In Alzheimer's disease there is obvious evidence of insulin resistance in the brain. Thiazolidinediones,a kind of insulin sensitizer,not only improves insulin sensitivity,but also decreases inflammation,promotes release and clearance of?-amyloid protein,all are beneficial to the improvement of memory.

Objective To evaluate hepatic artery resection and microsurgical reconstruction in radical resection of Klatskin's tumor.Methods We retrospectively reviewed clinical data of 7 patients with advanced hilar cholangiocarcinoma (Klatskin's tumor) who underwent left hemihepatectomy combined with right hepatic artery resection and microsurgical reconstruction with or without portal vein reconstruction from August 2008 to March 2012.Results Right hepatic artery was reconstructed with end-to-end anastomosis,using the reserved left hepatic artery (n =1),the remanent right hepatic artery (n =1),the hepatic artery proper (n =4) and the gastroduodenal artery (n =1),among those 2 patients underwent concomitant portal vein reconstruction.Post-operative pathology showed middle to low differentiated adenocarcinoma in 2 patients,low differentiated adenocarcinoma in 3 and papillary adenocarcinoma in 2.R0 resection was achieved in 6 patients.There was no post-operative liver failure,biliary-enteric anastomotic leakage or perioperative deaths.Conclusions Hepatic artery resection and microsurgical reconstruction increases the radical resection rate of advanced hilar cholangiocarcinoma and decreases postoperative complications.

OBJECTIVETo investigate the correct method of bone resection and posterior capsular soft tissue releasing in total knee arthroplasty (TKA) for the patients with rheumatoid arthritis with stiff knee in flexion.

METHODSFrom November 2009 to January 2012,15 patients with rheumatoid arthritis with stiff knee in flexion underwent primary TKA and releasing of the posterior soft tissues. There were 7 males and 8 females,aged 22 to 75 years old (58.7 years old on average). The preoperative range of movement(ROM) was (3.2 ± 1.7)°. According to Knee Society score (KSS) criterion, the preoperative clinical score was 23.3 ± 12.5 and functional score was 35.2 ± 9.8. Based on the correct osteotomy, effective releasing of posterior structures was used for different degrees of flexion contracture during the TKA procedure.

RESULTSAll the patients were followed up, and the average duration was 2.3 years (1.6 to 3 years). At the latest follow-up,the KSS clinical score was 81.7 ± 6.5 and functional score was 82.8 ± 9.3. The flexion and extension ROM of the knee joint was (103.5 ± 13.1). Three knees remained 50 flexion contracture deformity, but the function of the affect knees was good.

CONCLUSIONThe effective releasing of the soft tissue of posterior capsule is a major management for correction of the flexion contracture in TKA. The correct releasing of posterior structure can not only achieve fundamental gap of TKA but also effectively avoid bone over-resection.

Adult ; Aged ; Arthritis, Rheumatoid ; complications ; physiopathology ; surgery ; Arthrogryposis ; surgery ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Capsule Release ; methods ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVETo investigate the relation of the viral markers in serum and those expressed by hepatocytes to pathological lesions of hepatic tissue in patients with chronic hepatitis B.

METHODSThe relation of viral markers including HBsAg, HBsAb, HBeAg, HBeAb, HBcAb and HBV DNA in serum of 647 patients with chronic hepatitis B and HBsAg, HBcAg expressed by hepatocytes in 418 of these patients to pathological lesions of hepatic tissue was determined.

RESULTSViral markers in serum and those expressed by hepatocytes in patients with chronic hepatitis B were closely correlated with pathological lesions of hepatic tissue.

CONCLUSIONThe degree of inflammation and fibrosis in hepatic tissue is milder in serum HBsAg, HBeAb, HBcAb positive and HBV DNA negative patients but more serious in those with negative hepatocytic expression of HBsAg and HBcAg. HBV DNA is not significantly associated with pathological lesions of hepatic tissue.

Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral ; blood ; genetics ; Female ; Hepatitis B Core Antigens ; blood ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; immunology ; physiology ; Hepatitis B, Chronic ; blood ; pathology ; virology ; Host-Pathogen Interactions ; Humans ; Infant ; Infant, Newborn ; Liver ; pathology ; virology ; Male ; Middle Aged ; Young Adult

