Objective To investigate the intervention ways of endoscopes in the treatment of esophagus stenosis due to carcinoma of esophagus and improvement of quality. Method 11 cases of advanced carcinoma of esophagus were included in this study. Operation and chemical therapy were unavailable for these patients. Memory trestle with membrane and made of alloy of Nickel－ titanium was inserted under intervention of endoscope. Trestle was posed in stenosis part of esophagus under direction of X－ ray. Trestle could be dilated 3－ 7 days after operation due to its reaction characteristics to temperature. So, redilated therapy was unnecessary. Trestle could reconstruct swallowing tract and made feeding through mouth become available during limited survival time.Results All trestles were successfully inserted.Half－ fluid feeding was available after operation. Obstruction was removed in all patients(100％ ).Conclusion Method described in this study was safe and effective .Effective swallowing tracts were reconstructed in all patients after trestle was planted and quality of life and survival time were both improved.

OBJECTIVETo study the relationship between syndrome type and the parameters of hemorrheology and platelet activation in patients with acute gout arthritis of dampness-heat blockage (DHB) type and stasis-heat accumulation (SHA) type.

METHODSForty patients with acute gouty arthritis were divided into 2 groups according to TCM syndrome differentiation, the DHB group (n=24) and the SHA group (n=16), and 20 healthy people were taken as the control group. Hemorrheological parameters, platelet activating factor (PAC-1) and P-selection (CD62p) in them were detected.

RESULTSPlasma viscosity, outcome of erythrocyte sedimentation and K value of its equation, levels of PAC-1 and CD62p were higher, erythrocyte electrophoresis index was significantly lower in gout patients of both types than those in the control group (all P < 0.01), and the levels of PAC-1 and CD62p in the SHA group were higher than those in the DHB group (P < 0.05).

CONCLUSIONDHB type and SHA syndrome type of acute gout arthritis are correlated with parameters of hemorrheology and platelet activation, and the different levels of these pameters showed in the two types, may be the internal factors for their genesis.

Acute Disease ; Adult ; Aged ; Arthritis ; blood ; pathology ; physiopathology ; Diagnosis, Differential ; Female ; Gout ; blood ; pathology ; physiopathology ; Hemorheology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; P-Selectin ; blood ; Platelet Activating Factor ; metabolism ; Platelet Activation ; Syndrome

Our previous work demonstrated that under the conditions of restraint stress and under the control of central nervous system (CNS), an immune suppressive protein of stress (ISPS) was generated in peripheral lymph tissue and released into the blood stream, acting as an immune suppressor. In the present work, a protein similar to ISPS was found in human tonsil (a peripheral lymph tissue). Human tonsil was homogenized and the extract was prepared. It was found that lymphocyte proliferation was significantly suppressed by the extract. The suppression induced by the extract was partially reversed by the monoclonal antibody against ISPS (2C4). In ELISA test, the extract was able to bind to the monoclonal antibody. By immunohistochemistry, many ISPS positive cells were found in human tonsil. The ISPS positive cells were also found in human lymph nodes. Taken together, all the results demonstrate that a protein similar to ISPS may exist in human peripheral lymphoid tissue.
Animals ; Humans ; In Vitro Techniques ; Lymphocyte Activation ; drug effects ; Mice ; Mice, Inbred BALB C ; Palatine Tonsil ; chemistry ; cytology ; Restraint, Physical ; Suppressor Factors, Immunologic ; pharmacology ; Tissue Extracts ; pharmacology

OBJECTIVETo explore the dosimetric variance in forward intensity modulated radiotherapy (IMRT) based on 4D CT and 3D CT after breast conserving surgery.

METHODSSeventeen patients after breast conserving surgery underwent 3D CT simulation scans followed by respiration-synchronized 4D CT simulation scans at free breathing state. The treatment plan constructed using the end inspiration (EI) scan was then copied and applied to the end expiration (EE), and 3D scans and dose distribution were calculated separately. Dose-volume histograms (DVHs) parameters for the CTV, PTV, ipsilateral lung and heart were evaluated and compared.

