Objective To investigate theeffect of ischemic postconditioning (IPO) on ischemia/reperfusion injury via mitochondrial pathway.Methods Male Sprague-Dawley rats were divided into three groups by means of random number table.Rats in IRI group and IPO group received liver transplantation.The portal vein in IRI group was opened immediately after liver implantation to restore the blood supply.The graft rats in IPO group received IPO before the portal vein was completely opened: 60-s ischemia and 60-s reperfusion of the portal vein,repeated 6 times).The rats in the sham-operation group were only subject to dissociation of the liver ligament.Six h after portal vein reperfusion,liver function was tested.The expression of Bcl-2 mRNA and Bax mRNA was detected by using real time-PCR.The protein expression of Cyt-c was detected by using Western blotting.The apoptosis and necrosis of liver tissue and the mitochondrial transmembrane potential were detected by using flow cytomertry.The changes of mitochondrial structure were observed under an electron microscope.Results The liver functions in IRI group and IPO group were significantly worse (P＜0.05),the levels of Bax mRNA were significantly higher (P＜0.05),the levels of Bcl-2 mRNA were significantly lower (P＜0.05),the levels of Cyt-c protein were significantly higher (P＜0.05),the levels of apoptosis and necrosis were significantly higher (P＜0.05),and mitochondrial transmembrane potential (MTP) of liver cells was significantly lower (P＜0.05) than in sham operation group.The changes of all the parameters in IRI group were more significant than in IPO group (P ＜ 0.05).The morphological changes of the liver mitochondria were also significantly aggravated in IRI group as compared with IPO group.Conclusion IPO reduced IRI by inhibiting the mitochondrial signaling pathway in rats undergoing liver transplantation.

Objective To investigate the therapeutic efficacy of HPV16 E7 peptide pulsed dendritic cells (DCs) in recurrent condyloma acuminate (CA). Methods A total of 32 cases of recurrent CA (more than 3 times) were divided into the treatment group and the control group. Patients (11 cases, HPV16 +and HLA A2 +) in the treatment group received treatment with DCs, while the other 21 cases in the control group were treated with interferon. A follow up of 6 months was conducted in all patients. The pathological lesions, the peripheral T cell subpopulations of the patients, and the therapeutic efficacy before and after treatment were observed. Results The size of the lesions became smaller or disappeared in the treatment group. The infiltrated lymphocytes increased, but the koilocytotic cells decreased in the lesions. No significant change in the peripheral T cell subpopulations was found before and after therapy. The recurrence rates in the treatment group and the control group were 18.2% and 61.9%, respectively. Conclusion The therapy by E7 peptide pulsed dendritic cells can improve the local immune status in the skin and reduce the recurrence rate significantly in patients with recurrent CA.

Objective To evaluate the clinical efficacy and adverse effects of CAG regimen in treatment of primary, refractory and relapsed acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS), and analyse the factors influencing long-term survival. Methods Sixty-one patients with AML ( primary, n = 27; refractory, n = 18; relapsed, n = 16) and 9 patients with MDS were treated with CAG regimen. Examinations on liver and renal function, electrocardiogram and bone marrow cytology were performed before and after treatment, and adverse effects of CAG were observed. Short-term efficacy was evaluated based on clinical manifestation, peripheral blood and bone marrow cytologic examinations. Patients were followed up, overall survival ( OS) and disease free survival ( DFS) were analysed, and long-term efficacy of CAG regimen was evaluated. The factors influencing long-term survival were analysed by Log-rank test of survival curve. Results After a course of treatment by CAG regimen, the total effective rate was 71% , and 34 patients (49%) experienced complete remission. The median time of follow up was 45 months, the median OS was 28 months, and the median DFS was 23 months. Age, level of lactate dehydrogenase (LDH), remission condition after a course of treatment by CAG regimen and adoption of HD-Ara-C regimen as consolidation treatment were influencing factors for OS and DFS. The dominant clinical adverse effects were bone marrow depression, with 13 d as the median duration of agranulocytosis ( neutrophil <0.5 ×10~9/L) and 9 d as the median duration of thrombocytopenia (platelet <20 ×10~9/L). Conclusion CAG regimen may lead to favourable therapeutic effects in treatment of primary, refractory and relapsed AML and high risk MDS, and may yield less adverse effects and better long-term therapeutic effects. Age, level of LDH, remission condition after a course of treatment and adoption of HD-Ara-C regimen as consolidation treatment are dominant influencing factors for survival.

INTRODUCTIONBicuspid aortic valve (BAV) is the most common form of adult congenital heart disease. When compared to patients with a normal trileaflet aortic valve, dilatation of the aortic root and the ascending aorta (Asc Ao) are the common findings in patients with BAV, with consequent higher risk of developing aortic aneurysm, aortic dissection and rupture. We aim to determine the site of the Asc Ao where maximum dilatation occurs in Asian adult patients with BAV.

MATERIALS AND METHODSAll subjects underwent full echocardiography examination. The diameter of the Asc Ao was measured at 3 cm, 4 cm, 5 cm, 6 cm and 7 cm from the level of aortic annulus to the Asc Ao in 2D from the parasternal long-axis view.

RESULTSA total of 80 patients (male/female: 45/35; mean age: 45.3 ± 16.2 years) with congenital BAV and 30 normal control group (male/female: 16/14; mean age: 45.9 ± 15.1 years) were enrolled. The indexed diameters of the Asc Ao were significantly larger than the control group. In patients with BAV, maximum dilatation of Asc Ao occurred around 6 cm distal to the aortic annulus.

CONCLUSIONIn patients with BAV, dilatation of Asc Ao is maximal at the mid Asc Ao region around 6 cm distal to the aorta annulus.

Adult ; Aneurysm, Dissecting ; epidemiology ; Aorta ; diagnostic imaging ; Aortic Aneurysm ; epidemiology ; Aortic Diseases ; diagnostic imaging ; epidemiology ; Aortic Rupture ; epidemiology ; Aortic Valve ; abnormalities ; diagnostic imaging ; Case-Control Studies ; Comorbidity ; Dilatation, Pathologic ; diagnostic imaging ; epidemiology ; Echocardiography ; Female ; Heart Valve Diseases ; diagnostic imaging ; epidemiology ; Humans ; Male ; Middle Aged ; Risk Factors ; Singapore ; epidemiology

Adult ; Cardiovascular Diseases ; physiopathology ; Cardiovascular Physiological Phenomena ; Case-Control Studies ; Female ; Heart ; physiopathology ; Humans ; Pregnancy ; Sports ; Stress, Psychological ; physiopathology

Objective To investigate the safety of rituximab combination chemotherapy in the treatment of B-cell non-Hodgkin' s lymphoma (B-NHL) complicated with hepatitis B virus (HBV) infection,and assess the incidence of HBV reactivation reduced by prophylactic lamivudine.Methods A retrospective study of HBV-related markers,HBV-DNA and liver function was performed before and after rituximabcontaining treatment in B-NHL patients.Thirty nine B-NHL patients with HBcAb(+)/HBsAb(-) were divided into prophylactic group (14 cases) and control group (25 cases).The incidences of HBV reactivation,functional damage of liver were measured.Results Among the 108 B-NHL patients who received rituximab combinatio nchemotherapy,15 (13.89 ％) were HBsAg (+) and 39 (36.11％) HBsAg (-) / HBcAb (+).Of the 15 HBsAg (+)patients,2 (13.3 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 7.7 ％(1/13) in patients who received prophylactic antiviral treatment and 50 ％ (1/2) in those who did not receivelamivudine.Among the 39 HBsAg (-) / HBcAb (+) patients,3 cases (7.7 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 0 in patients who receivcd prophylactic lamivudine treatment and 12 ％ (3/25) in those who did not receive this antiviral drug.Conclusion Prophylactic lamivudine before rituximab combination chemotherapy can reduce HBV reactivation obviously.

