Objective To investigate the effect of continuous blood purification (CBP) on pro-or anti-inflammatory immune function and prognosis in patients with sepsis. Methods One hundred and two patients with sepsis were randomized into the CBP group (60 cases) and the control group (42 cases). The patients in the control group were treated with conventional therapy, and the patients in the CBP group received at least 72 h CBP treatment additionally. The APACHEⅡ score, SOFA score, the 28 day survival rate and ICU length of stay were recorded and levels of spleen Th1, Th2 were assessed by FACS flow cytometry. Enzyme linked immunoadsordent assay (ELISA) was used to determine the levels of serum IL-1, IL-10 and TNF-α before and at 24, 48, 72 h after the treatment. Results The APACHEⅡscore and SOFA score decreased markedly in the CBP group after the treatment (Р <0.05). The period of staying in ICU of patients in the CBP group was shorter than that of patients in the control group (Р < 0.05). There was no significant difference of the 28 day survival rate between the two groups (91.6% vs 71.2%, Р > 0.05). Compared with the control group, levels of IL-1, IL-10 and TNF-α were decreased markedly, and the ratio of Th1 / Th2 was increased significantly at 72 h after the treatment in the CBP group (Р < 0.05). Conclusion CBP can eliminate inflammatory mediators, and help to enhance the immune function, and restore the balance of Th1 / Th2 in patients with severe sepsis.

OBJECTIVE: To explore the effects of Salvia miltiorrhiza on renal morphology and renal function of rats with streptozotocin diabetes. METHODS: Thirty male Wistar rats were randomly divided into three groups, which were normal control group, untreated group and Salvia miltiorrhiza-treated group. Diabetic nephropathy was induced in rats of the last two groups by intraperitoneal injection of streptozotocin after unilateral nephrectomy. Then the rats in the normal control and untreated groups were fed with normal saline while those in the Salvia miltiorrhiza-treated group were fed Salvia miltiorrhiza preparation for 8 weeks. The glomerular volume (VG), kidney-to-body weight ratio (KW/BW), urinary albumin excretion rate (UAER) and creatinine clearance (Ccr) were observed. The expression levels of transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF), fibronectin (FN) and plasminogen activator inhibitor-1 (PAI-1) were detected by real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) at the end of the experiment. RESULTS: UAER, Ccr, VG and KW/BW ratio were significantly higher in the untreated group than those in the normal control group (P<0.05). The expression levels of TGF-beta1, CTGF, PAI-1 and FN in the untreated group were also significantly higher as compared with those in the normal control group (P<0.05). UAER, Ccr, VG, KW/BW ratio and the levels of TGF-beta1, CTGF, PAI-1 and FN in the Salvia miltiorrhiza-treated group were obviously lower than those in the untreated group (P<0.05). CONCLUSION: Salvia miltiorrhiza can protect rats with streptozotocin diabetes from diabetic nephropathy by suppressing the over-expressions of TGF-beta1, CTGF, PAI-1 and FN in renal cortex.

OBJECTIVEMicrocapsule chemoembolism is a promising treatment of tumors. We describe a deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum.

METHODSLingual artery cast specimens from cadavers were microscopically examined, and 78 patients with tongue cancer were recruited and treated with the deep lingual arterial embolization therapy.

RESULTSMicrocapsule embolism occurred approximately at the fifth or sixth level of the deep lingual artery branches. The five-year survival rate was 88.5% (69 out of 78), and the ten-year survival rate 52.6% (41 out of 78).

CONCLUSIONThe deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum is an effective therapy to treat carcinoma in mid-margin or mid-body of the tongue.

Antineoplastic Agents ; administration & dosage ; Capsules ; Carboplatin ; administration & dosage ; Chemoembolization, Therapeutic ; methods ; Drug Carriers ; administration & dosage ; Humans ; Injections, Intra-Arterial ; Tongue ; drug effects ; Tongue Neoplasms ; therapy

OBJECTIVETo investigate the clinical outcomes of lower cervical spinous process laminar screw technique in open door laminoplasty.

METHODSFrom February 2005 to June 2010,12 patients with cervical myelopathy were treated with open door laminoplasty by lower cervical spinous process laminar screw technique. There was intervertebral disc herniation with degenerative stenosis in 5 patients, ossification of posterior longitudinal ligament with osteophyte in 6 patients, cervical traumatic instability with spinal cord injuries in 1 patient. Nerve function, complications, and the cervical canal to body ratio (CBR), range of motion (ROM) and the anteroposterior serial alignment were observed by Japanese Orthopedic Association (JOA) score, X-ray, CT and MRI.

RESULTSThe surgical time was from 1.5 to 2 h with an average of 110 min; blood loss during operation was from 450 to 800 ml with an average of 580 ml. Postoperative complication occurred in 1 case with upper limb pain and 1 case with cerebrospinal fluid leakage. All patients were followed up from 1 to 2 years with an average of 21.8 months. JOA score improved from preoperative 9.5 +/- 1.8 to postoperative 13.6 +/- 2.4 (P < 0.01). X-ray, CT, MRI showed CBR increased obviously (P < 0.01); ROM on flexion-extension and cervical lordosis decreased respectively from (40.0 +/- 10.0) degrees and (65.0 +/- 12.0)% before operation to (15.0 +/- 5.0) degrees and (42.0 +/- 8.0) % at the final follow-up (P < 0.01).

CONCLUSIONLower cervical spinous process laminar screw technique in open door laminoplasty for cervical syndrome is safe and can obtain satisfactory effects, has strong internal fixation and reduce the risk of re-closure.

Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Spinal Stenosis ; surgery

OBJECTIVETo investigate the potential regulatory role played by the hormone resistin in lipid metabolism and expression of nuclear factor (NF)-kB and tumor necrosis factor (TNF)-a during hepatic steatosis.

METHODSA non-alcoholic fatty liver disease (NAFLD) cell model was established by treating the normal human hepatic cell line, L02, with palmitic acid. Four research groups of L02 cells were generated: C group (control, no palmitic acid treatment), P group (NAFLD model, treated with 20 microg/ml palmitic acid), CR group (C group treated with 50 microg/L recombinant human resistin), and PR group (P group treated with 50 microg/L recombinant human resistin). All treatments were carried out for 72 hours. Oil red O staining was used to detect the intracellular changes in lipid drops. Biochemical assays were used to measure triglycerides (TGs), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) levels in culture medium. The mRNA and protein expression levels of insulin receptor substrate (IRS)-2, NF-kB, and TNF-a were determined by reverse transcription-polymerase chain reaction and Western blot analysis, respectively.

RESULTSThe TG, ALT, AST, and GGT levels were higher in the P, CR, and PR groups than in the C group. The NF-kB mRNA level was also higher in the P, CR, and PR groups (Student's t = 17.64, 22.03, 26.06 respectively) than in the C group, as was the TNFa mRNA level ( t = 5.67, 5.38, 11.64), but the IRS-2 mRNA level was lower ( t = 8.19, 9.23, 20.93) (all, P less than 0.05). In addition, no significant difference in these mRNA levels were found between the P group and the CR group (NF-kB: t = 1.75, TNFa: t = 0.58, IRS-2: t = 2.14; all, P more than 0.05). The detected protein levels of NF-kB, TNFa, and IRS-2 were consistent with the mRNA levels.

CONCLUSIONResistin can promote steatosis in LO2 cells through the NF-kB signaling pathway, thereby contributing to the NAFLD pathogenic process.

Cell Line ; Fatty Liver ; metabolism ; Humans ; Liver ; metabolism ; NF-kappa B ; metabolism ; Non-alcoholic Fatty Liver Disease ; Resistin ; metabolism ; Signal Transduction ; Tumor Necrosis Factor-alpha ; metabolism

Objective To compare the odds ratio of waist circumference (WC) and/or body mass index (BMI) on cardiovascular risk factors. Methods Data on a cross-sectional study involving 41 087 adults (19 567 male, 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of the Chinese Working Group on Obesity for Children (WGOC) (BMI, 24 and 28 kg/m2; WC, male 85 cm, female 80 cm), the study population were divided into 9 groups. The prevalence and odds ratio (OR) of cardiovascular disease (CVD) risk factors were compared among these 9 groups. Variation and standard β were indexes being used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Within each of the BMI categories, with few exceptions, indices levels on CVD risk factors were significantly increased (decreased for HDL-C levels) with the increase of WC, and vice versa. After adjusting the effects of age, sex, income, education, sedentary activity and dietary factors, the ORs of hypertension in adults with higher WC within each of the BMI categories were higher than adults with lower WC, and the ORs of hypertension in adults with higher BMI within each of the WC categories were higher than adults with lower BMI. Similar trends were found for high fast plasma glucose (FPG) and dyslipidemia. The variation in CVD risk factors explained only by WC and BMI were quite similar,but slightly larger when combined WC with BMI. Standard β was higher on BMI when predicting systolic BP and was higher on WC when predicting TG, TC and HDL-C. Conclusion BMI and WC were independently associated with the risk factors on CVD.To combine the BMI and WC, the results could accurately evaluate the risk of CVD, thus to provide substantive evidence that the WGOC cutoff points for the WC might help in identifying those population under increased risk.

Angiogenic gene therapy and cell-based therapy for peripheral arterial disease(PAD) have been studied intensively currently. This study aimed to investigate whether combining mesenchymal stem cells(MSCs) transplantation with ex vivo human hepatocyte growth factor(HGF) gene transfer was more therapeutically efficient than the MSCs therapy alone in a rat model of hindlimb ischemia. One week after establishing hindlimb ischemia models, Sprague-Dawley(SD) rats were randomized to receive HGF gene-modified MSCs transplantation(HGF-MSC group), untreated MSCs transplantation (MSC group), or PBS injection(PBS group), respectively. Three weeks after injection, angiogenesis was significantly induced by both MSCs and HGF-MSCs transplantation, and capillary density was the highest in the HGF-MSC group. The number of transplanted cell-derived endothelial cells was greater in HGF-MSC group than in MSC group after one week treatment. The expression of angiogenic cytokines such as HGF and VEGF in local ischemic muscles was more abundant in HGF-MSC group than in the other two groups. In vitro, the conditioned media obtained from HGF-MSCs cultures exerted proproliferative and promigratory effects on endothelial cells. It is concluded that HGF gene-modified MSCs transplantation therapy may induce more potent angiogenesis than the MSCs therapy alone. Engraftment of MSCs combined with angiogenic gene delivery may be a promising therapeutic strategy for the treatment of severe PAD.
Animals ; Bone Marrow ; metabolism ; pathology ; Bone Marrow Transplantation ; Cells, Cultured ; Hepatocyte Growth Factor ; genetics ; Hindlimb ; pathology ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; metabolism ; pathology ; Neovascularization, Physiologic ; genetics ; Rats

OBJECTIVETo assess the therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy, so as to provide basis for clinical treatment and further study.

METHODSAccording to Cochrane systematic assessment method of evidence-based medicine, Meta analysis on randomized controlled trials or half randomized controlled trials of acupoint stimulating therapy for deglutition disorders after apoplexy were made.

RESULTSIn 37 Chinese literatures, 3 697 patients in total were enrolled, and the results indicated that the effective rate of acupoint stimulating therapy on deglutition disorders after apoplexy was better than that in the control group [RR was 1.38, 95% CI (1.28, 1.49), Z = 8.38, P < 0.01]; and the cured rate also was better than that of the control group [RR was 2.56, 95% CI (2.15, 3.04), Z = 10.70, P < 0.01].

CONCLUSIONThe therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy is better than that of the control group, but more randomized, double blind, controlled trials with good designs are needed to confirm this result.

Acupuncture Points ; Deglutition Disorders ; therapy ; Evidence-Based Medicine ; Humans ; Meta-Analysis as Topic ; Randomized Controlled Trials as Topic ; Stroke ; complications ; Treatment Outcome

AIMTo explore the protective effect of propyl gallate against neuronal injury in the boundary zone of the infarction area in the rat cerebral ischemia-reperfusion model and its possible mechanism.

METHODSTransient focal ischemia induced by middle cerebral artery occlusion in the rats was established by ligation of the left internal carotid artery for 2 h. Rats were treated by propyl gallate with different doses (23.5, 47 and 94 micromol x kg(-1)) for three days before operation. Coronal brain sections were collected after 1 , 2, 4, 6, 12 and 24 h of reperfusion, neuronal injury in the boundary zone of the infarction area was evaluated by TUNEL and Nissl staining. The expression of activated Caspase-3, total SAPK/JNK, p38MAPK and their phosphorylation (Thr183/Tyr185, Thr180/Tyr182) was investigated by immunohistochemistry and Western blotting with corresponding antibodies.

RESULTSAlthough SAPK/JNK immunoreactivity did not increase at each time point in the boundary zone of the infarction area after reperfusion, p-SAPK/JNK immunoreactivity increased significantly at 1 h and then decreased gradually, and p38MAPK immunoreactivity was enhanced at each time point, peaked at 6 h. Expression of p-p38MAPK peaked at 6 h. Activated Caspase-3 immunoreactivity appeared at 6 h in the boundary zone of the infarction area and peaked at 12 h. TUNEL positive neurons were observed at 12 h and became more abundant at 24 h. The number of Nissl positive neurons decreased gradually and apoptosis ratio of neurons peaked at 24 h. Propyl gallate reduced the immunoreactivity of SAPK/JNK, p-SAPK/JNK, p38MAPK and p-p38MAPK markedly at 1 and 6 h. Propyl gallate with doses of 47 and 94 micromol x kg(-1) were more effective.

CONCLUSIONInhibition on the activation of SAPK/JNK and p38MAPK is the possible protective mechanism of propyl gallate against neuronal injury induced by cerebral ischemia-reperfusion.

Animals ; Apoptosis ; drug effects ; Brain Ischemia ; etiology ; Caspase 3 ; metabolism ; Enzyme Activation ; drug effects ; Infarction, Middle Cerebral Artery ; complications ; MAP Kinase Kinase 4 ; metabolism ; Male ; Neurons ; pathology ; Neuroprotective Agents ; pharmacology ; Propyl Gallate ; pharmacology ; Putamen ; pathology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; enzymology ; etiology ; pathology ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo assess the accuracy and feasibility of combination of CT coronary angiography (CTCA) and adenosine stress myocardial perfusion scintigraphy (MPS) for diagnosis of coronary artery disease (CAD).

METHODSCTCA, MPS were performed in 105 patients with suspected or diagnosed CAD within 4 weeks before coronary angiography (CAG) examination.

RESULTSThe sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 97.1%, 75.0%, 88.2%, 93.1% and 89.5%, respectively, for CTCA; 79.7%, 63.9%, 80.9%, 62.2% and 74.3%, respectively, for MPS and 97.2%, 98.5%, 98.5%, 89.7% and 95.2%, respectively, for CTCA + MPS.

CONCLUSIONCombination of CTCA and adenosine stress MPS, which provided both anatomical and functional information of coronary vessels, could significantly increase the specificity and PPV of diagnosing CAD with CTCA.

Aged ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Myocardial Perfusion Imaging ; Predictive Value of Tests ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed