Adult ; Cauda Equina ; injuries ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; complications ; physiopathology ; surgery ; Lumbar Vertebrae ; pathology ; surgery ; Male ; Middle Aged ; Recovery of Function

Shanghai University of TCM was the first Chinese medicine university that established field-grade experimental teaching center in China.And both of the Chinese medicine and Chinese herbs experimental teaching centers became national experimental teaching demonstration centers.There is general improvement in laboratories conditions,so the experimental teaching team building is the critical factor of improving experimental teaching quality.The experimental teaching team of Shanghai University of TCM consists of excellent teachers as its backbone,and lecturers and technicians from fields in traditional Chinese medicine Chinese herbs and clinical practices.The team members cooperate with each other by setting up experimental teaching research groups to improve teaching quality,which plays an important role in building experimental teaching demonstration center.

OBJECTIVETo explore the correlationship between platelet count and efficacy of traditional Chinese medicine (TCM) or Western medicine (WM) in treating rheumatoid arthritis (RA) patients.

METHODSA total of 356 patients with confirmed diagnosis of active RA from 9 clinical centers were randomly assigned to the TCM group (184 cases) and the WM group (172 cases). The TCM group was treated with basic therapy (administration of glucosidorum tripterygll totorum and Yishen Juanbi Pill) and TCM syndrome differentiation dependent treatment, while the WM group was treated with non-steroidal anti-inflammatory drugs and slow-acting anti-rheumatic drugs. The therapeutic efficacy was assessed with ACR20, the joint damage degree of both hands was evaluated by X-ray.

RESULTSThe platelet count was positively correlated to the X- ray grading of joint damage, namely, patients with a more severe joint damage often presented a higher platelet count. After treatment, in patients with joint damage of X-ray grade II or III and effectively treated with TCM, also in patients with joint damage of grade III and effectively treated with WM, the platelet count was lower than that in those treated ineffectively.

CONCLUSIONPlatelet count is closely correlated to the efficacy of drug therapy, therefore, it may be taken as an important index for judging the curative effect of therapeutic approach in treating RA patients.

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; blood ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Platelet Count ; Treatment Outcome ; Tripterygium ; chemistry

OBJECTIVETo explore the correlations between diagnostic information and therapeutic efficacy in rheumatoid arthritis (RA) with decision tree model analysis.

METHODSThree hundred and ninety seven patients came from 9 clinical centers were randomly divided into the Western medicine (WM) group (n=194) treated with non-steroidal anti-inflammatory drugs and slow-acting antirheumatic drug and the Chinese medicine (CM) group (n=203) with basic therapy and syndrome-differentiation dependant TCM treatment. TCM and WM diagnostic information were collected. The ACR 20 was used for efficacy evaluation and the information of patients before treatment was analyzed by SAS 8.2 statistical package. Through single-factor exploratory analysis, odds ratio of efficacy and variable was calculated taken P < 0.2 as the including criteria for data mining analysis with decision tree model. All data were classified into the training set (75%) and verifying set (25%) with efficacy as the variable for layering to make further verification of the data-mining analysis.

RESULTSTwenty variables were included in the CM group and 26 in the WM group in the data-mining model. In the former, 9 variables were positively correlated to the efficacy, including degree of arthralgia, tenderness and morning stiffness, number of swollen joint, and joint with tenderness, levels of IgM, rheumatoid factor (RF), C-reactive protein (CRP), and total assessment from doctor; and disease duration and degree of nocturnal polyuria were negatively correlated to that. While in the latter, 8 were positively correlated to the efficacy, including erythrocyte sedimentation rate (ESR), sour and weak waist and knees, white fur in tongue, joint ache and stiffness, swollen joint, and total assessment from doctor and patient, and red tongue with yellow fur and leucocyte count negatively correlated to it. Data mining with decision tree analysis revealed that different combinations of morning stiffness, slight red tongue, joint tenderness and nocturnal polyuria in the CM group, and those of white fur in tongue, CRP level, leucocyte count and morning stiffness in the WM group showed different efficacy, which were also verified in the randomly chosen verifying set.

CONCLUSIONTo analyze the correlations between diagnostic information and therapeutic efficacy with decision tree analysis is conformed to the theory of TCM in applying treatment according to syndrome differentiation individually, thus it would contribute to elevate the accuracy of therapy.

Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; diagnosis ; drug therapy ; Decision Trees ; Diterpenes ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Epoxy Compounds ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phenanthrenes ; therapeutic use ; Phytotherapy ; Treatment Outcome

OBJECTIVETo analyze the symptomatic factors of rheumatoid arthritis (RA), and to explore the correlations between these factors and the efficacy of TCM herbal and western medicinal therapies.

METHODSFour hundred and thirteen patients with confirmed diagnosis as active RA came from 9 clinical centers were randomly divided into the Western medicine (WM) treated group (n=204) and the traditional herbal medicine (CM) treated group (n=209). The scheme of WM therapy included administration of voltaren extended action tablet, methotrexate and sulfasalazine. That of CM therapy included basic treatment and medication by syndrome differentiation. Eighteen items of often seen symptoms of the patients were collected before and after treatment. The therapeutic effect was evaluated by the American College of Rheumatology 20% improvement (ACR 20) and all data were analyzed using SAS 8.2 statistical software package. The category of symptoms was analyzed by factor analysis. The correlation of changes of various common factors with the therapeutic efficacy were analyzed by one-way ANOVA test.

RESULTSFour common factors were obtained from the 18 items of symptoms, which could better reflect respectively the local status of arthritis, and symptoms of Cold-syndrome, Asthenia-syndrome and Heat-syndrome in traditional Chinese medicine (TCM). Both CM and WM therapies showed consistent effect on the common factors that reflects the state of RA, but CM therapy showed superior effect on the common factors to improve Asthenia-syndrome to that of WM therapy.

CONCLUSIONFactor analysis could be used to categorize and study the important factor symptoms in the syndrome differentiation of TCM, and the results of factor analysis were in accord with the category of TCM syndrome differentiation. The exploration on the correlation of common factor and therapeutic efficacy could better exhibit the characteristics of TCM efficacy.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Methotrexate ; therapeutic use ; Middle Aged ; Phytotherapy ; Sulfasalazine ; therapeutic use

OBJECTIVETo analyse the cartilage erosion related blood biochemical and immune factors in rheumatoid arthritis (RA) and to explore the special influences of Chinese medicine (CM) and Western medicine (WM) on these factors.

METHODSThree hundred and ninety-seven patients, with confirmed diagnosis of active RA, were randomly assigned to the WM group (194 patients) and the CM group (203 patients). The WM applied covered non-steroid anti-inflammatory agents and slow acting medicine; and the CM given included basic remedy and syndrome differentiating medication. Related blood biochemical and immunological indexes were determined before and after treatment to screen out the cartilage erosion related factors and to compare the influence of CM and WM on them.

RESULTSPatients' peripheral red blood cell (RBC) and platelet (PLT) count were changed closely along with their degree of cartilage erosion. RBC count increased in the CM group and PLT count lowered in the WM group after treatment, all showed statistical significance; comparison of the two indexes between the two groups showed that statistical difference presented in RBC but not in PLT count.

CONCLUSIONBoth WM and CM can ameliorate the cartilage erosive factor in RA, but they are acting in different ways.

Adult ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; blood ; drug therapy ; Cartilage, Articular ; drug effects ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Erythrocyte Count ; Female ; Humans ; Male ; Methotrexate ; therapeutic use ; Middle Aged ; Phytotherapy ; Platelet Count ; Prednisone ; therapeutic use ; Young Adult

Objective To explore the surgical effect to traumatic tentorial herniation with bilater- al mydriasis.Methods The patients were divided into three groups,ie,epidural hematoma group,a- cute diffuse brain swelling group and cerebral contusion and/or subdural hematoma group,to perform clinical outcome analysis.Half year after operation,the neurological outcome was scored according to the Glasgow Outcome Scale.Results Of all,there were three cases with good recovery,10 with moderate disability,nine with severe disability and 10 with vegetative survival but 35 deaths.The outcome was the best in epidural hemotoma group but the poorest in acute diffuse brain swelling group.Conclusions The operative effect of traumatic cerebral herniation with bilateral mydriasis is related with the type of orig- inal injury that is important for selection of operation.Patients with cerebral herniation caused by epidural hematoma should receive immediate operation that will induce better outcome.The operation is not vital for those with cerebral herniation caused by acute diffuse brain swelling.Emergent surgery can save lives of some patients with cerebral contusion and/or subdural hematoma.Rapid diagnosis,correct operation and perioperative treatment may ensure the success of surgery.

OBJECTIVETo explore the duration of enterovirus (EV) nucleotides positive in feces samples of hand-foot-mouth disease (HFMD) patients after recovery.

METHODSA consecutive 6-week follow up were carried out towards 49 cases of laboratory-diagnosed HFMD patients. A total of 5 - 8 g feces sample was collected from each patient once a week. The common EV nucleotides of HFMD were detected by RT-PCR method and analyzed by Kaplan-Meier Survival Analysis Method.

RESULTSThe subtypes of the 49 HFMD patients included 16 enterovirus 71 (EV71), 15 coxsackievirus A16 (CoxA16) and 18 EV; a six-week follow up was carried out among all of them. In the first week, one EV71 patient and two EV patients were lost; in the fourth week, one CoxA16 were lost; and in the fifth week, one EV71 patient was lost. During the consecutive 6-week follow-up, the positive rates of EV nucleotides among EV71 patients were 81.3%, 60.9%, 47.4%, 33.9%, 27.1% and 18.1% separately; and the positive rates in CoxA16 group were 93.3%, 73.3%, 53.3%, 33.3%, 16.7% and 8.3% respectively. In EV group, the positive rates of EV nucleotides were 44.4% and 7.4% in the first two weeks and then turned to negative in the next 4 weeks. There was significant statistical difference in positive rates of EV nucleotides among different patients (χ(2) = 11.78, P = 0.001); however, each group of HFMD patients showed a declined trend with the extension of time.

CONCLUSIONThe duration of EV nucleotides positive in feces samples of HFMD patients lasted for a long period since their recovery; and the positive results in EV71 and CoxA16 patients might last for 6 weeks.

Child, Preschool ; Enterovirus ; genetics ; isolation & purification ; Feces ; virology ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; virology ; Humans ; Infant ; Nucleotides ; isolation & purification

OBJECTIVEHuman selenoprotein P (HSelP) is unique protein that contains 10 selenocysteines encoded by 10 inframe UGA, which typically function as stop codon. The function of HSelP remains unclear, in part due to the inability to express it by gene recombinant technique. This study is to investigate expression and purification of recombinant HSelP in prokaryotic expression system, and its activity to induce apoptosis in vitro.

METHODSThe shorter HSelP isoform was cloned. After the selenocysteine (SeCys) at 40th position from N terminus of the HSelP shorter isoform was mutated into cysteine by PCR, it was expressed in E. coli. The expressed product was purified with DEAE column and identified by Western blot. Subsequently, its function on induction of mitochondrial apoptotic activity was studied.

RESULTSThe mutant HSelP shorter isoform expressed in prokaryotic system was purified by DEAE column to 90% homogeneity. The purified product, HSelP280m, induced the opening of mitochondrial permeability transition pore (PTP) and decreased the transmembrane potential in a dose-dependent manner. These events could be abolished by PTP specific inhibitors.

CONCLUSIONHSelP280m can induce the opening of mitochondrial PTP, which provides a basis for investigating the structure and function of recombinant HSelP.

Animals ; Apoptosis ; drug effects ; Cloning, Molecular ; Cysteine ; genetics ; Escherichia coli ; metabolism ; Humans ; Ion Channels ; drug effects ; Male ; Membrane Potentials ; drug effects ; Mice ; Mice, Inbred BALB C ; Mitochondria, Liver ; physiology ; Mitochondrial Membrane Transport Proteins ; Mutation ; Protein Isoforms ; Proteins ; genetics ; metabolism ; pharmacology ; Selenium ; Selenocysteine ; genetics ; Selenoprotein P ; Selenoproteins

OBJECTIVETo investigate the genetic abnormalities of fetuses with congenital heart diseases (CHD), and to provide guidance for the management of pregnancy and genetic counseling.

METHODSEighty-one fetuses with CHD detected by fetal echocardiography were analyzed by karyotyping after amniocentesis, cordocentesis or chorionic sampling. Then 22q11.2 deletion/duplication was detected by a competitive fluorescent multiplex short tandem repeat assay in 47 CHD fetuses without chromosomal abnormalities. With fluorescence in situ hybridization (FISH) using LSI dual color DNA probe, the deletion/duplication status was confirmed.

RESULTSThirty-four of 81 CHD fetuses had chromosomal anomalies, and 1 of the 47 CHD fetuses without chromosomal anomalies had duplication at chromosome 22q11. The incidence of aneuploidy associated CHD was 43.2%. The rate of chromosomal anomalies is higher in the cases associated with extra-cardiac anomalies than in that with isolated CHD (64.5% versus 28.0%). In the 35 fetuses with chromosomal abnormalities, 19 (54.3%) were trisomy 18.

CONCLUSIONChromosomal abnormalities occurred in 43.2% of CHD cases and trisomy 18 is the most common aneuploidy. The likelihood of chromosomal anomaly increases when there is extracardiac involvement. Testing for the 22q11.2 microdeletion/duplication is recommended in all CHD fetuses without chromosomal anomalies. It is important for the further management of pregnancy and genetic counseling.

Adult ; Amniocentesis ; methods ; Chromosome Aberrations ; chemically induced ; classification ; Female ; Fetal Development ; genetics ; Gestational Age ; Heart Defects, Congenital ; diagnostic imaging ; genetics ; Humans ; Karyotyping ; Pregnancy ; Trisomy ; physiopathology ; Ultrasonography, Prenatal