Objective To investigate the relationship between bile amylase (BA) elevation and biliary tract disease in patients with normal pancreaticobiliary junction (NPBJ). Methods The bile juice was collected from bile duct in 202 consecutive cases who underwent therapeutic endoscopic retragrade cholangiopancreatography (ERCP) for biliary diseases ( biliary bile group), and from gallbladder (GB) in 73 consecutive cases who underwent percutaneous transbepatic cholecystoscopy for extraction of GB stone ( GB bile group). In biliary bile group, in addition to the measurement of BA, the level of lipnse (n =68), bacteria culture ( n = 149 ), manometry of Oddi's sphincter ( n = 27 ) and bile duct ( n = 38) were also performed. In GB bile group, additional GB biopsy was taken in 31 cases. No patient with pancreaticobiliary maljunction, history of cholangiojejunostomy or post-endoscopic sphincterotomy was included in the study. Results In biliary bile group, BA level was elevated in 95 patients (47. 0% ), in which there was no significant difference between neoplastic and non-neoplastic cases ( 56. 9% vs. 43.7%, P > 0. 05 ), although BA was elevated in most patients with hiler cholangiocarcinoma (7/9). The level of BA was correlated with bile lipase (r =0. 561 ), but not with pressure of Oddi's sphincter or bile duct. No significant difference in positive rate of bile bacteria culture was detected between patients with normal BA level and those with elevated level. In GB bile group, BA level was elevated in 25 patients (34. 3% ), in which the frequency of GB epithelium dysplasia is 87.5%, which was significantly higher than that from patients with normal BA level ( P < 0. 001 ). Conclusion The patients with biliary tract disease and NPBJ have high incidence of reflux of pancreatic juice into bile duct. In patients with elevated BA level, there was no significant difference between incidences of neoplastic or non-neoplastic disease, while the frequency of GB epithelium dysplasia and hilar cholangiocarcinoma were higher than those from patients with normal BA level.

Aged ; Angina Pectoris, Variant ; physiopathology ; Coronary Vasospasm ; physiopathology ; Coronary Vessels ; physiopathology ; Humans ; Male

Adult ; Aged ; Aged, 80 and over ; Bile Duct Diseases ; diagnosis ; Bile Duct Neoplasms ; diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; Cytodiagnosis ; Cytological Techniques ; methods ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases ; diagnosis ; Pancreatic Neoplasms ; diagnosis

Objective To identify the configuration of the fascial sheath of the sciatic nerve in the adult pelvis . Methods A total of 14 cadaveric pelvic specimens and 20 living subjects were used for cadaveric examination and magnetic resonance imaging ( MRI) observation , respectively .The cadaveric specimens were investigated by the local latex injection method ( n =10 ) sectional anatomy ( n=2 ) or histological staining methods ( n =2 ) .The MR images were collected and analyzed from twenty patients without pelvic disorders .Results The injected latex did not diffuse along the pelvic segment of the sciatic nerve .Sectional anatomical and histological data showed that the architecture of the fascial sheath of the sciatic nerve varied at different levels .An intact circular sheath around the nerve was rarely observed .There was no fascia barrier between the obturator and sciatic nerves .Appearance on MRI was consistent with the cadaveric observation.Conclusion No intact fascial sheath exists along the pelvic segment of the sciatic nerve , thus sciatic anesthesia may block the obturator nerve .

OBJECTIVETo express and purify the protein coded by the TRAF-type zinc finger domain of myasthenia gravis (MG)-related gene P9 (P9-ZFD) and to prepare P9-ZFD antiserum for detecting expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of patient with MG.

METHODSThe cDNA encoding P9-ZFD was amplified by RT-PCR. The cloned P9-ZFD cDNA was ligated into pET24a, and the P9-ZFD recombinant protein was induced via E. coli. BL21 (DE3) and purified by histidine affinity chromatography. P9-ZFD antiserum was prepared and its titer and specificity were determined by ELISA and Western blot. Expression and subcellular distribution of P9-ZFD protein in the skeletal muscles of MG and control were studied.

RESULTSThe molecular weight of purified P9-ZFD protein was about 30 kD. Its purity was more than 95%. Antiserum specific for P9-ZFD was excellent. P9-ZFD protein is fully confined to the cytoplasm membrane of skeletal muscle cell of MG, obvious immunostaining was absent in the A, I, and Z bands of cytoplasm and no immunoreactivity was observed in the skeletal muscle cell of control.

CONCLUSIONP9-ZFD protein is expressed as a cytoplasm membrane-bound protein and has obvious distribution difference in the skeletal muscle cells of patient with MG and normal control.

Adult ; Cell Membrane ; metabolism ; Escherichia coli ; metabolism ; Female ; Humans ; Muscle Proteins ; biosynthesis ; genetics ; Muscle, Skeletal ; metabolism ; pathology ; Myasthenia Gravis ; metabolism ; Peptide Fragments ; biosynthesis ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; Zinc Fingers

OBJECTIVETo explore the effect of Dandi Tablet (DDT), a TCM preparation for tonifying Shen and activating blood circulation, on blood lipids and sex hormones in women of postmenopausal stage.

