OBJECTIVEThe study examined the changes of serum caspase-3 and IL-8 levels following selective head cooling with mild hypothermia (SHC) treatment in neonates with hypoxic-ischemic encephalopathy (HIE) in order to explore the mechanism of neuroprotection of SHC against HIE.

METHODSThirty-three neonates with moderate or severe HIE were randomly assigned to two groups: SHC treatment (n=16) and conventional treatment (n=17). Serum levels of caspase-3 and IL-18 were measured using ELISA before treatment and 24 hrs, 48 hrs, 72 hrs and 5 days after treatment.

RESULTSSerum caspase-3 levels in the SHC group decreased 24 and 48 hrs after treatment (3.8±1.9 and 2.6±1.2 ng/mL, respectively) compared with 6.1±2.3 ng/mL at 24 hrs and 7.2±3.1 ng/mL at 48 hrs in the conventional treatment group (P<0.05). Serum IL-18 levels in the SHC group decreased 24 hrs, 48 hrs and 72 hrs after treatment (119±30, 76±33 and 71±40 ng/mL, respectively) compared with those in the conventional treatment group (138±28 ng/mL at 24 hrs, 156±60 ng/mL at 48 hrs and 182±54 ng/mL at 72 hrs; P<0.01).

CONCLUSIONSSHC treatment can inhibit the release of caspase-3 and the expression of IL-18 in neonates with moderate or severe HIE. This may contribute to the neuroprotection of SHC against HIE.

Caspase 3 ; blood ; Female ; Humans ; Hypothermia, Induced ; Hypoxia-Ischemia, Brain ; blood ; therapy ; Infant, Newborn ; Interleukin-18 ; blood ; Male

Objective To explore the best operation time and approach, and the improvement mechanism of radiation encephalopathy in patients with nasopharyngeal carcinoma. Methods The data of 9 patients with radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma who admitted to our hospital from January 1996 and December 2008 were retrospectively analyzed. The neurological manifestations, imaging, neurosurgery strategies and pathological features of the patients were collected and analyzed. The efficacy and the follow-up results were compared. Results MRI showed such typical encephalopathy as severe edema or necrosis in the temporal lobe in most patients adopted radiotherapy; edema and necrosis in the brain tissues, hyaline degeneration and blocking in the small blood vessels were showed by pathologic examination. Some patients manifested as having unilateral edema or liquefactive necrosis in the brain with marked mass effect. After the surgery, the edema in the patients' brain was alleviated; 8 patients got improvement and discharged from the hospital in 2-3 weeks with stable vital signs. Eight patients achieved complete remission of headache with 1 having mild headache. Conclusion When medical treatment is not effective in patients who developed edema or liquefactive necrosis after radiotherapy, neurosurgery is a good therapeutic strategy, which can alleviate the symptoms, help clarify the diagnosis and guide the follow-up treatment.

OBJECTIVETo investigate the collagen constitution of hyperplastic scar (HS) in different ages and the change of relative factors.

METHODSThirty cases with HS were divided into two groups according to patients' age: group 1 (1 - 19 years, A) and group 2 (20 - 50 years, B). The normal skin (NS) from corresponding age of volunteers was employed as control group. The changes in TGFbeta1, collagenase (MMP-1) and tissue inhibitor of metalloproteinase (TIMP-1beta) and the collagen ratio were observed by means of in situ hybridization technique and SABC (Strept-Avidin-Biotin complex) immunohistochemistry and image analysis.

RESULTSThe ratio of type I to type III collagen in A group was 6.48 in average and 3.76 in B group, but there was no evident difference in the ratio during the disease process in both groups. The expression of TGFbeta1 in A group was much higher than that in B group (P < 0.01). The TIMP-1 mRNA expression showed no difference among all age groups in HS patients, but it was much higher than that in NS group. The MMP-1 expression was evidently lower than TIMP-1 expression, and there was no difference in MMP-1 expression compared with NS group.

CONCLUSION(1) The TGFbeta1 expression in HS patients was negatively correlated with age, and the increased expression of TGFbeta1 produced an increase ratio of type I to type III collagen. (2) High level expression of TIMP-1 led to the formation of HS by inhibiting MMP-1 expression, and the expression was not related to age.

Adolescent ; Adult ; Age Factors ; Burns ; metabolism ; pathology ; Child ; Child, Preschool ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Collagen Type I ; biosynthesis ; Collagen Type III ; biosynthesis ; Female ; Humans ; Infant ; Male ; Matrix Metalloproteinase 1 ; biosynthesis ; Middle Aged ; Tissue Inhibitor of Metalloproteinase-1 ; biosynthesis ; Transforming Growth Factor beta1 ; biosynthesis ; Young Adult

OBJECTIVETo determine the prevalence of non-fatal injuries among children aged 5-14 years in China.

METHODSData of 21 973 children aged 5-14 years were extracted from the Fourth National Health Service Survey of China carried out between June 15 and July 10, 2008. Injury-related indicators included: history of ever having had an injury, and injury frequency, cause, location and severity.