RESULTSThe CTV volume difference was biggest between T0 and 3D CT, and the volume difference was 4.10 cm(3). Mean dose of PTV at EE was lower than that at EI (P = 0.019), but there were no statistically significant difference between 3D and EI, EE (all P > 0.05). The homogeneity index (HI) at EI, EE, 3D plans were 0.149, 0.159 and 0.164, respectively, and a significant difference was only between EI and EE (P = 0.039). The highest conformal index (CI) was at EI phase (P < 0.05), and there was no significant difference between EE and 3D (P = 0.758). The V(40) and V(50) of ipsilateral lung at EE phase were lower than that at EI (P < 0.05). There were no significant differences in all the indexes for heart (P > 0.05).

CONCLUSIONSThe breast deformation during respiration may be disregarded in whole breast IMRT. PTV dose distribution is significantly changed between EI and EE phases, and the differentiation of the lung high dose area between EI and EE phases may be induced by thorax expansion. 3D treatment planning is sufficient for whole breast forward IMRT, but 4D CT scans assisted by respiratory gating ensures more precise delivery of radiation dose.

Adenocarcinoma, Mucinous ; diagnostic imaging ; radiotherapy ; surgery ; Adult ; Breast Neoplasms ; diagnostic imaging ; radiotherapy ; surgery ; Carcinoma, Ductal, Breast ; diagnostic imaging ; radiotherapy ; surgery ; Dose Fractionation ; Female ; Four-Dimensional Computed Tomography ; methods ; Humans ; Imaging, Three-Dimensional ; methods ; Mastectomy, Segmental ; Middle Aged ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; Respiration

OBJECTIVETo observe the resulting change in patients who achieved HBeAg/Anti-HBe seroconversion after lamivudine treatment.

METHODS68 patients were observed for over 24 months. They were HBeAg/Anti-HBe with a seroconversion time > or = 6 months and the course of lamivudine treatment was > or = 18 months.

RESULTSAfter lamivudine treatment, the rate of HBeAg/Anti-HBe seroconversion was 25.19%, the rate of YMDD mutations was 20.59%, and the rate of relapse was 27.94% for these patients that achieved HBeAg/Anti-HBe seroconversion in observation and in the follow-up period. Lamivudine was still an effective drug for these patients with relapses. The rate of relapse was in correlation to the patients' age and the ALT level before treatment. The rate of relapse was not correlated to the HBV DNA level before the course of treatment. YMDD mutations were not correlated to the relapses.

CONCLUSIONEven with a HBeAg/Anti-HBe seroconversion time > or = 6 months, the rate of relapse was still higher in patients with chronic hepatitis B that received lamivudine. The patients with long-term lamivudine treatment should be observed and have frequent follow-up visits.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Follow-Up Studies ; Hepatitis B Antibodies ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male

OBJECTIVETo understand antibody responses to and RNA sequences of Hantavirus in patients with hemorrhagic fever renal syndrome (HFRS) in Yantai areas and to demonstrate the type of the prevalent viruses caused HFRS.

METHODSSerum specimens collected at acute and convalescent stages from 90 patients with HFRS and IgM and IgG antibodies against Hantavirus were detected with ELISA, and cross plaque reduction neutralizing tests were performed to detect neutralizing antibody. Viral RNA was extracted from the patients? sera by using Trizol method and nested PCR was utilized to amplify the specific segments of the viral cDNA and the products of the PCR were TA cloned and then the nucleotide sequences were determined.

RESULTSThe IgM antibody was positive in 82.2% (88/107) of the patients while the IgG antibody was positive in 85.7% (66/77) of the patients. Both the serologic and sequence analyses demonstrated that the epidemic of HFRS in Yantai areas was caused by mixed types of Hantavirus. The prevalent strains of Hantavirus had higher homology with the strains isolated in Korea than with those isolated previously in China.

CONCLUSIONSThe serologic and sequencing analyses indicated that the epidemic of HFRS in Yantai areas was caused by mixed types of Hantavirus dominated by type SEO.

Antibodies, Viral ; blood ; Base Sequence ; China ; DNA, Viral ; analysis ; Disease Reservoirs ; Hantaan virus ; classification ; genetics ; immunology ; Hemorrhagic Fever with Renal Syndrome ; virology ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Molecular Sequence Data ; Sequence Analysis, DNA ; Serotyping

AIMTo explore the effects of tRNA on the growth of mammalian cells.

METHODSL929, NIH3T3, MCF-7 and PC12 cells were seeded in 96 well culture plate individually, and incubated at 37 degrees C in 5% CO2 for 4 h, the tRNAs from different species were added to the culture media individually. After certain time of incubation, the viability of the cells was evaluated by the MTT methods. Sub-confluent L929 cells were incubated with 200 microg/ml ytRNA for different times, then the cells were pooled and analyzed with flow cytometry assay.

RESULTStRNA specifically inhibited the growth of L929 cells in a dose-dependent manner. The sizes of tRNA-treated cells showed larger sizes and longer processes than those of untreated cells. Flow cytometric analysis further showed that most of tRNA-treated cells were arrested in S phase of the cell cycle.

CONCLUSIONThe cell growth inhibitory effects of tRNAs were caused mainly by their degraded fragments. The results suggested that tRNA or its degraded fragments might play important roles in regulation of cell proliferation.

Animals ; Cell Cycle Checkpoints ; physiology ; Cell Line ; Cell Proliferation ; Fibroblasts ; cytology ; Flow Cytometry ; Mice ; RNA, Transfer ; physiology

OBJECTIVETo investigate the curative effect of different internal fixation for ipsilateral fractures of the femoral neck and shaft.

METHODSBy retrospective study of 27 patients who sustained ipsilateral femoral shaft and neck fractures from June 1993 to March 2004. There were 22 male and 5 female, with an average age of 35 years (range in 14 to 65 years). The femoral neck and shaft fractures were stabilized with dynamic hip screw system (DHS) in 3 cases,with dynamic compression plate and cannulated lag screw in 12 cases, with constructive nail in 8 cases, with antegrade intramedullary locking nail and cannulated lag screw in 4 cases. There were 13 cases used of the temporary fixation of Kirschner wire before the pexia of the femoral neck fractures.

RESULTSAll of the patients were followed up for 36 to 75 months, with an average of 44 months. The average healing period of femoral neck fracture was 4.5 months in 25 cases, nonunion of femoral neck fractures in 2. The average healing period of femoral shaft fracture was 6 months in 27 cases. In 14 cases that not using temporary fixation of femoral neck with Kirschner wire, there were nonunion of femoral neck in 2 and slight coxa vara in 3.

CONCLUSIONThere are a wide choice of internal fixation method for treatment of ipsilateral fracture of the femoral neck and shaft, the fixation with dynamic compression plate and cannulated lag screw is a handy method. It would be avoided to the replacement and trauma, emporary fixing the fracture with Kirschner wire before the pexia of the femoral neck fracture.

Adolescent ; Adult ; Bone Nails ; Bone Plates ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Femur Neck ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Middle Aged

OBJECTIVETo study the imageology changes of degenerative cartilage endplate to different degree, and to explore its clinical significances.

METHODSThe imageology data (MRI or CT) of 58 patients with degenerative disc disease of L4, 5 (including 34 patients with lumbar disc herniation). The patients were divided into three groups depending on the mean signal intensity rate of degenerative disc and cerebrospinal fluid: light degenerative group of 17 cases, intermediate degenerative group of 17 cases, and severe degenerative group of 24 cases. The signals of intervertebral disks on T2WI of sagittal magnetic resonance imaging were inputted into the computer and the concave angles of endplate were measured. Anteroposterior diameter and transverse diameter of the endplate were measured from the CT scan of L4, 5, and then the relative curvature of endplate was got. The change patterns of the concave angle and the relative curvature of vertebral endplates were analyzed when the lumbar disc was differently degenerative.

