OBJECTIVETo explore the distribution characteristics of basic syndromes and its related factors in patients with chronic functional constipation (CFC).

METHODSThe complete data of 538 patients with CFC were collected and initial database was established with Epidata 3. 0. TCM syndrome typing was performed. The distribution characteristics of basic syndromes were analyzed using SPSS 17. 0 Software. The univariate and multivariate Logistic regression analyses were performed with SPSS 17. 0 Software to determine basic syndrome related factors such as age, engaged professionals, sleep quality, depression, mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation, and so on.

RESULTSThe TCM syndrome frequency of CFC patients was sequenced from high to low as qi deficiency syndrome (380 cases, 70.6%), qi stagnation syndrome (337 cases, 62.6%), blood deficiency syndrome (234 cases, 43.5%), yin deficiency syndrome (220 cases, 40.9%), yang deficiency syndrome (197 cases, 36.6%), and others(58 cases, 10. 8%) . Most patients were complicated with complex syndromes, and the most common complex syndromes were qi deficiency complicated qi stagnation syndrome (275 cases, 51.1%) and qi deficiency complicated blood deficiency syndrome (222 cases, 41.3%). Aging, work fatigue, and exercise conditions were main related factors for qi deficiency syndrome (P <0. 01, P <0. 05). Poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, defecation barriers constipation were main related factors for qi stagnation syndrome (P <0.01). Sleep quality and poor emotional (depression and anxiety tendencies) were main related factors for blood deficiency syndrome (P <0. 01, P < 0.05). Stimulating beverages were main related factor for yin deficiency syndrome (P <0.05). Engaged in mental work and slow transit constipation were main related factors for yang deficiency syndrome (P < 0. 01, P <0. 05).

CONCLUSIONSCFC is featured as complex syndromes. The most common complex syndromes were qi deficiency complicated qi stagnation syndrome and qi deficiency complicated blood deficiency syndrome. Basic syndrome related factors such as age, engaged professionals, sleep quality, poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation were associated with the distribution of CFC syndromes.

Anxiety ; complications ; Constipation ; complications ; diagnosis ; psychology ; therapy ; Depression ; complications ; Diagnosis, Differential ; Factor Analysis, Statistical ; Fatigue ; Humans ; Medicine, Chinese Traditional ; Qi ; Stress, Psychological ; complications ; Syndrome ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

BackgroundStudies confirmed that ultraviolet A (UVA)- riboflavin photodynamic therapy can control keratoconus progresses by altering the physicochemical property of cornea.The collagen components of amniotic membrane transplantation is similar to that of cornea and amniotic membrane transplantation has been widely used to ocular surface reconstruction.However,the study on UVA riboflavin-induced-collagen crosslinking for amniotic tissue is less now.ObjectiveThis study was to investigate the role of UVA-riboflavin on frozen-preserved human amniotic membrane.Methods Human amnions were obtained in informed consent and prepared into 2 mm×15 mm pieces and were then divided into 4 groups using lottery method and 6 pieces for each group.The first 3 groups were treated with the photosensitizer riboflavin and UVA-irradiation ( wavelength:370 nm ; irradiation energy:1,2 or 3 mW/cm2,distance:10 mm) for 30 minutes,and the untreated fourth group was as control group.Biomechanical stress-strain test was performed using a microcomputer-controlled biomaterial tester and the stress(mN) was recorded when the strains were set to 5％,10％ and 15％.The 7 mm diameter of human amniotic membrane pieces were trephined and divided into 4 groups(5 pieces for each group) with the treated method as mentioned above,and then the buttons were exposed to 0.1％ collagenase Ⅰ solution.The transparency was scored and the complete dissolving time was record.In histological evaluation,three groups (3 pieces for each group) of human amniotic membranes were treated using UVAriboflavin(3 mW/cm2),0.1％riboflavin,normal saline for 30 minutes respectively and examined under the transmission electron microscopy.This study was performed under the permission of the Ethic Commission of Beijing Tongren Hospital.ResultsWhenthestrainwas 5％,10％,15％,thestressof controlgroupand1,2,3 mW/cm2UVA group were statistically signifcantly different ( F =3.411,P =0.037; F =9.927,P =0.001;F=11.118,P=0.000).The tensile strength of human amniotic membrane cross-linked with UVA-riboflavin was statistically significantly increased in comparison to the control group (P＜0.05 ),and the tensile strength of human amniotic membrane became stronger as UVA power increased.The complete dissolve time was (8.6± 1.8 ) hours for the control group,(39.6± 2.3 ) hours for 1 mW/cm2 UVA group,(71.4±0.9 ) hours for 2 mW/cm2 UVA group,(78.8± 1.8 ) hours for 3 mW/cm2 UVA group,showing the enhanced anti-enzyme ability of human amniotic membrane after cross-linking(P＜0.01 ).The collagen density in the UVA-riboflavin treated group was increased,the connection among the collagen fibers as well as between the stroma and the epithelium became tighter than those of control group.ConclusionsCollagen cross-linking with UVA-riboflavin make the biomechanical strength and enzymatic resistance of human amniotic membrane enhance and ultrastructure change of human amniotic membrane.

OBJECTIVETo find new serum tumor markers for ovarian epithelial cancers by 2-DE DIGE and MALDI-TOF/TOF proteomic methods, in order to improve the diagnostic sensitivity and specificity.

METHODSSerum samples from 103 cases of ovarian epithelial cancers, 60 cases of healthy women, 63 cases of benign ovarian tumors and 63 cases of benign pelvic diseases were collected. Sera of 20 cases of ovarian epithelial cancers (A), 20 cases of ovarian benign tumors (B), 20 cases of pelvic benign diseases (C) and 20 cases of health control (D) were matched by age and pooled, respectively. After depletion of high abundance serum albumin and IgG, the samples were assayed by 2-DE DIGE. The test was repeated three times. Analysis with DeCyder software revealed significant differential protein spots which were identified by MAIDI-TOF/TOF. Western blot and ELISA were used to validate the candidate serum markers.

RESULTS1) There were 41 proteins having significant differences between the groups. MAIDI-TOF/TOF successfully identified 28 proteins. Haptoglobin (Hp) was the most significantly up-regulated protein, and transferrin (Tf) was the most significantly down-regulated protein. 2) Western blot and ELISA proved that there were significant differences in Hp and Tf between ovarian epithelial cancers and normal controls (P = 0.000), between ovarian epithelial cancers and ovarian benign tumors (P = 0.000), between ovarian epithelial cancers and benign pelvic disease sera (P = 0.000). 3) CA125 + Hp + Tf combined detection of ovarian cancer had higher sensitivity and specificity than CA125, Hp or Tf detection alone.

CONCLUSIONHp and Tf are differently expressed in the sera of patients with ovarian epitheliual cancers. They can be used as serum biomarkers for ovarian epithelial cancers. CA125 + Hp + Tf combined detection may improve the sensitivity and specificity of diagnosis of ovarian epithelial cancers.

Adenocarcinoma, Clear Cell ; blood ; Biomarkers, Tumor ; blood ; Cystadenocarcinoma, Mucinous ; blood ; Cystadenocarcinoma, Serous ; blood ; Electrophoresis, Gel, Two-Dimensional ; Endometriosis ; blood ; Female ; Haptoglobins ; analysis ; Humans ; Ovarian Neoplasms ; blood ; Pelvic Inflammatory Disease ; blood ; Proteins ; analysis ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Teratoma ; blood ; Transferrin ; analysis

Objective To investigate the expression of non receptor protein tyrosine phosphatase 12 (PTPN12) in hepatocellular carcinoma (HCC) and its adjacent tissues and investigate the relationship between the expression of non receptor protein and prognosis of hepatocellular carcinoma (HCC).Methods The expresson of PTPN12 protein in HCC tissues and adjacent liver tissues was detected by immunohistochemistry.The relationship between the expression of PTPN12 protein and prognosis of primary hepatocellular carcinoma was evaluated by rank correlation and Cox proportional hazards regression model.Results Compared with the adjacent liver tissues,the expression of PTPN12 protein in HCC tissues was significantly lower (55.83％ vs 43.12％,P＜0.005).Further analysis showed that the decreased expression of PTPN12 was closely related with tumor recurrence (x2 =4.346,P=0.015).Single factor analysis showed that the decreased expression of PTPN12 in hepatocellular carcinoma and liver cancer specific survival and recurrence of hepatocellular carcinoma related (x2=5.687,P＜0.001),and multivariate Cox proportional hazards regression model analysis showed that the expression of PTPN12 in patients with liver cancer were independent prognostic factors (x2 =6.687,P＜0.05).Conclusion The expression of PTPN12 protein was down or absent in human hepatocellular carcinoma,and the expression of PTPN12 may be a biomarker for the recurrence and prognosis of HCC patients.

Objective To study the expression of adhesion molecules CD44 and ICAM-1 in BALB/c mice infected with Mycoplasma pneumoniae (MP) and elucidate the relationship between MP and infection.Methods BALB/c mouse MP model was established by MP nasal instillation,and the pathological changes of lung in MP mice were observed.The expression levels of adhesion molecules CD44 and ICAM-1 in serum and bronchoalveolar lavage fluid of mice infected with 5,8,15,20 and 30d MP were determined by ELISA.Results Compared with the model group,MP infected BALB/c mice after lung inflammation was significantly up-regulated MP,the expression in BALB/c mice infected with the serum and bronchoalveolar layage fluid in CD44 and adhesion molecule ICAM 1 (t5 d serum CD44 =53.64 ng/L,t5 d BALF CD44 =144.3 ng/L;t5 d serum ICAM-1 =73.72 ng/L,t5 d BALF ICAM-1 =165.06 ng/L,all P＜ 0.000;t8 d serum CD44 =40.86 ng/L,t8 d BALF CD44 =21.31 ng/L;t8 d serum ICAM-1 =30.57 ng/L,t8 d BALF ICAM-1 =19.61 ng/L,all P＜0.000).The Mycoplasma pneumoniae infection increased the expression levels of adhesion molecules CD44 and ICAM-1 in mice.Conclusion After MP mice were cured,the expression of CD44 and ICAM-1 was down regulated,and the up regulation of CD44 and ICAM-1 expression might be related to the severity of MP pneumonia.

Objective: To evaluate the inhibitory effect of tumor vaccines in colon carcinoma model mice. Methods: Mouse bone marrow⁃derived dendritic cells（BMDCs）were stimulated by using CpG β⁃glucan nanoparticles（CNP）in vitro. The BMDCs were divided into PBS group，NP group（without CpG nanoparticles），Lysate group（MC38 cell lysate）and CpG group（CpG1826），which were determined for the expression of marker molecules on the surface by flow cytometry and for the contents of interleukin⁃6（IL⁃6）and IL⁃12p40 in the culture supernatant by ELISA. The tumor lysate nano⁃vaccine was pre⁃ pared by mixing 50 mg／mL tumor lysate（MC38 cell lysate）with 200 mg／mL CNP in a volume ratio of 1∶1，with which mice were subcutaneously immunized as Vaccine group. Vaccine group，PBS group，CNP group and Lysate group were im⁃ munized once a week，for three times in total. Mice were subcutaneously inoculated with MC38 cells，2 × 105 cells for each， in the right lower limb 1 h after the last immunization，and measured for tumor volume once every three days to plot the tumor growth curve. The ratios of CD3+ CD4+ T and CD3+ CD8+ T cells in the blood were analyzed by flow cytometry and the levels of tumor necrosis factor⁃α（TNF⁃α）and interferon γ（IFNγ）in the blood and spleen of mice were determined by ELISA. Results: CNP effectively increased the expression of CD11c+ CD80+，CD11c+ CD86+，CD11c+ MHC⁃Ⅱ+ and the secretion of IL⁃6 and IL⁃12p40 in BMDCs in vitro，which were significantly higher than those in other 4 groups（t = 4. 3 ~ 46. 2，each P < 0. 05）. Compared with that of the other three groups，the tumor volume of mice in Vaccine group decreased significantly（t =2.6~3.4，eachP <0. 05）；TherewasnosignificantdifferenceinCD3+ CD8+ TandCD3+ CD8+ Tcellratios（t = 0.5~ 1. 9，each P > 0. 05）；The content of IFNγ in blood increased significantly（t = 3. 8 ~ 4. 6，P < 0. 05），while thatof TNF⁃α showed no significant difference（t = 0. 4 ~ 2. 0，each P > 0. 05）；However，the contents of IFN γ and TNF⁃α in spleen increased significantly（t = 6. 3 ~ 13. 0，each P < 0. 001）. Conclusion The prepared nano⁃vaccine of tumor lysate improvedtheimmune level in mice and effectively inhibited the growth of colon carcinoma.

OBJECTIVE: To investigate the relationship between serum level of homocysteine and the development of collaterals in patients with severe coronary artery stenosis (SCAS). METHODS: Eighty patients with at least one vessel stenosis over 90% among the 3 main vessels of coronary artery were consecutively enrolled into the study according to angiographic estimation. The development of collaterals was classified by Rentrop's method. RESULTS: The serum levels of homocysteine among the single-vessel, bi-vessel and tri-vessel coronary artery disease groups had no significant difference; there was no linear correlation between the serum level of homocysteine and Gensini's score. The level of homocysteine in the poorly developed collaterals was significantly higher than that in the well-developed collaterals in the SCAS patients (P<0.001). Multiple stepwise logistic analysis revealed that homocysteine negatively correlated with the development of collaterals (P<0.001, odds ratio=0.353; 95% confidence interval=0.201 - 0.620), whereas it positively correlated with the number of stenosis vessels. CONCLUSION The serum level of homocysteine is independently and negatively associated with the development of collateral circulation in severe SCAs patients.
Adult ; Aged ; Aged, 80 and over ; Collateral Circulation ; Coronary Angiography ; Coronary Circulation ; Coronary Stenosis ; blood ; physiopathology ; Female ; Homocystine ; blood ; Humans ; Logistic Models ; Male ; Middle Aged

Intracranial atherosclerotic disease (ICAD) of a major intracranial artery, including middle cerebral artery (MCA),basilar artery, is the most common causes of stroke and is associated with a high risk of recurrent stroke in China. The difficulty to treatment these high-risk disease is to identify high-risk stroke subgroups and to develop more effective treatments (aggressive medical therapy/endovascular therapy). With the benefits, including non-invasive, in vivo, and no-ionizing radiation, 3.0 Tesla high-resolution magnetic resonance imaging (HR MRI) could be used to stratify high-risk patients, monitor progression of disease, and evaluate clinical efficacy, based on MCA wall structure and plaque characteristic. HR MRI has the latency of predicting high-risk patients benefit from endovascular therapy, having a broad application prospect during psot-SAMMPRIS era. The current research on MCA stenosis using HR MRI focuses on methodoiogy, diagnosis and differential diagnosis, etiology, and lacks of clinical efficiency evaluation and prognostic analysis of ICAD treatment, especially lacks the research on in-stent restenosis, which needs further investigation.
Brain ; China ; Constriction, Pathologic ; Diagnosis, Differential ; Humans ; Intracranial Arteriosclerosis ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; pathology ; Plaque, Atherosclerotic ; Prognosis ; Stroke ; Treatment Outcome

OBJECTIVETo evaluate the feasibility and curative effect of thymectomy for myasthenia gravis (MG) by video-assisted thoracoscopic surgery (VATS) through right anterior-lateral approach.

METHODSFifty-six patients of MG were treated with thoracoscopic thymectomy and mediastinal fat dissection through right anterior-lateral approach from August 2001 to October 2007. The feasibility, safety, complication and remission for MG were retrospectively analyzed.

RESULTSFifty-five operations were completed by VATS. The mean operative time and blood loss were (96.2 +/- 52.1) min and (68.7 +/- 21.4) ml, respectively. The brachiocephalic vein injury by the electric coagulator occurred in two cases and one of them performed thoracotomy for homeostasis, the other performed ligation. The postoperative pathology showed hyperplasia in 38 cases, atrophy in 5 cases, thymoma in 12 cases and cyst of thymus in 1 case. And the operative complication included one myasthenia crisis (1.8%) at the third day and one death (1.8%) at the eighth day because of postoperative hemorrhage. The average length of stay was (7.9 +/- 2.9) d. All cases were followed up from one to seventy months. Eight (14.3%) of complete remission, 39 cases (69.6%) of partial remission and 7 cases (12.5%) of no change were found. The total effective rate was 83.9%.

CONCLUSIONSThoracoscopic thymectomy through right anterior lateral approach is technically feasible, safe and minimally invasive. It has a high remission rate for MG.

Adolescent ; Adult ; Aged ; Child ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; surgery ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thymectomy ; methods ; Treatment Outcome

OBJECTIVETo investigate the clinical application of the reversed sural neurovascular fasciocutaneous flap.

METHODSFrom January 2007 to May 2009,10 patients (6 males and 4 females) with soft tissue defects on lower limbs were treated by reversed sural neurovascular fasciocutaneous flap. The end-to-side neuroanastomosis were used to reinnervate the flap and microsurgery was used for anastomosing small saphenous vein. The age ranged from 16 to 55 years (mean, 32 years). There were 6 patient with soft tissue defects on foot, 2 patients with exposed bone after operation, 2 patients with chronic ulcer on limb. The patients were evaluated with appearance, blood supply, texture and 2-PD of the flaps.

RESULTSAll the patients were followed for 6 to 24 months (mean, 15 months). The flaps in all 10 patients survived completely. The appearance, blood supply and texture of the flaps were excellent and 2-PD was 9 to 12 mm.

CONCLUSIONThis flap has sufficient blood supply and high survival rate. It also effectively retains the feeling of dorsolateral heeland improved quality of life.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; blood supply ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome ; Young Adult