"Wise men could recognize similarities, but the fool only recognizes differences" in Su-wen, which expounded clinical thinking methods of Chinese medicine (CM). "To recognize similarities and differences simultaneously" is of important clinical significance in understanding the laws of diseases. CM pays much attention to recognize similarities, while modern medicine emphasizes the differences observed. In order to develop integrative medicine (IM), similarities recognition and differences identification must be combined together to innovate new thinking methods of IM.
Humans ; Integrative Medicine ; standards ; Medicine, Chinese Traditional

BACKGROUND: The effect of pituitary adenylate cyclase activating polypeptide (PACAP) during traumatic brain injury (TBI) and whether it can modulate secondary injury has not been reported previously. The present study evaluated the potential protective effects of ventricular infusion of PACAP in a rat model of TBI. METHODS: Male Sprague Dawley rats were randomly divided into 3 treatment groups (n=6, each): sham-operated, vehicle (normal saline)+TBI, and PACAP+TBI. Normal saline or PACAP (1g/5L) was administered intracerebroventricularly 20 minutes before TBI. Right parietal cortical contusion was produced via a weight-dropping method. Brains were extracted 24 hours after trauma. Histological changes in brains were examined by HE staining. The numbers of CD4+ and CD8+ T cells in blood and the spleen were detected via flow cytometry. RESULTS: In injured brain regions, edema, hemorrhage, inflammatory cell infiltration, and swollen and degenerated neurons were observed under a light microscope, and the neurons were disorderly arrayed in the hippocampi. Compared to the sham group, average CD4+ CD8– lymphocyte counts in blood and the spleen were significantly decreased in rats that received TBI+vehicle, and CD4– CD8+ were increased. In rats administered PACAP prior to TBI, damage was attenuated as evidenced by significantly increased CD4+, and decreased CD8+, T lymphocytes in blood and the spleen. CONCLUSION: Pretreatment with PACAP may protect against TBI by influencing periphery T cellular immune function.

OBJECTIVETo establish an improved procedure for isolation and identification of epitopes from a random peptide library displayed on the bacterial surface.

METHODSEpitopes were screened from FliTrx random peptide library by a monoclonal antibody 3B9 against HBV-PreS2 protein. The enrichment was monitored in each round. Higher affinity clones were obtained by increasing the washing strength and randomly selected for sequencing and Western blot analysis.

RESULTSClones specifically binding to antibody were enriched in each round. Ten sequences were obtained from sixteen sequenced clones, seven of them contained the common motif RXRGXY with high homogeneity to 135-140 amio acids in HBV-PreS protein and have positive results in Western blot analysis. The other three sequences have no typical motif RXRGXY and showed different Western blot results.

CONCLUSIONSIt's easy and quick to drive epitopes from a random peptide library displayed on the bacterial surface.

Amino Acid Sequence ; Animals ; Antigens, Viral ; immunology ; Bacterial Proteins ; immunology ; Flagellin ; immunology ; Hepatitis B Surface Antigens ; genetics ; immunology ; isolation & purification ; Immunodominant Epitopes ; immunology ; Molecular Sequence Data ; Peptide Library ; Protein Precursors ; genetics ; immunology ; isolation & purification

OBJECTIVETo investigate the expression of telomerase in various lesions of adrenal cortex.

METHODSBy autoradiography-based telomeric repeat amplification protocol, telomerase expression was detected in 36 samples of adrenocortical lesions, including 29 cases adrenocortical adenoma (8 Cushing's syndrome, 17 aldosteronism and 4 nonfunctional adenomas), 5 cases of hyperplasia of adrenal cortex (presented with Chushing' syndrome), 2 cases adrenocortical carcinoma, and 4 samples of normal adrenal cortex.

RESULTSOf the 40 samples, 2 cases of adrenocortical carcinomas had telomerase expression, and the others had no telomerase expression detected.

