【Objective】 The characteristics of syndrome patterns of osteoporosis(OP) in traditional Chinese medicine (TCM) were investigated by cluster analysis,thus to supply evidences for the prevention and treatment of OP.【Methods】The data of 246 OP patients collected by four diagnostic methods were classified into items by cluster analysis.Thenthe principal component analysis was usedtosummarizethe TCMsyndrome patters of OPbyanalyzing the representativeness of eachitem.【Results】Forty-sevenitems were obtained after cluster analysis,andtheitems of short of breath withreluctancetotalk,lassitude and weakness,soreness of thelower back,white coating,vertigo,pale and enlargedtongue had a higher incidences.Whenthe items of OP were classified into four patterns of deficiency of liver and kidney yin,deficiency of spleen and kidney yang,deficiency of Qi and blood,and Qi stagnation and blood stasis,the patterns distribution was clear and had a good representiveness.The patterns of deficiency of liver and kidney yin,and deficiency of spleen and kidney yang had higher incidences of 34.7 %and 30.1 %respectively.【Conclusion】OP classifiedintofour patterns of deficiency of liver and kidney yin,deficiency of spleen and kidney yang,deficiency of Qi and blood,and Qi stagnation and blood stasis is practical in clinic,and most of OPpatients have the manifestations of kidney deficiency.

Objective To investigate the protein expression and genetic alterations of c-myc in primary systemic anaplastic large cell lymphoma (ALCL) and discuss its relationship with clinicopathologic features and immunophenotypes.Methods 87 cases of ALCL were selected.Immunohistochemical method was used to detect the protein expression of c-myc,ALK,CD3,CD10,CD20,CD30 and EMA.c-myc and ALK genetic alterations were detected by using fluorescence in situ hybridization (FlSH).The interrelationships between protein expression,genetic alterations and clinicopathological parameters were analysed statistically.Results Immunohistochemical results:of 87 cases,ALK protein was expressed in 54 cases (62.1％).c-myc protein was expressed in 27 cases (31.0 ％).ALK and c-myc were co-expressed in 20 cases (23.0 ％).c-myc protein expression,ALK and c-myc co-expression increased with the upgrade of ALCL clinical stages,and the expression was higher in International Prognostic Index (IPI) high-risk groups than in low-risk groups (P ＜ 0.05).FISH test results:of 87 ALCL cases,there were 50 cases (57.5 ％) of ALK rearrangements and 19 cases (21.8 ％) of ALK aneuploidy.c-myc rearrangement was detected in none of 87 ALCL cases,but there was aneuploidy in 19 cases (21.8 ％).The differences of c-myc aneuploidy in ALK positive and negative groups were statistically insignificant (P ＞ 0.05),while they were statistically significant in c-myc groups (P ＜ 0.05) and in different IPI groups (P ＜ 0.05).Conclusion c-myc protein expression and aneuploidy were related with ALCL clinical stages and IPI,which could be used as an indicator of estimating ALCL malignant degree and predicting prognosis.

Objective To investigate the dysregulation of HER-2 protein and gene in non-small cell lung cancer (NSCLC), and to identify the association between clinicopathological features,prognosis and HER-2 aberrations amongst protein and gene. Methods 140 NSCLC tissues (89 squamous cell carcinoma, 51 adenocarcinoma) with operative section and detailed case were taken from pathology department of Shanxi Cancer Hospital from Jan 2006 to Feb 2007, while 70 normal tissues were set as control group. Immunohistochemistry was applied to detect the state of HER-2 protein expression,and fluorescence in situ hybridization (FISH) was applied to test the status of gene amplification. Results In normal and NSCLC tissues, over-expression of HER-2 was detected in 0 case and 17 (12.14 %) cases (P < 0.05), respectively. The over-expression of HER-2 was associated with the pathological type of NSCLC, which was detected more frequently in adenocarcinoma (χ2 = 4.19, P = 0.04), rather than the gender, age, smoke history, clinical stages, and lymphatic metastasis of patients. 40 (28.57 %) cases presented HER-2 gene copy number ≥3, including 6 (4.29 %) patients with HER-2 gene amplification, 34 (24.29 %) patients with HER-2 gene multicopy. HER-2 gene amplification was associated with the pathological type (P = 0.024), smoke history (P = 0.048) and age (P = 0.015), rather than lymphatic, gender, clinical stages. None clinicopathological features were presented correlation with HER-2 gene multicopy (P > 0.05). There was no significantly difference in survival between patients with and without HER-2 protein over-expression and HER-2 gene dysregulation (P > 0.05). HER-2 protein over-expression was associated with HER-2 gene amplification (P > 0.05), while no relationship between HER-2 protein overexpression and HER-2 gene multicopy (P < 0.01). Conclusions The over-expression of HER-2 is related to pathological type of NSCLC with more frequent expression in adenocarcinoma. The incidence rate of HER-2 gene amplification in patients with adenocarcinoma histology, never-smokers, and young age is high. The HER-2 protein over-expression and gene dysregulation show no relation with the prognosis of NSCLC.

Objective To develop a HPLC method for determining 14 hydrolyzed amino acids in Pfaf fia .Methods The sample was derivatized with phenyl isothiocyanate (PITC) .Amino acids were separated on Waters XBridge Shield RP18 (4.6 mm × 250 mm ,5 μm) column at the flow rate of 0.8 ml/min ,detected at 254 nm .The column temperature was 25 ℃ . Results The response was linear for 14 amino acids with a correlation coefficient r>0 .9990 .The average recoveries (n=6) were 90 .2%-105 .1% .Amino acids derivative solution remained stable in 24 hours .Conclusion This well-established method is very reliable .It can be used as a quantitative determination method for 14 amino acids in Pfaf fia .

OBJECTIVETo investigate the clinical effect of acellular dermal matrix (ADM) combined with auto-skin grafting on deep burn wound ,and the result of long-term follow-up and histological examination.

METHODSOne hundred and fifty-two patients with deep burn hospitalized from February 2000 to July 2003 were repaired with porcine ADM and auto split-thickness graft. Wound healing rate was assessed 1 week after operation. Degree of cicatricial hyperplasia was examined 1, 3, 6, 12 months after operation. Wound samples from 5 patients were harvested for histological examination 72 months after operation, for which transmission electron microscopy were employed in 2 cases.

RESULTSGrafts completely survived was seen in 116 patients (accounting for 76.3% of cases), survival rate over 95% were observed in 23.7% of cases. One hundred and twenty-seven patients were followed up 1 month after operation, in whom mild local contraction, cord like scar was seen along its junction with skin, its texture was soft ,and there was no pruritus or blister formation. One hundred and one patients were followed up 3 months after operation, and the graft showed mild contraction less marked when compared with that of the site where auto split-thickness skin grafting was used. Articular function was good. Eighty-two patients were followed up 6 months after operation,color and texture of grafts were similar to normal skin with no obvious cicatricial hyperplasia. Fifty-eight patients were followed up 12 months after operation, the texture of grafts was similar to normal skin without obvious reject reaction. Sixteen patients were followed up over 72 months after operation, the grafts appeared dry compared with normal skin. Histological examination showed: tissue structure of grafts was similar to normal skin, intact small sweat gland and sweat gland cells were not found in dermal layer.

CONCLUSIONHeterologous ADM combined with auto split-thickness graft can survive in human body without obvious immune rejection reaction for a long time. No intact small sweat gland or sweat gland cells in dermis is a problem worth of study in regeneration of skin function.

Adolescent ; Adult ; Aged ; Burns ; surgery ; Dermis ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Skin, Artificial ; Transplantation, Autologous ; Young Adult

