Objective:To investigate the expression of Bcl-2 and Bax in renal tissues of patients with hepatitis B virus- associated glomerulonephritis(HBV-GN).Methods:Twenty HBV-GN specimens with complete nephrology data and 10 normal renal specimens were randomly chosen for the present study.Cell apoptosis was detected by means of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL)and the apoptotic index was calculated;immunohistochemistry was used to detect the protein expression of Bax and Bcl-2.ResuLts:The apoptotic index in HBV-GN group was obviously higher than that of the control group;the apoptotic cells were mainly distributed in the proximal and distal renal tubules and the collecting duct epithelial cells,seldom seen in the glomerular cells.The expression of Bcl-2 in HBV-GN patients was predominately present in the renal tubular epithelia cells(positive in the plasma,membrane and nuclear);the expression of Bax was found in both glomerular cells and renal tubular cells,mainly in tubular epithelial cells,seldom seen in Bowman's capsule or glomerular mesangial region.Conclusion:Apoptosis in the kidney of HBV-GN patients mainly occurs in the renal tubular epithelial cells;expression of Bax and Bcl-2 is mainly in the renal tubular epithelial cells,suggesting that the injury of tubular interstitial damage may be one of the important factors for the development of HBV-GN.

Objective To study the expression and value of CXCR1 and CXCR2 on neutrophils, CD14~+ monocytes and CD3~+ T lymphocytes of peripberol blood of ankylosing spondylitis(AS)patients and to investigate the correlation between CXCR1,CXCR2 and disease activity.Methods A case control study was designed and enrolled 30 active AS,30 active rheumatoid arthritis(RA)and 30 healthy controls.The levels of CXCR1 and CXCR2 expression on neutrophils,CD3~+ T cells and CD14~+ monocytes of peripheral blood of the patients and healthy controls enrolled were measured and analyzed by flow cytometry by measuring the mean fluorescence intensity(MFI)channel.The correlations between the level of CXCR1 and CXCR2 anti disease activity or functional index of AS such as BASDAI,BASF1,ESR and CRP were analyzed.Results The MFI of CXCR1 expression on CD3~+ T lymphocytes of peripheral blood was significantly higher in AS patients (41?24)than that in RA patients(18?10)and healthy controls(19?7)(P

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a promising agent for anticancer therapy. The identification of small molecules that can establish the sensitivity of prostate cancer (PCa) cells to TRAIL-induced apoptosis is crucial for the targeted treatment of PCa. PC3, DU145, JAC-1, TsuPr1, and LNCaP cells were treated with Andrographolide (Andro) and TRAIL, and the apoptosis was measured using the Annexin V/PI double staining method. Real time-polymerase chain reaction (PCR) and Western blot analysis were performed to measure the expression levels of target molecules. RNA interference technique was used to down-regulate the expression of the target protein. We established a nude mouse xenograft model of PCa, which was used to measure the caspase-3 activity in the tumor cells using flow cytometry. In this research study, our results demonstrated that Andro preferentially increased the sensitivity of PCa cells to TRAIL-induced apoptosis at subtoxic concentrations, and the regulation mechanism was related to the up-regulation of DR4. In addition, it also increased the p53 expression and led to the generation of reactive oxygen species (ROS) in the cells. Further research revealed that the DR4 inhibition, p53 expression, and ROS generation can significantly reduce the apoptosis induced by the combination of TRAIL and Andro in PCa cells. In conclusion, Andro increases the sensitivity of PCa cells to TRAIL-induced apoptosis through the generation of ROS and up-regulation of p53 and then promotes PCa cell apoptosis associated with the activation of DR4.

OBJECTIVETo evaluate the immuno-effects of hepatitis B (HB) vaccination in adults.

METHODSFive groups were sampled by means of cluster sampling, and serum HBsAg, anti-HBs and anti-HBc were tested in every group at people aged from 18 to 50. Recombinant HB vaccine was injected to the ones that HBsAg, anti-HBs and anti-HBc were all negative. Concentration of anti-HBs in serum was tested after one year and three years of vaccination. Immuno-effects of recombinant HB vaccination in adults at different ages and between sexes, were then calculated.

