BACKGROUND: Macrophage migration inhibitory factor (MIF) is mainly concerned with macrophage mobilizing function, as the upper stream cytokine of tumor necrosis factor-α(TNF-α), interleukin-1β (IL-1β), which may have critical effect in the process of the onset of rheumatoid arthritis. OBJECTIVE: To explore the correlations between the change of serum MIF and the activity of rheumatoid arthritis (RA) disease.DESIGN, TIME AND SETTING: Non-randomized control and case study, which was carried out in the Bethune International Peace Hospital of Chinese PLA from September in 2005 to October in 2006.PARTICIPANTS: Sixty RA patients were included in this study, and other thirty healthy subjects were selected as the control group. There were significant differences in age and sex between the two groups. METHODS: Clinical data of sixty RA patients were selected by carrying out retrospective analysis, then on the basis of disease activity score (DAS) accumulated points, they were divided into active and inactive group respectively, who were contrasted with 30 health adults. MAIN OUTCOME MEASURES: ① Morning stiffness (in minutes), joint tenderness index, arthrocele index, semi-quantity rheumatoid factor (RF), C-reactive protein concentration (CRP), erythrocyte sedimentation rate (ESR), and platelet count (PLT) were recorded; ② To compare the level of serum MIF, IL-1β and TNF-α among active group, inactive group, and control group; ③ The correlation analysis was carried out among the level of serum MIF, inflammatory index and clinical observation index.RESULTS: There was significantly increased in serum MIF of patients in the active group compared to of inactive and normal groups (P < 0.05), but there were no significantly differences between inactive and control groups (P > 0.05). There were significant correlations between the serum MIF concentration and active inflammatory index of RA disease, blood sedimentationrate (ESR), C-reactive protein (CRP), platelet counting (PLT), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), swell joint index (SJI) and tenderness joint, but no significant difference was observed between the serum MIF, age, disease course, morning stiffness and rheumatoid factor (RF).CONCLUSION: The serum MIF concentration is significantly increased in patients with RA, and it may be a useful parameter for monitoring disease activity of RA.

BACKGROUND:Finding of neural stem cells(NSCs)brings new hope for repairing central nervous system(CNS)injury.However,the influence of internal environment after brain injury on the survival and differentiation of NSCs is a complexand variable process.OBJECTIVE:To observe the survival and differentiation of human embryonic NSCs following implantation into rats with fluid percussion brain injury.DESIGN:Open experiment.SETTING:Department of Neurosurgery,Guangdong Provincial Hospital of Traditional Chinese Medicine;Beijing Institute of Neurosurgery.MATERIALS:This experiment was carried out In the Laboratory of Neural Stem Cells,Beijing Institute of Neurosurgery from September 2002 to March 2003.Twenty-four female SD rats,aged 7 weeks,with body mass of(250±10)g,were provided by the Experimental Animal lnstitute, Chinese Academy of Medical Sciences[License Nd. SCXK(Jing)2002-2003]. Cerebrum of 8-week aborted fetus was obtained (Informed consents were obtained from parturients and their relatives). Fetal survival was monitored by B ultrasonic wave during abortion. BrdU monoclonal antibody(Sigma Company),rabbit anti-nidogen polyclonal antibody(Chemicon Company),mouse anti-microtubule-associated protein 2 (MAP-2)monoclonal antibody(Neomarkers Company),rabbit anti-gliaI fibrillary acidic protein(GFAP)polyclonal antibody (Biogenex Company).METHODS:① CerebraI cortex cells of 8-week aborted human fetus was harvested and cultured in vitro for obtaining human embryronic NSCs.②Rat models of hydraulic impact injury were developed.Bone window of motor sensory area of cerebral cortex was set at 2.5mm posterior to bregma which was zero point and 3.0 mm lateral to midline.Hydraulic impact injury parameters were set as impact pressure 0.3 MPa. impact time 25 ms and impact time once. ③BrdU-labeled human embryronic NSCs were implanted into injured area al 24 hours after injury.After 1 and 4 weeks.rats were sacrificed.Adjacent sections were doubly stained bv BrdU/MAP-2 and BrdU/GFAP.MAIN OUTCOME MEASURES:①Survival and immigration of implanted human embryonic NSCs.②Differentiation of implanted human embryonic NSCs.RESULTS:①BrdU-positive cells were oval and brown.At 1 and 4 weeks after implantation,BrdU-positive cells survived and migrated,and they migrated more widely at 4 weeks after implantation. ②At 1 week after implantation,more BrdU-positive cells were found in the subcortical granular layer and subcortex,and BrdU/MAP-2-positive cells were more than BrdU/GFAP-positive cells;At 4 weeks after implantation,BrdU-positive cells were significantly reduced,and found in choroid plexus and blood capillary,and BrdU/GFAP-positive cells were more than BrdU/MAP-2-positive cells.CONCLUSION:Implanted human embryonic NSCs can survive in the region of brain injury.gradually differentiate into astrocytes during rehabilitation and are easily digested by endothelial phagocytes.It indicates that immunological rejaction possibly influences the survival of human embryonic NSCs.

