AIMTo study the effects of hydrocortisone sodium succinate on sodium current in human atrial myocytes and in guinea pig ventricular myocytes.

METHODSSingle cardiac myocytes were isolated by enzyme. The effects of hydrocortisone sodium succinate on sodium current (INa) were assessed by applying whole-cell patch clamp techniques.

RESULTSHydrocortisone sodium succinate (1, 3, 10 micromol x L(-1)) was shown to inhibit INa of both human atrial myocytes and guinea pig ventricular myocytes in concentration dependent manner and the IC50 were 6.97 and 8.74 micromol x L(-1), respectively. The inhibition effects acted quickly (1-3 min) and the maximal activating voltage of INa was not changed in both human and guinea pig cardiac myocytes.

CONCLUSIONHydrocortisone sodium succinate can exhibit inhibitory effects on INa in both human and guinea pig cardiac myocytes, and its inhibitory effects act rapidly, which are not consistent with genomic effects, so there may be nongenomic effects.

Adolescent ; Adult ; Animals ; Cell Separation ; Child ; Child, Preschool ; Guinea Pigs ; Heart Atria ; pathology ; Heart Defects, Congenital ; pathology ; Heart Ventricles ; cytology ; Humans ; Hydrocortisone ; analogs & derivatives ; pharmacology ; Myocytes, Cardiac ; drug effects ; physiology ; Patch-Clamp Techniques ; Sodium Channels ; drug effects

Objective： The aim of this study was to investigate the best choice of the three treatment modalities of preserving laryngeal functions in T3 laryngeal carcinoma. Methods： There were 94 cases with T3 laryngeal carcinoma (Stage Ⅲ and Ⅳ ) who were treated by three kinds of modalities of preserving laryngeal functions： definitive radiotherapy, salvage surgery for the failures of definitive radiotherapy, partial laryngectomy. We compared their survival curve, recurrence rate of the primary and secondary site, and the complications. Results： The survival curve of the partial laryngectomy groups was better than that of the definitive radiotherapy group in supraglottic carcinoma (P=0.0248). In glottial carcinoma, the survival curve of partial laryngectomy group and salvage surgery group were insignificantly different, both of them were better than that of definitive radiotherapy group (P=0.0075). The complication rate of the salvage surgery group was significantly higher than that of partial laryngectomy group (60％ Vs 16.7％ ); We regarded the definitive radiotherapy group and salvage surgery group as one group, it's primary site recurrence rate was significant higher than that of partial laryngectomy group (45.8％ Vs 19.4％ ). Conclusion： Partial laryngectomy is the most effective way among the three modalities of preserving laryngeal functions to treat T3 laryngeal carcinoma.

OBJECTIVETo investigate reasonable surgical therapy for conjoined twins.

METHODSTwo pairs of gastrothoracopagus were admitted in July 2004 and April 2005 respectively. The first pair was separated by emergency surgery for the rupture of umbilical hernia resulting in the exposure of intestines. The thoracic and abdominal wall was repaired with local skin flaps, and the secondary wound was covered with artificial skin. Skin expanders were embedded in thoracic and abdominal wall 2 months after birth in the second pair. The surgical separation was performed one month after. The deficiencies of pericardium, sternum and abdominal wall were reconstructed by allogenic grafting of pericardium, porous polyethylene implant and monofilament polypropylene patch respectively. The thoracic and abdominal wall was repaired with expanded rotation skin flap.

RESULTSThe first twins died of respiratory failure and circulatory and respiratory failure 2 hours and 39 hours after the separation respectively. Both of the second pair survived and were discharge after healing.

CONCLUSIONSThe separation of gastrothoracopagus should be performed after skin expansion in the interest of the closure of wound. It's better to use porous polyethylene implant and monofilament polypropylene patch to reconstruct the sternum and abdominal wall respectively.

Abdominal Wall ; abnormalities ; surgery ; Fatal Outcome ; Female ; Humans ; Infant ; Infant, Newborn ; Reconstructive Surgical Procedures ; Thoracic Wall ; abnormalities ; surgery ; Twins, Conjoined ; surgery

OBJECTIVETo investigate the factors that influence survival of the patients with differentiated thyroid carcinoma in young people and evaluate the efficiency of unilateral lobectomy plus isthmectomy with therapeutic cervical lymph node dissection and postoperative TSH (thyroid stimulating hormone) suppressive therapy.

METHODSOne hundred and thirty-one patients under 30 years old with differentiated thyroid carcinoma treated in this hospital (14 cases no more than and 117 cases more than 16 years) from Jan. 1st, 1985 to Dec. 31st, 1997 were retrospectively reviewed. One hundred and twenty-eight patients were received only surgery and TSH suppressive therapy, and 3 patients received chemotherapy or radiotherapy because of the progressive metastasis in necks or mediastina. A multivariate analysis was performed in these patients by the Cox proportional hazard model.

RESULTSThe mean follow-time (x +/- s) of all patients were (140.86 +/- 43.76) months, with range from 20 to 229 months; Ninety-eight patients followed more than 10 years. Ten patients died of thyroid cancer. The overall 10-year survival rate was 97.18%. The 10-year survival rate for patients < or = 16 years of age and > 16 years were 75.97% and 96.57% respectively (P = 0. 0006). The 10-year survival rate for women and men were 94.91% and 93.69% respectively (P = 0.5261). The 10-year survival rates of patients with papillary thyroid carcinoma and follicular thyroid carcinoma were 93.77% and 96. 55% respectively (P = 0.8137). For patients with tumor size of < or = 1 cm, 1-4 cm and >4 cm the survival rate was 100.0%, 96.40%, and 80.67% respectively (P = 0. 0589). The 10-year survival rates of patients with or without lymph node metastasis were 88.37% and 100. 0% respectively (P = 0.0313). For patients of with or without distant metastasis, The survival rate was 96.64% or 60.00% (P = 0.0000). The 10-year survival rates with or without recurrence were 86. 67% and 95.48% respectively (P = 0. 5681). Using multivariate analysis, risk factors that independently influence survival were distant metastasis, tumor size and age.

CONCLUSIONSThe distant metastasis, tumor size and age at diagnosis were the independent factors influencing survival significantly. The status of lymph node metastasis may have certain effect on the prognosis. Unilateral lobectomy plus isthmectomy with a therapeutic cervical lymph node dissection followed by postoperative TSH suppressive therapy is a favourable model to children and young adults with DTC without distant metastasis, but to the patients with distant metastasis, their prognosis of this therapy model is disappointing.

Adenocarcinoma, Follicular ; mortality ; pathology ; surgery ; Adolescent ; Adult ; Child ; Female ; Humans ; Lymphatic Metastasis ; Male ; Papilloma ; mortality ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; mortality ; pathology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the quantity, subset of dendritic cells (DC) and their costimulatory molecule expression in peripheral blood (PB) of the patients with myelodysplastic syndromes (MDS).

METHODSTotal DC (Lin1(+) HLA-DR(+)), myeloid DC (mDC) (Lin1(-) HLA-DR(+) CD11c(+)) and plasma DC (pDC) (Lin1(-) HLA-DR(+) CD123(+)) in fresh PB samples of 38 MDS patients and 19 normal controls were assayed by flow cytometry with the monoclonal antibodies. The expressions of costimulatory molecules CD80, CD86 and CD40 on these DCs were also assayed in the same way.

RESULTSThe number of total DC in PB of low-risk and high-risk MDS patients was significantly higher than that in normal controls [(33.7 +/- 7.0) x 10(6)/L, (56.3 +/- 29.0) x 10(6)/L vs (12.1 +/- 1.4) x 10(6)/L, respectively] (P < 0.05), that of mDC in PB of low-risk and high-risk MDS patients was higher than that of normal controls too [(16.7 +/- 6.3) x 10(6)/L, (28.7 +/- 17.6) x 10(6)/L vs (5.5 +/- 0.9) x 10(6)/L] (P < 0.05), but pDC in low-risk and high-risk MDS patients was not significantly higher than that in normal controls (P > 0.05). The percentage of total DC in PB mononuclear cells (PBMNC) of low-risk and high-risk MDS patients [(2.37 +/- 0.53)% and (3.58 +/- 1.39)% respectively and that of mDC (0.90 +/- 0.35)%, (1.51 +/- 0.70)% respectively] were higher than that of normal controls [(0.68 +/- 0.08)%, and (0.32 +/- 0.05)% respectively] (P < 0.05), but that of pDC in MDS cases was not higher than that of normal controls (P > 0.05). The expressions of CD80 and CD86 between MDS patients and normal controls had significant difference (P < 0.05).

CONCLUSIONSTotal DC and mDC were increased significantly in MDS, but pDC did not. The costimulatory molecules (CD80 and CD86) except CD40 expressed higher on the DC of MDS patients. It suggested that the inflammatory injury related APC increased in MDS, but the antitumour immunity related APC did not . What found here might be one of the mechanisms involved in the pathogenesis of MDS.

Adolescent ; Adult ; Aged ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; CD40 Antigens ; metabolism ; Dendritic Cells ; immunology ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; metabolism ; pathology

OBJECTIVEThis study was designed to evaluate whether sentinel node (SN) biopsy can accurately assess the cervical lymph node status of oral tongue carcinoma, as well to research the best method and indications of SN biopsy.

METHODSPreoperative lymphoscintigraphy with (99m)Tc-SC and intraoperative sentinel node mapping with methylene blue dye were administered on 20 cases of oral tongue carcinoma with cN(0) neck and 5 cases with cN(+) neck; routine pathological examination was used to assess the status of SNs. The results of routine pathological examination of cervical specimen were set as golden standard to assess the efficacy of SN biopsy in evaluating the cervical lymph node status.

RESULTS53 SNs were detected in 24 cases out of the total 25 cases (96%), averaging 2.2 SNs per case. SNs were detected in all 20 cases with cN(0) neck, in which 4 cases with occult cervical metastasis were detected by SN diopsy, without false negative case found in the procedure. In 5 cases with cN(+) neck, SNs were detected in 4 cases. In 4 cases whose SNs were detected, there were 5 cN(+) necks, out of which SNs were detected in 4 cN(+) necks but failed to predicted the cervical lymph node status in 2 necks. However, SNs were detected in 2 out of the other 3 cN(0) necks, both of which were diagnosed as SN(+)pN(+).

CONCLUSIONSNuclear lymphoscintigraphy and blue dye mapping can be used to trace the SNs in cases with oral tongue carcinoma, with satisfactory detective rate. SN biopsy can accurately evaluate the cervical lymph node status in cases of oral tongue carcinoma with cN(0) neck. Whether it can be used to evaluate the lymph node status of the cN(0) neck in case with a contralateral cN(+) neck is worthy of further research.

Humans ; Sentinel Lymph Node Biopsy ; Tongue Neoplasms ; pathology

BACKGROUNDAlthough heart transplantation has become a standard therapy for end-stage heart disease, there are few published studies regarding the use of transplant organs from marginal donors. Here we describe the clinical outcome we have obtained using marginal donor hearts.

METHODSWe analyzed 21 cases of orthotopic heart transplantation for end-stage heart disease performed in our department between September 2008 and July 2010. Of these patients, six received hearts from marginal donors and the remainder received standard-donor hearts. The two groups were compared in terms of both mortality and the incidence of perioperative complications such as infection, acute rejection, and right heart insufficiency.

RESULTSThe 1-year survival rate of both groups was 100%. Only one death was recorded in standard-donor group during follow-up. Patients who received marginal donor hearts (83%) experienced more early complications than did the standard-donor-heart group (13%), but the mortality of the two groups was the same. The duration of post-ICU stay was greater in the marginal donor group than in the standard-donor group, (35.5 ± 17.4) days and (21.7 ± 2.6) days, respectively (P < 0.05).

CONCLUSIONSThe use of marginal donor hearts increases the number of patients who can receive and benefit from transplants. However, it may introduce an increased risk of early complications, thus care should be taken both in the choice of patients who will receive marginal donor hearts and in the perioperative treatment of those for whom the procedure is performed.

Adult ; Antibodies, Monoclonal ; therapeutic use ; Female ; Heart Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Methylprednisolone ; therapeutic use ; Middle Aged ; Recombinant Fusion Proteins ; therapeutic use ; Tissue Donors

OBJECTIVETo develop a real-time fluorescent PCR protocol suitable for the routine screening of AZFc/DAZ microdeletions on the Y chromosome in azoospermic and oligozoospermic male infertility patients.

METHODSA set of real-time fluorescent PCR was established. Eighty-seven azoospermic and ligozoospermic patients undergoing ICSI in the IVF center and 30 azoospermic men undergoing testicular biopsy in the clinic of urology surgery were screened for AZFc/DAZ microdeletions of Y chromosome.

RESULTSEleven cases (9.4%) of AZFc/DAZ microdeletions were found in 117 cases of azoospermic and oligozoospermic patients by screening of realtime fluorescent PCR. Four cases (6.6%) were found in 61 oligozoospermic patients, and 7 cases (12.5%) were found in 56 azoospermic patients.

CONCLUSIONThe real-time fluorescent PCR protocol presented in this study is an easy and reliable method for detection of AZFc/DAZ microdeletions on the Y chromosome, which yields identical results to those of the multiplex PCR.

Chromosome Deletion ; Chromosomes, Human, Y ; Deleted in Azoospermia 1 Protein ; Fluorescence ; Humans ; Infertility, Male ; genetics ; Male ; Polymerase Chain Reaction ; methods ; RNA-Binding Proteins ; genetics

OBJECTIVETo study the clinical characteristics of autoimmune hemolytic anemia (AIHA) with both warm and cold autoantibodies.

METHODSClinical and laboratory characteristics of 23 cases of AIHA with both warm and cold autoantibodies admitted to our hospital between January 1994 and April 2004 were analyzed retrospectively.

RESULTSIn comparison with the AIHA patients with both warm and cold autoantibodies in the 1980s, the present patients showed the following features: The proportion of this kind AIHA in all AIHA patients increased from 17.6% to 22.1%. There were more females, more primary cases (73.9%), more mixed subtypes of autoantibodies and more of IgM (56.5%). The hemolysis was related with thermal amplitude of autoantibodies and quantity of complement. The response to cortisone and other immunosuppressive drugs was good. The relapse rate was 77.8% in a median follow-up time of 4 months.

CONCLUSIONSAIHA with both warm and cold autoantibodies is related with the type and thermal amplitude of the autoantibody and the activation of complement. It can be treated effectively with combined immunosuppressive therapy, but the relapse rate is high.

Adolescent ; Adult ; Aged ; Anemia, Hemolytic, Autoimmune ; drug therapy ; immunology ; Autoantibodies ; immunology ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin M ; immunology ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo explore the characteristics on molecular epidemiology of Mycobacterium tuberculosis isolates from hospitals in Tianjin area.

METHODSOne hundred M. tuberculosis isolated strains were collected in succession from August 16th-December 25th, 2005 in Tianjin Haihe Hospital and genotyped by spoligotyping and multiple locus variable number-tandem repeat(VNTR). Data was analyzed by cluster software. Based on the concept of Beijing lineage, it was determinate two sub-groups: atypical Beijing strains and W strain/typical family strains by multiplex and real-time PCR. The associations of subgroups with drug resistance and age were assessed by the chi2 test.

RESULTS96 M. tuberculosis strains were genotyped in which 91.7% (88/96) strains belonged to Beijing genotype (including 3 Beijing-like strains) by spoligtyping. VNTR typing could differentiate 60 genotypes among the 88 Beijing genotype strains. 93.2% of the Beijing lineage M. tuberculosis strains of this study belonged to W strain/typical Beijing family strains (82/88). No statistically significant differences were observed in the proportions of the two sub-groups in patients of different age, or drug resistance (P > 0.05).

CONCLUSIONThe M. tuberculosis Beijing genotype strains were dominated on tuberculosis hospital patients of Tianjin area. The discriminatory power of VNTR typing was higher than that of spoligtyping. The two sub-groups of Beijing lineage had been prevalent in Tianjin, however W strain/typical Beijing family strains were of preponderance.

Bacterial Typing Techniques ; China ; epidemiology ; Cluster Analysis ; DNA, Bacterial ; genetics ; Drug Resistance, Bacterial ; Genotype ; Humans ; Minisatellite Repeats ; Molecular Epidemiology ; Mycobacterium tuberculosis ; classification ; genetics ; isolation & purification ; Sequence Analysis, DNA ; Tuberculosis ; epidemiology