Objective To investigate the changes in brain MRI scan in neuromyelitis optica (NMO).Methods MRI images in 27 cases with NMO were examined in a retrospective study.Results Twenty-two of 27 patients (81.5%) had abnormal brain MRI findings,which were classified as nonspecific (7 cases),atypical (1 case),multiple sclerosis-like (3 cases) and ventricle-aqueduct-syringocoele lesions (11 cases).The lust type is the most common (40.7%).Furthermore,the analysis showed that the number of brain lesions positively correlated with lag time from the onset to the last MRI scan (r=0.475,P=0.025).Conclusions Brain lesions in NMO are diverse,which might result from different pathogenesis.However,ventricle-aqueduct-syringocoele is the most common lesion.Early brain MRI examination of suspected cases is essential.

A new HPLC-UV technique for the separation and analysis of 10 monosaccharides achieved within 13.5 min using 1-phenyl-3-methyl-5-pyrazolone (PMP) as the labelling molecule of the reductive monosaccharides has been established by combining common high performance liquid chromatography-UV and C18 column. The established technique was applied to the quantification of the monosaccharide components in extract of Silybum marianum. The results showed that the tested 10 monosaccharides as PMP derivatives were baseline separated under the HPLC conditions proposed. It was confirmed that Silybum marianum extract was composed of mannose, rhamnose, glucuronic acid, galacturonic acid, glucose, xylose, galactose and arabinose with the molar ratio of 0.66:0.84:0.58:1.0:1.6:0.69:2.7:4.8. Quantitative recoveries of the compositional monosaccharides separated from the extract were in the range of 92.4%-104.0%, and the RSD values fell within 0.68%-3.81%. The results demonstrated that the proposed HPLC method was simple, rapid, convenient, and precise, and it was applicable to the analysis of the compositional monosaccharides of Silybum marianum extract.

Administration, Oral ; Adolescent ; Female ; Histiocytosis, Langerhans-Cell ; complications ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Prednisone ; administration & dosage ; therapeutic use ; Retrospective Studies ; Skin Ulcer ; drug therapy ; etiology ; pathology ; Thalidomide ; administration & dosage ; therapeutic use ; Treatment Outcome

This study is to investigate the effects of phenytoin sodium, lidocaine (sodium channel blockers), propranolol (beta-adrenergic receptor antagonist), amiodarone (drugs prolonging the action potential duration) and verapamil (calcium channel blockers) on arrhythmia of mice induced by Bufonis Venenum (Chansu) and isolated mouse hearts lethal dose of Chansu. Arrhythmia of mice were induced by Chansu and then electrocardiograms (ECGs) were recorded. The changes of P-R interval, QRS complex, Q-T interval, T wave amplitude, heart rate (HR) were observed. Moreover, arrhythmia rate, survival rate and arrhythmia score were counted. Isolated mouse hearts were prefused, and the lethal dose of Chansu was recorded. Compared with control group, after pretreatment with phenytoin sodium, broadening of QRS complex and HR were inhibited, and the incidence of ventricular arrhythmia was reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with lidocaine, the prolongation of P-R interval and broadening of QRS complex were inhibited, and the incidences of ventricular arrhythmia were reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with propranolol, prolongation of P-R interval, broadening of QRS complex, prolongation of Q-T interval and HR were inhibited, and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically, while survival rate was improved. After pretreatment with amiodarone, HR was inhibited, the incidences of ventricular tachycardia were reduced dramatically. Lastly, after pretreatment with verapamil, the prolongation of P-R interval and Q-T interval were inhibited and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically; the isolated mouse hearts lethal dose of Chansu was reduced significantly. In in vivo experiments, phenytoin sodium was most effective against the mice arrhythmias induced by Chansu while cautious use of verapamil for Chansu inducing arrhythmia should be noted. It is also concluded that mice ventricular arrhythmias induced by Chansu might be most closely related to sodium channel, supraventricular arrhythmias might be related to beta-adrenergic receptor, and calcium channel plays an important role in conduction block. In in vitro experiments, phenytoin sodium was most effective, followed by lidocaine and propranolol, and amiodarone had no obvious effect and verapamil reduced the lethal dose of Chansu.

Objective To investigate the characteristic MRI appearance of neuromyelitis optics (NMO) and muhip]e sclerosis (MS) in the spinal cord.Methods Twenty cases of MS and 23 cases of NMO were examined by MRL All image appearances were analyzed.Results The characteristic MRI appearance of NMO patients in the spinal cord was linear medullary lesion (LML), linear medullospinal lesion (LMSL), linear spinal lesion (LSL) and longitudinally extensive transverse myelitis (LETM), and spinal cord MRI with contiguous T2-weighted signal abnormality extending over 3 or more vertebral segments (23 cases), while in MS, spinal cord MRI with contiguous T2-weighted signal abnormality often extended less than 3 vertebral segments (only 12 cases, χ2 = 19.142, P < 0.01), and the distribution of spinal lesion usually was eccentric (17 cases, compared with NMO group, χ2 = 25.256, P < 0.01).Conclusions NMO is distinct from MS.In MRI, spinal lesion in NMO usually conforms to the distribution of aquaporin 4, while spinal lesion in MS always conforms to the demyelination.NMO has neuroimaging features that move it ever closer to distinct disease status.

Objective To evaluate the effect of the percutaneous transluminal septal myocardial ablation(PTSMA)on the left ventricular function in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods All HOCM patients underwent echocardiogram measurements before and after the PTSMA procedure.The peak velocity of mitral annulus was measured at Doppler tissue pulsed wave mode.Doppler tissue imaging(DTI)was obtained at the 4- and 2-chamber apical view,and the peak systolic(Sa),early diastolic(Ea),and late diastolic(Aa)myocardial velocities of mitral annulus was measured at the long apical view.Results Compared with the velocity parameters before the PTSMA procedure,the peak Sa and Ea after the PTSMA were significantly lower while Aa was un-significantly lower.Conclusions In patients with HOCM,the diastolic and systolic function of the left ventricle decreased after the PTSMA procedure.

BACKGROUNDMitochondrial DNA 4977-bp deletion (DeltamtDNA(4977)) was reported in many human neoplasia. However, its biological significance remains to be evaluated and the molecular mechanism needs to be investigated. In this study, we analyzed the frequency of DeltamtDNA(4977) in gastric cancer (GC) cell lines and tissues, as well as reactive oxygen species (ROS) contents and manganese superoxide dismutase (MnSOD) expression levels in GC cell lines to explore its biological significance and molecular mechanism.

METHODSSemi-quantitative PCR and real-time PCR were used to detect the incidence of DeltamtDNA(4977) in 13 GC cell lines and 272 human gastric tissues (108 GC specimens and the respective adjacent normal tissues, and 56 normal gastric mucosa from non-cancer patients). We further identified intracellular ROS production by flow cytometry and MnSOD expression by semi-quantitative reverse transcription-PCR (RT-PCR) and Western blotting. Statistical analyses were carried out using the Logistic regression analysis and Kaplan-Meier method.

RESULTSBased on our earlier study, we optimized the PCR amplification condition by reducing the cycle number. In this study, we systematically documented the high incidence of DeltamtDNA(4977) in GC cell lines (10/13, 76.9%), GC tissues (86/108, 79.6%), matched normal tissues (73/108, 67.6%), and normal gastric mucosa of non-cancer patients (29/56, 51.8%). A significantly higher incidence of mutated DeltamtDNA(4977) was observed in GC tissues with respect to the adjacent normal tissues (79.6% vs 67.6%, P = 0.045), and they were both higher than that in normal controls (P < 0.05). Most importantly, we linked the DeltamtDNA(4977) mutations with the expression level of MnSOD and ROS contents. The cell lines containing lower expression level of MnSOD was found to have generally higher frequent DeltamtDNA(4977) and more ROS.

CONCLUSIONThe decreased anti-oxidative ability, which leads to increased ROS contents, is correlated with the mtDNA damage during gastric carcinogenesis.

Adult ; Aged ; Aged, 80 and over ; Blotting, Western ; Cell Line, Tumor ; DNA, Mitochondrial ; genetics ; Female ; Humans ; In Vitro Techniques ; Male ; Middle Aged ; Mutation ; Reactive Oxygen Species ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms ; genetics ; metabolism ; Superoxide Dismutase ; genetics ; metabolism

The Continuing Education Department of Chinese Medical Association has undertaken and participated in a number of tasks for the training of primary health care personnel in recent years. It has been recognized that the main measures to promote the development of primary continuing medical education including four aspects: national policies provide the direction of the development; medical progress is the output of the primary continuing medical education; the combination of multiple measures is a good way to carry out the primary continuing medical education; and technical means are the support of the development. Through understanding and grasping such factors as the national policies, medical development, education level, and technical conditions, and actively thinking about the relevant countermeasures, we can steadily and rapidly continue to promote the healthy development of continuing medical education at the grassroots level.

OBJECTIVETo evaluate the prognostic significance of various clinicopathologic parameters in gastrointestinal stromal tumor (GIST), and to study the frequency of c-kit exon 11 mutations in this tumor.

METHODSOne hundred and fifty-six cases of gastric or small intestinal GIST were retrieved from the archival files of the Department of Pathology, Chinese PLA General Hospital. The clinical features, site of occurrence, tumor diameter, mitotic index, coagulative tumor necrosis, and risk grade were studied and analyzed statistically. Tumor DNA was extracted and c-kit exon 11 was amplified. Upon detection by denaturing high-performance liquid chromatography, the amplified exon 11 was sequenced.

RESULTSFor the 83 cases of gastric GIST studied, the mean age of patients was 55.4 years. Follow-up information was available in 62 cases, with 17 cases having local recurrence or distant metastasis. The 5-year survival rate was 66.5% +/- 17.1%. For the 73 cases of small intestinal GIST studied, the mean age of patients was 50.6 years. Follow-up information was available in 43 cases, with 22 cases having local recurrence or distant metastasis. The 5-year survival rate was 61.8% +/- 18.3%. In general, for gastric GIST, age younger than 50 years (P = 0.046), advanced clinical stage (P = 0.0001), large tumor size (P = 0.0001), high mitotic index (P = 0.0001), presence of coagulative tumor necrosis (P = 0.0001), and high risk grade (P = 0.004) were associated with lower survival rate. COX hazard proportional model revealed that advanced clinical stage (P = 0.001), large tumor size (P = 0.001), high mitotic index (P = 0.002) and high risk grade (P = 0.018) indicated worse prognosi. For small intestinal GIST, advanced clinical stage (P = 0.010) and presence of coagulative tumor necrosis (P = 0.036) were associated with lower survival rate. Advanced clinical stage was an independent prognostic factor. A total of 25 cases harbored c-kit mutations. The frequency of c-kit mutations was 32% and 22.5% for gastric and small intestinal GIST respectively. For gastric GIST, c-kit mutations occurred mainly in patients older than 50 years. In contrast, c-kit mutations in small intestinal GIST occurred in the age group of 40 to 49 years.

CONCLUSIONSFor gastric GIST, advanced clinical stage, tumor diameter, mitotic index and risk grade are the main prognostic indicators. For small intestinal GIST, advanced clinical stage and presence of coagulative tumor necrosis indicate poor prognosis. In general, small intestinal GIST is more frequently associated with metastasis and tumor relapse than gastric GIST. The occurrence of c-kit mutations also correlates with age of patients.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Neoplasms ; secondary ; DNA, Neoplasm ; genetics ; Disease-Free Survival ; Exons ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; genetics ; pathology ; Humans ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Mutation ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Proportional Hazards Models ; Proto-Oncogene Proteins c-kit ; genetics ; Survival Rate ; Tumor Burden ; Young Adult

OBJECTIVETo construct a mouse that specifically expresses Cre recombinase in hepatocyte.

METHODSA hepatocyte specific transgenic construct containing mouse albumin promoter, the Cre recombinase gene and the poly (A) of human growth factor gene was generated. The linearized constructs were introduced into the fertilized eggs by microinjection to obtain the transgenic mice. The transcriptional specificity of Cre recombinase was detected by reverse transcription polymerase chain reaction (RT-PCR). The expression and function of Cre recombinase were detected by PCR and Southern Blot after crossing the Alb-Cre transgenic mice with the Smad4 conditional knockout mice.

RESULTSThe linearized constructs were microinjected into 837 fertilized eggs, and then the 797 effective eggs of microinjected eggs were implanted into the oviducts of 27 pseudo pregnant mice. In the 53 offspring, there were 6 mice carrying the transgene identified by polymerase chain reaction (PCR) and Southern Blot. Cre recombinase transcripts were detected in the livers and testis of the Alb-Cre transgenic mice using RT-PCR. The Cre recombinase was expressed in the livers of the double heterozygous for Alb-Cre and Smad4 floxed allele, and the exon 8 floxed by loxP site was deleted.

CONCLUSIONA hepatocyte-specific Cre transgenic mouse was generated successfully. The Cre recombinase expressed specifically in liver and could mediate the recombination between loxP sites in vivo.

Animals ; Female ; Hepatocytes ; metabolism ; Humans ; Integrases ; genetics ; Mice ; Mice, Transgenic ; Viral Proteins ; genetics