Objective To explore the clinical values of the serum homocysteine (Hcy) and platelet aggregation rate in type 2 dia‐betes patient with cerebral infarction .Methods Totally 65 cases of type 2 diabetes patients with cerebral infarction ,55 simple type 2 diabetes patients and 50 cases who took health examination were enrolled in the study .The serum homocysteine and platelet ag‐gregation rate were detected ,the blood pressure ,weight and height of the patients were measured .The multi‐factor Logistic regres‐sion analysis was used to detecting the risk factors in type 2 diabetes patients with cerebral infarction .Results The serum homo‐cysteine level and platelet aggregation rate were significantly higher in diabetes patients with cerebral infarction than those simple diabetes patients or healthy group (P< 0 .05) .The levels of serum homocysteine and platelet aggregation rate were positively corre‐lated with the severity of diabetes patients with cerebral infarction .Conclusion Serum homocysteine and platelet aggregation rate are much higher in type 2 diabetes patients with cerebral infarction ,which indicated that we can predict the process of the cerebro‐vascular disease through detecting the serum homocysteine and platelet aggregation rate .

BACKGROUND: Angiogenesis in atherosclerotic plaque occurred on the basis of atherosclerotic lesions, and the new formed blood vessels promoted the development of angiogenesis. Soluble vascular endothelial growth factor receptor 1 (sFlt-1) gene transfection reduces neointimal formation after vascular injury in rabbits, also reduces early vascular inflammation and proliferation, and the formation of neointima lately.
OBJECTIVE: To observe the effects of highly expressed sFlt-1 on atherosclerotic plaque.
METHODS: A total of 48 male New Zealand rabbits were divided into four groups randomly: normal control group (n=8), sham operation group (n=8), bal oon injury+high lipid diet+pEGFP-N1 group (n=16) and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group (n=16). Normal control group and sham operation group were supplied with normal diet. Bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group were supplied with high lipid diet and injured by bal oon 2 weeks later. Bal oon injury+high lipid diet+pEGFP-N1 group was transfected with pEGFP-N1 and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group was transfected with pEGFP-N1-sFlt-1.
RESULTS AND CONCLUSION: In the bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group, blood lipid levels apparently increased. At 3 days after model establishment, sFlt-1 expression levels noticeably increased, and atherosclerotic plaque formed to different degrees. Plaque area, plaque perimeter, plaque maximum thickness and the number of positive-cel s within the plaque were significantly less in the bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group than in the bal oon injury+high lipid diet+pEGFP-N1 group. These results confirm that sFlt-1 gene may express effectively in iliac artery wal of rabbit, inhibited the formation of atherosclerotic plaque and delayed the development of atherosclerotic plaque.

OBJECTIVETo explore the feasibility and safety on lung resection surgery with the combined method of microinjection acupuncture (MIA) and intravenous anesthesia instead of compound traditional acupuncture and drug anesthesia (ADA).

METHODSNinety cases of lung resection surgery were randomized into a general anesthesia group, a MIA group and a ADA group, 30 cases in each one. In the general anesthesia group, before surgery, the intramuscular injection of atropine 0. 5 mg was used; during surgery, the anesthesia induction was followed with intravenous injection of fentanyl citrate, propofol and rocuronium bromide and the dosage was increased accordingly; after surgery, the analgesia pump was applied. In the MIA group, on the basis of general anesthesia, before anesthesia induction, the acupoint catgut embedding was applied to Jiaji (EX-B 2) of T4 , T6 and T, , Feishui (BL 13), Xinshu (BL 15) and Geshu (BL 17) on the affected side and bilateral Quchi (LI 11) and Zusanli (ST 36); after surgery, the analgesia pump was applied. In the ADA group, on the basis of general anesthesia, before! anesthesia induction, electroacupuncture (EA) was applied to Hegu (LI 4), Neiguan (PC 6) , Houxi (SI 3) and Zhigou (TE 6) for 30 min; during surgery, EA and intravenous medication were combined at the same acupoints as those before surgery; after surgery, moxibustion and the analgesia pump were applied in combination for analgesia. In each group, the biological indices were monitored during surgery at 11 time points named T. (before anesthesia I induction), T1 (intubation in general anesthesia induction), T2 (skin incision), T3 (rib exposure in muscular incision) T. (chest open), T, (lung removal), T6 (drainage tube implantation), T7 (chest closure), T (muscular stitching), T, (skin stitching) and T0 (extubation). The actual dosage of anesthetics during surgery and the, dosage of fentanyl citrate in analgesia pump were quantified after surgery. Results (1) In the MIA group and ADA group, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(1. 23±0. 28) µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1, (1. 1±0. 38µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1 , both P<0. 05]. The increased dosage of propofol and rocuronium bromide was not different during surgery among the groups (all P>0. 05). (2) In the MIA group and ADA group, after surgery, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(11. 0±1. 04)µg/kg vs (15. 4±1. 52µg/kg, (11. 5±1. 38µg/kg vs (15. 4±1. 52µg/kg, both P<0. 05], reducing by 25% in comparison. (3) The differences in heart rate and blood pressure at 11 time points during surgery were not significant among the three groups (all P>0. 05).

