Objective To study the management of prostate sarcoma. Methods Four cases of prostatic sarcoma were presented with review of the literature. Results Of the 4 cases,two were spindle cell sarcoma,one leiomyosarcoma and the other rhabdomyosarcoma.Combined modality therapies were used,including surgical,radiation,chemotherapy,Chinese herb medicine and immunotherapy.One case has been out of follow up and one has survived 22 months without tumor.The other two patients died within 7 and 19 months after operation. Conclusions Prostatic sarcoma is an aggressive malignancy with a bad prognosis.Individualized treatment should be formulated.

Objective The prosthesis used for aortic valve replacement (AVR) can be too small in relation to body size,thus causing valve prosthesis-patient mismatch (PPM).The aim of this article was to summarize the preventive strategy of PPM during AVR.Methods A total of 357 patients [203 males,154 females; mean age (54.9 ± 18.7 ) years ] underwent AVR between February.2010 and December 2011.The weight and body surface area (BSA) of the group is( 60.1 ± 11.4 )kg and (1.67 ± 0.21 )m2 respectively.The aortic valve prosthesis effective orifice area (EOA) was divided by body surface area (BSA) to obtain the EOA index (EOAI).PPM was then defined as none or mild if EOAI was ＞ 0.85 cm2/m2,as moderate for (0.65 - 0.85 ) cm2/m2 and as severe for ＜ 0.65 cm2/m2.To avoid PPM,a simple three-step algorithm was applied:Step 1,Calculate the patient's BSA from weight and height;Step 2,Calculate the minimal valve EOA required based on the BSA to ensure an EOAI ＞0.85 cm2/m2 ; Step 3,Select the type and size of prosthesis that has reference values for EOA greater or equal to the minimal EOA value obtained in step 2.For patients with a small aortic root,the following three methods was used:( 1 ) Replace aortic valve with simple interrupted suture technique ; (2) Apply new type and high-performance prosthetic valves such as St.Jude Medical Regent mechanical valve ; (3) Enlarge the narrowed aortic root when necessary.Results Of all 357 patients,272 patients received mechanical AVR and 85 bioprosthetic AVR.Among the 49 patients who received AVR with simple interrupted suture technique.St.Jude Medical Regent mechanical valve was implanted in 38 patients and the aortic root enlargement was performed in 11 patients.The total prevalence of PPM was 6.4％ and there was no severe PPM.The prevalence of PPM with mechanical AVR and bioprosthetic AVR was 1.8％ and 21.2％ respectively.There were 4 deaths during early period of operation,and the operative mortality was 1.1％.Conclusion Prosthesis-patient mismatch can be effectively prevented at the time of AVR with appropriate measurement.

Objective To observe the effect of moxibustion on the blood lipid and hemorheology in senile patients with coronary heart disease (CHD) due to heart blood stagnation who underwent interventional treatment.Method A hundred senile CHD patients were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by conventional medications, while the treatment group was additionally by thunder-fire moxibustion. The blood lipid and hemorheology were observed before the treatment and after 3 treatment courses.Result The blood lipid parameters (including CHO, TG, HDL-C and LDL-C) were changed significantly in the treatment group after the intervention (P<0.05). The CHO, TG, and LDL-C levels of the treatment group were significantly different from that of the control group (P<0.05). The hemorheology parameters (whole blood viscosities at a high-, middle-, and low-shear rate, and fibrinogen) were significantly changed in the treatment group after the intervention (P<0.05). The whole blood viscosities at a high-, middle-, and low-shear of the treatment group were markedly different from that of the control group (P<0.05).Conclusion Thunder-fire moxibustion can down-regulate the blood lipid and blood viscosity of CHD patients undergone interventional treatment, and thus improve myocardial ischemia.

