Objective:To observe the effect of sleep apnea hypopnea syndrome (SAS) on sleep staging of bipolar disorder patients in different states. Methods:A total of 210 healthy controls aged 18-65 and 235 bipolar disorder patients of the same age were collected. The bipolar disorder patients were divided into depressive, manic and mixed states. Sleep time structure, sleep posture, heart rate and other indicators were collected by using sleep quality assessment system based on cardiopulmonary coupling analysis. According to whether the apnea-hypopnea index (AHI) was ≥ 5 times/h, whether they had SAS were determined. Two-way multivariate analysis of variance was conducted, investigating the effect of clinical states and SAS, on several sleep indicators. Results:SAS significantly prolonged rapid eyes movement (REM) sleep time of patients in depressive state (P=0.000) and shortened deep sleep time of patients in manic state (P=0.011). In addition, the heart rate during sleep (including deep sleep, light sleep and REM sleep) of patients in manic state increased most significantly among the three clinical states (P=0.000). Lying supine aggravated SAS most significantly in manic state among the three clinical states (P=0.002). Conclusion:SAS has different effects on the sleep staging of bipolar disorder patients in different states.

BACKGROUNDThere are definite gender differences in patients with macular holes. Menopausal women over 50 years are most affected. We aimed to observe the effect of estrogen on collagen gel contraction by cultured human retinal glial cells. It is speculated that estrogen could strengthen the tensile stress of the macula by maintaining the correct morphology and contraction.

METHODSEstrogen was used to determine its effects on collagen gel contraction, and its function was measured using morphological changes in cells. Human retinal glial cells were cultured in collagen solution. The cells were then exposed to collagen gels and the degree of contraction of the gel was determined.

RESULTSEstrogen at differing concentrations had no effect on the growth of human retinal glial cells. However, after exposed to collagen gel block, less contraction was noted in the estrogen-treated group than in the control group.

CONCLUSIONSEstrogen can inhibit collagen gel contraction by glial cells. These results suggest a mechanism for macular hole formation, which is observed in menopausal females.

Cells, Cultured ; Collagen ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Estrogens ; pharmacology ; Female ; Humans ; Neuroglia ; drug effects ; metabolism

Adult ; Appendiceal Neoplasms ; immunology ; pathology ; Dendritic Cell Sarcoma, Follicular ; immunology ; pathology ; Humans ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-kit ; analysis ; Receptors, Complement 3b ; analysis

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

A novel sesquiterpenoid (1) and three known compounds identified as isoaltenuene (2), altenuene (3), and alternariol 4, 10-O-dimethyl ether (4), were isolated in our investigation of the cytotoxic constituents from solid cultures of the endophytic fungus Colletotrichum sp. The structures of these compounds were elucidated through spectroscopic data analysis. All compounds exhibited cytotoxic activity against lung cancer cell line A549, breast cancer cell line MDA-MB-231 and pancreatic cancer cell line PANC-1. Compound 4 could induce the PANC-1 cells inflation or death, but couldn't induce apoptosis at the IC50 of 60.2 microg x mL(-1).
Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Colletotrichum ; chemistry ; Humans ; Inhibitory Concentration 50 ; Lactones ; chemistry ; isolation & purification ; pharmacology ; Molecular Structure ; Sesquiterpenes ; chemistry ; isolation & purification ; pharmacology

Catheterization ; adverse effects ; methods ; Catheterization, Central Venous ; adverse effects ; methods ; Female ; Humans ; Middle Aged ; Subclavian Artery ; surgery

PURPOSEThis prospective observational study aims to evaluate the accuracy of dead-space fraction derived from the ventilator volumetric capnography (volumetric CO₂) or a prediction equation to predict the survival of mechanically ventilated patients with acute respiratory distress syndrome (ARDS).

METHODSConsecutive VD/VT measurements were obtained based upon a prediction equation validated by Frankenfield et al for dead-space ventilation fraction: VD/VT = 0.320 + 0.0106 (PaCO₂-ETCO₂)⁺ 0.003 (RR)⁺0.0015 (age) in adult patients who had infection-related severe pneumonia and were confirmed as having ARDS. Here PaCO₂ is the arterial partial pressure of carbon dioxide in mmHg; ETCO₂, the end- tidal carbon dioxide measurement in mmHg; RR, respiratory rate per minute; and age in years. Once the patient had intubation, positive end expiratory pressure was adjusted and after Phigh reached a steady state, VD/VT was measured and recorded as the data for the first day. VD/VT measurement was repeated on days 2, 3, 4, 5 and 6. Meanwhile we collected dead-space fraction directly from the ventilator volu- metric CO₂ and recorded it as Vd/Vt. We analyzed the changes in VD/VT and Vd/Vt over the 6-day period to determine their accuracy in predicting the survival of ARDS patients.

RESULTSOverall, 46 patients with ARDS met the inclusion criteria and 24 of them died. During the first 6 days of intubation, VD/VT was significantly higher in nonsurvivors on day 4 (0.70 ± 0.01 vs 0.57 ± 0.01), day 5 (0.73 ± 0.01 vs. 0.54 ± 0.01), and day 6 (0.73 ± 0.02 vs. 0.54 ± 0.01) (all p =0.000). Vd/Vt showed no significant difference on days 1e4 but it was much higher in nonsurvivors on day 5 (0.45 ± 0.04 vs. 0.41 ± 0.06) and day 6 (0.47 ± 0.05 vs. 0.40 ± 0.03) (both p=0.008). VD/VT on the fourth day was more accurate to predict survival than Vd/Vt. The area under the receiver-operating characteristic curve for VD/VT and Vd/Vt in evaluating ARDS patients survival was day 4 (0.974 ± 0.093 vs. 0.701 ± 0.023, p = 0.0024) with the 95% confidence interval being 0.857-0.999 vs. 0.525-0.841.

CONCLUSIONCompared with Vd/Vt derived from ventilator volumetric CO₂, VD/VT on day 4 calculated by Frankenfield et al's equation can more accurately predict the survival of ARDS patients.

Adult ; Capnography ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Respiration, Artificial ; Respiratory Dead Space ; physiology ; Respiratory Distress Syndrome, Adult ; mortality ; physiopathology

Female ; GTP-Binding Protein gamma Subunits ; genetics ; Humans ; Male ; Mutation ; Pedigree ; Silver-Russell Syndrome ; diagnosis ; genetics

Objective To study the effect of arthroscopic internal fixation combined with arthrodesis on patients with advanced ankle arthritis and American Orthopedic Ankle Association Scoring System (AOFAS) and visual analogue scale (VAS). Methods 84 patients with advanced ankle arthritis from January 2012 to January 2015 were randomly divided into experimental group (42 cases) and control group (42 cases) by random number method. The patients in the control group were treated with traditional open ankle arthrodesis, the experimental group under the arthroscopic assisted internal fixation joint fusion. Then compare the time of surgery, intraoperative blood loss, postoperative hospitalization time and complication. The follow-up period was 12 to 36 months. Used the AOFAS score system to evaluate the curative effect. Use VAS to evaluate the degree of ankle pain. Results The operation time and intraoperative blood loss were significantly lower in the experimental group than that in the control group (P < 0.05). The postoperative hospital stay and the time of joint fusion were lower in the experimental group than that in the control group (P < 0.05). The incidence of complication (9.52%) in the experimental group was significantly lower than that in the control group (25.57%) (P < 0.05). The results of follow-up showed that the VAS and AOFAS scores of the experimental group were better than those in the control group (P < 0.05). Conclusion The procedure of arthroscopic endoscopic fusion is short, the bleeding rate is low, the incidence of complications is low, the healing rate is high, and the follow-up effect is accurate. It is suitable for clinical use.

BACKGROUNDEndostatin is a potent inhibitor of tumor angiogenesis. In the preliminary studies, we developed a mutant endostatin containing Arg-Gly-Asp-Arg-Gly-Asp (RGDRGD) sequences. In this study, we compared the antitumor effects of mutant endostatin and Bcl-2 antisense oligonucleotides both in combination and individually.

METHODSThe artificially synthesized Bcl-2 ASODN (antisense oligonucleotides) included a translation-initiation site and was transfected into the bladder cancer cells by Lipofectamine. Cell growth was investigated by the tumor cell growth chart, MTT assay, caspase-3 activity detection assay, AO/EB fluorescein stain, and the annexin V-FITC apoptosis detection assay. In the in vivo study, UM-UC-3 bladder cancer cells were subcutaneously implanted into nude mice and the growth of tumor was examined. The ultrastructure of the tumor tissues in the treated and control groups were observed.

RESULTSThe cell growth chart showed that the cell population of the treated combination group decreased by 52.04% compared to the control group. The inhibition rate of the treated combination group was (79.66 ± 6.79)%, whereas those of the individual ASODN and ES groups were (53.39 ± 3.22)% and (50.22 ± 5.46)% respectively. In the caspase-3 activity detection using AO/EB fluorescein stain and annexin V-FITC apoptosis detection assay, the co-inhibitory effect was higher than the individual inhibitory effects (P < 0.05). There were significant differences in the inhibition of the solid tumor growth in the in vivo study.

CONCLUSIONSOur findings indicated that Bcl-2 antisense oligonucleotides enhance the antitumor effects of mutant endostatin both in vitro and in vivo. We noted the synergistic effects of Bcl-2 antisense oligonucleotides combined with mutant endostatin.

Angiogenesis Inhibitors ; administration & dosage ; Animals ; Cell Line, Tumor ; Drug Synergism ; Endostatins ; administration & dosage ; Mice ; Thionucleotides ; administration & dosage ; Urinary Bladder Neoplasms ; pathology