CONCLUSIONn The combined method of MIA and intravenous anesthesia significantly reduces the dosage of intravenous anesthetics during and after lung resection surgery as compared with ADA, presenting the similar analgesic effect as simple intravenous medication and the good safety. The combined method of MIA and intravenous anesthesia is much

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Lung ; surgery ; Lung Diseases ; physiopathology ; surgery ; Male ; Microinjections ; Middle Aged ; Propofol ; administration & dosage ; Young Adult

ObjectiveTo investigate the relationship between cytokine gene polymorphisms and long-term humoral response in children vaccinated against hepatitis B during infancy.MethodsA total of 293 children (6.08±0.59 years old) who received three doses of hepatitis B vaccine according to a 0-,1-,6-month schedule during infancy and were negative for HBsAg and/or anti-HBc,were enrolled.Of them,83children with anti-HBs ＜10 mIU/ml were considered as long-term poor responders ( group A),and 210 others with anti-HBs ≥ 10 mIU/ml were defined as long-term responders ( group B).A total of 11 single nucleotide polymorphisms (SNPs) of IL-1β,IL-2,IL-4,IL-10,IL-12B,and IL-13 were detected with PCR-restriction fragment length polymorphism.ResultsThe allele frequencies of -33T,-589T,and 2979T in IL-4 gene in group A were 86.1%,86.1% and 90.4%,respectively,higher than those in group B (76.0%,76.9%,and 83.3%,respectively,all P＜0.05).In IL-4 gene,frequencies of TT genotype at position -33 and -589 in group A were 74.7% and 75.9% respectively,higher than those in group B (57.1% and 59.0% respectively,both P＜0.01 ),while the frequencies of CT at position -33 and -589 in group A was 22.9% and 20.5% respectively,lower than those in group B (37.6% and 35.7% respectively,both P＜0.05).The genotype distributions of IL-4 2979 and the allele or genotype distributions of 8 other SNPs showed no significant differences between group A and group B.ConclusionPolymorphisms at position -33,-589,and 2979 in IL-4 gene are associated with the long-term humoral response in children vaccinated against hepatitis B during infancy.

Objective To investigate whether cesarean section on pregnant women with chronic hepatitis B virus (HBV) infection may reduce mother-to-infant transmission risk of HBV.Methods Preserved serum samples of pregnant women at 15-20 weeks of gestation which were collected from July 2002 to August 2004 in 14 counties of Jiangsu Province were analyzed retrospectively.These samples were tested for HBV serologic markers with enzyme immunoassay,and 419 cases of positive hepatitis B surface antigen (HBsAg) were found.HBV DNA level of these HBsAg-positive women were further quantitatively measured with real-time polymerase chain reaction assay.Children of these 419 HBsAg-positive mothers were followed up during October 2009 to March 2010 and 298 of them were contactable (71.1％),among which 281 were enrolled in final analysis as they had complete information and had been vaccinated with three regular doses of HBV vaccine during infantile period.The 281 children were tested for serum HBV markers.The HBV infection rate in these children at age 5-7 was compared between those born by cesarean setion (CS group,n =136) and by vaginal delivery (VD group,n=145).T-test,x2 test or Fisher's exact test was used to analyze relevant parameters.Results(1) Maternal HBeAg-positive rates [25.7％ (35/136) vs 34.5％ (50/145)],HBV DNA levels in HBeAg-positive women [(2.30 × 106) IU/ml vs (2.09× 106) IU/ml],the percentages of HBIG injection after birth [38.2％ (52/136) vs 35.9％ (52/145)],breastfeeding ratios [82.4％ (112/136) vs 75.9％ (110/145)],and children' s ages at the follow-up [(5.9 ± 0.8) vs (6.0±0.6)] were comparable between CS group and VD group (all P＞0.05).(2) Among these 281 children,272 (96.8％) were HBsAg-negative,9 (3.2％) were HBsAg-positive and 163 (58.0％) were anti-HBs-positive.The prevalence of HBsAg-positive [(2.9％ (4/136) vs 3.4％ (5/145)],HBsAg negative and anti HBc positive [0.0％ (0/136) vs 1.4％ (2/145)] and anti-HBs positive [57.4％(78/136) vs 58.6％(85/145)] in CS group were similar to those in VD group.Conclusions Cesarean section does not reduce the risk of mother-to-infant transmission of HBV.In clinical practice,elective cesarean section should not be suggested in order to prevent HBV vertical infection.

Objective To investigate the knowledge awareness of medical staff in department of Obstetrics and Gynecology,on prevention of mother-to-child transmission of hepatitis B virus(HBV).Methods Medicatl staff,who attended national or local medical conferences of Obstetrics and Gynecology from July 29th to October 25th in 2011,were invited to complete a questionnaire containing questions on clinical implications of HBV serologic markers,relevant prevention measures and including intervention measures for both pregnant women and infants.Data were collected and analyzed by Chi-square test or Fisher's exact test.Results A total of 559 answers were analyzed.Of the 559 staff,85.0％(n=475) were doctors and 15.0％(n=84) were nurses.The percentages ofstaff from primary,secondary and tertiary hospitals were 13.2％(n=74),36.9％(n=206) and 49.9％ (n=279).Overall,90.0％ (503/559) participants agreed that positive hepatitis B surface antigen (HBsAg) was contagious,but 27.5％ (154/559) mistook that the presence of antibody against hepatitis B e antigen (anti-HBc) and/or antibody against hepatitis B core antigens (anti-HBc) with negative HBsAg was contagious.Totally,96.3％ (519/539) respondents knew that pregnant women should be screened for HBV infection,and those from secondary hospitals had more consciousness of HBV screening for pregnant women than those from tertiary hospitals [99.0％ (201/203) vs94.7％(250/264),x2=6.466,P=0.011].Although,95.3％ (511/536) realized that infants of mothers with positive HBsAg should receive hepatitis B immunoglobulin (HBIG) and vaccination,but 61.6％ (330/536) and 80.4％ (427/531) of the enrolled medical staff knew the exact regimen.With the available immunoprophylaxis,13.8％ (74/536) participants mistakenly believed that cesarean section may prevent HBV mother-to-child transmission,and only 13.0％ (69/532) correctly answered that neonates of women with positive HBsAg can be breast-fed.Additionally,54.4％ (290/533) participants mistakenly believed that HBsAg positive pregnant women needed HBIG injection during pregnancy to reduce HBV mother to-child transmission.Conclusions Medical staff in obstetric and gynecological department has essentially mastered the strategies of prevention of mother-to-child transmission of HBV,but much more details should be stressed.

Objective To study the changes of life span and pathology in superoxide dismutase 1 (SOD1)-G93A mice after intracardiac transplantation of human mesenchymal stem cells (hMSCs).Methods hMSCs were isolated from bone marrow cells obtained from healthy donors and cultured.The purity and morphology were assessed by flow cytometry (FCM).hMSCs (3×10~6) resuspended in 0.2 ml DMEM was injected into the heart of 8 week-old SOD1-G93A mice.In non-transplantion control SOD1-G93A mice, only DMEM was injected.The mice were evaluated for signs of motor deficit with 4-point scoring system previously described by Weydt et al.The age of onset and life span in mice were assessed.The pathological change including number of motor neurons was investigated by Nissl staining.Immunofluorescence staining with specific human nuclear antibody was used to confirm the transplant of hMSCs in mice.Results The onset symptoms in untreated SOD1-G93A mice appeared at (156.56±3.60) days of age and the average life span was (188.32±3.51) days.hMSCs transplantation delayed the onset of ALS type symptoms about 16 days (x~2=10.888, P=0.001) and prolonged the life span about 14 days compared to the untreated SOD1-G93A littermates((202.19±4.09) days vs (188.32±3.51) days, x~2=3.917, P=0.04).The loss of motor neurons in untreated mice was earlier and more severe than in hMSCs transplanted mice.At 20 weeks, the number of motor neurons in transplanted mice was significantly higher than those in untreated mice.Human specific nuclear antigen in brain and spinal cord was detected in transplanted SOD1-G93A mice.Conclusion hMSCs can be implanted for a long-term into central nervous system by intracardiac transplantation and the transplantation can prolong life span, and delay the onset of the disease and motor neuron loss in SOD1-G93A mice.

Objective To investigate whether human breast milk may bind to hepatitis B surface antigen (HBsAg) and its characteristics.Methods Breast milk samples from five women with negative HBsAg and hepatitis B surface antibody (anti-HBs) at one to two months post delivery were fractioned into cream and skimmed milk by centrifugation.The human breast milk and each fraction as well as cow and goat milk samples,served as controls,were separately incubated with highly purified yeast recombinant HBsAg,followed by determination of their binding capability to HBsAg by enzyme linked immunosorbent assay (ELISA) and the inhibition rate for binding of HBsAg to anti-HBs by quantitative chemiluminescence microparticle immunoassay.After boiled for 1 min or pasteurized in 65 ℃ for 30 min,the thermal stability of the active components of milk was detected.One-way ANOVA and SNK tests were performed for statistical analysis.Results The operative concentration of HBsAg was 0.1 μg/ml.Breast milk from all five women showed significantly better binding capability to HBsAg than cow or goat milk (1.306±0.300 vs 2.157±0.150 and 2.232±0.093,F=34.303,P＜0.01).The quantitative experiments showed that the inhibition rate of human breast milk was higher than that of the control group [(74.26± 17.26)％ vs (0.00±5.50)％,F=57.806,P＜0.01].The binding ability to HBsAg of skimmed milk was comparable with that of whole milk,indicating milk protein(s) played critical roles in binding to HBsAg (0.877 ± 0.486 vs 0.513 ± 0.069 and 0.376 ± 0.146,F=44.475,P＜0.01).After boiled for 1 min or Pasteurization,the binding ability to HBsAg of whole breast milk remained,but that of skimmed milk went down (F=16.598,P＜0.01).Both whole breast milk and skimmed milk could inhibit the binding of HBsAg to anti-HBs (F=278.341 and 269.408,both P＜0.01).Conclusions The inhibition of binding to HBsAg by human breast milk indicates that human milk may interact with HBsAg.The active components mainly exist in milk proteins and are thermal stable.

Objective To retrospectively review the epidemiological data from 159,242 patients hospitalized after traumatic brain injury in traffic accidents and provide epidemiological evidences for the prevention and treatmentmeasures.Methods Patient data were collected using the Chinese Trauma Database for the years 2001-2007.Epidemiological features of age,gender,time distribution,length of hospital stay,state of injury,and treatment outcome were recorded.Results Age of the patients was (33.01 ± 15.20) years and ratio of male to female patients was 2.39∶ 1.The majority were aged 21-50 years with the 31-40 age group were more vulnerable.Annual average growth of age was 3.92％.Within a year,number of the patients accounted for 54.10％ from July to December with it reached the peak in October.Mean length of stay was 20.20 days with the longest stay in the ≥90 age group and shortest stay in the ≤10 age group.Mean hospital charges was 13 689.8 yuan with the ≤10 age group occupying the least and 51-60 age group occupying the most.Overall cure rate was 66.92％ and mortality was 4.22％.Proportion of severe traumatic brain injury in traffic accidents increased and related cure rate decreased with increased age.Male patients showed higher death rate and lower cure rate compared with female patients.Conclusions Incidence of traffic accidents-related traumatic brain injury is the most in the young and middle-aged population and is prevalent in the second half year.There should be emphasis on the aged or male patients.Measures to prevent and treat the injury may produce better results when defined based upon these epidemiologic features.

Objective: To observe the effect of preoperative effect on peri-operative pain in patients following a thoracotomy. Methods: 120 cases following lung-cancer thoracotomy were randomly allocated into four groups, 30 in each group. Cases in group A and B were treated with acupuncture analgesia 3 d before operation; cases in group A and C were treated with acupuncture analgesia after operation; and cases in group D were treated with general anesthesia. The pain management indexes in four groups were all controlled below 3. After that, analgesia-related β-endorphin and stress-related cortisol were observed before and after operation. In addition, the specific doses of postoperative analgesic-Fentanyl in four groups were compared. Results: The comparison of β-endorphin between group A, C and D showed P<0.05 one day before operation, so did group B, C and D 1 day before operation. The intra-group comparison of cortisol between the day of admission and 1 day after extubation and between 1 day before operation and one day after extubation in group A, B and D showed P<0.05, so did group C between the day of admission and 1 day after extubation. In addition, the contents of Fentanyl in postoperative analgesic pump in four groups showed P<0.05 through one-factor analysis of variance, showing a significant difference. Conclusion: Preemptive analgesia could increase the β-endorphin in patients following a thoracotomy and showed remarkable advantage when compared with the conventional postoperative analgesia. It did not cause significant difference regarding stress index cortisol. Acupuncture has no remarkable advantage when compared with operation and extubation for the major immediate stress. Additionally, postoperative acupuncture could be a substitute for the dose of pain killers and the match can be reduced by 20%.