ObjectiveTo observe the changes of serum homocysteine acid ( Hcy),interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP)and elucidate the clinical significance in patients with acute stroke. MethodsA total of 126 acute stroke patients were enrolled in the investigation. Based on the MESS,patients were divided into different groups according the severity and prognosis, and 108 physically healthy subjects were selected as controls. The concentration of serum Hcy, IL-6, and hs-CRP were determined in all cases after being attacked at day 3,day 14 and day 28 respectively. Results①The levels of Hcy, IL-6, hs-CRP in patients with acute stroke were significantly higher than controls ( (58.24 ±9.86) μmol/L vs. ( 17.12 ±4.23) μ mol/L, (59.64 ±13.82) ng/L vs. (18.46 ±4.62) ng/L,(19.78 ±6.12) mg/L vs. (2.28 ±0.82) mg/L,all P＜0. 01 ). ②The levels of Hcy,IL-6, hs-CRP in patients with mild, moderate and severe acute stroke were significantly higher than controls (P ＜ 0.01 ) at 3 day after the onset; and the Hcy, IL-6, hs-CRP were also significantly lower in mild cases with acute stroke compared with moderate and severe cases (P ＜ 0. 01 ). At day 14 ,the moderate and severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild cases and controls (P ＜ 0.01 ). At day 28 the severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild and moderate cases and controls (P ＜ 0.01 ) ③At day 28, the levels of Hcy, IL-6, hs-CRP in basically recovered and remarkably improved cases were significantly lower than unrecovered cases [ ( 16.12 ± 4.74) μmol/L, ( 1 8.42 ± 5.02) μ mol/L vs. ( 48.69 ± 7.89)μmol/L; ( 19.52 ± 5.67 ) ng/L, ( 20. 74 ± 6. 13 ) ng/L vs. ( 51.26 ± 11.66 ) ng/L, ( 3.21 ± 1.36) mg/L,(3.24 ± 2.51 ) mg/L vs. ( 8.86 ± 1.32 ) mg/L respectively, all P ＜ 0. 01 ]. ConclusionsThe levels of serum Hcy, IL-6, hs-CRP are significant biomarkers to evaluate the severity and prognosis of acute stroke.

Adult ; Altitude ; Chordoma ; surgery ; Endoscopy ; Female ; Humans ; Nasal Cavity ; surgery ; Paranasal Sinuses ; surgery ; Skull Base ; surgery ; Video-Assisted Surgery

Photothermal therapy (PTT) has attracted significant attention due to minimal side effects and high treatment specificity. However, it often requires very high temperature to achieve complete tumor ablation under a single PTT. Such high temperature brings obvious thermal damage and inflammatory response to the body, affecting the therapeutic effect. In recent years, nitric oxide (NO) has been used to significantly inhibit tumor growth and enhance the sensitivity of tumor cells of temperature and drugs, thus enhancing the therapeutic effect. However, compounds as NO donors often have some disadvantages such as poor biocompatibility and untargeted delivery, etc., therefore, this medical application based on NO therapy is limited. In conclusion, the organic combination of NO donors and photothermal agents (PTAs) is expected to overcome the shortcomings of single therapy and achieve the antitumor effect of "1 + 1 > 2". In view of the rapid development of NO combining with PTT in tumor therapy, this review firstly introduces the antitumor mechanisms of different types of NO donors. Then the treatment strategy based on NO combined with PTT is discussed. Finally, the prospects and challenges of this combination therapy strategy in the clinical treatment of cancer are discussed.

A gap is found between the existing quality of care,and social expectations and the PDCA model.Peking University People's Hospital applied the quality control circle in building a supervision platform for medical quality and sustained improvement of civilized services.This study demonstrated the efforts in this regard made by the hospital,and the major outcomes of the platform in its 6-year practice in identifying service defects,optimizing service processes and sustained improvement of medical services.In addition,it also shared insights on enhanced real-time supervision,standardized management,and long-term mechanisms of the hospital.

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

AIM To study the chemical constituents from Phyllodium pulchellum (L.) Desv..METHODS The ethyl acetate and n-butanol fractions of P.pulchellum 95％ ethanol extract were isolated and purified by Sephadex LH-20,silica,ODS and pre-HPLC column,then the structures of isolated compounds were identified by physicochemical properties and spectral data.RESULTS Eleven compounds were isolated and identified as phydroxybenzoic acid (1),protocatechuic acid (2),protocaechuic acid methyl ester (3),protocatechuic acid ethyl ester (4),ethyl gallate (5),p-coumaric acid (6),caffeic acid ester (7),loliolide (8),uridine (9),arbutin (10),daucosterol (11).CONCLUSION Compounds 4-11 are isolated from genus Phyllodium for the first time,compounds 2 and 3 are first obtained from this plant.

Objective To investigate the possible mechanism of aggregation and activation of neu-trophils(polymorphonuclear neutrophils,PMN)in mice with chlamydial pneumonitis. Methods C57BL/ 6 mice were inoculated intranasally with 3×103 inclusion-forming units(IFU)of Chlamydia muridarum(Cm) to induce the murine model of chlamydial pneumonitis. Samples of lung tissues collected at different time points after infection were stained by hematoxylin and eosin for histopathological assessment of inflammation. The levels of myelo-peroxidase(MPO)were detected for the evaluation of PMN aggregation. The mononu-clear cells were isolated from lung tissues. The inflammatory cells were counted with Giemsaˊs staining. CD11b+Gr1+ cell population and CD11b expression in lung mononuclear cells were analyzed by flow cytome-try. The expression of chemokines(MIP-2,LIX,KC and MCP-1)in lung tissues at mRNA level was meas-ured by RT-PCR. Results Chlamydial pneumonitis was induced in mice by intranasal inoculation of 3×103 IFU of Cm. Compared with the mice from control group,large amounts of inflammatory cells including PMN, monocytes and lymphocytes were induced in lung tissues of mice with Cm infection. PMN responded earlier than monocytes to the infection. The levels of MPO were significantly increased in mice with Cm infection and reached the highest level on the 7th day after infection. A decline in MPO levels was observed on the 14th day but the levels were still higher than those on day 0. The percentages and total numbers of CD11b+Gr1+ cells were significantly increased after Cm infection. Moreover,an increased expression of PMN CD11b was also detected by flow cytometry. The expression of chemokines(MIP-2,LIX,KC and MCP-1)was in-creased in lung tissues of mice after Cm infection. The results of the study indicated that Cm infection in-duced the expression of PMN chemoattractants,resulting in the recruitment of PMN. Conclusion The infil-tration and activation of PMN in lung tissues of mice were induced by Cm infection through increasing the ex-pression of chemokines. PMN played an important role in immune responses against Cm infection.

Abdominal Pain ; etiology ; Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Purpura, Schoenlein-Henoch ; complications ; pathology

OBJECTIVE: To compare the anesthesia properities of hyperbaric bupivacaine with those of isobaric and hypobaric solutions when administered in the supine position undergoing hip surgery or lower limb surgery using continuous spinal anesthesia. METHODS: Sixty patients( ASA I approximately III ) scheduled for hip or lower limb surgery were randomly divided into 3 groups with 20 patients in each group: Group A: 0. 375% hyperbaric bupivacaine solutions; Group B :0.375% isobaric bupivacaine solutions; and Group C: 0. 375% hypobaric bupivacaine solutions. The following variables were measured every 2 minutes during the first 30 minutes after the intrathecal injection : the onset time of sensation block, the highest plane of analgesia, the time to reach complete motor blockade, and the plane of analgesia and the extent of lower extremities' movement (modified bromage score, BMS) at different time after the administration. Meanwhile the changes of hemodynamics were recorded. RESULTS: There was no statistical difference among the basic conditions ( P > 0.05). The onset time of sensation block, and the time to reach complete motor blockade, and the time receiving the highest sharp pain sensory block in Group A were significantly shorter than those in Group B and Group C ( P < 0.01 ). The plane of analgesia obtained in the hyperbaric group was significantly higher than in both the isobaric and the hypobaric groups ( P < 0.01). The mean arterial pressure(MAP) , HR in the hyperbaric group decreased significantly after the intrathecal injection( P < 0.05 ). CONCLUSION The 0.375% Isobaric bupivacaine used during contiuous spinal anesthesia in the supine position produces a suitable and a more "controllable" anesthesia, but a minimum dosage of 10 approximately 12.5 mg is required to obtain adequate anesthesic conditions with moderate hemodynamic changes and satisfying analgesia effects. Under similar conditions, 0. 375% hyperbaric bupivacaine produces major hemodynamic consequences with high cephalad spread and 0. 375% hypobaric bupivacaine has a too long onset time.
Adult ; Anesthesia, Spinal ; methods ; Bupivacaine ; Female ; Hemodynamics ; Hip Joint ; surgery ; Humans ; Injections, Spinal ; Lower Extremity ; surgery ; Male ; Middle Aged ; Posture ; Solutions

Objective:To investigate the effect of IL-17A on the differentiation and maturation of murine bone marrow-derived dendritic cells( BMDCs ) . Methods: Murine bone marrow cells were isolated and cultured in RPMI1640 complete medium in the presence of GM-CSF(20 ng/ml) for 8 days to induce differentiation of murine bone marrow cells to DC progenitors. Then these cells were treated with LPS(1 μg/ml) for 36 h which polarized immature DCs into mature DCs. Different concentrations of rmIL-17A(10 or 100 ng/ml) was added to the culture medium at different stages of BMDC differentiation and maturation. Co-stimulatory molecules expression on BMDC were analyzed by flow cytometry,and the culture supernatants were analyzed for IL-12p40 and IL-10 level by ELISA. Results:rmIL-17 could promote co-stimulatory molecules( CD40,CD80,CD86 and MHCⅡ) expression on BMDCs in a does-dependent manner,especially,the expression of CD40 and MHCⅡhad a significant increase in high concentration of rmIL-17A group;rmIL-17A was added while LPS induced maturation of BMDCs. CD40,CD80,CD86 and MHCⅡexpression on BMDC increased sharply in LPS plus rmIL-17A stimulation group,besides,CD86,MHCⅡ showed a higher level expression on BMDC with the increase of con-centration of rmIL-17A. Furthermore,secretion of IL-12p40 and IL-10 increased significantly in the group of DCs treated with LPS plus low concentration of rmIL-17 compared with the group without rmIL-17(P<0. 001). However,high concentration of rmIL-17A group showed significantly higher levels of IL-12p40(P<0. 001),but there was no difference in IL-10. Conclusion:IL-17A promotes the phe-notypic development of BMDC progenitors propagated in GM-CSF and cooperate with LPS to induce BMDC differentiation and matura-tion.