SUMMARY Lymphoma is a systemic disease. It is not uncommon to be found involved in digestive or central nervous system. However, lymphoma involved in these two systems at the same time is rare. The clinical feature of a case of lymphoma with gastrointestinal bleeding and limbs weakness was investigated and the literature was reviewed. The patient came to our hospital with melena and hematemesis. She was diagnosed as gastric ulcer by gastroscopy and biopsy showed lymphoma. Two days after she came to hospital, the patient presented with progressing limbs weakness. Magnetic resonance imaging (MRI) showed irregular abnormal signals in T2-T4 vertebra, which was enhanced obviously. A strip abnormal signal could be seen in spinal cord and involved in neighboring centrum and ribbing. The lesion extended to paravertebral tissue. The final diagnosis was lymphoma involved in stomach and spinal cord. Diseases presented with both upper digestive tract bleeding and symptoms of central nervous system were rare, including malignancies, virus infection and some therapy. Lymphoma was one of the causes. On the other hand, spinal cord ischemia might occur after gastrointestinal bleeding. Thus, doctors should examine the patients carefully to diagnose these diseases.

BACKGROUND: Mild hypothermia might in some degree affect the functions and metabolism of the vital organs, and its effects can be harmful sometimes but may also be favorable on some other occasions, which remained to be further studied.OBJECTIVE: To examine the effect of mild hypotherrnia on cardiac function of rats with experimental cerebral infarction by observing the changes in the cardiac energy reserve and electrocardiogram (ECG) manifestations,as well as the ultrastructural changes of the myocardium.DESIGN: Randomized controlled experiment.SETTING: Department of Neurology, Renmin Hospital of Wuhan University.MATERIALS: This experiment was carried out in the Laboratory of Department of Neurology, Renmin Hospital of Wuhan University. Totally 58SD rats were randomized into sham operation group (n=10), cerebral infarction with normal temperature group (normal temperature group, n=24),cerebral infarction with mild hypothermia treatment group (mild hypothermia group, n=24).METHODS: Middle cerebral artery occlusion (MCAO) was induced in normal temperature group and mild hypothermia group with a suture intro duced into the middle cerebral artery of the rats. The rats in- sham opera tion group were only subjected to skin incision and vessel ligation without suture insertion into the middle cerebral artery. The rats in mild hypother mia group were kept at 4 ℃ with their anal temperature maintained at (34±1.0) ℃, while the rats in sham operation group and normal tempera ture group w ere kept at room temperature (20 ℃). Twelve hours later, the levels of myocardial ATP, DTP, adenosine phosphate and energy reserve were determined, and the changes in myocardial ultrastructure were ob served under electron microscope. MAIN OUTCOME MEASURES: ① Changes of myocardial energy metabolism; ② Changes of cardiac electrophysiology; ③ Ultrastructural changes of the myocardium. RESULTS: All the 58 rats survived the operation and all enter the re sult analysis. The levels of myocardial ATP, DTP and energy reserve were significantly lowered in normal temperature group and mild hypothermia 12 hours after the ischemia in comparison with the sham operation group (P ＜ 0.01), but the level of ATP and energy reserve in mild hypothermia group was higher than those of normal temperature group (P ＜ 0.01). No significant difference was noted in ECG abnormality rate between normal temperature group and mild hypothermia group (P ＞ 0.05), but the heart rate was found obviously lower in mild hypothermia group [(290.92±44.18) vs (472.20±12.79) bpm, P ＜ 0.01], with 3 rats showing heart rate less than 150 bpm. Ultrastructural observation revealed the presence of my ocardial ischemic impairment in normal temperature group and mild hy pothermia group, but the impairment in mild hypothermia group was less severe. CONCLUSION: Heart rate can be markedly reduced during general mild hypothermia treatment for cerebral infarction to improve myocardial energy reserve and alleviate myocardial ischemia due to cerebral infarction without increasing the abnormality rate of ECG.