Objective To investigate the expressions of programmed death-ligand 1 (PD-L1) and PD-L2 and phosphorylated protein kinase B (p-AKT) in diffuse large B-cell lymphoma (DLBCL) patients and their correlations with clinicopathological features and prognosis. Methods A total of 68 paraffin-embedded specimens of DLBCL patients diagnosed in Shanxi Provincial Cancer Hospital with detailed follow-up record from January 2010 to December 2012 were included in the study. The expressions of PD-L1, PD-L2 and p-AKT proteins in DLBCL were detected by using immunohistochemistry (IHC). Results The positive rate of PD-L1 protein in DLBCL patients was 22.1％ (15/68), which was related to germinal center B-cell (GCB) subtype or not (χ2= 5.591, P= 0.018), clinical stage (χ2= 3.969, P= 0.046), international prognostic index (IPI) grades (χ2=4.178, P=0.041) and treatment remission rate (χ2=6.587, P=0.010). The positive rate of PD-L2 protein in DLBCL patients was 14.7％ (10/68), which was related to extranodal metastasis or not (χ2=6.772, P= 0.009). The positive rate of p-AKT for DLBCL patients was 61.8％ (42/68), which was correlated with age (≥60 years old) or not (χ2=6.227, P=0.013), Eastern Cooperative Oncology Group (ECOG) grades (χ2=4.005, P=0.045), B symptoms (χ2=10.187, P=0.001) and treatment remission rate (χ2=4.096, P=0.043). Univariate survival analysis showed that the overall survival (OS) rate and progression free survival (PFS) rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P< 0.05). In the patients with non-GCB subtype, OS rate and PFS rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P<0.05). p-AKT protein positive expression group had poorer OS rate and PFS rate compared to p-AKT negative expression group (both P< 0.05). Correlation analysis showed that PD-L1 protein expression was correlated with PD-L2 and p-AKT proteins expressions (r= 0.380, P= 0.001;r= 0.273, P= 0.025). The prognosis was worse when p-AKT and PD-L1 proteins was co-expressed (P< 0.05). Multivariate analysis suggested high expressions of PD-L1 and p-AKT proteins were independent prognosis risk factors in DLBCL (both P<0.05). Conclusions The expressions of PD-L1 and p-AKT proteins may be involved in the occurrence and development of DLBCL. Blocking PD-1 and PD-L1 access or combined blocking could provide a promising future for the clinical therapy.

OBJECTIVETo investigate the influence of intranasal instilling titanium dioxide (TiO2) nanoparticles on monoaminergic neurotransmitters at different-time exposure.

METHODSCD female mice were intranasally instilled three different-sized (25 nm, 80 nm and 155 nm) TiO, suspension every other day in a dose of 50 mg/kg body weight. The control group was instilled the same volume of Milli-Q water. Inductively coupled plasma-mass spectrometry (ICP-MS) was used to analyze the titanium contents in murine brain after exposure to TiO2 particles 2 days, 10 days, 20 days and 30 days. The monoaminergic neurotransmitters such as norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), 5-hydroxyindole acetic acid (5-HIAA), 3, 4-dihydroxyphenylacetic acid (DOPAC), and homovanillic (HVA), were determined by reversed-phase high performance liquid chromatography (RP-HPLC) with electrochemical detector.

RESULTSAfter exposure to TiO, nanoparticles 10 days, the titanium contents in murine brain were increased, the titanium content in the 25 nm group was up to (1059.3 +/- 293.5) ng/g. In 20 days, the titanium content decreased slowly with the metabolism of titanium in vivo, but it kept at a high level, the content decreased to (654.7 +/- 269.2) ng/g in the 25 nm group. After exposure to TiO2 nanoparticles 30 days, the titanium contents had no obviously change. Because of the accumulation of TiO, in the brain, the contents of NE and 5-HT increased significantly after exposure to 80 nm and 155 nm TiO, nanoparticles 20 days, while the decreased contents of DA, DOPAC, HVA and 5-HIAA were observed.

CONCLUSIONThe inhaled TiO2 nanoparticles could be translocated to and deposited in murine brain after absorbing by nasal mucosa, and further influence the releases and metabolisms of monoaminergic neurotransmitters in brain.

Administration, Intranasal ; Animals ; Biogenic Monoamines ; metabolism ; Brain ; drug effects ; metabolism ; Brain Chemistry ; Female ; Metal Nanoparticles ; Mice ; Neurotransmitter Agents ; metabolism ; Time ; Titanium ; administration & dosage ; pharmacology

BACKGROUNDThere is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure (CHF) patients. This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain.

