Animals ; Apolipoproteins ; blood ; Cattle ; Colostrum ; Esterases ; blood ; Female ; Insulin-Like Growth Factor I ; Lipids ; blood ; Nephrotic Syndrome ; blood ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Objective To investigate the expression of proliferating cell nuclear antigen(PCNA) in renal tissues of children with primary nephrotic syndrome(NS),and elucidate the relationship between PCNA expression and cell proliferation in renal tissues from the children with primary NS.Methods Paraffin-embedded renal biopsy tissue sections from 39 patients with primary NS were examined by immunohistochemical staining with anti-PCNA monoclonal antibody,normal renal tissue sections from 6 nephrectomized patients with nephroma were selected as control. Possible correlation between the percentage of PCNA positive cells and the pathologic type , histopathological score, clinical indices (serum albumin ,serum cholesterol ,serum creatinine and 24 hours urine protein ) before renal biopsy of NS were evaluated separately .Results The percentage of PCNA positive cells in glomeruli and tubulom terstitium of NS patients was significantly higher than that of the control (P

The pol gene of HIV-1 encodes mainly three enzymes: reverse transcriptase (RT), protease (PR) and integrase (IN). Currently, FDA approved drugs targeting RT and PR are available and administered in various combinations, while no anti-IN drug was approved. HIV-1 integrase is an essential enzyme for the viral replication and an interesting target for the design of new pharmaceuticals for multi-drug therapy of AIDS. The 288 amino acids of IN (32kDa) recognizes specific sequences in the long terminal repeats (LTRs) of the retroviral DNA. The IN protein catalyzes the 3′-processing step and the 5′-strand transfer step reaction in vivo, which was called integration and this reaction could be analysed by ELISA Assay in vitro. It has been reported that F185K and C280S mutations of HIV-1 integrase would improve the enzyme solubility, and the catalytical activity of the enzyme was the same as that of the wild-type enzyme in vitro. In order to build the platform of screening inhibitor against integrase of HIV-1 virus, the IN enzyme was expressed and the function of integrase protein was assayed. The cDNA of clade B HIV-1 genome was used as a template, overlapped PCR was used to construct site mutagenesis of F185K/C280S and NdeI/Xho I restriction sites were brought in. The PCR product was cloned into the prokaryotic vector pET-28a(+) to form a recombined plasmid, transferred into the host cell E.coli(BL21 DE3). The recombined clones were identified by PCR and Nde I/Xho I digestion .The positive plasmid was sequenced, and the successfully recombined plasmid in the host cell was induced by IPTG. The expressed IN protein was puriied sy the Co+ affinity chromatography column and SDS-PAGE was used to analyze the molecular weight and specificity. In addition, ELISA assay was used to analyze the function of the recombined IN protein. The recombinant protein was soluble, and expressed highly and stably in E.coli. The molecular weight of the expression product was identical to the expectation. The IN protein was proved to be functional in 3′ processing and 5′strand transfer by ELISA. It will be helpful to build the platform of screening inhibitors against HIV-1 integrase.

Objective To analyze and evaluate the efficacy of living donor liver transplantation (LDLT) and deceased
donor liver transplantation (DDLT). Methods The clinical data of prognosis and influencing factors of 320 children with liver transplantation were analyzed retrospectively. The 320 children were divided into LDLT group (n=252) and DDLT group (n=68) based on their operation styles. In LDLT group, all donors to recipients were immediate relatives within three generation. In DDLT group, all livers were obtained from cardiac death or brain death donors. The survival and incidence of complications were observed between two groups. Results The 1-year, 2-year and 3-year cumulative survival rates for recipients were 95.1%, 93.5% and 93.5% in LDLT group, and 92.3%, 92.3% and 82.4% in LDLT group. There was no significant difference between the two groups (Log-rank χ2=0.69,P=0.41). During the follow-up period,14 cases died (5.56%) in LDLT group, in which 8 deaths due to respiratory complication, 3 deaths due to multiple organ failure, and 3 deaths due to graft failure. In DDLT donor group, 5 cases died (7.35%), in which 1 death due to respiratory complication, 2 deaths due to multiple organ failure, 1 death due to intra-abdominal hemorrhage, and 1 case of unknown cause of death. There were no significant differences in portal vein thrombosis (PVT), outflow tract obstruction, biliary tract complications and pulmonary infection between the two groups (P>0.05). The ratio of hepatic artery thrombosis (HAT) was lower in LDLT group than that of DDLT group (1.98%vs. 10.29%,χ2=10.245,P<0.01). Conclusion Living donor liver transplantation is an effective method to treat end-stage liver disease.

OBJECTIVETo evaluate clinical outcome after anterior cruciate ligament (ACL) reconstruction with double-bundle or single-bundle by meta-analysis.

METHODSRandomized controlled trials (RCTs) on differences of clinical outcomes of ACL reconstruction were retrieved in Ovid Medline, PubMed, Embase, Cochrane Library, CBM and VIP database. Relevant journals or conference proceedings were also searched manually. Then extracted the date of KT-1000 arthrometer, pivot-shift testing, Lysholm score and IKDC final score in these researches. RevMan 5.0.23 software was used for data analyses.

RESULTSEight prospective RCTs met the inclusion criteria. The combined results of meta-analysis indicated that there was statistical difference between two operative procedures on postoperative KT-1000 arthrometer side-to-side [WMD = -0.35, 95%CI (-0.61, -0.08), P = 0.01], Lysholm score [WMD = -1.91, 95%CI (-3.45, -0.37), P = 0.01]. But the difference of KT-1000 arthrometer side-to-side is demonstrated to be clinically insignificant. Others indicated that there was no statistical differences with respect to IKDC final score [OR = 1.80, 95%CI (0.98, 3.31), P = 0.06], having a normal or nearly normal pivot-shift testing [OR = 1.64, 95%CI (0.85, 3.16), P = 0.14].

CONCLUSIONSDouble-bundle reconstruction does not result in clinically significant advantage when compared with single-bundle. The results do not support the theory that double-bundle reconstruction controls knee rotation better.

Anterior Cruciate Ligament ; surgery ; Humans ; Joint Instability ; surgery ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome

OBJECTIVETo analyze the relationship between invasive pituitary adenomas and cavernus sinus and cariod artery and to predict their surgical outcomes.

METHODSTotally 270 patients with pituitary tumors were investigated in this retrospective study, including 113 men and 157 women, with a mean age of 40.8 years. The mean disease history was 3.6 years. Pituitary microadenomas were diagnosed in 56 cases, macroadenomas in 118 cases, and hugeadenomas in 96 cases. Adrenocorticotropic hormone-releasing adenomas (Cushing's diseases) were diagnosed in 40 cases, growth hormone-releasing adenomas in 58 cases, prolactinomas in 57 cases, and non-functional pituitary adenomas in 115 cases. Transsphenoidal microsurgery were performed on 260 patients, while transcranial microsurgery on 6 patients.

RESULTSThe percentage of invasive pituitary adenomas was about 3.6% in microadenomas, 20.4% in macroadenomas, and 61.4% in hugeadenomas. Rate of total removal was 94.1% in non-invasive pituitary adenomas, and was 58.8% in invasive pituitary adenomas.

CONCLUSIONSIt is important to analyze the grade of invasive pituitary adenomas to improve the removal of pituitary adenomas, avoid injuring cariod artery, and increase the rate of total removal.

Adenoma ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Carotid Arteries ; pathology ; surgery ; Cavernous Sinus ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hypophysectomy ; methods ; Magnetic Resonance Imaging ; Male ; Microsurgery ; Middle Aged ; Neoplasm Invasiveness ; Pituitary ACTH Hypersecretion ; pathology ; surgery ; Pituitary Neoplasms ; pathology ; surgery ; Radiotherapy, Adjuvant ; Retrospective Studies ; Treatment Outcome

The purpose of this study is to summarize teaching experiences on channel and acupoints. The method of classified teaching is put forward and approached to explore the law of acupoint teaching. It is held that the method could reduce randomness and enhance appropriateness, rationality and scientific validity of the teaching. Class hours are thus optimized and the best teaching result achieved. Acupoints are classified into 4 categories of core points, focal points, regular points and ordinary points according to their use frequency and theoretical importance. Classification methods, principles and categories are then determined. And content of courses, teaching techniques and requirements are introduced as well. Suggestions are offered on enriching teaching contents, for instance, paraphrasing of the acupoint names, indications, point prescriptions and clinical experiences. Thus the conclusion is made that it is imperative to reform the conventional sort of acupoints classified by only focal points and ordinary points as well as the related teaching methods.
Acupuncture ; education ; standards ; Acupuncture Points ; Cyclobutanes ; Humans ; Teaching ; standards

OBJECTIVETo explore factors influencing the recurrence of patients with Cushing's disease after transsphenoidal surgery.

METHODSWe retrospectively analyzed the clinical data of 182 patients treated by transsphenoidal surgery with Cushing's disease in our department in PUMC Hospital from 1992 to 2002.

RESULTSThe recurrence rates were significantly different when patients had different radiological findings (P = 0.001), operative methods (P = 0.001), histological findings (P = 0.04), and postoperative cortisol levels (P = 0.02); however, such difference was not found in term of tumor size (P = 0.43).

CONCLUSIONRadiological findings, operative methods, histological findings, and postoperative cortisol estimates may be the factors influencing the recurrence of patients treated by transsphenoidal surgery.

Adenoma ; complications ; surgery ; Female ; Humans ; Hypophysectomy ; methods ; Male ; Pituitary ACTH Hypersecretion ; etiology ; surgery ; Pituitary Neoplasms ; complications ; surgery ; Recurrence ; Retrospective Studies

OBJECTIVETo study the clinical characteristics, diagnosis and surgical effects of thyroid-stimulating hormone pituitary adenomas (TSH-omas).

METHODSThe clinical data of 19 patients (14 female and 5 male) with TSH-omas were analyzed retrospectively in this study from January 2001 to December 2008. The patients ranged from 20 to 70 years old (average 40.5 years old) and had disease histories from 1 to 228 months (average 55 months). Among these patients, 15 of them complained of thyrotoxicosis symptoms, while the other 4 patients' symptoms were associated with headache and/or visual disturbance caused by the tumor mass effect. Initially, 12 of the 15 patients with thyrotoxicosis symptoms were misdiagnosed with Grave's disease. As a result 2 of them received (131) Iodine, and one received subtotal thyroidectomy. All of these patients underwent transsphenoidal microsurgery.

RESULTSAverage follow-up period was 3.6 years (6 months-7 years). Pathological analysis of the surgical specimen showed pituitary adenoma in all patients, immunohistochemistry were positive for TSH in 17 cases, negative for TSH in 2, positive for growth hormone in 2, positive for prolactin in 1, and positive for adrenocorticotrophic hormone in 1. Postoperative MRI revealed that the tumors in 15 patients were removed totally, though 4 patients still had residual tumors. The thyroid hormone level tests suggested that 13 patients could be considered normal 3 months after their tumors were removed, though 2 of patients with normal postoperative MRI and thyroid hormones showed increased levels of TSH. For these 2 patients, tumors did not recur and their thyroid hormone levels returned to normal after pituitary radiotherapy. The cure rate was 11/19 after surgery and 13/19 after surgery plus pituitary radiotherapy.

CONCLUSIONSThe screening test for hyperthyroidism patients with high TSH levels is a key point to improve the accuracy rate in early diagnoses of TSH-omas. The transsphenoidal microsurgery is first choice to treat TSH-omas, while pituitary radiotherapy and somatostatin analogs are beneficially adjunctive therapies.

Adult ; Aged ; Female ; Humans ; Hyperthyroidism ; metabolism ; Male ; Middle Aged ; Pituitary Neoplasms ; diagnosis ; metabolism ; surgery ; Retrospective Studies ; Thyrotropin ; metabolism ; Young Adult

OBJECTIVETo investigate the clinical results and influence factors in surgical treatment of the Lisfranc joint injury.

METHODSFrom Jan. 2009 to Nov. 2011 ,13 patients (14 feet) with Lisfranc joiat injury received open reduction and screw or wire or external fixation including 9 males and 4 females with an average age of 42 years old ranging from 18 to 61 years. According to the Myerson classification,there were 1 case of type A, 9 of type B and 4 of type C. All the patients received open reduction and internal (1 with external) fixation with screw or Kirschner wire within 22 days after injury. The postoperative function was estimated by mid-foot scoring scale of AOFAS. X-ray were used in radiography estimation.

RESULTSAll the patients were followed up for 5 to 30 months (averaged 20 months). According to mid-foot scoring scale of AOFAS,there were 8 feet with excellent results,4 with good and 2 with fair results. The anatomical reduction was observed in 12 feet and all the patients obtained bony union according to the results of X-ray.

CONCLUSIONOpen reduction and internal fixation is a good choice for the treatment of Lisfranc joint injury. A preoperative estimate,proper reduction during operation and maintainence after operation may influence the clinical results.

Adolescent ; Adult ; Female ; Foot Injuries ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tarsal Joints ; injuries ; surgery