RESULTSGood immuno-effects of recombinant HB vaccination in adults were noticed. After one year and three years of vaccination with 5 micro g recombinant HB vaccine, the anti-HBs positive rates were 82.76%, 70.77% while the serum concentrations of anti-HBs were 55.91 mIU/ml and 35.41 mIU/ml respectively. When 10 micro g was used, the concentrations were 83.74%, 72.22%, 56.89 mIU/ml and 30.29 mIU/ml respectively. The effects did not show significant differences between different doses on 10 micro g and of 5 micro g. Concentration of anti-HBs reduced when time went by. The factors such as age and sex influenced the effects of immunity on recombinant HB vaccination.

CONCLUSIONGood immunity could be obtained when recombinant hepatitis B was vaccinated in vulnerable population aged 18 to 50.

Adolescent ; Adult ; Female ; Hepatitis B ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; immunology ; Humans ; Male ; Middle Aged ; Vaccination ; Vaccines, Synthetic ; immunology

Objective To understand the obsessive-compulsive symptoms (OCS) and relative influencing factors among college students with left-behind experience. Methods College students with left-behind experience were selected from three universities in Anhui Province. The Chinese Obsessive-Compulsive Inventory-Revised (OCI-R), Rosenberg Self-Esteem Scale (RSES), Self-Rating Depression Scale (SDS) and self-edited basic situation questionnaires were used to measure the OCS, self-esteem, depression and left-behind experience. Multivariate logistic regressions model was applied to examine the influential factors of OCS. Results A total of 2 291 college students with left-behind experience were investigated. The detection rate for OCS in college students with left-behind experience were 26.5%. Regarding the OCS in college students with left-behind experience, significant differences were found in the following aspects: frequency of meeting with parents, parenting style, conflicts with caregivers, smoking and drinking (all P<0.05). Logistic regression analysis showed that caregiver adopts strict parenting style (OR=1.300, 95%CI:1.025-1.649,P=0.030), indulgent parenting style (OR=1.372, 95%CI:1.017-1.852, P=0.038), smoking (OR=1.982, 95%CI:1.305-3.011, P=0.001), depressive symptoms (OR=2.423, 95%CI:1.954-3.005, P<0.001), medium self-esteem (OR=0.604, 95%CI:0.481-0.759, P<0.001) and high self-esteem (OR=0.488, 95%CI:0.362-0.659, P<0.001) were influencing factors of OCS. Conclusions The prevalence rate of OCS among college students with left-behind experience is high. Some interventions should be taken to reduce the OCS among college students with left-behind experience.

Objective To explore the value of dual-phase contrast-enhancement multislice computed tomography (MSCT) in the assessment of acute myocardial infarction volume and perfusion in porcine models. Methods The distal left anterior descending coronary arteries of 5 pigs were balloon-occluded for 90 min and followed by reperfusion. MSCT was performed 1 min (early phase) and 5 min (delayed phase) after administration bolus of 100 mL of iodinated contrast material 30 min after reperfusion. On the same day, hearts were excised, sectioned in 8 mm short-axis slices, and stained with TTC. Infarction volume was defined as the sum of the hyper-enhanced area and surrounding hypo-enhanced area in all slices on delay enhanced phase of MSCT and the TTC-negative area on TTC staining slices. Infarction volume was expressed as percentage of total slice volume. Results Acute infarction detected by MSCT was characterized by early myocardial perfasion defects in the early phase of the contrast bolus (early defects) with surrounding residual defects and late enhancement observed in the late phase. Mean CT attenuation value of early defects was significantly different from CT attenuation value of remote myocardium [(213±55)HU vs (304±30)HU](P < 0.05), CT attenuation values of residual defects and late enhancement were also significantly different from those of remote myocardium [(360±75) HU vs (90±37) HU and (152±23) HU vs (190±37) HU, repectively](P < 0.01, P < 0.05). The mean infarction volume was (8.9± 1.0)% on MSCT and (9.2±1.4)% on TTC pathology images. The infarction volume assessed by MSCT compared well with TTC staining slices. Conclusion Acute reperfused myocardial infarction zone has specific enhancement pattens different to remote normal zone on dual phase MDCT, which is in good agreement with in vivo Trc pathology in the assessment of acute reperfused myocardial infarction shortly offer reperfusion.

