Objective To investigate the effect of tamoxifen on pituitary tumor transforming gene ex-pression in C6 cell and tumor growth of glioma in vivo. Methods Animal models were established on 32 SD rats with C6 cells of glioma. The rats bearing with C6 glioma were divided into 4 groups randomly, which were treated without tamoxifen or with different doses of tamoxifen(0. 02 mg · kg-1 · d-1, 0. 2 mg · kg-1 · d-1, 2mg · kg-1 · d-1) once a day for 20 days. The dimension of tumors were measured, the tumor inhibition rates were caculated, and living state of the rats were observed. The expression of PTTG mRNA was detected by RTPCR. Results All kinds of doses of tamoxifen could inhibit the tumors growth in rats with C6 glioma, and the tumor volume were reduced by 47.6%, 35.5% and 21.2% in the high-, middle-and low-dose groups respec-tively, there were significantly differences among the 4 groups ( P < 0. 05 ). Low-, middle- and high- dose of tamoxifen all could inhibit the expression of PTTG mRNA, and there were significantly differences among the 4 groups in PTTG mRNA expression ( P < 0. 05 ). Conclusion Tamoxifen can inhibit PTTG expression and the growth of glioma cell line C6 in vivo significantly in dose-dependent manner, which provides a theory basis for clicinal use of tamoxifen in patients with gliomas.

Background C57BL/6(B6) is a kind of routine mouse specie used in experimental autoimmune uveitis (EAU) research.Previous studies showed that the pathogenesis of uveitis related to inflammatory cytokines secreted by different helper T(Th) cells.However,the interaction of different Th cells in EAU is unclear.Objective This study was to investigate the dynamic changes of inflammatory factors in the spleen and serum after immunization in EAU mice.Methods Forty-four SPF B6 mice were immunized by injection of interphotoreceptor retinoid-binding protein (IRBP) and complete Freund adjuvant (CFA) emulsion via caudal vein and footpad.Indirect ophthalmoscope was used to examine the eyes 3 times per week and the inflammatory response was scored based on Thurau's criteria.In the thirty day after injection,20 model eyes were extracted and the sections of eye tissue were prepared for histopathological examination.The spleens of model mice were enucleated before injection and 2,5,10,15,20,25,30 days after injection,and reverse transcriptase PCR (RT-PCR) was used to detect the contents of interleukin-17 (IL-17) mRNA,interferon-γ (IFN-γ) mRNA,tumor necrosis factor-α (TNF-α) mRNA and IL-10 mRNA,and the contents of IL-17,IFN-γ,TNF-α and IL-10 in model serum were assayed by ELISA in 24 model mice.The experimental protocol and use of the animals were approved by Ethic Committee for Care and Use of Laboratory Animals of Shandong University of Traditional Chinese Medicine.Results Mild inflammatory response was seen in 12 days under the indirect ophthalmoscope with the scores of 0.5.The inflammatory scores peaked in 13-15 days with the scores of 1.0 and alleviated after that with the inflammatory scores of 0.5 in 30 days after injection.The histopathological score was consistent with the clinical score in the models on the 30 days.The serum IL-17 content of model mice was (0.98±0.05) ng/L before injection and increased to (51.85 ±2.42) ng/L on the fifth day,and decreased to (4.01±0.06)ng/L on the fifteen day.But,the serum IL-17 level increased to (25.00±0.94)ng/L again on the 25th day,and then lowed to (6.01 ±0.21)ng/L 30 days after injection,showing a significant elevation in comparison with that of before injection (P=0.000).The serum IFN-γ content of the model mice was (1.02±0.09)ng/L before injection and increased to (50.54±0.48) ng/L on the fifth day,and (73.21±0.12) ng/L on the tenth day,and then it declined gradually until (5.15±0.18)ng/L in the 30th day,which was still higher than that of before injection (P=0.000).After injection of IRBP+CFA,the serum TNF-α level upregulated from the second day to fifth day with the peak values (134.25±0.59)ng/L,and declined to valley on 15th day.A repeat elevation of serum TNF-α level was found on the 20th day with the values (60.54±0.62)ng/L and followed by decrease till the 30th day,which was higher than that of before injection (P=0.660).Serum IL-10 was detectable in the tenth day and peaked on the 15th day.Then a slight decrease was seen till the 30th day,compared with before injection(P =0.000).The contents of IL-10 mRNA,IL-17 mRNA,TNF-α mRNA,IFN-γmRNA in mice spleens followed the same pattern with serum levels of their proteins.Conclusions IL-17,IFN-γ,TNF-α and IL-10 are key inflammatory factors of Th1,Th2 and Th17,they present with specific changes during EAU,it confirming that IFN-γ probably play a pathogenic role in EAU,IL-17 and TNF-α levels probably associated with the chronic and recurrent procedure of uveitis,IL-10 plays an inhibit role in EAU.

