AIM: To study effect of the Bushen Ningxin decoction, a Chinese medicine, on the adherence of monocytes to endothelial cells and its mechanism. METHODS: Using cultured human umbilical vein endothelial cells (HUVECs) as target cells, oxidized low density lipoprotein (ox-LDL) was added to the endothelial cell culture to prepare the model of human endothelial cell injury. The serum of rabbits having been treated with Bushen Ningxin decoction was added to trial architecture, the adherence of monocyte-like cell line U937 to HUVECs was analyzed using Rose Bengal staining. In addition, the expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1(VCAM-1) and E-selectin in HUVECs was measured by flow cytometry. RESULTS: Treatment of HUVEC with ox-LDL (100 mg/L) for 24 hours significantly increased adhesion of U937 to HUVECs. If serum of the animal treated with Bushen Ningxin decoction was added to trial architecture, the adhesion decreased significantly. The flow cytometry analysis showed that ox-LDL could induce the expression of ICAM-1, VCAM-1 and E-selectin in HUVECs. Serum of the animal treated with Bushen Ningxin decoction significantly decreased the expression of ICAM-1, VCAM-1 and E-selectin in HUVECs. CONCLUSION: The Bushen Ningxin Chinese herb-containing serum has an inhibitory effect on the adherence of monocytes to endothelial cells, probably by way of down-regulating the expression of ICAM-1, VCAM-1 and E -selectin in endothelial cells.

OBJECTIVETo explore the feasibility and safety of radical mediastinal lymphadenectomy in thoracoscopic esophagectomy for esophageal cancer.

METHODSWe retrospectively analyzed the clinical data of a cohort of 147 patients with esophageal cancer who underwent thoracoscopic esophagectomy. Seventy-one patients received traditional lymphadenectomy for the periesophageal and subcarinal lymph nodes (traditional dissection group), while 76 patients received radical lymph node dissection for the bilateral recurrent laryngeal nerve lymphatic chains as well as the periesophageal and subcarinal nodes (radical dissection group). The number of retrieved lymph nodes, incidence of node metastasis, the operation time, estimated blood loss, complications, morbidity and mortality were compared between the two groups.

RESULTSThoracoscopic esophagectomy was completed in all patients with no conversion to thoracotomy. There were no significant differences of operational time and blood loss between the two groups [(89 ± 32) min versus (99 ± 32) min, P = 0.064; (152 ± 108) ml versus (107 ± 82) ml, P = 0.261]. In all patients, the total and average number of retrieved mediastinal nodes were 1644 and 11.2 ± 5.9/case, and the incidence of metastatic lymph nodes was 24.5%. The total and average number of retrieved mediastinal nodes were 999 and 13.6 ± 6.4/case in the radical dissection group, significantly higher than that in the traditional dissection group (645 and 9.1 ± 4.4/case) (P < 0.001). The average number of retrieved nodes and node metastasis rate in the radical dissection group were significantly higher than in the traditional dissection group (13.1 ± 6.4 versus 9.1 ± 4.4, P < 0.001; 35.5% versus 12.7%, P < 0.05). In the total group of 147 cases, the metastasis rates of periesophageal, subcarinal nodes and nodes along the recurrent laryngeal nerve lymphatic chains were 19.7%, 3.4% and 17.1%, respectively. There was thoracic lymph node metastasis in 27 cases with a metastasis rate of 35.5% in the radical dissection group, significantly higher than that in 9 cases and 12.7% in the traditional dissection group (P > 0.001). In the 1644 retrieved thoracic lymph nodes, there were 90 positive metastatic lymph nodes (metastasis ratio 5.5%). Among the 1644 lymph nodes, the metastasis ratio of periesophageal lymph nodes was 6.5%, subcarinal lymph modes 2.4% and the recurrent laryngeal nerve chain lymph nodes 7.5%. Among the 147 cases, complications occurred in 60 cases, with an overall morbidity rate of 40.8%. There were no significant differences of the incidence rates of overall complications, pulmonary complications and recurrent laryngeal nerve injury between the two groups (P > 0.05).

CONCLUSIONThoracoscopic esophagectomy with radical mediastinal lymphadenectomy is technically Safe and feasible.

Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; Male ; Mediastinum ; pathology ; surgery ; Middle Aged ; Retrospective Studies ; Survival Rate ; Thoracoscopy ; methods

Objective:With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques,it is necessary to re-examine the therapeutic strategy for the treat-ment of petroclival meningiomas.To sum up the operative experience and methods in microsurgical resec-tion of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach.To explore the minimally invasive operation approach of petroclival meningiomas,to raise the removal degree and to improve the postoperative result using this approach.Methods:The clinical data of the consecutive 21 patients with the petroclival meningiomas were reviewed retrospectively.The meth-od,degree of tumor resection,techniques of the combining keyhole approach,Karnofsky performance score (KPS)before and after operation were also analyzed.The neuronavigation guided operation was performed in 9 cases,and 12 cases were operated in the neuroelectrophysiological monitoring.Results:Total excision of the tumor resection (Simpson,Ⅰ -Ⅱlevels)was conducted in 18 cases (85.7%,18 /21),and 3 patients underwent close resection (Simpson Ⅲ level,14.3%,3 /21).Postoperative three-dimensional CT showed good lock bone flap restoration;Postoperative pathology confirmed meningioma. Postoperative cranial nerve dysfunction or new original nerve dysfunction were aggravated in 5 cases (23.8%),including transient trochlear nerve (3 cases),abducent nerve (1 case),and the motor branch of trigeminal nerve paralysis (1 case).Abducent nerve paralysis (1 case)appeared,with hearing impairment.After the 3-month follow-up,11 cases had the same KPS aspreoperation,7 cases improved,and 3 cases not improved.The KPS score was 77.14 ±23.12 on average,and there was no statistically significant difference compared with that before operation (P >0.05 ).The postoperative follow-up for half a year showed fluent speaking and writing in 19 cases (KPS 70 or higher),and general recovery in 2 cases (KPS <70).The postoperative follow-up for 3 -29 months showed no tumor recur-rence or progress.Conclusion:The combining trans-subtemporal and suboccipital retrosigmoid keyhole approach is simple,safe,and minimally invasive,and an ideal operation approach of petroclival menin-gioma.To master the operation skills and the intraoperative matters needing attention in the operation,is favorable to improve the resection rate and curative effect.

BACKGROUNDCataracts is considered be formed because of an abnormal glucose metabolic pathway or oxidative stress. We explored the damaging role of ONOO- and antagonism of cholecystokinin octapeptide-8 (CCK-8) in diabetic cataractal rat lenses.

METHODSA diabetic cataractal animal model was established by peritoneal injection of streptozotocine (STZ). Thirty-six normal SD rats were taken as control group; seventy-two were given STZ (45 mg/kg) and then divided into STZ group and CCK-8 group (peritoneal injection CCK-8). STZ induced diabetic rats were treated with CCK-8 for 60 days. Lenses were examined with slit lamp at 20, 40 and 60 days. Immunofluorescent staining and Western blot analysis were used for determining nitrotyrosine (NT, a marker for ONOO-). PT-PCR and gene array analysis were used for determining the expression of inducible nitric oxide synthetase mRNA (iNOS mRNA) in lens epithelium (LEC).

RESULTSSTZ group rats developed lens opacity by 20 days that reached a high level by 60 days after STZ injection. CCK-8 group rats delayed the cataract formation. CCK-8 group rats delayed the cataract formation. There was no distinct expression of NT and iNOS mRNA in control group. In STZ group, there were distinct expression of NT and upregulation of iNOS mRNA; however, CCK-8 group showed weak expression of NT and downregulation of iNOS mRNA.

CONCLUSIONSNT, which may be a new form of oxidative stress, was expressed in diabetic rat LEC although CCK-8 could reverse NT damage in LEC. The results suggested that CCK-8 might be a useful therapeutic agent against diabetic cataract. The antagonizing mechanism of CCK-8 may be related to direct antagonism of ONOO- as well as its inhibition of the expression of iNOS mRNA for production of NO and therefore decrease in the formation of ONOO-.

Animals ; Blotting, Western ; Cataract ; etiology ; prevention & control ; Diabetes Mellitus, Experimental ; complications ; Fluorescent Antibody Technique ; Male ; Nitric Oxide Synthase Type II ; genetics ; Oxidation-Reduction ; Peroxynitrous Acid ; metabolism ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Sincalide ; pharmacology ; Streptozocin ; Tyrosine ; analogs & derivatives ; genetics

OBJECTIVETo explore the relationship between latex allergen and clinical presentation as well as allergenic cross-reactivity between latex and other allergens, to know the incidence of latex allergy in Chinese children and elucidate the allergenic cross-reactivity of latex with other allergens.

METHODSTotally 265 children with allergic disorders were assayed with 13 international standard allergen agents by means of SPT.

