Objective To investigate the protective effect of sevoflurane on the brain against focal ischemia-reperfusion(I/R)injury and its mechanism.Methods Twenty-four male SD rats weighing 250-300 g were randomly allocated into 3 groups(n=8 each):group Ⅰ sham operation;grouop Ⅱ I/R and group Ⅲ I/R + sevoflurane.The rats were anesthetized with intraperitoneal chloral hydrate 300 mg?kg~(-1).Middle cerebral artery occlusion(MCAO)was produced by insertion of a 4-0 mono-filament nylon thread with rounded tip at bifurcation of right common carotid artery into internal carotid artery.The nylon thread was advanced cranially until resistance was felt.The depth of insertion was 18-20 mm.After 3 h MCAO the thread was withdrawn to allow reperfusion.In group Ⅲ the animals inhaled 1.0 MAC sevoflurane for 30 min at 30 min before reperfusion.The rectal temperature of the animals was kept at 36.5-37.5℃.At the end of 24 h reperfusion the animals were weighed again.The animals'neurological deficit was evaluated using Zea Longa score(0=no defcit,4=unable to walk and unconscious).The animals were then killed.The neuronal apoptosis in striatum was assessed(TUNEL)and the PKC protein expression in striatum was determined by immunocyto-chemistry.Results The body weight of the animals in I/R group was significantly reduced after 24h reperfusion as compared to the body weight before ischemia (P＜0.01),while in control group and sevoflurane group there was no significant difference in the body weight before and after sham operation or I/R.The neurological deficit scores were significantly higher in I/R group than in sevoflurane group.The number of apoptotic neurons in striatum was significantly higher in I/R group than in sevoflurane group.The PKC expression in striatum was significantly higher in sevoflurane group than in I/R group (P＜0.01).Conclusion 1.0 MAC sevoflurane inhalation has protective effect on the brain against I/R injury. Upregulation of PKC expression in striatum decreased by I/R is involved in the mechanism.

Objective To investigate prospectively the diagnostic significance of ulnar/median nerve amplitude ratio in motor neuron disorders.Methods Patients referral to our department between May 2009 and February 2012,due to muscle weakness,inflexible,cramps and atrophy,were consecutively enrolled.Conventional nerve conduction studies of 4 extremities (using surface electrodes) and needle electromyography were performed in all patients with fixed examiner.The compound muscle action potentials (CMAP) were recorded from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) with stimulation of ulnar and median nerve at wrist,respectively.Moreover,the ratio of CMAP amplitude between ADM and APB (ADM/APB) was calculated in the patients who met the diagnostic criteria for definite amyotrophic lateral sclerosis (ALS) and Hirayama disease (HD).The patients with Guillain-Barré syndrome (GBS) and other popyneuropathies (PN) were served as case-controls,and 34 healthy volunteers (aged (45.7 ± 16.3) years) as normal-controls.Results (1) There were 78 cases with ALS,25 HD,51 GBS and 140 other PN,with the mean age(years) of 54.7 ± 11.6,17.6 ± 2.2,41.3 ± 18.4 and 57.1 ± 14.3,respectively.(2) ADM/APB in the ALS subgroup was 2.28 ±2.87 (0.12-22.38),HD0.66±0.36 (0.05-1.34),GBS 1.42 ± 1.33 (0.25-9.85),other PN 1.36 ± 1.48 (0.08-14.44) and normal-controls 1.07 ± 0.28 (0.61-1.64,F =6.872,P =0.000),respectively.(3) The areas under receiver operator characteristic curve in patients with ALS was 0.830 (s-x =0.039) and HD 0.691 (sx =0.039,P =0.000) ; the diagnostic sensitivity and specificity for ALS patients were 36.7％ and 93.3％,respectively,with cutoff value of ADM/APB =2; and the diagnostic sensitivity and specificity for HD patients were 53.6％ and 89.0％,respectively,with cutoff value of ADM/APB =0.7.Conclusions The ulnar/median CMAP amplitude ratio increases in ALS,but decreases in HD,which may be served as a relatively specific electrophysiological index.ADM/APB amplitude ratio ＞ 2.0 is suggested to be a diagnostic parameter for ALS and ＜ 0.7 for HD.

