human lung squamous cell carcinoma in early stage.METHODS:The mRNA was extracted from cancer tissue and normal lung tissue.The mixed probes were labeled and hybridized with chip containing 480 carcinoma related genes,then analyzed by SuperArray Image software to study the gene expression patterns in lung squamous cell carcinoma.RESULTS:192 genes associated with lung squamous cell carcinogenesis were found,which were grouped into transporter,adhesion molecules,cytoskeleton proteins,transcription regulator,genes associated with metabolism and immune response according to functions.127 gens were positive to lung squamous cell carcinogenesis and 65 genes were negative to lung squamous cell carcinogenesis.CONCLUSION:The screen of gene expression profile of human lung squamous cell carcinoma provides valuable information for the research of molecular mechanism of the lung squamous cell carcinogenesis.

Objective To investigate the impact of pair box 3 (PAX3) gene mutations on transcriptional ac‐tivity of target gene microphthalmia -associated transcription factor (MITF) and the role it plays in the pathogene‐sis of Waardenburg syndrome type I .Methods The 293T cells were transient transfected with wild type (WT ) PAX3 and mutant type (M T ) H80D ,H186fsX5 plasmids .We observed and analysed the regulation effects of WT/MT PAX3 on the transcriptional activities of MITF and the influence of the two mutants on WT PAX3 function u‐sing luciferase activity assays ,detect DNA binding capacity of WT/MT PAX3 to MITF gene promoter using a bioti‐nylated double - stranded oligonucleotide probe containing PAX3 binding motif ATTAAT to precipitate PAX3 , H80D and H186fsX5 respectively .Results H80D mutant was partially functional and was able to transactivate the MITF promoter in part ,but it was dramatically reduced as compared with WT PAX 3(P<0 .01) .H186fsX5 mu‐tant was loss -of -function and failed to transactivate the MITF promoter as compared with WT PAX 3 (P<0 .01) . None of them showed dominant -negative effect on WT PAX3(P>0 .05) .WT PAX3 and H80D mutant were able to bind specifically to the ATTAAT motif on the MITF promoter ,whereas H186fsX5 PAX3 lost the DNA -binding ability .Conclusion The mutations H80D and H186fsX5 made down-regulation of MITF transcription and decrease syn‐thesis of melanin ,which resulted in haploinsufficiency of PAX3 protein and caused mild phenotypes of WS1 .

OBJECTIVETo establish an implanted model of human colonic carcinoma on chick embryo, and to study the effects of anti-angiopoietin-2 antibody on its vascularization.

METHODSThe human colonic adenocarcinoma cell line HT-29 was transplanted on the chick embryo's chorioallantoic membrane(CAM), and the angiogenesis characteristics were observed by stero-microscope, light microscope and immunohistochemistry. Furthermore, the effects of anti-angiopoietin-2 antibody on angiogenesis and tumor growth were also investigated.

RESULTSThree to seven days after HT-29 cell line was implanted into CAM, tumors grew rapidly and new blood vessels grew toward tumors. Five days after anti-angiopoietin-2 antibody was given, the number of blood vessels in anti-angiopoietin-2 antibody group was significantly down-regulated than that in tumor control group observed by stero-microscope (37.2+/-4.6 vs 56.8+/-7.4, P<0.01), but was up-regulated than that in normal control group (37.2+/-4.6 vs 9.6+/-2.4, P<0.01). Microvessel density(MVD) in anti-angiopoietin-2 antibody group was much lower than that in tumor control group by histological examination (9.6+/-2.4 vs 20.2+/-5.8, P<0.01).

CONCLUSIONAngiopoietin-2 antibody is able to inhibit the angiogenesis induced by colorectal cancer cell line HT-29 obviously. The anti-angiopoietin-2 antibody may be potentially useful for clinical treatment of colonic carcinoma.

Angiopoietin-2 ; immunology ; Animals ; Antibodies, Monoclonal ; pharmacology ; Chick Embryo ; Colonic Neoplasms ; blood supply ; HT29 Cells ; drug effects ; Humans ; Neoplasm Transplantation ; Neovascularization, Pathologic

A 56-year-old female was admitted to Department of Gastroenterology at Peking Union Medical College Hospital with diarrhea for seven months, and abnormal liver function for six months. She had a history of type 1 diabetes. The main clinical manifestations were recurrent fatty diarrhea and abnormal liver function, accompanied by abdominal and retroperitoneal lymphadenopathy, elevated CA19-9 and CEA. Progressive impairment of hepatic synthetic function and shrinkage of liver developed in a short period of time. The pathology of liver biopsy suggested that nodular regeneration of hepatocytes was followed by hyperplasia of thin bile ducts after submassive necrosis. Intestinal mucosa biopsies were performed twice. The pathology showed that the intestinal villi were completely blunt, accompanied with crypt hyperplasia. Goblet cells disappeared with reduced mucin. Paneth cells were barely seen without intraepithelial infiltration of lymphocytes. Rifaximin was not effective, while glucocorticoids improved clinical situation. The diagnosis of autoimmune enteropathy was finally confirmed by multidisciplinary team including departments of gastroenterology, pathology, endocrinology, hematology, infectious diseases, and rheumatology. With the administration of glucocorticoid and sirolimus, diarrhea relieved and liver function returned to normal.

Objective To explore the self-face recognition and its relationship to empathy in patients with schizophrenia.Methods Sixty-two schizophrenic patients and fifty -four healthy subjects were assessed with the self-face recognition task (SFRT) and the interpersonal reactivity index-C (IRI-C).Results The SFRT reaction time in the patients group( (2188 ± 1138) ms) was significantly longer than that in the control group( ( 1152 ± 326) ms) (P ＜ 0.01 ) ;the accuracy in the patients group ( (80 ± 16) ％ ) was significantly lower than that in the control group ( (88 ± 6) ％ ) (P ＜ 0.01 ).The IRI-C total scores,the subscores in perspective taking,the subscores in fantasy and empathic concern of IRI-C were significantly lower in the patients group(respectively(44.82 ± 10.50),(8.98 ± 3.56),( 11.87 ± 4.38 ),( 14.73 ± 4.00) ) than those in the control group ( respectively (49.85 ± 10.28),( 10.78 ± 3.86),( 14.98 ± 6.12),( 17.39 ± 4.56) ) ; the subscore in personal distress of IRI-C in the patients group(9.37 ± 5.12) was significantly higher than those in the control group(6.52 ± 3.89) ( P＜ 0.01 ).There was significant positive correlation between the accuracy for self-face recognition in SFRT and the subscore in fantasy of IRI-C ( r =0.322,P ＜ 0.05 ),the reaction time of SFRT had significantly positive correlation with the subscore in personal distress.Conclusion Schizophren patients have general impairments of self-face recognition and empathic abilities,and the self-face recognition is related to the empathic abilities.

OBJECTIVETo study the relationship between liver pathological changes and serum HBeAg and HBV DNA in 1057 patients with chronic hepatitis B.

METHODSLiver puncture biopsy for histopathological examinations were performed in 1057 patients with chronic hepatitis B. The quantitative analysis of serum HBV DNA by fluorogenic quantitative PCR and HBeAg by chemoluminescence were also conducted.

RESULTSThe inflammatory grade and fibrosis stage were higher in HBeAg-negative patients (G4 and S4 were 7.83% and 12.17% respectively) than in HBeAg-positive patients (G4 and S4 were 3.39% and 5.44% respectively). The inflammatory grade and fibrosis stage were higher in HBeAg-positive patients with low-level HBV DNA (G3G4 was 45.64% and S3S4 was 30.20% for HBV DNA104-105), whereas they were higher in HBeAg-negative patients with high-level HBV DNA (G3G4 was 54.55% for HBV DNA106-107 and S3S4 was 42.85% for HBV DNA108-109).

CONCLUSIONThere were some correlation between the liver pathological changes and serum HBeAg and HBV DNA levels in patients with chronic hepatitis B. It is important to perform the liver pathological examination and antiviral therapy as early as possible in patients with HBeAg-negative chronic hepatitis B.

