Bodily Secretions ; virology ; Humans ; Pharynx ; virology ; Pneumonia ; diagnosis ; virology ; Respiratory System ; virology

OBJECTIVETo explore the role of toll-like receptor 2 (TLR2) and toll-like receptor 4 (TLR4) in myocardial ischemia/reperfusion injury (MI/RI) by observing the dynamic expression changes at mRNA and protein levels early after myocardial ischemia/reperfusion (I/ R).

METHODSThe Wistar rats were randomly divided into Sham and I/R group (n = 42), and killed according to different reperfusion time (1, 2, 4, 6, 12, 24 h and 7 d). Structural and morphous changes of myocytes were observed under optical microscope. The mRNA and protein levels of TLR2 and TLR4 were detected using real-time PCR (RT-PCR). Monocyte chemokine protein-1 (MCP-1) and interleukine-6 (IL-6) mRNA levels were measured by reverse transcriptase-polymerase chain reaction (rt-PCR).

RESULTS(1) With the extension of reperfusion time, the myocardial infarct size increased smoothly, and reached the plateau at 4 h, then stayed in the platform. After reperfusion for 7 d, the ventricular had been remodeled. (2) At the beginning of reperfusion, myocardial structure showed no significant change in Sham group, but had different degrees of injury in I/R group. In rats of the group reperfused for 7 d the left ventricular remodeling could be visible. (3) Compared to sham group,TIR2, TLR4, MCP-1, IL-6 mRNA level were increased in myocardium in I/R group. TLR2 and TLR4 both peaked at 4 h of reperfusion, IL6 peaked at 6 h, followed by a gradually decrease. TLR4 and IL-6 mRNA levels rose again at 7 d. MCP-1 level in I/R group remained fairly with sham group at the beginning of reperfusion, and markedly elevated at 7 d.

CONCLUSIONExpression of TLRs mRNA in myocardium during early after myocardial ischemia/reperfusion increased rapidly and activated TLRs might play an important role in MI/RI through promoting the generation of inflammatory factors. At the late reperfusion, TLRs levels raise again and the expression of inflammatory factors increase once again, Those may probably affect the remodeling of ventricular, and injure myocardial structure and function.

Animals ; Chemokine CCL2 ; metabolism ; Disease Models, Animal ; Interleukin-6 ; metabolism ; Male ; Myocardial Reperfusion Injury ; metabolism ; Rats ; Rats, Wistar ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism

OBJECTIVETo explore the relationship between myeloperoxidase (MPO) 129 A/G promoter polymorphisms and the severity of coronary artery disease (CAD).

METHODSThe study enrolled 267 patients who had been diagnosed as coronary artery diseases by coronary angiography. The serum MPO activity was detected by colorimetric method. PCR-RFLP method was used to decide the genotypes of the patients. The severity of CAD was evaluated by the numbers of stenotic coronary arteries and the Gensini scores respectively.

RESULTSThe MPO 129 locus G and A alleles frequency were 0.893 and 0.107, respectively. No significant difference was observed in serum MPO activity between different genotypes (P > 0.05). The distribution of genotypes in different Gensini score groups had no significant difference (P > 0.05). The patients with GG genotypes were prone to develop mutivessel diseases.

CONCLUSIONNo significant correlation exists in MPO 129 locus polymorphism and serum MPO activity. The MPO 129 locus polymorphism isn't a reasonable predict factor of CAD severity.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Artery Disease ; blood ; genetics ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Peroxidase ; blood ; genetics ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics ; Risk Factors ; Severity of Illness Index

BACKGROUNDRadial artery (RA) occlusion (RAO) is not rare in patients undergoing coronary intervention by transradial approach (TRCI). Predictors of and prevention from RAO have not been systematically studied. This study aimed to analyze the risk factors of the weakness of RA pulsation (RAP) and its predictive value for RAO after TRCI, and simultaneously to describe a feasible and effective approach to maintain RA patency.