BACKGROUND: Sub-hypothermia has been widely used to treat cerebral infarction. Whether sub-hypothermia treated on body surface affects blood pressure or not, or the effect is advantageous or disadvantageous should be researched further.OBJECTIVE: To observe the effect of sub-hypothermia on blood pressure of rats with experimental cerebral infarction so as to investigate its influence on cerebral protective function.DESIGN: Randomized controlled study.SETTING: Neurological Department of Renmin Hospital of Wuhan University.MATERIALS: The experiment was completed in the Neurological Laboratory of Renmin Hospital of Wuhan University. Totally 120 SD rats were selected and divided randomly into control group and experimental group with 60 in each group.METHODS: Rats in experimental group were maintained at 4 ℃ 3 hours after MCA obstruction, and rectal temperature was maintained at (34±1.0) ℃;rats in control group were maintained at room temperature (20 ℃). All animals were reperfused 2 hours after MCA obstruction. Heart rate,breath, blood oxygen saturation, anus temperature and blood pressure were assayed with monitor. Rats were sacrificed under anesthesia after 24 hours, and cerebral tissue was taken out to measure the total volume of infarct focus.MAIN OUTCOME MEASURES: ① Changes of heart rate, breath,blood oxygen saturation, · mean arterial blood and blood pressure of rats in the two groups before and after treatment; ② volume of infarct focus of rats in the two groups.RESULTS: ① Values of blood pressure in both groups were increased after obstruction as compared with those before obstruction [(150±7.2),(129±5.7) mm Hg; (149±7.5), (130±2.2) mm Hg, P ＜ 0. 01], and there was not significant difference (P ＞ 0.05). Blood pressure was decreased obviously in sub-hypothermia group at the beginning of sub-hypothermia (P＜ 0.01). ② Volume of cerebral infarction was obviously smaller in subhypothermia group than that in control group [(153.17±26.83) mm3,(251.45±36.70) mm3, P ＜ 0.01].CONCLUSION: Sub-hypothermia can both reduce the volume of cerebral infarction and decrease the blood pressure obviously.

Objective To analyse the effective rate and adverse effect of only levetiracetam (LEV) versus LEV plus other drugs in the treatment of middle and old aged patients with partial seizures (PS) and secondary generalized tonic-clonic seizure (SGTCS).Methods The self-control study was used and 59 elderly patients with PS and SGTCS were treated with LEV single or plus drug (therapeutic dose was 1000-2000 mg/d,bid).The effective rate and the side effects of LEV were observed and compared between LEV single and plus drug or between the patients with only epilepsy versus epilepsy plus other diseases,respectively.Results The effective ratios at the end of 3,6,9and 12 months after LEV treatment were 76.2％,70.6％,64.3％ and 66.7％,respectively and there were no significant difference among above time points (x2=1.911,P＞0.05).A chi-square test showed that the differences in effective ratios were not statistically significant (P＞ 0.05) between single and combination of drugs (x2 =1.437) and between two groups of patients at the end of 12 months.Clinical effect of LEV showed no remarkable difference between different types of epilepsy at the end of 6 months (x2 =1.315,P＞0.05)and 12 months(x2 =2.700,P＞0.05).The control ratio of epileptic attack was higher in single LEV than in combination drugs (x2 =10.83,P＜0.05).The total side effects were 13.6％,including somnolence,weakness,anorexia,headache,irritability and forgetfulness.Conclusions The curative effects of levetiracetam single or in combination are definite,stable and continuous for PS and SGTCS,especially in combination with other diseases.

BACKGROUND: Caspase-3 is a cysteine proteinase that can promote cell apoptosis. Ciliary neurotrophic factor has many kinds of biological activities, such as protecting various neurons from injury, especially motorial neurons, thereby reducing the occurrence of nerve cell injury.OBJECTIVE: To observe the Influence of ciliary neurotrophic factor on spinal cord caspase-3 expression in different ages rats following sciatic nerve injury, aiming to make further investigation about the changing regularity and modulating character of peripheral nerve damage at various ages rats.DESIGN: Randomized controlled experiment.SETTING: Ultrasound Department and the 5th Research Institute of Daping Hospital, Field Surgery Research Institute of the 3rd Military Medical University of Chinese PLA.MATERIALS: This experiment was carried out at the Field Surgery Research Institute of the 3rd Military Medical University of Chinese PLA from April 2000 to December 2001. Altogether 810 wistar rats including infant rats with body mass of 30-100 g (birth age of 20 days), adult rats of 200-350 g (birth age of 4 m), elder rats of 400-800 g (birth age of 18-24 m),were selected with 270 rats in each age stage. Female and male does not limit.METHODS: [1] Experimental animal grouping: Various age rats were randomly divided into normal group (n=18), ciliary neurotrophic factor group(n=126) and physiological saline group (n=126), rats in ciliary neurotrophic factor group and physiological saline group were subdivided into 1 day, 3days, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks subgroups. [2] Animal model preparation: In Ciliary neurotrophic factor group and physiological saline group, rats were cut off a piece of sciatic nerve of 2 mm long, both ends connected with silica tube for constructing neuranagenesis cab, in which 15 μL recombined ciliary neurotrophic factor (25 mg/L) was injected in ciliary neurotrophic factor group, and 15 μL physiological saline in physiological saline group. [3] Preparation and examination of specimen:Six rats were randomly selected from each group, lumbar L3-5 spinal cord were obtained for carryingonnation, caspase-3 activity examination and Western blotting examination.MAIN OUTCOME MEASURES: [1] Expression of spinal cord caspase-3 with IHC assay. [2] Distribution and expression intensity of spinal cordcaspase-3 by Western blotting technique. [3] Changes in caspase-3 activity.RESULTS: Altogether 810 rats completed the experiment, all data was entered the final result analysis. [1] Expression of spinal cord caspase-3 with IHC assay: After injury, neuronal caspase-3 expression became strengthened at injured side of various age physiological saline groups, which obviously increased at posttraumatic 2 weeks and 4 weeks, but less expressed at 8 weeks and 12 weeks; while in ciliary neurotrophic factor group, posttraumatic caspase-3 expression was mostly obvious at 2 weeks and 4 weeks. [2] Distribution and expression intensity of spinal cordcaspase-3 by Western blotting technique: Caspase-3 expression was not significant difference between various age subgroups in normal group(P ＞ 0.05). Comparing to the same age normal group and non traumatic group, caspase-3 expression was strengthened at 1 week, 2 weeks, 4 weeks in various age physiological saline group and ciliary neurotrophic factor group damages (P ＜ 0.05-0.01); in ciliary neurotrophic factor group, caspase-3 showed weaker expression at 1 week, 2 weeks, 4 weeks in infants; 2weeks and 4 weeks in adults, 4 weeks in elders comparing to corresponding physiological saline group, difference was significant (P ＜ 0.05-0.01).The comparison between untraumatic side of each group and normal group showed no statistical difference (P ＞ 0.05). [3] Changes in caspase-3 activity: In child, adult and elder physiological saline groups, caspase-3 activity was increased in traumatic spinal cord, moreover caspase-3 activity was higher than elder and adult group at various age point (P ＜ 0.05-0.01); in child, adult and elder ciliary neurotrophic factor groups, caspase-3 activity is lower than physiological saline group (P ＜ 0.05-0.01). After damage,caspase-3 activity at traumatic side in physiological saline group and ciliary neurotrophic factor group was difference from normal group but without significant meaning (P ＞ 0.05), except the expression in child posttraumatic 12 weeks group was lower than normal group (P ＜ 0.05).CONCLUSION: After sciatic nerve damage, caspase-3 protein expression and activity were found to be increased in spinal cord of different age groups rats which can be reduced by extragenous ciliary neurotrophic factor, which playing protective role on spinal cord nerve cells, such protection would gradually attenuated in child group, adult group to elder group in turns.

Recent years have witnessed tremendous progress in vitreoretinal surgery.The treatment of vitreoretinal diseases has increased enormously and its related indications expanded widely with the contribution of the emerging novel technologies,methods,equipment and new ideas.Attaching importance to minimally invasive surgery,application of auxiliary drugs,development of improved equipment and surgical technique were the main features. Further basic and clinical research is necessary to promote innovation and development of vitreoretinal surgery in China to keep pace with and surpass advanced technology.

BACKGROUND: Thermosensitive hydrogel materials present stability at human body temperature, which is necessary for its application as a medical implant, thus the lower critical solution temperature (LCST) of thermosensitive hydrogel should be beyond the human body temperature by adjustment.OBJECTIVE: To prepare a thermosensitive hydrogel poly-N-isopropylacrylamide-co-N-hydroxymethylacrylamide P(NIPAAm-co-NHMPA) with over 37 ℃ LCST, and primarily appraise its safety as a medical implant in vivo.DESIGN: Random, non-blind, group control, animal experimental study.SETTING: Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology(HUST).MATERIALS: The experiments were carried out in the Central Laboratory, Union Hospital, Tongji Medical College, HUST and the Key Laboratory of Biomedical Polymer Materials of the Ministry of Education, College of Chemistry, Wuhan University between January and October in 2007. NIPAAm monomer and NHMPA monomer were purchased from Aldrich Company, crosslinking agent N, N'-methylene bisacrylamide from Fluka Company, and initiator ammonium persulfate and accelerating agent tetramethyl ethylene diamine from Sigma Company.METHODS: ①Taking ammonium persulfate and tetramethyl ethylene diamine as oxidation-reduction initiation system, while N, N'-methylene bisacrylamide as cross-linking agent, P-NIPAAm-co-NHMPA was prepared with the addition of NHMPA in the reaction system. LCST was determined by shrinking tests.②A series of biocompatibility tests such as sensitization test, acute systemic toxicity test, genetic toxicity test and implantation test were conducted in several experimental animals to evaluate the safety of the implant. MAIN OUTCOME MEASURES: The erythema and edema of stimulated lesions were recorded in sensitization test; the general state of each animal in acute systemic toxicity test were recorded 4, 24, 48 and 72 hours after injection; in genetic toxicity test, mouse bone marrow polychromatic erythrocyte (PEC) micronucleus was counted six hours after injection under microscope; sections after implantation were observed under light microscope.RESULTS: ①Synthesized hydrogel showed thermosensitive character and the LCST was 38 ℃.②In sensitization test, there was no erythema and edema occurred after leaching liquor and saline were injected; acute systemic toxicity test result revealed no symptom of toxicity; the genetic toxicity test suggested no difference of PEC frequency between experimental group and negative control group; in vivo implantation test, the inflammation around the material was mild and limited.CONCLUSION:P(NIPAAm-co-NHMPA) shows good biocompatibility and can be potentially used as an implant material.

Objective To explore the effect of nuclear factor-kappa B (NF-κB) decoy oligode-oxynucleotides (ODN) on respiratory function and expressions of IL-1β and IL-13 in serum following se-vere lung contusion in rabbits. Methods A total of 40 New-Zealand rabbits were randomly divided into four groups, ie, severe lung contusion group (Group A, n=12), severe lung contusion with NF-κB scrambled decoy ODN intervention group (Group B, n=12), severe lung contusion with sense NF- B de-coy ODN intervention group (Group C, n=12) and normal control group (Group D, n =4). After the contusion model was set up, the sense and scrambled NF-κB decoy ODN were infused into the rabbits via the jugular veins in different groups, with 20 g per experimental rabbit. After contusion, respiratory fre-quency, tidal volume, airway pressure, respiration flow rate curve and end expiration nitric oxide concen-tration were detected at 1, 2, 3 and 4 hours. The expressions of IL-1β and IL-13 in serum were observed by means of ELISA. Results After sense NF-κB decoy ODN intervention, alveolar ventilation, arteri-al PO_2 and pulmonary compliance were improved, compared with Group A and Group B, with statistical difference (P<0.01). The expression of IL-1β was decreased and that of IL-13 increased after sense NF-κB decoy ODN intervention to the severe lung contusion, compared with Groups A and B, with statis-tical difference (P <0.01). The expression of IL-1β was increased to peak level at 1 hour after contu-sion, which continued to the end of the experiment. While expression of IL-13 was decreased at 1 hour af-ter contusion and reached the minimum level at 4 hours. With intervention with sense decoy ODN, the in-creased expression of IL-1β was down-regulated, but expression of IL-13 remained at high level, with sta-tistical difference compared with Group A and Group B (P < 0.01). Conclusions Intervention with sense NF-κB decoy ODN can significantly protect the respiratory function, reduce the expression of IL-1β and increase expression of IL-13 after severe lung contusion.

Angiocardiography ; Anti-Infective Agents ; therapeutic use ; Aorta ; abnormalities ; surgery ; Bronchopneumonia ; diagnosis ; drug therapy ; Cardiac Surgical Procedures ; methods ; Ductus Arteriosus, Patent ; diagnosis ; surgery ; Female ; Heart Defects, Congenital ; diagnosis ; surgery ; Humans ; Infant ; Pulmonary Artery ; abnormalities ; surgery ; Tomography, Spiral Computed

Objective The stimulating factors and etiology of myocyte hypertrophy are not yet clear.We aim to investigate the mechanisms of bone morphogenetic protein 4 (BMP4)-induced H9C2 myocyte hypertrophy in rats by activating the extracellular signal regulating kinase ( ERK1/2) signaling pathway. Methods Rat H9C2 myocytes were cultured, the model of BMP4-induced H9C2 myocyte hypertrophy was established, and the cells were randomly di-vided into control A, BMP4 A, and angiotensinⅡ( AngⅡ) groups to be treated for 48 hours.The changes in the expression of ERK1/2 protein phosphorylation were observed at 0, 10, 30, 60, and 120 min after treated with BMP4 at the concentration of 50 μg/L and at 30 min after treated with BMP4 at 0, 10, 50, and 100 μg/L.The changes of the H9C2 myocytes were also observed after blocking the ERK1/2 signaling pathway.The cells were divided into control B, BMP4 B, BMP4+PD98059, and PD98059 groups to be cultured with 50μg/L BMP4 for another 48 hours after 30 min blockage with PD98059 at 50 ×10 -6 mol/L.The size and area of the cells were measured by inverted microscopy and image J Software, their total protein content detected by BCA, and the expressions of p-ERK1/2 and brain natriuretic peptide ( BNP) determined by Western blot. Results Compared with control A, the BMP4 A, and AngⅡ groups showed markedly larger cell areas ([649.74 ±2.03] vs [744.85 ±1.31] and [748.39 ±1.54] μm2), higher protein contents ([243.18 ±3.69] vs [340.09 ±2.14] and [347.43 ± 3.30] pg/cell), and higher expressions of the BNP protein ([0.72 ±0.44] vs [0.96 ±0.55] and [1.07 ±0.55]/GAPDH), with statistically significant differences between any two groups (P>0.05).After BMP4 intervention, the expression of p-ERK1/2 manifes-ted a time-dependent trend of first going up and then coming down, reaching the peak at 30 min, with the ERK1/2 protein phosphoryl-ation significantly higher at 30 min than at 10 min (P>0.05), especially than at 0, 60, and 120 min (P>0.01).The level of p-ERK1/2 protein phosphorylation in the mytocytes was elevated with the increased concentration of BMP4, remarkably higher at 50μg/L than at 0 and 10μg/L, but lower than at 100μg/L ( P>0.01) .The cell area, protein content, and BNP protein expression of the H9C2 myocytes were significantly lower in the BMP4+PD98059 group ([650.49 ±1.28] μm2, [244.06 ±3.48] pg/cell, and [0.55 ±0.15]/GAPDH) than in the BMP4 B group ([746.04 ±1.45] μm2, [343.57 ±4.11] pg/cell, and [0.79 ±0.55]/GAPDH) (P>0.01). Conclusion BMP4 may induce hypertrophy of rat H9C2 myocytes by activating the ERK1/2 signaling path-way.Early blocking of ERK1/2 activation may contribute to the management of myocardial hypertrophy.