ObjectiveTo investigate the effects of hyperbaric oxygen therapy on T-lymphocytes 1 and cytokines including IL-6, IL-10 and TNF-α asindicators well representing immune function and inflammation in normal rats and rats with systemic inflammatory response syndrome. Methods Forty Sprague-Dawley male Rats were randomly ( random number) divided into five groups.Rats of group A were treated by saline solution (0.9 ％ NaCl,5 mL/kg),and served as control group; rats of group B were treated with saline solution and hyperbaric oxygen therapy three times; rats of group C were treated with zymosan (500 mg/kg) ; rats of group D were treated with zymosan and hyperbaric oxygen therapy once; and rats of group E were treated with zymosan and hyperbaric oxygen therapy three times.At 24 hours after saline or zymosan administration,rats were sacrificed and blood samples were collected from the portal vein.CD3 +,CD4+,CD8+ cells were counted by flow cytometer,and plasma levels of IL-6,IL-10 and TNF-αwere measured by ELISA.The results were analyzed by one - way ANOVA and LSD post-hoc test.Results CD4 T cell of normal rats was decreased by hyperbaric oxygen (P＜0.01 ),CD4/CD8 T cell ratio was also decreased ( P ＜ 0.05 ).Of rats with zymosan administration,CD4 T cells and CD8 T cells were both decreased on a parallel (P＜0.01 ).A single one HBO and HBO for three times both raised the percentage of CD4 T cells which was significantly decreased by zymosan administration ( P ＜ 0.01 and P ＜ 0.05 ).In rats without hyper- inflammation,hyperbaric oxygen therapy showed a pro-inflammatory effect by elevating TNF-α (P＜0.01),IL-6 (P＜0.05) and reducing 1L-10 (P＜0.05).ConclusionsHBO reduces CD4 T cells in normal rats.HBO reduces the production of TNF-α,IL-6 and IL-10 during hyper- inflammation.HBO is pro - inflammatory in normal rats and minor SIRS rats withourt appreciable hyper-inflammation in circulation.

Objective To study the correlation of serum hepcidin with residual renal function and micro-inflammation state in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods Thirty-four stable CADP patients were involved in this study as observers (CAPD group),who had accepted CAPD treatment more than three months; twenty non-dialysis patients with stage 5 of chronic kidney disease were selected as control group.According to the level of high sensitivity Creactive protein (hs-CRP),CAPD patients were divided into two subgroups.There were 14 patients in the hsCRP elevated group (hs-CRP ＞ 3.00 mg/L) and 20 patients in the hs-CRP normal group.In addition,there had been 14 patients with residual renal function in CAPD group.Serum hepcidin was measured by ELISA.Serum Ferritin (FER),hs-CRP,routine blood and biochemistry were measured by routine methods.Calculated estimated glomerular filtration rate (eGFR).Pearson correlation and linear regression were used to assess the correlation of serum hepcidin with other laboratory parameters in CAPD patients.Results (1) Serum hepcidin was significantly higher in CAPD patients than control group,but eGFR was significantly lower (P ＜ 0.01).(2) Serum hepcidin levels of no residual renal function patients increased more significantly in CAPD group (P ＜ 0.05).(3) Serum hepcidin levels were higher in hs-CRP elevated group than hs-CRP normal group (P ＜ 0.05).(4) Pearson correlation analyses revealed that serum hepcidin was positively correlated with hs-CRP (r=0.501) and FER (r=0.847,all P ＜ 0.01),and was negatively correlated with Hb (r=-0.919),TRF (r=-0.751),TIBC (r=-0.532,all P ＜ 0.05).(5) Multiple linear regression analysis showed that ferritin and hs-CRP were closely associated with serum hepcidin level in CAPD.Conclusions Serum hepcidin level markedly elevate in CAPD patients,especially in the patients with no residual renal function and micro inflammatory state increased more significantly.

Objective To analyse the failed total hip arthroplasty(THA) and to improve its long term results. Methods Thirty five patients(36 hips) undergone revision THA from November 1996 to April 1999, were grouped according to the different causes of the primary failed THA. Results Statistical analysis failed to show the factors related to the failures. In any one failed case, the causes were usually more then one item. The most common causes of failed surgery found in 24 cases were aseptic loosening and peri prosthetic osteolysis, wear out of acetabulum was seen in 7, malpositioned prostheses in 6 and postoperative dislocation in 3. Infection and fracture of femoral stem happened in 3 and 2 patients respectively. Conclusion THA has been extensively used as an effective procedure for the reconstruction of hip joint. Long term excellent clinical results are related to strict selection of indications, appropriate prosthesis, and finally the experience and surgical technique of the surgeon are also of importance to the final outcome.

Objective To explore the pancreatic kininogenase enteric-coated tablets in the treatment of diabetic retinopathy (DR) patients and its effect on the optic disc and macula retinal hemodynamics. Methods 86 cases (140 eyes) of DR patients were randomly divided into pancreatic kininogenase group and normal group with 43 cases in each group, two groups were treated with basic therapy, pancreatic kininogenase group were combined with pancreatic kininogenase treatment. The best corrected visual acuity and the clinical effect of optic disc and macula retinal hemodynamic changes were compared between two groups. Results After treatment, the best corrected visual acuity (BCVA) in pancreatic kininogenase group was greater than the normal group (P<0.05), the retinal neovascularization and fluorescein leakage area in pancreatic kininogenase group was less than the normal group (P<0.05). The disc vascular and macular retinal blood flow volume (VOL), blood flow velocity (FLW)values in pancreatic kininogenase group were larger than those of normal group, and the clinical curative effect of pancreatic kininogenase group was better than that of normal group (P<0.05). Conclusion Pancreatic kininogenase enteric-coated tablets in the treatment of DR patients can improve the optic disc and macular retinal hemodynamic parameters, improve visual acuity and reduce the retinal neovascularization and fluorescein leakage area, so as to improve the clinical treatment effect.

Objective To study the relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS). Methods Sixth-seven patients definitely diagnosed by potysomnography (PSG) as OSAHS were divided into three groups according to their apnea-hypoventilation index (AHI), 14 in mild group (5 < AHI≤20), 21 in moderate group (20 < AHI≤40) and 32 in severe group (AHI 40). And, 18 healthy persons (AHI <5) were recruited as controls. Blood samples were obtained form all of them after PSG performance for measuring apoptotic endothelial cells (CD146AnnV+) and serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Serum level of MDA and CD146AnnV+ in moderate and severe OSAHS group were significantly higher than those in control group (all P < 0.05). Serum level of SOD in moderate and severe OSAHS group was significantly lower than that in control group (P < 0.05). CD146AnnV+ correlated positively with AHI, the longest apnea time (LAT) and oxygen desaturation index (ODI) (r = 0.778, 0.609 and 0.689, respectively, all P < 0.05) and correlated reversely with saturation of arterial blood oxygen at night (SaO2min) (r =-0.635, P < 0.01). CD146AAnnV+ correlated positively with serum level of MDA (r = 0. 698, P < 0.01), and correlated reversely with serum level of SOD (r =-0.705, P < 0.01). Results of linear multivariate regression analysis showed that AHI, serum levels of SOD and MDA were independent risk factors for endothelial cells apoptosis in patients with OSAHS. Conclusions There existed oxidative stress due to intermittent hypoxia in patients with OSAHS, which could be one of the major causes in exacerbating endothelial damage.

BACKGROUND: The degree of neurofilament (NF) phosphorylation is closely correlated with the occurrence of Alzheimer disease (AD), and apolipoprotein E4 (apoE4) is a generally acknowledged liability factor for AD, but the effect and mechanism of apoE4 on the NF phosphorylation in neurons are not very clear. It has been reported that in the neurons cultured in vitro and in brain tissue of AD patients, the amino acid residues of apoE4 protein C terminal (272-299) could be truncated by hydrolysis,and produce truncated-apoE4 fragment. The latter interacts with the NF phosphorylation in neurofibrillary tangles (NFTs), which are the characteristic pathological changes of AD.OBJECTIVE: To observe the effect of truncated-apoE4 overexpression on the NF phosphorylation in the cultured neurons.DESIGN: A non-randomized controlled observation.SETTING: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the Laboratory of Biochemistry and Molecular Biology, Tongji Medical College, Huazhong University of Science and Technology in December 2005. The mice neuroma cell strain N2a was provided by Dr. Xu.METHODS: The truncated-apoE4(△272-299) cDNA was subcloned into pEGFP-c3 to form pEGFP-T-apoE4 recombinant. Then pEGFP-c3, pEGFP-apoE4 and pEGFP-T-apoE4 were transfected into N2a cells by lipofectamine2000 respectively. NF phosphorylation was detected by Western blot assay. The activities of glycogen synthase kinase-3 (GSK-3) and cyclin-dependent kinase 5(CDK-5) were measured.MAIN OUTCOME MEASURES: The degree of NF phosphorylation and the activities of GSK-3 and CDK-5 were mainly observed.RESULTS: In the transfected groups, the contents of phosphorylated NF were significantly increased, the GSK-3 activities were significantly increased, which were the most significant in the pEGFP-T-apoE4 transfected group (P＜0.05), but the CDK-5 activities were not significantly different from that in th e control group (P＞0.05).CONCLUSION: These results indicate that in vitro overexpression of truncated-apoE4(△272-299) can lead to NF hyperphosphorylation by activating of GSK-3 but not CDK-5, which may be the underline mechanism of AD induced by truncated-apoE4(△272-299).

Humans ; Jaw, Edentulous ; therapy ; Maxilla ; Prostheses and Implants

ObjectiveTo evaluate the efficacy of radical transurethral bladder tumor resection plus chemotherapy for the treatment of muscle-invasive bladder cancer. Methods Thirty-two patients,who were diagnosed muscle-invasive bladder cancer by preoperative CT and cystoscopy and not tolerating or rejecting radical cystectomy were treated by transurethral resection of bladder tumor (TURBt).The maximum diameter of tumor ranged from 1 - 5 cm,3 cm on average.After conventional intravenous chemotherapy ( docetaxel 75 mg/m2 + oxaliplatin 130 mg/m2),and given intravenous therapy (HCPT 20 mg + 20 ml saline).Regular cystoscopy was used to monitor tumor recurrence.The examination was performed quarterly in the first 2 years post operation,twice a year since the third year.ResultsThe tumors of 32 cases were resected completely.Operative time were 15 -70 min,the blood loss was 10 -150 ml,without serious complications during the operation.Pathological report showed 32 cases of transitional cell carcinoma.Clinical stages were T2a 20 cases,T2b 12 cases.Pathological grade were G2 13 cases,G3 19 cases.There was no bone marrow suppression,anemia or other severe complications was seen in 32 cases that received chemotherapy.3 of which manifested as low fever,mild nausea,and headache,respectively,having a rest 2 to 3 days the symptoms disappeared.32 patients were followed up for 3 - 60 months,a mean of 28 months.After 1 year the recurrence rate was 9.4％ (3/32),after 2 years was 12.5％ (4/32).The TNM stage of these recurrence cases were 4 cases with T2a and 3 cases with T2b.12 patients died,5 patients died of bladder cancer metastasis.Other 20 patients were survival with no recurrence.ConclusionRadical TURBt plus chemotherapy could be a treatment for the selected patients with muscle invasive bladder cancer.

Objective To evaluate the targeted killing of malignant melanoma cells by aclarubicin liposomes conjugated with vascular endothelial growth factor(ADM-VEGF-SSL)in vitro.Metheds To detect the binding abilitv of liposomes to malignant melanoma(MM)cells,the human malignant melanoma cell line A375 was cultured in the presence of ADM-VEGF-3H-SSL or ADM-3H-SSL for 2 days followed by the detection of radioactivity of these cells.Then.A375 cells were cultured with various concentrations(0.01,0.1,1,10,100 mol/L)of ADM-VEGF-SSL,ADM-SSL or free ADM for 48 hours in the 48-hour cytotoxity test,or for 0.5 hour followed by another 48-hour culture in drug-free medium in the 0.5-hour cytotoxity test.After that,MTT assay was used to detect the survival rate of these cells.Results ADM-VEGF-SSL could specifically bind to and kill A375 cells.The binding rate of ADM-VEGF-SSL was 2.15 folds as high as that of ADM-SSL.The survival rate of A375 cells after being treated with ADM-VEGF-SSL for 48 hour was similar to that with flee ADM(P＞0.05).but lower than that with ADM-SSL(P＜0.05),while the survival rate of melanocytes treated with ADM-VEGF-SSL was higher than that with free ADM or ADM-SSL(both P＜0.05).As shown by the 0.5-hour cytotoxity test.shortening the treatment course did not attenuate the effect of ADM-VEGF-SSL on A375 cells.Conclusions ADM-VEGF-SSL can specifically recognize A375 cells.efficiently deliver adriamycin into tumor cells,markedly inhibit the proliferation of A375 cells,and eventually,a targeted kill of these cells is realized.

BACKGROUND: Aseptic loosening and infection are difficult to diagnose due to their similar clinical manifestations following total hip replacement.There lacks routine examinations or gold standard to diagnose peri-prosthetic infection.OBJECTIVE: To evaluate the clinical effectiveness of technetium-99m-labelled triphase isotope scinitigraphy in the diagnosis of peri-prosthetic infection following total hip arthroplasty.METHODS: A total of 11 patients with suspected peri-prosthetic infection were selected,with continuous hip pain,prosthesis loosening and abnormal serum indexes,including 7 males and 4 females,with an average age of 63.8(53-74)years.The average time of prosthesis usage was 14.5(0.5-30)years.The technetium 99m-labelled bone scintigraphy images were obtained to observe the density variation of the infection region during the blood flow phase,blood pool phase and late phase and compared with normal lateral limb.Time-radioactive uptake curve was made using software to analyze the diagnostic results.In addition,the diagnostic value of the triple-phase bone scinitigraphy was analyzed using the intraoperative frozen section results(neutrophil < 5 under 10 high power visual fields: no infection).RESULTS AND CONCLUSION: Of 11 patients,2 cases showed negative result of triple-phase bone scinitigraphy,and intraoperative frozen section analysis showed < 5 polymorphonuclear cells per high-power field,who underwent one-stage revision surgery; 8 displayed positive result of tdple-phase bone scinitigraphy,and intraoperative frozen section analysis showed > 5polymorphonuclear cells per high-power field,who underwent two-stage revision surgery; 1 case showed negative result of triple-phase bone scinitigraphy but intraoperative frozen section analysis showed > 5 polymorphonuclear cells per high-power field,who also underwent two-stage revision surgery.Results show that positive results of triple-phase bone scintigraphy were related to peri-prosthetic infection,which has great value for revision surgery in combination with histopathological examination.