Objective To study the effects of enteral immunonutrition on immune function in patients with multiple trauma. Method A total of 32 patients with multiple trauma admitted to general ICU in ChangZheng hospital, Shanghai from March 2007 to May 2008 were randomly (random number) divided into two groups,enteral immunonutrition group (EIN group, n = 16)and the general formula enteral nutrition group (EN group, n = 16).Two groups of patients on the third day after injury began to accept the EIN and the general formula EN which respectively support at least 14 days. The patients peripheral blood lymphocyte count (TLC), immunoglobulin (IgG,IgM, IgA) ,and T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were detected on the day of the group formation, the seventh and the fortteenth day of the nutritional support. Results TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in EIN Group on the 7th and 14th day than that on the first day ( P ＜0.05), and extended with the EIN and sustained increase. All immunization indicators of EN group on the 7th day were no significant changes compared with the day of the group formation, and on the 14 th day TLC, IgG, IgM,IgA, CD4 and CD4/CD8 ratio were significantly higher than that on the day of the group formation ( P ＜ 0.05),but were significantly lower than that in the EIN group on the 14th day ( P ＜ 0.05). Conclusions Compared with the general formula EN, EIN is more helpful to restore and increase the humoral and cellular immune function in early post-multitraumatic phase.

To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone (AMH).A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy (TLH group,n =32),laparoscopic subtotal hysterectomy (LSH group,n =31) and laparoscopic myomectomy (LM group,n =33).Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation.No significant differences existed in AMH in LM group[(1.42 ±0.65),(1.31 ±0.53) & (1.33 ±0.61) μg/L,P ＞ 0.05].The levels of AMH in both groups were significantly lower than those at pre-operation [(1.17 ± 0.11),(1.01 ±0.10),(0.48±0.54) & (1.18±0.93),(0.45 ±0.39),(0.14±0.0) μg/L,P＜0.001].The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up [(-37.4 ± 37.6) ％ vs.(-27.0 ± 23.0) ％,P =0.017].The results showed that LM had no effect on ovarian reserve.Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

Cestode Infections ; parasitology ; Humans ; Infant ; Male

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

Objective To explore the mechanism of Xiaoying decoction on experimental autoimmune thyroiditis (EAT) rats in view of regulatory T cells and Th17 cells.Methods SD rats were divided into five groups,normal control group,model control group,tripterygium glycoside group,Xiaoying decoction low and high dose groups.Except for normal control group,the other groups were established the model of EAT.Rats in the Xiaoying decoction low,and high dose groups were given Xiaoying decoction of 17.24 and 68.95 g·kg-1;rats in the tripterygium glycoside group were given tripterygium glycoside 6.25 mg·kg-1.The serum free triiodothyronine(FT3),free thyrocyte(FT4) and thyroglobulin antibody were detected by RIA method.Thyrocyte morphology was observed under optical microscope.The expression levels of Foxp3 mRNA and IL-17 mRNA were detected by real-time PCR.The changes of Treg cells and Th17 cells were analyzed by flow cytometry.Results Compared with the normal control group,FT3,FT4 and TgAb were increased in the model control group (P ＜0.01,P ＜0.01,P ＜0.05).Compared with the model control group,FT3,FT4 and TgAb were decreased in tripterygium glycoside group and Xiaoying decoction high dose group (P ＜ 0.05).The infiltration score in the normal control group,model control group,tripterygium glycoside group,Xiaoying decoction low and high dose groups were 0,4,4,3.5,2.Compared with model control group,the infiltration was improved (P ＜0.01).Foxp3 mRNA expression was decreased while IL-17 mRNA increased in the model control group as compared with the normal control group(P ＜ 0.01).In contrast,the expression of Foxp3 mRNA was increased and IL-17 mRNA expression was decreased in Xiaoying decoction low and high dose groups,tripterygium glycoside group as compared with the model control group (P ＜0.05).Compared with the normal control group,rats in the model control group had fewer Treg cells and more Th17 cells (P ＜0.01).Compared with the model control group,the percentage of Treg cells was elevated and Th17 cells was reduced in tripterygium glycoside group and Xiaoying decoction high dose groups (P ＜ 0.01).Conclusion The therapeutic mechanism of Xiaoying decoction on EAT rats may be related to changing the percentage of regulatory T cells and Th17 cells with up-regulating the expression of Foxp3 mRNA and down-regulating the expression of IL17mRNA.