Objective To know the influence of gastrointestinal decontamination (including gastric lavage and activated charcoal treatment) on prognosis of asymptomatic presentation poisoning patients.Method six hundred and twenty seven asymptomatic presentation poisoning cases through January 1999 to December 2006 were reviewed retrospectively.Duration of ED stay and intubation requiring rate were compared between the intervention group and control group (patients treated only with supportive care),as well as complications associated with gastrointestinal decontamination intervention.Results Statistic analysis reveals no difference between the intervention group and the control group in rate of intubation (6.5 % vs 5.3 %,P=0.51) and emergency care unit admission (28.1% vs 26.6%,P=0.68).Meanwhile duration of ED stay is prolonged profoundly in prevention group [ (11.2?4.7) vs (8.9?5.0),P

BACKGROUND: Altered mental status (AMS) is a very common emergency case, but the exact etiology of many AMS patients is unknown. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly challenging for emergency physicians. The aim of this study is to provide a framework for the assessment of AMS patients. This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management. METHODS: This is a prospective cohort observational study. We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months (June 2009 to June 2011). Demographic characteristics, clinical manifestations, assessment approaches, causative factors, emergency treatments and outcomes were collected prospectively. RESULTS: In 1934 patients with AMS recruited, accounting for 0.93％ of all emergency department (ED) patients, 1026 (53.1％) were male, and 908 (46.9％) female. Their average age was 51.95±15.71 years. Etiologic factors were neurological (n=641; 35.0％), pharmacological and toxicological (n=421; 23.0％), systemic and organic (n=266; 14.5％), infectious (n=167; 9.1％), endocrine/metabolic (n=145; 7.9％), psychiatric (n=71; 3.9％), traumatic (n=38; 2.1％), and gynecologic and obstetric (n=35; 1.9％). Total mortality rate was 8.1％ (n=156). The death rate was higher in elderly patients (≥60) than in younger patients (10.8％ vs. 6.9％,P=0.003). CONCLUSIONS: Patients with AMS pose a challenge for ED physicians. The most frequently encountered diagnostic categories causing AMS were primary CNS disorders, intoxication, organ system dysfunction, and endocrine/metabolic diseases. AMS has a high fatality rate in the ED. AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects. Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.

BACKGROUNDThe association between vulnerability of plaque assessed with intravascular ultrasound (IVUS) and plasma levels of fibrinolytic biomarkers was determined in patients with acute coronary syndrome (ACS). However, few data are available on the relationship between the levels of tissue type plasminogen activator (t-PA) and virtual histological intravascular ultrasound (VH-IVUS) signs of plaque instability.

METHODSEighty-nine patients with ACS were enrolled in the study. Blood was collected to measure t-PA levels by liquid phase bead flow cytometry. Eighty-nine nonbifurcate lesions (identified by coronary angiography and ECG) were investigated using IVUS before catheterization. IVUS radiofrequency data obtained with a 20 MHz catheter were analyzed with IVUS virtual histological software. The areas of plaque and media were calculated and lesions were classified into two groups: VH-IVUS derived thin cap fibroatheroma (VH-TCFA) and non-VH-TCFA plaque.

RESULTSPlasma t-PA level in the patients with TCFA was significantly lower than that with non-TCFA ((1489+/-715) pg/ml vs (2163+/-1004) pg/ml). Decreased plasma levels of t-PA were associated with plaque vulnerability. Plasma levels of t-PA correlated negatively with plaque plus media and necrotic core in plaque in patients with ACS.

CONCLUSIONSt-PA is an independent risk factor and a powerful predictor of vulnerable plaques. Decreased levels of t-PA may reflect instability of atherosclerotic plaques and might therefore serve as noninvasive determinants of those at high risk for consequent adverse events.

Acute Coronary Syndrome ; blood ; pathology ; Aged ; Coronary Artery Disease ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; Tissue Plasminogen Activator ; blood ; Ultrasonography, Interventional

OBJECTIVETo study the circadian patterns of the incidence of upper gastrointestinal bleeding (UGIB) and its relationship with climatic factors in Beijing.

METHODSWe searched all UGIB records from August 1, 2005 to July 31, 2007 from Beijing Emergency Center and tracked the meteorological data during the same period. The variation of the incidence of UGIB was compared based on day, month, and season. The relation between climatic factors and the incidence of UGIB was also analyzed.

RESULTSTotally 2 580 patients, including 1 888 males (73.2%) and 692 females (26.8%) were included in the study. The mean age was significantly different between males and females [(53.3 +/- 20.4) years vs. (63.3 +/- 20.7) years, P < 0.05]. The occurrence of UGIB were significantly different among different seasons (chi2 = 49.82, P < 0.01), months (chi2 = 83.43, P < 0.01), and hours (chi2 = 126.79, P < 0.01). UGIB cases were presented more frequently in winter and spring, especially in January. More UGIB cases were presented at night, especially from 8 pm to midnight. Partial correlation test showed that the incidence of UGIB significantly correlated with temperature (r = -0.3785, P = 0.001) and barametric pressure (r = -0.3002, P = 0.011). No correlation was found between UGIB incidence and wind speed (P = 0.086) and relative humidity (P = 0.971).

CONCLUSIONSThe incidence of UGIB varies in different months and seasons in Beijing. Its climate-related risk factors may include temperature and barametric pressure, but not include relative humidity and wind speed.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Circadian Rhythm ; Female ; Gastrointestinal Hemorrhage ; epidemiology ; Humans ; Incidence ; Male ; Meteorological Concepts ; Middle Aged ; Seasons

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Echocardiography, Transesophageal ; Endocarditis ; complications ; diagnostic imaging ; Humans ; Lung Abscess ; diagnostic imaging ; etiology ; Male ; Pulmonary Embolism ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Tricuspid Valve ; diagnostic imaging ; pathology

OBJECTIVETo explore the clinical features of respiratory failure secondary to hypothyroidism.

METHODWe retrospectively analyzed the clinical data of 4 patients with respiratory failure secondary to hypothyroidism.

RESULTSRespiratory failure secondary to hypothyroidism usually happened in the aged patients, presenting as myxedema, disturbance of consciousness, anemia, and hyponatrium. Respiratory symptoms were rare. Type II respiratory failure might occur as disease progressed. The clinical presentation of hypothyroidism was atypical and easily neglected. The hypoxia and hypercapnia ameliorated after thyroid hormone therapy.

CONCLUSIONHypothyroidism is a rare reason of respiratory failure. The prognosis is good after hormone therapy and mechanical ventilation.