RESULTS(1) The concave angle of endplate (L4 inferior endplate, L5 superior endplate) gradually increased among the light degenerative group, intermediate degenerative group and severe degenerative group (P < 0.01). (2) The relative curature of endplate (L4 inferior endplate, L5 superior endplate) gradually increased. There was significant difference between the light degenerative group and intermediate degenerative group (P < 0.0l), and there was significant difference between the light degenerative group and severe degenerative group (P < 0.0l). There were no significant difference between intermediate degenerative group and severe degenerative group (P < 0.05). (3) The concave angle of endplate had positive correlation with relative circularity (r = 0.786, 0.490).

CONCLUSIONThe concave angle and relative curvature of endplate generate corresponding changes when the lumbar disc are differently degenerative. The changes of concave angle and relative curvature of endplate are important factors of lumbar disc hernia and lower back pain, which may evaluate the probability of intervertebral disk hernia.

Adult ; Cartilage ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; pathology ; Lumbar Vertebrae ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged

OBJECTIVETo identify factors associated with response to lamivudine in chronic hepatitis B patients.

METHODSClinical data of 233 chronic hepatitis B patients treated with lamivudine 100mg daily (91 patients were switched to Adefovir 10mg daily or Adefovir 10mg in combination with lamivudine 100mg daily) were retrospective. HBV DNA level and serum HBV markers were detected by polymerase chain reaction and enzyme-linked immunosorbent assay. Kaplan-Meier, long-rank, t test were conducted to evaluate the data.

RESULTS(1) The rates of HBV DNA loss, ALT normalization, viral breakthrough(VB), HBeAg loss and seroconversion were 63.4% , 83.8%, 30.9%, 30.9%, and 14.3%, respectively, in HBeAg(+) patients; and these were 84.6%, 81.3%, 14.3%, respectively in HBeAg(-) patients.(2) The rates of HBV DNA loss, HBeAg loss, HBeAg seroconversion, viral breakthrough (VB) were 55% and 66.7% (P more than 0.05), 55.0%, and 66.7% (P less than 0.05), 17.5% and 33.3% (P less than 0.05), 50% and 34.3% (P less than 0.05) in HBeAg(+) patients with baseline ALT less than 2.5 ULN and HBeAg(+) patients with baseline ALT is more than or equal to 2.5 ULN, respectively. (3) For HBeAg(+) patients, viral breakthrough rate was significantly lower in patients with baseline HBV DNA less than 10(6) copies/ml than that in patients with baseline HBV DNA more than 10(6) copies/ml patients (23.4% VS 46.3%, P less than 0.05) among HBeAg(+) patients. (4) The rate of HBV DNA loss, HBeAg loss, HBeAg seroconversion and viral breakthrough for the patients with IVR at week 24 were 76.3%, 72.3%, 40.8% and 28.9% compared to 47.6% (P less than 0.01), 46% (P less than 0.01), 12.7% (P less than 0.01) and 47.6% (P less than 0.05) for those without IVR. (4) For the 44 patients with viral breakthrough, 32 were switched to Adefovir monotherapy or adefovir in combination with lamivudine therapy, and 12 continued to receive lamivudine monotherapy. HBV DNA loss, HBeAg seroconversion were 40.6%, 21.9% for those switch/add group compare to 16.7%, 16.7% for the lamivudine monotherapy group. There were no significant differences in the background factors (sex, diagnosis, antiviral period, pre-tx ALT, pre-tx HBV DNA) between these two groups.

CONCLUSIONBoth the baseline ALT and HBV DNA are associated with the efficacy of lamivudine in chronic hepatitis B patients. Patients with baseline ALT is more than or equal to 2.5*ULN and (or) HBV DNA level of less than 1*10(6) copies/ml have better efficacy and lower rate of breakthrough rate. IVR at week 24 is an important predictive factor of a favorable response to lamivudine therapy. For the patients with viral breakthrough, those switched to/added on Adefovir have a favorable result.

Adenine ; analogs & derivatives ; pharmacology ; therapeutic use ; Adolescent ; Adult ; Alanine Transaminase ; blood ; Antiviral Agents ; pharmacology ; therapeutic use ; DNA, Viral ; blood ; Drug Administration Schedule ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Organophosphonates ; pharmacology ; therapeutic use ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Treatment Outcome ; Young Adult