RESULTSIn 79 children with latex allergenic SPT position, 53 were boys and 26 were girls with an average age of 5.6 years, and 14 cases had episodes occurred in winter, 14 cases in spring, 24 cases in summer, and 27 cases in autumn. Of them, 66 cases presented as asthma, 5 cases atopic skin disorders, 1 case anaphylactoid purpura, 1 case hives and 6 cases only had mild cough. Statistical analysis showed that the positive percentage of the latex SPT had no obvious relation with sex and age, but was higher in summers and autumns than in winters and springs (P < 0.01). Children with allergic symptoms had higher positive rate in latex allergenic SPT than those without them, that is, the positive percentage of the latex SPT significantly increased among children presenting with some allergic symptoms, such as asthma, hives and atopic skin disorders (P < 0.01). All the children with latex allergenic SPT position had cross-reactivity with acarid allergen, 62.0% approximately 43.0% with animal protein allergens including milk, cats, shrimp, dogs, eggs in the order of decreasing cross-reaction rate, and 10.1% - 3.8% with mold and plant farina allergens. But the cross-reactivity between latex and mold or tree farina I were not statistically significant.

CONCLUSIONThirty percent of the children with allergic disorders were latex allergenic SPT positive. Latex allergenic SPT positive results were significantly correlative to allergic clinical presentation and season, while were not relative to sex and age. The cross-reactivity of latex with acarid was most common, followed by animal protein allergens, while the cross-reactivity with mold and plant farina allergen was rare.

Allergens ; immunology ; Animals ; Asthma ; immunology ; Child ; Child, Preschool ; Cross Reactions ; Female ; Humans ; Infant ; Latex Hypersensitivity ; classification ; diagnosis ; immunology ; Male ; Predictive Value of Tests ; Seasons ; Skin Tests

OBJECTIVETo compare the difference of early postoperative hip abductor strength and function between improved Gibson anterolateral approach (group A) and conventional Gibson posterolateral approach (group B) in patients who had underwent total hip arthroplasty (THA).

METHODSAmong 149 patients performing total hip arthroplasty,130 patients were followed up and were randomly divided into two groups (19 unqualified cases were excluded). Group A included 65 cases who underwent anterolateral approach, and the other group included 65 cases who underwent posterolateral approach. In the group A, male:female = 26:39,with an average age of (72.5 ± 8.3) years old, BMI of (24.7 ± 3.7) kg/m², and hip abductor strength of (1.08 ± 0.49) N · m/kg. In the group B, male:female = 30:35, with an average age of (71.6 ± 7.1) years old, BMI of (25.5 ± 3.9) kg/m², and hip abductor strength of (1.05 ± 0.51) N · m/kg. In the age-related control group, male:female = 33:32, with an average age of (73.1 ± 7.5) years old, BMI of (24.2 ± 3.8) kg/m², and hip abductor strength of (1.17 ± 0.53) N · m/kg. The age, BMI, hip abductor strength, anatomy of surgical approach, hip abduction angles and Harris score in all patients were evaluated at the day before surgery and at 1, 2, 3, 6, and 12 months after surgery. All preoperative clinical data (age, BMI and abductor strength of the uninjured side limb ) of these cases had no significant differences.

RESULTSAt 1, 2, 3, 6, and 12 months after surgery, the hip abductor strength in group A were (0.53 ± 0.13), (0.66 ± 0.21), (0.85 ± 0.15), (0.95 ± 0.19), (1.03 ± 0.13) N · m/kg respectively, while in group B were (0.46 ± 0.14), (0.57 ± 0.18), (0.78 ± 0.12), (0.85 ± 0.18), (0.98 ± 0.14) N · m/ kg respectively.The differences between the two groups at the 6th months after operation were significant; the hip abduction angles in group A were (25.35 ± 4.31)°, (36.53 ± 5.13)°, (48.07 ± 1.62)°, (61.53 ± 1.77)°, (68.62 ± 3.16)°,while in group B were (23.47 ± 2.41)°, (33.42 ± 4.23)°, (46.64 ± 2.51)°, (60.96 ± 1.75)°, (67.47 ± 4.36)°. The differences between the two groups at the 3rd month after operation were significant. Harris score in the group A were 72.23 ± 2.57, 79.36 ± 3.91, 84.75 ± 3.17, 88.63 ± 2.16, 95.21 ± 1.37 repectively ; while in the group B were 71.58 ± 3.62, 78.96 ± 2.21, 83.97 ± 3.57, 87.92 ± 2.94, 94.83 ± 1.62 respectively. There were no significant differences between them.

CONCLUSIONOwing to less muscles interrupted, the THA with improved Gibson anterolateral approach offers a better improvement in earlier hip abductor strength and abduction angle compared with the conventional surgery.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Muscle, Skeletal ; physiology ; Postoperative Period

OBJECTIVETo develop a quantitative method for methylation analysis of the p16 gene based on mismatch hybridization and chemiluminescence.

METHODSGenomic DNA was modified by sodium bisulfite to convert all unmethylated but not methylated cytosines to uracil, and subsequently a pair of primer having no CpG sites was designed for amplification target DNA containing methylated or unmethylated CpG sites. The PCR product spanning CpG sites were hybridized with two oligonucleotide probes which perfectly matched the methylated and unmethylated CpG sequences respectively, and the hybrids were detected by chemiluminescent method. The percentage of methylated target sequences could be estimated by calculating the ratio of signals obtained with two probes.

RESULTSThe percentage of methylation of artificial mixtures DNA showed a linear relation. There was a negative correlation between the methyaltion index with p16 transcriptional mRNA of p16 gene in tumor cell lines.

CONCLUSIONCompared with existing methods, this assay is nonisotopic, rapid, simple, and can be widely applied to the study of DNA methylation.

Cell Line, Tumor ; CpG Islands ; DNA Methylation ; Genes, p16 ; Humans ; Luminescent Measurements ; Nucleic Acid Hybridization ; Promoter Regions, Genetic ; Reverse Transcriptase Polymerase Chain Reaction ; Sulfites

OBJECTIVETo study the effects of Bushen Ningxin recipe (BNR) on atherosclerosis in ovariectomized rabbits.

METHODSTwenty-six female New Zealand white rabbits of three months old were randomly divided into four groups, the normal group, the sham operation group, the control group (ovariectomized) and the treated group (ovariectomized and treated with BNR). All rabbits, except the normal group, were fed with high-cholesterol diet starting from two weeks after operation, and to the treated group BNR was given additionally for 3 months. Levels of blood lipid (TC, TG, LDL-C and HDL-C) and NO were measured at the end of the 12th week, and at the same time, histomorphological and pathological examination of aorta under light microscopy and scanning electron microscopy, and the ratio of atherosclerotic area of lesion/endothelium ratio (AL/AE) and thickness of endothelium/medium ratio (TE/TM) were estimated using image analyzer.

RESULTSNo significant difference was found in levels of blood lipid between groups, except those in the normal group. As compared with the control group, in the treated group, level of serum NO was higher, AL/AE and TE/TM were lower and the pathological changes of aorta was milder.

CONCLUSIONBNR could inhibit the atherosclerosis formation in ovariectomized rabbits, it showed protection on vascular endothelial cells.

Animals ; Arteriosclerosis ; pathology ; prevention & control ; Cholesterol ; blood ; Cholesterol, Dietary ; administration & dosage ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; pharmacology ; Female ; Nitric Oxide ; blood ; Ovariectomy ; Postmenopause ; Rabbits ; Random Allocation ; Triglycerides ; blood

OBJECTIVEThe expression of CD25, CD45RA, CD45RO on umbilical cord blood mononuclear cells (CBMCs) and CD3(+) T lymphocytes was investigated to explore the mechanism of immunosuppressive effects of intravenous immunoglobulin on neonatal immune function.

METHODSUmbilical cord blood mononuclear cells and CD3(+) T lymphocytes isolated from 8 neonates were studied. The expression of CD25, CD45RA, CD45RO on umbilical cord blood mononuclear cells (CBMCs) and CD3(+) T lymphocytes induced with various stimuli of different combinations of IVIG and phytohemagglutinin (PHA) including (1) control group, (2) PHA activation group, (3) IVIG pre-inhibition group, (4) PHA pre-activation group, (5) PHA+IVIG group was measured with four-color immunofluorescence antibodies staining-flow cytometric technique. The results were also compared with peripheral blood mononuclear cells of 8 adults (PBMCs).

RESULTSIVIG inhibited the PHA-induced proliferation of CBMCs as reflected by the decreased expression of CD25 and CD45RO. The amounts of CD25(+) and CD4(+)CD45RO(+) CBMCs reached 77.52% +/- 2.31% and 64.29% +/- 3.09% after PHA use. But a decreased response in CD25(+) (7.66% +/- 1.20% and 7.78% +/- 1.46%) and CD4(+)CD45RO(+) CBMC (3.18% +/- 1.90% and 3.11% +/- 0.08%) was observed when IVIG was added in both IVIG pre-inhibition group and PHA+IVIG group. As compared with PBMCs, IVIG failed to induce the increase of the expression of CD45RA in CBMCs whereas CD45RA(+) PBMCs increased from 54.93% +/- 3.63% to 72.77% +/- 0.39% in IVIG pre-inhibition group. Moreover, IVIG inhibited the expression of CD25 and CD45RO on cord blood CD3(+) T lymphocytes no matter whether they were activated with PHA or not. The amounts of CD25(+) and CD4(+)CD45RO(+) CD3(+) T lymphocytes reached 97.92% +/- 2.19% and 80.41% +/- 5.57% after PHA use. But a decreased response in CD25(+) CBMCs (77.29% +/- 0.63%, 51.48% +/- 1.85% and 62.73% +/- 1.24%) and CD4(+)CD45RO(+) CD3(+) T lymphocytes (35.47% +/- 2.55%, 40.14% +/- 1.16% and 36.41% +/- 2.96%) was observed when IVIG was added in IVIG pre-inhibition group, PHA pre-activation group and PHA+IVIG group, and the degree of inhibition of IVIG on cord blood CD3(+) T lymphocytes was much lower than that of CBMCs.

CONCLUSIONSCord blood T lymphocytes activation was inhibited by IVIG through the inhibition of CD25(+) CBMCs expression and the prevention of transformation from CD4(+)CD45RA(+) cells into CD4(+)CD45RO(+) cells. This IVIG-mediated suppression of activation in cord blood T cells may be derived from the indirect effect of other immune cells or molecules other than the direct effects on T cells. IVIG failed to induce the increase of expression of CD45RA in CBMCs, which may be related to the fact that majority of CBMCs were CD45RA(+) cells, but this may not rule out that the immunosuppressive effect of IVIG could be accomplished by the increase of CD45RA(+) cells in adult peripheral blood mononuclear cells. The suppressive effect of IVIG on CD4(+)CD45RO(+) T lymphocytes may account for its inhibitory effect on immunoglobulin production of neonates' B cells. Considering that naïve CD45RA(+) cells dominate in neonates and IVIG can inhibit transformation from CD4(+)CD45RA(+) cells into CD4(+)CD45RO(+) cells, it is recommended that IVIG should be used properly in neonates, otherwise it may deteriorate their poor immune function especially when it is used for prophylaxis or as a treatment of neonatal non-infectious diseases, and its immunosuppressive action will increase the susceptibility of neonates to infection.

Adult ; CD3 Complex ; biosynthesis ; immunology ; Cell Survival ; drug effects ; Cells, Cultured ; Female ; Fetal Blood ; cytology ; immunology ; Flow Cytometry ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; adverse effects ; immunology ; Immunologic Factors ; adverse effects ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; immunology ; Infant, Newborn ; Injections, Intravenous ; Interleukin-2 Receptor alpha Subunit ; biosynthesis ; immunology ; Leukocyte Common Antigens ; biosynthesis ; immunology ; Leukocytes, Mononuclear ; cytology ; drug effects ; immunology ; Lymphocytes ; cytology ; drug effects ; immunology ; Male

OBJECTIVETo explore the safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma.

METHODSFrom January 2005 to March 2012, 260 patients with esophageal carcinoma received thoracoscopic esophagectomy (TE group), while 322 patients underwent conventional open esophagectomy (OE group). Operative procedures, perioperative complications, reoperation, readmission to intensive care unit (ICU), and perioperative mortality were compared between the two groups.

RESULTSCompared with OE group, TE group possessed less thoracic operative time [(105±30) min vs. (112±41) min, P=0.000], less blood loss [(95±48) ml vs. (107±44) ml, P=0.002], shorter postoperative hospital stay [(14.3±7.5) d vs. (16.9±9.5) d, P=0.000] and more lymph node harvest from thorax [(13.5±5.0) vs. (11.6±4.7), P=0.000]. The total perioperative complication rate was lower in TE group than that of OE group (34.6% vs. 45.0%, P=0.011), as well as perioperative mortality (0.8% vs. 3.4%, P=0.032). Lower rate of readmission to ICU (5.4% vs. 10.6%, P=0.024) was found in the TE group as compared to the OE group, while the reoperation rate was comparable (1.5% vs. 2.5%, P=0.425).

CONCLUSIONThoracoscopic esophagectomy is advantageous than open procedure in terms of surgical safety.

Aged ; Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy ; adverse effects ; methods ; Video-Assisted Surgery