METHODSSeventy-three women were randomly divided into two groups. The 46 subjects in the DDT group were treated with DDT (consisted of prepared Rehmannia Root 24 g, Dogwood Fruit 9 g, Poria 9 g, Water-plantain 9 g, Tuber Peony bark 9 g, Chinese Yam 12 g and Red Sage 15 g, etc.) twice a day, 4 tablets each time. The 27 subjects in the control group were treated with nylestriol (each tablet contains 2.5 mg of 17 alpha-ethynylestriol-3-cyclopentyl ether) 5 mg every month, for 3 successive months. Levels of blood lipids, including total cholesterol (TC), triglyceride (TG), high and low density lipoprotein cholesterol (HDL-C, LDL-C), apoprotein A and B (apoA, apoB) and sex hormones, including follicular stimulating hormone (FSH) and estradiol (E2) were determined before and after treatment.

RESULTSCompared with pre-treatment, after treatment, levels of TC/HDL-C and FSH significantly lowered, HDL-C and E2 increased in both groups (P < 0.05 or P < 0.01), levels of TG lowered and apoA increased significantly in the DDT group (P < 0.05).

CONCLUSIONDDT has the effect of elevating levels of estrogen and improving blood lipid metabolism, therefore shows a coronary heart disease preventive effect in women of postmenopausal stage.

Adult ; Aged ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Coronary Disease ; prevention & control ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Middle Aged ; Phytotherapy ; Postmenopause ; Tablets ; Triglycerides ; blood

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

BACKGROUND:Deep vein thrombosis after total knee arthroplasty has attracted increasing attention in recent years,but how to detect deep vein thrombosis in the early time in clinical practice remains unclear.Whether it is necessary to perform type-B ultrasonic or other invasive examination in lower limbs has become a hot issue.OBJECTIVE:To explore the significance of D-Dimer and fibrin degradation products in the prediction of deep vein thrombosis after total knee arthroplasty.METHODS:56 patients received total knee arthroplasty were colected from Department of Orthopedics,The 306th Hospital of Chinese PLA,between December 2012 and February 2014.The D-Dimer and fibrin degradation products were dynamicaly monitored before operation and at 1,3,5,7,10 days post-operation.Al the patients received type-B ultrasonic examination in double lower limbs at 10 days post-operation,and divided into thrombus group and non-thrombus group.The D-Dimer and fibrin degradation products in the two groups were compared.RESULTS AND CONCLUSION:Deep vein thrombosis was found in 13 cases by ultrasonic-B postoperation,D-Dimer and fibrin degradation products showed no significant difference between the two groups at 1 week after operation (P＞0.05),but the difference was significant at 10 days (P＜0.01).D-Dimer and fibrin degradation products index should be monitored dynamicaly for at least 10 days after operation,which is helpful for the earlydiagnosis of thrombosis.

Objective To investigate the effects of blockade of OX40/OX40L costimulation pathway on mice islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice.Methods C57BL/6 mice were induced into diabetes mellitus as recipients,and were transplanted with DBA/2 mice islets.The recipients were divided into four groups,(1) treated with IgG as controls,(2) anti-OX40L mAb,(3) anti-CD154,(4) combined treatment of anti-OX40L mAb and anti CD154mAb.The mean survival time (MST) of islet allograft was observed.The expression of OX40 in activated T cells of CD154 deficient mice was detected.Effector T cells were obtained from the spleen of CD154 deficient mice cultured with or without anti-OX40L mAb for 3 days.The proliferation of T cells was assayed.Results The MST in the control group,anti-OX40L mAb group,anti-CD154 mAb group and anti OX40L mAb + anti-CD154 mAb group was 19,22,48,and ＞150 days respectively (P ＜0.05).The OX40 expression was readily induced in the 66％ activated T effector cells.CD154 deficient T effector cells proliferation was inhibited by the addition of anti-OX40L mAb in the culture in a dose-dependent fashion.Conclusion The blockade of OX40/OX40L costimulation pathway can promote islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice by inhibiting the proliferation of T cells.

Objective To extract,isolate and identify the polysaccharide from ginseng,and to investigate its anti-tumor activity in vitro. Methods The ginseng polysaccharide was obtained through water extraction and ethyl alcohol deposition method. Use the Sevage method to remove the protein in the crude polysaccharide. The structural characteristics of the polysaccharide were determined by FT-IR spectra.The RM-1 and HeLa cells were divided into control group and different concentrations (0,50,100,200,300,400 and 500 mg·L-1 )of ginseng polysaccharide groups. The survival rates of the cells in various groups were detected by MTT method. The indirect killing effects of ginseng polysaccharide with different concentrations (0,50,100,200,300,400 and 500 mg·L-1 )on the cancer cells were determined by CTL test. Results The extraction rate of ginseng polysaccharide was 8.7 6% and the structural characteristics demonstrated that the main component of the extract was polysaccharide.The result of MTT showed that there were no significant differences of the survival rates of RM-1 and HeLa cells between different concentrations of ginseng polysaccharide groups after treated for 24 h compared with control group (P>0.05).The result of CTL test showed that the cytototic LHD release rates in different concentrations of ginseng polysaccharide groups were increased significantly (P<0.05)compared with control group;with the increase of ginseng polysaccharide concentration, the cytotoxic LDH release rates were increased firstly and then were decreased.When the concentration of ginseng polysaccharide was 100 mg·L-1 ,the cytotoxic LDH release rate was the biggest.Conclusion Ginseng polysaccharide can indirectly inhibit the growth of the tumor cells by activating T cells and play an anti-tumor effect.