RESULTSThe overall prevalence of non-fatal injuries among the children in the previous 12 months was 17.0 per 1000 subjects. The leading causes of non-fatal injuries were falls, animal bites, traffic accidents, falling objects and burns. The majority of children sustained only one injury. The main place of injury was at home in 40% and 54% of urban boys and girls, respectively, at school in 48% of rural boys, and at home and at school each in 33% of rural girls. Medical treatment for one day was the main option for 80% of urban boys and girls, 84% of rural boys, and 72% of rural girls.

CONCLUSIONNonfatal injuries among children aged 5-14 years are a serious public health concern in China.

Accidents ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Data Collection ; Female ; Humans ; Male ; Prevalence ; Rural Population ; Wounds and Injuries ; epidemiology

Adolescent ; Adult ; Female ; Hepatitis ; therapy ; Humans ; Liver, Artificial ; Male ; Middle Aged ; Plasma Exchange

BACKGROUNDReal-time perfusion imaging (RTPI) using ultrasound contrast agents has shown good "accuracy" in detecting myocardial infarction, however its accuracy in the assessment of peri-infarct ischemia and stress echocardiography are not known. The aim of this study was to determine the accuracy of RTPI in assessment of peri-infarct ischemia during dobutamine and adenosine stress.

METHODSWe employed the RTPI modality (Agilent and ATL Philips) in a canine model (18 dogs) of distal coronary occlusion and proximal coronary stenosis. Using coronary flow probe recordings, the physiologic significance of proximal coronary stenosis was established by confirming abolition of the coronary reserve. The contrast agent Optison was given as a slow bolus injection at baseline, during prolonged distal coronary occlusion, during adenosine bolus stress and during dobutamine stress. Triphenyltetrazolium chloride (TTC) staining was used to verify a distal infarction. RTPI recordings at baseline, the distal coronary occlusion and stress protocols were randomly mixed and reviewed blindly.

RESULTSIn all but one dog, RTPI detected a distal infarct as small as 9% of the left ventricle. The sensitivity, specificity and overall diagnostic accuracy of RTPI in the detection of distal infarcts were: 94%, 89% and 92%, respectively. The sensitivity, specificity, and overall diagnostic accuracy of RTPI in the assessment of peri-infarction ischemia were 83%, 92% and 88% for adenosine stress and 95%, 86% and 91% for dobutamine stress, respectively.

CONCLUSIONSEven small distal infarcts can be detected by RTPI; peri-infarct ischemia can be accurately recognized by RTPI during stress; adenosine and dobutamine stress appear equally reliable in the RTPI evaluation of peri-infarct ischemia.

Adenosine ; toxicity ; Animals ; Coronary Circulation ; drug effects ; Dobutamine ; toxicity ; Dogs ; Echocardiography ; methods ; Female ; Hemodynamics ; drug effects ; Male ; Myocardial Infarction ; diagnostic imaging

OBJECTIVETo compare clinical outcomes of superior labrum from anterior to posterior (SLAP) repair and biceps tenodesis in treating type I SLAP injury.

METHODSFrom March 2009 to March 2012, 38 patients with type II SLAP injury were treated with SLAP repair and biceps tenodesis, and all patients were unilateral SLAP injury. Sixteen patients treated with biceps tenodesis included 8 males and 7 females with an average age of (49.3±3.7) years old (ranged, 45 to 54); 10 cases were on the left side and 6 cases on the right side; 10 cases were caused by falling down, 2 cases were caused by throwing damage and 4 cases were caused by daily life damage; the time from injury to operation were from 3 to 8 weeks. Twenty-two patients treated with SLAP repair included 14 males and 8 females with an average age of (49.0±2.8) years old (ranged, 44 to 56); 13 cases were on the left side and 9 cases were on the right side; 14 cases were caused by falling down, 5 cases were caused by throwing damage and 3 cases were caused by daily life damage; the time from injury to operation were from 3 to 7 weeks. Preoperative, postoperative at 6 months, 1 year and 2 years' UCLA and SST score were compared between two groups.

RESULTSThere was no significant differences in UCLA and SST score between two groups before operation. At 6 months after operation, UCLA and SST score in biceps tenodesis group was higher than SLAP group, and action,range of anteflexion, strength of anteflexion, degree of satisfaction in biceps tenodesis group was higher than SLAP group. There was no significant meaning in SST and UCLA score between two groups at 1 and 2 years after operation.

CONCLUSIONShort-term efficacy of biceps tenodesis for SLAP injury is better than SLAP repair, but long-term efficacy is fairly.

Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Joint ; injuries ; surgery ; Tendon Injuries ; surgery ; Tenodesis

OBJECTIVETo analyze the relationship between pesticide exposure and adverse pregnancy outcomes in famers.

METHODSA search was conducted to collect the articles about the relationship between pesticide exposure and adverse pregnancy outcomes published worldwide from 1990 to February 2012. Meta-analysis was performed on the collected articles using RevMan 4.2 software.