CONCLUSIONSNo significant telomerase expression was found among different endocrine functional benign adrenocortical lesions. Telomerase expression may be used as an important marker of malignant adrenocortical tumor.

Adrenal Cortex ; enzymology ; Adrenal Cortex Neoplasms ; enzymology ; Adrenocortical Adenoma ; enzymology ; Biomarkers, Tumor ; analysis ; Cushing Syndrome ; enzymology ; Humans ; Telomerase ; analysis ; biosynthesis ; genetics

OBJECTIVETo evaluate the application of nephron-sparing surgery (NSS) in the treatment of renal cell carcinoma (RCC).

METHODSThe clinical data of 221 RCC patients who received nephron-sparing surgery were retrospectively reviewed. Open surgery was performed for 203 cases and laparoscopic surgery for 18 cases. The renal arteries were blocked and ice fragments were used for 115 patients. Biopsy was performed on renal tissue adjacent the tumor for 136 patients. After operation 156 patients were treated with interferon and interleukin II. Among these 221 patients, 132 patients (59.7%) were followed for 3-56 months (mean: 28 months).

RESULTSThe mean distance from the edge of normal tissue to the tumor was 0.4 cm (0.2-1.0 cm). The mean volume of blood loss was 180 ml (50-1 000 ml). Pathological examination showed clear cell carcinoma (n = 195), chromophobe renal carcinoma (n = 12), papillary renal carcinoma (n = 7), cystic renal carcinoma (n = 6), and sarcomatoid clear cell carcinoma (n = 1). Biopsies in 136 patients showed negative results. Post-operative complications included leakage of urine (n = 1), hemorrhage or hematuria (n = 5), and infarction of blood vessel of lower limbs (n = 2). During the follow-up, no patients died for this reason, although tumor recurrence (n = 4, 1.8%) and metastasis (n = 3, 1.4%) were noted.

CONCLUSIONNSS is a safe and effective method to treat carefully selected RCC patients.

Adult ; Aged ; Carcinoma, Renal Cell ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Nephrons ; surgery ; Retrospective Studies ; Young Adult

Objective To evaluate the development of the sphincter muscle complex(SMC)and defecation function in pediatric patients with congenital anorectal malformations(ARM).Methods A total of 64 children underwent MRI,among whom 39 were patients with ARM,and the others were patients without ARM undergoing MRI because of other dieases.The dimensions of the SMC in different planes were evaluated with different sequences and coils.The relationship between the SMC development and the defecation function was investigated.Results In control group,the absolute value of SMC width was (3.63?0.22)mm,which had a high correlation with age(r=0.998,P0.05).The SMCs in intermediate ARM patients[muscle index(MI)=0.47?0.05]and low ARM patients(MI=0.49? 0.05)were well developed.The SMCs in a portion of patients with high ARM(MI=0.28?0.06)were poorly developed,when MI≤0.18,anorectal contraction pressurewas significantly lower(t=3.55, P0.18[(0.85?0.20)vs(2.24?1.02)kPa].The length of anal canal with high-pressure[(10.88?3.64)vs(20.26?4.34)mm]was shorter(t=5.18,P0.18,the anorectal angle was less than 90 degrees,and normal continent function was found in 21 of 23 cases(91%).Conclusion MRI can be employed to evaluate the development of SMC in patients with ARM,MI was an objective criteria to evaluate the development of SMC.When MI≤0.18, maldevelopment of SMC will be highly suspected.

Purpose: To intelligently diagnose whether there is bladder outlet obstruction (BOO) in female with decent detrusor contraction ability by focusing on urodynamic study (UDS) data. Materials and Methods: We retrospectively reviewed the UDS data of female patients during urination. Eleven easily accessible urinary flow indicators were calculated according to the UDS data of each patient during voiding period. Eight diagnosis models based on back propagation neural network with different input feature combination were constructed by analyzing the correlations between indicators and lower urinary tract dysfunction labels. Subsequently, the stability of diagnostic models was evaluated by five-fold cross-validation based on training data, while the performance was compared on test dataset. Results: UDS data from 134 female patients with a median age of 51 years (range, 27–78 years) were selected for our study.Among them, 66 patients suffered BOO and the remaining were normal. Applying the 5-fold cross-validation method, the model with the best performance achieved an area under the receiver operating characteristic curve (AUC) value of 0.949±0.060 using 9 UDS input features. The accuracy, sensitivity, and specificity for BOO diagnosis model in the testing process are 94.4%, 100%, and 89.3%, respectively. Conclusions The 9 significant indicators in UDS were employed to construct a diagnostic model of female BOO based on machine learning algorithm, which performs preferable classification accuracy and stability.

Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Paraganglioma, Extra-Adrenal ; pathology ; surgery ; Retroperitoneal Neoplasms ; pathology ; surgery

OBJECTIVEThrough questionnaire and screening, epidemiology of syphilis in pregnant women and related risk factors were studied, to develop effective policy and reducing the negative impact of the disease.

METHODSAll pregnant women who appeared at the hospitals the first time, were included, in Shenzhen city. Tolulized Red Unheated Serum Test (TRUST) method was used for primary screening and positive results were confirmed by the Treponema Pallidum Particle Agglutination (TPPA) test at the Shenzhen Center for Disease Control and Prevention (SZCDC). Positive patients were informed and treated and the pregnancies were managed accordingly at the SZCDC.

RESULTSFrom 2003-2005, 418,871 (94.7%) pregnant were screened. Epidemiological and treatment data were collected from 2019 positive cases of infectious syphilis (0.48%). Among them, 94.2% were between 20 and 35 years old, with 93.6% of them had only junior high school education and 63.4% of them worked as commercial services or jobless which was significantly higher than other occupations (OR = 8.628). 89.5% of them were from other cities, significantly higher than from local residents (OR = 8.733). Gestational weeks at original diagnosis was longer and the infection rate higher.

CONCLUSIONThe infection rate of syphilis in Shenzhen was still at a high level which was related to occupation, education level, place of residency, gestational weeks at first diagnosis etc. Further screening measures and early intervention were important.

Adolescent ; Adult ; China ; epidemiology ; Female ; Gestational Age ; Humans ; Pregnancy ; Risk Factors ; Socioeconomic Factors ; Syphilis ; diagnosis ; epidemiology ; etiology ; Young Adult

OBJECTIVETo investigate and discuss the diagnosis and treatment of ectopic ACTH syndrome.

METHODSClinical data of 32 cases of ectopic ACTH syndrome, recruited from January 1990 to April 2003 in our hospital, was analyzed.

RESULTSAll of the 32 cases presented with clinical and biochemical evidences of Cushing's syndrome. Ten cases were definitively diagnosed as ectopic ACTH syndrome by finding ectopic tumors; 4 cases were highly suspected as ectopic ACTH by blood sampling from femoral vein and infra-petrosal vein and 18 cases were suspected as ectopic ACTH by imaging examinations. Fifteen cases (47%), without identified source of ectopic hormone, were treated with bilateral or unilateral total adrenalectomy, with 1-year survival rate of 60%. Seven cases (22%), with possible source of ectopic hormone, underwent no intervention, with 1-year survival rate of 0. Ten cases underwent radical resection of tumor, 6 of which were bronchial carcinoids and 4 of which were thymic carcinoids, with 1-year survival rate of 60%.

CONCLUSIONIt is very difficult to localize the tumor of ectopic ACTH syndrome patients. Bilateral adrenalectomy followed by hormonal replacement is effective for most of the patients without identifying source of ectopic hormone.

ACTH Syndrome, Ectopic ; diagnosis ; mortality ; therapy ; Adolescent ; Adrenalectomy ; methods ; Adult ; Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Survival Rate