Humans ; Melanoma ; diagnosis ; genetics ; Precision Medicine

Objective To probe the causes,early recognition and effective therapy of posttraumatic biloma.Methods The data of all patients with the injury of the liver and bile duct treated in our center during the past 10 years were reviewed.Patients,diagnosed with biloma were retrospectively analyzed in respects of sex,age,cause of biloma,methods and efficacy of diagnosis and treatment.Results There were 46 patients with biloma.Of them,40 were found after liver trauma of grade Ⅲ-Ⅴ.The incidence of biloma was 15.2％ (40/263).In grade Ⅳ,Ⅴ,and Ⅲ,it was 22.6％ (31/137) and 7.1％ (9/126) respectively (x2 =12.20,P ＜ 0.01) and in blunt and penetrating injury,it was 19.3％ (35/181) and 6.1％ (5/82) respectively (x2 =7.67,P ＜ 0.01).Of these 40,36 were found during the course of conservative therapy of severe liver trauma; and 4 were found after laparotomy for the liver trauma.The remaining 6 cases of biloma had a history of injury to extrahepatic bile duct with a incidence of 18.8％(6/32).All 46 patients received spiral CT scaning plus MRI in 9,and ERCP in 11.Of those 40 with biloma after severe liver trauma,28 were cured by ultrasound-guided or computed tomography scan-guided pigtail drainage; and the remaining 12,in whom the biloma volume ＜ 30 cm3 resolved spontaneously.Six patients in whom the biloma as a result of injury to extrahepatic bile duct were cured by surgical intervention.There was no death and complication related with the therapy of biloma.Conclusions Attention should be given to biloma formation,when nonoperative therapy is exercised for severe liver trauma.Ultrasound-or CT scan-guided pigtail drainage is an effective option,but those due to injury of extrahepatic bile duct require surgical intervention.

This study is to screen the Chinese herbal compounds which could inhibit the production of Abeta and investigate the underlying mechanism. Ten types of compounds which have potential value in the treatment of AD were selected as initial screening trial. The cell models which used could overexpress Abeta and beta-secretases or Abeta and gamma-secretases. Extracellular Abeta was determined by ELISA after the cell models treated with different concentrations of compounds (0.5-100 micromol x L(-1)), separately. Then the compounds were selected which could inhibit extracellular Abeta and their best concentration ranges were decided, too. Furthermore, the cell viability and apoptosis rate, the level of intracellular Abeta, beta and gamma-secretases were determined after the cell models treated with different concentrations of selected compounds. The results showed that 4 of the 10 compounds could reduce the level of extracellular Abeta; they were cryptotanshinone, astragalosides, gastrodin and paeoniflorin, and their best concentration ranges were 0.5-5.0, 0.5-5.0, 5.0-50, 1.0-25 micromol x L(-1), respectively. Further study indicated that the 4 selected compounds were nontoxic to the cellular models and lowering intracellular Abeta were more effective compared with extracellular; of which astragalosides and gastrodin showed dose-dependent inhibition to the activities of beta and gamma-secretases, with the maximum inhibiting rates of 78.2% and 80.3%, respectively. In conclusion, cryptotanshinone, astragalosides, gastrodin and paeoniflorin could inhibit the expression and secretion of Abeta, and the underlying inhibiting mechanism of astragalosides and gastrodin were related with the reduction of the beta and gamma-secretase activities, respectively.
Amyloid Precursor Protein Secretases ; metabolism ; Amyloid beta-Peptides ; antagonists & inhibitors ; Apoptosis ; Benzyl Alcohols ; pharmacology ; Cell Line ; Dose-Response Relationship, Drug ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; pharmacology ; Glucosides ; pharmacology ; Humans ; Monoterpenes ; pharmacology ; Phenanthrenes ; pharmacology ; Saponins ; pharmacology