DNA, Viral ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; immunology ; Hepatitis B, Chronic ; blood ; pathology ; virology ; Humans ; Liver ; pathology ; virology

Objective To implement and evaluate evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia.Methods This study is a prospective before and after comparison study.Collected 200 acute stroke patients with dysphagia and divided them into test group (trained medical staffs) and control group(untrained medical staffs) equally according to the time order.Two groups of 100 patients were surveyed using a checklist before and after implementation of 10 guidelines about nutrition support.Before the implementation of guidelines,the staffs were enforced training,and summarized regularly.Compliances with guidelines by doctors and nurses were compared,and outcomes of patients were assessed.Results Compared with the control group,the correct implementation of the project significantly improved in the experimental group on nutritional risk screening (92.0％,64.0％; x2 =22.840),nutritional supplements selection (80.0％,48.0％; x2 =22.220),nutrition infusion methods (90％,18％ ; x2 =1.040) and nutrition infusion adjustment (abdominal distension/adjusted:21/10,6/4;x2 =9.634,constipation/adjusted:41/40,57/53 ; x2 =5.122,all P ＜ 0.05).The mortality rate,poor prognosis and length of stay in department of neurology intensive care unit and in hospital were not significant different between the experimental group and the control group.The incidence of hospital-acquired pneumonia was significantly lower in the experimental group (44.3％) than that in the control group (67.5％,x2 =7.281,P =0.007),but other patient outcomes were unaffected significantly.Conclusion Implementation of evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia is associated with improvements in clinical quality and selected patient outcomes.

Central Nervous System Infections ; cerebrospinal fluid ; Child ; Child, Preschool ; Humans ; Infant ; Insulin-Like Growth Factor Binding Protein 3 ; cerebrospinal fluid ; Insulin-Like Growth Factor II ; cerebrospinal fluid ; Male

AIMTo investigate the effect of resveratrol on EMMPRIN expression of macrophages.

METHODSHuman monocytic cell line THP-1 cells were co-cultured with EMMPRIN-highly-expressed MCF-7 cells; MMP-9 production was assayed by zymography. THP-1 cells were induced by PMA, expression of EMMPRIN was assayed by Western blotting. Cells were treated with resveratrol or PPARgamma agonist--pioglitazone during differentiation, EMMPRIN expression and MMP-9 activity were assayed. U937 cells were co-transfected with PPARy expression and luciferase-coding reporter vector, then cultured with pioglitazone or resveratrol, the activating capability of resveratrol on PPARgamma was evaluated by measuring the luciferase activity. THP-1 cells were pretreated with PPARgamma antagonist--GW9662 before pioglitazone or resveratrol treatment, then assayed for EMMPRIN expression and MMP-9 production.

RESULTSEMMPRIN expression was greatly increased during the differentiation from monocytes to macrophages; co-culturing with MCF-7 cells significantly increased MMP-9 production by monocytes. Both resveratrol and pioglitazone markedly inhibited EMMPRIN expression during monocytes differentiation. Resveratrol significantly activated PPARgamma and GW9662 greatly decreased the effect of resveratrol on EMMPRIN and MMP-9.

CONCLUSIONEMMPRIN expression is greatly up-regulated from monocytes to macrophages, which may play a role in inducing MMPs production by monocytes/macrophages. Resveratrol can significantly inhibit EMMPRIN expression via activating PPARgamma, which may be the underlying mechanism of its inhibitory effect on MMPs production by monocytes/macrophages.

Anilides ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Basigin ; biosynthesis ; genetics ; Blotting, Western ; Breast Neoplasms ; metabolism ; pathology ; Cell Differentiation ; drug effects ; Cell Line ; Cell Line, Tumor ; Coculture Techniques ; Dose-Response Relationship, Drug ; Female ; Humans ; Luciferases ; genetics ; metabolism ; Macrophages ; cytology ; drug effects ; metabolism ; Matrix Metalloproteinase 9 ; biosynthesis ; Monocytes ; cytology ; drug effects ; metabolism ; PPAR gamma ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Stilbenes ; pharmacology ; Thiazolidinediones ; pharmacology ; U937 Cells