Objective To investigate the role of and relationship between reactivity to autologous serum and dermatophagoides farinae (Df) in the pathogenesis of chronic urticaria (CU). Methods Autologous serum skin test (ASST) and skin prick test (SPT) to Df were carried out in 831 patients with CU. The correlation between reactivity to autologous serum and Df was statistically analyzed. Results The positivity rate of ASST and SPT to Df was 51.74% and 64.62%, respectively in the 831 patients. SPT was positive in 56.52% of patients with positive ASST and in 73.86% of those with negative ASST (P ＜ 0.05). In patients with positive ASST, the degree of autologous serum reactivity was negatively correlated with that of reactivity to Df (P ＜ 0.05). Conclusions The skin reactivity to Df and autologous serum plays an important role in the pathogenesis of CU, and the degree of the reactivity to Df and autologous serum is negatively correlated. To conduct ASST and SPT simultaneously in patients with CU may favor the clinical classification and therapy of CU.

Objective:To explore the effect of family history of cancer on clinical features and prognostic factors in nasopharyngeal car-cinoma (NPC) patients. Methods:The clinical data of 89 NPC patients with a family history of cancer and 388 NPC patients without a family history of cancer were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possi-ble prognostic factors. Results:The clinical characteristics of NPC patients with and without family history of cancer were compared. The gender, age, TNM stage, pathological type, and hemoglobin radiotherapy concentration before treatment did not significantly dif-fer between the two groups (P>0.05). NPC patients with a family history of cancer had better 3-year overall survival than those with-out family history of cancer (91.6%vs. 85.5%), but no statistically significant difference was observed (P=0.211). Both univariate and multivariate analyses showed that T, N, and TNM stages were the important prognosis factors affecting 3-year overall survival (OS), progression free survival (PFS), and distant metastasis-free survival (DMFS) of NPC (P<0.05). However, neither family history of cancer nor family history of NPC in 3-year OS, PFS, LRFS, and DMFS was significant in NPC patients (P>0.05). Conclusion:NPC patients with family history of cancer had better 3-year OS than those without family history of cancer, but no statistically significant observation was found. Large T stage or high lymph node stage contributed to poor survival of NPC. Family history of cancer had no significant in-fluence on the survival of NPC patients.

Objective To investigate Th1/Th2 pattern of response in psoriasis and to study the effects of CTLA4Ig on Th1/Th2 shift in psoriasis. Methods The levels of IL-2, IFN-?and IL-4 were assessed by ELISA in the supernatant of cultured peripheral blood mononuclear cells (PBMCs) from 33 patients with psoriasis vulgaris and 20 healthy blood donors. Cytokine synthesis was induced by activation with phytohemagglutinin (PHA) and staphylococcal enterotoxin B (SEB) with or without CTLA4Ig. Results Levels of IL-2, IFN-?and IL-4 were markedly increased by PBMCs from psoriatic patients incubated with SEB (P

Objective To investigate the status of expression and gene polymorphism of cytotoxic T lymphocyte-associated molecule4(CTLA4)on peripheral blood mononuclear cells(PBMCs)from patients with psoriasis.Methods Expression of CTLA4mRNA/antigen and polymorphism of CTLA4gene were analyzed in33and133patients with psoriasis confirmed clinically and/or pathologically,respectively.Expression of CT-LA4mRNA and antigen was detected by in situ hybridization and immmunohistochemistry.CTLA4exon1and3'untranslated region were amplified by polymerase chain reaction(PCR)and the amplified products were identified by single-stand conformation polymorphism(SSCP),restriction fragment length polymorphism(RFLP)or sequencing.Results Expression of both mRNA and antigen of CTLA4was significantly weaker on PBMCs induced by staphytococcal enterotoxin B(SEB)in patients with psoriasis than that in normal con-trols,without a regular pattern.The guanine49on exon1in association with fragment106bp of3'untranslat-ed region was shown to be linked to the susceptibility of psoriasis.Conclusion Defective translation and ex-pression of CTLA4take place in patients with psoriasis,which is possibly related to the polymorphism of CT-LA4.Our results suggest that CTLA4may be one of the candidate genes which cause autoimmunity in psoria-sis.