ObjectiveTo investigate hepatocyte growth factor (HGF) levels in the tissue and serum of patients with chronic hepatitis,cirrhosis or hepatocellular carcinoma (HCC),and analyze the clinical significances of HGF for HCC.MethodSurgical specimens from 97 patients were collected during Dec.2003 to Aug.2008 in the Third Central Hospital.The patients were prospectively enrolled and categorized into four groups:normal subjects ( n =11 ),chronic hepatitis B or C ( n =6＝,cirrhosis ( n =20)and HCC ( n =60 ) including well-differentiated ( n =21 ),moderately differentiated ( n =23 ),poorly differentiated (n =16) specimens.N0 (n =24),N1 (n =21 ),N2 (n =54) and N3 (n =43) were tissues respectively removed from liver at 0,1,2 or 3 cm beyond the margin of tumor.HGF mRNA expression in liver tissues was determined by real-time quantitative reverse transcription- (RT)-PCR.Serum HGF levels in the other cases of normal subjects ( n =20),chronic hepatitis B or C ( n =20),cirrhosis ( n =20) and HCC (n =57) were measured by ELISA.The Kaplan-Meier method with log-rank test was employed for survival analysis.Univariate and multivariate analyses were performed to identify prognostic factors in each group.ResultsThe HGF mRNA in normal subjects,chronic hepatitis,cirrhosis,N3,N2,N1,N0 and HCC were0.99(0.78-1.66),2.15(1.06-3.40),1.78(1.18-2.73),4.59(2.67 -8.63),3.86 ( 2.25 - 6.45 ),3.12 ( 1.59 - 5.74 ),2.92 ( 0.88 - 5.99 ) and 0.48 ( 0.19 - 1.06 ) respectively.The serum concentration of HGF in the normal subjects,chronic hepatitis,cirrhosis and HCC patients were (0.31 ± 0.05 ),(0.65 ± 0.07 ),( 1.27 ± 0.30 ) and ( 2.06 ± 0.66) μg/L respectively.The highest level of HGF mRNA was found in N3,while the HGF mRNA expression in HCC was [ (2.14 ± 0.52 ) μg/L] lower than that not only in the non-tumor tissues,but also in the normal control ( U =196.50,P =0.03 ).The serum concentration of HGF was significantly higher in patients with chronic hepatitis,cirrhosis or HCC than in normal subjects.The serum HGF level of HCC was bounced after hepatectomy (t =2.70,P ＜0.01 ).On the logistic regression analysis,the tumor numbers and Child-pugh were related with the levels of the tissue HGF mRNA and serum HGF of HCC,OR were0.15 (95％CI:0.03-0.72,P＜0.05) and0.13 (95％CI:0.27 -0.89,P ＜0.05 ),respectively.Univariate analysis using the Cox proportional hazards model in the complication groups revealed that the levels of the tissue HGF mRNA and serum HGF were significant risk factors of death for HCC,OR were 0.02 (95％ CI:0.00 - 0.52,P ＜ 0.05 ) and 10.01 (95％ CI:1.16 -86.23,P ＜ 0.05 ),respectively.On the Log-rank analysis,no statistically difference in the cumulative survival was found between the two groups categorized by median (0.49) of tissue HGF mRNA 2 - AACT (X2 =0.13,P =0.72).While the HCC patients were dichotomized by their the median(0.69 μg/L) of serum HGF concentration,the death risk for the patients with higher levels of HGF was increased 2.84 fold than those with lower levels (95％ CI:1.03 - 7.92,P ＜ 0.05 ).ConclusionHGF mRNA expression is decreased in tumor tissues,while its level in tumor adjacent live and serum is significantly elevated and is in association with shortened postoperative survival of HCC patients.