METHODSSociodemographics, serum levels of creatinine, NT-proBNP, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10, and two-dimensional echocardiographic left ventricular ejection fraction (LVEF) were determined in 305 patients with CHF. A questionnaire packet including the Brief Pain Inventory (BPI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess the degree of pain rated on a 0 - 10 scale and the quality of life (QOL). A six-minute walking test was performed during routine clinic visits. Major adverse cardiac events (MACE) were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke at follow-up.

RESULTSPain occurred in 25.6% of CHF patients, and was more common when the New York Heart Association (NYHA) functional class was worse. More patients with pain were female in gender, and had more co-morbidities, lower LVEF, and shorter distance during the 6-minute walking test. Despite similar serum levels of creatinine, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), IL-6 and IL-10, the TNF-α levels were higher and MLHFQ scores were greater in CHF patients with pain. At follow-up, CHF patients with moderate to severe pain (≥ 4 scale) had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke. Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.

CONCLUSIONSPain occurs in all stages of the CHF trajectory, and its incidence increases as clinical functional status is worsened. The presence of pain exerts a negative impact on clinical outcome and QOL in patients with CHF.

C-Reactive Protein ; metabolism ; Echocardiography ; Female ; Heart Failure ; metabolism ; physiopathology ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Male ; Pain ; metabolism ; physiopathology ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: To review the clinical data of pathological morphology, diagnosis, surgical treatment of cor triatriatum in 15 patients. METHODS: Fifteen patients with a mean age of (14.6+/-10.3) years (range from 6 months to 40 years) were performed operations under extracorporeal circulation. Fourteen of the patients had cor triatriatum sinister, and 1 had cor triatriatum dexter; 12 of the 15 patients had other cardiac abnormalities. The excision of the fibromuscular membrane was accomplished through a right atrial incision in all of the 14 cases, and the associated abnormalities were corrected at the same time. RESULTS: One patient died after the operation, and the other survivors had good outcome. CONCLUSION Operation is necessary if the diagnosis is clear. The patients generally have good prognosis. Surgical results of cor triatriatum depend on the complexity of associated defects and the adequacy of the repair.
Adolescent ; Adult ; Child ; Child, Preschool ; Cor Triatriatum ; surgery ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

BACKGROUNDPotentially lethal ventricular arrhythmias (PLVAs) occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases. This study investigated the prevalence and prognostic significance of PLVAs in patients with chronic heart failure (CHF).

METHODSData concerning demographics, etiology of heart failure, NYHA functional class, biochemical variables, electrocardiographic and echocardiographic findings, and medical treatments were collected by reviewing hospital medical records from 1080 patients with NYHA II-IV and a left ventricular (LV) ejection fraction ≤ 45%. PLVAs were defined as multi-focal ventricular ectopy (> 30 beats/h on Holter monitoring), bursts of ventricular premature beats, and nonsustained ventricular tachycardia. All-cause mortality, sudden death, and rehospitalization due to worsening heart failure, or cardiac transplantation during 5-year follow-up after discharge were recorded.

RESULTSThe occurrence rate of PLVAs in CHF was 30.2%, and increased with age; 23.4% in patients < 45 years old, 27.8% in those between 45 - 65 years old, and 33.5% in patients > 65 years old (P = 0.033). Patients with PLVAs had larger LV size and lower ejection fraction (both P < 0.01) and higher all-cause mortality (P = 0.014) during 5-year follow-up than those without PLVAs. Age (OR 1.041, 95%CI 1.004 - 1.079, P = 0.03) and LV end-diastolic dimension (OR 1.068, 95%CI 1.013 - 1.126, P = 0.015) independently predicted the occurrence of PLVAs. And PLVA was an independent factor for all-cause mortality (RR 1.702, 95%CI 1.017 - 2.848, P = 0.031) and sudden death (RR 1.937, 95%CI 1.068 - 3.516, P = 0.030) in patients with CHF.

CONCLUSIONPLVAs are common and exert a negative impact on long-term clinical outcome in patients with CHF.

Adult ; Aged ; Arrhythmias, Cardiac ; mortality ; physiopathology ; Electrocardiography ; Female ; Heart Failure ; physiopathology ; Humans ; Male ; Middle Aged ; Regression Analysis