Recent studies have found that autophagy was not only involved both in the occurrence and development of viral myocarditis (VMC),but also,it plays a key role in anti-viral infections by degradating the viral components,presenting viral antigens and activating the immune response.Meanwhile,the virus can also escape the protective antiviral activity and maintain their own survival and replication by inducing the autophagy of the host cells,becoming the accelerator of the viral infection.The interaction of the virus and the host cell autophagy in VMC is a complex process.Its detailed pathogenesis has yet to be further explored.

Objective To investigate the feasibility of laparoscopic surgery for hydronephrosis caused by retroper-itoneal fibrosis.Methods Reported the diagnosis and treatment procedure and result of 1 case of hydronephrosis caused by retroperitoneal fibrosis on left side,who underwent laparoscopie surgery.Investigated the feasibility of hydronephrosis caused by retroperitoneal fibrosis with literature review.A 55-year-old female patient had interrupt-able left lower extremity swollen with nausea and vomiting for five months.The blood test showed progressive eleva-ting of creatinine and urea nitrogen.The highest creatinine value was 503 μmol/L.The computerized tomography showed renal atrophy on right side and there was a stenosis on crossing place between inferior segment on left ureter and iliac blood vessels,also there is a soft tissue image in front of aorta and around iliac blood vessels,the superior ureter was dilated.We set double J tube into left ureter before surgery with semi-reclining position toward right side,set trocar cannula through 1 era,4 em below the umbilicus as well as the same two points on lateral external oblique muscle of abdomen,set laparoscope from 1 cm below the umbilicus.We found the abdominal membrane pale and touch as tabular.There was serious eonglutination between middle segment ureter and around iliac blood vessels after we cut open retroperitoneal membrane.We carefully dissected the ureter for 9 cm and soluted the eonglutination a-round the ureter,then set the ureter into abdominal cavity and closed retroperitoneal membrane.Results The pa-tient recover well after surgery and sutured out after 5 days,pulled out the double J tube after I month.The patient had low back pain ,fever and oliguria after the double J tube was pulled out and recovered with spasmolysis,analge-sia and antibiosis treatment after 2 days.The voiding volume and renal function became normal.The B-type ultra-sound test showed hydronephrosis on left side was lessened.The ultrasound test after 3 months result showed hydro-nephrosis was significantly lessened than before surgery and renal function was normal.Conclusions The laparo-scopic ureterolysis surgery for retroperitoneal fibrosis is minimally invasive,less suffering and quick recovery.Be-cause of few case report and short follow-up time is more eases and long-term follow-up are needed to elucidate the therapeutic efficacy of this treatment.

Objective To investigate the inhibitory effects of trichostatin A(TSA)on bladder cancer cell lines and its synergetic effect with anticancer drugs in treating bladder cancer in vitro and in vivo.Methods The inhibitory effects of TSA on human bladder cancer cell lines in vitro were detected by MTT assay.Hoechst staining was used to observe morphology for apoptotic cells after TSA treatment.Western blot was used to detect expression of acetyl-histone H3 and survivin.In vivo synergetic effects of TSA with anticancer drugs were detected in bladder cancer model rats.Results TSA significantly inhibited growth of bladder cancer cell lines in concentration and time dependent manner.Better results of tumor inhibition have been achieved when it was combined with DDP,MMC and ADM than used alone.After TSA treatment,the survivin expression in bladder cancer cells decreased and acetyl-histone H3 expression increased.Intravesical application of TSA combined with MMC can significantly inhibited tumor growth and progression.Conclusion TSA has direct anti-cancer effect and can enhance the action of several chemotherapy agents markedly.TSA may be an excellent candidate agent for intravesical application to treat bladder cancer.

Head ; surgery ; Humans ; Neck ; surgery ; United States

Objective To observe the clinical characteristics and prognosis in children with high take -off coronary artery.Methods The clinical characteristics,laboratory examinations and prognosis were retrospectively ana-lyzed in 49 children with high take -off coronary artery who had been admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from April 2009 to December 201 2.Results Among 49 medical records of children with high take -off coronary artery,34 cases were male and 1 5 cases were female,with a mean age of (9.28 ±4.42)years old,and the youngest patient was 1 3 months old,and the oldest patient was 1 7 years and 2 months old.The 64 -section multidetector CT angiography of all patients showed one or both coronary arteries originated from 1 .0 cm higher than the junction area of sinus and aorta,including 38 high take -off of the left coronary artery,7 high take -off of the right coronary artery and 4 high take -off of both coronary arteries.The chief complaints of the patients included chest pain (22 cases,44.90%),chest tightness(1 3 cases,26.53%),declining of exercise tolerance(7 cases,1 4.29%),fatigue (5 cases,1 0.20%),palpitation(3 cases,6.21 %),syncope(1 case,2.04%).Electrocardiogram(ECG)of those pa-tients showed ST -T changes,atrioventricular block,sinus tachycardia,pathological Q -wave,proiosystole and bundle branch block.Ultrasonic cardiogram(UCG)indicated 1 4 patients with the enlarged left ventricle,including 2 patients with ejection fraction lower than 60%.After 1 0 days hospitalization,the anesis of chest pain and chest tightness were significantly different statistically(P <0.05),but there was no significant difference in ECG and UCG.Thirty -nine out of 49 children were followed for 1 year.After 3 months,6 patients with ST -T problem showed normal ST -T segment. After 6 months,1 0 patients with ST -T problem showed normal ST -T segment.After 1 year,1 7 patients with ST -T problem showed normal ST -T segment.Conclusions High take -off coronary artery is a rare malformation of the coronary artery,which can cause myocardial ischemic,leading to multiple clinical manifestations and may result in ECG changes and the left ventricle enlargement.High take -off coronary artery can be confused with myocarditis and myocar-dial lesion clinically.Patients receiving systemic treatment may have their symptoms released,but ECG and UCG may not relieve in a short term.Patients with high take -off coronary artery need long -term observation.