Background More efforts have been made in the functional protection of the glaucoma ganglion cells (RGCs) nowadays.As main ingredient,astragalus polysaccharides (APS) enhances neuron regeneration protein expression and promotes peripheral nerve recovery.But whether APS has a protecting effect on RGCs is incompletely clear.Objective The purpose of this study was to evaluate the neuroprotective effect of APS on the RGCs in a rat model of experimental glaucoma.Methods Forty-four SPF SD rats were divided into 4 groups randomly as follows:normal control group,negative control group,low dose APS group and high dose APS group,with 10 rats for each group.APS of 500 mg/kg or 2000 mg/kg (2.5 ml) was administered by gavage feeding once daily for 2 weeks in low dose or high dose of APS group,respectively,and the same volume of normal saline solution was applied instead of APS in the model control group.Two weeks later,aspirate 0.2 ml aqueous followed by methylcellulose injected into the anterior chamber to create the acute ocular hypertension model in the three groups above.No any intervention was performed in the normal control group.The rats were sacrificed on the fifth day after model established to take a retinal section.Ocular hypertension-induced damage was evaluated by regular retina histopathologic examination.Immunolhistochemistry for caspase-3 and TUNEL kits were used to determine the expression of caspase-3 protein in retina and apoptosis rate of RGCs.Retinal cross-sections were analyzed by Image Pro Plus 5.1 software to determine the thickness of various retinal layers and the positive staining cell density in the retinal ganglion cell layer (RGCL).Results On the fifth day after establishment of models,intraocular pressure (IOP) was significantly elevated in the model control group,low dose APS group and high dose APS group in comparison with the normal control group (t=-8.900,-10.700,-11.300,P＜0.01).Retinal morphology was normal in the rats of the normal control group,but in the model control group,rat retina was significantly thickened from severe retinal edema and cell arrangement disorder.Mild retinal abnormality was seen in the low dose APS group;while obvious retina edema was in high dose APS group.The entire retinal thickness,outer nuclear layer thickness and retinal nerve fiber thickness values were lower in the low dose APS group than those of model control group (t =-23.700,-14.770,-11.640,P＜0.01).However,no difference was found in outer nuclear layer thickness and retinal nerve fiber thickness values between high dose APS group and normal control group (t =-0.780,-0.460,P ＞ 0.05).Percentage of positive RGCs for caspase-3 protein and rate of apoptotic RGCs were significantly reduced in low dose APS group compared with model control group (caspase-3:F=87.710,P=0.001;RGCs apoptosis:F=272.840,P＜0.01).Conclusions 500 mg/kg APS can protect retina and RGCs against ocular hypertension-induced damage.The protection of APS is non-dosedependent.

OBJECTIVETo explore the clinical and laboratory characteristics of myleodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) with PDGFRβ abnormalities.

METHODSChromosome specimens were prepared directly and/or short-time culture of bone marrow cells. Karyotyping was performed with R-binding technique. Fluorescence in situ hybridization (FISH) was performed using PDGFRβ, PDGFRα, FGFR1 break-apart probes and whole chromosome 5 and 12 painting probes, respectively. The expression of JAK2 V617F was measured with quantitative PCR.

RESULTSThe clinical and hematological findings of 27 patients were compatible with diagnosis of MDS/MPN. PDGFRβ rearrangement was detected in 4 patients with D-FISH, and 2 of which were confirmed as t(5;12) by chromosome painting. PDGFRα, FGFR1 and JAK2 V617F mutation were not detected in these 4 PDGFRβ positive MDS/MPN patients with.

CONCLUSIONSPDGFRβ gene rearrangement may be detected in some MDS/MPN patients. FISH is a convenient and reliable approach to detect PDGFRβ gene.

Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Myeloproliferative Disorders ; genetics ; Neoplasms ; Receptor, Platelet-Derived Growth Factor beta ; genetics

AIMTo study the expression and effect of TLR4 and NFkappaB protein in hippocampus neuron in rats exposed to chronic hypoxic hypercapnia.

METHODSThe disorder of learning-memory in pulmonary hypertension rat model was reproduced by chronic hypoxic hypercapnia. Thirty rats were randomly divided into three groups: normal control group, hypoxic hypercapnia 2-week and 4-week group. The number of apoptosis neurons in hippocampus CA1/3 was counted by TUNEL method. Activity of TLR4 and NFkappaB in hippocampus CA1/3 was detected by using SP immunocytochemical technique.

RESULTSThe expression of TLR4 protein in hippocampus CA1/3 in group 2HH( CA1: 0.1275 +/- 0.0242, CA3: 0.1156 +/- 0.0376) and 4HH (CA1: 0.1522 +/- 0.0187, CA3: 0.1427 +/- 0.0453) were significantly higher than those in the NC group (P < 0.05, P < 0.01). The positive expression of NFkappaB were showed in cell nucleus in group 2HH (CA1: 0.1326 +/- 0.0324, CA3: 0.1301 +/- 0.0112) and group 4HH (CA1: 0.1612 +/- 0.0428, CA3: 0.1578 +/- 0.0365), and significantly higher than those in the NC group (P < 0.05, P < 0.01). The apoptosis of neural cells in hippocampus CA1/3 gradually increased with the time of exposure, and reached peak at 4 weeks (P < 0.01 vs NC group).

