Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.

Purpose :To investigate the relationship of peripheral blood T-lymphocyte subsets with the acuterejection or severe CMV infection in transplanted patients. Methods :T-lymphocytes subsets of peripheral bloodwere consecutively detected by using mice-verse-human T-lymphocytes subsets monoclonal antibody-OKT serialsand flow cytometer. Results:The difference of CD4/CD8 ratios between the no acute rejection group and the acuterejection group, or between the acute rejection remission group and the resistant acute rejection group was signif-icant ( P ＜0.05); In patients with intensive CMV infection, the CD4/CD8 ratios were converse to the acute re-jection group. Conclusions:These results indicated that monitoring of peripheral blood T-lymphocyte subsets wasof much benefit to early diagnosis and differential diagnosis of acute rejection of intensive CMV infection and rea-sonable treatment.

Background People recently realized that it is important for artificial vascular biodegradable graft to bionically mimic the functions of the native vessel.In order to overcome the high risk of thrombosis and keep the patency in the clinical small-diameter vascular graft (SDVG) transplantation,a double-layer bionic scaffold,which can offer anticoagulation and mechanical strength simultaneously,was designed and fabricated via electrospinning technique.Methods Heparin-conjugated polycaprolactone (hPCL) and polyurethane (PU)-collagen type Ⅰ composite was used as the inner and outer layers,respectively.The porosity and the burst pressure of SDVG were evaluated.Its biocompatibility was demonstrated by the 3-(4,5-dimethyl-2-thiazol)-2,5-diphenyl-2H tetrazolium bromide (MTT) test in vitro and subcutaneous implants in vivo respectively.The grafts of diameter 2.5 mm and length 4.0 cm were implanted to replace the femoral artery in Beagle dog model.Then,angiography was performed in the Beagle dogs to investigate the patency and aneurysm of grafts at 2,4,and 8 weeks post-transplantation.After angiography,the patent grafts were explanted for histological analysis.Results The double-layer bionic SDVG meet the clinical mechanical demand.Its good biocompatibility was proven by cytotoxicity experiment (the cell's relative growth rates (RGR) of PU-collagen outer layer were 102.8％,109.2％ and 103.5％,while the RGR of hPCL inner layer were 99.0％,100.0％ and 98.0％,on days 1,3,and 5,respectively) and the subdermal implants experiment in the Beagle dog.Arteriography showed that all the implanted SDVGs were patent without any aneurismal dilatation or obvious anastomotic stenosis at the 2nd,4th,and 8th week after the operation,except one SDVG that failed at the 2nd week.Histological analysis and SEM showed that the inner layer was covered by new endothelial-like cells.Conclusion The double-layer bionic SDVG is a promising candidate as a replacement of native small-diameter vascular graft.

OBJECTIVETo assay ligustilide content in the herb of Szechwan Lovage Rhizome (Chuanxiong, CX), which is the dried rhizome of Ligusticum chuanxiong in order to assess the quality.

METHODLigustilide was quantitatively analyzed by high-performance liquid chromatography in 21 CX samples. An Alltima C18 column (4.6 mmx 150 mm, 5 microm) was used as the analytical column. The mobile phase consisted of water and acetonitrile (40:60). The flow rate was maintained at 1.0 mL x min(-1) with the column temperature at ambient conditions. The detection wavelength was set at 350 nm.

RESULTThe average content of Z-ligustilide in 21 CX samples was found to be 7.40 +/- 3.54 mg x g(-1)(x +/- s, n = 21). Therefore,the content of Z-ligustilide in CX should not be less than 0.66% (calculated on the dried basis).

CONCLUSIONThe overall analytical procedure is rapid and accuracy which is considered suitable for the quantitative analysis of ligustilide in CX. The amount of ligustilide in CX samples collected from different cultivation areas was obviously different. However, a relatively higher content of ligustilide was generally found in the CX collected from its main cultivated areas.

4-Butyrolactone ; analogs & derivatives ; analysis ; China ; Chromatography, High Pressure Liquid ; methods ; Ecosystem ; Ligusticum ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Rhizome ; chemistry

Objective To assess the value of real-time intraoperative neuronavigation integrated with ultrasound in the resection of deep-seated brain tumor. Methods Thirty patients with deep-seated brain tumor were treated with microneurosurgery guided with real-time ultrasound integrated with the Brain Lab IGSonic navigation. During the ultrasound based operation, the degree of brain shift and the tumor border was timely observed, and then the tumor was resected totally. Results Guiding with navigation integrated ultrasound, we noticed the brain shift with various degrees happening in 30 patients,and the border of tumor was exposed and the tumor was resected totally without serious complications.Conclusions Intraoperative ultrasound integrated with navigation is a reliable guidance which can accurately re-localize the border of deep-seated brain tumor even when the tumor is shifting, timely delineate the reformatted images from ultrasound and totally resectcd the tumor, thus decrease the surgical time and increase the safety of surgical procedure.

OBJECTIVETo evaluate the clinicopathological characteristics and prognosis of poorly differentiated neuroendocrine carcinoma of the stomach.

METHODSTwenty-three poorly differentiated neuroendocrine carcinomas of the stomach were treated in the Department of Abdominal Surgery at the Cancer Hospital, Fudan University between January 1996 and December 2007. Clinicopathological characteristics and survival data were analyzed.

RESULTSPoorly differentiated neuroendocrine carcinomas of the stomach accounted for 0.52% of all the gastric carcinomas. The tumor occurred more often in males (18 of 23), older patients (mean age of 62 years), upper third of the stomach (16 of 24,one patient had more than one lesion) with large size (mean diameter of 6.8 cm). TNM stages were as follows: stage II in 3 patients, stage III in 12, and stage IIII in 8. Thirteen patients underwent curative resection, while 8 underwent palliative resection and 2 others underwent exploratory laparotomy with biopsy. Of the 21 surgical resection specimens, vascular invasion was found in 18 patients (85.7%), perineural invasion in 16 patients (76.2%), and regional lymph node metastasis in 17 patients (81.0%). Follow up time ranged from 3 to 63 months. Mean overall survival time was 17.7 months. The 1-year, 2-year, and 5-year survival rates were 47.8%, 19.1%, and 4.3%, respectively. Statistically significant differences in survival curves were observed which were related to tumor staging and surgery type, but not related to gender, age, tumor location, or diameter.

CONCLUSIONSPoorly differentiated neuroendocrine carcinomas of the stomach are rare and with poor prognosis. Tumor stage and surgical type have potential impact on survival.

Adult ; Aged ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology

OBJECTIVETo study the incidence, clinicopathological characteristics, diagnosis, treatment, and prognosis of synchronous or metachronous primary cancers in patients with gastric cancer.

METHODSClinical data of 4426 patients with gastric cancer in our hospital from 1996 to 2007 were reviewed.

RESULTSSeventy-four (1.7%) patients had synchronous or metachronous primary cancer of other organ, of whom 10 were synchronous and 64 were metachronous. Colorectal cancer was the most common type of primary cancer in other organs (43.8%), followed by breast cancer (16.3%). The mean time interval between gastric cancer and metachronous primary cancer was 82.2 (3-354) months. The mean age at the diagnosis of gastric cancer was 61.2 (33-84) years. The 5-year overall survival rate was 42.3%. The 5-year survival rates in patients with synchronous cancer, pre-metachronous cancer or post-metachronous cancer were 15.2%, 42.9% and 51.3%, respectively. Causes of death were primary cancers of other organ in 11 patients, gastric cancer in 24, and renal failure in 1 patient.

CONCLUSIONSPrimary cancer of other organ should be considered in the management of gastric cancer. Aggressive treatment should be used for the second primary cancer. Gastric cancer is the main cause of death in these patients.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; diagnosis ; Prognosis ; Stomach Neoplasms ; diagnosis