Aged ; Aged, 80 and over ; Female ; Humans ; Hypothyroidism ; complications ; drug therapy ; therapy ; Male ; Middle Aged ; Respiratory Insufficiency ; drug therapy ; etiology ; therapy ; Thyroid Hormones ; therapeutic use

OBJECTIVETo report two de novo acute myeloid leukemia (AML) patients with t(11;22)(q23;q11.2) and summarize the clinical and biological characteristics.

METHODSBone marrow cells morphology, immunophenotype, chromosome karyotype, fluorescence in situ hybridization (FISH), PCR and gene sequencing were performed. Clinical manifestation and routine laboratory tests were analyzed.

RESULTSThe patients were diagnosed as AML-M₂ and AML-M₅ by morphology and immunophenotype results. Both patients carried t(11;22)(q23; q11.2) and one of them carried an additional chromosome abnormality. MLL-SEPTIN5 fusion transcript was identified in two patients by RT-PCR and sequencing. The two patients got hematologic complete remission after induction chemotherapy with daunorubicin, homoharringtonine, and cytarabine (DHA) or daunorubicin and cytarabine (DA). One of them relapsed and died during consolidation therapy with intermediate-dose cytarabine.

CONCLUSIONLeukemia with t(11;22)(q23;q11.2) chromosome translocation met the clinical and laboratory manifestations of AML. The MLL-SEPTIN5 fusion transcript was the distinctively biological etiology. Patients with t(11;22)(q23;q11.2) were vulnerable to relapse after conventional chemotherapy and had poor prognosis. Allogeneic hematopoietic stem cell transplantation should be recommended as early as possible.

Adult ; Chromosome Aberrations ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 22 ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; drug therapy ; genetics ; Male ; Prognosis ; Translocation, Genetic

Objective:To explore therapeutic effect of percutaneous coronary intervention(PCI)combined tirofiban hydrochloride on aged patients with acute ST elevation myocardial infarction(ASTEMI)and its influence on cardiac function and myocardial microcirculation.Methods:A total of 90 aged ASTEMI patients undergoing PCI in our hospital from Jul 2013 to Mar 2016 were selected.According to hospitalization order,they were randomly and e-qually divided into pure PCI group and combined treatment group(received tirofiban based on pure PCI group), both groups were treated for one month.ST segment regression degree,corrected TIMI frame count(CTFC)and TIMI flow grade after PCI,contrast agent acoustic peak intensity in myocardial microcirculation(PI)and serum CK-MB peak concentration before and after PCI,LVEF,LVEDd and LVEDV before and six months after PCI, and incidence rate of adverse events were measured and compared between two groups.Results:Compared with pure PCI group after PCI,there were significant rise in ST segment regression degree[(43.8 ± 7.1)% vs.(66.2 ± 8.2)%],TIMI flow grade[(2.1 ± 0.5)grade vs.(2.9 ± 0.6)grade]and PI[(7.1 ± 1.1)vs.(8.6 ± 1.2)],and sig-nificant reductions in CTFC[(27.3 ± 8.0)frame vs.(18.9 ± 6.6)frame],and serum CK-MB peak level[(296.5 ± 58.1)U/L vs.(199.3 ± 32.4)U/L]in combined treatment group,P= 0.001 all.Compared with pure PCI group on six months after PCI,there was significant rise in LVEF[(54.2 ± 8.3)% vs.(61.1 ± 8.0)%],and signifi-cant reductions in LVEDd[(48.1 ± 7.7)mm vs.(41.3 ± 8.1)mm]and LVEDV[(85.4 ± 10.6)mm3vs.(80.2 ± 10.4)mm3]in combined treatment group,P<0.05 or <0.01.Total incidence rate of adverse events of com-bined treatment group was significantly lower than that of pure PCI group(8.89% vs.26.67%),P=0.001.Con-clusion:PCI combined tirofiban hydrochloride can significantly improve myocardial microcirculation and cardiac function with low incidence rate of cardiovascular adverse events.The mechanism may be related to improving effect of tirofiban hydrochloride on myocardial microcirculation.