PURPOSE: Acute appendicitis (AA) is one of the most common causes of an acute abdomen. The accuracies of the Alvarado and the acute inflammatory response (AIR) scores in the diagnosis of appendicitis is very low in Asian populations, so a new scoring system, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) system, was designed recently. We applied and compared the Alvarado, AIR, and RIPASA scores in the diagnoses of appendicitis in the Iranian population. METHODS: We prospectively compared the RIPASA, Alvarado, and AIR systems by applying them to 100 patients. All the scores were calculated for patients who presented with right quadrant pain. Appendectomies were performed; then, the postoperative pathology reports were correlated with the scores. Scores of 8, 7, and 5 or more are optimal cutoffs for the RIPASA, Alvarado, and AIR scoring systems, respectively. The sensitivities, specificities, positive predictive values, negative predictive values (NPVs), positive and negative likelihood ratios (LRs) for the 3 systems were determined. RESULTS: The sensitivity and the specificity of the RIPASA score were 93.18% and 91.67%, respectively. The sensitivities of the Alvarado and the AIR scores were both 78.41%. The specificities of the Alvarado and the AIR scores were 100% and 91.67%, respectively. The RIPASA score correctly classified 93% of all patients confirmed with histological AA compared with 78.41% for the Alvarado and the AIR scores. CONCLUSION: The RIPASA scoring system had more sensitivity, better NPV, a positive LR, and a less negative LR for the Iranian population whereas the Alvarado scoring system was more specific.
Abdomen, Acute ; Appendectomy ; Appendicitis* ; Asian Continental Ancestry Group ; Diagnosis ; Humans ; Pathology ; Prospective Studies ; Sensitivity and Specificity ; Skates (Fish)*

Fuantai-03(FAT-03), isolated from the Dasyatis akajei, has a strong antiangiogenic activity. The recombinant Fuantai-03 (GST/rFAT-03) fusion protein can be obtained with the DNA recombination technology. In this study, expression conditions of GST/rFAT-03 were optimized by response surface experimental design method. The constructed engineering bacteria containing GST/rFAT-03 plasmid was induced by isopropy-beta-D-thiogalactosid (IPTG), the GST affinity column was used for isolation and purification, and then the effects of different culture time, IPTG concentration, induction temperature and induction time on the amount of soluble GST/rFAT-03 fusion protein were compared. The culture time for optimal expression was 6.13 h, IPTG concentration was 0.36 mmol/L, induction temperature was 19.71 degrees C, and induction time was 13.60 h. The amount of soluble GST/rFAT-03 fusion protein was 7.57 mg/L under above mentioned expression conditions. The results also showed that rFAT-03 significantly inhibited angiogenesis in chicken chorioallantoic membrane in a dose-dependent manner. Moreover, the soluble form of the target protein is useful for further work on purification and on studying its biological function.
Angiogenesis Inhibitors ; biosynthesis ; genetics ; Animals ; Chickens ; Chorioallantoic Membrane ; blood supply ; Escherichia coli ; genetics ; metabolism ; Fish Proteins ; biosynthesis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Skates (Fish)

OBJECTIVE: Adult appendicitis (AA) with equivocal computed tomography (CT) findings remains a diagnostic challenge for physicians. Herein we evaluated the diagnostic performance of several clinical scoring systems in adult patients with suspected appendicitis and equivocal CT findings. METHODS: We retrospectively evaluated 189 adult patients with equivocal CT findings. Alvarado, Eskelinen, appendicitis inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), and adult appendicitis score (AAS) scores were evaluated, receiver operating characteristic analysis was conducted, and the optimal, low, and high cut-off values were determined for patient classification into three groups: low, intermediate, or high. RESULTS: In total, 61 patients were included in the appendicitis group and 128 in the non-appendicitis group. There were no significant differences between the area under the curve of the clinical scoring systems in the final diagnosis of AA for equivocal appendicitis on CT (Alvarado, 0.698; Eskelinen, 0.710; appendicitis inflammatory response, 0.668; RIPASA, 0.653; AAS, 0.726). A RIPASA score greater than 7.5 had a high positive predictive value (90.9) and an AAS score less than or equal to 5 had a high negative predictive value (91.7) in the diagnosis of AA. CONCLUSION: The accuracy of clinical scoring systems in the diagnosis of AA with equivocal CT findings was moderate. Therefore, a high RIPASA score may assist in the diagnosis of AA in patients with equivocal CT findings, and a low AAS score may be used as a criterion for patient discharge. Most patients presented with intermediate scores. The patients with equivocal CT findings may be considered as a third diagnostic category of AA.
Adult* ; Appendicitis* ; Classification ; Clinical Decision-Making ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Multidetector Computed Tomography ; Patient Discharge ; Retrospective Studies ; ROC Curve ; Skates (Fish)

AIM: Dasyatis jenkinsii is used traditionally to treat inflammatory complaints and arthritis by the fisherman community and local population. The present study was designed to scientifically investigate the traditional practice through the analgesic, anti-inflammatory, and organ toxicity studies and characterization of bioactive compounds of crude extracts of D. jenkinsii. METHOD: Solvent extract of homogenized fresh fish was prepared using petroleum ether and diethyl ether. The chemical and spectral analyses of extracts were carried out using FT-IR and GC-MS. Analgesic and anti-inflammatory activities were assessed by hot plate, tail clip, and carrageenan induced rat paw edema methods. The organ toxicity of each extract was assessed on brain, liver, and kidney of mice. RESULTS: The IR spectrum indicated the presence of aromatic and aliphatic compounds. GC-MS analysis revealed the presence of 1-(4-carboxy)phenylnona-2, 5-diene and 3-hydroxymono-glyceryl hydrogen phthalate in the petroleum ether extract and carboxyl serine, dihydrotryptophan, and indolyl carboxylic acid in the diethyl ether extract. Both extracts showed significant analgesic and anti-inflammatory effects in all the methods tested. The vital organs of the test animals were not affected by the crude extracts significantly. CONCLUSIONS The presence of biologically active compounds in the crude extracts with analgesic and anti-inflammatory properties justifies the traditional knowledge and paves the way for isolation of these compounds for further experimentation.
Analgesics ; administration & dosage ; chemistry ; Animals ; Anti-Inflammatory Agents ; administration & dosage ; chemistry ; Edema ; drug therapy ; Humans ; Male ; Mice ; Pain ; drug therapy ; Rats ; Skates, Fish ; Spectroscopy, Fourier Transform Infrared

OBJECTIVETo explore the effect of Ray cartilage glycosaminoglycans (RCG) on the expression of MMP-9 in Lewis lung carcinoma of mice.

METHODThe model of mice with Lewis lung carcinoma was induced. The experimental mice were randomly divided into normal saline group, RCG groups at varied concentrations and CTX group. Tumor growth state was observed, and tumor inhibitory rate of primary tumor and number of lung metastasis focus were measured. The expression of MMP-9 mRNA and protein in Lewis lung carcinoma was determined with RT-PCR and Western blot.

RESULTAs compared with normal saline group, tumor growth curves in RCG groups were smooth, there were significant differences of inhibitory rates of primary tumor and number of lung metastasis focus between RCG groups and normal saline group, and MMP-9 mRNA and protein expression levels in RCG groups were reduced significantly.

CONCLUSIONRCG can inhibit effectively the growth and metastasis of implanted Lewis lung carcinoma in C57BL/6 mice, which is probably attributed to reducing the expression of MMP-9 mRNA and protein.

Animals ; Antineoplastic Agents ; isolation & purification ; pharmacology ; Carcinoma, Lewis Lung ; enzymology ; pathology ; Cartilage ; chemistry ; Cell Line, Tumor ; Glycosaminoglycans ; isolation & purification ; pharmacology ; Matrix Metalloproteinase 9 ; biosynthesis ; genetics ; Mice ; Mice, Inbred C57BL ; Neoplasm Transplantation ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Skates (Fish)