Adolescent ; Adult ; Female ; Health Care Surveys ; Health Status ; Humans ; Male ; Medical Waste Disposal ; Middle Aged ; Occupational Health ; Personnel, Hospital ; Young Adult

Objective To investigate the relationship of the lymphangiogenesis and lymphatic metastasis by observing the expression of proliferating cell nuclear antigen in the hamster tongue cancer development and analyzing the correlations of lymph vessel density (LVD), lymphatic vessel area (LVA) and malignance or lymphatic metastasis of tongue cancer cells. Methods Forty_two hamster tongue cancer models were induced by painting 1.5% 7,12-dimethylben(a) anthracene (DMBA) acetone solution after scratching, 7 models were sacrificed every two weeks. The pathological changes of tongue cancer were determined by the HE staining. The lymphatic hyperplasia was determined by PCNA and Desmoplakin(DP I +Ⅱ) Immunohistochemical double staining. The tumors and lymphatic endothelial cell proliferation index (proliferation index, PI), lymphatic vessel density (LVD) and lymphatic vessel area (LVA) were measured and statistically analyzed. Results The oncogenesis of tongue was divided into three stages: atypical hyperplasia, carcinoma in situ and early invasive stage;atypical hyperplasia group:PI (91.55), LVA (7570.23), LVD (2.50);carcinoma in situ group: PI (113.36), LVA (12105.45), LVD (3.73);early invasive group: PI (124.67), LVA (14524.33), LVD (5.33). The PI, LVA and LVD were compared among groups above (P<0.05), and the correlation of PI with LVA and LVD was positive (P<0.05);Lymphatic metastasis group:PI (130.50), LVA (15430.67), LVD (6.17), non lymphatic metastasis group:PI (113), LVA (12711.67), LVD (3.67), the PI, LVA and LVD were compared between the two groups above (P<0.05).Conclusion With the development of hamster tongue cancer, lymphatic endothelial cell proliferation activity increased, suggesting that the lymphangiogenesis existed in the tongue carcinogenesis process;the values of the LVD and LVA increased in the hamster tongue cancer development, which was positively correlated with the cancer cell malignance and lymphatic metastasis.

Objectives: To investigate the effects of adhesion and proliferation of bone mesenchymal stem cells (BMSCs) in the surface of lactic acid/glycolic acid/asparagic acid-co-polyethylene glycol PLGA-[ASP-PEG] tri-block polymer scaffolds, try to find a new biomaterial to induce seed cells in vitro for bone tissue engineering. Methods: Modified PLGA with polyethylene glycol (PEG) and asparagic acid (ASP) that has many ligands, and synthesis PLGA-[ASP-PEG] polymer material. BMSCs were cultured in PLGA-[ASP-PEG] polymer material and PLGA used as control group. Through precipitation method, MTT assay and total cellular protein detection to test the adhersion and proliferation of BMSCs. Scanning electron microscope is used to observe cells appearance. Results: BMSCs on the surface of PLGA-[ASP-PEG] polymer scaffolds are adherention to the culture flask, the number of cells is much higher than PLGA’s. The precipitation method suggest that adhesion and proliferation of BMSCs on the surface of PLGA-[ASP-PEG] is much higher than the control group(P

Objective To investigate the relationship between serum HBeAg level and inflammation grade (G)/fibrosis stage (S) in the liver tissues of chronic hepatitis B (CHB) patients in the immune clearance phase (IC). Methods Both liver biopsy samples and serum samples were consecutively collected from CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during March 2007 to June 2010.Electro-chemiluminescence and fluorogenic quantitative polymerase chain reaction (PCR) methods were used to determine HBeAg titer and hepatitis B virus (HBV) DNA level,respectively.The relationships between HBeAg titer and liver pathological stages were analyzed using Spearman rank correlation analysis.Receive operating characteristic (ROC) curve was used to evaluate the diagnostic value of HBeAg for liver pathological stages.Results Totally 249 patients with CHB were enrolled into this study.The serum HBeAg absorbances in patients with liver inflammation G1 to G4 were (2.93±2.85),(2.96±2.74),(2.69±2.67) and (2.30±2.41) lg s/co,respectively,while those in patients with liver fibrosis S1 to S4 were (2.99±2.74),(2.89±2.73),(2.58±2.55) and (2.32±2.44) lg s/co,respectively,which indicated that serum HBeAg titers were significant different in patients with different grading and staging of liver tissues (x2 =47.13,P＜0.01; x2 =74.12,P＜0.01).Spearman rank correlation analysis showed that serum HBeAg titer was negatively correlated with inflammation grades and fibrosis stages of liver tissues (r=-0.418 and-0.532,respectively; both P＜0.01).ROC curve analysis revealed that the areas under the curve (AUC) were 0.74 (G≥≥3) and 0.73 (G≥4),and the HBeAg (s/co) cut-off values were 2.95 and 2.64 lg s/co,respectively.Similarly,ROC curve analysis revealed that the AUC were 0.80 (S≥3) and 0.77 S≥4),and the HBeAg cut-off values were 2.99 and 2.82 lg s/co,respectively.Conclusions The serum HBeAg titer is negatively correlated with the inflammation grades and fibrosis stages m liver tissues of CHB patients in IC phase.The level of HBeAg may be used as an adjunctive noninvasive marker to reflect the inflammation and fibrosis status in the liver.

Objective To investigate the relationship between levels of ceruloplasmin (CP) and inflammation grade,fibrosis stages in liver of patients with chronic hepatitis B (CHB),and to establish liver fibrosis non-invasive model and evaluate its diagnostic value for liver pathological stages.Methods Both liver biopsy samples and sera were collected from 148 consecutive CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during January 2009 to June 2011.The relationships between CP and liver pathological stages were analyzed using Spearman rank correlation analysis.Receiver operator characteristic (ROC) curve was used to evaluate the diagnostic value of CP for liver pathological stages.The diagnostic values of relevant indicators were analyzed by Logistic regression.The liver pathology-predicting model was built and the diagnostic value of the model was analyzed by ROC curve.Results The mean values of CP in 148 CHB patients with liver inflammation grades of G1 to G4 were (212.5 ± 34.9),(205.5± 32.0),(201.4 ± 37.7) and (172.8 ± 20.4) mg/L,respectively,which were significantly different by ANOVA test (F=6.309,P＜0.01).Similarly,the mean values of CP in patients with liver fibrosis stages of S1 to S4 were (217.4±32.3),(206.0±37.7),(194.2±29.8) and (179.7±30.4) mg/L,respectively,which were significantly different by ANOVA test (F =8.608,P ＜ 0.01).Spearman rank correlation analysis showed that CP was negatively correlated with liver inflammation grades (r=-0.316,P＜0.01) and fibrosis stages (r=-0.404,P＜0.01).ROC curve analysis revealed that the area under the curves (AUC) were 0.71 (S≥2),0.70 (S≥3) and 0.72 (S=4).Multiple Logistic regression analysis showed that CP,α-fetoprotein,cholesterol,platelet and age were independent predictors for liver fibrosis.ROC curve analysis revealed that AUC were 0.84 in model-1 (S≥2),0.83 in model-2 (S≥3) and 0.87 in model-3 (S=4).The accuracy rates were 71.8％,80.3％ and 79.2％,respectively.Conclusions The CP levels are negatively correlated with inflammation grades and fibrosis stages in the liver of CHB patients.CP could be an important non-invasive indicator for liver fibrosis and the model including CP can be used to predict liver fibrosis in CHB.

Objective To compare the imaging characteristics of multiple sclerosis (MS) and neuromyelitis optica (NMO) for better diagnosis and differential diagnosis.Methods The brain and spinal MRI images of 60 MS and 48 NMO cases were retrospectively reviewed.The imaging characteristics including the predilection site,morphological features,enhancement manifestations were summarized.All data was analyzed by using t test and Chi square test with SPSS 13.0.Results (1) The three top predilection sites of brain in head MRI of MS patients were periventricular white matter (34 cases in 60),subcortical white matter (27 cases in 60),brain stem (23 cases in 60).MS lesions also were found in basal ganglia,cerebellum,corpus callosum and thalamus,as well as cortex (9 cases in 60).By contrast,brain lesions were observed in 59.4％ (19/32) of NMO patients,and the three top predilection sites of NMO by turns were brain stem (13 cases in 19),periventricular white matter (12 cases in 19),subcortical white matter (7 cases in 19).Furthermore,the lesions surrounding third ventricle (6 cases in 19) and the tegmentum of brain stem near peri-aqueduct (8 cases in 19) in NMO were not found in patients of MS.The involvement of brain stem and thalamus was more frequent in NMO than in MS (x2 =5.267,6.004,P ＜0.05,respectively).(2) The lesions of spinal cord in MS patients were typically oval,peripheral,and asymmetric,but in NMO patients they were longitudinally extensive and centrally located.The mean number of involved vertebral segments in NMO patients was significantly more than that in MS patients (7.3 vs 2.2,t =-9.288,P ＜ 0.01).Furthermore,the number of spinal cord lesions in MS patients was remarkably more than that in NMO (2.0 vs 1.3,t =4.565,P ＜0.01).The ratios of occurrence of spinal cord swelling and distension of NMO patients was 58.3％ (28/48),which was significantly higher than 21.9％ in MS (7/32,x2 =10.370,P ＜0.01).(3)The enhancement pattern in MS was circular (7 cases in 42),oval (6 cases in 42) and irregular (4 cases in 42),while in NMO was mainly sheet-shaped with mild enhancement (5/11).The lesions of spinal cord showed in MS mainly manifested as oval enhancement (16 cases in 26) and linear enhancement (8 cases in 26),while in NMO lesions manifested as strand or mild linear enhancement (26 cases in 35).Conclusions NMO has several distinct imaging characteristics,which are helpful for differentiation from MS.

OBJECTIVE To evaluate the protective effect of Agaricus bisporus intracellular polysaccharides(IPS) and exopolysaccharides (EPS) on immunological liver injury induced by concanavalin A (Con A). METHODS Mice were pretreated with IPS and EPS (100, 200 and 400 mg kg- 1, ig) daily for 12 d. Immunological liver injury was induced by Con A 25 mg·kg-1 byinjection via the tail vein of mice.Eight hours after injection of Con A, the indexes of the liver, spleen and thymus, serum level of glutamicpyruvic transaminase (GPT), glutamic-oxalacetic transaminase (GOT), tumor necrosis factor-α (TNF-α) and interferon- γ (IFN- γ), splenic lymphocyte percentages of CD4 + and CD8 + , and liver homogenate content of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured. Liver pathological changes were observed by HE staining. RESULTS Compared with normal group, the autoimmune liver injury in mice induced by Con A resulted in an increase in the liver index (P<0.01) , spleen index (P<0.01), the activity of GPT (P<0.01) and GOT (P<0.01), the content of TNF- α (P<0.01) and IFN- γ (P< 0.01), and the level of MDA (P<0.01), but a decrease in the thymus index (P<0.01), the percentage of CD4+ (P<0.01) , the ratio of CD4+/CD8+ (P<0.01), and SOD activity (P<0.01). Compared with model group, treatment with IPS (200 and 400 mg·kg-1) and EPS (200 and 400 mg·kg-1 ) respectively resulted in an increase in the thymus index (P<0.01) but in a decrease in the liver index and spleen index (P<0.01). Similarly, the activity of GOT and GPT was decreased obviously (P<0.01), and the content of TNF-α and IFN-γ in IPS and EPS 200 and 400 mg·kg-1 groups was decreased. Compared with model group, the activity of SOD in IPS and EPS (200 and 400 mg·kg- 1) group was increased (P<0.01) while MDA was decreased (P<0.01). Moreover, the percentage of CD4 + Iymphocytes decreased (P<0.01), whereas no significant difference was found in the ratio of CD4 +/CD8 + .Pathological changes of the liver were observed under a microscope. Pretreatment with IPS and EPS could effectively reduce the liver injury induced by Con A. CONCLUSION IPS and EPS have certain protective effect on immunological liver injury, which may be related to their ability to clean up free radicals, control lipid peroxidation and regulate the balance of the immune system.

Objective Sarcopenia and metabolic syndrome share similar pathophysiological mechanisms. The aim of this study was to investigate the prevalence of sarcopenia among health examination population, and to analyze the relationship between sar-copenia and blood pressure, blood glucose, uric acid and lipids. Methods Physical examination data of 1191 healthy persons in the medical examination center of the hospital from Mar 2011 to Jun 2011 were collected. The weight, skeletal muscle, body fat, body mass index ( BMI) , waist circumference,body fat percentage, waist-hip ratio and visceral fat area were analyzed by human body compositionanalyzer and the prevalence of sarcopenia was observed. At the same time, triglyceride (TG), total cholesterol (TC), high density lipo-protein-cholesterol ( HDL-C ) , low density lipoprotein-cholesterol ( LDL-C) , uric acid and fasting blood glucose were also detected. Results The prevalence rate of sarcopenia of the subjects was 5.21%, and the highest incidence was found in ≥60 years group( 11.11%) . The prevalence rates of overweight and obesity were 33.8% and 10.2%, respectively. The prevalence of sarcopenia is grad-ually higher along with increasing BMI. The prevalence rates of sarcopenia of overweight and obesity subjects were 5.47% and 26.23%, respectively. Compared with the normal control group, the level of weight[(66.34±11.75)kg vs (76.71±12.84)kg ], BMI[(23.37± 3.13) vs (28.05±3.66)], body fat percentage[(25.33±6.06)% vs (36.76±4.47)%], waist circumference[(83.19±9.56)cm vs (95.45±13.74)cm] and visceral fat area[(88.96±29.74)cm2 vs (136.91±25.56)cm2] were higher in the sarcopenia group (P<0.05). Compared with the normal control group, the incidence of systolic blood pressure[(125.59±30.04)mmHg vs (139.39±19.79) mmHg], diastolic blood pressure[(75.82±11.95)mmHg vs (82.34±10.96)mmHg ] TG[(1.56±1.12)mmol/L vs (1.98±1.72)mmol/L] and uric acid[(313.75±83.07)mmol/L vs (335.55±96.07)mmol/L] were higher in the sarcopenia group (P<0.05). Compared with the normal subjects, the detectable rates of abnormal diastolic blood pressure, fasting blood glucose, uric acid, and LDL-C were increased in the sarcopenia, obesity and sarcopenia combined with obesity subjects (P<0.05). The odds ratio of abnormal systolic blood pressure, diastolic blood pressure, uric acid, and LDL-C increased in the sarcopenia, obesity and sarcopenia combined with obe-sity subjects using logistic regression analyses after correction of gender and age. Conclusion The sarcopenia may have some con-nection with metabolic risk factors. Early detection of sarcopenia can help to distinguish people predisposed to metabolic syndrome, and it has important significance for prevention of chronic disease.

Objective The aim of this prospective observational study was to analyze the prevalence and the predictive factors of hemorrhagic events after abdominal paracentesis in patients with acute-on-chronic liver failure (ACLF).Methods ACLF patients who received at least one episode of abdominal paracentesis were prospectively enrolled between January 2010 to December 2013. Prevalences of intraperitoneal and abdomen hemorrhage complications were examined. t test was performed for continuous variables and chi-square test was performed for categorical variables.Binary Logistic regression was used to analyze the risk factors of hemorrhage.Results A total of 525 abdominal paracenteses were carried out on 185 ACLF patients within a 4-year period,with 289 (55 .0%)for diagnostic purpose and 236 (45 .0%)for therapeutic purpose.A total of 16 (3.0%)hemorrhagic complications were identified, with 4 cases of abdominal wall hematomas and 12 cases of intraperitoneal hemorrhage.Patients were divided into hemorrhage group and non-hemorrhage group according to this complication.Age,gender, Child-Pugh score,volume of ascitic fluid removed,underlying cirrhosis,platelet count and thrombin time were not significantly different between two groups (all P > 0.05 ).Patients with bleeding events had lower fibrinogen levels and higher prothrombin time,international normalized ratio,activated partial thromboplastin time and model for end-stage liver disease score (all P <0.05).After adjustment of other factors,multivariate regression analysis indicated that low fibrinogen level was the only independent predictor of hemorrhagic complication (OR=0.105,95%CI :0.018-0.608,P =0.012).Conclusion Low fibrinogen level is the independent predictor of severe hemorrhagic complications following paracenteses in patients with ACLF.

BACKGROUND: As a micro-injurying and reduplicative treatment of osteoarthritis,the arthroscopic debridement has got the affirmation of numerous scholars. But as one of the standard procedures in artnroscopic debridement,synovectomy is called in question recently.OBJECTIVE: To explore the applied value of synovectomy in the arthroscopic debridement of osteoarthritis.DESIGN: Retrospective controlled analysis.SETTING: Department of Orthopaedics, Fushun Central Hospital.PARTICIPANTS: Sixty-five patients received synovectomy in the arthroscopic debridement of knee joint osteoarthritis in the Department of Orthopaedics,Fushun Central Hospital from February 1997 to December 2000.Thirty-two among them,with complete data and over 1 year's followup,were taken for synovectomy group. Forty-eight patients received the arthroscopic debridement of knee joint osteoarthritis without synovectomy in the Department of Orthopaedics,Fushun Central Hospital from January 2001 to November 2003.Thirty among them,with complete data and over 1 year's follow-up,were taken for control group.METHODS: Synovectomy was taken as the factor of intervention in the operation to perform grouping. The analysis of curative effect was performed to control with joint douching,corpus liberum removal,osteophyma cleaning,meniscus fitting,cartilage gouging,synovectomy and without synovectomy or part synovectomy. Lysholm evaluation standard of knee joint osteoarthritis was used to the knee joint functional evaluation beween preoperation and postoperative 1 year in two groups. And operative time,postoperative draining quantity,postoperative 7-day visual analog score,postoperative 1-year Lysholm score of knee joint, were recorded.MAIN OUTCOME MEASURES: Preoperative and postoperative 1-year Lysholm score of knee joint,operative time,postoperative draining quantity,postoperative 7-day visual analog score.RESULTS: Sixty-two patients were included and all of them entered the result analysis.The preoperative patients in two groups were comparable with each other and the differences of Lysholm score were not significant (t=0.127,P=0.899).The operative time was longer in synovectomy group than in control group,the differences were significant (t=9.547,P ＜ 0.001)and the postoperative draining quantity was more in synovectomy group.The postoperative visual analog score was bigger in synovectomy group than in control group and the differences were significant [the scores of synovectomy and control groups were respectively (4.6±1.1),(2.8±1.4),t=6.206,P ＜ 0.001].The differences of knee joint score in 1-year follow-up were not significant [the scores of synovectomy and control groups were respectively (77.6±11.9),(79.0± 10.3),t=0.562,P=0.576].CONCLUSION: Synovectomy can not increase the curative effect in the near future in the arthroscopic debridement of osteoarthritis. On the contrary,the operative time was longer,the operative wound was larger and postoperative reaction was more serious. It should not be used in the debridement generally.