Antibodies, Antiphospholipid ; blood ; immunology ; Antiphospholipid Syndrome ; diagnosis ; etiology ; immunology ; Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Partial Thromboplastin Time

Objective To investigate the peripheral blood Th17 and CD4 + CD25 + regulatory T cell levels and their correlations in patients with primary hepatocellular carcinoma (PHC).Methods Peripheral blood samples were collected from 30 PHC patients and 25 healthy controls in the First Affiliated Hospital of Zhejiang University from June 2008 to May 2009.Mononuclear cells were isolated and the Th17 and CD4 + CD25 + regulatory T cells were detected by flow cytometry and compared between patients and controls by t test.Spearman test was performed to analyze the correlation of Th17 with CD4 + CD25 +regulatory T cell concentrations.Results The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood in healthy controls were (2.10 ± 0.87) ％ and (7.10 ± 2.32) ％ ; while those in PHC patients were (3.38±1.68)％ and (11.78±5.62)％ (t=3.640 and 4.162,P＜0.01).The level of Th17 cells was positively associated with that of CD4 + CD25 + regulatory T cells in PHC patients (r =0.821,P ＜0.01).Conclusion The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood are high in PHC patients and positively correlated with each other,which indicates that CD4 + CD25 + regulatory T cells may contribute to the disease progression and pathogenesis of carcinoma through inducing Th17 cells differentiation.

Aged ; Antitubercular Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Factor VIII ; therapeutic use ; Hemophilia A ; drug therapy ; etiology ; Humans ; Lumbar Vertebrae ; Male ; Phytotherapy ; Tuberculosis, Spinal ; complications ; drug therapy

AIM:To investigate the myocardial protective effect of endometrial stem cell ( EnSC)-derived cyto-kine cocktail ( EdCC) on myocardial ischemic reperfusion injury and the MEK-ERK signaling pathway.METHODS: A mouse model of myocardial ischemic reperfusion injury was established.Infarct area, cell apoptosis, and expression of cleaved caspase-3 and phosphorylatied ERK1/2 were determined by TTC/Evans blue staining, TUNEL assay and Western blot, respectively.RESULTS:The mesenchymal characteristics were observed in the EnSCs with expressing CD90 and in absence of CD34 and CD45.EdCC contained (6 811 ±312) ng/g epidermal growth factor (EGF) protein.The phospho-rylation of ERK1/2 markedly increased after injection of EdCC, but was abolished by MEK1 inhibitor PD98059 ( 5 mg/kg) .EdCC decreased the infarct area and apoptotic cell number in the border zone and inhibited caspase-3 activation. However, the effects were abolished by MEK1 specific inhibitor PD98059.EGF did not decrease the infarct area, but the EGF receptor antagonist AG-1487 (6 mg/kg) partly abolished the myocardial protective effect of EdCC.CONCLUSION:EdCC protects the myocardium from ischemic reperfusion injury via activating MEK1-ERK signaling pathway, indicating an essential role in the transmission of stem cell therapy from the cell transplantation to cytokine based strategy.

Objective To establish the model of P2 peptide-induced experimental autoimmune neuritis(EAN)in rats and explore the roles of Th_1/Th_2 type eytokines in EAN.Methods Lewis rats were grouped into EAN rats and control rats.The EAN rats were immunized by injection into both hind footpads of inoculums containing 100 ?g or 200 ?g of P2_(57-81)peptide and FCA while the control rats were immunized with FCA only.Clinical scores were compared at the maximum of disease.Supernatant productions of IFN- ?, IL-4 and IL-10 secreted by lymphocytes and obtained on day 14 after the immunization were examined. Histopathological assessment of sciatic nerves was made.Results Peak clinical scores of P2_(57-81)200 ?g (3.6?0.3)group were significantly higher than P2_(57-81)100 ?g group(2.2?0.6,P

Objective To investigate the effect of radical surgical excision of total cyst for hepatic cystic echinoccosis. Methods During six years,86 patients with hepatic cystic echinococcosis were treated by radical surgical excision of the total cyst.Hospital stay,abdominal drainage time,residual cavity drainage,accumulated liquid in residual cavity,residual cavity infection and recurrence were compared with that in 90 cases receiving internal capsule extirpation. Results Radical surgical excision of total cyst for hepatic cystic echinococcosis is safe and very effective,the average hospital stay was significant shorter(P＜0.001)and there was no significant complications such as billiay fistula,residual cavity infection,accumulated liquid of residual cavity and recurrence of hydatid cyst. Conclusion Radical surgical excision of total cyst is an ideal and new therapeutic method for the treatment of hepatic cystic eehinococcosis.

Objective To compare the results of the three grades pictures affiliated With the Synotophore and to choose the opti- mal pictures for the clinician.Design Retrospective case series.Participants 41 normal persons and 44 cases of intermittent exotropia. Methods All participants were separately examined the three grades function with different kinds and degrees pictures affiliated with the Synotophore.The average radian measured with four sorts of pictures of the first grade function and the average measured with the three sorts of pictures of the second grade function were analysed,the stereoacuity of third grade function was measured with qualitative picture and random dot quantitative picture.Comparison was made between two groups of the people who possessed with stereoacuity. Main Outcome Measures Radians and seconds gained from the pictures affiliated with the Synotophone,Results Synotophore of the superposition of the first grade function:the outcome of using four sorts of pictures to examine the normal persons were 1.47+1.68, 1.21?1.21,1.68?1.60,1.32?1.27,F=0.595,P=0.619;the intermittent exotropias were 8.41?4.30,8.73?4.26,8.45?3.86,8.73?4.28,F= 0.070,P=0.987;the difference was not prominent.The fusion range of the second grade of Synotophore,using three different pictures to examine the normal persons were 26.03?6.17,21.11?6.87,17.21?5.40,F=17.260,P=0.000,the result of the fusion range has direct proportion with the degrees of the pictures,the bigger the picture was,the larger the fusion range,the difference was statistically signif- icant.And there was no significant differences for the intermittent exotropias when examined with the same pictures(21.74?7.43,21.31?7.82,20.32?7.53),F=0.590,P=0.556.The stereoaeuity of the third grade of Synotophore,in the normal person group 85.4% and 100%, X~2=4.877,P=0.027,the results were statistically significant between the qualitative picture and the random dot quantitative picture. About the intermittent exotropia group,no statistically significant differences were detected(72.73% and 59.10%),X~2=1.821,P=0.177. Condusion Choose pictures randomly when examine the first grade function of Synotophore;for the second grade function of Syno- tophore in both groups may choose intergraded degree pictures;the stereoacuity of the third grade of Synotophore,normal group should choose quantitative pictures,while strabismic patients may choose both of them.(Ophthalmol CHN,2008,17:120-122)

Objective To summarize and discuss the diagnostic and treating experiences of chronic pancreatitis with mass in the head. Methods Eight patients of chronic pancreatitis with mass in the head who were misdiagnosised as carcinoma of head of pancreas were analyzed retrospectively in the past 10 years. Results All the patients exhibited abdominal pain,5 of whom were with jaundice and 3 with anorexia. All the patients were misdiagnosised as carcinoma of head of pancreas before the operation,but the pathology after operation indicated chronic pancreatitis. The pancreaticoduodenectomy was performed in 5 patients,the choledochojejunostomy in 2 patients,while the exploratory laparotomy in 1 patient. After the operations,the abdominal pain was relieved in 7 patients, while 2 patients who accepted pancreatoduodenectomy suffered from pancreatic fistula,1 of whom died in the end. Conclusion It’s hard to differentiate the chronic pancreatitis with mass in the head from the carcinoma of head of pancreas before operation. If the carcinoma of head of pancreas can’t be excluded during the operation,the pancreatoduodenectomy should be performed,while the duodenum-preserving total resection of the head of the pancreas or any intra-drainage operations should be done if chronic inflammation is found in the whole pancreas with a negative result of the biopsy of the pancreas through the needle aspiration.

Objective To investigate the role of contrast enhanced ultrasound (CEUS) in evaluating and guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) and its feeding vessels. Methods From January 2006 to June 2007, 71 patients with 75 hypervascular HCC in Peking University Cancer Hospital who underwent RFA were included in the study. The diagnosis was conifrmed by ultrasound guided biopsy for all patients. These patients were not suitable for transcatheter arterial chemoembolization (TACE) or had poor responds to TACE. They were divided into two groups, which included group percutaneous artery ablation (PAA) combining RFA and group RFA. There were 38 patients with 39 HCC in group PAA combining RFA and CEUS were used to identify the range of HCC inifltration. Firstly, PAA of the feeding vessels was conducted under the guidance of color doplor lfow imaging (CDFI). Then CEUS was performed to evaluate HCC perfusion after blocking the feeding vessels. Finally, the rest of the tumor was ablated by RFA. In group RFA, there were 33 patients with 36 HCC, who did not undertake PAA before RFA. Generally, the RFA was planned based on tumor size and location, and the ablation started with deep part of HCC or portion close to nearby organs. Contrast CT was used as a post-RFA imaging for follow-up at 1, 3 and 6 months post-RFA. T test was used to compare the difference in focal lesions number between two groups, andχ2 tests were used to compare the difference in necrosis rate between two groups after treatment. Results In group PAA combining RFA, post-PAA CEUS showed intratumor perfusion decreased more than 70%in 31 HCC (79.5%, 31/39). Of them, 13 HCC (33.3%, 13/39) showed complete perfusion defect with clear margin, called“solar eclipse sign”. The rest 8 HCC (20.5%, 8/39) showed 40%-70%of perfusion defect. In group PAA combining RFA, CDFI showed 35 (83.3%, 35/42) feeding vessels were blocked, and 3 vessels (7.1%, 3/42) showed signiifcant decreased lfow signal after PAA. There were average 3.18±1.42 ablations per HCC in group PAA combining RFA, and 4.32±1.56 in group RFA. The number of ablations per HCC in group PAA combining RFA was signiifcantly less than group RFA (t=2.524, P=0.015). The tumor necrosis rate at 1 month post-RFA in group PAA (92.3%, 36/39) combining RFA was signiifcantly higher than that of group RFA (66.7%, 24/35) (χ2=8.264, P=0.001). Conclusions With CEUS, PAA can effectively block the feeding vessels of HCC, enhance ablated necrosis in the tumor and signiifcantly increase necrosis rate post-RFA for large hypervascular HCC. CEUS-assisted PAA can improve efifciency of RFA with less ablation number and better result.

OBJECTIVETo evaluate the impact of closed high-pressure suction drainage on the healing of the perineal wound after abdominoperineal resection.

METHODSPatients undergoing rectal abdominoperineal resection in the Wuhan Tongji Hospital from January 2009 to January 2011 were randomized into two groups including the study group(n=61, closed high-pressure suction drainage) and the control group(n=59, presacral drainage). The drainage volume, primary healing rate, and the healing time of perineal wounds were compared.

RESULTSThe total volume of the drainage in the first 3 days was (448.1±142.9) ml in the study group and (548.3±190.6) ml in the control group, the volume of the drainage on the third day was (28.1±12.7) ml and (125.9±84.3) ml respectively. The primary healing rate was 93.4%(57/61) in the study group and 74.6% (44/59) in the control group, the healing time was (13.5±3.5) days and (20.1±5.1) days respectively.

CONCLUSIONClosed high-pressure suction drainage may promote perineal wound healing following rectal abdominoperineal resection.

Abdomen ; surgery ; Adult ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Perineum ; surgery ; Rectal Neoplasms ; surgery ; Wound Healing