Antigens, CD34 ; metabolism ; Craniotomy ; Diagnosis, Differential ; Follow-Up Studies ; Hemangiosarcoma ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Skull ; pathology ; surgery ; Skull Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To discuss the clinical characteristic and diagnosis of children with moyamoya disease(MMD).Method The clinical features of 4 children with MMD were analyzed.Results The early clinical spectrum in children with MMD was transiently ischemic attack,and presented with injured neuron manifestations after some seizures,such as paralysis,extremity sensory disturbance, seizure of epilepsy,language disorder,involuntary movement and psychotic symptoms.Magnetic resonance angiography(MRA) and DSA demonstrated multiple cerebral vessels occlusion or stenosis and moyamoya vessels,so MRA became the first choice for detec- ting MMD.Conclusions The clinical symptom and neuron symptom of children MMD may not be typical,and it is easily misdiagnosed.Its correct diagnosis depends on thorough physical examination,appropriate laboratory tests,and the general knowledge of this disease.

Hamartoma ; complications ; surgery ; Humans ; Hydrocephalus ; etiology ; Hypothalamic Diseases ; complications ; surgery ; Infant ; Male ; Postoperative Complications ; etiology ; Puberty, Precocious ; etiology ; Subdural Effusion ; etiology

Objective To identify the important risk factors for type 2 Diabetes Mellitus (T2DM) and develop effective strategies to address the problem of T2DM.Our study aimed to evaluate the association between apolipoprotein E (ApoE) genetic polymorphism and type 2 diabetes,and to provide clues for the etiology of T2DM.Methods Based on the criteria of inclusion and exclusion,we extracted,pooled,analyzed and assessed the case-control studies of ApoE polymorphism and T2DM published in PubMed,Web of Science,Medline,WanFang,VIP,and CNKI databases by R soft-ware (version 3.4.3).We used Random-effect models when heterogeneity was present in between-study,and fixed-effect models otherwise.Results We had 59 studies covering 6,872 cases with T2DM and 8,250 controls,and compared the alleles and genotypes of ApoE between cases and controls.When we conducted a comparison between ApoE ε4 and ε3 alleles,we produced a pooled OR of 1.18 (95％ CI:1.09-1.28;P ＜ 0.001).ApoE ε2/ε2 genotype displayed a possible association with T2DM (OR =1.46;95％ CI:1.11-1.93;P =0.007),ε3/ε4 genotype showed a 1.11-fold risk (OR =1.11;95％ CI:1.01-1.22;P =0.039) and ε4/ε4 genotype had a 1.71-fold risk of developing T2DM (OR =1.71;95％ CI:1.33-2.19;P ＜ 0.001) when they were compared with ε3/ε3 genotype.Conclusions There is an association between ApoE polymorphism and T2DM:allele ε4 and genotypes (ε2/ε2,ε3/ε4,and ε4/ε4) are associated with the increased risk for the development of T2DM,and they may be risk factors for T2DM.

To develop a sensitive and rapid liquid chromatographic-tandem mass spectrometric (LC-MS/MS) method for simultaneous quantitation of metformin and glipizide in human plasma, metformin, glipizide and internal standard diphenhydramine were separated from plasma by protein precipitation with acetonitrile (containing 0.3% formic acid), then chromatographed by using a Zorbax Extend C18 column. The mobile phase consisted of acetonitrile-water-formic acid (70:30: 0.3, v/v/v), at a flow rate of 0.50 mL x min(-1). A tandem mass spectrometer equipped with atmospheric pressure chemical ionization source was used as detector and operated in the positive ion mode. Selected reaction monitoring (SRM) using the precursor/production combinations of m/z 130-->m/z 60, m/z 446-->m/z 321 and m/z 256-->m/z 167 were used to quantify metformin, glipizide and diphenhydramine, respectively. The linear concentration ranges of the calibration curves for metformin and glipizide were 2.00 - 2000 ng x mL(-1) and 1.00 - 1000 ng x mL(-1), respectively. The lower limits of quantitation of metformin and glipizide were 2.00 ng x mL(-1) and 1.00 ng x mL(-1), respectively. The method proved to be sensitive, simple and rapid, and suitable for clinical investigation of compound preparation containing metformin and glipizide.
Administration, Oral ; Chromatography, Liquid ; methods ; Glipizide ; administration & dosage ; blood ; pharmacokinetics ; Humans ; Hypoglycemic Agents ; administration & dosage ; blood ; pharmacokinetics ; Male ; Metformin ; administration & dosage ; blood ; pharmacokinetics ; Sensitivity and Specificity ; Tandem Mass Spectrometry ; methods ; Young Adult

Objective To investigate the expression of caspase-10 in differentiated thyroid carcinoma and association with its development and metastasis. Methods Thyroid samples from 37 patients in a period from January 2006 to December 2007, with differentiated thyroid carcinoma were retrospectively analyzed for caspase-10 by immunohistocbemistry(streptavidin-perosidase, S-P), compared to control group of 46 cases with nodtdar goiter. The relationship between the expression of caspase-10 and the clinical pathologic characteristics of thyroid carcinoma were also explored simultaneously. Results caspase-10 were observed as brown or yellow particles located in the cytoplasm or cell membrane of nodular goiter but there were no significant evidence for its positive expression in thyroid carcinoma, caspase-10 expression was markedly down-regulated in differentiated thyroid carcinoma(29.73%,11/37) compared with benign nodules(71.74%,33/46, χ2=14.528, P<0.01). The positive expression in 18 cases with lymph node metastasis(11.11%,2/18) was significantly lower than those in 19 patients without lymph node metastasis(47.37%,9/19; χ2=4.210, P<0.01). There was no significant correlation(P> 0.05) between the expression of caspase-10 and the clinical pathologic characteristics including male, age, TNM stage and pathologic type. Conclusion Down-regulation of caspase-10 may play a critical role in carcinogenesis and development of differentiated thyroid carcinoma.

Objective To investigate the clinical,neuroimaging and myopathological features of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes(MELAS).Methods The clinical manifestations,neuroimaging and myopathological features of 31 patients with MELAS diagnosed in our Neuromuscular Center in the recent 7 years were retrospectively analyzed.A3243G point mutations were analyzed by RFLP method in 10 patients.Results ①Clinical features:There were 18 male patients and 13 female patients.The age of onset ranged from 3 to 43 years,averaging 21.9 years.The averaged duration was 4.9 years.Thirteen patients in this group had family history of maternal inheritance pattern.The main clinical manifestations included short stature(26 patients),recurrent headache and vomiting(24 patients), muscle weakness(22 patients),epileptic seizure(21 patients),cognitive decline(19 patients),visual disturbance(17 patients),sensorineural deafness(16 patients),ataxia(6 patients),psychiatric symptom (8 patients),external ophathalmoplegia(2 patients)and diabetes mellitus(9 patients).The serum CK level was slightly elevated in 6 patients,and the fasting blood lactic acid was increased in 15 of the 18 detected patients.②Neuroimaging features:The stroke-like lesions were mostly confined to cerebral cortex, including temporal lobe(24 patients),occipital lobe(21 patients),parietal lobe(12 patients)and frontal lobe(4 patients).Three patients had deep white matter involvement.Migrating stroke-like lesions were confirmed in 4 patients by repeated cranial CT/MRI examination.In addition,cerebral atrophy(17 patients)and bilateral basilar ganglion calcification(11 patients)were found.③Myopathological features: Scattered ragged red fibers(RRF)in various number were found in all the patients by MGT staining.Other founding included strongly SDH-reactive blood vessel(27 patients),COX enzyme deficiency(19 patients), and mild to moderate lipid storage in RRF(20 patients).④MtDNA analysis showed 9 patients with A3243G point mutation in all the detected 13 patients.Conclusion The clinical and neuroimaging features may offer important clue to the diagnosis of MELAS,but a definite diagnosis of MELAS relies on the myopathology and mtDNA mutation analysis.