Objective:To observe the therapeutic efficacy of acupuncture plus Tai Ji Quan (Tai Chi) in recovering the neurological function and treating depression state in post-stroke depression patients,together with a 12-month follow-up.Methods:A total of 105 eligible post-stroke depression patients were randomized into an acupuncture plus Tai Ji group (53 cases) and a control group (52 cases) based on their visiting sequence.The patients all received routine treatment and rehabilitation training for stroke.In addition,the control group was given oral administration of citalopram hydrobromide tablets,1 month as a course of treatment,for 3 courses in total.Meanwhile,the acupuncture plus Tai Ji group received acupuncture and practiced Tai Ji Quan,for 1 month and 12 months respectively.Before the intervention,after 1-month intervention and 12 months later,the National Institute of Health stroke scale (NIHSS),Barthel index (BI) and Hamilton depression rating scale (HAMD) were adopted for efficacy evaluation.Results:Prior to the intervention,there were no significant differences in HAMD,NIHSS and BI scores between the two groups (all P＞0.05);after 1-month intervention,there were significant between-group differences in NIHSS,BI and HAMD scores (P＜0.05 or P＜0.01);the 12-month follow-up revealed significant between-group differences in NIHSS,BI and HAMD scores (all P＜0.01).In the treatment of stroke,the total effective rate was 84.4％ in the acupuncture plus Tai Ji group,significantly higher than 68.9％ in the control group (P＜0.05);in the treatment of depression,the total effective rate was 86.7％ in the acupuncture plus Tai Ji group,significantly higher than 77.8％ in the control group (P＜0.05).Conclusion:Acupuncture plus Tai Ji Quan can produce a significant efficacy in improving the limb motor function and depression in post-stroke depression patients.

OBJECTIVETo investigate the clinical significance of promoter methylation status of hPer3 gene in acute myeloid leukemia (AML) patients and the in vitro effect of decitabine (DCA) on AML cell lines HL-60 and U937.

METHODSThe promoter methylation status of hPer3 gene and mRNA expression levels in bone marrow of 206 AML and 40 iron deficiency anemia (IDA) patients (as control) were detected by methylation specific PCR (MS-PCR) and real-time PCR (RT-PCR). The HL-60 and U937 cell lines were treated with different concentrations of DCA for 48 and 72 h. The inhibition rates of cell proliferation were detected by methyl thiazolyl tetrazolium (MTT); the early apoptosis rates by staining with Annexin V and PI; the CD14 and CD11b expressions by flow cytometry (FCM); the promoter methylation status of hPer3 gene by MS-PCR; and the hPer3 mRNA expressions levels by RT-PCR.

RESULTSThe promoter methylation rates of hPer3 in newly diagnosed (ND) group, partial remission(PR) group, complete remission (CR) group, relapse (R) group and control group were 93.65% (59/63), 54.39% (31/57), 24.66% (18/73), 61.54% (8/13) and 0% (0/40), and the hPer3 mRNA expression levels were 0.19 ± 0.08, 6.28 ± 2.11, 52.76 ± 14.17, 8.18 ± 4.36, 75.03 ± 18.16, respectively. There was a significant statistic difference between any two group (P < 0.01) excepting for between PR and R group (P > 0.05). After DCA treatment, the promoter hypermethylation status of hPer3 was reduced and the mRNA and CD14, CD11b expression levels were up regulated in a dose dependent manner with an induction of cell apoptosis.

CONCLUSIONSPromotor methylation status and mRNA expression of hPer3 gene may be indicators for evaluating AML. DCA can induce the expression of hPer3 gene and cells apoptosis in AML.

Adolescent ; Adult ; Aged ; Azacitidine ; analogs & derivatives ; pharmacology ; Cell Proliferation ; DNA Methylation ; Female ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Period Circadian Proteins ; genetics ; Promoter Regions, Genetic ; U937 Cells ; Young Adult

AIMTo investigate the effects of exercise on phosphorylated and total ERK1/2, and mRNA of ERK2.

METHODSMale rats were randomly divided into control and trained groups. The trained rats were submitted to 1 h or 1.5 h of exercise daily and had a fragment of their excised gastroenemius muscle, 24 h or 48 h after the last training session. The train lasted for 7 weeks. The changes in the expressions of ERK1/2 and p-ERK1/2 were determined by Western blotting.The expression of ERK2 mRNA was determined by RT-PCR.

RESULTSExercise led to a marked increase in p-ERK1/2 of trained groups as compared with controls, and increased ERK1/2 protein expression of training 1.5 h/d, 24 h and 48 h after the last training session. ERK2 mRNA was increased by exercise 1 h/d, 24 h and exercise 1.5 h/d, 24 h and 48 h after the last training session. Glucose tolerance test found that blood insulin concentration was decreased with exercise training.

CONCLUSIONEndurance exercise could increase muscle responsiveness to insulin by improving the total ERK1/2 and p-ERK1/2, ERK2 mRNA expression.

Animals ; Glucose Tolerance Test ; Insulin ; physiology ; Male ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Muscle, Skeletal ; metabolism ; Phosphorylation ; Physical Conditioning, Animal ; physiology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley