OBJECTIVE: To investigate the relation between the expression of tPA, MMP-2, MMP-9 and AEG-1 in the human brain tissue and the ethanol concentration under the acute alcohol poison, and to analyze the role of alcohol and trauma in the mechanism of death of subarachnoid hemorrhage. METHODS: Fifteen real cases were collected in this study. The brain tissues were researched by histological examination and the concentration of ethanol in heart blood were detected. The tPA, MMP-2, MMP-9 and AEG-1 in brainstem, brain and cerebellum were observed respectively by immunohistochemistry. RESULTS: In alcohol poisoning groups with or without trauma, the acute alcohol toxicity resulted in the swelling of brain tissues. The tPA, MMP-2, MMP-9 and AEG-1 of brainstem, brain and cerebellum showed high expression in alcohol victims, and the tPA in cerebellum showed no difference. The expression of the MMP-2, MMP-9 and AEG-1 showed good relation with the ethanol concentration in blood (P < 0.05, r > 0.6). CONCLUSION The expressions of tPA, MMP-2, MMP-9 and AEG-1 are significant higher in alcohol victims, and expressions of MMP-2 and MMP-9 and AEG-1 have positive correlation with the alcohol concentration. The alcohol has acute toxicity to brain cells.
Alcohol Drinking/adverse effects* ; Brain ; Cell Adhesion Molecules/metabolism* ; Craniocerebral Trauma/etiology* ; Death ; Ethanol/poisoning* ; Heart/drug effects* ; Humans ; Matrix Metalloproteinase 2/metabolism* ; Matrix Metalloproteinase 9/metabolism* ; Membrane Proteins ; RNA-Binding Proteins ; Subarachnoid Hemorrhage/complications*

To investigate the modulation on the P-glycoprotein in the jejunum by combined use of Glycyrrhiza inflata and Kansui with ussing chamber and rt-pcr, Rhodamine 123 (R123), a P-gp substrate and fluorescein sodium (CF), a model drug of non-P-gp substrate transported by a passive diffusion were taken as investigational drugs. Because these two drugs can be easily assayed and widely used in various research fields. The permeability of R123 or CF via Wistar rat jejunum membranes was evaluated by in vitro ussing chamber after oral administration of four different decoctions of Glycyrrhiza inflata and Kansui for 1 week. And the concentration of R123 or CF was determined by the fluorospectrophotometry in the receiving solution. Meanwhile the expression of mdr1a in P-glycoprotein was detected by real-time fluorescent quantitative PCR. After oral administration of combined decoction of the single drug, the absorptive directed permeability of R123 increased significantly (P < 0.01). On the other hand, Kansui and combine decoction of the two drugs also decrease the permeability of secretory directed transport (P < 0.05). No action of Glycyrrhiza inflata was found on the secretory transport of R123 [Papp = (2.56 +/- 0.38) x 10(-5), cm x s(-1)] across the jejunum tissues, while Papp of control group was found [Papp = (2.35 +/- 0.27) x 10(-5), cm x s(-1)]. After oral administration of Kansui decoction for 1 week and 2 weeks, the levels of mdr1a expression in Wistar rats were lower than that of the control group, but there were no significant difference in the results. Meanwhile, Glycyrrhiza inflata had no effect on transport of CF across the jejunum tissues, though the other three groups could decrease the permeability of CF, as compared with control group. Kansui may slightly inhibit P-glycoprotein function in the intestinal membrane. For another, some compositions in Kansui inhibit P-glycoprotein function, and some others strengthen the tight junction between cells in the intestinal membrane to decrease permeability of CF. As the inhibitory action to P-glycoprotein was enhanced by combination of Glycyrrhiza inflata and Kansui, based on the results, it may be one of the mechanisms of creating toxicity once co-administration of Glycyrrhiza inflata and Kansui.
ATP Binding Cassette Transporter, Sub-Family B ; genetics ; metabolism ; ATP-Binding Cassette, Sub-Family B, Member 1 ; antagonists & inhibitors ; pharmacokinetics ; Administration, Oral ; Animals ; Biological Transport ; drug effects ; Cell Membrane Permeability ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Euphorbia ; chemistry ; Fluorescein ; pharmacokinetics ; Glycyrrhiza ; chemistry ; Intestinal Absorption ; Intestinal Mucosa ; metabolism ; Jejunum ; metabolism ; Male ; Plants, Medicinal ; chemistry ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Rhodamine 123 ; pharmacokinetics

OBJECTIVEThe study aimed to evaluate the efficacy of endoscopic therapy for early postoperative anastomotic hemorrhage.

METHODSFourteen patients experienced an episode of early postoperative anastomotic hemorrhage and were treated endoscopically from January 2005 to June 2010. The clinical data was analyzed retrospectively.

RESULTSFourteen patients(9 males and 5 females, median age 57.5 years, range 26-74 years) were diagnosed with postoperative hemorrhage between 6 hours to 14 days after surgery. The blood loss ranged from 500 to 1500 ml. Sclerosing agent injection, electrocoagulation, and hemoclips were attempted to control the bleeding. Endoscopic approach to control early postoperative anastomotic hemorrhage was successful in all the patients. No recurrent bleeding was observed during the follow-up. No complications associated with endoscopic therapy.

CONCLUSIONEndoscopic approach for the management of early postoperative anastomotic hemorrhage is feasible with high success rate and associated with no complications.

Adult ; Aged ; Female ; Hemostasis, Endoscopic ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage ; surgery ; Retrospective Studies ; Surgical Stomas ; Treatment Outcome

Objective To assess the frequency of different subtype of spinocerebellar ataxias (SCAs) in Chinese Han population. Methods The nueleotide repeat mutations of SCA1, SCA2, SCA3/ MJD, SCA6, SCAT, SCA8, SCA10, SCA12, SCA17 and dentatorubral-pallidoluysian atrophy (DRPLA) were detected by the polymerase chain reaction (PCR), denaturing polyacrylamide gel electrophoresis (PAGE), Southern blot, recombinant DNA technology by T-vector cloning and direct sequencing technique in a cohort of 559 Mainland Chinese patients affected by spinocerebellar ataxia, including 363 families with autosomal dominant SCA (AD-SCA) and 196 sporadic cases. Results Among the 363 AD-SCA families, 15 families (4. 13%) were positive for SCA1, 26 (7. 16%) for SCA2, 187 (51.52%) for SCA3/MJD, 6 (1.65%) for SCA6, 7 (1.93%) for SCA7, 1 (0. 28%) for SCA12 and 1 (0. 28%) positive for SCA17; 120(33. 06%) were negative for all the tested SCAs. There were 2 (1.02%) SCAI, 3 (1.53%) SCA2, 15 (7. 65%) SCA3/MJD, 3 (1.53%) SCA6 and 173 (88.27%) not identified in the 196 sporadic SCA patients. None of the SCA8, SCA10 and DRPLA mutation was found. Conclusions SCA3/MJD is a substantially common subtype of AD-SCAs and sporadic SCA in Chinese Han patients with SCAs, subsequently followed by SCA2, SCA1, SCAT and SCA6; SCA12 and SCA17 are uncommon subtypes, while SCA8, SCA10, and DRPLA are rare, if not absent. SCA17 subtype was initially identified in mailand China. Some other genes might be causative in those unidentified AD-SCA pedigrees, and other etiological factors besides genetic cause might contribute for those sporadic cases.

OBJECTIVEThe goal of study is to explore the cytotoxic activity and its underlying mechanisms of the extract of Spatholobus suberctus in human lung cancer A549 cells.

METHODThe inhibitory effects of the extract on proliferation of human lung cancer cell line A549 was measured by MTT cell viability assay and growth curve. Cell cycle was analyzed using flow cytometry. Apoptotic morphological changes was observed by HE staining technique and AO/PI double-staining confocal laser scanning microscope (CLSM). Employing agarose gel electrophoresis and Annexin V-PI assay, we examed the presence of cytoplasmic histone-associated DNA fragments, and membrane phosphatidylserine (PS) externalization as well as caspase-3 activation.

RESULTThe extract of S. suberctus shows strong cytotoxic power on A549 cells during 24 hours and IC50 is 25.54 mg x L(-1). The cells in S-phase increase while the cells in G0-G1 and G2-M decrease. These changes recovered after 48 hours. The nucleus became pyknosis between 8 to 12 hours and many vacuoles and granules in cytoplasm can be seen. Membrane phosphatidylserine externalization occurs in a dose-dependent and time-dependent manner afer 12 hours. Caspase-3 activity has no more changes in a converse dose-dependent manner. No cytoplasmic histone-associated DNA fragments was detected by agarose gel electrophoresis.

CONCLUSIONThe extract of S. suberctus shows a direct anti-tumor activity. The drug acts quickly and causes S delay in one cell cycle. The main cell death feature appears to be non-apoptotic programmed cell death.

Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Cell Death ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fabaceae ; chemistry ; Flow Cytometry ; Humans ; Lung Neoplasms ; Microscopy, Confocal

OBJECTIVETo observe the efficacy of cardiac resynchronization therapy for patients with refractory congestive heart failure.

METHODSThirty-one patients with refractory congestive heart failure received cardiac resynchronization therapy. Before operation, all patients received standard drug therapy (28 cases) or integrated with CRRT (3 cases). Coronary sinus and its branches were shown by direct angiography with hollow angiographic catheter (11 cases) and by balloon angiographic catheter (20 cases). Left ventricle and right ventricle electrodes were implanted to 3 patients with atrial fibrillation, 4 patients with paroxysmal ventricular tachycardia or ventricular fibrillation received CRT-D implantation. electrocardiogram, 24 hours Holter, echocardiography and physical clinical examinations were made at baseline, 6, 12, 18 and 24 months post resynchronization therapy.

RESULTSPacemakers were successfully implanted in all 31 patients. One patient implanted with CRT-D died of multiple organ failure on third day after operation, 1 patient suffered sudden cardiac death 5 months after therapy and 2 patients were lost to fellow up 6 and 12 months after operation, respectively. Results from the remaining 27 patients showed that QRS duration was significantly decreased (153 +/- 8.4 at baseline vs. 132 +/- 9.8 at 24 months follow up) and cardiac function significantly improved (LVEF 0.29 +/- 0.10 at baseline vs. 0.41 +/- 0.11 at 24 months follow up, P < 0.05 vs. baseline) during follow up compared to baseline. Malignant ventricular arrhythmia occurred in 3 patients with CRT-D and successfully terminated and converted to sinus rhythm.

CONCLUSIONSCardiac resynchronization therapy could improve cardiac function for patients with refractory congestive heart failure. CRT-D can effectively terminate the malignant ventricular arrhythmia.

Aged ; Cardiac Pacing, Artificial ; methods ; Defibrillators, Implantable ; Female ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; Treatment Outcome

OBJECTIVETo compare oncologic outcomes between doublet and triplet adjuvant chemotherapy for gastric cancer patients undergoing radical resection.

METHODSPatients with gastric cancer receiving adjuvant chemotherapy after radical resection from January 2004 to December 2008 were included. Doublet was defined as 5-FU 750 mg/m² (days 1-5) or capecitabine 1000 mg/m² (days 1-14) plus cisplatin 60 mg/m² (day 1) or oxaliplatin 130 mg/m² (day 1), while triplets had epirubicin 50 mg/m² (day 1) added. Chemotherapy was initiated 4-6 weeks after surgery, repeated every three weeks for 6 cycles. Patients were followed-up in the outpatient clinic until death or the most recent follow up(April 30, 2010). Cox proportional- hazard model and Chi-square test were used to test statistical difference.

RESULTSA total of 316 patients (210 received doublets, 106 received triplets) had a median follow-up time of 47 months. Seventy-seven patients died at the end of the follow-up. Two groups were comparable except for age (median age of 57 in doublets, 51 in triplets, P<0.01). The two groups had similar disease-free survival (16 months vs. 23 months, P=0.656) and 3-year overall survival(59.6% vs. 64.8%, P=0.293). There was no significant difference in severe adverse side effects between the two groups (21.9% vs. 30.2%, P=0.107).

CONCLUSIONTriplet adjuvant chemotherapy appears not to be associated with superior efficacy than doublet regimen for patients with gastric cancer after radical resection.

Capecitabine ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Humans ; Male ; Middle Aged ; Postoperative Care ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; drug therapy

OBJECTIVETo evaluate the efficacy and safety of neoadjuvant chemotherapy in patients with locally advanced gastric cancer, and to analyze the relevant factors of recurrent death of gastric cancer after adjuvant chemotherapy.

METHODSClinical data of 49 patients who underwent neoadjuvant chemotherapy for locally advanced gastric cancer between July 2007 and June 2011 were reviewed. Preoperative staging was determined by endoscopic ultrasonography and abdominal computer tomography (CT) or magnetic resonance imaging (MRI). Chemotherapy was administered for regimen of two or three drugs. Prognostic factors were analyzed by univariate and multivariate analysis with Cox proportional hazard model.

RESULTSThe response rate was 33.3% (16/48) and disease control rate was 93.8% (45/48). Forty-four (89.8%, 44/49) patients received curative resection after neoadjuvant chemotherapy, among whom 90.9% (40/44) underwent D2 lymphadenctomy. Thirty-two cases had pathological response and 2 patients had pathological complete response. The average hospital stay was 11.6 days and 2 patients had longer hospitalization because of postoperative pancreatic complications. The toxicities were most in grade 1-2. All the patients were followed up postoperatively and the median follow-up was 21.6 months. Median progression-free survival was 29.6 (95%CI:24.0-35.2) months and median overall survival was 34.6 months (95%CI:29.8-39.4). Imaging response (P=0.038, RR=0.168, 95%CI:0.031-0.904) and pathological response (P=0.007, RR=0.203, 95%CI:0.064-0.642) were identified as independent prognostic factors with COX multivariate analysis.

CONCLUSIONSNeoadjuvant chemotherapy has quite high disease control rate and R0 resecting rate for patients with locally advanced gastric cancer. Imaging response and pathological response are most important prognostic factors in those patients.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; methods ; Preoperative Care ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; surgery ; Treatment Outcome

Objective To investigate the methods and efficacy of microscopic surgical treatment in patients with anterior communicating artery aneurysm. Methods The clinical data of 35 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from January 2008 to January 2011 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed; their surgical techniques and efficacy were concluded. Results All the aneurysms in 35 patients were successfully clipped. Follow-up was performed for 3-6 months: complete recovery was achieved in 19 patients, good recovery in 11, and mild disability in 3 (including 1 with psychiatric symptom); death appeared in 2 patients. Conclusion The microsurgery via pterional approach is an effective method in treating anterior communicating artery aneurysms,resulting from its full exposure of aneurysms and few complications; adequate dissection and exposure of the entire H shaped complex body of anterior communicating artery are the keys to a successful clipping of aneurysm neck; and the selection of aneurysm clip suitable for the aneurysm and the preservation of the perforating arteries should be specially emphasized.

OBJECTIVETo investigate the CAG trinucleotide repeat expansion in spinocerebellar ataxia (SCA) types 1, 2, 3, 6, 7, 12, and 17 from Chinese Han.

METHODSThe pathological CAG triplet repeat expansions of the SCA1, SCA2, SCA3/Machado-Joseph disease (MJD), SCA6, SCA7, SCA12 and SCA17 genes were analyzed in a cohort of 559 Mainland Chinese patients affected by spinocerebellar ataxia, including 363 probands from families with autosomal dominant SCA and 196 sporadic cases. Polymerase chain reaction, agarose gel electrophoresis, recombinant DNA technology by T-vector cloning and direct sequencing were performed to detect the CAG-repeat number of abnormal allele.

RESULTSAmong the 559 SCA patients, twenty-three were positive for SCA1, the ranges of expanded CAG repeats were from 39 to 60 (mean:51.09+/-4.88); thirty-two were positive for SCA2, the ranges of expanded CAG repeats were from 36 to 51 (mean:40.34+/-4.40); three hundred and five were positive for SCA3/MJD, the ranges of expanded CAG repeats were from 49 to 86 (mean:73.84+/-5.07); nine were positive for SCA6, the ranges of expanded CAG repeats were from 23 to 29 (mean:25.56+/-1.94); twenty-seven were positive for SCA7, the ranges of expanded CAG repeats were from 38 to 71(mean:58.22+/-10.90); three were positive for SCA12, the ranges of expanded CAG repeats were from 51 to 52 (mean:51.33+/-0.58); and finally, two were positive for SCA17, the range of expanded CAG repeats were from 53 to 55 (mean:54.00+/-1.41).

CONCLUSIONThe 39 CAG repeats of SCA1, 49 CAG repeats of SCA3 and 51 CAG repeats of SCA12 are all the shortest known causative expanded alleles, while the 86 CAG repeats of SCA3/MJD is the largest full expanded allele that has never been reported. Furthermore, it is the first report of SCA17 subtype in Mainland Chinese and first research that established the abnormal reference standard of CAG repeat number of different subtypes of SCA in Chinese Han.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; genetics ; Ataxin-7 ; Ataxins ; Base Sequence ; Child ; Child, Preschool ; Cohort Studies ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Nerve Tissue Proteins ; genetics ; Protein Phosphatase 2 ; genetics ; Spinocerebellar Ataxias ; ethnology ; genetics ; Trinucleotide Repeat Expansion ; Young Adult