METHODSBetween June 2006 and March 2010, all patients who underwent TRCI were classified according to the weakness of RAP after removing compression bandage with confirmation by Doppler ultrasound for the first 30 consecutive patients. Among a total of 2658 patients studied, 187 (7%) patients having a weaker RAP were prospectively monitored. At 1 h after bandage removal, the ulnar artery in puncture side of all patients was blocked with manual compression to favor brachial and collateral artery blood flow through the RA until a good RAP was restored. The primary analysis was the occurrence of RAO.

RESULTSDoppler ultrasound demonstrated the significant reduction of both systolic velocity (61.24 ± 3.95 cm/s vs. 72.31 ± 3.57 cm/s) and diastolic velocity (1.83 ± 0.32 cm/s vs. 17.77 ± 3.97 cm/s) in RA at access side as compared to the contralateral RA (all P < 0.001), but these velocities in ipsilateral ulnar artery (81.2 ± 2.16 cm/s and 13.1 ± 2.86 cm/s, respectively) increased profoundly. The average time of ulnar artery compression was 4.1 ± 1.2 h (ranged 2.5-6.5 h). There were two patients experienced persistent RAO with a success rate of 98.9% and RAO in 0.075% of patients after ulnar artery compression was applied. The pulsation of the ulnar artery after compression was removed had not been influenced by the compression.

CONCLUSIONSAfter intervention using TRCI approach, the presence of a weaker RAP is an indicator of imminent RAO. The continuing compression of ipsilateral ulnar artery is an effective approach to maintain RA patency.

Aged ; Arterial Occlusive Diseases ; prevention & control ; Catheterization, Peripheral ; Female ; Hemostasis ; physiology ; Humans ; Male ; Middle Aged ; Radial Artery ; Ulnar Artery

OBJECTIVETo evaluate the potential benefits of placing intra-aortic vacant guide wire on interventional treatment of aorto-ostial lesions.

METHODSA total of 86 consecutive patients underwent percutaneous coronary interventions (PCI) for aorto-ostial lesions were randomly divided into conventional treatment group (group A) and intra-aortic vacant guide wire group (group B). Standard PCI techniques were applied in group A and an intra-aortic vacant guide wire was placed outside the guiding catheter before the guiding catheter into the target coronary artery in group B on basis of standard PCI techniques. The number of guiding catheter, guide wire, X-ray exposure time, total PCI time, the incidence of pressure drop and malignant arrhythmia, contrast agent dose and the number of failure cases were compared between the two groups.

RESULTSThe number of used guide wire was similar between the groups (2.0 ± 1.1 vs. 2.2 ± 0.4, P > 0.05) and the number of guiding catheter used was significantly more in group A than in group B (2.3 ± 1.1 vs. 1.3 ± 0.5, P < 0.01). The X-ray exposure time (18.8 min ± 6.9 min vs. 14.2 min ± 5.7 min, P < 0.01) was significantly less in groups B and the total PCI time (31.2 min ± 8.1 min vs. 20.1 min ± 4.5 min, P < 0.01) and the amount of contrast agent (193.5 ml ± 25.4 ml vs. 130.6 ml ± 32.8 ml, P < 0.01) and the frequency of pressure drop (19 cases vs. 2 cases, P < 0.01) were all significantly higher in group A than in group B. Incidence of malignant ventricular arrhythmia (8 vs. 0) and procedure failure (6 vs. 0) was also higher in group A compared to group B.

CONCLUSIONThe method of using Intra-aortic vacant guide wire is associated with reduced risk and improved success rate of PCI for aorto-ostial lesions.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Artery Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the clinical curative effect of "oblique-pulling" maneuver in patients with lumbar intervertebral disc herniation (LIDH).

METHODSSixty-five LIDH cases were randomly divided into experimental group and control group. In the experimental group 32 patients were treated by "oblique-pulling" maneuver, and 32 patients in the control group were treated by lumbar traction therapy. One case were excluded from the study and another one case were dropped from the study. After one course of treatment, the therapeutic effects of the two groups were compared quantitatively by using the JOA and VAS scores, including the improvement of signs, symptoms, living ability, and low back and leg pain.

RESULTSAfter one course of treatment, in the experimental group, 7 cases were controlled well, 16 cases were marked effect, 8 cases were effect, 1 case was no effect. In the control group, 4 cases were controlled well, 10 cases were marked effect, 13 cases were effect, 4 cases was no effect in control group. The clinical effective rate of the experimental group was 96.86%, which was higher than 87.10% of the control group (P < 0.05). In the experimental group the scores of JOA and VAS were obviously improved after treatment (P < 0.001) and the improvement was better than that of control group (P < 0.01).

CONCLUSIONThe "oblique-pulling" maneuver has the characteristics of simple operation, repeatability, good efficiency, high safety.

Adult ; Female ; Humans ; Intervertebral Disc Displacement ; Lumbar Vertebrae ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Pain Measurement

The present study aimed to determine the role of tissue injury in migration of mesenchymal stem cells (MSCs) intravenously transplanted into heart and to establish experimental basis for improving stem cell therapy in its targeting and effectiveness. MSCs were isolated from bone marrow of male Sprague-Dawley rats and purified by density centrifuge and adhered to the culture plate in vitro. Female rats were divided randomly into four groups. Myocardial ischemia (MI) transplanted group received MSCs infusion through tail vein 3 h after MI and compared with sham-operated group or normal group with MSCs infusion, or control group received culture medium infusion. MI was created in female rats by ligating the left anterior descending coronary artery. The heart was harvested 1 week and 8 weeks after transplantation. The characteristics of migration of MSCs to heart were detected with expression of sry gene of Y chromosome by using fluorescence in situ hybridization (FISH). Ultrastructural changes of the ischemic myocardium of the recipient rats were observed by transmission electron microscope (TEM). One week or 8 weeks after transplantation, sry positive cells were observed in the cardiac tissue in both of MI transplanted group and sham-operated group, the number of sry positive cells being significantly higher in MI transplanted group (P<0.01). No significant difference was found in the number of sry positive cells between 1 week and 8 weeks after transplantation. No sry positive cells were observed in the hearts of control and normal group. In addition, the ultrastructure of some cells located in the peri-infarct area of MI rats with MSCs transplantation was similar to that of MSCs cultured in vitro. These results indicate that MSCs are capable of migrating towards ischemic myocardium in vivo and the fastigium of migration might appear around 1 week after MI. The tissue injury and its degree play an important role in the migration of MSCs.
Animals ; Cell Movement ; Cell Tracking ; Female ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; Myocardial Ischemia ; therapy ; Myocardium ; ultrastructure ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo assess the prognostic value of minimal residual disease (MRD) in childhood B-cell acute lymphoblastic leukemia (ALL) after induction chemotherapy.

METHODSFrom September 2001 to October 2004, 102 patients with newly diagnosed B-ALL were enrolled in protocol ALL-XH-99. MRD after induction therapy, before high-dose methotrexate and early intensification as well as at 1 year and 2 year maintenance therapy was detected by multiparameter-flow-cytometry (MP-FCM).

RESULTS(1) The probability of 39-month event-free survival (EFS) for patients with a level of MRD < 10(-4), was significantly higher than for those with a higher MRD [(83.00 +/- 9.90)% vs 0.00%, P < 0.01]. (2) Univariate analysis indicated that the MRD level at achieving complete remission (CR) had no relationship with the biologic features at presentation (gender, age, white blood cells and cytogenetic abnormalities), but did with Philadelphia chromosome, the time reaching CR, ALL-XH-99 risk group and lymphoblasts in bone marrow on day 19 after induction therapy (P < 0.05). (3) Multivariate analysis suggested that MRD level after the first induction course was an independent prognostic factor (hazard ratio, 5.381; 95% CI 0.004 to 0.624; P < 0.05).