OBJECTIVETo analyze the risk factors of heterotopic (HO) ossification after total lumbar disc replacement and probe the preventive strategies for it.

METHODSThe radiographs and clinical data of 78 discs in 65 patients who received artificial lumbar disc replacement (ADR) from April 1998 to December 2003 were analyzed retrospectively by two radiologists and one orthopaedic surgeon and then postoperative HO were graded according to McAfee system. The bony formations in disc spaces, time of HO were found, and range of motion (ROM) of the operated levels were measured on radiographic films. In addition, the risk factors such as preoperative peri-annulus ossification, bony endplates injuries, and subsided or mal-position of the prostheses were also analyzed by Logistic regression analysis.

RESULTSPostoperative HO was found in 10 spaces of 9 cases. Class I of HO were occurred in 7 patients at means 2.1 years postoperatively with normal range of motion preserved. Three of them turned into class II or III with 10 degrees of mean ROM in the following 2.5 years. Another 2 (2/9) cases with preoperative peri-annulus ossification had bridging trabecular bone (class III) between the endplates and 9 degrees of ROM 2 years after surgery, then turned into class IV at 6 years with 0 degrees and 4 degrees of motion in the operated levels. As the risk factors of HO, preoperative annulus ossification (2 cases), bony endplates injuries (5 cases), mal-positioned prostheses (2 cases) and subsided prostheses (2 cases) were found simultaneity with significant positive relation to HO occurred (P < 0.05).

CONCLUSIONSFactors such as preoperative ossification of annulus, endplate injuries, prosthesis subsided and mal-position would have higher risks to have HO occurred after ADR, but ROM of most affected levels are preserved. Strict control indication and avoid all above risk factors can prevent HO occurring effectively.

Adult ; Aged ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Ossification, Heterotopic ; etiology ; prevention & control ; Prosthesis Implantation ; adverse effects ; Retrospective Studies ; Risk Factors

OBJECTIVETo explore early diagnosis, treatment and prevention of gastrointestinal (GI) bleeding after cardiac surgery.

METHODSIn the last 13 years, cases complicated with GI bleeding after cardiac surgeries were analyzed retrospectively.

RESULTSFourty-four GI bleeding occurred post-operatively in (6 +/- 3) d. The mortality was 23% (10/44). Thirty-eight were located in upper GI tract, of them 26 underwent conservative therapy while 4 died of other than GI bleeding cause; six underwent laparotomy while 1 and 3 died of septicemia and multi-organ failure respectively; six underwent gastric endoscopic hemostasis by electrocautery or clipping the bleeding vessel while all survived. Six were located in lower GI tract, and 2 of them underwent laparotomy without finding bleeding section and died of multi-organ failure. By multivariable logistic regression analysis, deaths were highly related to the post-operative ventilator-dependence, acute renal insufficiency, intra-aortic balloon pump (IABP) assisting and laparotomy.

CONCLUSIONThe mortality of GI bleeding after cardiac surgeries is very high, early gastrointestinal endoscopic examination and minimally invasive intervention can treat this complication more effectively. GI bleeding must be prevented whenever complicating post-operative ventilator-dependence, acute renal insufficiency, and IABP assisting after cardiac surgery.

Adult ; Aged ; Cardiac Surgical Procedures ; adverse effects ; Early Diagnosis ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; mortality ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors

BACKGROUNDThe role of B-cell remains an enigma in the pathogenesis of ankylosing spondylitis (AS). This study aimed to investigate the distributions of B-cells and subsets in peripheral blood of AS patients and observe their changes in etanercept-treated AS patents.

METHODSWe detected the proportions of CD19(+) B-cell, naive B-cell (CD19(+)CD27-), memory B-cell (CD19(+)CD27dim) and plasmablast (CD19(+)CD27high) in peripheral blood of 66 patients with AS (39 at active stage, 27 at stable stage; 35 patients with peripheral joint involvement, 31 patients with axial involvement alone), 30 patients with rheumatoid arthritis (RA) and 30 healthy volunteers using flow cytometry. And then we observed the changes of the above indexes of 39 active AS patients treated with etanercept in a randomized, double-blind, placebo-controlled trial.