Objective To explore the liver toxicities of the VDLD scheme in children with malignant tumor.Methods In a prospective trial,the levels of serum total protein,albumin, globulin,rate of albumin/globuin alanine aminotransferase,aspartate transaminase,gamma glutamyltranspeptidase,total bile acid and alkaline phosphatase were tested in children with malignant tumour before and after VDLD scheme,and compared with each other.Results The concentration of the serum total bile acid was significantly increased after VDLD scheme than before(P

Child, Preschool ; Humans ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; genetics ; therapy ; Male

OBJECTIVETo evaluate the indications of uvulopalatopharyngoplasty (UPPP) and clinical staging for oropharyngeal narrow in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSixty-six OSAHS patients were retrospectively analyzed, the data of physical examination and clinical staging for oropharyngeal narrow were built based on body mass index (BMI), palate-tongue position, tonsil sizes and hypertrophy degree in lateral side of oropharynx. The patients who had palatine-tongue position in degree 1 to 2 (no significant tongue enlargement) were defined as stage I (32 cases). The patients who had palatine-tongue position in degree 3 to 4 (tongue enlargement) were defined as stage II (34 cases). Among them, the patients with tonsil sizes 0 to 1 were stage I a (5 cases) and stage IIa (10 cases), another group with tonsil size 2 to 4 were stage I b (27 cases) and stage II b (24 cases), respectively. The indications of UPPP were evaluated according to the results of polysomnography (PSG) before and after operation.

RESULTSPSG in 1 to 2 years after operation showed: the surgical efficiency of UPPP had not any difference (P > 0.05) among different groups with the severity of OSAHS(labeled in preoperational AHI and LSaO2). Surgical results was better in patients with BMI < 30 kg/m2 (P = 0.023). Success of operation was defined as postoperational AHI <20/h and reduced more than 50% compared to preoperational AHI and symptoms alleviated significantly. Successful rates of UPPP in stage I b (70.4%, 19/27 cases) were statistically higher than that of other groups (I a:0%; I b:70. 4%; II a:20.0%; II b: 16.7%).

CONCLUSIONSClinical staging system for oropharyngeal narrow is based on palate-tongue position and tonsil size. It is helpful to choose the surgical indications of UPPP for patients with OSAHS. It is the best UPPP indication for stage I b patients who had no tongue enlargement (palatine-tongue position 1 to 2) and accompanied with enlargement of tonsil size (in degree 2 to 4) and their sleep breathing disorder could be alleviated through UPPP.

Adult ; Aged ; Body Mass Index ; Contraindications ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery

Poly (ADP-ribose) polymerase-1 (PARP-1) plays as a double edged sword in cerebral ischemia-reperfusion, hinging on its effect on the intracellular energy storage and injury severity, and the prognosis has relationship with intervention timing. During ischemia injury, apoptosis and oncosis are the two main cell death pathway sin the ischemic core. The participation of astrocytes in ischemia-reperfusion induced cell death has triggered more and more attention. Here, we examined the protective effects and intervention timing of the PARP-1 inhibitor PJ34, by using a mixed oxygen-glucose deprivation/reperfusion (OGDR) model of primary rat astrocytes in vitro, which could mimic the ischemia-reperfusion damage in the "ischemic core". Meanwhile, cell death pathways of various PJ34 treated astrocytes were also investigated. Our results showed that PJ34 incubation (10 μmol/L) did not affect release of lactate dehydrogenase (LDH) from astrocytes and cell viability or survival 1 h after OGDR. Interestingly, after 3 or 5 h OGDR, PJ34 significantly reduced LDH release and percentage of PI-positive cells and increased cell viability, and simultaneously increased the caspase-dependent apoptotic rate. The intervention timing study demonstrated that an earlier and longer PJ34 intervention during reperfusion was associated with more apparent protective effects. In conclusion, earlier and longer PJ34 intervention provides remarkable protective effects for astrocytes in the "ischaemic core" mainly by reducing oncosis of the astrocytes, especially following serious OGDR damage.
Animals ; Apoptosis ; Astrocytes ; cytology ; drug effects ; Cell Survival ; Cells, Cultured ; Glucose ; deficiency ; Humans ; Lactate Dehydrogenases ; metabolism ; Male ; Models, Biological ; Oxygen ; metabolism ; Phenanthrenes ; pharmacology ; Poly(ADP-ribose) Polymerase Inhibitors ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects

The development of acupuncture-moxibustion and Tuina in Namibia was introduced in the article. The history of acupuncture in Namibia is only 15 years, and there are 3 acupuncturists and Tuina practitioners with permanent resident permit in Namibia. The University of Namibia has already established a medical college, which is now cooperating with the concerning Chinese medical university of China and carrying out education for the undergraduate students. The development of acupuncture-moxibustion and Tuina has a great potential in Namibia with an extensive indication involving diseases of internal medicine, surgery, gynecology, pediatrics, orthopedics, and neurology.
Acupuncture ; education ; Acupuncture Therapy ; Humans ; Massage ; Namibia

OBJECTIVEThe reporting of patient-reported outcomes (PRO) instrument development is vital for both researchers and clinicians to determine its validity, thus, we propose the Preferred Reporting Items for PRO Instrument Development (PRIPROID) to improve the quality of reports.

