Humans ; Minimally Invasive Surgical Procedures ; Neurosurgery ; methods

Biomarkers ; blood ; Child ; Child, Preschool ; Critical Illness ; Early Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gastrointestinal Diseases ; blood ; diagnosis ; etiology ; Humans ; Infant ; Male ; Peptides ; blood ; Severity of Illness Index ; Trefoil Factor-2

Aged ; Case-Control Studies ; Cerebral Infarction ; blood ; genetics ; Female ; Fibrinogen ; genetics ; metabolism ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic

Objective To identify the outcome of pregnancy and the alteration of renal function in women with nephrotic syndrome. Methods From 2003 to 2007, 59 pregnant women with nephrotic syndrome in our hospital were enrolled in the study. Their clinical data were retrospectively analyzed, including the time of kidney disease onset, 24-hour proteinuria, serum albumin, serum creatinine, blood uric acid, blood pressure, fetal survival, fetal mortality, rate of premature delivery, birth weight of the newborn, and proteinuria, renal function, blood pressure of the patients during their postpartum follow-up. Logistic regression analysis was used to identify the risk factors influencing the outcome of the patients and the newborns. Results The average gestational week was (20.35±9.40) weeks when proteinuria was detected in these pregnant women. The 24-hour proteinuria ranged from 3.5 to 15 g/24 h (median 5.1 g/24 h). The serum albumin was between 10 and 28 g/L (median 22.5 g/L). The serum creatinine was between 32 and 825 μmol/L (median 84 μmol/L) and the serum uric acid ranged from 196 to 793 μmol/L (median 385.5 μmol/L). Pregnancy-induced hypertension syndrome occurred in 75% of the patients, among whom 55.5% suffered from preeclampsia. Forty-three (72.9%) newborns survived , among whom 76.7% (33/43) were premature births and 62.8% (27/43) were low birth weight infants. 50% of the pregnant women still had nephrotic syndrome after delivery. 75% of 24 patients with pre-existing chronic glomerulonephritis had increased proteinuria during pregnancy. Among the 38 patients with renal insufficiency, 36.8% had poorer renal function after delivery. 23.7% of the patients progressed into end stage renal failure after delivery, 80% of whom had serum creatinine ≥ 265 μmol/L. 89% of the patients had persistent hypertension after childbirth. The Logistic regression analysis indicated hyperuricemia during pregnancy (P=0.018, OR=1.012) and the increase of serum creatinine (P=0.039, OR=1.005) were risk factors of renal failure in pregnant women after delivery. Hyperuricemia (P=0.012, OR=1.006)was the risk factor of fetal death. Conclusions Pregnancy with nephrotic syndrome leads to a low fetal survival. Hyperuricemia is the most important risk factor of the poor outcome of pregnant women and newborn.

Background Research demonstrated that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid GluR2 (AMPA-GluR2) is associated with amblyopia.It has been shown that levodopa and cytidine diphosphate choline can improve visual function of amblyopic children,but the mechanism is unclear.Objective This study was to explore the possible effects of levodopa and cytidine diphosphate choline on amblyopia.Methods Monocular deprivation (MD) animal models were created in 60 2-week-old SD rats by monolateral eyelid suturing and observed for 31 days and reared in natural light together with 15 other matched normal healthy SD rats.The models were randomly divided into the MD group,levodopa group,cytidine diphosphate choline group and normal saline control group,with 15 rats for each group.40 mg/kg of levodopa,80 mg/kg of cytidine diphosphate choline,I ml normal saline were given to the rats,respectively,for 28 consecutive days.Expressions of the AMPA-CluR2 protein and AMPA-CluR2 mRNA in the rat visual cortex were detected by immunohistochemistry,Western blot and real-time fluorescence quantitative PCR.Use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression values of the AMPA-GluR2 protein (AMPA-GluR2/β-actin) and AMPA-GluR2 mRNA (2-△△Ct) were significantly lower in the MD group than those of the normal control group (protein:0.32 ± 0.02 vs.0.64 ± 0.05,t =13.287,P＜0.05 ;mRNA:0.30±0.01 vs.0.84±0.03,t=38.184,P＜0.05).Those in the levodopa group were significantly increased in comparison with the normal saline solution group (protein:0.59 ±0.04 vs.0.33 ±0.03,t =11.628,P＜0.05 ; mRNA:0.71±0.06 vs.0.33 ±0.02,t =13.435,P＜0.05).The expression values of the AMPA-GluR2 protein and AMPA-GluR2 mRNA were significantly increased in the cytidine diphosphate choline group compared with the normal saline solution group (protein:0.52 ± 0.04 vs.0.33 ± 0.03,t =8.497,P ＜ 0.05 ; mRNA:0.48± 0.04 vs.0.33 ± 0.02,t =7.500,P＜0.05).Conclusions AMPA-GluR2 is associated with the plasticity of visual development.Levodopa and cytidine diphosphate choline may improve visual function by down-regulating the expression of AMPA-GluR2 in the visual cortex.

