Objective To compare the clinical efficacy of tension-free hernioplasty with three operative methods, and analyze the reasons of complications. Methods All Chinese articles dealing with the tension-free hernioplasty included in CNKI from 1997 to 2004 were collected, and divided into three groups according to different operative methods, the clinical efficacy of which was compared. Results The frequecy of foreign matter feel in the Rutknow group was significantly higher than that in the other two groups (P

Objective:To explicit phenylephrine (PE), α1-adrenergic receptor (α1-AR) on myocardial fibrosis regulation and interleukin-1 (IL-1), IL-6, tumor necrosis factor-α (TNF-α) expressions in pressure overloaded mice.
Methods:A total of 49 KM mice were randomly divided into 3 groups: Blank control group, n=7, Sham operation group, n=7, Transverse abdominal aortic constriction (TAC) group, n=35, and 8 weeks later, the mice in TAC group were further divided into 5 sub-groups as TAC control, TAC+PE, TAC+Praz, TAC+Prop, TAC+Carv sub-groups, n=5 in each sub-group, and the animals were respectively treated for 3 weeks. Left ventricular collagen volume fraction (CVE), hydroxyproline content and IL-1, IL-6, TNF-α expressions were examined respectively.
Results: By 8 weeks treatment, compared with Blank control group, TAC group had obvious myocardial fibrosis, increased hydroxyproline content and IL-1, IL-6, TNF-α expressions,P<0.001. Compared with TAC control sub-group, TAC+PE, AC+Prop, TAC+Carv sub-groups showed decreased CVF, hydroxyproline content and IL-1, IL-6, TNF-αexpressions,P<0.001, while the above changes were not obvious in TAC+Praz sub-group,P>0.05; CVE and hydroxyproline content were similar between TAC+PE and TAC+Prop sub-groups, while the expressions of IL-1, IL-6 and TNF-α were obviously decreased in TAC+Prop sub-group,P<0.05. Conclusion: PE may improve myocardial ifbrosis and IL-1, IL-6, TNF-α expressions by activating α1-AR in pressure overloaded mice, α1-AR might be a defending factor for myocardial ifbrosis.

Adolescent ; Adult ; Darier Disease ; therapy ; Electroacupuncture ; Female ; Humans ; Young Adult

Objective: To observe the effect of phenylephrine (PE) on pressure overload induced myocardial ifbrosis (MF) with its relevance to transforming growth factor-β1 (TGF-β1), drosophila mothers against decapentaplegic protein 3 (smad3) and connective tissue growth factor (CTGF) signal pathway in experimental rats.
Methods: A total of 28 male SD rats were randomly divided into 4 groups: Control group, AAC (abdominal aorta coarctation) group, AAC+PE group and AAC+prazosin group.n=7 in each group. Collagen volume fraction (CVF) of left ventricle was observed by myocardial collagen morphology, left ventricular myocardial tissue protein expressions of α-smooth muscle actin (α-SMA), TGF-β1, smad3 and CTGF were measured by immunohistochemistry, protein expression of α-SMA was also examined by Western blot analysis.
Results:①Myocardial collagen morphology presented that compared with Control group, AAC, AAC+PE and AAC+prazosin groups had increased CVF, allP<0.01; compared with AAC group, AAC+PE group had decreased CVF, P<0.01.②Immunohistochemistry demonstrated that compared with Control group, AAC, AAC+PE and AAC+prazosin groups had up-regulated protein expressions of α-SMA, TGF-β1, smad3 and CTGF, allP<0.01; compared with AAC group, AAC+PE group had down-regulated protein expressions of α-SMA, TGF-β1, smad3 and CTGF, allP<0.01.③Western blot analysis indicated that compared with Control group, AAC, AAC+PE and AAC+prazosin groups had the higher α-SMA expression, allP<0.05; compared with AAC group, AAC+PE group had the lower α-SMA expression, P<0.01.
Conclusion: Phenylephrine could improve pressure overload induced MF in experimental rats which might be related to TGF-β1/smads signal pathway inhibition and CTGF down-regulation.

Objective To explore the effect and safety of rituximab (RTX) in children with frequently relapsed nephrotic syndrome.Methods Twelve children (8 male and 4 female) with frequently relapse nephrotic syndrome were treated with RTX.They all showed resistance to various immunosuppressive agents and relapsed when steroid was reduced at 1.5-2.0 mg/kg.All immunosuppressive agents were stopped.Steroid was prescribed at doses of 2 mg/(kg · d),followed by alternate-day dosing (2 mg/kg) after proteinuria was negative for 5 days,and then tapered by 5 mg every 2 weeks until to low dose (＜ 0.5 mg/kg on alternate day) or discontinued.RTX was administered at a dose of 375 mg/m2 once every week for 3 weeks.Results The patients were followed up for 4-19 months [median (7.79 ± 3.00) months].Proteinuria turned negative on 1-14 d after first RTX treatment.Mean steroid dosages were significantly reduced than before treatment [alternate-day dosing (1.83 ± 1.02) mg/kg vs alternate-day dosing (0.34 ± 0.16) mg/kg,t =3.78,P =0.002].Gingival hyperplasia and Cushing appearance were significantly improved and steroid-induced glaucoma disappeared.The height was significantly increased compared with before treatment [(2.21 ± 1.40) cm/year vs (8.27 ±2.10) cm/year].Six cases had no relapse during follow-up.Another 6 cases relapsed in 5.5-19.0 months.All patients showed CD19 + B lymphocytes depletion after RTX treatment.However,CD19 + recovery could be seen in 5.5-12.0 months.Serum immunoglobulin did not significantly change.None of the patients was found with adverse events.Conclusions RTX can significantly reduce the dosage of steroid or even stop medication in children free of immunosuppressive agents,maintain remission for (7.79 ± 3.00) months,significantly improve the adverse reaction induced by steroid and immune-suppression.Thus,for children with frequently relapsed nephritic syndrome/steroid-dependent nephrotic syndrome who show resistance to immunosuppressive therapies,RTX treatment may be considered.

Objective: To explore the effect of suberoylanilide hydroxamic acid (SAHA) improving cardiac hypertrophy via inhibiting histone deacetylases (HDAC) in experimental mice and to provide a new idea for prevention and treatment of cardiac hypertrophy. Methods: Cardiac hypertrophy mice model was established by thoracic aorta ligation. A total of 60 Kunming mice were randomly divided into 4 groups: Normal control group, Sham operation group, Cardiac hypertrophy (CH) group and CH+SAHA group. There were 6 mice used in each group. Myocardial cell morphology was observed by HE staining, cardiac function was assessed by echocardiography, mRNA and protein expressions of HDAC5 (the isoform of HDAC) and β-MHC were examined by RT-PCR and Western blot analysis. Results: The mice in CH group had myocardial cell hypertrophy, disordered arrangement and hyperchromatic nucleus. Compared with Sham operation group, CH group showed decreased left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic volume (LVEDV) and increased thickness of inter-ventricular septum (IVS), allP<0.05; CH group presented elevated mRNA and protein expressions of HDAC5 and β-MHC,P<0.05. SAHA obviously decreased HDAC5 expression, down regulated cardiac hypertrophy related β-MHC gene expression, improved cardiac function and hypertrophy, all P<0.05. Conclusion: HDAC were involved in myocardial hypertrophy; SAHA could inhibit HDAC expression and therefore,improved myocardial hypertrophy in experimental mice.

Objective To analyze the clinical,molecular and genetic features of a Chinese family with WalkerWarburg syndrome(WWS).Methods The clinical data of the proband and his family members were collected.Genomic DNAs from the patient and his parents were extracted with standard procedures from the peripheral blood leukocytes.Polymerase chain reaction and DNA direct sequencing were employed to analyze all of the 20 exons of the POMT1 gene to determine the mutation,and the relationship between genotype and phenotype was analyzed.Results The proband presented with delayed psychomotor development,muscle hypotonia and early joint contractures,his serum creatine kinase was elevated moderately and the brain magnetic resonance imaging (MRI) displayed brain structural malformations,cerebellar cyst,bilateral dilatation of the lateral ventricle,cerebellum and brainstem dysplasia.Further genetic testing detected a compound heterozygous mutation of c.313C ＞ T,p.Arg105Cys inherited from his father,a frameshift mutation c.2208delG,p.Trp736X inherited from his mother,both of which were known as pathogenic mutations.Conclusions According to the study,the proband carried compound heterozygous mutation of POMT1 gene,and his parents were heterozygous carriers,which is consistent with autosomal recessive inheritance.The child is definitely diagnosed as WWS.Genetic counseling and prenatal diagnosis are available for this family.

Objective The study examined the influence on marginal bone levers at implants which implants were assigned to open healing and implant-abutment connection restored according to a platform-switching concept. Methods One implant were placed in the first molar of mandible of 48 patients , randomly assigned to open (OH) or submerge (SH) healing. Standardized radiographs were obtained after implant surgery, when implant transfer and crown mounting, and 6 ,12 and 24 months after implants restoration, then evaluated for implant-bone-lever alterations(ΔIBL). Results After 6 months after implants restoration,ΔIBL were (-0.25 ± 0.08)mm mm(OH)and (-0.26 ± 0.12)mm(SH). After 12 months follow-up, ΔIBL were (-0.29 ± 0.13)mm (OH)and (-0.31 ± 0.14) mm(SH), and after 24 months later, ΔIBLwere (-0.34 ± 0.15)mm(OH)and (-0.33 ± 0.11)mm (SH). Conclusions Platform-switched implants showed very limited peri-implant bone-lever alterations. The healing-mode neither affected the total amount nor the temporal patterns of ΔIBL.

Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.

Purpose To study the clinicalpathologic features,diagnosis,differential diagnosis and prognosis of cervical adenoid basal carcinoma (ABC) for improving further recognition and avoiding the likelihood of unnecessarily aggressive treatment to this disease.Methods Clinical presentations and pathological features of 4 cases of cervical ABC were analyzed by hematoxylin and eosin staining,immunohistochemical EnVision staining and in situ hybridization technology.The relevant literatures were reviewed.Results The age of 4 cases with cervical ABC ranged from 53 to 67 years (mean:61.5 years).All of the 4 patients underwent hysterectomy with bilateral salpingo-oophorectomy.Microscopically,the tumors were composed of small,well-differentiated and uniform basaloid cells and the tumor cells formed rounded nests or cords.The tumor cells arranged in palisading at the periphery of the nests.Some of the nests had central cystic spaces and there may also be focal glandular or squamous differentiation in the centre of the nests.Cervical intraepithelial neoplasia (CIN) lesions were observed in all 4 cases.Immunohistochemically,all the tumor cells were negative for CK7,ER,CEA,CD117 and S-100,while CK5/6,CK8/18,CK19,p16,p53,BCL-2 and p63 were positive.HPV 16/18 DNA were positive by in situ hybridization.The patients remained alive without recurrence and metastasis after follow-up 19 to 62 months.Conclusion ABC of the uterine cervix is a rare neoplasm with excellent prognosis.Differentiation of ABC from adenoid cystic carcinoma,basaloid squamous carcinoma,neuroendocrine carcinoma and adenosquamous carcinoma is important due to their different prognosis.Treatment is predominantly hysterectomy or laser electrocantery excision procedure (Leep).Radiotherapy or chemotherapy is not recommeded.