METHODSAbiding by the guidance published by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, we had performed 6 steps for items development: identified the need for a guideline, performed a literature review, obtained funding for the guideline initiative, identified participants, conducted a Delphi exercise and generated a list of PRIPROID items for consideration at the face-to-face meeting.

RESULTSTwenty three items subheadings under 7 topics were included: title and structured abstract, rationale, objectives, intention, eligibility criteria, conceptual framework, items generation, response options, scoring, times, administrative modes, burden assessment, properties assessment, statistical methods, participants, main results, and additional analysis, summary of evidence, limitations, clinical attentions, and conclusions, item pools or final form, and funding.

CONCLUSIONSThe PRIPROID contains many elements of the PRO research, and this assists researchers to report their results more accurately and to a certain degree use this instrument to evaluate the quality of the research methods.

Humans ; Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Research Report ; Research Support as Topic ; Treatment Outcome

OBJECTIVETo observe the expressions of human beta-defensin 1 and 2 (hBD-1 and hBD-2) in nasal mucosa before and after the endoscopic sinus surgery and investigate the effects of hBD-1 and hBD-2 on the healing process after the surgery.

METHODSThe patients undergoing endoscopic sinus surgery for chronic sinusitis were divided into 3 groups according to the response to the surgery, namely cured group, response group and non-response group. With those from healthy control subjects as the control, nasal mucosa samples were collected from the patients at 1 week, 2 weeks, 1 month, 3 months and 6 months after the surgery for detection of hBD-1 and hBD-2 mRNA and protein expressions by RT-PCR and Western blotting.

RESULTShBD-1 and hBD-2 were expressed in both normal and chronic sinusitis mucosa, but the expression levels varied significantly between the individuals. The expression levels of hBD-2 was significantly correlated to the patients' response to the surgical treatment (P<0.05). hBD-1 showed slight differences between the individuals, but was not associated with the patients' prognosis.

CONCLUSIONThe expressions of hBD-2 mRNA and protein are significantly increased in patients with good response to endoscopic sinus surgery for chronic sinusitis, suggesting the value of hBD-2 as an indicator of the patients' prognosis.

Case-Control Studies ; Chronic Disease ; Endoscopy ; Humans ; Nasal Mucosa ; metabolism ; Postoperative Period ; Prognosis ; RNA, Messenger ; genetics ; Sinusitis ; metabolism ; surgery ; beta-Defensins ; metabolism

OBJECTIVEThe purpose of this study was to explore the relationship between originate and breakout and radiofrequency catheter ablation strategy in patients undergoing radiofrequency ablation for premature ventricular contractions originating from the aortic sinus cusp (ASC) using 3-dimensional electro anatomic mapping.

METHODSThis study included 21 consecutive patients (10 male) underwent ablation for frequent PVCs originating from ASC in our hospital between May 2009 and February 2012. Electro anatomic mapping and ablation of right ventricular outflow track (RVOT) and left ventricular outflow track (LVOT) were performed with the 7F 4-mm-tip ablation catheter from right femoral vein and artery. Activation mapping and pacing mapping were performed in all patients.

RESULTSAblation was successful in all 21 patients successful ablation target in left coronary sinus cusp (LCC, n = 17), in right coronary sinus cusp (RCC, n = 2) and in noncoronary sinus cusp (NCC, n = 2). Seven patients showed a RBBB morphology (group A) and 14 patients showed a LBBB morphology (group B). In group A, earliest ventricular activation (EVA) was recorded 22 - 34 (27.4 ± 4.6) ms earlier before QRS at the site of catheter ablation in ASC. In group B, EVA was later in RVOT than that in ASC in 5 patients and EVA at the site of catheter ablation in RVOT and ASC was 22 - 28 (25.2 ± 2.7) ms and 26 - 40 (32.8 ± 5.2) ms, respectively (t = -3.6, P = 0.024) while EVA was earlier in the remaining 9 patients and EVA recorded in RVOT and ASC was 22 - 38 (28.7 ± 5.9) ms and 18 - 28 (22.7 ± 3.6) ms, respectively (t = 3.8, P = 0.005).

CONCLUSIONPatients with premature ventricular contractions originating from the ASC often show preferential conduction to the RVOT, which may explain the LBBB morphology of ECG in these patients.

Adult ; Aged ; Bundle-Branch Block ; etiology ; pathology ; physiopathology ; Catheter Ablation ; methods ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Sinus of Valsalva ; physiopathology ; Ventricular Premature Complexes ; complications ; pathology ; physiopathology ; Young Adult