Objective This study aimed to investigate whether more intensive induction regimen plus autologous bone marrow transplantation and 13-cis-retinoic acid can alter the extremely poor prognosis of high-risk neuroblastoma patients.Methods Five children with stage Ⅳ neuroblastoma were studied. One was under one year old, which was founded by neuroblastoma screening. The oldest one was 5 year old. The duration of illness before admission was from 7 days to 4 months. Primary site of the disease was adrenal gland in four patients and retroperitoneal in one. All of the patients had multiple metastasis. Urine VMA/Cr was more than normal in two patients. NSE elevated in all 5 patients. The MYCN amplification more than 10 copies in three patients. All of the patients received high-dose chemotherapy, radical removal of the original tumor and metastatic retroperitoneal lymph nodes, local radiation, plus supralethal preconditioning regimen followed by autologous bone marrow transplantation as well as 13-cis-retinoic acid.Results All the five patients got a complete response after the induction regimen. Follow-up 4-33 months, five patients keep complete responses and three patients disease-free survival, two patients had mild renal failure.Conclusions High-dose induction chemotherapy plus autologous bone marrow transplantation as well as 13-cis-retinoic acid may can improve the prognosis of high-risk neuroblastoma patients.

In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3% chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n=9), and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aalpha/beta, Adelta, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aalpha/beta, Adelta, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3% chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Adelta fiber mediated CAP was 108+/-20 and 92+/-14 min respectively (P>0.05). In normal rats the duration of first and third blocked Adelta fiber mediated CAP was 110+/-20 and 75+/-16 min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the important factors affecting the development of tachyphylaxis.
Anesthetics, Local/*administration & dosage ; Nerve Block ; Procaine/administration & dosage ; Procaine/analogs & derivatives ; Sciatic Nerve ; *Tachyphylaxis/physiology

We compared the analgesic profile between patient-controlled analgesia (PCA) using oxycodone and morphine in post total abdominal hysterectomy patients. Eighty-four ASA I or II patients, aged 18 to 65 years who underwent total abdominal hysterectomy were recruited into this prospective, double blind, randomised controlled study. They were randomised to receive either PCA oxycodone 0.7 mg per bolus or PCA morphine 1 mg per bolus for postoperative pain relief. At the end of surgery, all patients received IV morphine 0.1 mg/kg and skin incision was infiltrated with 20 mls of bupivacaine 0.25%. Post-operative pain scores, opioids consumptions, sedation scores and side effects were assessed upon arrival and at 30 minutes after arrival to recovery area, as well as at 6 hours and 24 hours after the operation in the ward. Patients’ overall satisfaction was also assessed 24 hours postoperatively.No significant differences were observed in terms of postoperative pain scores, opioids consumption, sedation scores, side effects as well as patient’s overall satisfaction between the PCA oxycodone and PCA morphine group. Oxycodone was comparable to morphine as PCA in terms of total opioid consumption, pain scores and satisfaction level for patients undergoing total abdominal hysterectomy and therefore may be an alternative to morphine in postoperative pain management as PCA
morphine ; oxycodone ; pain scores ; patient controlled analgesia ; total abdominal hysterectomy

OBJECTIVETo study on the purification of strictosamide from Nauclea officinalis by macroporous resin to provide reference for production.

METHODThe best macroporous resin was selected among 10 kinds of resins according to adsorption and desorption of the static adsorption experiments. The adsorption quantity, elution volume of water, concentration and elution volume of alcohol were determined according to the single factor experiment.

RESULTHPD400 was the best resin, and the best adsorption quantity was 20.23 mg x g(-1), the elution volume of water and 30% alcohol was 6 BV, and the elution volume of 70% alcohol was 4 BV.

CONCLUSIONThis technology is simple, feasible, and it can provide reference for the industrialized production.

Adsorption ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ethanol ; chemistry ; Resins, Synthetic ; chemistry ; Rubiaceae ; chemistry ; Technology, Pharmaceutical ; methods ; Vinca Alkaloids ; chemistry ; isolation & purification

In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3% chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n=9), and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aalpha/beta, Adelta, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aalpha/beta, Adelta, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3% chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Adelta fiber mediated CAP was 108+/-20 and 92+/-14 min respectively (P>0.05). In normal rats the duration of first and third blocked Adelta fiber mediated CAP was 110+/-20 and 75+/-16 min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the important factors affecting the development of tachyphylaxis.
Anesthetics, Local ; administration & dosage ; Animals ; Nerve Block ; Procaine ; administration & dosage ; analogs & derivatives ; Rats ; Sciatic Nerve ; Tachyphylaxis ; physiology

OBJECTIVETo assess the relationship between microglia activation and apoptosis of neurons, and the significance of activated microglias in the formation and progression of senile plaques in Alzheimer's disease.

METHODSIL-1alpha and beta-amyloid immunohistochemistry, combined with TUNEL assay were used to assess brain tissue samples from 10 patients with Alzheimer's disease and 4 negative control cases without neurological disease.

RESULTSThe number of resting microglias in the brains of Alzheimer's disease patients was similar to that of the control group (P > 0.05), but the number of activated microglias was significant greater in the Alzheimer's disease patients than that of the controls (P < 0.01). The activated microglias displayed altered size and morphology, and was therefore, categorized into three subtypes as primed, enlarged and phagocytic microglias. The numbers of primed, enlarged and phagocytic microglias were 5.4 +/- 0.87, 11.5 +/- 1.25, and 3.4 +/- 0.32 microglia/mm2 and represented 26.6%, 56.65%, and 16.75% of all activated microglias respectively. The number of TUNEL positive apoptotic neurons was significantly greater in Alzheimer patients than that in the control group (P < 0.05). There was a close relationship between the apoptosis of neurons and the activation of microglias (P < 0.01). The activated microglias were differentially distributed among four different plaque types in Alzheimer patients. Many primed (42.3%) and most of the enlarged and phagocytic microglias (56.2% and 70.6%) were present in the diffuse neuritic plaques.

CONCLUSIONSHyperplasia and activation of microglias are a common phenomena in AD and may play an important role in its pathogenesis. There is a close relationship between the apoptosis of neurons and activation of microglias. The activation of microglias may play a key pathogenic role in senile plaque formation and progression of Alzheimer disease.

Aged ; Alzheimer Disease ; etiology ; pathology ; Amyloid beta-Peptides ; analysis ; Apoptosis ; Cell Count ; Cell Differentiation ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Interleukin-1 ; analysis ; Microglia ; chemistry ; classification ; pathology ; Middle Aged ; Phagocytes ; pathology

INTRODUCTIONThe proteins found in tears play an important role in maintaining the ocular surface and changes in tear protein components may reflect changes in the health of the ocular surface. Proteomics provides a comprehensive approach for cataloguing all the proteins of the tear proteome, which will help to elucidate disease pathogenesis, make clinical diagnoses and evaluate the influence of medications on the structure, composition and secretion of tear proteins. In this study, an alternative proteomic strategy was investigated to explore the human tear proteome.

MATERIALS AND METHODSTear samples were obtained from patients who had pterygium and were collected on the first day and third day after pterygium surgery. Tears pooled from 6 patients were used in the analysis. Reverse-phase high-pressure liquid chromatograph (RPHPLC) was used as the first step to separate intact proteins into 21 peaks. Each fraction was then tryptic-digested and analysed by nanoLC-nano-ESI-MS/MS to characterise the protein components in each fraction.

RESULTSIn total, 60 tear proteins were identified with high confidence, including well-known abundant tear proteins, and tear-specific proteins such as lacritin and proline-rich proteins. Among them, proline-rich protein 5 was found for the first time in tear fluid. A large number of plasma proteins were also observed in tear fluid.

CONCLUSIONSThe results showed that the proteomic strategy used in this study was successfully applied to analyse tear proteome.

Eye Proteins ; analysis ; Humans ; Mass Spectrometry ; methods ; Proteome ; Tears ; chemistry

OBJECTIVETo investigate the effects of wild type p16 gene on the proliferation and metabolism of human keloid fibroblasts.

METHODSEukaryotic expression vector pcDNA3-p16 was constructed and imported into KFb by gene transfection mediated by liposome. And the positive clones were screened by G418. The transfected and untransfected KFbs were stained by Immunocytochemical method. The expression of p16 protein was observed. The changes of the proliferation and DNA synthesis of KFb before and after transfection were observed and compared by drafting cell growth curve and by (3)H-TdR incorporation method.

RESULTSThe recombinant vector pcDNA3-p16 was successfully constructed and identified by enzyme digestion. The positive clones were identified by G418 selection for 10 days from transfected KFb and with p16 protein expression. The growth rate of transfected KFb slowed down obviously and its DNA synthesis decreased significantly (P < 0.05) when compared with those of normal KFb.

CONCLUSIONp16 gene might inhibit the growth and DNA synthesis of KFb.

Cell Proliferation ; Cells, Cultured ; DNA ; biosynthesis ; Fibroblasts ; metabolism ; pathology ; Genes, p16 ; Genetic Therapy ; Humans ; Keloid ; genetics ; pathology ; Transfection

Disinfection ; Escherichia coli ; isolation & purification ; Hospitals ; Medical Waste ; Sewage ; Waste Products ; Water Microbiology

Spinal anesthesia (SA) is gaining recognition as a safe and efficacious regional alternative to general anesthesia for elective lumbar surgery. However, unfamiliarity with management issues related to its use has limited the adoption of awake spine surgery, despite its benefits. Few centers in the United States routinely offer SA for elective lumbar surgery, and a comprehensive workflow to standardize SA for lumbar surgery is lacking. In this article, we examine recent literature on the use of SA in lumbar surgery, review the experience of our institution with SA in lumbar surgery, and provide a cohesive outline to streamline the implementation of SA from the perspective of the anesthesiologist. We review the critical features of SA in contemporary lumbar surgery, including selection of patients, methods of SA, intraoperative sedation, and management of several important technical considerations. We aimed to flatten the learning curve to improve the availability and accessibility of the technique for eligible patients.