BACKGROUND:The majority of published article on cardiopulmonary resuscitation (CPR) used healthy animals. In fact, patients commonly have severe heart diseases before CPR, leading to ventricular fibrillation. OBJECTIVE: To investigate outcome of myocardial function and cardiopulmonary resuscitation in myocardial infarction rats treated with bone marrow mesenchymal stem cells (MSCs) transplantation.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the University of Southern California and Second Hospital of Sun Yat-sen University from April to August 2007.MATERIALS: A total of 18 adult male SD rats were randomly divided into model control and cell transplantation groups with 9 animals in each group. In addition, 1 SD rat aged 1 month was used to prepare bone marrow MSCs.METHODS: Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). Animals respectively received 5×106 MSCs (0.1 mL) marked with PKH26 in phosphate buffer solution (PBS) or PBS alone 4 weeks after LAD ligation. Ventricular fibrillation and CPR were performed 4 weeks after MSCs or PBS injection.MAIN OUTCOME MEASURES: Heart function was evaluated by ultrasound cardiography 2, 4 weeks after transplantation; hemodynamics was measured before and 4 hours following CPR. Myocardial tissues were harvested 72 hours after CPR for pathological exanimation.RESULTS: Compared with model control group, ejection fraction of transplantation group was significantly increased 2 and 4 weeks after transplantation (P<0.01), and cardiac index, dp/dt40, and -dp/dt were significantly improved before and within 4 hours after CPR (P<0.01, P<0.05). Moreover, the rats survived longer in transplantation group (72 hours) after CPR compared with control group (P<0.05). Pathological section results showed a large number of PKH26-1abeled MSCs in the rnyocardium.CONCLUSION: Myocardial function, hemodynamics and survival time after CPR were significantly improved in animals treated with MSCs transplantation.

BACKGROUNDThe induction of immune tolerance and suppression of allograft rejection has become the focus in the study of liver transplantation. The effect of immune therapy with anti-CD40L mAb alone or in combination with cyclosporine A (CsA) on the recipient survival and Th1/Th2 cytokine profile was studied to elucidate its immunological mechanism and role in rat orthotopic liver transplantation.

METHODSThe model of rat orthotopic liver transplantation was established by modified Kamada's technique. Recipients were divided into group A (control group): SD-->SD; group B (group of rejection): SD-->Wistar without any treatment; group C: SD-->Wistar with CsA monotherapy from day 1 to day 5; and group D: SD-->Wistar with CsA from day 1 to day 5 and anti-CD40L mAb on day 0 and day 2. The survival of the recipients in all groups was observed and ELISA technique was used to detect the level of cytokines in peripheral blood on post-transplant day 7.

RESULTSThe survival period of recipients in groups A (> 60 days) and D (> 60 days) was significantly longer than that in group B (13.8 +/- 2.4 days). The serum levels of interleukin 2 (IL-2) and interferon gamma in group B were significantly higher than those in other groups; the level of tumor necrosis factor alpha was higher but not statistically significant. In contrast, the serum levels of IL-4 and IL-10 in group D were elevated more significantly than those in group B (P < 0.05).

CONCLUSIONSCombined immune therapy can prolong the survival of allografts. Increased expression of Th2 cytokines, which is closely related to the induction of tolerance and suppression of rejection, is beneficial to the long-term survival of recipients and allografts.

Animals ; Antibodies, Monoclonal ; therapeutic use ; CD40 Ligand ; antagonists & inhibitors ; Cyclosporine ; therapeutic use ; Cytokines ; blood ; Enzyme-Linked Immunosorbent Assay ; Graft Survival ; Immunosuppressive Agents ; therapeutic use ; Liver Transplantation ; Male ; Rats ; Rats, Sprague-Dawley ; Th1 Cells ; immunology ; Th2 Cells ; immunology

OBJECTIVETo evaluate the dimensional stability and detail reproduction of five additional silicone impression materials after autoclave sterilization.

METHODSImpressions were made on the ISO 4823 standard mold containing several marking lines, in five kinds of additional silicone. All the impressions were sterilized by high temperature and pressure (135 °C, 212.8 kPa) for 25 min. Linear measurements of pre-sterilization and post-sterilization were made with a measuring microscope. Statistical analysis utilized single-factor analysis with pair-wise comparison of mean values when appropriate. Hypothesis testing was conducted at alpha = 0.05.

RESULTSNo significant difference was found between the pre-sterilization and post-sterilization conditions for all locations, and all the absolute valuse of linear rate of change less than 8%. All the sterilization by the autoclave did not affect the surfuce detail reproduction of the 5 impression materials.

CONCLUSIONSThe dimensional stability and detail reproduction of the five additional silicone impression materials in the study was unaffected by autoclave sterilization.

Dental Impression Materials ; chemistry ; Dental Models ; Hot Temperature ; Materials Testing ; Microscopy ; Polyvinyls ; chemistry ; Silicone Elastomers ; chemistry ; Siloxanes ; chemistry ; Sterilization ; methods

Background Placement of an orbital implant is a main way to prevent orbital atrophy with aging.But its mechanism is under clear.Researchs showed that bone growth factors play important role during the development and repair of bone,especially transforming growth factor-β1(TGF-β1).Objective Present study was to investigate the expression of TGF-β1 protein in orbital bone after enucleation or enucleation with placement of an orbital implant and its function in the mechanisms of preventing and treating the orbital malformed development after enucleation with placement of an orbital implant.Methods Twenty-one age- and weight-matched New Zealand white young rabbits were randomly divided into the enucleation,implant and control groups,and each group including seven rabbits.Eyeball nucleation surgery was performed in the left eyes of 7 1-month-old rabbits,and a spherical orbital implant was inserted after enucleation of the left in matched rabbits in implant group.The left eye of normal rabbits served as controls.The rabbits were sacrificed in 1 month after surgery.The expression of TGF-β1 protein in the left orbital bone was detected using enzyme immunoassay and FITC labelling immunoassay technique in the sections of zygomatic bones.The content of TGF-β1 protein in the left orbital bone tissue was measured by ELISA method.This use of animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The height and width of orbital in enucleation group were significantly lower than those of implant and normal control groups(height:P=0.00,P=0.00;width:P =0.00,P=0.00).The positive bone cells of both enzyme immunoassay and FITC staining were increased in the implant and control groups in comparison with enucleation group,but the positive response intensity for TGF-β1 was resembled between implant group and control group.ELISA result revealed that the content of TGF-β1 protein in bone tissue was significantly lower in the enucleation group than in implant and control groups(P=0.00,P=0.00).The expression and content of TGF-β1 protein in bone tissue is similar between the implant group and the control group(P=0.41). Conclusion The experiment results indicate that TGF-β1 protein participate in the orbital development.TGF-β1 played important role in the prevention and treatment of enucleation-induced orbital malformation in the eye with placement of an orbital implant.

OBJECTIVETo investigate the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors.

METHODSA search of studies in PubMed and MedLine (from 1999 to 2008) was performed to assess the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors. The articles were retrieved with the entries of "gastrointestinal stromal tumors", "imatinib", "c-kit" and "mutation". A meta-analysis was performed to assess the data included.

RESULTSA total of 15 articles were collected in this analysis. No significant differences was found in incidence of mitoses (> 5/50 HPF) between the patients with wild type c-kit (wild type group) and the ones with mutated c-kit (mutation group) (P = 0.710); tumor recurrence and metastasis rate after surgery was significant higher in the mutation group than that in wild type group (P = 0.010); as for imatinib response with different c-kit mutation types, the results showed the incidence of clinical response (complete response + partial response) was significantly higher in mutation group than that in wild type group (P = 0.009), but the imatinib resistance rate was lower in mutation group (P = 0.000); three studies provided data for imatinib resistance with c-kit second mutations, the results showed the second mutations mainly focus on exon 13, 14, 17.

CONCLUSIONSC-kit mutation is related closely with the incidence of recurrence and metastasis in GIST after surgery. The mutations of c-kit influences the therapeutic effects of imatinib.

Antineoplastic Agents ; therapeutic use ; Benzamides ; Case-Control Studies ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; Humans ; Imatinib Mesylate ; Mutation ; Piperazines ; therapeutic use ; Prognosis ; Proto-Oncogene Proteins c-kit ; genetics ; Pyrimidines ; therapeutic use

OBJECTIVETo investigate the clinical pathological characteristics and prognosis of gastrointestinal stromal tumors (GISTs).

METHODSOne hundred and seven cases, admitted to our hospital from Apr. 1996 to Oct. 2005, were detected by Envision immunohistochemical method and diagnosed as GISTs. Their pathological features, immunohistochemical phenotypes, clinical manifestations and imaging findings were analyzed.

RESULTSOf the 107 GISTs, 107 cases were positive for vimentin (107/107, 100%), 107 cases were positive for CD117 (107/107, 100%), 89 cases were positive for CD34 (89/107, 83.2%), 14 cases were positive for SMA (14/107, 13.1%), 10 cases were positive for desmin (10/107, 9.3%), 22 cases were positive for S-100 (22/87, 20.6%) and 15 cases were positive for NSE (15/107, 14.0%). Among all the GISTs, 73 cases occurred in stomach (68.2%), 28 in small intestine (26.2%), 1 in colon (0.9%) and 5 occurred in other position including mesentery, omentum, and retroperitoneum (4.7%). Fifteen cases were diagnosed as very low grade (14.0%), 25 cases as low grade (23.4%), 33 cases as low malignancy (30.8%) and 34 cases as high malignancy (31.8%). The follow-up was obtained successfully in 89 cases (83.2%). Fourteen cases (13.1%) were confirmed to have recurrences or metastases by review and medical records.

CONCLUSIONSThe diagnosis of GIST depends on pathological observation and immunohistochemical study. CD117 is a sensitive marker for the diagnosis of GIST. Surgical resection is the choice for treating GIST. Extended resection, even combined resection of involved organs, is required for malignant GIST.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged

OBJECTIVETo study the clinical and pathologic features of tumors and tumor-like lesions in the bones of hands and feet.

METHODSClinical, X-ray and pathologic features of 154 cases of tumors and tumor-like lesions in the bones of hands and feet between 1991 and 2002 were investigated.

RESULTSIn the bones of hands and feet the frequency and distribution of many lesions were distinctive when compared to those of other skeletal sites. Cartilaginous lesions were most common (60%), and 72% of them were enchondromas. Enchondromas were most often situated in the second to fifth phalanges and metacarpal bones. Chondroblastomas most frequently involved the irregular bones (such as calcaneus, talus and osnaviculare) of the feet. Whereas the occurance of osteochondromas in the bones of the hands and feet was lower than in the long bones. Most "osteochondromas" of the phalanges were subungual exostoses. A group of reactive or reparative lesions, which are related to trauma, such as subungual exostosis, giant cell reparative granuloma, florid reactive periostitis and bizarre parosteal osteochondromatous proliferations typically occurred in the bones of the hands and feet, but these tumor-like lesions were often misdiagnosted. Another feature of lesions in the bones of the hands and feet was that there were much more benign than malignant lesions (21:1), and that chondrosarcomas were common in malignancies. The diagnostic criteria for benign and malignant cartilaginous tumors in the bones of hands and feet were different from those in long bones and flat bones.

CONCLUSIONSBone tumors of the hands and feet are different from that of long bones, flat bones and axial bones. Because the hands and feet are frequently exposed to trauma, reactive and reparative lesions often occur in these sites. These tumor-like lesions may simulate benign and malignant neoplasia. Knowledge of different types of lesions which commonly affect these sites is of benefit in assessing lesions of the bones of hands and feet.

Bone Neoplasms ; pathology ; Cartilage ; pathology ; Chondroblastoma ; pathology ; Chondroma ; pathology ; Chondrosarcoma ; pathology ; Foot ; Hand ; Humans ; Osteochondroma ; pathology

OBJECTIVETo describe the incidence and mortality rates of esophageal cancer from 1974-2002 in Cixian county of Hebei province. Basic information on comparative geographical, epidemiological, and clinical research was collected.

METHODSIn early 1970s, cancer registry system in Cixian was established, collecting information on all the esophageal cancer cases in Cixian. Data was checked manually, then computerized, coded and analyzed using the software--SPSS 11.5.

RESULTSFrom 1974 to 2002, there were 18 471 esophageal cancer cases in Cixian, with 11 068 males and 7403 females, respectively. The age standardized incidence rate (ASR) for males was 208.77 per 100,000, while 120.47 per 100,000 for females. The trend of incidence rate of esophageal cancer had decreased during the 29 years from 1974 to 2002 (trend chi(2) = 19.94, P < 0.001). From 25 years of age onward, the incidence rates of the lower age groups declined with the increase of age. As for geographic distribution, the incidence rate in mountainous areas and hilly areas showed a significant declining trend in mountainous areas, chi(2) = 195.00, P < 0.001; hilly areas, chi(2) = 46.08, P < 0.001. The esophageal cancer incidence in plain areas remained steady, but had a slight increase in recent years. From 1969 to 2002, there were 18,736 cases died of esophageal cancer with 11 598 males and 7138 females. The ASR for male was 127.17 per 100,000 and 101.57 per 100,000 for female. Compared with the year 1969, the mortality rate of esophageal cancer in 2002 had a 37.96% decline. The proportion of esophageal cancer among malignant tumors in different decades decreased significantly.

CONCLUSIONThe trend of the incidence rate of esophageal cancer had been decreasing for the last 29 years. The incidence rate in mountainous areas and hilly areas showed a declining trend while in the plain areas it remained steady but having slight increase in the recent years. The mortality rate of esophageal cancer had a significant decrease from 1969 to 2002.

Adult ; Age Factors ; China ; epidemiology ; Esophageal Neoplasms ; epidemiology ; mortality ; Female ; Humans ; Incidence ; Male ; Registries ; Software

BACKGROUND: Stem cells are still controversial for the treatment of old myocardial infarction. Multimodal imaging evaluation is one of the key points in the study of stem cell transplantation, which can evaluate the therapeutic efficacy of stem cell transplantation from the perspective of molecular imaging. OBJECTIVE: To evaluate the therapeutic efficacy of coronary artery bypass graft (CABG) with different stem cell transplantation in patients with old myocardial infarction using multimodal imaging technology. METHODS: Sixty patients with old myocardial infarction were enrolled and randomly divided into three groups to receive CABG, CABG+autologous bone marrow stem cell transplantation (CABG+BMC) or CABG+autologous peripheral blood stem cell transplantation (CABG+PBSC), respectively. All the patients were scanned with gated PET/CT (13N-NH3?H2O/18F-FDG), echocardiography and coronary angiography at different time points orderly (at baseline, 1, 12 and 24 months after treatment). We compared the degree of coronary stenosis (%), left ventricular ejection fraction (LVEF), percentage of defect size with myocardial perfusion/metabolic abnormal radioactive distribution (A) and the ratio of defect area (R).RESULTS AND CONCLUSION: In the diagnosis of survival myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value for the gated PET/CT were 92.1%, 85.6%, 93.4% and 78.4%, respectively. After the above treatments, the extent of coronary stenosis decreased significantly in the three groups (P < 0.05), which was improved most at 1 month after treatment (P < 0.05). In the CABG+BMC and CABG+PBSC groups, the LVEF value increased significantly after treatment (P < 0.05). In the CABG+BMC group, the A value decreased significantly at 1 and 24 months after treatment as compared with the baseline (P < 0.05), and the A value was further decreased, indicating a significant difference at 12 and 24 months after treatment (P < 0.05). In the CABG+BMC group, the R value significantly decreased at 1 month after treatment compared with the baseline (P=0.019). To conclude, the multimodal imaging is better to evaluate the prognosis of patients undergoing CABG with different stem cell transplantation, which is beneficial for the selection of treatment and therapeutic evaluation in myocardial infarction patients. CABG combined with stem cell transplantation can improve the left ventricular function of patients in a short time, and CABG+BMC is superior to CABG+PBSC to improve the survived myocardial function in patients.

Objective To investigate the feasibility of transient blocking of both pulmonary artery and veins for surgical treat- ment of central lung cancer with stage Ⅲ to preserve the normal pulmonary.Methods Firstly,the relation of the pulmonary artery, the lung neoplasm and the enlarged mediastinal lymph nodes was investigated.If the hilum of lung remained frozen,the pericardium was opened and the pulmonary artery,the upper and lower lobe pulmonary veins were dissected.Then those three vessels were blocked.When the pulmonary cireulation was stopped,bloodless lobectomy and pulmonary artery angioplasty and/or anastomosis were performed.Then the blockers were released,and pulmonary circulation was restored.The time of blocking was(35?15)minutes (16～66 minutes).Results All 20 patients suffer from stage Ⅲ central lung cancer,which' s the hila of lung remained frozen,re- ceived complete resection of the tumor.The normal functioning pulmonary tissue in the 20 patients was preserved instead of pneumone- ctomy.The average amount of bleeding was 256 ml(180～420 ml)during operation.All 20 patients recovered well.Conclusion Transient blocking of both pttlmonary artery and veins for surgical treatment of stage Ⅲ central lung cancer is and innovation in surgical technique,which makes the operation safe and easy.This technique may provide a chance to patients,with poor cardio-pulmonary function.In addition,this technique widens the surgical indications for patients suffering from lung cancer.