Drug-Eluting Stents ; adverse effects ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; etiology ; Thrombosis ; etiology ; physiopathology

BACKGROUNDSome studies found that cholinesterase (ChE) can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome (SIRS) early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed.

METHODSFrom September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria: patients aged ≥ 65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein (CRP) were measured, and the Acute Physiology and Chronic Health Evaluation (APACHE) II and Glasgow Coma Scale (GCS) scores were evaluated within the first 24 hours in the ICU. Fisher's exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student's t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis.

RESULTSThe clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients (46 male, 20 female, mean age (78.70 ± 8.08) years) who died were included in the deceased group and 58 patients (34 male, 24 female, mean age (76.02 ± 6.57) years) who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group (all P > 0.05), but there were significant differences in lactic acid (P = 0.011), D-dimer (P = 0.011), albumin (P = 0.007), CRP (P = 0.008), and ChE (P < 0.0001). The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE (both P < 0.05). D-dimer and albumin were correlated with ChE (Spearman's rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and < 0.0001). Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was (P < 0.0001). The receiver operating characteristic curve of ChE had an area under the curve of 0.797 (standard error = 0.04; P < 0.0001), and a ChE of 103.00 U/L was the cut-off value with sensitivity = 0.793, specificity = 0.742.

CONCLUSIONSerum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.

Aged ; Aged, 80 and over ; Cholinesterases ; blood ; Female ; Humans ; Male ; Prognosis ; Systemic Inflammatory Response Syndrome ; blood ; enzymology ; pathology

Nine compounds were isolated from an ethanol extract of the roots of K. roxburghii by using a combination of various chromatographic techniques including column chromatography over silica gel, MCI gel, Sephadex LH-20, and reversed-phase HPLC. On the basis of physical-chemical properties and spectroscopic data analysis, their structures were identified as munjistin (1), 1-methoxy-3,6-dihydroxy-2-hydroxymethyl-9,10-anthraquinone (2), 1,2,3-trihydroxy-9,10-anthraquinone (3), arjunolic acid (4), hyptatic acid-A (5), hyptatic acid-B (6), 2α,3β,24-trihydroxyurs-12-en-28-oic acid (7), 2α,3β,23-trihydroxyurs-12-en-28-oic acid (8), and daucosterol (9). Compounds 1-9 were obtained from this genus for the first time.
Anthraquinones ; chemistry ; isolation & purification ; Rubiaceae ; chemistry ; Triterpenes ; chemistry ; isolation & purification

Objective To make correct diagnosis for Rathke cleft cyst(RCC)and cystic pituitary adenomas(CPA)through retrospective analysis of characteristics of MRI.Methods RCC (n=30)and CPA (n=30)confirmed by surgery and pathology were analyzed retrospectively.Following characteristics of lesions were observed:morphology,size,location,range,T1WI signal intensity and patterns of enhancement,presence of intracystic fluid level,septum,nodule,hypointense rim on T2WI and change of the pituitary stalk.The independent sample t-test and χ2 test were used respectively to analyze differences between two groups of continuous variables and categorical variables.Results Most of RCC were oval,less than 2 cm3,under the optic chiasm and within the bilateral cavernous sinus,various for signal intensity,without or with thin-walled contrast enhancement.Intracystic nodule accounted for 40% of cases and there were double cystic nodules in 1 case.Obvious contrast enhancement of intracystic nodule was found in 1 case.Pituitary stalk was in center.Most of CPA were snowman shaped,bigger than 2 cm3,off middle line location,with compression of the optic chiasm and sellar base,had thick-walled contrast enhancement,with intracystic fluid level and septum,had hypointense rim on T2WI.The pituitary stalk was shifted.Conclusion The MRI findings of RCC and CPA are significant differences in the shape,size,intracapsular structure,enhanced performance and changes of surrounding structure.

Lumbar adjacent segment degeneration is defined as degenerative changes cranial or caudal to surgical segments.Some patients developed corresponding clinical symptoms in addition to radiological degeneration,which is called adjacent segment disease.Although many new surgical techniques emerged in recent years,the problem of adjacent segment degeneration has not really been resolved.MEDLINE/PubMed,Cochrane Controlled Trials Registry and EMBASE were comprehensively searched.All randomized or nonrandomized clinical studies of lumbar degenerative diseases treated by fusion/fixation,decompression-alone or artificial lumbar disc replacement were included.The number of cases enrolled in these studies was greater than or equal to 20 cases and the minimum age of the patients was 18 years old.Case reports,reviews or meta-analyses,papers with unobtainable text and abstract,and studies of trauma,infection,oncology and inflammatory disease were all excluded.The diagnostic criteria of adjacent segment degeneration,as well as the incidence and risk factors of adjacent segment degeneration and reoperation were reviewed.The concepts of adjacent segment degeneration in different literatures were very confusing,and radiological degeneration was often mixed in use with symptomatic degeneration.It was therefore difficult to make any conclusion due to lack of a standard.In addition,the previous studies did not fully understand the pathogenesis and risk factors of the disease,especially the effect of the index level on adjacent segments.Moreover,most of the current studies were retrospective,therefore,convincing conclusions can hardly be drawn due to lack of high-level evidence.The main reason for reoperation after lumbar fusion is adjacent segment degeneration.Therefore,the most important way to reduce the rate of reoperation is to reduce the incidence of adjacent segment degeneration.In the future,the diagnostic criteria for adjacent segment degeneration should be unified first.And it is extremely important to thoroughly understand the mechanism and risk factors of adjacent segment degeneration by comprehensive studies and clarify them through high-level evidence.