Anemia, Aplastic ; genetics ; metabolism ; Bone Marrow Cells ; metabolism ; Case-Control Studies ; Cell Line ; Child ; Child, Preschool ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Gene Expression Profiling ; Humans ; Male ; Mesenchymal Stromal Cells ; metabolism

Abdominal Cavity ; Adolescent ; Child ; Female ; Humans ; Neoplasms, Muscle Tissue

Animals ; Antibiotics, Antineoplastic ; administration & dosage ; toxicity ; Apoptosis ; drug effects ; Daunorubicin ; administration & dosage ; toxicity ; Disease Models, Animal ; Female ; In Situ Nick-End Labeling ; Male ; Myocardium ; cytology ; metabolism ; pathology ; ultrastructure ; Neuregulins ; metabolism ; pharmacology ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Receptor, ErbB-2 ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P<0.05). On post-operation day 1, there were no significant differencesin comparing ALT and AST levels between the two groups (P>0.05); the TBIL level in the observation group was significantly lower than that in the control group (P<0.01); there were no significant differences in comparing the urea nitrogen and creatinine levels between the two groups (P>0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P<0.01). on post-operation day 1, there was no significant difference in comparing MMSE score between the two groups (P>0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.

Objective To evaluate the performance of nested PCR in the detection of different fungi in paraffin wax embedded tissues. Methods Forty-four tissue samples were resected from rats infected with Fonsecaea monophora, patients with chromoblastomycosis, sporotrichosis or penicilliposis marneffei followed by preparation of paraffin wax embedded tissue sections for pathological examination and DNA extraction. Nested PCR was performed by using specific primers targeting the ribosomal DNA of Fonsecaea, Sporothrix and Penicillium marneffei, respectively. The sensitivity and specificity of nested PCR were analyzed and compared with those of pathological examination. Results The nested PCR showed positive results in 8 of 20 samples from rats with chromoblastomycosis, 7 of 10 samples from patients with sporotrichosis and all of the 10 samples from patients with penicilliposis marneffei, but not in the control samples. In the detection of Fonsecaea,Sporothrix schenki and Penicillium marneffei, the sensitivity was 40% ,70% and 100%, respectively, and the specificity was consistently 100%, for the nested PCR. Pathological examination revealed fungal elements in 95%, 70% and 80% of the corresponding samples, respectively. Conclusion Detection of fungal DNA in paraffin wax embedded tissue by nested PCR can be applied to the diagnosis of deep mycosis, especially to the diagnosis of penicilliposis marneffei.

Objectives To explore the clinical features and pathological types of childhood Henoch-Sch?nlein purpura ne-phritis (HSPN)with proteinuria. Methods Clinical and pathological data of 180 children with HSPN presenting with proteinuria were retrospectively analyzed in groups according to 24-hour urinary protein levels. Results The moderate proteinuria (57 cases, 31.7%) was the most common clinical type, followed by high-grade proteinuria (51 cases, 28.3%), mild proteinuria (46 cases, 25.6%) and microalbuminuria (26 cases, 14.4%). According to the International Study of Kidney Disease of Children , the major pathological type of HSPN are grade II (92 cases, 51.1%) and grade III (73 cases, 40.6%). The main pathological changes of moderate proteinuria were grade II (31 cases, 54.4%), and the main pathological changes of high-grade proteinuria were grade III (33 case, 64.7%). The pathological grade was progressively increased along with severity of proteinuria. The difference was statistically significant (χ2=39.54, P=0.002). The main immunopathological type was IgA+IgM (84 cases, 46.7%), followed by IgA+IgM+IgG (55 cases, 30.6%). No correlation was found among immunopathological typing, pathological typing and clinical typing (P>0.05). Conclusions The HSPN children with massive proteinuria show more severe pathological changes, but the se-verity of clinical symptoms is not completely consistent with the pathological damages.

Objective To investigate the efficacy and safety of microsurgery for trigeminal neuralgia (TN) in elderly patients.Methods Totally 143 patients with intractable primary TN who received microsurgery were retrospectively analyzed.There were 92 cases in the elderly group with age of 65-82 years,and the other 51 cases in control group with age of 40-62 years.All the patients in both groups were classified as American Society of Anesthesiologists (ASA) Scale Grade 1 to 3.After suboccipital retrosigmoid craniotomy,microvascular decompression (MVD) was performed in 136patients and partial sensory trigeminal rhizotomy in 7 patients.The complications and efficacy were compared between the two groups.Results 87 cases in the elderly group and 49 cases in control group underwent MVD procedure,complete and part pain relief were achieved in 78 cases and 9 cases in the elderly group,45 cases and 4 cases in control group,respectively.After an average follow-up period of 2.6 and 2.1 years,4 cases (5.1％) among 79 follow-up cases and 3 cases (6.5％) among 46follow-up cases experienced TN recurrences in the elderly and control groups,respectively.No statistically significant differences existed in the efficacy and recurrence rate between the two groups (P＞0.05).There were 3 cases with aseptic meningitis,1 cases with hearing decrease,1 case with cerebrospinal fluid leakage,1 case with pulmonary infection and 1 cases with deliration in the elderlygroup,meanwhile,1 cases with aseptic meningitis,1 case with tinnitus and 1 case with cerebrospinal fluid leakage after surgery in control group (P＞0.05).No facial hypoesthesia appeared in the patients receiving MVD.5 cases in the elderly and 2 cases in control group underwent partial trigeminal rhizotomy with facial hypoesthesia,but the pain released,and no recurrence was found.There were no dead cases in both groups.Conclusions With cautious and proper treatment,microsurgical procedure can be performed safely and effectively in the elderly TN.