Objective:This study aimed to detect the special methylation profile in peripheral blood for hepatocellular carcinoma (HCC). Methods:The methylation status of 12 tumor suppressor genes (TSGs) in the plasma of 55 HCCs and 54 chronic liver diseases (CLDs) was tested by methylation-specific PCR (MSP). Results:In HCC, the methylation frequencies were 78.18%in APC, 63.64%in cyclin D2, 58.18% in TFPI2, 49.09% in DKK3, 49.09% in GSTP1, 47.27% in p16, 40.00% in Sigma 14-3-3, 18.18% in SFRP2, 16.36% in ppENK, 9.09% in DKK2, 7.27% in NPTX2, and 5.45% in LHX1. In CLD, the methylation frequencies were 27.78% in APC, 22.22%in cyclin D2, 7.41%in TFPI2, 3.70%in DKK3, 16.67%in GSTP1, 37.04%in p16, 37.04%in Sigma 14-3-3, 11.11%in SFRP2, 20.37%in ppENK, 7.41%in DKK2, 7.41%in NPTX2, and 9.26%in LHX1. The methylation frequencies of APC, cyclin D2, TFPI2, DKK3, and GSTP1 were higher in HCC than in CLD (P<0.01). The methylation index (MI) of the five-gene methylation profile was statistically higher in HCC (median, 0.6;IQR, 0.4-0.8) than CLD (median, 0.2;IQR, 0-0.2) (P<0.01). In HCC, MI was statistically related to the patient's age. Older patients with HCC had a higher MI. No significant correlation was observed between MI and other clinicopathological data. Moreover, MI was not related to the disease free survival and the overall survival in HCC. Conclusion:This five-gene methylation profile may be a promising biomarker for the assistant diagnosis of HCC.

Objective To study the characteristics of hemogram and myelogram with Brucellosis patients.Methods 25 Brucellosis patients' bone marrow and peripheral blood smears were observed,at the same time a deep clinical inverstigation on the patients was conducted. Results The counts of blood cells were decreased in part pa-tients, and a typical lymphocytes were found in peripheral blood of 64% patients. The marrow proliferative activities were normal(92% ) or higher(8% ),and all patients had poisonous granules. Red cell proliferative activities were normal(68% ) or lower(32% ). The counts of megakaryocytes were normal,but the maturity of megakaryocyte was hindered. All patients' histocytes were increased at different degrees. NAP were increased. Conclusion The changes of hemogram and myelogram have clinical significance for diagnosis of Brucellosis, but primary hematologic disease with Brucellosis should be distinguished.

Objective To investigate the early diagnostic value of plasma D-dimer level in acute aortic dissection (AAD) . Method A total of 80 patients with chest pain were enrolled from January 2006 to March 2009, and 40 patients of them were confirmed to be AAD with computerized tomographic angiography (CTA), and these patients were matched with 40 controls presenting suspected dissection, which were ruled out later. The D-dimer test was performed in all patients within 12 hours after onset of chest pain,and plasma D-dimer concentrations were compared between two groups. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of D-dimer used for diagnosing AAD were analyzed. The receiver operating characteristic (ROC) curve was also established. The statistical analysis of data was carried out by using Mann-Whitney test with SPSS 11.5 software. Results The plasma D-dimer oncentrations in AAD were significantly higher than those in controls [(5.48±7.95) vs. (0.64±0.75), P <0.0l]. Receiver operating characteristic curve analysis showed that D-dimer ( > 0.5 μg/mL) was predictive in the diagnosis of AAD, and the area under ROC curve was 0.848 ± 0.042, (95% CI: 0.766-0.930) with 87.5% sensitivity, 62.5% specificity,70% PPV and 83.3% NPV. Conclu-sions D-dimer may be a valuable biomarker in early diagnosis of AAD.

OBJECTIVETo investigate the effect of anti-atrial fibrillation of Philos DDDR pacemaker on atrial tachyarrhythmia.

METHODSThirty-eight patients with sick sinus syndrome and paroxysmal atrial fibrillation (AF) were implanted with Philos DDDR pacemaker. After implantation, auto-Mode-Switch (AMS) function was switched "on" and AF preventive algorithms were "off" in all cases. The number of AMS, atrial premature beats, heart rate and the percentage of atrial and ventricular pacing were recorded by pacemaker diagnostic function for one-month after procedure. AF preventive algorithms function with "middle" (approx 8 bpm) was then switched on and the same parameters as above from the database of pacemaker diagnostic function were collected for additional one month.

RESULTSThe symptoms of dizziness, dyspnoea, and palpitation in the majority of patients were dramatically improved regardless of whether the AF preventive algorithms function was switched "on" or "off" after pacemaker implantation. There were no significant clinical changes in most patients when AF preventive algorithms were "on". However, 5 cases (13.2%) had palpitations and short of breath. These symptoms were relieved by changing the algorithms from "middle to slight (approx 4 bpm)". When AF preventive algorithms were switched on, atrial premature beats were reduced significantly (P < 0.05) with a dramatic increase in atrial pacing percentage and heart rate (P < 0.05). However, there was no significant difference in AMS (P > 0.05) between the two groups of AF preventive algorithms function switching "on" and "of", indicating that atrial tachyarrhythmias were not inhibited by anti-atrial fibrillation pacemaker.

CONCLUSIONThis study suggested that atrial fibrillation and atrial tachycardia were not reduced by implantation of an anti-atrial fibrillation Philos DDDR pacemaker, although atrial premature beats decreased significantly with increasing atrial pacing percentage when AF preventive algorithms were in "middle" and "slight".

Aged ; Aged, 80 and over ; Algorithms ; Atrial Fibrillation ; therapy ; Cardiac Pacing, Artificial ; methods ; Female ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial

OBJECTIVETo analyze the potential mechanism of preventive and therapeutic effects of (90)Sr on hypertrophic scar, and to observe its clinical effect.

METHODSFibroblasts isolated from human hypertrophic scar were cultured in vitro and radiated by (90)Sr with the dose varying from 0 Gy (control group) to 5 Gy (LD group), 10 Gy (MD group), and 15 Gy (HD group). The cell cycle and apoptosis rate were determined by flow cytometry at post radiation hour (PRH) 24, 48, and 72. The concentration of type I collagen in cell supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Therapeutic effects of (90)Sr radiation were evaluated among 348 patients with hypertrophic scars, 40 patients with keloids, and 114 patients for scar prevention after surgical operation. The number of fibroblasts after HE staining was compared among normal skin tissue, hypertrophic scar, and hypertrophic scar treated with (90)Sr radiation. Data were processed with one-way analysis of variance and q test.

RESULTS(1) Apoptotic rates in MD and HD groups at PRH 48 were higher than those at PRH 24, and the apoptotic rate was similar between MD group and HD group at PRH 72. Apoptotic rate in LD group at PRH 48 was significantly higher than that at PRH 24, but it decreased rapidly at PRH 72, which was significantly lower than those in MD and HD groups (with F values all equal to 916.711, P values all below 0.01). (2) At PRH 24, cell ratios of each phase in LD and HD groups were similar, and cell ratio of S phase in HD group [(48.1 ± 1.0)%] was higher than those in the other three groups (with F values all equal to 200.277, P values all below 0.01). At PRH 72, cell ratio of S phase in MD and HD groups was respectively (85.7 ± 5.2)%, (73.0 ± 8.4)%, implying that cells were blocked in S phase, and the values were all higher than those in control and LD groups (with F values all equal to 111.105, P values all below 0.01). (3) At the same time point, the concentration of type I collagen decreased along with the increase of radiation dose (with F values from 5044.449 to 8234.432, P values all below 0.01). With the same radiation dose, the concentration of type I collagen increased along with prolongation of time (with F values from 333.395 to 2973.730, P values all below 0.01). (4) Clinical observation showed the (obvious) effective rate of radiation for pathological scars and that for scar prevention after surgical operation added up to 88.45%. The number of fibroblasts per 200 times visual field in patients after (90)Sr radiation (86 ± 20) was less than that in patients without treatment [(198 ± 65), F = 208.405, P < 0.05].

CONCLUSIONSThe effect of (90)Sr radiation on fibroblasts and extracellular matrix can contribute to inhibition of scar formation, and the clinical effect is significant.

Adolescent ; Adult ; Apoptosis ; radiation effects ; Cell Cycle ; radiation effects ; Cells, Cultured ; Child ; Child, Preschool ; Cicatrix, Hypertrophic ; metabolism ; pathology ; radiotherapy ; Collagen Type I ; metabolism ; Female ; Fibroblasts ; radiation effects ; Humans ; Male ; Strontium Radioisotopes ; therapeutic use ; Young Adult

Aneurysm, Dissecting ; diagnostic imaging ; etiology ; Coronary Angiography ; Coronary Artery Bypass ; Humans ; Male ; Mammary Arteries ; diagnostic imaging ; Middle Aged

BACKGROUND:As the regulators of cytokines, suppressors of cytokine signaling (SOCS) play an important role in the inflammation reaction. Some studies found that SOCS-1 and SOCS-3 were involved in the pathogenesis of some inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease. But the expressions of SOCS in coronary heart disease have not yet been reported. This study aimed to investigate the expression and clinical significance of SOCS-1 and SOCS-3 in the myocardium of patients with sudden cardiac death (SCD).METHODS:Myocardial autopsy specimens were collected from 24 patients at the Forensic Medicine Department of Sun Yat-Sen University, Guangzhou, China between 2005 and 2006. Of them, 9 patients had autopsy findings consistent with coronary atherosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 died of acute myocardial infaction (MI group), and 8 died from traffic accidents and trauma (control group). The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of the non-MI, MI and control groups were detected using RT-PCR. The levels of SOCS-1 and SOCS-3 proteins were detected using immunohistochemistry. Statistical analyses were performed using SPSS version 13.0 software and the data were analyzed by ANOVA.RESULTS:The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the non-MI and MI groups were significantly higher than those in the control group[(0.788±0.101), (0.741±0.111) vs. (0.436±0.044), (P<0.01); (0.841±0.092), (0.776±0.070) vs. (0.454±0.076), (P<0.01)] respectively. The antibody-positive cells of SOCS-1 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[(320.00±48.48), (347.14±70.88) vs. (42.50±10.35), (P<0.01)] respectively. The antibody-positive cells of SOCS-3 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[(381.11±59.25) vs. (40.00±10.69), (P<0.01)] and[(332.86±111.91) vs. (40.00±10.69), (P=0.001)].CONCLUSION:The expressions of SOCS-1 and SOCS-3 in the myocardium of patients with SCD from coronary heart disease are significantly increased and contribute to the pathogenesis of SCD.

Objective To study the contents of puerarin in decoction with different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix; To verify the rationality of compatibility ratios of Huangqi Gegen Decoction and Yu y e Decoction; To provide references for clinical medication. Methods Different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix were set as 0:1, 1:1, 2:1, 3:1, 4:1, 1:2, 1:3, and 1:4. SinoChrom ODS-BP (4.6 mm × 250 mm, 5 μm) was used as the chromatographic column to detect the contents of puerarin;methanol-0.1% phosphoric acid (35:65) was used as the mobile phase with 0.5 mL/min flow rate; sample volume was 20 μL; the wavelength was 250 nm. Results The regression equation of puerarin was Y=66 449.269 1X-175 665.663 1 (r=0.999 6) in the range of 5 to 300 μg/mL, showing a good linear relationship. The repeatability, stability and recovery rate were fine as well. The contents of puerarin were (2.506 7±0.025 8)%, (2.526 7±0.071 2)%, (2.863 3± 0.086 4)%, (2.956 7±0.119 6)%, (2.835 0±0.078 7)%, (2.480 0±0.072 4)%, (2.530 0±0.064 8)%, and (2.183 3±0.128 9)% in different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix with 0:1, 1:1, 2:1, 3:1, 4:1, 1:2, 1:3, and 1:4, respectively. Conclusion When the compatibility ratios of Astragali Radix and Puerariae Lobatae Radix are 2:1. 3:1, and 4:1, the contents of puerarin in decoction are the highest. This study verifies that the compatibility ratios of Astragali Radix and Puerariae Lobatae Radix in classical prescriptions are rational, which can be the optimal compatibility ratios in clinic.

Objective Radiological findings of very rare hemangioendotheliomas in the orbit have not been reported.Radiological findings on different imaging studies of four cases with hemangioendotheliomas in the orbit were described and the literature was reviewed so as to understand features of hemangioendotheliomas in the orbit.Methods CT and MR imaging findings of four cases with hemangioendotheliomas in the orbit confirmed by histopathology were analyzed retrospectively.Results A mass was found in the superotemporal quadrant in the anterior extraconal space of the orbit in three cases and in the inferonasal quadrant in one case. CT studies revealed a homogeneously ovoid tumor with benign remodeling of the adjacent bone in three cases and a homogeneously irregular mass without any bony change in one case.MR imaging showed a mass in the orbit that was mildly hypointense on T_1-weighted sequences and hyperintense on T_2-weighted images with areas of flow voids representing vessels within the peripheral portion of the tumor in four cases.All four patients demonstrated significant enhancement immediately after intravenous administration of contrast material and a type D time-signal intensity curve (TIC)pattern on MR dynamic contrast enhancement scanning.Conclusions Hemangioendotheliomas in the orbit appeared as a hypervascular tumor predominantly in the extraconal space with areas of flow voids within the tumor and early significant enhancement of the tumor after intravenous administration of contrast material.MR imaging is the best method in demonstration of features of hemangioendotheliomas in the orbit and in diagnosis of these tumors.