Cognition ; Cognition Disorders ; Humans ; Manganese ; Occupational Exposure

OBJECTIVETo explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.

METHODSFifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypotensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi (LI 11), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hematoma volume and neurological deficit score were compared at different time points between the two groups.

RESULTS(1) Blood pressure: from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [(164.3 +/- 21.6) mmHg vs (158.6 +/- 21.5) mmHg] and MAP [(113.4 +/- 4.9) mmHg vs (106.7 +/- 6.1) mmHg] were significant between the two groups (both P < 0.05). From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [(147.3 +/- 21.6) mmHg vs (158.4 +/- 23.5) mmHg, (97.2 +/- 5.3) mmHg vs (106.6 +/- 5.1) mmHg, both P < 0.05)]. (2) Hematoma volume: from the admission to 6 h after disease onset, the volume was increased by (4.15 +/- 0.73) mL in the convertional treatment group and (2.67 +/- 0.33) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). From the admission to 24 h after disease onset, it was increased by (5.57 +/- 1.26) mL in the convertional treatment group and (3.14 +/- 1.18) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). (3) Neurological deficit score: the score was increasing gradually in first 3 days after disease onset in the two groups. The score (38.39 +/- 6.84) in the acupuncture group on the first day was different significantly as compared with that (42.37 +/- 7.46) in the conventional treatment group (P < 0.05). On the 10th days, the score (24.68 +/- 5.42) in the acupuncture group was different significantly from that (29.74 +/- 7.36) in the convertional treatment group (P < 0.05).

CONCLUSIONThere is no peak of blood pressure rising, and the continuous hemorrhagic volume is less in 24 h and neurological deficit score is improved in the acupuncture group. Acupuncture brings the positive significance in the treatment of cerebral hemorrhage at the early stage.

Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Hemorrhage ; physiopathology ; therapy ; Female ; Hematoma ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

Cognition Disorders ; chemically induced ; Humans ; Manganese ; toxicity ; Manganese Poisoning ; epidemiology

BACKGROUND:Stroke is the leading cause of death and long-term disability. This study was undertaken to investigate the factors influencing daily activities of patients with cerebral infarction so as to take interventional measures earlier to improve their daily activities. METHODS:A total of 149 patients with first-episode cerebral infarction were recruited into this prospective study. They were admitted to the Encephalopathy Center, Department of Neurology, the First Affiliated Hospital of Wenzhou Medical College in Zhejiang Province from August 2008 to December 2008. The baseline characteristics of the patients and cerebral infarction risk factors on the first day of admission were recorded. White blood cell (WBC) count, plasma glucose (PG), and many others of laboratory targets were col ected in the next morning. Barthel index (BI) was calculated at 2 weeks and 3 months respectively after onset of the disease at the outpatient clinic or by telephone cal . Lung infection, urinary tract infection and atrial fibrillation if any were recorded on admission. The National Institute of Health Stroke Scale (NIHSS) scores and the GCS scores were recorded within 24 hours on and after admission, at the second week, and at the third month after the onset of cerebral infarction respectively. RESULTS:The factors of BI at 2 weeks and 3 months after onset were the initial PG level, WBC count and initial NIHSS scores. Besides, urinary tract infection on admission was also the factor for BI at 3 months. CONCLUSION:Active measures should be taken to control these factors to improve the daily activities of patients with cerebral infarction.

Adult ; Aged ; Antineoplastic Agents ; pharmacology ; therapeutic use ; DNA-Binding Proteins ; genetics ; metabolism ; Drug Therapy, Combination ; Endonucleases ; genetics ; metabolism ; Female ; Fluorouracil ; pharmacology ; therapeutic use ; Humans ; Male ; Middle Aged ; Organoplatinum Compounds ; pharmacology ; therapeutic use ; RNA, Messenger ; drug effects ; metabolism ; Statistics as Topic ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; Survival Analysis ; Treatment Outcome

Objective To evaluate the methods and consequences of surgical technique in the treatment of Stanford A aortic dissection.Methods 108 patients with type Standford A aortic dissection underwent surgery in our study,including urgent surgery in 53 and selective surgery in 55.The operation was performed under deep hypothennic circulatory arrest (DHCA) in 85 cases.Surgical procedures included ascending and semi arch replacement or total arch replacement (some cases combined with stented graft implanted into the descending aorta),"elephant trunk" procedure.Concomitant procedures included repair of intimal tear in arch or descending aorta,Bentall procedure,aortic valve replacement,Cabrol or modified Cabrol procedure,aortic valvuloplasty,mitral valvuloplasty or mitral valve replacement,tricuspid valvuloplasty and CABG.Results In-hospital mortality was 6.5% (7 of 108 patients).The mor- tality was 7.5% (4 of 53 patients) in urgent surgery group and in elective surgery group was 5.4% (3 of 55 patients).Ninety six percent survived patients were followed up for 1 month to 13.3 years [mean (3.2?1.3) years] and 2 deaths occurred during the fel- low-up period.3 patients underwent re-operatian.Conclusion The choice of surgical procedures depend on the location of intimal tear for Stanford A aortic dissection.The better operative effects can be expected with proper surgical indication,perfecting surgical technique,and enhancing postoperative treatment.

Objective To investigate the expression of JNK2 in hyperoxic lung injury ,and explore the protective effect of sub-stance P (SP) on hyperoxic lung injury and its mechanism .Methods Sixteen SD rats were divided into four groups with 4 rats in each group :room-air and f 9 g/L saline group (group A) ,room-air and SP group (group B) ,hyperoxia injury group and f 9 g/L sa-line group (group C) ,hyperoxia injury group and SP group (group D) .Rats ingroup B and D were injected with SP 1 × 10-6 mol · L -1 · kg -1 · d-1 intraperitoneally ,group A and group C were injected with an equal volume of 9 g/L saline .The animals were sac-rificed after 14 days of experiment .Lung pathology was examined with light microscopy ,lung wet/dry (W/D) ratio and the level of SP and PCNA and TUNEL in lung were evaluated .The Superoxide dismutase (SOD) ,malondialdehyde (MDA) and glutathione (GSH) level were assayed respectively in lung tissue .The quanlity of JNK2 protein was detected by Western blot analysis .Results Compared with group A ,the high oxygen groups all had different degrees of lung injury ,,while the lung pathological pictures in group D was improved significantly compared with group C .Western blot showed that level of JNK2 in group C was obviously higher than that of group A ;After the intervention ,level of JNK2 in group D was lower than that of group C .The lung W/D retio , TUNEL and PCNA expression and distribution SOD ,MDA and GSH was consistent with the trends of JNK2 protein expression . Conclusion High oxygen stress can activate damage lung tissue JNK 2 activity ;SP protection mechanism of high oxygen lung injury may be induced by cutting high oxygen activation of JNK 2 to inhibit oxidative damage .

This study was aimed to investigate the T cell (helper T cells) immune status in ITP patients and its relation with therapeutic response. 20 de novo ITP patients were enrolled (8 males, 12 females) with a median age of 41 (20 to 81). Real-time RT-PCR method was used to measure the gene expression of Th cells including T-bet, IFN-γ, GATA-3, TGF-β, Foxp3, IL-2, IL-4 in PBMNC of ITP patients before and after conventional dose of prednisone therapy [1 mg/(kg·d)] and in PBMNC of 20 normal controls. The results showed that T-bet, IFN-γ and IL-2 were significantly over-expressed in PBMNC of ITP patients before treatment compared with that in normal controls (p < 0.01), and compared with that before treatment, T-bet, IFN-γ, and IL-2 were markedly down-regulated in ITP patients after treatment. Before treatment, the expressions of Foxp3, TGF-β, GATA3 and IL-4 in ITP patients did not show difference from normal controls, while after treatment Foxp3 were more up-regulated than that before treatment (p < 0.05). After treatment, TGF-β expression showed a different pattern between old and young patients. TGF-β expression was down-regulated (p < 0.05) among ITP patients younger than 60, while up-regulated in older patients. It is concluded that there is an imbalance of Th1/Th2/Treg cytokines in ITP patients, which can be reversed by glucocorticoid treatment. The conventional dose of glucocorticoid may be regarded as effective therapy for de novo ITP patients, it may correlate with improvement of imbalance between Th1/The2/Treg cytokines.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Forkhead Transcription Factors ; metabolism ; Gene Expression ; Gene Expression Regulation ; Glucocorticoids ; therapeutic use ; Humans ; Interferon-gamma ; metabolism ; Interleukin-2 ; metabolism ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; metabolism ; pathology ; T-Box Domain Proteins ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism ; Transforming Growth Factor beta ; metabolism ; Young Adult

Objective To evaluate the relationship between the pathomechanism of neuropathic pain (NP)-inducced depression and autophagy in the cortex of the frontal lobe in rats.Methods Forty healthy male Sprague-Dawley rats in which IT catheters were successfully placed,aged 8-10 weeks,weighing 200-220 g,were divided into 4 groups (n =10 each) using a random number table method:sham operation group (group S),group NP,NP plus dimethyl sulfoxide group (group ND) and NP plus autophagy inducer rapamycin group (group NR).The neuropathic pain model was established by ligation of the left fifth spinal nerve of anesthetized rats in NP,ND and NR groups.Rapamycin 0.1 μgwas intrathecally injected via the intrathecal catheter immediately after ligation of the spinal nerve and every day after ligation once a day for 21 consecutive days in group NR.The equal volume of dimethyl sulfoxide was intrathecally injected instead of rapamycin in group ND.The mechanical paw withdrawal threshold (MWT) was measured before ligation and at 1,3,7,10,14 and 21 days after ligation.The forced swimming test was performed at 3 days before ligation and 14 and 21 days after ligation.The rats were sacrificed after the last measurement of the behaviour testing,and the prefrontal cortex was removed for determination of the expression of microtubule-associated protein light chain 3 Ⅰ (LC3 Ⅰ) and LC3 Ⅱ,Beclin-1 and p62 (by Western blot).The ratio of LC3 Ⅱ/LC3 Ⅰ was calculated.Results Compared with group S,the MWT was significantly decreased after ligation,the time of immobility was prolonged,the expression of LC3 Ⅰ was down-regulated,the expression of LC3 Ⅱ,Beclin-1 and p62 was up-regulated,and the LC3 Ⅱ/LC3 Ⅰ ratio was increased in NP and ND groups (P＜0.05).Compared with group NP,the MWT was significantly increased after ligation,the time of immobility was shortened,the expression of LC3 [and p62 was down-regulated,the expression of LC3 Ⅱ and Beclin-1 was up-regulated,and the LC3 Ⅱ/LC3 Ⅰ ratio was increased in group NR (P＜0.05).Conclusion Enhanced autophagy in the cortex of the frontal lobe is involved in the endogenous antidepressant mechanism in rats with NP.

OBJECTIVETo investigate the number of peripheral blood CD5(+) B cells and their ability of secreting IL-10 in patients with immune thrombocytopenia (ITP).

METHODSPeripheral blood lymphocytes were isolated from 57 pre-treated, 40 post-treated ITP patients and 25 controls using Ficoll-Hypaque density centrifugation and then stained with PE-CD5/FITC-CD19 for flow cytometric analysis. After 24-hour culture, lymphocytes were stained with APC-IL-10 for intracellular cytokine detection. ELISA assay was employed to determine IL-10 concentration in supernatants.

RESULTSThe percentage and absolute number of CD5(+) B cells in peripheral blood from pre-treated ITP patients were significantly higher than that from normal controls (3.75 ± 2.37)% vs (2.10 ± 1.08)%, P < 0.01; (6.29 ± 5.77)× 10(7)/L vs (3.06 ± 1.90)× 10(7)/L, P < 0.01. CD5(+) B cells expressed more intracellular IL-10 than other lymphocyte subsets both in ITP patients and normal controls. The percentages of IL-10(+) cells within CD5(+) B cells in pre-treated ITP patients and normal controls were (29.51 ± 20.73)% and(15.90 ± 9.58)%, respectively(P < 0.01). Intracellular mean fluorescence intensity (MFI) of IL-10 in CD5(+) B cells was 27.95 ± 13.99 in pre-treated patients, which was significantly higher than that in controls (P < 0.01). In contrast, IL-10 concentration in supernatants was (173.05 ± 102.50) ng/L in pre-treated ITP group, which was lower than that (230.61 ± 76.96) ng/L in controls. In patients who achieved remission, the number of CD5(+) B cells decreased to level comparable to normal controls. While intracellular IL-10 MFI of CD5(+) B cells in post-treated ITP patients remained as high as in pre-treated ones, the IL-10 concentration in supernatants increased to level similar to controls.

CONCLUSIONThe significantly increased number of CD5(+) B cells and accumulated IL-10 in CD5(+) B cells suggested impaired IL-10 secretion in ITP patients. The number and the ability of secreting IL-10 of CD5(+) B cells could be restored after effective treatments in patients with ITP.

Adult ; Aged ; B-Lymphocytes ; immunology ; metabolism ; CD5 Antigens ; metabolism ; Case-Control Studies ; Female ; Humans ; Interleukin-10 ; blood ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; blood ; immunology ; Young Adult