Objective To describe the treatment experience of post-operative complications after total arch replacement for acute type A aortic dissection in 34 cases.Methods The subjects were 34 consecutive patients (Twenty-eight males and 6 females,age 34.0 -60.0 yrs) who received total arch replacement for acute Stanford type A aortic dissection from Jan.2005 to Oct.2010 in our hospital.The duration from the onset of the symptoms to the hospitalization ranged from 4 - 18 hrs.Pre-operative 2-D Echo revealed aortic valve regurgitation in 8 patients and mitral valve regurgitation in 1 patient.Results Three patients died after operation ( mortality 8.8％ ).Severe complications included acute kidney injury in 13 cases,respiratory dysfunction in 12 cases,paraplegia in 1 case,mental disorder in 10 cases and excessive post-operative bleeding in 2 cases.Conclusion The incidence of the complications after total arch replacement is still high and severe.Intensive care should be stressed peri-operatively and early diagnosis and treatment for post-operative complications are important procedures.

Objective To evaluate the clinical significance of the change of serum matrix metalloproteinases (MMP)-1,-2,-3 and -9 in acute and chronic aortic diseases and acute myocardial ischemia.Methods The blood serum levels of MMP-1,-2,-3 and -9 were detected in 30 patients with acute aortic dissection,19 patients with chronic aortic dissection,19 patients with aortic aneurysm and in 12 patients with acute myocardial ischemia,as well as in 16 healthy individuals who served as the control group.Serum MMP levels were measured by using an ELISA technique.Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection ( [19.10 ± 3.11 ] μg/L vs [11.89 ± 1.31 ] μg/L,P =0.02).Significantly lower levels of MMP-1 were found in healthy controls compared to the groups of patients ( [1.30 ± 0.56 ] μg/L vs [2.99 ± 0.78 ] μg/L in acute aortic dissection,P =0.03,[3.12 ±0.78] μg/L in chronic dissection,P =0.02,[3.01 ± 1.01 ] μg/L in thoracic aortic aneurysm,P =0.03 and [5.01 ± 0.98 ] μg/L in acute myocardial ischemia,P =0.01 ).Higher levels of M MP-1 and MMP-3 were detected on males.There was a positive correlation between MMP-1 and increasing age ( r =0.38,P ＜ 0.05 ).In patients operated for acute type A aortic dissection,the levels of MMP-1,MMP-3 and MMP-9 increased immediately after surgery,while the levels of MMP-2 decreased.Twenty-four hours after surgery levels of MMP-1,-2 and -9 were almost equal to the preoperative ones( P ＞ 0.05 ).Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia,when evaluated in combination with imaging techniques.

Objective To evaluate the clinical feasibility of quality assurance of helical tomotherapy intensity modulated radiation therapy (IMRT) through a series of clinical case studies. Methods Tomotherapy planning system was used to provide optimized IMRT treatment plans. To verify the dose of IMRT plans,the cylindrical Virtual Water phantom,0.056cm3 AISL, ion chamber and EDR2 film were used for getting the absolute and relative doses from tomotherapy IMRT planning. The film and ion chamber were placed into the phantom. The doses of the interesting points and isodose distribution of the axial plane were measured,then the results were compared with those from the calculation in planning system for verification. Before the irradiation,kVCT images of the phantom were registered by tomotherapy MVCT images. So the setup of phantom was guided for verifying the position. Results The isedose distribution (on the axial plane) measured by the film was well consistent with that calculated by tomotherapy planning system. The error between the measured dose and predicted dose in the measured points was less than 3%. The setup error of the phantom was able to be kept within 1 mm. There was 2 mm offset along the vertical direction of couch from the virtual isocenter to beam isocenter,which should be considered during the phantom/patient setup. Conclusions The procedures for quality assurance of tomotherapy IMRT are feasible in our experience. And helical tomotherapy IMRT QA system has been constituted.