To study the drug-drug interaction of morinidazole and warfarin and its application, a sensitive and rapid liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the determination of R-warfarin/S-warfarin in human plasma. In a random, two-period crossover study, 12 healthy volunteers received a single oral dose of 5 mg racemic warfarin in the absence and presence of morinidazole. Blood samples were collected according to a pre-designed time schedule. R-warfarin, S-warfarin and methyclothiazide were extracted with ethylether : methylenechloride (3 : 2), then separated on a Astec Chirobiotic V (150 mm x 4.6 mm ID, 5 microm) column using 5 mmol x L(-1) ammonium acetate (pH 4.0) - acetonitrile as mobile phase at a flow-rate of 1.5 mL x min(-1). The mobile phase was splitted and 0.5 mL x min(-1) was introduced into MS. A tandem mass spectrometer equipped with electrospray ionization source was used as detector and operated in the negative ion mode. Quantification was performed using multiple reaction monitoring (MRM). The resolution of warfarin enantiomers is 1.56. The linear calibration curves for R-warfarin and S-warfarin both were obtained in the concentration range of 5 - 1 000 ng x mL(-1). Intra- and inter-day relative standard deviation (RSD) for R-warfarin and S-warfarin over the entire concentration range across three validation runs was both less than 10%, and relative error (RE) ranged from -4.9% to 0.7%, separately. The method herein described is effective and convenient, and suitable for the study of metabolic interaction between morinidazole and warfarin. The results showed that coadministration of warfarin with morinidazole did not affect the pharmacokinetics of either R-warfarin or S-warfarin.
Anticoagulants ; blood ; pharmacokinetics ; Chromatography, Liquid ; Drug Interactions ; Humans ; Nitroimidazoles ; blood ; pharmacokinetics ; Spectrometry, Mass, Electrospray Ionization ; Stereoisomerism ; Tandem Mass Spectrometry ; Warfarin ; blood ; pharmacokinetics

BACKGROUNDPhakic intraocular lens (pIOL) implantation has been a popular means for the treatment of high ametropia. Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no perfect system can directly measure it. The present study was to evaluate the accuracy, repeatability and reproducibility of direct sulcus diameter measurements obtained by a full-scale 50-megahertz (MHz) ultrasound biomicroscopy (UBM).

METHODSA fresh cadaver human eye with a scale marker inserted through the posterior chamber plane from 3 o'clock to 9 o'clock meridian and 30 randomly selected eyes from 30 normal subjects were scanned by full-scale 50-MHz UBM in horizontal meridional scan plane. The distance between the scales and the whole length of the marker inside the cadaver eye were measured by the same observer using the "built-in" measurement tools and the indicating error of instrument was calculated. Reproducibility of the measurement was evaluated in 30 eyes by 2 operators using Blander and Altman plot test. Repeatability was evaluated from 10 successive eyes randomly selected from the 30 eyes by one operator.

RESULTSOn a scale of 1 mm, the greatest indicating error was 40 microm; the mean largest indicating error of 1 mm scale from the 10 images was (26 +/- 14) microm; on a scale of 11 mm, the greatest indicating error was 70 microm; the error rate was 0.64%. The mean length of the needle inside the eye of the 10 images was 11.05 mm, with the mean indicating error of 47 microm, the average error rate was 0.43%. For ciliary sulcus diameter measurements in vivo, the coefficient of variation was 0.38%; the coefficients of repeatability for intra-observer and inter-observer measurements were 1.99% and 2.55%, respectively. The limits of agreement for intra-observer and inter-observer measurement were -0.41 mm to 0.48 mm and -0.59 mm to 0.58 mm, respectively.

CONCLUSIONThe full-scale 50-MHz UBM can be a high accuracy and good repeatability means for direct measuring the ciliary sulcus diameter and useful for size determining of posterior chamber pIOL.

OBJECTIVETo study the effect of buffer on separate capacity of macroporous resin. To evaluate the quality of ferulic acid liposome and determine its entrapment efficiency.

METHODDifferent type of macroporous resin counterpoised by buffer system of Na2 HPO3-NaH2, PO3 was used to separate the free ferulic acid from the preparation and HPLC was used to determine the concentration of the ferulic acid to calculate the entrapment efficiency.

RESULTThis method had good linearity in the range of 0.56 - 2.8 g x mL(-1) (r = 0.999 6). The precision RSD was less than 1.1%. The adsorption effect of macroporous resin on liposome was reduced while it had no effect on the absorption ability of macroporous resin on the ferulic acid by the usage of buffer. The recovery of HPD450 resin on blank liposome was between 97.2% - 100.8%, while the average recovery is 98.1%.

CONCLUSIONBuffer system can enhance the separate ability of macroporous resin on liposome and free drug.