Objective To compare the efficacies of the treatment of sternal fracture with wire fixation and the titanium sternal fixation system. Methods Thirty patients with sternal fracture from May 2003 to July 2009 were followed up. Among them,there were 20 patients with wire fixation (wire fixation group), 10 patients with the titanium sternal fixation system (titanium sternal fixation system group). The conditions before, during and after operation,complications and effects were compared to evaluate the effieaeies of titanium sternal fixation system. Results The operative time of titanium sternal fixation system group and wire fixation group were (67.0 ± 7.9) min and (90.0 ± 8.6) min, the blood loss were (11.0 ± 5.4) ml and (48.0 ± 8.4)ml,the duration of drainage were (0.5 ± 0.4) days and (1.9 ± 0.7) days,the amount of drainage were (1.9 ± 1.3) ml and (19.0 ± 4.6) ml, the average hospitalized days were (2.3 ± 0.5) days and (6.9 ± 0.9) days, the duration of pain were (1.5 ± 0.5) days and (3.8 ± 1.1) days, there were all significant difference between two groups (P < 0.05). The rates of wound infection, delayed union or nonunion, re-fracture,plate fracture or plate shift of wire fixation group were 5% (1/20) ,5% (1/20) ,5% (1/20), 10% (2/20). But the rates of titanium sternal fixation system group were 0, there were all significant difference between two groups (P < 0.05). Conclusion The treatment of sternal fracture with titanium sternal fixation system is a simple and stable fixation,high bone union rate and few complications,especially for the sternal fracture.

OBJECTIVE: This study aimed at understanding of the role of calcium homeostasis in cardiomyocytes from hypoxia, burnt serum-induced injury. METHODS: Alterations in cytosolic free calcium concentration (Ca(i)), calcium influx and viability of the cardiomyocytes in vitro after hypoxia, burnt serum stimulus were observed. RESULTS: Ca(i) increased markedly, in the meantime, the cellular transmembrane calcium influx increased and the viability of the cells decreased significantly following hypoxia, burnt serum-induced injury. CONCLUSIONS: In our study cytosolic calcium ion was transported abnormally in the cardiomyocytes after burn, to result in Ca(i) increase and runaway calcium homeostasis, thus the normal cellular function was disturbed. This may be one of the important factors in the development of burn-induced cardiac injury.

OBJECTIVETo enhance the knowledge and the effect of the diagnosis and treatment of primary epithelioid sarcoma of the penis.

METHODSOne rare case of primary epithelioid sarcoma of the penis was studied with regard to its primary clinical process and characteristics, differential diagnosis and method of treatment.

RESULTSAn operation was performed on the penis to treat the epithelioid sarcoma. The diagnosis was confirmed by immunohistological and pathological techniques. There was no evidence of relapse during the three-year follow-up after operation.

CONCLUSIONThe possibility of primary epithelioid sarcoma of the penis should be considered if a mass or induration of the proximal penis and the symptoms of urethremphraxis are found. Total phallectomy could be chosen as an appropriate method of treatment. Unless adenopathy is palpable, node dissections are not recommended.

Adult ; Diagnosis, Differential ; Humans ; Male ; Penile Neoplasms ; diagnosis ; pathology ; surgery ; Sarcoma ; diagnosis ; pathology ; surgery

OBJECTIVEThis study aimed to evaluate the effects of treatment with different powers of Nd: YAG laser irradiation on root surfaces and Streptococcus mutans (S. mutans) adhesion.

METHODSExtracted teeth because of severe periodontal disease were divided into the following four groups: control group, laser group 1, laser group 2, and laser group 3. After scaling and root planning, laser group 1, laser group 2, and laser group 3 were separately treated with Nd: YAG laser irradiation (4/6/8 W, 60 s); however, the control group did not receive the treatment. Scanning electron microscopy (SEM) was used to determine the morphology. S. mutans were cultured with root slices from each group. Colony forming unit per mL (CFU·mL⁻¹) was used to count and compare the amounts of bacteria adhesion among groups. SEM was used to observe the difference of bacteria adhesion to root surfaces between control group (scaling) and laser group 2 (6 W, 60 s), thereby indicating the different bacteria adhesions because of different treatments.

RESULTSMorphology alterations indicated that root surfaces in control group contain obvious smear layer, debris, and biofilm; whereas the root surfaces in laser group contain more cracks with less smear layer and debris. The bacteria counting indicated that S. mutans adhesion to laser group was weaker than that of control group (P<0.05). No statistical significance among the laser groups (P>0.05) was observed. Morphology alterations also verified that S. mutans adhesion to laser group 2 (6 W, 60 s) was weaker than that of control group (scaling).

CONCLUSIONSThis study demonstrated that Nd: YAG laser irradiation treatment after scaling can reduce smear layer, debris, and biofilm on the root surfaces as compared with conventional scaling. The laser treatment reduces the adhesion of S. mutans as well. However, Nd: YAG laser irradiation can cause cracks on the root surfaces. In this experiment, the optimum laser power of 6 W can thoroughly remove the smear layer and debris, as well as relatively improve the control of thermal damagee.

Bacterial Adhesion ; Dentin ; Humans ; Lasers, Solid-State ; Microscopy, Electron, Scanning ; Neodymium ; Smear Layer ; Streptococcus mutans ; Tooth Root

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.
Animals ; Erectile Dysfunction* ; Hemodynamics ; Lithotripsy ; Male ; Models, Animal ; Penis ; Peripheral Nervous System Diseases ; Phosphodiesterase 5 Inhibitors ; Shock*

OBJECTIVETo investigate the application value of colonic transit test (CTT) combined with anorectal manometry (ARM), barium enema (BE) and defecography (DFG) in accurately evaluating colonic lesions of slow transit constipation complicated with adult megacolon.

METHODSClinical data of 47 above patients admitted between October 2007 and February 2015 in the People's Hospital of Hunan Province were analyzed retrospectively. All the patients were examined with≥2 times of CTT combined with ARM and BE, and 42 cases received additional DFG at the same time, to evaluate colonic lesions before operation. Operative biopsy pathology was used as the standard. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of positioning in the ascending colon and caecum, transverse colon and descending colon were calculated, and the consistency was represented by Kappa test(Kappa value≥0.75 indicates good consistency, meanwhile higher Kappa value indicates better consistency). The Heikkinen score was used to evaluate defecation function at postoperative 6 months.

RESULTSThe age of 47 patients was from 18 to 56 years old. Compared with intraoperative findings and biopsy pathology, the diagnostic coincidence rate was 89.4% by CTT combined with BE and DFG positioning, which suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=12), transverse colon (n=26) and descending colon (n=9), while intraoperative findings and biopsy pathology suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=11), transverse colon (n=23) and descending colon (n=13). The sensitivity was 88.3%, specificity 93.5%, PPV 92.1%, NPV 94.9% and Kappa value was 0.827(P<0.001). Procedures performed included segmental colectomy (n=8), subtotal colectomy (n=29), total colectomy (n=10). There was no serious complication during and after operation. Defecatory function was excellent in 24 cases (60.0%), good in 10 (25.0%), and moderate in 6 (15.0%) evaluated by Heikkinen score at postoperative 6 months. A total of 40 patients were followed up from 1 to 7 years (median 3 years) and there was no long-term diarrhea and recurrence of constipation or giant colon after operation.

CONCLUSIONPreoperative detection of CTT combined with ARM, BE and DFG in patients with slow transit constipation complicated with adult megacolon can make a more precise assessment of the extent of colonic lesions in advance, which has a good clinical predictive value.

Adolescent ; Adult ; Barium Enema ; Cecum ; pathology ; physiopathology ; surgery ; Colectomy ; methods ; Colon ; pathology ; physiopathology ; surgery ; Constipation ; complications ; diagnosis ; pathology ; surgery ; Defecography ; Female ; Gastrointestinal Transit ; physiology ; Humans ; Male ; Manometry ; Megacolon ; complications ; pathology ; surgery ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Prognosis ; Recovery of Function ; physiology ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVETo investigate the clinical reliability of quantitative evaluation by seminiferous tubule scores on spermatogenesis dysfunction, using the testis tissues of azoospermia patients for analysis of histological changes.

METHODSOne hundred and twelve Chinese patients with azoospermia underwent open testicular biopsy and their testicular biopsy specimens were evaluated by 10-score (on testicular biopsy) and 5-Grade (on seminiferous tubule spermatogenesis) scale. The 112 patient, 22 to 46 years old [(29.0 +/- 4.4) years old] included 105 cases of obstructive and 7 cases non-obstructive azoospermia. Of the total number, there were 96 primary infertile cases and 16 secondary infertile cases with infertile marriage of 2-12 years [(4.0 +/- 2.8) years]. Various seminiferous tubule characteristics were categorized by 10-score as follows: [1] degenerating Sertoli cells and no germinal epithelium; [2] no germ cells and only Sertoli cells; [3] no spermatids and primary spermatocytes and only spermatogonia; [4] no spermatids and few primary spermatocytes; [5] no spermatids and numerous primary spermatocytes; [6] no mature spermatids and few round immature spermatids; [7] no mature spermatids and numerous round immature spermatids; [8] < 20 mature spermatids/tubules, germinal epithelium height < 80 microns and spermiation absent; [9] > 20 mature spermatids/tubules, germinal epithelium height < 80 microns and spermiation rarely < 80 microns; [10] > 20 mature spermatids/tubule and germinal epithelium height 80 microns and spermiation common. Seminiferous tubule spermatogenesis was catagorized by 5-Grade scale as follows: [1] tubular sclerosis; [2] sertoli cell only; [3] arrested spermatogenesis; [4] reduced spermatogenesis; [5] intact spermatogenesis.

RESULTSIn terms of the 10-score scale on testicular biopsy, scores of 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 corresponded with total patient numbers of 5 (4.5%), 38(33.9%), 2(1.8%), 6(5.4%), 2(1.8%), 17(15.2%), 6(5.4%), 19(17%), 10(8.9%) and 7(6.3%), respectively. According to the 5-Grade scale on the seminiferous tubule spermatogenesis, Grades 1, 2, 3, 4 and 5 corresponded with 5(4.5%), 38(33.9%), 33(29.5%), 29(25.9%) and 7 (6.3%), respectively. Tubular diameter, the thickness of the lamina propria, the height of the germinal epithelium and serum FSH correlated with the average seminiferous tubule scores (P < 0.01).

CONCLUSIONThe seminiferous tubule scores obtained through testicular biopsy may provide important quantitative information concerning the etiology and pathogenesis and of azoospermia may serve as a helpful guide to the fundamental, clinical and therapeutical study of element, clinic and therapy.

Adult ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Middle Aged ; Oligospermia ; physiopathology ; Seminiferous Tubules ; physiopathology ; Spermatogenesis