RESULTS(1) Percentages of CD19(+) B-cells in active or peripheral joint involvement AS patients increased more obviously than those in stable or axial involvement alone AS patients (both P = 0.001), and percentage of CD19(+)CD27high B-cells in AS patients with peripheral joint involvement was significantly higher than that in cases with axial involvement alone or healthy volunteers (P = 0.005 and 0.006, respectively); (2) The percentage of CD19(+) B-cells in AS patients was positively correlated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, Patient's Global Assessment (PGA) scores, total back pain scores and nocturnal back pain scores (r = 0.270, 0.255, 0.251 and 0.266, P = 0.029, 0.039, 0.042 and 0.031, respectively); (3) At week 6 and week 12, there were no statistical differences of the percentages of B-cells and subsets between etanercept group and placebo group of AS patients (P > 0.05); the percentage of CD19(+) B-cells in etanercept group was higher than that in healthy volunteers at week 12 (t = 3.320, P = 0.003).

CONCLUSIONSMisbalance is present in B-cells and some subsets in peripheral blood of active AS patients with peripheral joint involved. B-cells might play an important role in the pathogenesis of AS patients. The high percentage of CD19(+) B-cells in active AS patients cannot be down-regulated after 12-week etanercept treatment.

Adolescent ; Adult ; Antigens, CD19 ; immunology ; B-Lymphocytes ; drug effects ; immunology ; Etanercept ; Female ; Flow Cytometry ; Humans ; Immunoglobulin G ; pharmacology ; therapeutic use ; Immunosuppressive Agents ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Spondylitis, Ankylosing ; drug therapy ; immunology ; Tumor Necrosis Factor Receptor Superfamily, Member 7 ; immunology ; Young Adult

BACKGROUNDEpinephrine infiltration of the nasal mucosa causes hypotension during functional endoscopic sinus surgery (FESS) under general anesthesia. A prospective randomized-controlled study was designed to determine whether relatively light general anesthesia is superior to fluid expansion in reducing epinephrine-induced hypotension during FESS.

METHODSNinety patients undergoing elective FESS under general anesthesia were randomly assigned to three groups with 30 patients in each. Each patient received local infiltration with adrenaline-containing (5 microg/ml) lidocaine (1%, 4 ml) under different conditions. For Group I, anesthesia was maintained with propofol 2 microg/ml and rimifentanil 2 ng/ml by TCI. Group II (control group) and Group III received propofol 4 microg/ml and rimifentanil 4 ng/ml, respectively. In Groups I and II, fluid expansion was performed with hetastarch 5 ml/kg within 20 minutes; hetastarch 10 ml/kg was used in Group III. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 30-second-intervals for 5 minutes after the beginning of local infiltration. Simultaneously, the lowest and the highest MAP were recorded to calculate the mean maximum increase or decrease percent in MAP for all patients in each group. Data analysis was performed by chi(2) test, one-way analysis of variance, or one-way analysis of covariance.

RESULTSHemodynamic changes, particularly a decrease in MAP accompanied by an increase in HR at 1.5 minutes (P < 0.05), were observed in all groups. The mean maximum decrease in MAP below baseline was 14% in Group I, 24% in Group III and 26% in Group II. There were statistically significant differences between Group I and Groups II and III (P < 0.05). The mean maximum increase in MAP above baseline was 9% in Group I, 6% in Group III and 2% in Group II.

CONCLUSIONRelatively light general anesthesia can reduce the severity of epinephrine-induced hypotension more effectively than fluid expansion during FESS under general anesthesia.

Adolescent ; Adult ; Anesthesia, General ; Endoscopy ; Epinephrine ; adverse effects ; Female ; Humans ; Hypotension ; chemically induced ; prevention & control ; Male ; Middle Aged ; Paranasal Sinuses ; surgery ; Plasma Volume ; Prospective Studies