To explore the protective effect of sodium tanshinone IIA sulfonate (STS) on microcirculatory disturbance of small intestine in rats with sepsis, and the possible mechanism, a rat model of sepsis was induced by cecal ligation and puncture (CLP). Rats were randomly divided into 3 groups: sham operated group (S), sepsis group (CLP) and STS treatment group (STS). STS (1 mg/kg) was slowly injected through the right external jugular vein after CLP. The histopathologic changes in the intestinal tissue and changes of mesenteric microcirculation were observed. The levels of tumor necrosis factor-α (TNF-α) in the intestinal tissue were determined by using enzyme-linked immunoabsorbent assay (ELISA). The expression of intercellular adhesion molecule-1 (ICAM-1) in the intestinal tissue was detected by using immunohistochemisty and Western blot, that of nuclear factor κB (NF-κB) and tissue factor (TF) by using Western blot, and the levels of NF-κB mRNA expression by using RT-PCR respectively. The microcirculatory disturbance of the intestine was aggravated after CLP. The injury of the intestinal tissues was obviously aggravated in CLP group as compared with S group. The expression levels of NF-κB p65, ICAM-1, TF and TNF-α were upregulaed after CLP (P<0.01). STS post-treatment could ameliorate the microcirculatory disturbance, attenuate the injury of the intestinal tissues induced by CLP, and decrease the levels of NF-κB, ICAM-1, TF and TNF-α (P<0.01). It is suggested that STS can ameliorate the microcirculatory disturbance of the small intestine in rats with sepsis, and the mechanism may be associated with the inhibition of inflammatory responses and amelioration of coagulation abnormality.

[Objective]The oxidative injury of retinal pigment epithelium(RPE)plays a key role in the pathogenesis of age-related macular degeneration(ARMD). This study is to investigate the effects of endoplasmic reticulum stress and the vital transcriptional factor X-box binding protein 1(XBP1)in acrolein-induced oxidative damage of RPE.[Methods]RPE cells were treated with acrolein (75μmol/L)for 2~24 h,expression of glucose regulated protein 78(GRP78)and XBP1 was determined by Western blot analysis. After being transfected with XBP1 siRNA with 24 h,the expression of XBP1 was knocked-down in RPE cells. Protein level of Nrf2 and SOD2 was then determined by Western blot analysis and intracellular Reactive Oxygen Species(ROS)generation was determined by DCF staining. Acrolein was added for 8 h after being transfected with XBP1 siRNA or control siRNA for 24 h. Apoptosis was detected by TUNEL assay before and after the treatment. Subretinal injection of Cre or GFP adenovirus was performed in XBP 1flox mice. After 1 week the mice were sacrificed. Total RNA was extracted from mice eyecups using TRIzol and real-time RT-PCR was performed to determine the two XBP1 down-stream genes,ERdj4 and p58IPK. Cryosectioning and immunofluorescent staining were performed to look at the expression of XBP1,Nrf2 and SOD2 in mice RPE.[Results]Protein level of GRP78 was significantly un-regulated after exposure to acrolein for 2 and 4 h. XBP1 was activated after acrolein treatment for 6 h. Knock-down of XBP1 by siRNA down-regu?lates anti-oxidant genes expression and increased ROS generation in RPE cells. Loss of XBP1 exacerbates acrolein-induced cell apoptosis. XBP1 was knocked-down in the RPE of XBP1flox mice after subretinal injection of Cre adenovirus. Decreased mRNA level of ERdj4 and p58IPK,and decreased Nrf2 and SOD2 expression were seen in the Cre-injected group.[Conclusions]Acrolein induces ER stress and activates XBP1 in RPE cells. Knock-down of XBP1 down-regulates anti-oxidant genes expression ,increases ROS generation,and exacerbates acrolein-induced cell apoptosis. XBP1 plays a role in the anti-oxidant defense in the RPE cells.

Objective:To investigate the anxious and despondent emotion in patients suffering from chronic eczema,and its influence factor thereof.Methods:The patients suffering from chronic eczema were investigated with self-rating anxiety scale(SAS),self-rating depression scale(SDS)and evsenck personality questionnaire(EPQ).The healthy persons were investigated with SAS and SDS.The severity of pruritus and skin rash in patients suffering from chronic eczema was assessed by visual analogue scale (VAS)and eczema area severity index (EASI).Results:The scores of SAS and SDS were significantly higher in patients with chronic eczema than that of healthy persons(P＜0.01).The multivariate stepwise regression analysis result demonstrated that the factors influencing anxious emotion were in turn severity of pruritus,disease position and stability of emotion introverted-extroverted disposition.The factors influencing despondent emotion were in turn disease position,course of disease,concealing,stability of emotion and severity of pruritus.Conclusion:There was obvious anxious and despondent emotion in patients with chronic eczema.These emotions were closely correlated with psychosocial factors,severity of pruritus and skin rash.

Objective To explore the Chinese medical students′attitudes towards communication skills learning .And their communication skills are assessed by themselves in this study .Methods The cross-sectional survey of 127 undergraduates was completed in Sichuan University .Students were evaluated using Communication Skills Attitude Scale(CSAS) and Scale of medical student′s doctor-patient communication behavior which had been published at home or abroad .Results The mean PAS score of 127 students was 51 .43 ,which was 18 .50 points higher statistically significant than the mean NAS score 32 .94 .And there were no difference between undergraduates and eight-year medical students ,also between female and male .95 .28% students agree that“learning the doctor-patient communication skills and learning clinical skills are equally important” .Concerning Scale of medical student′s doctor-patient communication behavior ,the mean score for 127 students was 104 .93(total score is 150) .The mean scores for male was higher than male(P=0 .008) ,but the mean score for undergraduates and eight-year students had no statistic differ-ences .Conclusion Medical students have positive attitudes towards communication skills and have low self-assessments ,and we should enhance the communication skills training .

OBJECTIVE: To summarize the biocharacteristics, separation and purification as well as the culture technique of bone marrow mesenchymal stem cell, which has the potentiality of multiple cellular differentiations, locatedinduced differentiation of bone and cartilage, cellular carrying tray and application in bone tissue engineering.DATA SOURCES: Relative articles were retrieved through Medline database according to the key words of "mesenchymal stem cell, tissue engineer" in English between January 1990 and December 2004. Meanwhile,relative articles were also retrieved in Chinese journal full-text database and Wanfang database with the same key words in Chinese between January 1994 and December 2004.STUDY SELECTION: Articles were retrieved first to select those references which were related to the aspects of biology, isolation and culture of mesenchymal stem cell in tissue engineering. Representative and lated references were included; however, researches on non-bone tissue engineering and repetitive studies were excluded. The rest of articles were looked up for their full text.DATA EXTRACTION: There were 78 articles on mesenchymal stem cell in tissue engineering. Among them, 31 papers were included; the otherbut 47 papers including 13 articles of similar contents and 34 studies on nonbone tissue engineering were excluded.DATA SYNTHESIS: Mesenchymal stem cell mainly existed in bone marrow and could differentiated into multiple tissue cells and increase in vitro.① There were three methods for separation, purification and culture of mesenchymal stem cells: density gradient centrifugation, flow cytometry and adherent screening method. Other scholars obtained cell strain of mesenchymal stem cell through single-cell cloning technique, but this way was more difficult to obtain multiple seed cells. At present, density gradient centrifugation was widely used. ② Mesenchymal stem cell could differentiate into bone cells and cartilae cells through adding inductor into eligible culture medium. Ideal scaffolds could carry and retain the vitality of cells, support rapid endogeny of vessels and be benefit for observing new bone formation under X ray. New bone might be absorbed and replaced in bone rebuilding and form or increase conductive bridging of host bone. Functions of differentiated cells could be maintained by the interaction between scaffolds surface and cells, and the histocompatibility was well. ③ Mesenchymal stem cell was an kind of ideal target cells for gene therapy. It could shift growth factor or cytokine and express foreign protein after multiple desintegration in vitro. It was successful in bone tissue engineering.CONCLUSION: Modern tissue engineering which is presented by stem cells develops quickly at present, but tissue engineering of mesenchymal stem cell starts just now. Bone marrow mesenchymal stem cell is characterized by easily materializing, potentiality of multiple tissue differentiation, stable genetic background, non-rejection in implant button and high proliferation. All properties determine that it will be a useful thing in cell and gene therapy as well as tissue engineering.

Objective To study the clinical features of visual dysfunction in children with cerebral palsy (CP) and related factors. Methods Between 2006 and 2009, one hundred and sixty-three children (aged 4 to 108months, mean age 29.05 ± 20.51 months) with CP at Qingdao's Rehabilitation Center for Disabled Children were enrolled into this study, including 117 boys and 46 girls. All the children were retrospectively reviewed for perinatal risk factors. Ophthalmologists examined their visual parameters, including refraction, visual acuity, eye position and movement, and fundoscopy. Results Among the 163 children, 61 had visual dysfunctions, an occurrence rate of 37.4%. They included refractive errors in 39 (23.9%) , strabismus in 50 (30.7%) , abnormal eye movement in 26(15.9%) , and abnormal fundoscopic findings in 13 (7.9%). Thirty-seven children's visual acuity was examined,and 19 of them (51.4%) had low visual acuity. Patients who showed periventicular leukomalacia (PVL) or lesions in the occipital lobe on MRI examination had a high incidence of visual dysfunction. Preterm and low birth-weight were risk factors for visual dysfunction in these CP children. Conclusions Visual dysfuntion is a common complication in CP children. Early ophthalmological assessment and intervention are important for CP children.

Humans ; Infant ; Male ; Mycobacterium tuberculosis ; Otitis Media ; microbiology ; Tuberculosis