Acute Disease ; Anemia, Refractory ; etiology ; therapy ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Female ; Histocompatibility Testing ; Humans ; Leukemia ; complications ; pathology ; therapy ; Male ; Treatment Outcome

Objective To evaluate brush cytology under endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary strictures, and to analyze the factors influencing the diagnosis yield.Methods Brush cytology was applied in 144 patients with suspected malignant biliary strictures at ERCP.Brushing in bile duct was performed for 10 times from 2004 to 2006, while at least 20 times of brushing and repeated manipulation were performed at biliary strictures from 2007 to 2009. Cytological samples were processed immediately after brushing and analyzed by the same pathologist. Efficacy of brush diagnosis was evaluated based on reference to histopathology after surgery and/or clinical diagnostic criteria. Results Malignant stricture was finally diagnosed in 96 patients, and benign diseases in other 48. Brush cytology was positive in 78 of 96 patients with malignant stricture ( sensitivity 81.3% ), and negative in all patients without malignancy ( specificity 100. 0% ). Overall accuracy of diagnosis was 87.5%. Positive rate of malignancy by brush between 2007 and 2009 was 87.7% (50/57), while that between 2004 and 2006 was 71.8%, which were significantly different ( P ＜ 0. 05 ). The positive rate was not correlated with stricture location or tumor type. No major complications occurred, except for 4 moderate acute pancreatitis, 3 cholangiolitis and 2 biliary bleeding. Conclusion Brush cytology is of high sensitivity and specificity for malignant biliary stricture.Repeated brushing and manipulation can facilitate diagnosis yield.

OBJECTIVETo research the effect and route of celastrol on Akt signaling pathway of human leukemia cell line K562 apoptosis.

METHODSThe activities of K562 proliferation cells were detected by MTT assay; cell apoptosis was detected by Hoechst 33258 staining assay, DNA fragmentation assay, and Annexin V/PI double-labeled cytometry; the expression and phosphorylation level of Caspase family members and AKT signaling pathway related proteins were determined by Western blot before and after celastrol treatment, and further the effect of AKT signaling pathway on celastrol-induced-apoptosis was analyzed.

RESULTSK562 cell proliferation was inhibited by celastrol in a time- and dose-dependent manner, with the IC50 value for 24 h of (2.15 +/- 0.11) micromol/L. Celastrol induced K562 cells apoptosis in a dose-dependent manner, apparent DNA fragmentation and typical apoptotic morphological changes, and accompanied Caspase-3, 8 activation in the apoptosis process were shown after cells were treated with 2.0 micromol/L celastrol for 24 h. And the celastrol induced apoptosis could be blocked by 50 micromol/L z-VAD-fmk (caspase inhibitor), but augmented by 25 micromol/L WORT (PI3K-Akt inhibitor). Moreover, Celastrol decreased the expressions of p-Akt, survivin and Bcl-2 in the Akt signaling pathway.

CONCLUSIONSCelastrol inhibited the proliferation of K562 cells and induced cell apoptosis by way of activating caspase cascade. The decreased level of Akt phosphorylation during celastrol-induced-apoptosis process suggested that celastrol acted synergistically with PI3K-Akt inhibitors in K562 cell apoptosis inducing.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Humans ; K562 Cells ; Proto-Oncogene Proteins c-akt ; metabolism ; Signal Transduction ; drug effects ; Triterpenes ; pharmacology

OBJECTIVETo observe the therapeutic effect of Kangyi Zhongyu Decoction (KZD) combined with gonadotropin releasing hormone-a (GnRH-a) on infertile patients with severe endometriosis.

METHODSSeventy-five infertile patients with the diagnosis of endometriosis confirmed by laparoscope who were scheduled to receive in vitro fertilization and embryo transfer (IVF-ET) were randomly assigned to three groups, they were treated respectively with KZD (A), GnRH-a (B) alone and combined of both (C), and IVF-ET were applied in the patients after 3 months of treatment. The clinical efficacy and adverse reactions in the three groups were observed and the changes of serum cancer antigen 125 (CA125) and endometrial antibody (EMAb) levels before and after treatment were tested.

RESULTSScore of dyspareunia in Group A and C was obvioushy lower than that in Group B after treatment (P <0.01). Pregnancy rate in Group C was higher than that in Group A and B (P <0.05), with the adverse reactions less than in Group B (P <0.01). The positive rate of plasma EMAb was reduced obviously after treatment in Group C with the level lower than that in the other two groups (P<0.05).

CONCLUSIONThe combined use of KZD and GnRH-a is a new method in treating infertile patients with severe endometriosis with ideal effectiveness and fewer adverse reactions, and it could advance the successful rate of reproductive assistant technique.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Embryo Transfer ; Endometriosis ; complications ; drug therapy ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Infertility, Female ; drug therapy ; etiology ; Integrative Medicine ; methods ; Phytotherapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the effect of early high-loading-dose tirofiban on platelet activity for patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.

METHODSA total of 120 acute STEMI patients were treated with 300 mg aspirin and 600 mg loading dose clopidogrel and randomized to high-dose tirofiban (25 µg/kg bolus followed by 0.15 µg×kg(-1)×min(-1) infusion for 36 hours, n = 40), standard-dose tirofiban (10 µg/kg bolus followed by 0.15 µg×kg(-1)×min(-1) infusion for 36 hours, n = 40) or control (no tirofiban, n = 40) before angiography. Inhibition of platelet aggregation (IPA) was assessed before angiography, at 10 min and 24 hours after tirofiban infusion, and at 12 and 24 hours after stopping tirofiban infusion by the thrombelastography assay.

RESULTSThere was no significant difference in baseline of IPA between the 3 groups (P > 0.05). IPA was significantly higher in high-dose tirofiban group compared with standard-dose tirofiban and no tirofiban group at 10 minutes after tirofiban infusion [(84.2 ± 12.0)% vs. (67.8 ± 26.8)% and (31.5 ± 21.9)%, all P < 0.01]. At 24 hours after tirofiban infusion, the IPA of high-dose and standard-dose tirofiban was similar [(93.0 ± 9.8)% vs. (88.5 ± 18.1)%, P > 0.05] and was significantly higher than no tirofiban group [(40.4 ± 22.8)%, all P < 0.01]. IPA was similar at 12 and 24 hours after stopping tirofiban use among the 3 groups (all P > 0.05). The maximum amplitude of high-dose tirofiban and standard-dose tirofiban groups at different time points was similar (all P > 0.05), and maximum amplitude in both tirofiban groups was significantly lower than in no tirofiban group at 10 min [(47.2 ± 7.6) mm and (50.0 ± 9.8) mm vs. (57.7 ± 6.5) mm, all P < 0.01] and at 24 hours after stopping tirofiban infusion [(54.6 ± 5.6) mm and (54.3 ± 9.0) mm vs. (59.6 ± 4.0) mm, all P < 0.01].

CONCLUSIONEarly use of high-loading-dose of tirofiban on top of 600 mg loading dose clopidogrel is more efficient on inhibiting platelet activity than standard dose of tirofiban in patients with acute STEMI undergoing primary primary percutaneous coronary intervention.

Aged ; Blood Platelets ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; physiopathology ; Percutaneous Coronary Intervention ; Platelet Activation ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Treatment Outcome ; Tyrosine ; administration & dosage ; analogs & derivatives ; therapeutic use