CONCLUSIONThe activation of TLR4 and NFkappaB may play an important role in the apoptosis of hippocampus neural cells in rat exposed to chronic hypoxic hypercapnia.

Animals ; Apoptosis ; Hippocampus ; metabolism ; pathology ; physiopathology ; Hypercapnia ; metabolism ; physiopathology ; Hypertension, Pulmonary ; metabolism ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; Male ; NF-kappa B ; metabolism ; Neurons ; metabolism ; physiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism

OBJECTIVETo observe the effect of acupuncture on proliferation and differentiation of neural stem cells in brain tissues of rats with traumatic brain injuny.

METHODSThirty SD rats were randomly and equally allocated to the sham-operated, the model and the acupuncture groups. The traumatic brain injury model was established by the free drop method. For the rats in the acupuncture group, acupuncture was applied once a day for 7 days. Brain histotomy was carried out when treatments were completed. Immunohistochemical techniques were adopted to detect the cells that express nestin, neurofilament proteins (NF)-200 and glial fibrillary acidic proteins (GFAP), the markers of neural stem cells, neurons, astrocytes respectively.

RESULTSCompared to the sham-operated group, the number of nestin-positive cells and NF-200-positive cells in brain tissues was decreased significantly in the model group (P < 0.01), whereas the number of GFAP-positive cells was significantly increased P<0.01). Compared to the model group, the positive cells of nestin, NF-200, GFAP in brain tissues in the acupuncture group were increased obviously (P<0.01).

CONCLUSIONSAcupuncture can significantly increase the number of nestin-positive cells, NF-200-positive cells and GFAP-positive cells, indicating the significant increase of neural stem cells, neurons and astrocytes in number. Acupuncture can improve neuranagenesis by promoting the proliferation and differentiation of neural stem cells in brain tissues. This might be one of the mechanisms for acupuncture to treat traumatic brain injury and to promote the repair of nervous function.

Acupuncture Therapy ; Animals ; Brain ; pathology ; Brain Injuries ; pathology ; therapy ; Cell Differentiation ; Cell Proliferation ; Cerebral Cortex ; pathology ; Glial Fibrillary Acidic Protein ; metabolism ; Intermediate Filament Proteins ; metabolism ; Male ; Nerve Tissue Proteins ; metabolism ; Nestin ; Neural Stem Cells ; metabolism ; pathology ; Neurofilament Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the effect of internal urethrotomy with Super-impulse plasma electrode (SIPE) method on urethral stricture.

METHODSA total of 48 patients clinically diagnosed as having urethral stricture were hospitalized and treated with SIPE under the endoscope from February 2005 to August 2006. The patients' symptoms and clinical signs were compared before and after the treatment. In addition, techniques in operating SIPE were discussed.

RESULTSOf the 48 patients, 46 were cured and 2 experienced recurrence after the operation. A 3-18 months follow-up revealed no complications.

CONCLUSIONSIPE under the endoscope is safe and effective in the treatment of urethra stenosis. It is easy to handle and the results are satisfactory.

Adult ; Aged ; Cicatrix ; Endoscopy ; methods ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Urethra ; surgery ; Urethral Stricture ; surgery

OBJECTIVETo evaluate the clinical efficiency and safety of two-micron laser resection of the prostate-tangerine technique (TmLRP-TT) for the treatment of large-volume ( > 70 ml) prostate in patients with benign prostatic hyperplasia (BPH).

METHODSThis retrospective analysis included 80 BPH patients with the prostatic volume larger than 70 ml, all treated by TmLRP-TT. We comparatively analyzed the levels of hemoglobin and serum sodium before and after surgery, recorded intra- and post-operative com- plications, and followed up the patients at 6 and 12 months after operation for International Prostate Symptom Score (IPSS), quality of life (QOL), maximum flow rate (Qmax), and postvoid residual urine volume (PVR).

RESULTSAll the operations were successfully completed. The mean hemoglobin decreased (0.68 +/- 0.43) g/dl intraoperatively, but no apparent reduction was observed in serum sodium. Lower urinary tract symptoms were relieved significantly in all the cases. At 12 months after surgery, IPSS was decreased by 73.89% as compared with the baseline (20.03 +/- 6.9 vs 5.23 +/- 3.59), QOL by 64.55% (4.09 +/- 1.19 vs 1.45 +/- 1.36), and PVR by 79.30% (97.31 +/- 57.90 vs 20.14 +/- 24.20 ml), while Qmax increased by 140.42% ([8.04 +/- 3.62] vs [19.33 +/- 3.28] ml/s). The incidence of complications was low either intraoperatively or during the 12 months after operation.

CONCLUSIONTmLRP-TT is a safe and effective surgical endoscopic approach to the treatment of large-volume prostate in BPH patients.

Aged ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome