Acupuncture Therapy ; Endophthalmitis ; etiology ; therapy ; Facial Paralysis ; complications ; Humans ; Male ; Middle Aged

Objective To study the efficacy of late course accelerated fractionation(LCAF) radio- therapy in the treatment of nasopharyngeal carcinoma(NPC).The end-po s were local control,radiation-in- duced complications,factors influencing survival.Methods From December 1995 to April 1998,178 NPC patients were admitted for radiation treatment.The radiation beam used was ~(60)Co?or 6 MV X-ray.For the first two-thirds of the treatment,two daily fractions of 1.2 Gy were given to the primary lesion ,with an interval of≥6 hours,5 days per week to a total dose of 48 Gy/40 fractions,over a period of 4 weeks.For the last one third of the treatment,i.e.beginning from the 5th week,an accelerated hyperfractionation schedule was carried out.The dose per fraction was increased to 1.5 Gy,2 fractions per day with an interval of≥6 hours,the total dose for this part of the protocol was 30 Gy/20 fractions over 2 weeks.Thus the total dose was 78 Gy in 60 fractions in 6 weeks.Results All patients completed the treatment.Acute mucosi- tis:none in 2 patients,Grade 1 in 43,Grade 2 in 78,Grade 3 in 52,and Grade 4 in 3 patients.Local control rate:the 5-year nasopharyngeal local control rate was 87.7%,and the cervical lymph node local control rate was 85.7%.The 5-year distant metastasis rate was 26.1%,and 5-year survivals was 67.9%. Sixteen patients had radiation-induced cranial nerve palsy.Conclusions With this treatment schedule, patient's tolerance is good,local control and 5 year survivals are better than control groups of conventional fractionation and hyperfractionation radiotherapy.Radiation-related late complication does not increase.Ran- domized clinical trials are being carried out to further confirm the efficacy of LCAF for nasopharyngeal carci- noma.

OBJECTIVETo discuss the objective characteristics and mechanism of nystagmus direction, intensity and time in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) .

METHODSA total of 233 patients with HSC-BPPV, whereas 179 horizontal semicircular canalithasis (HSC-Can) and 54 horizontal semicircular cupulolithiasis (HSC-Cup) were involved respectively. The induced nystagmus in roll tests recorded by video-nystagmograph(VNG) , whose direction, intensity and time characteristics were compared in various BPPV.

RESULTSHorizontal nystagmus was both induced by turning left or right in HSC-BPPV roll tests. The direction of the induced nystagmus was the same with turning in HSC-Can. The latency, duration time and intensity ([AKx(-)D] ± s) turning to lesion and normal side were (1.922 ± 1.501)s and (1.447 ± 0.855)s, (25.620 ± 10.409)s, and (22.110 ± 10.931)s, (56.441 ± 33.168)°/s and (24.239 ± 13.892) °/s in HSC-Can. The latency, duration time and intensity turning to lesion side were larger than normal side (t = 3.715, 15.219 and 4.070, P < 0.01) , the difference was statistically significant, and the intensity rate was about 2: 1. The direction of the induced nystagmus was opposite to turning in HSC-Cup. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2: 1, the difference was statistically significant (t = -7.634, P < 0.01) . While the latency and intensity of turning to lesion side in HSC-Can were larger than turn to normal side in HSC-Cup, and the difference detected no statistically significant difference (t = 1.554 and 0.305, P > 0.05).

CONCLUSIONSThe induced nystagmus intensity of head to two sides in roll tests for HSC-BPPV both follow Ewald's law, and the ratio between stronger and weaker are both 2: 1. These nystagmus parameters of VNG in roll tests are an objective guideline for BPPV diagnosis.

Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; Electronystagmography ; Head ; Humans ; Nystagmus, Pathologic ; complications ; diagnosis ; Semicircular Canals ; Vertigo

Cell Culture Techniques ; methods ; Fixatives ; Humans ; Immunohistochemistry ; methods ; Tissue Fixation ; methods

OBJECTIVETo investigate the expressions of myogenic markers MyoD, myogenin,and desmin in skeletal muscle differentiation of human bone marrow mesenchymal stem cells (hBM-MSCs).

METHODSMyogenic markers MyoD, myogenin,and desmin of hBM-MSCs cultured in vitro were detected by immunofluorescence and RT-PCR. A total of 21 8-to-10 week-old immunosuppressed mdx mice were transplanted with 1x107 passage 5 of hBM-MSCs. The mice were euthanized 2-24 weeks after transplantation,and gastrocnemius muscle were analyzed for human MyoD, myogenin,desmin,and dystrophin (Dys) expressions by immunohistochemistry and RT-PCR.

RESULTSThe numbers of MyoD-,myogenin-,and desmin-positive cells per 100 hBM-MSCs were 23.5∓5.3, 30.7∓6.2, and 28.4∓5.7, respectively. MyoD, myogenin, and desmin mRNA was observed in passage 5 of hBM-MSCs. After two weeks of hBM-MSCs transplantation,a small number of MyoD-and myogenin-positive cells were observed in skeletal muscle of mdx mice,and desmin-positive cells were observed 4 weeks after transplantation. Expressions of MyoD and myogenin were detected in the muscle of mdx mice 2-4 weeks after hBM-MSCs transplantation, which reached a peak 12-16 weeks later. Desmin was expressed in the muscle of mdx mice 4-8 weeks after transplantation,with much more expression after 16 weeks of transplantation. A small number of Dys-positive cell and Dys mRNA expression were presented in the muscle of mdx mice 4 and 8 weeks after hBM-MSCs transplantation,respectively. The expression of Dys in the muscle of mdx mice increased gradually after transplantation.

CONCLUSIONhBM-MSCs have the potential of myogenic differentiation in vitro and contribute to myogenic conversion in xenogeneic animal,during which the up-regulation of MyoD and myogenin expressions may play an important role.

Animals ; Biomarkers ; Bone Marrow Cells ; cytology ; metabolism ; Cell Differentiation ; Cells, Cultured ; Desmin ; metabolism ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Mice, Inbred mdx ; Muscle, Skeletal ; cytology ; metabolism ; MyoD Protein ; metabolism ; Myogenin ; metabolism ; Up-Regulation

OBJECTIVETo investigate the dynamic distribution of human bone marrow mesenchymal stem cells (hBM-MSCs) in mdx mice.

METHODSTwenty-four 8-10-week-old immunocompromised mdx mice were transplanted with 1 x 10(7) passage 5 hBM-MSCs labeled with bromodeoxyuridine (BrdU) by means of injection into the tail vein. The mice were euthanized 48 hours and 2, 4, 8, 12, 16, 20, and 24 weeks after transplantation. BrdU-positive cells in tissue and organs of the mice were detected by immunofluorescence analysis. Skeletal muscle was stained for anti-human nuclei mouse monoclonal antibody (anti-Hu) and analyzed for human dystrophin (Dys) expression by immunohistochemistry and reverse transcription-polymerase chain reaction.

RESULTSAfter transplantation, BrdU-positive cells were found in most organs (especially in bone marrow, liver, and lung) within 4 weeks, and these cells in liver and lung decreased gradually after 4 weeks. At 48 hours after transplantation, BrdU-positive cells were found in bone marrow, which reached a peak level after 2 weeks and were still detectable after 16 weeks. BrdU-positive cells in skeletal muscle increased gradually over time of transplantation. A small number of anti-Hu positive cells were detected in skeletal muscle 2 weeks after transplantation. A small number of Dys positive cell were seldom found at 4 weeks and small Dys mRNA expression detected 4 weeks after transplantation. The proportion of anti-Hu in parallel with Dys positive cells and Dys mRNA in skeletal muscle of mdx mice increased gradually over time of transplantation.

CONCLUSIONAfter being transplanted into mdx mice, hBM-MSCs are mainly distributed in bone marrow, liver, and lung during the early time (2-4 weeks) , and then in bone marrow and skeletal muscle (after 4 weeks).

Animals ; Bone Marrow Cells ; cytology ; Dystrophin ; genetics ; metabolism ; Humans ; Immunocompromised Host ; Immunohistochemistry ; Mesenchymal Stem Cell Transplantation ; methods ; Mice ; Mice, Inbred mdx ; Muscle, Skeletal ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVE: To study the sequences of off-ladder alleles of PowerPlex 16 kit in Chinese Han population and their nomenclature. METHODS: 10071 Samples from unrelated individuals in Chinese Han population were screened by using PowerPlex 16 kit and ABI 377 or 3100. The samples showing off-ladder alleles were re-screened with PAGE and the off-ladder alleles were obtained and sequenced. RESULTS: 32 off-ladder alleles were found in 11 STR loci, whose frequencies ranged from 0.05 per thousand to 4.02 per thousand. These alleles were classified as four types: (1) having complete repeat but its length is out of the ladder; (2)having incomplete repeat; (3) having deletion or insertion of one or two base(s) in flanking sequence; (4) having deletion of some segment. CONCLUSION Off-ladder alleles have various types. It demonstrates varying repteating number of the core unit, and variation in the flanking sequence or core sequence as well. The nomenclature of International Society for Forensic Haemogenetics cannot define these alleles effectively.
Alleles ; Asian People/genetics* ; Base Sequence ; China/ethnology* ; DNA/analysis* ; Female ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Male ; Sequence Analysis, DNA ; Tandem Repeat Sequences/genetics*

Background: Shared decision making using patient decision aids (PtDAs) was established over a decade ago, but few studies have evaluated its efficacy in Asian countries. We therefore evaluated the application of PtDAs in a decision conflict between two muscle relaxant reversal agents, neostigmine and sugammadex, and sequentially analyzed the regional differences and operating room turnover rates. Methods: This multicenter, outcome-assessor-blind, randomized controlled trial included 3,132 surgical patients from two medical centers admitted between March 2020 and August 2020. The patients were randomly divided into the classical and PtDA groups for pre-anesthesia consultations. Their clinicodemographic characteristics were analyzed to identify variables influencing the choice of reversal agent. On the day of the pre-anesthesia consultation, the patients completed the four SURE scale (sure of myself, understand information, risk-benefit ratio, encouragement) screening items. The operating turnover rates were also evaluated using anesthesia records. Results: Compared with the classical group, the PtDA group felt more confident about receiving sufficient medical information (P < 0.001), felt better informed about the advantages and disadvantages of the medications (P < 0.001), exhibited a superior understanding of the benefits and risks of their options (P < 0.001), and felt surer about their choice (P < 0.001). Moreover, the PtDA group had a significantly greater tendency to choose sugammadex over neostigmine (P < 0.001). Conclusions PtDA interventions in pre-anesthesia consultations provided surgical patients with clear knowledge and better support. PtDAs should be made available in other medical fields to enhance shared clinical decision-making.

OBJECTIVETo investigate the effects of perindopril and spirolactone on plasma aldosterone (Ald) and left atrial remodeling and function in a canine model of atrial fibrillation (AF).

METHODSAdult dogs were randomly assigned to receive normal diet (group A), perindopril (group B, 1 mgxkg(-1)xd(-1)) and spironolactone (group C, 10 mgxkg(-1)xd(-1), n = 6 each) and rapid paced (500 beats/min) for 8 weeks. Plasma Ald levels as well as atrial dimension and function at baseline and at 4 and 8 weeks after pacing were measured by RIA and echocardiography, respectively. Incidence of maintained AF and AF duration were recorded when pacing was stopped after 8 weeks of pacing. Left and right atrial tissues were collected for measurements of tissue Ald levels and fibrosis.

RESULTSPlasma Ald was similar among groups at baseline (P > 0.05) and significantly increased post 4 and 8 weeks pacing in group A (P < 0.05) while remained unchanged post pacing in group B and C (P > 0.05) compared to respective baseline level. Atrial Ald was significantly lower in group B and C compared that in group A post 8 weeks pacing (P < 0.05). Left atrial dimension, end-systolic and end-diastolic volume were significantly increased while left atrial ejection fraction (LAEF) was significantly reduced post pacing in group A (all P < 0.05 vs. baseline) and thses changes were significantly attenuated in group B and C (P < 0.05 vs. group A). Incidence of maintained AF and AF duration post pacing as well as interstitial collagen volume fraction were significantly lower in group B and C compared those in group A (P < 0.05).

CONCLUSIONIncreased Ald might be an important pathogenesis for AF formation and progression, spironolactone and perindopril could attenuate atrial remodeling and improve atrial function by reducing plasma and tissue Ald levels in this model.

Aldosterone ; metabolism ; Animals ; Atrial Fibrillation ; metabolism ; pathology ; physiopathology ; Atrial Function ; Disease Models, Animal ; Dogs ; Male ; Mineralocorticoid Receptor Antagonists ; pharmacology ; Perindopril ; pharmacology ; Spironolactone ; pharmacology

OBJECTIVETo investigate the principle and measures of combined treatment of the patients with hyperlipidemic severe acute pancreatitis (HL-SAP).

METHODSThe clinical data of 54 patients with HL-SAP including two phases from January 1996 to December 2000 and from January 2001 to August 2006 were analyzed retrospectively. In the first phase, 25 patients were performed by routine methods to decrease triglyceride, or additional operative treatments. In the second phase, 29 cases were treated by multiple ways of non-operative combined therapy, or additional operative treatments mainly by minimally invasive procedures.

RESULTSAmong 54 cases with HL-SAP, 33 cases (61.1%) received non-operative therapy and 21 cases (38.9%) received surgical intervention. Overall mortality was 18.5% (10/54). In the first phase of 25 cases, the mortality in non-operative group and surgical intervention group was 21.4% (3/14) and 36.3% (4/11), respectively. In the second phase of 29 cases, the mortality in non-operative group and surgical intervention group was 10.5% (2/19) and 10.0% (1/10), respectively. The overall curative rate, morbidity, overall mortality, content of triglyceride at the fourth day after onset, APACHE II score at the fourth day after onset and average stay were obviously improved in the second phase compared with the first phase (P < 0.05).

CONCLUSIONSAccording to individualized therapy principles, treatment for HL-SAP should emphasis on multiple ways of non-operative combined therapy and appropriate choices of the timing, indication in surgical intervention. And the choice of operative procedure should follow the principle of minimally invasive surgery. Meanwhile, pay more attention to monitoring and controlling the level of triglyceride post-discharge for the patients with the history of HL-SAP.

Adult ; Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias ; complications ; therapy ; Hypolipidemic Agents ; therapeutic use ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pancreatitis, Acute Necrotizing ; diagnosis ; etiology ; therapy ; Prognosis ; Retrospective Studies