OBJECTIVE To investigate the feasibility of endoscopic sinus surgery under local anesthesia.METHODS A total of 810 patients underwent endoscopic sinus surgery from January 2000 to December 2007 with complete follow-up data were included in this study.Validity of anesthesia was evaluated using VAS(visual analogous scale).Operation time,bleeding quantity during operation,operation therapeutic efficacy,hospitalization cost and patient's evaluation to the operation were recorded.RESULTS The mean VAS score of local anesthesia was 3.18?0.46.Cases with no pain and mild pain accounted for 78.28%,with moderate pain 16.71%,and with severe pain 5.01%.The average bleeding quantity during operation,operation time,complication incidence,cure rate at 6 months after operation,hospitalization cost,patients' evaluation in local anesthesia were(43.25?27.46)ml,(41.14?9.479) min,1.78%,78%,4000～6000 yuan(RMB),9.28? 2.21 respectively.CONCLUSION For the endoscopic sinus surgery,most cases can be operated under local anesthesia if the indication were selected correctly and the sophisticated skills and advanced instrument were available.

Brucellosis ; complications ; Cytomegalovirus Infections ; complications ; Humans

Acute Disease ; Adult ; Altitude Sickness ; blood ; enzymology ; Glutathione ; blood ; Glutathione Peroxidase ; blood ; Humans ; Lipid Peroxidation ; Male ; Military Personnel ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Oxidoreductases ; metabolism ; Superoxide Dismutase ; blood

1H NMR metabonomics approach was used to reveal the chemical difference of urine between patients with Xiao-Chaihu Tang syndrome (XCHTS) and healthy participants (HP). The partial least square method was used to establish a model to distinguish the patients with Xiao-Chaihu-Tang syndrome from the healthy controls. Thirty-four endogenous metabolites were identified in the 1H NMR spectrum, and orthogonal partial least squares discriminant analysis showed the urine of patients with Xiao-Chaihu Tang syndrome and healthy participants could be separated clearly. It is indicated that the metabolic profiling of patients with Xiao-Chaihu Tang syndrome was changed obviously. Fifteen metabolites were found by S-pot of OPLS-DA and VIP value. The contents of leucine, formic acid, glycine, hippuric acid and uracil increased in the urine of patients, while threonine, 2-hydroxyisobutyrate, acetamide, 2-oxoglutarate, citric acid, dimethylamine, malonic acid, betaine, trimethylamine oxide, phenylacetyl glycine, and uridine decreased. These metabolites involve the intestinal microbial balance, energy metabolism and amino acid metabolism pathways, which is related with the major symptom of Xiao-Chaihu Tang syndrome. The patients with Xiao-Chaihu Tang syndrome could be identified and predicted correctly using the established partial least squares model. This study could be served as the basis for the accurate diagnostic and reasonable administration of Xiao-Chaihu-Tang syndrome.
Humans ; Least-Squares Analysis ; Medicine, Chinese Traditional ; Metabolome ; Metabolomics ; Proton Magnetic Resonance Spectroscopy ; Syndrome ; Urinalysis

Objective To present a preliminary latest procedure for portal hypertension and evaluate the technical feasibility and efficacy of portacaval shunt creation through the percutaneous transhepatic approach in order to make a hemodynamic comparison with that of the classic TIPS.Methods Thirty-eight patients with portal hypertension(36 men;mean age 57 years,range 32～73)were referred for PTPS procedure because of bleeding varices(n=36),intractable ascites(n=1),and hepatopulmonary syndrome(n=1).The severity of liver disease was classified as Child-Pugh B in 27 and C in 11.The PTPS was created by a percutaneous transhepatic puncture into right portal vein and then through left portal vein to the hepatic segment of IVC followed by a prefabrication stress stent-graft placement at the very site.Results Technical and functional success of 100% was achieved in all patients,without related complications.The postprocedural portal vein-IVC gradients mean 13 cmH_2O was achieved with the follow-up period mean 493 days.No recurrence of variceal bleeding and controlled refractory ascites were achieved,and still more with primary patency rate of the involved vascular structure up to 94.8% at 365 days,much better than classic TIPS. Conclusions Portacaval shunt creation using the prefabrication stress stent via percutaneous transhepatic technique is safe and feasible.The compact coincidence was obtained between the stent and the involved vessel with restoration of intrahepatic portal venous bemodynamics together with partial lowering of portal venous pressure and guaranteeing intrahepatic perfusion through right portal vein.It is also obviously to have postoperative prevention of shunt restenoses and lowering postoperative incidence of hepato-encephalopathy.

OBJECTIVETo explore the relationship between genetic polymorphisms of glutathione S-transferase (GST) M1, T1 and susceptibility to mountain sickness.

METHODSForty-three soldiers with acute mountain sickness and 80 healthy soldiers matching with sex/age and training under the same condition were divided into case group and control group. A multiple polymerase chain reaction method was used to detect GSTM1 and GSTT1 genes in genomic DNA isolated from peripheral blood cells from both cases and controls.

RESULTSThe frequency of the GSTT1 positive genotype was significantly higher in cases (69.8%) than in controls (42.5%) (P = 0.004, OR = 3.12, 95% CI 1.42 approximately 6.86). The frequency of GSTM1 negative genotype was also higher in cases (72.1%) than in controls (52.5%) (P = 0.03, OR = 2.34, 95% CI 1.05 approximately 5.02). Persons with both GSTM1 and GSTT1 negative genotypes had 5-fold more risk than those with GSTT1 negative and GSTM1 positive genotypes in developing mountain sickness (OR = 5.04, 95% CI: 1.00 approximately 25.3).

CONCLUSIONGenetic polymorphisms of glutathione S-transferase M1, T1 may be the risk factors in the development of mountain sickness.

Acute Disease ; Adult ; Altitude Sickness ; genetics ; Case-Control Studies ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Glutathione Transferase ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Risk Factors

OBJECTIVETo study the response of rat bone marrow mesenchymal stem cells (MSCs) to a single period of mechanical strain and expression patterns of transforming growth factor-beta (TGF-beta) and insulin-like growth factor-II (IGF-II) after mechanical stretch.

METHODSBone marrow MSCs were isolated from SD rats and cultured in vitro. A four-point bending apparatus were used to perform a single period of mechanical strain (2000 microepsilon, 40 min) on MSCs. Cellular proliferation and alkaline phosphatase (ALP) activity of MSCs were examined and gene expression patterns of TGF-beta and IGF-II were detected by SYBR green quantitative real-time RT-PCR.

RESULTSCell proliferation, ALP activity and expression of TGF-beta and IGF-II were all significantly up-regulated in stretched MSCs when compared with their controls. The mRNA levels of TGF-beta and IGF-II got top increase immediately after mechanical loading and increased about 51.44 and 8.92 folds, respectively, when compared with control cells. Expression of TGF-beta and IGF-II decreased with time and returned to control level at 12 h after mechanical stimulus, despite of a small increase at 6 h.

CONCLUSIONThe mechanical stretch can promote MSCs proliferation, up-regulate its ALP activity and induce a time-dependent expression increase of TGF-beta and IGF-II which in turn result in osteogenic differentiation of MSCs. Mechanical stimulus is a key stimulator for osteogenic differentiation of MSCs and vital for bone formation in distraction osteogenesis.

Animals ; Bone Marrow Cells ; Cell Differentiation ; Cell Proliferation ; Insulin-Like Growth Factor II ; Mesenchymal Stromal Cells ; Osteogenesis ; Osteogenesis, Distraction ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Somatomedins ; Transforming Growth Factor beta

OBJECTIVEWe aimed to perform a meta-analysis of clinical trials on the efficacy of autologous bone marrow-derived cells (BMCs) transfer for patients with chronic ischemic heart disease.

METHODSWe searched MEDLINE, EMBASE, and Cochrane database through September 2009. Eligible studies were randomized controlled trials of autologous BMCs infusion in patients with chronic ischemic heart disease. We gathered information about left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and death, and did a random-effect meta-analysis to obtain summary effect estimates for outcomes. The pooled analyses were performed and forest plots were generated with RevMan 5.0 software. Heterogeneity was assessed by meta-regression with STATA 10.0 software. Additionally, subgroup analysis was performed to compare the effect of intracoronary BMCs transfer with intramyocardial cell injection on LVEF.

RESULTSEleven trials with 490 participants were identified. There were 268 patients in BMCs group, and 222 in control group. In control group, the patients received saline injection or autologous plasma injection or no injection. BMCs transfer was performed via intracoronary transfer or intramyocardial injection. Compared with controls, BMCs transfer significantly improved LVEF by 4.63% (95%CI 2.42 to 6.84; P < 0.01). BMCs transfer was also associated with significant reductions in LVEDV (standardized mean difference -0.55, 95%CI -0.94 to -0.17, P = 0.005) and LVESV (standardized mean difference -0.45, 95%CI -0.73 to -0.17, P = 0.002). In addition, BMCs treatment was associated with a significant effect on death (OR 0.42, 95%CI 0.18 to 1.01, P = 0.05). Subgroup analysis indicated that intramyocardial cell injection was preferred due to its more significant improvement of LVEF than intracoronary cell therapy. Meta-regression suggested the existence of a negative association between baseline LVEF and LVEF change.

CONCLUSIONBMCs infusion is associated with a significant improvement in LVEF, and an attenuation of left ventricular remodeling.

Bone Marrow Transplantation ; Humans ; Myocardial Ischemia ; surgery ; Randomized Controlled Trials as Topic ; Transplantation, Autologous

OBJECTIVETo detect the DNA damage of mice endometrial cells induced by carbon disulfide with single cell gel electrophoresis (SCGE) and explore the mechanism of embryo implantation disorder.

METHODSEndometrial cells, obtained by mechanical scrape, were used to test cell viability by trypan blue. Single cell suspension was exposed to the different concentrations of carbon disulfide (CS(2)) at four dose groups (0, 500, 1000, 2500 micromol/L). DNA damage was detected by SCGE. The SCGE results were analyzed by CASP software.

RESULTSDifferent dosages of CS(2) concentration induced different varying degrees of damage, forming typical normal cell and comet cell images. Compared with the control group, HDNA% decreased by 7.49%, 12.19% and 24.36% respectively, and TDNA%, TL, OTM increased by 7.13, 11.60, 23.18, 3.68, 5.98, 9.62, and 9.16, 16.84, 39.32 times respectively, in the groups of 500, 1000, 2500 micromol/L CS(2) (P < 0.01). Compared with the group of 500, 1000 micromol/L CS(2), TDNA%, TL, CL, TM, OTM in the group of 2500 micromol/L CS(2) increased by 1.98, 0.92, 1.27, 0.52, 0.37 and 0.17, 5.31, 1.90, 2.97, 1.26 times respectively(P < 0.01). Compared with the group of 500 micromol/L CS(2), TDNA%, TL, CL, TM, OTM in the group of 1000 micromol/L CS(2) increased by 0.55, 0.49, 0.16, 1.18, 0.76 times respectively (P < 0.01). The result of regression analysis showed that regression coefficients between HDNA%, TDNA%, TL, TM, OTM and the doses were -13.78, 13.78, 0.05, 4.38 and 3.23 respectively.

CONCLUSIONSCS(2) exposure could induce DNA damage in the endometrial cells of mice at the phase of implantation. The degree of DNA damage increases with the increasing CS(2) concentration. CS(2) might affect the implantation of embryo by doing harm to the endometrial cells.

Animals ; Carbon Disulfide ; toxicity ; Comet Assay ; DNA Damage ; Embryo Implantation ; drug effects ; Endometrium ; cytology ; drug effects ; Female ; Mice ; Mice, Inbred Strains

The aim of this study was to obtain the soluble protein of human pregnane X receptor ligand binding domain (PXRLBD) through the coexpression of PXRLBD and 88 amino acids of steroid receptor coactivator-1 (SRC88) and apply the protein to constructing a new model of screening PXR ligands. Expression plasmid of pETDuet-1-SRC88-PXRLBD was constructed and transformed into Escherichia coli Rosetta (DE3) to coexpress PXRLBD and SRC88 via induction by IPTG at low temperature. Then an equilibrium dialysis model was constructed to study the interaction between PXRLBD and drugs including clotrimazole and dexamethasone, using HPLC as the analysis method. The results showed that the soluble protein of PXRLBD was obtained and the HPLC data indicated that clotrimazole bound to PXRLBD, while dexamethasone did not bind to PXRLBD, which indicated the successful establishment of a new method for studying the interaction between PXR and drugs. The new method may be useful in the screening of PXR ligands in vitro.
Clotrimazole ; metabolism ; Dexamethasone ; metabolism ; Dialysis ; methods ; Drug Interactions ; Escherichia coli ; genetics ; metabolism ; Histone Acetyltransferases ; genetics ; metabolism ; Humans ; Ligands ; Nuclear Receptor Coactivator 1 ; Plasmids ; Protein Binding ; Receptors, Steroid ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism ; Transformation, Genetic