Objective To discuss the features and surgical management of ectopic hyperparathyroidism.Methods Clinical data of 66 cases of ectopic hyperparathyroidism were retrospectively analyzed.Results There were 66 cases of ectopic hyperparathyroidism accounting for 11.5％ (66/575) of all ectopic hyperparathyroid cases admitted during the period from 1982-2010.Prevalence of mediastinal ectopic lesions was 71.2％ (47/66),among those 65.2％ (42/66) was in anterosuperior mediastinum,and 28.8％ (19/66) in the non-typical loci of the neck.Radionuclide imaging of parathyroid glands was the most sensitive (87.0％) method among all common positioning examinations.Average number of operation episode was 1.47,and all lesions were finally resected.After surgery 49 cases presented with transient hypocalcemia,and were cured by calcium administration.52 cases were followed up,with recurrent hyperparathyroidism in 1 case.Conclusions Diagnosis and treatment of ectopic hyperparathyroidism are dependent on the understanding of common locations of ectopic parathyroid glands.Preoperative correct location and surgical expertise are helpful for successful resection.

OBJECTIVETo study the influences of endocannabinoid-anandamide (AEA) on the proliferation and apoptosis of the colorectal cancer cell line (CaCo-2) and to elucidate the effects of CB1 and lipid rafts, and to further elucidate the molecular mechanism and the effect of AEA on the generation and development of colorectal cancer.

METHODSHuman colorectal cancer cell line CaCo-2 was cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum in 5% CO(2) atmosphere at 37°C. CaCo-2 cells were divided into different groups and treated with different concentrations of AEA, AEA + SR141716A, AEA + AM630 and AEA + methyl-β-cyclodextrin (MCD). MTT assay was used to determine the effects of AEA, its putative CB1, CB2 receptor antagonists (SR141716A and AM630) and MCD on the proliferation of CaCo-2 cells. Annexin V-PE/7AAD binding assay was used to detect apoptosis in the CaCo-2 cells. Western-blot was applied to check the expressions of CB1, CB2, p-AKT and caspase-3 proteins in different groups of CaCo-2 cells.

RESULTSAEA inhibited the proliferation of CaCo-2 cells in a concentration-dependent manner and the effect could be antagonized by SR141716A and MCD. The inhibiting rates were (21.52 ± 0.45)%, (42.16 ± 0.21)%, (73.64 ± 0.73)% and (83.28 ± 0.71)%, respectively, at different concentrations of AEA (5, 10, 20 and 40 µmol/L). The three groups (20 µmol/L AEA, 20 µmol/L AEA + 10 µmol/L SR141716A and 20 µmol/L AEA + 1 mmol/L MCD) showed different inhibiting rates [(73.64 ± 0.73)%, (16.15 ± 0.75)% and (12.58 ± 0.63)%], respectively. Annexin V-PE/7AAD binding assay showed that AEA induced apoptosis in the CaCo-2 cells and MCD could antagonize this effect. The apoptosis rates of the three groups (control, 20 µmol/L AEA and 20 µmol/L AEA + 1 mmol/L MCD) were (2.95 ± 0.73)%, (39.61 ± 0.73)% and (14.10 ± 0.64)%, respectively. The expressions of CB1, CB2, p-AKT and Caspase-3 proteins were all observed in the CaCo-2 cells. AEA inhibited p-AKT protein expression and induced caspase-3 protein expression. The two actions were also antagonized by MCD.

CONCLUSIONSAEA can strongly suppress the proliferation of colorectal cancer CaCo-2 cells via the CB1 receptor and membrane cholesterol-LRs and induce apoptosis via lipid rafts. Anandamide plays a very important role in the carcinogenesis and development of colorectal cancer. MCD is a critical member in this system.

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arachidonic Acids ; antagonists & inhibitors ; pharmacology ; Caco-2 Cells ; Cannabinoid Receptor Modulators ; antagonists & inhibitors ; pharmacology ; Caspase 3 ; metabolism ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Endocannabinoids ; Humans ; Indoles ; pharmacology ; Membrane Microdomains ; metabolism ; Piperidines ; pharmacology ; Polyunsaturated Alkamides ; antagonists & inhibitors ; pharmacology ; Proto-Oncogene Proteins c-akt ; metabolism ; Pyrazoles ; pharmacology ; Receptor, Cannabinoid, CB1 ; antagonists & inhibitors ; metabolism ; Receptor, Cannabinoid, CB2 ; antagonists & inhibitors ; metabolism ; beta-Cyclodextrins ; metabolism

Professor XIAO Ji-fang, an experienced practitioner of Chinese medicine of Guangxi, is famous for his medical ethics, wide range of studies, comprehensive understanding of the classics, innovation, as well as u nique academic ideas. He focuses on mind-regulating in acupuncture and pulse diagnosis. At the same time, differentiation of syndromes, diseases and meridians are emphasized. The combination of acupuncture and moxibustion and integration of acupuncture and medicine are promoted. He is especially skilled at slow twisting needle insertion, Taiji needling therapy, scalp acupuncture and moxibustion with a herb prepared thread of Zhuang nationality, which all achieve remarkable effects.
Acupuncture Therapy ; history ; China ; History, 20th Century ; Humans ; Moxibustion ; history

OBJECTIVETo investigate the effect of uvulopalatopharyngoplasty (UPPP) to obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with resistant hypertension (RH).

METHODSUPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients, who also suffered from RH [who taking more than three kinds of antihypertensive drugs (including diuretics) and still not able to control blood pressure at 140/90 mm Hg (1 mm Hg = 0.133 kPa)]. Polysomnography monitoring, ambulatory blood pressure monitoring, apnea hypopnea index (AHI), lowest saturation of blood oxygen (SaO2) and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery.

RESULTSSix months after surgery,the total efficiency was 61.1% (22/36). The AHI median [25 quartile; 75 quartile] from 37.5 [26.0; 48.3]/h to 9.5 [9.0; 21.3]/h, the lowest the SaO2 average (x(-) ± s, the same below) increased from 0.655 ± 0.114 to 0.860 ± 0.037, the differences were statistically significant (P value < 0.05). 24 h systolic blood pressure, daytime systolic blood pressure, night contraction, diastolic and mean arterial pressure decreased from (160.8 ± 6.8), (170.5 ± 2.5), (163.6 ± 10.5), (100.8 ± 5.6) and (96.8 ± 7.5) mm Hg to (142.5 ± 7.3), (150.8 ± 7.6), (140.1 ± 6.4), (81.8 ± 7.4) and (93.7 ± 2.4) mm Hg, the differences were statistically significant (P < 0.05). The degrees of AHI descent and the average SaO2 improvement were concerned with the degree of systolic blood pressure, diastolic blood pressure decent (r > 0.80 and r(2) > 0.50). The average numbers of antihypertensive drugs decreased form (3.6 ± 0.5) to (2.9 ± 0.5) compared preoperatively and postoperatively, the difference was statistically significant (t = 5.537, P < 0.01). The use of antihypertensive medication reduced in 23 cases (23/36, 63.8%) compared preoperatively and postoperatively.

CONCLUSIONSThe blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation.

Adult ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension ; complications ; surgery ; Male ; Middle Aged ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; complications ; surgery ; Uvula ; surgery

OBJECTIVETo investigate the prevalence rates of snoring disease and obstructive sleep apnea-hypopnea syndrome (OSAHS) and their risk factors among truck drivers in Guangzhou, China.

METHODSA questionnaire survey was conducted in 374 truck drivers who were selected from 5 logistics companies in Guangzhou by cluster sampling. Those who had potential snoring disease or OSAHS underwent polysomnographic monitoring at night. The obtained data were analyzed to calculate the prevalence rates of snoring disease and OSAHS and determine the risk factors for OSAHS.

RESULTSA total of 335 subjects completely questionnaires, with a response rate of 90%. Among the 335 subjects, 125 (37.3%) had habitual snoring, and 42 (12.5%) had OSAHS according to the diagnostic criterion (apnea-hypopnea index ≥ 5 times/h). The multiple stepwise regression analysis showed that the risk factors for OSAHS were age, alcohol use, family history of snoring, body mass index, and upper airway abnormality. Of the subjects with grade ≥ 2 snoring and OSAHS, 65.4% often felt sleepy when driving during daytime, and 42% had suffered or nearly suffered traffic accidents due to sleepiness when driving. Moreover, 95.5% (320) of the 335 truck drivers did not consider snoring a disease, and 98% did not think traffic accident might be related to snoring.

CONCLUSIONThe prevalence rates of snoring disease and OSAHS among truck drivers are 37.3% and 12.5%, respectively. Therefore, prevention measures should be established according to the epidemiological characteristics to help the truck drivers realize the hazards of snoring disease and OSAHS, thus minimizing the prevalence and hazards of the diseases.

Adult ; Automobile Driving ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sleep Apnea, Obstructive ; epidemiology ; Snoring ; epidemiology ; Surveys and Questionnaires ; Young Adult

Objective To study the influence of SCNIA intronic mutations in mRNA splicing in febrile seizures related epilepsy,and investigate the association between splicing changes and genotype-phenotype-inheritance pattern.Methods Molecular cloning of 5 SCN1A intronic mutations was performed in patients with partial epilepsy with antecedent febrile seizures plus (PEFS+) and Dravet syndrome (DS) through constructing mutant and wild-type plasmids of pTragetE2-3-4-5 and E24-25-26 by using Minigene splicing assay,and the in vitro expressions in HENK293 cells were detected.The mRNA splicing changes were analyzed qualitatively and quantitatively by reverse transcription (RT)-PCR and real time quantitative (q)-PCR.Results (1) Using RT-PCR,DS mutants presented a whole exon skipping without significant remain of normal mRNA transcripts,while PEFS+ mutants showed partial exon skipping or intronic insertion with coexistence of normal and aberrant mRNA transcripts.(2) Statistical differences were found between relative quantity (RQ) of aberrant and normal mRNA in PEFS+ mutant (c.473+5G＞A:4.92％±1.05％ and 6.10％±0.21％;c.473+5G＞C:7.97％±1.12％ and 3.94％ ±1.25％) and that in DS mutant (c.602+1G＞A:60.51％±1.81％ and 0.060％±0.022％,P＜0.05);similarly,there were statistical differences between relative RQ of normal and aberrant mRNA in PEFS+ mutant c.4853-25T＞A (71.22％±11.92％ and 7.38％±1.61％) and that in DS mutant c.4853-1G＞C (0.08％±0.01％ and 22.11％±2.83％,P＜0.05).Conclusion The position and difference of splicing patterns of SCNIA intronic mutations are potential molecular pathogenesis for phenotypic difference of febrile seizures related epilepsy.

OBJECTIVETo study the potential risk factors of human infecting with Streptococcus suis.

METHODS1: M matched case-control study was conducted. 29 human cases of Streptococcus suis infection in the early phase were included in the case group, Patients' family members, neighbors and peoples who had worked together with patients to handle deceased or sick pigs in the last week were recruited as matched controls. There were 147 controls in total. Both cases and controls received questionnaire investigation including the ways to contact sick/dead pigs. Conditional logistic regression was employed to analyze matching data.

RESULTSAccording to the results of multivariate analysis, slaughtering (OR = 11.978, 95% CI: 3.355-42.756), carcasses cutting and processing (OR = 3.008, 95% CI: 1.022-8.849) sick/dead pigs were associated with cases related to human Streptococcus suis infection. The attributable risk proportion were 91.65% and 66.76% respectively. The other types of exposures to sick/ dead pigs, including feeding, selling, burying and eating, were not associated with the human Streptococcus suis infection in our study population.

CONCLUSIONSlaughtering, carcasses cutting and processing sick/dead pigs were important risky behavior for humans to be infected by Streptococcus suis.

Adult ; Aged ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Exposure ; adverse effects ; statistics & numerical data ; Risk Factors ; Streptococcal Infections ; epidemiology ; etiology ; microbiology ; Streptococcus suis ; physiology

OBJECTIVETo describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators.

METHODSEpidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done.

RESULTSThe population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found.

CONCLUSIONPreventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.

Adult ; Aged ; China ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Streptococcal Infections ; blood ; microbiology ; mortality ; pathology ; Streptococcus suis ; physiology ; Young Adult

OBJECTIVETo explore the feasibility of the tissue engineered venous grafts (TEVGs) constructed in vitro based on canine autologous bone marrow-derived endothelial progenitor cells (EPCs) and porcine decellularized aortic scaffolds implanted into the canine inferior vena cava.

METHODSTo draw out a volume of 8 - 12 ml of bone marrow from the canine (n = 8), to culture and expand EPCs in vitro using conditioned medium. After labeled with a red fluorescent dye PKH26-GL, the cells were seeded onto the luminal surface of decellularized porcine scaffolds with single, rotative method for 4 h. Following static culture for 24 - 72 h, the hybrids were implanted to replace autologous canine inferior vena cava about 4 cm long. Meantime one femoral artery-venous shunt about 1 cm long was performed. The non-seeded decellularized scaffolds (n = 4) were performed the same as control. Angiography was performed and the hybrids were explanted for morphology and labeled cells' immuno-fluorescence examinations at postoperative 10 d, 4 weeks and 12 weeks, respectively.

RESULTSThe patent number of experiment (control) group were 7/7 (2/4), 6/6 (2/2) and 4/4 (1/2) at postoperative 10 d, 4 weeks and 12 weeks, respectively. At 12 weeks, tightly confluence endothelial cells which covered the whole inner luminal surface of the explants were detected by immunohistochemistry of factor VIII and scanning electron microscopy, while fibrin-based pseudo-intima was detected on the inner luminal surface of matrix in the solo patent dog from the control group. Meanwhile, fibroblasts and alpha-actin positive cells in the matrices were found by transmission electron microscopy and alpha-actin immunohistochemistry. PKH26-GL labeled EPCs sustained on the luminal surface at a rather proportion accompanied by newly formed endothelial cells. However, the explants in both groups showed partial stenosis.

CONCLUSIONSSuch constructed tissue engineered venous graft based on canine autologous bone marrow-derived endothelial progenitor cells and porcine decellularized aortic matrices is promising and deserve to further improvement and testing.

Actins ; analysis ; Animals ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Bone Marrow Cells ; cytology ; metabolism ; ultrastructure ; Cells, Cultured ; Dogs ; Endothelial Cells ; cytology ; metabolism ; ultrastructure ; Factor VIII ; analysis ; Feasibility Studies ; Hematopoietic Stem Cell Transplantation ; Immunohistochemistry ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Stem Cells ; cytology ; metabolism ; ultrastructure ; Swine ; Tissue Engineering ; methods ; Transplantation, Autologous ; Veins ; Vena Cava, Inferior ; surgery

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology