Tripterygium glycosides preparation which extracted from the traditional Chinese herb Tripterygium wilfordii (TWHY), was widely used to treat the autoimmune diseases. Previous works demonstrated that TWHF had potent anti-inflammatory and immunosuppressive properties. But the different quality and high incident rate of side effects of different manufactures inhibited its clinical application. Since TWHF had been generally known to play a therapeutical effect by synergism of multiple constituents, it was necessary to build the relationship between the HPLC fingerprint and bioactivity so as to ensure the quality safety and efficacy. The HPLC fingerprint showed that description and content of peaks from different manufactures were diverse. Only 11 common peaks were found. In this study, mice spleen cells stimulated by Con A were used to test the proliferation inhibition bioactivity of TWHF preparations, which were incubated with 30, 15, 7.5, 3.75, 1.88 and 0.94 mg x L(-1) TWHF preparations for 48 h. The results showed that mice spleen cells proliferation was inhibited by all TWHF preparations significantly compared with the control group, which suggested the TWHF preparations showed immune suppress activity. The TWHF preparations from 7 manufacture showed different IC50 value, which might belong to different contents which showed in the HPLC fingerprint. Moreover, a relationship between the HPLC fingerprint and the bioactivity were established to identify important constituents by grey relational analysis (GRA). The result showed that all the contents were relative with the IC50, especially No. 5 and 10 peaks, but No. 1 peak, which was proved to be triptolide, had few contribute to the inhibition of mice spleen cells proliferation. The study of relationship between the HPLC fingerprint and the IC50 by GRA could help to investigate mechanism of bioactive and provide an evidence for the quantification of multi-constituents.
Animals ; Anti-Inflammatory Agents ; analysis ; pharmacology ; Cell Proliferation ; drug effects ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Glycosides ; analysis ; pharmacology ; Male ; Mice ; Mice, Inbred BALB C ; Spleen ; cytology ; drug effects ; Tripterygium ; chemistry

OBJECTIVETo observe the effect of Shenghua Decoction in reversing IFN-gamma inhibition induced by methotrexate (MTX).

METHODSPregnant Balb/C mice were randomly divided into the negative control group, Shenghua Decoction group, the MTX control group, and the MTX combined with Shenghua Decoction group. Pregnant mice in the 4 groups were respectively treated with normal saline (NS), Shenghua Decoction, MTX, and MTX combined with Shenghua Decoction for 7 successive days. Then mice were sacrificed 1 h after the last administration. Living fetus and dead fetus were counted to assess meto-maternal rejection. The percentages of interferon-gamma+(IFN-gamma+) and CD3+CD+IFN-gamma+ cells in spleen lymphocytes of pregnant mice were double stained for cytometric analysis. At the same time IFN-gamma message ribonucleic acid (mRNA) in the spleen mononuclear cells was detected by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSCompared with the negative control group, the number of dead fetus increased significantly after the administration of Shenghua Decoction (P > 0.05). The percentages of IFN-gamma+ and CD3+CD4+IFN-gamma+ in spleen mononuclear cells were elevated by 28.81% and 35.61% respectively (both P < 0.05). IFN-gamma mRNA expression increased (P < 0.05). After the administration of MTX, the number of dead fetus increased significantly. The percentages of IFN-gamma+ and CD3+CD4+IFN-gamma+ in spleen mononuclear cells were reduced by 24.23% and 26.77% respectively compared with the negative control group. Besides, the expression of IFN-gamma mRNA decreased obviously (P < 0.05). However, after the administration of MTX in combination of Shenghua Decoction, the number of dead fetus was further added. Moreover, the percentages of IFN-gamma+ and CD3+CD4+IFN-gamma+ cells obviously increased. The increment was 64.96% and 71.38% respectively when compared with the MTX group, and the expression of IFN-gamma mRNA was obviously up-regulated (P < 0.05).

CONCLUSIONShenghua Decoction showed reversing effect on MTX induced IFN-gamma inhibition by promoting the differentiation of IFN-gamma+Th1 subpopulation and up-regulating IFN-gamma expression, thus promoting the feto-maternal immunological rejection.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Immunosuppression ; Interferon-gamma ; immunology ; Methotrexate ; pharmacology ; Mice ; Mice, Inbred BALB C ; Pregnancy

AIMTo explore the role of humoral immunity in the pathophysiological process of freezing injury and the possible immune interference in the preventation and treatment of frostbite.

METHODSSevere experimental freezing injury model was made in Wistar rats( n = 20). The concentration of three types of immunoglobulin (IgG, IgA and IgM), two types of complement components (C3 and C4), and circulating immune complex (CIC) were measured respectively before and at 4h, 1d, 3d, and 5d after frostbite. At the same time, the tissue immune complex (TIC) in skeletal muscle and the contents of the red blood cell immune complex (RBC-IC) were also observed and then was the red blood cell immune adherence activity (RCIA).

RESULTSSerum IgG concentration decreased rapidly to the lowest level at 4 h after frostbite IgA concentration dropped to the nadir on 1 day after freezing. Decreases of both immunoglobulins were maintained during the 5 days after frostbite. The fate of both C3 and C4 were the same as those immunoglobulins. Freezing had rather less effect on IgM level. CIC concentration in serum, expressed as the percent of prefreezing increased rapidly and to the zenith on the 3 days post-freezing. By immunofluorescence microscopy, thin continuous linear pattern (IgG) was demonstrated along the SM on the first day post-freezing. Granular and nodular deposits (IgG) appeared along the SM as the time proceeded after frostbite. RBC-IC contents, expressed as the erythrocyte IC rosette rate, increased significantly and to the zenith on the 3 d post-freezing, while RCIA depressed to the nadir at the same time.

CONCLUSIONThe freezing frostbite is an immune complex related disease which have not been reported by others before.

Animals ; Antigen-Antibody Complex ; analysis ; immunology ; Frostbite ; blood ; immunology ; Immunoglobulin A ; immunology ; Immunoglobulin G ; immunology ; Immunoglobulin M ; immunology ; Immunoglobulins ; immunology ; Male ; Rats ; Rats, Wistar

OBJECTIVETo investigate the anatomic variation of nonrecurrent laryngeal nerve (NRLN) and its surgical identification and prevention during thyroidectomy.

METHODSThe database of 5 NRLN cases was analyzed to investigate the difference of operative maneuvers and procedures.

RESULTSAll 5 NRLN were located in the right side. Two cases were found have vocal cord paralysis and 1 case recovered in 3 cases who have NRLN injures.

CONCLUSIONSAny transverse bond should not be cut between vascular and laryngeal except middle thyroid vein. Recurrent laryngeal nerve (RLN) should be dissected during thyroid excision. Cervical pneumogastric nerve should be systematic dissected to detect whether RNLN is exist, if RLN is not exist in the same side.

Adult ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Recurrent Laryngeal Nerve ; anatomy & histology ; Recurrent Laryngeal Nerve Injuries ; Thyroid Diseases ; surgery ; Thyroidectomy ; methods ; Vocal Cord Paralysis ; prevention & control

OBJECTIVETo analyze the problems and complications of posterior discectomy for lumbar disc herniation.

METHODSFrom January 2005 to June 2010, 497 patients with lumbar disc herniation were treated by posterior discectomy, which data were analyzed retrospectively. There were 395 males and 102 females,ranging in age from 20 to 78 years with an average of 43.7 years. Among them, 405 cases were in single gap, 86 cases were in double gaps and 6 cases were in three gaps. The complication of operation and solution was analyzed.

RESULTSThe mean operative time was 70 min (from 45 to 210 min), and the mean hospitalization was 10 d (from 5 to 20 d). Forty-seven cases suffered operative complications. There were 16 cases of wrong location of segments (14 cases occurred in operation and 2 occurred after operation), 15 cases of less alleviation or aggravation of nerve symptoms (12 cases were poor alleviation and 3 cases were aggravation), 10 cases of urinary retention, 5 cases of cerebrospinal fluid leakage and 1 case of infection.

CONCLUSIONMinimally invasive process of posterior discectomy in treating lumbar disc herniation may complicate with many problems. The operative effects can be improved and the complication can be decreased if the ability of location is improved,surgical indications is correct and the operation is exactly performed.

Adult ; Aged ; Diskectomy ; adverse effects ; methods ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; methods ; Retrospective Studies

OBJECTIVETo compare the penetration abilities of resin infiltration into proximal lesions in primary molars with those of adhesive in vitro.

METHODSThirty-two extracted or exfoliated primary molars showing proximal white spot lesions were selected. Roots of the teeth were removed, and the crowns were cut across the white spot lesions perpendicular to the surface. Cut surfaces were examined (by stereo microscopy) and classified with respect to histological lesion extension (C1-C4): lesions confined to the outer half on enamel (C1), lesions confined to the inner half on enamel (C2), lesions confined to the outer half on dentin (C3), lesions extending into the inner half of dentin (C4). Corresponding lesion halves were etched for 120 s with 15% hydrochloric acid gel and were subsequently treated with either adhesive or resin infiltration. Specimens were observed with laser scanning confocal microscope (LSCM) in dual fluorescence mode. In confocal microscopic images, lesion depth and penetration depth of the resin infiltration or the adhesive in corresponding halves were measured, and penetration percentages were calculated respectively. Differences of the data between two groups were analyzed by Wilcoxon signed rank test. Variations of histological caries extensions were detected with Kruskal-Wallis H test.

RESULTSAt the same grading level (C1-C3) in histological caries extension, penetration depths of the resin infiltration group and the adhesive group were 240 (230, 260) µm vs 190 (150, 210) µm, 405 (300, 523) µm vs 180 (160, 200) µm, and 590 (430, 640) µm vs 180 (160, 200) µm respectively. There was significant statistical difference in the data between two groups (P < 0.05). Statistically significant difference in penetration depths of the resin infiltration group (at C1-C3) were found (P < 0.01). At the same grading level (C1-C3) in histological caries extension, percentage penetrations of the resin infiltration group and the adhesive group were [100.0% (96.2%, 100.0%)], [99.1% (95.7%, 100.0%)], [82.0% (81.1%, 92.2%)] and [79.2% (68.4%, 87.5%)], [41.8% (29.1%, 74.5%)], [30.2% (29.2%, 39.6%)], respectively. The difference between the above data was also significant (P < 0.05). Percentage penetrations of the resin infiltration group at C1 and C2 level was higher than those at C3 level (P < 0.05).

CONCLUSIONSThe resin infiltration is capable of penetrating almost completely into proximal lesions in primary molars.

Acid Etching, Dental ; methods ; Composite Resins ; chemistry ; Dental Caries ; pathology ; therapy ; Dental Cements ; chemistry ; Dental Enamel ; pathology ; Dental Enamel Permeability ; Humans ; Hydrochloric Acid ; pharmacology ; Molar ; pathology ; Surface Properties ; Tooth, Deciduous ; pathology

Gastric cancer is one of the common malignant tumors of digestive system in our country.The proportion of patients in advanced and late stage is large,and the choice of perioperative treatment program is always difficult in clinic.For most locally advanced gastric cancer,compared with standard radical surgery combined with postoperative adjuvant chemotherapy,perioperative treatment mode may further improve the survival of patients.However,the efficacy of conventional chemotherapy regimen has reached a plateau,while the progress of traditional molecular targeted therapy is relatively slow.In recent years,with the increasing role of immunotherapy in the treatment of advanced gastric cancer,more and more clinical studies have shown that immunotherapy can also achieve better efficacy in perioperative gastric cancer patients.This article reviewed the research progress of immunotherapy in perioperative gastric cancer in recent years.

OBJECTIVETo analyse the clinical feature and natural course of essential thrombocythemia (ET).

METHODSA retrospective analysis was conducted in ET patients treated in our hospital during May 1980 to December 2006.

RESULTSFour hundred and thirty eight patients (201 males and 237 females with a median age of 48 years) were diagnosed. Hemorrhage occurred in 101 cases (23.1%), thrombosis in 86 cases (19.6%), and both hemorrhage and thrombosis in 13 cases (3.0%). Splenomegaly occurred in 150 cases and hepatomegaly occurred in 60 cases. One hundred and forty-nine cases (34%) had no symptoms at diagnosis and 145 cases (33.1%) confirmed by routine blood tests due to other diseases. The median platelet count at diagnosis was 1000 x 10(9)/L [(533 -3740) x 10(9)/L]. Bone marrow biopsy was performed in 255 cases which showed mainly increase of enlarged mature megakaryocytes with hyper-lobulated nuclei and local proliferation of reticular fiber was revealed in 51 cases. JAK2V617F mutation was detected in 90(78.9%) of 114 patients studied. Karyotype analysis was performed in 180 cases and 6 (3.3%) had clonal chromosomal aberrations. Two hundred and sixty-one patients were followed up over 12 months with a median of 60 months (range from 12 to 300 months). Seventeen cases (6.5%) evolved into marrow fibrosis (MF) and one case into polycythemia vera (PV). One case evolved into PV 6 years and then MF 20 years after diagnosis of ET. Three cases developed acute monocyte leukemia (M5), myelodysplastic syndrome (MDS) and multiple myeloma (MM), respectively.

CONCLUSIONSET is a chronic myeloproliferative disorder characterized predominantly by thrombocytosis and hemorrhage. The percentage of asymptomatic cases is high. The prognoses for most cases were good with a few cases may evolve into MF.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Thrombocythemia, Essential ; genetics ; pathology ; Young Adult

OBJECTIVETo discuss the use of free jejunal flap in reconstruction for circumferential defect after tumor resection of hypopharyngeal and cervical esophageal cancer.

METHODSRetrospective review of 51 patients who underwent circumferential pharyngoesophageal reconstruction with free jejunal flap after tumor ablation.

RESULTSIn 51 patients, 5 had flap failure and the flap success rate was 90% (46/51). Forty-five patients had oral intake after operation excluding one who had anastomosis stenosis and 5 who had flap failure. The 1-year and 3-year survival rate was 62% and 48% respectively. Positive surgical marginal status and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area were indicators for bad prognosis. Except 5 patients who had flap failure, one of which died from mediastinal infection, no other severe complications occurred.

CONCLUSIONSPatients reconstructed with free jejunal flap after resection of hypopharyngeal and cervical esophageal cancer had low mortality and few complications. Those without positive surgical margin and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area had higher survival rate. Most of them had good quality of life. The choice of free jejunal flap for reconstruction of hypopharyngoesophageal defect was appropriate in selected patients who had guarantee of negative surgical margin and no external invasion.

Adult ; Aged ; Esophageal Neoplasms ; mortality ; surgery ; Esophagectomy ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; surgery ; Jejunum ; surgery ; Male ; Middle Aged ; Pharyngectomy ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Survival Rate

OBJECTIVE: To evaluate the surgical technique and clinical effect of arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels. METHODS: From May 2014 to May 2017, 22 patients with posterior root tear of medial meniscus were treated by pullout suture repair via the double tibial tunnels, including 8 males and 14 females, aged 34 to 53 years old, with a mean of averaged(45.7±4.7) years old. The patients were followed up for 12 to 24 months, with a mean of (16.4±5.2) months. RESULTS: The Lysholm score of knee joint before operation was 61.8±4.3, IKDC score before operation was 59.9±2.9, Lysholm score at the latest follow-up was 89.1±3.0, and IKDC score was 89.0±2.5. The difference was statistically significant. CONCLUSIONS Arthroscopic pullout suture repair via the double tibial tunnelsis an effective treatment for symptomatic posterior root tear of medial meniscus, and it can significantly improve the knee functional outcome.
Adult ; Arthroscopy ; Female ; Humans ; Male ; Menisci, Tibial ; Middle Aged ; Suture Techniques ; Sutures ; Tibial Meniscus Injuries ; surgery