Humans ; Male ; Mesylates ; poisoning ; Occupational Diseases ; Occupational Exposure ; adverse effects ; Young Adult

BACKGROUND: Animal experiments demonstrated that adding ultraviolet blood irradiation and oxygenation (UBIO) in cardioplegic solutions has myocardial protection during cardiopulmonary bypass (CPB).OBJECTIVE: To investigate the myocardial protective effect of UBIO as cardiac arresting solution in the process of CPB in old patients undergoing valve replacement.DESIGN, TIME AND SETTING: The randomized controlled trial of biochemistry level was performed at Department of Cardiac Surgery, Guizhou Provincial People's Hospital, from October 2006 to April 2008.PARTICIPANTS: A total of 46 old patients scheduled for heart valve replacement were randomly divided into test group and control group, with 23 patients in each group.METHODS: The test group was infuoed with the UBIO blood as a cardiac arresting solution via the ascending aorta. The UBIO blood accumulated from the subclavian vein (10 mL/kg) was heparinized and dealt with the ultraviolet irradiation (wave length 240-300 nm) and oxygenation. And then it was infused for the first antegrade coronary perfusion when the ascending aorta was cross-clamped, when the UBIO blood was produced, the equivalent quantitative saline was infused from another vein. The 4:1 cold oxygenated blood hyperhalemia cardioplegia was perfused and then maintained for 30 minutes. The control group was the same as the test group except that the cardiac arresting solution presented without the 4:1 cold oxygenated blood.MAIN OUTCOME MEASURES: Blood samples were withdrawn from coronary venous sinus before cross-clamping and at minutes 5 and 10 after aorta declamping, to measure the levels of superoxide dismutase (SOD) and the content of malondialdehyde (MDA). Before the beginning of CPB, and at hours 4, 24, and 48 after the end of CPB, venous blood was drawn to test the serum cardiac troponin I(cTnI) and creatine kinase isozyme (CK-MB).RESULTS: MDA levels of plasma were less in the test group than that of the control group after aorta declamping (P < 0.05),while the SOD activity was obvious greater than the control group (P < 0.05). At hours 4-48 after CPB, CK-MB and cTnl levels were lower in the test group than the control group (P< 0.05).CONCLUSION: Antegrade coronary first perfusion with UBIO during CPB has evident cardiac protective in old patients undergoing valve replacement by elevating SOD activity, decreasing MDA level, relieving myocardial reperfusion injury, as well as decreasing myocardial damage markers levels.

Objective To assesses the value of the Pipkin fracture classification on the treatment and prognosis of Pipkin fracture. Methods A total of 71 patients with Pipkin fractures treated from January 2002 to January 2007 were followed up and the detailed information of 63 patients were obtained. The clinical and radiographic evaluation criteria of Thompson was employed to evaluate the outcome, analyze the results and discuss the correlation between Pipkin fracture type and prognosis and hence propose the significance of Pipkin classification on the prognosis. Results There was no statistical difference in aspect of the outcome between type Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with minimum fracture, with fragment ＜ 1 cm,P＞0. 05). There showed statistical difference in outcome between types Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with acetabular rim fracture, P ＜0. 05). Conclusions Pipkin fracture classification system needs a further improvement. The type Pipkin Ⅳ injury that is combined with types Pipkin Ⅰ , Ⅱ , Ⅲ injuries with minimum fracture (fragment ＜ 1 cm) of the acetabular rim should be incorporated into types Pipkin Ⅰ ,Ⅱ , Ⅲ injury. Type Pipkin Ⅳ injury refers to types Pipkin Ⅰ ,Ⅱ , Ⅲ injuries, with major fracture of the acetabular rim and the hip joint instability. In addition, the Pipkin fracture type involving the fracture line, femoral neck and intertrochanteric region is hard to treat clinically and has poor prognosis, suggesting that this type of injury should be considered as special type Pipkin Ⅲ injury.

Objective To study the association between endometrioid uterine carcinomas and metabolic syndrome (MS). Methods A retrospective study was conducted on 123 patients who were admitted in Department of Gynecology Oncology, Zhejiang Cancer Hospital (study group) and 90 healthy women (control group) with matching age from Jan. 2005 to Mar. 2009. The general conditions[including age, whether menopausal, body mass index (BMI)];the risk factors for MS [including waist circumference,fasting plasma glucose, triglycerides(TG), high-density lipoprotein (HDL) and systolic and diastolic blood pressure]were analyzed. The clinical stage, histological type, and pathology differentiated degree of study group with or without MS were also analyzed by univariate analysis and Cox proportional hazards models.Results (1) The univariate survival analysis shown that there were no significant difference with age in two groups[(54.3±0.6) vs. (54.2±0.9) years;P>0.05], while the rate of menopausal, BMI(≥25 kg/m~2), the cases coupled with MS, the size of waist circumference (> 80 cm), the level of fasting plasma glucose (≥5.6 mmol/L),TG(> 1.7 mmol/L)and abnormal systolic and diastolic blood pressure in study group were higher than those in control group (67.5% vs. 48. 9%, 45.5% vs. 23.3%, 43.9% vs.18.9%, 50.4% vs. 27.8%, 53.7% vs. 21.1%, 40.7% vs. 21.1% and 40.7% vs. 25.6%,respectively, all P <0.05). The percentage of HDL(< 1.30 mmol/L) was higher in study group than that in control granp(63. 4% vs. 32. 2%, P <0.05). (2) There were not significant difference for the clinical stage, pathological type, grades between patients with or without MS in study group (P > 0.05). (3) The Logistic multivariate survival analysis shown that central obesity, higher TG, lower HDL and abnormal plasma glucose were independent risk factors for endometrioid uterine carcinomas coupled with MS (P< 0.05). Conclusion Metabolic syndrome is marginally associated with an increased risk of endometrioid uterine carcinomas, which may be the new point to screen, prevention and treatment endometrioid uterine carcinomas.

Objective To study the main subtypes messenger ribonucleic acid(mRNA) and the basal enzyme activity of phosphodiesterase (PDE) in rat pulmonary microvascular endothelial cells (PMVECs) through the examination mRNA expression and activity of PDE in vitro. The data were offered to reveal the relationship between PDE distributions, activity change and to accumulate data for the possibility of drug regulation of its functional alteration. Methods The cells were cultured with tissue-sticking method;the gene expression of PDEs was detected by reverse transcript polymerase chain reaction (RT-PCR), and the activity of PDEs was calculated by cyclic nucleotides content change examined with high performance liquid chromatogram (HPLC) before and after the PDE reaction( n ＝3). Results The PMVECs identified by cell immunofluorescence with polyclonal antibody of CD31 were dissociated and cultured, mRNAs of PDE1A, 1C, 2A,3A, 3B, 4A, 4D, 5A, 7A, 7B, 8A, 8B, 9A, 10A,11A were expressed in PMVECs, but there was no mRNA of PDE1B expressed in PMVECs. cAMP/cGMP-PDE in the extent of 5-20μl had a good linear correlation with its activity. Conclusion There are 17 kinds of PDE gene expression existing in PMVECs which contain of the basic enzyme with a higher activity.

Adhesives ; chemistry ; Benzene ; analysis ; Chromatography, Gas ; Hexanes ; analysis ; Toluene ; analysis ; Trichloroethylene ; analysis

AIMTo prepare thrombus-targeted urokinase liposomes and observe its improved thrombolytic efficacy on thrombus model rats.

METHODSThe ligand H-Arg-Gly-Asp-Ser-OH (RGDS) which has specific affinity to thrombus was synthesized by liquid phase method and anchored on the surface of liposomes by incorporating its conjugate with DSPE-PEG3,500-COOH into liposomal lipid bilayers, thus thrombus-targeted liposomes were produced. Urokinase (UK) liposomes were prepared at room temperature through method modification using hydrogenated soy phosphatidylcholine (HSPC); the in vivo thrombolysis of the obtained thrombus-targeted UK liposomes and its comparison with TBS (Tris-HCl buffered solution) control, free UK and UK liposomes were assessed on common carotid artery model rats.