CONCLUSIONThe MRD level at achieving CR is one of important prognostic factor in the treatment of childhood B-cell ALL, and might be used to assess the early treatment response.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukemia, B-Cell ; drug therapy ; Male ; Neoplasm, Residual ; diagnosis ; Prognosis ; Remission Induction

OBJECTIVETo assess the prognostic value of both morphological persistent disease on day 19, on complete remission (CR) and minimal residual disease (MRD) in the bone marrow (BM) after multiagent remission induction therapy.

METHODSFrom January 1998 to May 2003, 193 patients with newly diagnosed ALL were enrolled on protocol of ALL-XH-99. BM blast counts on day 19 and on CR after induction therapy were examined. BM MRD at the end of induction therapy was detected by MP-FCM.

RESULTS(1) The probability of 5-year event-free survival (pEFS) was significantly worse for patients with > or = 0.050 BM lymphoblasts on day 19 than that with < 0.050 BM lymphoblasts [(42.59 +/- 14.28)% vs (74.24 +/- 6.67)%, P < 0.001]. (2) The 5-year pEFS was significantly worse for patients with a low percentage of lymphoblasts (< 0.050) in BM on CR as compared to those with no morphological persistent lymphoblasts [(63.47 +/- 9.23)% vs (76.41 +/- 6.09)%, P < 0.05]. (3) No significant difference was found in BM lymphoblasts between patients with MRD (> or = 10(-4) of nucleated bone marrow cells) and those without MRD (< 10(-4)) at the end of induction therapy (P > 0.05). The 22-month pEFS was significantly worse for patients with MRD as compared with those without MRD on CR [(23.81 +/- 20.26)% vs (94.44 +/- 5.40)%, P = 0.001].

CONCLUSIONSBM lymphoblast > or = 0.050 on day 19 after induction therapy is an independent prognostic factor for childhood ALL; low percentage of lymphoblasts and minimal residual disease in BM on remission also do it. Patients with > or = 0.050 lymphoblast in BM on day 19 or with MRD > or = 10(-4) at the end of induction therapy should receive altered and more intensive chemotherapy.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Marrow ; drug effects ; pathology ; Bone Marrow Examination ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neoplasm, Residual ; diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; drug therapy ; pathology ; Prognosis ; Remission Induction ; Survival Analysis

OBJECTIVEEarly response to therapy is one of the most important prognostic factors in childhood acute lymphoblastic leukemia (ALL). This study aimed to assess the prognostic value of morphological assessment of bone marrow blasts during remission induction and determination of minimal residual disease (MRD) after remission induction.

METHODSFrom January 1998 to May 2003, 193 children with newly diagnosed ALL were enrolled on the ALL-XH-99 protocol. Blast cell count in the bone marrow was examined on day 19 of remission induction and by the completion of remission induction. MRD was measured with the flow cytometry. Event-free survival (EFS) was estimated by Kaplan-Meier analysis and the distributions of EFS were compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors.

RESULTSThe 4-year EFS was significantly worse in patients with > or = 5% lymphoblasts in the bone marrow on day 19 as compared to those with <5% lymphoblasts on that date (42.59%+/- 14.28% vs 74.24%+/- 6.67%; p< 0.01). The 4-year EFS was significantly worse in patients with any amount of lymphoblasts in the bone marrow on the remission date as compared to that of other patients with no morphologically identifiable blasts (63.47%+/-9.23% vs 76.41%+/- 6.09%; p<0.05). The patients with MRD <0.01 had significantly better outcome than those with a level > or = 0.01% (15-month EFS:94.44%+/-5.40% vs 23.81%+/- 20.26%; p<0.01).

CONCLUSIONSEarly treatment response as assessed by morphological examination or minimal residual leukemia determination by flow cytometry has important prognostic significance, and can be performed in a resource-poor patient population.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neoplasm, Residual ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; mortality ; pathology ; Prognosis ; Proportional Hazards Models ; Treatment Outcome