Humans ; Laryngopharyngeal Reflux ; Sleep Apnea, Obstructive

Objective To construct a novel VP 1 gene vaccine against coxsackievirus B 2 and to evaluate the effect of the cell-mediated immunity induced by it.Methods The immunodominant capsid protein VP 1 gene of CVB 2 was amplified by reverse transcript polymerase chain reaction (RT-PCR) and pcDNA 3-CVB 2VP 1was constructed by molecular cloning.The cytotoxic T lymphocyte (CTL) activity was measured by standard 51Cr-release cytotoxicity assay eight weeks after BALB/c mice were immuned by pcDNA 3-CVB 2VP 1.Results The eukaryotic expression vector was pcDNA 3 and subcloning fragment was CVB 2VP 1.The CTL activity of pcDNA 3-CVB 2VP 1 group was higher than that of the control (P

Objective To investigate possible reasons of different incidence of femoral head necrosis between two populations exposed to corticosteroid: severe acute respiratory syndrome (SARS) and renal allograft transplantation. Methods 67 cases of SARS and 59 cases of renal allograft transplantation were enrolled in the study. The following relevant data were reviewed: cumulative dosage (intravenous methylprednisolone and oral prednisone respectively), maximum single dosage, corticosteroids-exposing days, body weight, weight-load index, and minimum arterial oxygen pressure. MRI of bilateral hips was taken in all the patients. Results The incidence of femoral head necrosis of SARS (23.9%) was significantly higher than the renal allograft transplantation patients (6.8%) (P0.05). There was a very significant difference in minimum arterial oxygen pressure between two groups (P

Objective To investigate the changes in plasma concentrations of IL-6 and IL-10, pHi and the difference between tissue and arterial PCO2 [(P(t-a)CO2 ] during pulmonary surgery and the effects of thoracic epidural anesthesia on cytokine production and gut mucosal perfusion. Methods Twenty ASA class Ⅰ - Ⅱ patients undergoing elective pulmonary surgery, were randomly assigned to be operated upon under general anesthesia (group GA , n = 10) or under general anesthesia combined with thoracic epidural anesthesia (group GEA, n - 10) . Premedication in both groups consisted of pethidine 50mg and scopolamine 0.3 mg im 30 min prior to surgery and oral ranitidine 150 mg the night and 1 h before operation. Anesthesia was induced with fentanyl 2 ug?kg-1 , droperidol 1 mg, propofol 1.5-2.5 mg?kg-1 and succinylcholine 1-2 mg?kg-1 and maintained with inhalation of 1%-2.5% isoflurane and 50% N2O in oxygen and intermittent iv boluses of fentanyl and vecuronium. In GEA group epidural catheter was inserted through the needl placed at T7-8 or T8-9 and advanced cephalad for 2.5-3.0 cm. A loading dose of morphine 2 mg was given followed by epidural infusion of 0.4% ropivacaine at a rate of 6 ml?h-1 during maintenance of anesthesia and the concentration of isoflurance inhaled was reduced to 0.6%-1. 5% . Postoperative analgesia was provided by epidural infusion of 0.25% ropivacaine at 6-8 ml/2h until the morning of the 3rd postoperative day. Blood samples were taken before induction, at incision and 2 h, 4 h and 6 h after the incision and on the 1st and the morning of the 3rd postoperative day for determination of IL-6 ( by radioimmunoassay) and IL-10 (ELISA) . P(t-a)CO2 and pHi were assessed by tonometry before induction, at incision and 1 h, 2 h, 4 h and 6 h after the incision. Results (1) IL-6 and IL-10 increased significantly during operation as compared with the baseline value before induction in both groups and there was no significant difference between the two groups. (2) pHi decreased significantly during operation in both groups and there was no significant difference between the two groups. pHi was negatively correlated with IL-6. (3) P(t-a)CO2 increased significantly during operation in both groups and was negatively correlated with pHi. P(t-a)CO2 was significantly higher in GA group than that in GEA group at 4h after skin incision. Conclusion Pulmonary surgery elicits both pro- and and-inflammatory cytokine response which is not affected by thoracic epidural analgesia. Thoracic surgery leads to gut mucosal hypoperfusion of which P(t-a)CO2 is an indicator. Thoracic epidural anesthesia can improve gut mucosal perfusion. There may be some correlation between cytokine production and gut mucosal hypoperfusion.

Objective To compare the clinical effect of vacuum sealing drainage and traditional methods on open tibial fractures of Gustilo grade-Ⅲ.Methods Seventy-eight patients with open tibial fractures of Gustilo grade-Ⅲ were divided into two groups,43 patients in observation group were treated by vacuum sealing drainage,while 35 patients in control group were treated by traditional methods.The operative quality,postoperative recovery condition,clinical effect and rate of adverse reaction were analyzed between two groups.Results As for the hospital stays,healing time of wound and fracture,the observation group were significant shorter than control group (P＜0.05).The excellent and good rate of observation group was 83.72％,which was significantly higher than that of control group 65.71％ (P ＜0.01).The adverse reaction rate of observation group was 6.98％,which was significantly lower than that of control group 17.14％ (P＜0.05) Conclusions Vacuum sealing drainage used for treatment of open tibial fractures of Gustilo grade-Ⅲ can shorten wound and fracture healing time,reduce the incidence of adverse reaction and improve the clinical effect.It is worth of popularization and application.

Glomus Tumor ; diagnosis ; etiology ; Humans ; Neoplasms, Connective Tissue ; complications ; Osteomalacia

BACKGROUND:Ligamentum flavum hypertrophy is one of the most important factors of lumbar spinal stenosis, but the molecular mechanism is stil not very clear. OBJECTIVE:To explore the role of basic fibroblast growth factor, connective tissue growth factor and transforming growth factor β1 in hypertrophy of the lumbar ligamentum flavum. METHODS: The ligamentum flavum samples were divided into three groups according to different diseases: control group (acquired from the patients with lumbar spinal canal tumor,n=6), lumbar disc herniation (LDH) group (acquired from the patients with LDH,n=6) and lumbar spinal stenosis (LSS) group (acquired from the patients with LSS,n=6). Then the mRNA expressions of basic fibroblast growth factor, connective tissue growth factor, transforming growth factor β1 and colagen I, III, V of the ligamentum flavum were detected using real-time quantitative RT-PCR method. The roles of basic fibroblast growth factor, connective tissue growth factor and transforming growth factor β1 were explored. RESULTS AND CONCLUSION:The expression of basic fibroblast growth factor mRNA in the LSS group was significantly higher than that in the LDH and control groups (bothP < 0.05); the expression of connective tissue growth factor mRNA was not found statisticaly different among the three groups, although it was slightly higher in the LSS group (P> 0.05); the expression of transforming growth factor β1 mRNA was significantly higher in the LSS group than in the LDH and control groups (bothP < 0.01). The colagen I mRNA expressed significantly higher in the LSS group than the LDH and control groups (bothP < 0.05), but both the colagen III and V mRNA showed no significant difference among the three groups (P> 0.05). This study indicate that both basic fibroblast growth factor and transforming growth factor β1 play important roles in the formation process of the lumbar ligamentum flavum hypertrophy, and the main type of the colagen in the hypertrophied ligamentum flavum is colagen I.

Objective To study the relationship between tyrosine phosphorylation(TP)and protein expression of insulin receptor substrate-1(IRS-1)and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods IRS-1 expression and TP in skeleton muscle tissue were determined by Western blot and immunoprecipitation in women with GDM(GDM group,n=22),normal pregnant women(normal pregnancy group,n=22)and normal nonpregnant women(normal nonpregnant group,n=13).Fasting plasma glucose(FPG)and fasting insulin(FINS)were measured by oxidase assay and immunoradioassay. Results(1)The levels of FPG,FINS,and insulin resistance index were calculated according to homeostasis model assessment [ HOMA-IR;(5.6?0.8)mmol/L,(15.4?5.1)mU/L,and 1.2?0.5 ] in GDM group were significantly higher than those in normal pregnancy group [(4.4+0.5)mmol/L,(10.6 ?3.1)mU/L,and 0.8?0.3;P

0.05). Conclusions Bacterial biofilm formation on the surface of the catheter is an important pathogenetic factor,which contributes to the recurrence and antibiotic resistance of urinary tract infection. Shortening the period of catheter dwelling and using closed drainage remain the predominant prevention and treatment of urinary tract infection.

Objective To compare the difference of the microleakage repaired by direct method and indirect method of the funnel shaped root canal in the anterior teeth. Methods A total of 22 middle teeth at the similar size were collected, prepared into funnel root canal after finishing the root filling. The teeth were divided into A and B groups randomly, and there were 11 test pieces in each group. The root canal was repaired by direct method in group A and indirect method in group B. After 500 thermal-cold cycling and 240 000 dynamic cyclic loading,one tooth was selected in each group randomly. The microstructure were observed by scanning electron microscope (SEM). One piece of each group was randomly selected and the image of the core and the dentin was scanned by electron microscope. The remaining 20 pieces were dyed by India ink, dealt with transparent, compared and observed under the microscope. The degree of microleakage was recorded and analyzed in two groups. Results Under electron microscope, a gap can be observed in the bonding interface of group A. The gap was significantly bigger than that of group B. The leakage was significantly serious in group A than that in group B (P<0.05). Conclusion The level of microleakage of anterior teeth with flared canals, which is restored by fiber post core with the indirect method, is significantly better than that with the direct method. The indirect method has a good edge seal action and is more suitable for clinical application.