RESULTSTwelve articles were collected. Compared with the controls, the pesticide-exposed famers showed a combined odds ratio (OR) for spontaneous abortion of 1.52 (95%CI: 1.04 ∼ 2.21; P = 0.03), a combined OR for premature birth of 1.33 (95%CI: 1.09 ∼ 1.61; P = 0.005), a combined OR for dead fetus of 1.22 (95%CI: 1.16 ∼ 1.29; P < 0.01), a combined OR for stillbirth of 1.90 (95%CI: 0.58 ∼ 6.28; P = 0.29), a combined OR for birth defect of 2.02 (95%CI: 0.84 - 4.69; P = 0.12), a combined OR for low birth weight of 1.62 (95%CI: 0.60 ∼ 4.39; P = 0.34), a combined OR for neonatal death of 2.18 (95%CI: 0.54 ∼ 8.88; P = 0.28), and a combined OR for delayed conception of 1.43 (95%CI: 0.93 ∼ 2.18; P = 0.1). Pesticide exposure increased the risks for spontaneous abortion, premature birth, and dead fetus, but was not significantly associated with stillbirth, birth defect, low birth weight, neonatal death, and delayed conception.

CONCLUSIONPesticide exposure can cause adverse pregnancy outcomes in farmers, increasing the risks of spontaneous abortion, premature birth, and dead fetus.

Agriculture ; Female ; Humans ; Maternal Exposure ; Pesticides ; adverse effects ; Pregnancy ; Pregnancy Outcome ; Rural Population

This study was aimed to investigate the expression of c-MPL in acute myeloid leukemia (AML) and the correlation of the c-MPL expression with CD34 and CD38, so as to define the expression of c-MPL in leukemic stem cells. The expression levels of CD34, CD38 and c-MPL were detected by flow cytometry in bone marrow cells from 29 newly diagnosed AML patients. The relationship of c-MPL positive cell ratio with clinical parameters and correlation of c-MPL with CD34 and CD38 expression in AML patients were analyzed. The results showed that expression level of c-MPL in AML patients was significantly higher than that of normal controls (P < 0.05), and the expression level of c-MPL did not correlate with age, sex, white blood cell count, AML1-ETO fusion gene and remission after chemotherapy, but the expression of c-MPL in M2 and M5 patients was higher than that of normal control (P < 0.05). Expression of c-MPL in CD34 positive AML patients was obviously higher than that in CD34 negative AML patients (P < 0.01). c-MPL was significantly higher expressed in CD34(+) cells than that in CD34(-) cells (P < 0.001), while c-MPL expression was not significantly different between CD34(+)CD38(-) and CD34(+)CD38(-) cell groups. Positive correlation between c-MPL and CD34 expression was observed (r = 0.380, P = 0.042). It is concluded that expression of c-MPL is higher in AML patients, and positively correlates with the expression level of CD34. The c-MPL expresses in leukemic stem cells.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Middle Aged ; Neoplastic Stem Cells ; metabolism ; Receptors, Thrombopoietin ; metabolism ; Young Adult

OBJECTIVETo analyze the embryo development potential after intracytoplasmic injection of sperm from azoospermia patients with different spermatogenic functions.

METHODSWe performed ICSI with sperm retrieved from azoospermia patients with different spermatogenic functions using percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA). Then we recorded and analyzed the rates of normal fertilization, cleavages, excellent embryos and pregnancies.

RESULTSNo statistically significant differences were found between the PESA and TESA groups in the rates of normal fertilization ([74.9 +/- 19.6] vs [66.3 +/- 22.7]%, P > 0.05), cleavages ([96.7 +/- 8.6] vs [92.8 +/- 19.8]%, P > 0.05), excellent embryos ([43.5 +/- 26.2] vs [35.0 +/- 29.4]%, P > 0.05) and pregnancies (44.0 vs 52.0%, P > 0.05). The normal fertilization rates in the patients with normal spermatogenesis, mild spermatogenic dysfunction (SD), moderate SD and severe SD were (77.8 +/- 18.4), (68.4 +/- 18.5), (73.5 +/- 19.8) and (51.4 +/- 27.9)%, respectively, with significant difference between the normal spermatogenesis and mild SD groups (P < 0.05) as well as between the severe SD and the other groups (P < 0.05); the cleavage rates were (96.7 +/- 9.2), (96.5 +/- 15.0), (93.9 +/- 12.1) and (93.7 +/- 11.1)%, respectively, with no significant difference among the four groups; the excellent embryo rates were (47.1 +/- 25.8), (40.3 +/- 27.6), (36.2 +/- 23.1) and (15.0 +/- 24.6)%, respectively, with significant difference between the severe SD and the other groups; the pregnancy rates were 54.8, 50.0, 13.6 and 10.0%, respectively, with significant differences among the four groups (P < 0.001).

CONCLUSIONICSI by PESA or TESA is an effective approach to azoospermia. There are no significant differences between PESA and TESA in the rates of normal fertilization, cleavages, excellent embryos and pregnancies. The severity of spermatogenic dysfunction affects fertilization and initial development of embryos, which were shown in the rates of normal fertilization, excellent embryos and pregnancies but not that of cleavages.

Adult ; Azoospermia ; physiopathology ; therapy ; Embryonic Development ; Epididymis ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Young Adult