OBJECTIVETo introduce different surgical treatment for gyncomastia at different grades.

METHODS37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex.

RESULTSAll patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them.

CONCLUSIONSDifferent surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

Adolescent ; Gynecomastia ; classification ; surgery ; Humans ; Lipectomy ; Male ; Mammaplasty ; methods ; Nipples ; transplantation ; Retrospective Studies

OBJECTIVETo investigate the relationship between B-type natriuretic peptides (BNP) and subclinical target organ damage in essential hypertensive (EH) patients.

METHODSA total of 317 EH patients were divided into 3 groups according to BNP levels, namely normal (BNP<600 ng/L) group (n=102), moderate (600-883.5 ng/L) group (n=116), and elevated BNP (>883.5 ng/L) group (n=99). The blood pressure, left ventricular mass index (LVMI), the intima media thickness (IMT) of the common carotid artery, the plaque size in the coronary artery (CS) and microalbuminuria levels were analyzed in these patients.

RESULTSThe EH patients with moderate and elevated BNP showed significantly higher LVMI, IMT, CS and microalbuminuria levels than those with normal BNP level (LVMI: 102.8∓23.12 and 123.9∓26.47 vs 91.09∓18.71 g/m2; IMT: 0.95∓0.32 and 1.16∓0.37 vs 0.84∓0.28 mm; microalbuminuria: 31.36∓20.55 and 36.73∓22.07 vs 23.21∓18.68, P<0.01). After adjustment, BNP was positively correlated to LVMI, IMT, CS and microalbuminuria level (r=0.45, 0.43, 0.39 and 0.41, respectively, P<0.01). Multivariate logistic regression analysis showed that age, systolic blood pressure, BNP, FPG, and microalbuminuria, LDL-C, and BMI were all related to the occurrence of subclinical target organ damages.

CONCLUSIONBNP is positively correlated to subclinical target organs damages in EH patients.

Adult ; Aged ; Aged, 80 and over ; Albuminuria ; pathology ; Carotid Artery, Common ; pathology ; Carotid Intima-Media Thickness ; Female ; Humans ; Hypertension ; blood ; pathology ; Hypertrophy, Left Ventricular ; pathology ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood

OBJECTIVETo explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors (GIST) after complete resection.

METHODSTumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry (IHC). The association of above factors expressions with recurrence, metastasis and prognosis was examined.

RESULTSLog-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection (all P<0.05), and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival (all P<0.05). Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53 (all P<0.05), and the overall survival was only associated with Ki-67 (P<0.05).

CONCLUSIONKi-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Female ; Gastrointestinal Neoplasms ; metabolism ; surgery ; Gastrointestinal Stromal Tumors ; metabolism ; surgery ; Humans ; Hyaluronan Receptors ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Tumor Suppressor Protein p53 ; metabolism

Chitosan and its derivatives are extensively studied as non-viral gene delivery vectors nowadays. Polyethylene glycol-chitosan (mPEG-CS) copolymers were synthesized by oxidation of mPEG-OH and then combined mPEG-CHO with amino groups on chitosan chains. The in vitro cytotoxicity of copolymers was evaluated by MTT method. The results showed > 70% cell viability of HeLa and A549 cells after incubation with mPEG-CS copolymer from concentration 5 to 100 microg x mL(-1). The mPEG-CS copolymers with various degrees of PEG substitution were combined with DNA and the properties of mPEG-CS/DNA complexes were investigated such as nanoparticle size, zeta potential and agarose gel analysis. The best one among all these mPEG-CS copolymers was mPEG (3.55) -CS, for its capability to condense plasmid DNA was most efficient. For this reason, mPEG (3.55) -CS was picked out to mediate plasmid enhanced green fluorescence protein (pEGFP) and transfect HeLa and A549 cells. The expression of green fluorescence protein was observed by fluorescence microscope and the transfection efficiency was detected by flow cytometry. The gene expression mediated by mPEG-CS was resistant to serum, and the optimal transfection efficiency (8.1% for HeLa cells and 4.8% for A549 cells) of mPEG-CS/EGFP system was obtained under the condition of N/P 40 and 48 h transfection time. These results indicate that mPEG-CS copolymer is an efficient non-viral gene vector.
Adenocarcinoma ; pathology ; Cell Line, Tumor ; Chitosan ; chemistry ; toxicity ; Drug Carriers ; Genetic Vectors ; chemistry ; HeLa Cells ; Humans ; Lung Neoplasms ; pathology ; Nanoparticles ; Particle Size ; Plasmids ; Polyethylene Glycols ; chemistry ; toxicity ; Polymers ; Transfection

OBJECTIVETo analyze the relationships between smooth-muscle tumors of gastrointestinal (GI) tract and gastrointestinal stromal tumors (GISTs), and the efficacy of surgical management.

METHODSThe clinical and pathological data of 135 cases of GISTs were collected, including cases of leiomyomas/leiomyosarcoma between 1993 and 2003 and GIST between Jan. 2000 and Jul. 2005. The surgical outcomes were analyzed retrospectively.

RESULTS82.1% of former leiomyomas/leiomyosarcomas was corrected to GISTs. Overall 5-year survival rate was 79.7%. Univariate analysis revealed preoperative metastasis, tumor size, mitotic index, and postoperative metastasis or recurrence were correlated with overall survival in patients with completed resection. Multivariate analysis showed that only postoperative metastasis or recurrence were the indicators of poor prognosis, but without statistical significance (P=0.064). However, multivariate analysis for disease-free survival showed that preoperative metastasis and mitotic index were two independent predictors of poor prognosis (P=0.001 and P<0.001).

CONCLUSIONSMost former leiomyomas/leiomyosarcomas of GI tract should be corrected to the diagnosis of GISTs. Complete surgical resection is the choice of treatment for GISTs. Preoperative metastasis and mitotic index are two independent predictors of poor prognosis.

Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Prognosis ; Survival Rate

OBJECTIVETo observe the effect of rosuvastatin on left ventricular cardiac function, arteriosclerotic plaque and high sensitive C-reactive protein (hs-CRP) in hypertensive patients with mild elevation of LDL-C.

METHODSSeventy-nine patients with a SBP of 140-179 mmHg and/or a DBP of 90-109 mmHg and mild elevated LDL-C were treated with rosuvastatin for 12 months (n=40) or not (n=39). The changes of hs-CRP, arteriosclerosis plaque and cardiac function at the end of the 12-months treatment relative to the baseline levels were analyzed.

RESULTSAfter 12 months of treatment, LDL-C was decreased by 33.2% in rosuvastatin group but remained unchanged in patients without rosuvastatin treatment. The left ventricular peak filling rate (LVPFR) increased significantly from 1.85 to 2.59 (P<0.05) and the serum levels of hs-CRP reduced significantly (P<0.05) after rosuvastatin treatment. The size of the plaques reduced significantly after a 12-month rosuvastatin therapy.

CONCLUSIONRosuvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the left ventricular diastolic function and produce favorable effects on arteriosclerotic plaques.

Aged ; Arteriosclerosis ; complications ; pathology ; C-Reactive Protein ; metabolism ; Cholesterol, LDL ; blood ; Female ; Fluorobenzenes ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Hyperlipidemias ; drug therapy ; pathology ; physiopathology ; Hypertension ; drug therapy ; pathology ; physiopathology ; Male ; Middle Aged ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use ; Ventricular Function, Left ; drug effects

BACKGROUNDMetabolic syndrome (MS) is a risk factor for stroke and thromboembolism event. Left atrial or LA appendage (LA/LAA) thrombus is a surrogate of potential stroke. The relationship between MS and atrial thrombus remains unclear. In this study, we sought to investigate the effect of MS on risk stratification of LA/LAA thrombus formation in patients with nonvalvular atrial fibrillation (NVAF).

METHODSThis cross-sectional study enrolled 294 consecutive NVAF patients without prior anticoagulant and lipid-lowering therapies. LA/LAA thrombus was determined by transesophageal echocardiography. Risk assessment of LA/LAA thrombus was performed using the CHADS2 , CHA2DS2 -VASc, MS, CHADS2 -MS, and CHA2DS2 -VASc-MS scores. Logistic regression analyses were performed to determine which factors were significantly related to LA/LAA thrombus. Odds ratio (OR) including 95% confidence interval was also calculated. The predictive powers of different scores for the risk of LA/LAA thrombus were represented by C-statistics and compared by receiver operating characteristic (ROC) analysis.

RESULTSLA/LAA thrombi were identified in 56 patients (19.0%). Logistic analysis showed that MS was the strongest risk factor for LA/LAA thrombus in NVAF patients (OR = 14.698, P < 0.001). ROC curve analyses revealed that the C-statistics of CHADS2 -MS and CHA2DS2 -VASc-MS was significantly higher than those of CHADS2 and CHA2DS2 -VASc scores (CHADS2 -MS vs. CHADS2 , 0.807 vs. 0.726, P = 0.0019). Furthermore, MS was helpful for identifying individuals with a high risk of LA/LAA thrombus in the population with a low risk of stroke (CHADS2 or CHA2DS2 -VASc score = 0).

CONCLUSIONSMS is associated with LA/LAA thrombus risk in patients with NVAF. In addition to the CHADS2 and CHA2DS2 -VASc scores, the CHADS2 -MS and CHA2DS2 -VASc-MS scores provide additional information on stroke risk assessment.

Aged ; Atrial Appendage ; pathology ; Atrial Fibrillation ; complications ; physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome ; complications ; physiopathology ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Risk Factors ; Thrombosis ; etiology ; physiopathology

Chronic rhinosinusitis （CRS） is a highly heterogeneous disease with various epidemiological and immunopathological characteristics among patients of distinct races and regions. Despite adequate and proper medical and endoscopic surgical treatment， a significant proportion of patients with CRS still experience postoperative recurrence. Difficult-to-treat severe CRS represents a number of management challenges to the practicing clinician. The advent of type 2 biologics provides a new option for the treatment of refractory and relapsed CRS. Currently， biologics targeting type 2 inflammation have been shown to be effective in improving clinical outcomes， and become a promising therapy of refractory nasal polyps in patients from western countries. However， the therapeutic effect of biologics targeting type 2 inflammation still needs to be further verified in Asian CRS patients since patients with CRS in Asia present more type 1 and type 3 inflammatory endotype as well as mixed type 2 inflammation. In addition， the development of new biologics targeting the specific endotype of Asian CRS patients will be an important research orientation in the future. In this review， we discuss the historical perspective of type 2 biologics， the inflammatory endotype characteristics of CRS in Asian， current treatment status and potential therapeutic prospects.

OBJECTIVETo investigate the differential expression of isocitrate lyase in Penicillium marneffei phagocytized by nonstimulated and stimulated murine macrophages, and explore the role of glyoxylate pathway in pathogenesis of Penicilliosis marneffei.

METHODSPenicillium marneffei conidia and Raw264.7 cells were incubated in 16 cultures, which were divided to 4 groups for treatment with N-monomethyl-L-arginine (LNMMA, CI group), murine interferon-gamma (IFN-gamma) plus lipopolysaccharide (LPS) (T group), IFN-gamma plus LPS and LNMMA (TI group), or the same volume of culture medium (C group). The transcriptional levels of isocitrate lyase were detected using real-time RT-PCR, and its expression levels detected biochemically.

RESULTSThe transcriptional levels of isocitrate lyase in C, CI, T, TI groups were 1.00, 1.42, 33.09, and 74.88 (P<0.05), while the expression levels were 0.06, 0.07, 0.18, and 0.93, respectively (P<0.05). The content of nitric oxide in T group was significantly higher than that in the other groups (P<0.01), but the CFU of T group was the lowest (P<0.01).

CONCLUSIONReactive nitrogen intermediates induced by stimulated murine macrophages restrain the expression of isocitrate lyase of Penicillium marneffei and development of Penicillium marneffei, in which process the glyoxylate pathway may play an important role.

Animals ; Cell Line ; Fungal Proteins ; genetics ; Gene Expression Profiling ; Gene Expression Regulation, Enzymologic ; drug effects ; Gene Expression Regulation, Fungal ; drug effects ; Host-Pathogen Interactions ; Interferon-gamma ; pharmacology ; Isocitrate Lyase ; genetics ; Lipopolysaccharides ; pharmacology ; Macrophages ; drug effects ; immunology ; microbiology ; Mice ; Nitric Oxide ; immunology ; Penicillium ; genetics ; immunology ; physiology ; Phagocytosis ; immunology ; Reverse Transcriptase Polymerase Chain Reaction ; omega-N-Methylarginine ; pharmacology

OBJECTIVETo observe the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blocker (ARB) on tumor growth and angiogenesis in implanted gastric cancer mouse model, and to explore the probable mechanism of ACEI and ARB anticancer effect.

METHODSNude mouse model with human gastric cancer was established by subcutaneously inoculating human gastric cancer cell line SGC-7901. One week later, 60 mice were randomly divided into 5 groups: control group, perindopril group, captopril group, losartan group, and valsartan group. These groups respectively received the normal saline, perindopril (2 mg/kg), captopril (5 mg/kg), losartan (50 mg/kg), valsartan (40 mg/kg) by gavage once a day. Twenty-one days after treatment the tumors were removed and the tissues were stained by immunohistochemistry method to observe the expression of VEGF, MMP-7 and microvessel density (MVD).

RESULTSIn all the ACEI and ARB groups, tumor volumes were significantly inhibited and MVD also decreased significantly as compared with control group (all P<0.01). In captopril and perindopril groups, the expression of VEGF and MMP-7 decreased significantly as compared with control group(all P<0.05). In losartan and valsartan group, the expressions of VEGF were significantly decreased as compared with control group (all P<0.05). The expressions of MMP-7 between ARB groups and control group were not significantly different.

CONCLUSIONACEI and ARB can inhibit the tumor growth in gastric cancer model and suppress the angiogenesis of the tumor.

Angiotensin II Type 1 Receptor Blockers ; pharmacology ; Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; Animals ; Cell Line, Tumor ; Female ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neovascularization, Pathologic ; Stomach Neoplasms ; blood supply ; pathology