Objective To evaluate the clinical efficacy of the intratympanic inflation by tympanum inflatable balloon for patients with Meniere’s disease(MD) .Methods A total of 36 confirmed cases (according to the listening stage) of Ⅱ - Ⅲ period of MD patients were randomly divided into two groups :experimental group and control group ,18 cases of matched group ,who were staged before preoperation by hearing ,Ⅱ period (average threshold 25~40 dB HL) 6 cases ,Ⅲ period (41~70 dB HL) 12 cases ,were treated by intratympanic methylprednisolone per‐fusion after putting tympanostomy tube under endotoscope ,then once every 3 days perfusion with a total of three times .There were 18 cases of experimental group staged before preoperation by hearing ,Ⅱ period (average thresh‐old 25~40 dB HL) in 5 cases ,Ⅲ period (41~70 dB HL) 13 cases treated by using tympanum inflatable balloon in the tympanum under endotoscope .Two groups were given conventional improved microcirculation and nutritional therapy .Results In 18 cases of patients in experimental group ,for the 18 to 24 months follow -up after treatment ,6 cases of vertigo were fully controlled (grade A) ,10 cases of vertigo basically controlled (grade B) ,2 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 88 .89% (16/18) .After 18 to 24 months treatment ,two groups of 36 patients with tinnitus and pure tone average threshold had no obvious change .In 18 ca‐ses of patients in the matched group ,during the 18 to 24 months follow -up after treatment ,3 cases of vertigo were fully controlled (grade A) ,7 cases of vertigo basically controlled (grade B) ,8 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 55 .56% (10/18) .The experimental vertigo basic control rates were higher than the control group (χ2 = 4 .985 ,P<0 .05) .The activitives in the two groups had improved significantly . No obvious differences were found between two groups .Conclusion With the intratympanic gasing by tympanum in‐flatable balloon for patients of Ⅱ - Ⅲ Menier’s disease ,control rates was high and motile ability were improved , but tinnitus and hearing improvement was not obvious .

Objective To investigate muscle MRI characteristics of lower limbs in Chinese patients with dysferlinopathy. Methods Detailed clinical information of 42 patients with dysferlinopathy confirmed by Western blot or DYSF genetic test were studied retrospectively, including age, course, serum creatinine kinase (CK) and modified Gardner?Medwin and Walto score, and T1WI, STIR image. Each muscle was scored according to its fatty degeneration evaluated on T1WI (fat replacement score). The patients were divided into 3 groups:Miyoshi myopathy (MM), limb girdle muscle dystrophy 2B (LGMD 2B) and preclinical stage (asymptomatic hyperCKemia or exercise intolerance). The data including the scores of each muscle between MM and LGMD 2B were compared by ANOVA analysis and Chi square test. The relationship of fatty replacement score with course and GM?W score was analyzed by Spearman rank correlation analysis. Results Thirty nine patients underwent thigh MR scanning and 36 patients underwent leg MR scanning. At the thigh level, there is no specificity that the fatty replacement was found in both the anterior and posterior parts while the rectus femoris, sartorius and gracilis were rarely involved. At the leg level, the most severely involved muscle was the soleus, followed by gastrocnemius. It formed a sandwich?like pattern that the anterior part (anterior and posterior tibial muscle and peroneus longus muscle) and the posterior part (medial and lateral gastrocnemius) were less involved than the middle part (soleus). Of 42 patients, 14 cases were MM, and 24 were LGMD 2B. The fat replacement score of each muscle between two groups showed no significant differences (F=0.066 to 3.907,P all>0.05) except for the adductor muscle (F=5.239, P=0.028), semimembranosus (F=6.703, P=0.014) and semitendinosus (F=7.689, P=0.009). Of 4 pre?symptomatic cases, 3 showed edema of posterior part of leg on STIR, especially soleus. In all patients, the fat replacement score correlated positively with course (rs=0.732, P=0.000) and GM-W score (rs=0.485, P=0.001). Conclusions The MRI of Chinese patient with dysferlinopathy was characterized by the milder involvement of rectus femoris, sartorius and gracilis muscle in the thigh and a sandwich?like pattern in the leg, which is helpful for differential diagnosis of inflammatory Myopathy versus other types of muscular dystrophy.