RESULTSThe obtained liposomes were characteristic of high UK entrapment efficiency, small mean diameter and good storage stability. At the same dose (60,000 U.kg-1), compared to the wet thrombi weights of TBS control group, those of free UK group and UK liposome group showed no statistical difference, while those of targeted UK liposomes group were significantly decreased (P < 0.001); when evaluated in term of dry thrombi weights the result was slightly different. Compared to UK liposomes of the same dose, the targeted UK liposomes showed significantly improved thrombolytic efficacy (P < 0.01 in wet weights decrease and P < 0.05 in dry weights decrease respectively).

CONCLUSIONThe targeted UK liposomes displayed good targeted thrombolytic effect.

Animals ; Disease Models, Animal ; Drug Carriers ; Drug Delivery Systems ; Fibrinolytic Agents ; administration & dosage ; therapeutic use ; Liposomes ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Technology, Pharmaceutical ; Thrombosis ; drug therapy ; Treatment Outcome ; Urokinase-Type Plasminogen Activator ; administration & dosage ; therapeutic use

OBJECTIVETo investigate the nature of white matter lesion and correlation to memory impairment in patients with obstructive sleep apnea syndrome (OSAS) by diffusion tensor imaging ( DTI).

METHODWe conducted a cross-sectional study of 20 middle-aged male people (10 with OSAS and 10 healthy controls) group-matched by age, educational level, and socioeconomic status. DTI was performed on those people with OSAS and on matched controls. Fractional anisotropy(FA) and average diffusion coefficient(ADC) values were measured respectively in bilateral white matter of the frontal lobe, anterior cingulate gyrus, anterior cingulum, etc. At the same time, WMS values were detected respectively.

RESULTSRelative to controls, patients with OSAS had a lower FA in the white matter of right frontal lobe (0.444-/+0.025), splenium of corpus callosum (0.776-/+0.028 ), left anterior cingulate gyrus (0.154-/+0.021), right anterior cingulate gyrus (0.152-/+0.017), left anterior cingulum (0.372-/+0.022), right anterior cingulum (0.351-/+0.029), left centrum semiovale (0.501-/+0.029), peripheric white matter of left anterior angle (0.242-/+0.031), peripheric white matter of left posterior angle (0.338-/+0.029), peripheric white matter of right posterior angle (0.360-/+0.022 ), left parahippocampal gyrus (0.167-/+0.027), right parahippocampal gyrus (0.177-/+0.023). Besides, FA values of OSAS patients in the white matter of right frontal lobe and left centrum semiovale were strongly positively correlated with WMS values. While in comparison with that of healthy controls, ADC of OSAS patients was significantly higher in the white matter of right frontal lobe (8.589-/+0.264 x e(-10) mm(2)/s), trunk of corpus callosum (8.197-/+0.253 x e(-10) mm(2)/s), splenium of corpus callosum (8.218-/+0.194 x e(-10) mm(2)/s), left anterior cingulate gyrus (12.151-/+0.454 x e(-10) mm(2)/s), right anterior cingulate gyrus (12.113-/+0.524 x e(-10) mm(2)/s), right anterior cingulum (8.954-/+0.177 x e(-10) mm(2)/s),left centrum semiovale (7.333-/+0.220 x e(-10) mm(2)/s) and peripheric white matter of left anterior angle (9.186-/+0.465 x e(-10) mm(2)/s).

CONCLUSIONSThis study indicated that white matter and gray matter was both remarkably damaged in OSAS patients, which could contribute to memory impairment.

Adult ; Anisotropy ; Brain ; pathology ; Case-Control Studies ; Diffusion ; Humans ; Male ; Memory Disorders ; complications ; Middle Aged ; Sleep Apnea, Obstructive ; complications ; pathology

OBJECTIVETo study the clinicopathologic features and differential diagnosis of 18 cases of endocrine ductal carcinoma-in-situ (E-DCIS).

METHODSEighteen cases of breast cancer with features of E-DCIS were studied by light microscopy, histochemistry and immunohistochemistry. E-DCIS was diagnosed if the histologic patterns were compatible with those described in the literature and at least 50% of the tumor cells expressing two of the three neuroendocrine markers employed (chromogranin, synaptophysin and neuron-specific enolase).

RESULTSE-DCIS tended to occur in older women. All the patients were over 61 years old (mean age=71 years). The presenting symptoms were either palpable breast mass or had nipple discharge. Histologically, E-DCIS demonstrated an expansile intraductal growth pattern. Intraductal papilloma was not uncommon at the peripheral area of the tumor. The tumor cells were polygonal, oval or spindle in shape and contained abundant eosinophilic to granular cytoplasm and mildly to moderately pleomorphic nuclei. Intracellular or extracellular mucin was highlighted by periodic acid-Schiff (with diastase digestion) or alcian blue stains. Some tumor cells assumed a signet-ring configuration. All the three neuroendocrine markers were expressed by more than 50% of the E-DCIS cells. The neuroendocrine differentiation was further confirmed in some cases by CD57 and CD56 immunostaining. Pagetoid spread into adjacent ductolobular units was frequently seen in E-DCIS, and the expanded lobules were often not rimmed by myoepithelial cells. These two features helped to distinguish E-DCIS from usual ductal hyperplasia.

CONCLUSIONSE-DCIS represents a subgroup of low-grade DCIS, which carries characteristic morphologic features and immunophenotype. Conventional light microscopy usually permits a correct diagnosis. Ancillary histochemical and immunohistochemical studies can be helpful in doubtful cases.

Aged ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma in Situ ; metabolism ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Mastectomy ; methods ; Middle Aged ; Neuroendocrine Tumors ; metabolism ; pathology ; surgery ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism

OBJECTIVETo investigate the influence of therapeutic bloodletting at Jing-well points and hypothermia on acute cerebral edema after traumatic brain injury (TBI) in rats.

METHODSSeventy-five SD rats were randomly divided into sham-operation group (Sham), TBI group (TBI), bloodletting group (BL), mild-induced hypothermia group (MIH), and bloodletting plus MIH group (BL + MIH) (n = 15). The model of TBI was established by electric controlled cortical impactor (eCCI). The rats of BL group were bloodletting at Jing-well points immediately after injury, twice daily. While the MIH group was settled on a hypothermia blanket promptly after TBI for 6 hours, so that the temperature dropped to 32 degrees. Each of measurement was performed after 48 hours. Magnetic resonance imaging (MRI) was used to evaluate the dynamic impairment of cerebral edema after TBI (n = 3). In addition, mNSS score, measurements of wet and dry brain weight, and Evans Blue assay were performed to investigate the neurologic deficit, cerebral water content (n = 8), and blood-brain barrier permeability (BBB), (n = 4), respectively.

RESULTSMRI analysis showed that the cerebral edema, hematoma and midline shifting of rats in TBI group was more serious than other treatment group. Meanwhile compared with TBI group, the mNSS scores of every treatment group were meaningfully lower (all P < 0.05). Furthermore, treatment with BL+ MIH group was superior to the separated BL and MIH group (all P < 0.01). In addition, brain water content of each intervention group reduced to varying degrees (all P < 0.05), especially that of MIH group and BL + MIH group (P <0.01). BBB permeability of each treatment group was also significantly improved (all P < 0.01), and the improvement in MIH group and BL + MIH group was much better than the BL alone group (P < 0.05, P < 0.01).

CONCLUSIONOur major finding is that bloodletting at Jing-well points and MIH can reduce cerebral edema and BBB dysfunction and exert neuroprotective effects after TBI. The results suggest that the combination of BL and MIH is more effective than other treatment being used alone.

Animals ; Blood-Brain Barrier ; Bloodletting ; Brain ; pathology ; Brain Edema ; prevention & control ; Brain Injuries ; therapy ; Hypothermia, Induced ; Rats ; Rats, Sprague-Dawley