Adolescent ; Depression ; complications ; diagnosis ; drug therapy ; Humans ; Male ; Tourette Syndrome ; complications ; diagnosis ; drug therapy ; Treatment Outcome

OBJECTIVE: To explore the diagnostic value of brain natriuretic peptide (BNP) level in patients with sepsis of blood-stasis syndrome. METHODS: The prospective method of clinical diagnostic test and evaluation principles of diagnostic test were applied. One hundred and seventy-four patients with sepsis were divided into two groups: blood-stasis syndrome group and non blood-stasis syndrome group. The levels of serum BNP in two groups were detected. RESULTS: The level of BNP in sepsis patients was related to blood-stasis syndrome (P<0.01). BNP cut-off level was 150 ng/L, sensitivity was 85.3%, specificity was 81%, the maximum value of Youden index was 0.663, and the area under the receiver operating characteristic curve (ROC) value was (0.886+/-0.025). CONCLUSION: BNP can be used as an objective index of blood-stasis syndrome diagnosis for sepsis, and BNP with boundary value of 150 ng/L is an optimal biological index.

Objective To investigate the effect of angiotensin converting enzyme inhibitor (ACEI) captopril and angiotensin Ⅱ receptor antagonist losartan on the mRNA expression of matrix metalloproteinase (MMP)-1 and MMP-9 in vascular smooth muscle cells induced by angiotensin Ⅱ (Ang Ⅱ ).Methods Male Wistar rats' thoracic aortic vascular smooth muscle cells were cultured in vitro.The cultured cells were divided in to control group,Ang Ⅱ group,captopril group,losartan group,and captopril plus losartan group.Cells in all groups were collected at the culture end-point.MMP-1 and MMP-9 mRNA expressions were detected by RT-PCR method in the collected specimens,and the effects of Ang Ⅱ on MMP-1 and MMP-9 mRNA expression and the intervention effects of captopril and losartan were observed in different Ang Ⅱ concentrations and different action times to vascular smooth muscle cells.Results ( 1 ) MMP-1 mRNA expression gradually increased along with the increments of Ang Ⅱ concentration and the action time (P＜0.05),and the most significant concentration was 10-6 mol/L (P＜0.01).(2)Captopril (5 × 10-6 mol/L) and losartan (5 × 10-6mol/L) inhibited the action of AngⅡ (P＜0.05,P＜0.01).MMP-9 mRNA expression was 0.47±0.03 ,0.86 ± 0.04,0.94±0.14 and 1.12±0.19 vs.0.10±0.04 (P＜0.05,P＜0.01) respectively when Ang Ⅱ concentration was 10-7 ,10-6 ,10-5 and 10-4 mol/L respectively.Captopril (5 × 10-6mol/L) and losartan (5 × 10-6 mol/I) significantly inhibited the MMP-9 mRNA expression which was stimulated by Ang Ⅱ (P＜0.05,P＜0.01),especially in captopril plus losartan group.The MMP-9 mRNA expression increased with the prolonging of stimulating time of Ang Ⅱ,MMP-9 mRNA expression was earlier than that of MMP-1.Conclusions AngⅡ increases the expression of MMP-1 and MMP-9 of vascular smooth muscle cells in a dose-and time-dependence manner.Captopril and losartan inhibit the MMP-1 and MMP-9 mRNA expression of vascular smooth muscle cells induced by Ang Ⅱ ,and the inhibition is the strongest when losartan was combined with captopril.The inhibitive effects is positively correlated to action time.

Objective: To observe the influence of electroacupuncture with different frequencies on rats swimming endurance and sift out the optimal frequency parameter.Methods: Wistar rats were randomly allocated to control group, non-acupoint group and electroacupuncture with low frequency group (EA with 2 Hz group), electroacupuncture with medium frequency group (EA with 15 Hz group), and electroacupuncture with high frequency group (EA with 100 Hz group), acupoints Zusanli (ST 36) and Taichong (LR 3) were punctured and rats load swimming time was used as an index, and the change of swimming endurance time before and after acupuncture was observed. Results: After electro-acupuncture, swimming time was increased in 15 Hz and 100 Hz groups respectively, with the significant differences between before and after acupuncture (P＜0.05). There was also a significant difference in the percentage of increase in swimming time between 15 Hz group and other groups (P＜0.05).Conclusion: It is suggested that electroacupuncture at acupoints Zusanli (ST 36) and Taichong (LR 3) with a frequency of 15 Hz could enhance rats's swimming endurance, and 15 Hz might be an optimal frequency parameter during the electrical stimulation.

Objective To provide a clinical anatomic basis for the bi-pedicled gastrocnemius myocuta- neous flap which is to be used to repair defects of the Achilles tendon and posterior skin of the ankle.Methods In anatomic study,out of 30 cadaver specimens,bi-pedicled V-Y gastrocnemius myoeutaneous flaps were harvested to measure the downward sliding lengths of the flap when the knee was at flexion of different degrees.In clinic,12 patients with the Achilles tendon and posterior ankle skin defects were repaired with the bi-pedicled gastrocnemius myocutaneous flaps.The areas of composite defects ranged from 10 cm?6 cm to 6 cm?4 cm.They were followed up for four months to 12 years.Results The maximal sliding length of the flap reached (9.2?0.9)cm when the knee was at flexion of 90?.All the clinical flaps survived and ambulation of the patients recovered.The dorsiflexion and plantarflexion of the ankles reached 11.0??1.4?and 35.0??4.6?respectively.Conclusion This flap is suitable for one-stage repair of composite Achilles tendon defects.

Objective To analyze the factors that influence the disease-free survival time after radical prostatectomy for prostate adenocarcinoma and to study the expression and significance of Bcl-2,C-erbB-2,Ki-67 in prostate adenocarcinoma. Methods A total of 51 cases of prostate adenocarcinoma undergoing radical prostatectomy were reviewed.Cox proportional hazard model was used to investigate the impact and co-impacts of the factors,which included age, preoperative PSA level,Gleason scores of biopsies and operative specimens,EPE,MR,SVI,LN,PAT,PRT and having testes or not during follow-up.Immunohistochemical staining was used in biopsies and resected specimens to evaluate the positivity of Bcl-2,C-erbB-2,Ki-67 in 15 of the 51 cases. Results In stepwise Cox proportional hazards model, the prognostic factors for recurrence were age(P=0.011),maximal androgen blockade(P=0.017), positive margin of resection(P=0.000),postoperative Gleason score(P=0.002),having testes or not after operation(P=0.040).The expressions of 3 types of proteins showed negative correlation with the prognosis of prostate carcinoma. Conclusions Among clinicopathologic factors,positive resected margin is the most powerful prognostic factor.Patients will benefit from maximal androgen blockage before radical prostatectomy.Disease-free survival after radical prostatectomy is not influenced by not having pelvic lymphadenectomy after finding no enlarged lymph nodes intraoperatively.Not preserving testes after prostatectomy is a favorable factor.The prognosis of prostate carcinoma can be predicted with the expressions of Bcl-2,C-erbB-2 and Ki-67 in biopsies or resected specimens.

Objective To compare the changes of physiological parameters after cardiac arrest caused by asphyxia with that of cardiac arrest induced by ventricular fibrillation in rats and assess the values of the parameters on predicting ROSC and 24 h survival rate. Method Two groups of Sprague-Dwaley rats, which randomly (ramdom number) included 30 animals in each group, were investigated. Cardiac arrest were induced by asphyxia (AS group) or ventricular fibrillation(VF group). PETCO2, aortic pressure, left ventricular pressure and ECG of limb lead Ⅱ were recorded continuously, dP/dt4o was calculated with the windaq software. The parameters were compared between the two groups at baseline, precordial compression(PC) 10 s, PC 1 min, PC 3 min, ROSC 1 h and ROSC 2 h. The relations were explored between the parameters and ROSC/24 h survival rate. Results PETCO2,aortic pressure, left ventricular pressure and ECG have distinctive changes in the two groups. In group VF, PETCO2 of ROSC rats at BL, PC 1 min and PC 3 min were higher than those of Non-ROSC rats (P ＜ 0.05); PETCO2of 24 h survival rats at ROSC 1 h and ROSC 2 h were higher than those of 24 h death rats (P ＜ 0.05), which were not observed in the group AS. dP/dt40 and - dP/dt40 at ROSC 1 h and ROSC 2 h in group VF were higher than those in group AS (P ＜ 0.05). Conclusions Physiological parameters after cardiac arrest caused by asphyxia or that of cardiac arrest induced by ventricular fibrillation in rats have unique features respectively. PETCO2 in cardiac arrest caused by ventricular fibrillation may predict ROSC and 24 h survival rate. Researchers have to select the appropriate cardiac arrest model according their research purposes and clinical requirments.

Objective To investigate the effect of ifenprodil in the mice of bone cancer pain.Methods 96 male C3H/HeJ mice were divided randomly into tumor group( Group T),control group( Group C) and sham group( Group S).The α-minimal essence media(ct-MEM) with 2 × l05 osteosarcoma NCTC 2472 cells were implanted into the intramedullary space of the right femurs of mice to induce ongoing bone cancer related pain behaviors.The sham group was inoculated by α-MEM without any cells.On the 14th d after inoculation,pain ethology indexes such as the spontaneous lifting behaviors,the paw withdrawal mechanical threshold(PWMT) and the paw withdrawal thermal latency (PWTL)were observed on 1 d before inoculation and on 3 d,5 d,7 d,10 d,14 d,17 d,19 d,23 d after inoculation.Lumbar intumescentia of mice in each group were taken out to investigate the expression level of NR2B western blot after pain behaviors tests at the same time point after intrathecal injection.Results ( 1 ) At day14 after the operation,the obvious increasing of spontaneous lifting behaviors ( ( 12.88 ±1.64) ) and the expression of NR2B (2.12 ±0.13),the significant decreasing of PWMT( (0.39 ±0.17)g) and PWTL( ( 11.59 ± 1.67 ) s ) were observed in group T compared with group S and preoperative base level (P ＜ 0.05 ).(2) At day 17,day 19 and day 23 after the operation,compared with the basal level of dayl4 before administration and group C,the spontaneous lifting behaviors ( (5.13 ± 1.38),(4.70 ± 1.58),(5.64 ± 1.17) ) of group T were obviously decreased,PWMT ( ( 1.10 ± 0.65 ) g,( 0.95 ± 0.56 ) g,( 1.05 ± 0.26 ) g) and PWTL ( ( 15.17 ± 1.27) s,( 15.93 ± 2.18 ) s,( 16.28 ± 1.48 ) s ) were increased,the expression of NR2B ( ( 1.42 ± 0.17),(1.67 ±0.53),(1.14 ±0.79) ) were significantly decreased(P＜0.05).Conclusion Repeated intratheal injection of ifenprodil can efficiently relieve spontaneous lifting behaviors,mechanical hyperalgia and thermal hyperalgia and decrease the expression of lumbar intumescentia NR2B in the mouse model of bone cancer pain.

Objective To study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. Methods Ovarian cancer cell lines A2780(IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines( overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6(by transfecting with plasmid encoding for sense IL-6 ) in A2780 cells or deleting of endogenous IL-6expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. Results We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6. 25 and 7.31; endogenous, 7. 13 -8. 34 and 7. 61 - 10. 70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs ( the resistance multiple to cisplatin and paclitaxel was 0. 15 and 0. 10, 0. 10 and 0. 08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [ mitogen-activated protein kinase-extracellular signalregulated kinase (MEK) inhibitor ] and wortmannin [ phosphatidylinositol 3-kinase (PI3K) inhibitor ]significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase ( ERK ) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration.Conclusions These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes ( MDR1 and GST-π) and apoptosis-inhibiting genes ( bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PL3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.