Objective To investigate the effective therapic methods of the perioperative vasovagal reflex(RV)in patients with atrial arrhythmias(AAs)underwent by catheter ablation .Methods The clinical data in the patients with atrial arrhythmias(AAs) complicated by vasovagal reflex(RV)were retrospectively analyzed during the perioperative procedure of catheter ablation guided by three dimensional mapping system CARTO ;the clinical data were compared between patients with RV and without RV .Results A total of 535 patients with AAs underwent catheter ablation guided by three dimensional mapping system were collected from Janu‐ary 2010 to December 2012 ,and 35 cases of intraoperative RV were found .Compared by patients without RV ,the patients with RV had more elderly cases and the cases of hypertension ,coronary heart disease and diabetes .The RV occurrence was also associated with the fasting ,painful stimuli ,operation time and skill .Conclusion The perioperative RV often is occurred in the cases of high risk and have the precipitating factors ,and the good prognosis could be obtained by the detect and treatment as early as possible .

Objective To investigation the pathological characteristics of esophageal squamous cell carcinoma to provide reference criteria for delineating the target area in radiotherapy.Methods Fifty-two patients from the Fourth Hospital of HeBei Medical University underwent resection whom all had been proved to have esophageal squamous cell carcinoma before operation.Chest CT was scanned and transmitted to the 3- dimensional conformal planning system for radiotherapy by VRX-16 scanner.The lesion of esophageal carcinoma was delineated in the 3-dimensional rebuild CT image and the lesion volume was computed by digital rebuild program.Every surgically resected specimen was made into pathologic giant section.The actual size of the specimen was obtained by calculating the size under the microscope with the shrinkage ratio.Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration were observed in the giant section with a microscope and the order of such pathological characteristics were analysed statistically.Results 1.The tumor length by different method of preparation of operated specimens differed obviously.The longest was shown by CT. 2.Multicentric carcinomatous lesion was found in 15(29%)cases out of 52 patients.Proximal to the tumor,the mean distance between the multicentric carcinomatous lesion and the main lesion plus the length of the multicentric carcinomatous lesion was 3.02?1.45cm.Distal to the tumor,it was 2.60?2.44 cm.Severe dysplasia was found in 28 patients.Proximally,the mean distance between the severe dysplasia and the main lesion plus the length of the severe dysplasia was 2.45?1.30 cm.Distal to the tumor,it was 3.24?2.19 cm.Direct intramural infiltration was found in 41 patients,of which the mean length being 2.80?1.52 cm proximally and 2.02?1.51 cm distally. 3.Tumor thrombus was found in 6 patients and lymphoduct infiltration in 36 patients.Direct intramural infiltration was found at higher incidence in specimens complicated with lymphoduct infiltration(86%)and those complicated with tumor thrombus(91%).There were no apparent factors affecting severe dysplasia.The proximal distance to direct intra- mural infiltration was much longer than distally.Conclusions Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration may be observed in esophageal squamous cell carcinoma.Multicentric carcinomatous lesion and direct intramural infiltration are obviously correlated with lymphoduct infiltration.To cover 95% of the microscopic extension,a margin of 5.0 cm is needed proximal to the base of gross tumor volume,and 7.5 cm distal to it.To cover 90% of the microscopic extension,a margin of 4.5 cm is needed proximally,and 5.0 cm distally.

Objective To evaluate the value of DWI in assessing the biological characteristics of breast invasive ductal carcinoma (IDC).Methods Eighty-seven IDC lesions confirmed by postoperative pathology were involved in this retrospective study.The ADC values of IDC were compared among different lymph node status,grades,and molecular subtype.The correlations of ADC value and lymph node status,grades,and molecular subtype were evaluated.Results The ADC value of IDC with positive lymph node was lower than that with negative lymph node (P=0.035),and the ADC value of the high grade IDC was lower than those of medium grade IDC and low grade IDC (P=0.021,0.002).There was no significant difference of ADC value between different molecular subtypes.There was low negative correlation of ADC value with grades (r.s =-0.357,P 0.001) and week negative correlation of ADC value lymph node status and nolecular subtype (rs =-0.227,P=0.034;rs-0.093,P＜0.001).Conclusion DWI can provide useful information in evaluating the biological characteristics of IDC.

OBJECTIVETo explore Chinese medical theory of Fei and Dachang being interior-exteriorly correlated by observing changes of inherent immune response and acquired immune response in the lung tissue and the intestinal tissue of ulcerative colitis (UC) model rats and the intervention of Chinese compounds (CM).

METHODSSeventy rats were randomly divided into 5 groups, i.e., the normal control group (n = 10), the model group (n = 15), the treatment 1 group (n = 15, treated from Fei), the treatment 2 group (n = 15, treated from the intestine), and the Western medicine (WM) group [n = 15, treated with Sulfasalazine (SASP). Except those in the normal control group, the UC rat model was prepared by allergizing colon mucosa combined with TNBS-alcohol (50%) enema, and then intervened by medication (treated with CM complex prescription of treatment from lung, CM complex prescription of treatment from intestine, and SASP). After intragastric administration for 4 weeks, rats were sacrificed and samples taken. The expression of tumor necrosis factor α (TNF-α) and IL-8 contents in the lung tissue, the intestinal tissue, and the serum were detected by radioimmunoassay. Serum MedCAM-1 contents were detected using ELISA. Changes of the expression of Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB), neutrophil migration inhibition factor (MIF), mucosal addressin cell adhesion molecule-1 (MadCAM-1) mRNA in the lung tissue and the intestinal tissue were detected by real time PCR.

RESULTSCompared with the normal control group, the expression levels of TNF-α, TLR4 mRNA, IL-8, MIF mR- NA, and MadCAM-1 mRNA obviously increased in the model group (P < 0.01). Compared with the model group, the expression levels of TNF-α, TLR4 mRNA, IL-8, MIF mRNA, and MadCAM-1 mRNA obviously decreased in the treatment 1 and 2 groups (P < 0.01). The expression of MadCAM-1 mRNA in the intestinal tissue was obviously higher in the model group than in the normal control group (P < 0.01), while the expressions of TNF-α and NF-κB mRNA was obviously lower in the model group than in the normal control group (P < 0.05, P < 0.01). Compared with the model group, the expression of MadCAM-1 mRNA all significantly deceased in each treatment group (P < 0.05, P < 0.01). Serum TNF-α contents were higher in the model group than in the normal control group (P < 0.05). Compared with the model group, serum TNF-α contents could be lowered in the treatment 1 and 2 groups (P < 0.05, P < 0.01).

CONCLUSIONSThe main mechanisms of the intestinal injury in this UC model might be related with activation of acquired immune response, accompanied with lowered functions of inherent immune response. The main mechanisms of the lung injury in this UC model might be related acquired immune response and inherent immune response. Treatment from Fei and treatment from Dachang both could obviously improve the immunodissonance of Fei and Dachang, indicating the special relation between the lung tissue and the intestinal tissue, thus providing experimental evidence for Chinese medical theory of Fei and Dachang being interior-exteriorly correlated.

Aleurites ; Animals ; Colitis, Ulcerative ; drug therapy ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Enema ; Interleukin-8 ; metabolism ; Intestinal Mucosa ; immunology ; Intestines ; immunology ; Lung ; immunology ; Lung Injury ; NF-kappa B ; metabolism ; RNA, Messenger ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo observe the effect of RNA interference on CHK1 and CHK2 expression and change of G2/M phase arrest in esophageal carcinoma cells after irradiation.

METHODSFour sequences short hairhip RNA (shRNA) of each CHK1 and CHK2 genes were constructed and connected with vector of pENTR/U6 plasmid, respectively, and then transfected into Eca109 cells with lipofectamine 2000 reagent. Protein and mRNA expression of CHK1 and CHK2 genes were detected with Western blotting and RT-PCR, respectively. Cell cycling was measured by flow cytometry after 5 Gy irradiation. Cell survival rate after 5 Gy irradiation was evaluated by clonegenetic assay.

RESULTSFour shRNA vector each of CHK1 and CHK2 genes were successfully constructed and transfected into Ecal09 cells, respectively. Protein expression of CHK1 and CHK2 were obviously decreased. Their mRNA expressions were also decreased after transfected with shRNA of CHK1 and CHK2. Arrest of G2/M stage in Eca109 cells were obviously decreased only in cells transfected with CHK1 shRNA but not with CHK2 shRNA at 12 h after 5 Gy irradiation. In first progeny Eca109 cells transfected with CHK1 and CHK2 shRNA, expression of CHK1 and CHK2 protein was also decreased. The level of phosphorylated CHK2-T68 expression was decreased at 1 h after 5 Gy irradiation, and at 72 h only transfected with CHK2 shRNA but not with CHK1 shRNA. Phosphorylation level of CHK1-S345 was not increased after transfected with CHK1 or CHK2 shRNA, but arrest of G2/M stage still remained at 12 h after 5 Gy irradiation and at 72 h accordingly. The cell survival rate was decreased in Eca109 cells transfected with CHK1 or CHK2 shRNA after 5 Gy irradiation.

CONCLUSIONAfter transfected with shRNA of CHK1 or CHK2, their expressions of mRNA and protein in Ecal09 cells are markedly inhibited and this inhibition effect can be observed in their first progeny cells and at least hold for 3 days. Arrest of G2/M phase can be reduced after irradiation when teansfected with shRNA of CHK1 and the radiosensitivity of Ec109 cells can be increased.

Blotting, Western ; Cell Division ; genetics ; physiology ; radiation effects ; Cell Line, Tumor ; Cell Survival ; genetics ; physiology ; radiation effects ; Checkpoint Kinase 1 ; Checkpoint Kinase 2 ; Esophageal Neoplasms ; genetics ; pathology ; physiopathology ; G2 Phase ; genetics ; physiology ; radiation effects ; Gamma Rays ; Genetic Vectors ; Humans ; Protein Kinases ; genetics ; metabolism ; Protein-Serine-Threonine Kinases ; genetics ; metabolism ; RNA Interference ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection

OBJECTIVETo investigate the pathologic features and diagnostic algorithm of light chain nephropathy (LCN).

METHODSSeven cases of LCN were studied by light microscopy, electron microscopy and immunolabeling of light chains (kappa, lambda) by immunofluorescence and immunoelectron microscopy.

RESULTSThe histopathology of 7 cases by light microscopy was variable, with 3 cases showing nodular glomerulosclerosis, 1 case showing mild to moderate mesangial proliferation, and 3 cases showing cast nephropathy with minimal glomerular change. Immunofluorescence study revealed positive staining of a single type of light chain in mesangium (nodular pattern) or along glomerular basement membrane (linear), along tubular basement membrane and around arteriolar walls in all the 7 cases. Ultrastructurally, electron-dense granular deposits were identified in mesangium, subendothelial aspect of glomerular basement membrane, outer aspect of tubular basement membrane and arteriolar walls. Immunogold labeling of light chains showed distinct labeling of a single type light chain in the granular electron-dense materials (5 cases being kappa-positive and 2 being lambda-positive).

CONCLUSIONSLCN typically shows nodular glomerulosclerosis. The ultrastructural change is characteristic and important for diagnosis. Immunolabeling of light chains by immunofluorescence and immunoelectron microscopy carries further diagnostic value, especially in cases with minimal light microscopic change.

Adult ; Aged ; Female ; Glomerulosclerosis, Focal Segmental ; immunology ; pathology ; Humans ; Immunoglobulin Light Chains ; immunology ; Immunoglobulin kappa-Chains ; immunology ; Immunoglobulin lambda-Chains ; immunology ; Kidney Diseases ; immunology ; pathology ; Kidney Glomerulus ; immunology ; pathology ; ultrastructure ; Male ; Microscopy, Fluorescence ; Microscopy, Immunoelectron ; Middle Aged

OBJECTIVETo investigate modulatory role of Rac1 protein in epidermal stem cell (ESC) migration during wound healing, in order to provide a reference for enriching basic theory of wound healing and guiding clinical application.

METHODSConstitutively active mutant of Rac1 protein (Rac1Q61L) or dominant negative isoform of Rac1 protein (Rac1T17N) was transfected into ESC using a retroviral vector FUGW, and retroviral vector FUGW transfected into ESC in singles was used as blank control. The cells were divided into 3 parts according to the random number table and treated as follows. First, equal numbers of cells were inoculated into 24-well plates coated with collagen I (20 µg/mL), collagen IV (20 µg/mL) or fibronectin (10 µg/mL). Cells adhered to above matrices were quantitated using CytoTox 96 colorimetric kit. Second, 1000 cells adhered to collagen IV, after being stained with tetramethyl rhodamine isothiocyanate-phalloidin, were collected for observation of cell morphology and comparison of spreading area under confocal laser scanning microscope. Third, ESC with density of 2 × 10(5) cells per well were placed in upper compartment of Transwell chamber, DK-SFM culture medium alone or that containing stromal cell derived factor 1 (SDF-1) was added into lower compartment of Transwell chamber. Migration of ESC was observed using inverted phase contrast microscope, and the result was denoted as migration rate. Lastly, ESC with density of 7.5 × 10(5) cells per well was inoculated into 6-well plates for 12 hours, and treated with 4 µg/mL mitomycin C for 2 hours. The remaining scratch width of monolayer was respectively measured 6 hours or 12 hours after scratching to calculate the percentage of remaining scratch width. Data were processed with t test.

RESULTSCompared with that of blank control, the number of Rac1Q61L-transfected cells adhered to collagen I was significantly increased (t = 5.302,P < 0.05), while the number of Rac1T17N-transfected cells adhered to collagen I, IV, and fibronectin were all obviously decreased (with t value respectively 13.741, 15.676, 8.256, P values all below 0.05). Confocal laser scanning microscope showed that spreading area of Rac1Q61L-transfected ESC (with laminate pseudopodia on edge) and Rac1T17N-transfected ESC was respectively larger and smaller as compared with that of blank control. With SDF-1 effect, the migration rate of Rac1T17N-transfected ESC was decreased by 78.0% and Rac1Q61L-transfected ESC was increased by 43.4% as compared with that of blank control. Without SDF-1 effect, the migration rate of Rac1T17N-transfected ESC was decreased by 55.2%, while the migration rate of Rac1Q61L-transfected ESC was close to that of blank control. Six or 12 hours after scratching, the percentage of remaining scratch width in Rac1Q61L-transfected ESC was lower as compared with that in blank control [(39 ± 9)% vs. (43 ± 5)%, (6 ± 5)% vs. (18 ± 7)%, with t value respectively 1.027, 4.389, with P value respectively above and below 0.05], while that in Rac1T17N-transfected ESC [(81 ± 9)%, (71 ± 11)%, respectively] was obviously higher as compared with that in blank control (with t value respectively 11.386, 11.726, P values all below 0.05).

CONCLUSIONSRac1 protein may control the migration of ESC by regulating its adhesion, spreading, and chemotaxis, and it plays an active role in wound healing accelerated by ESC.

Cell Movement ; Cell Proliferation ; Epidermis ; cytology ; Epithelial Cells ; Humans ; Mutation ; Stem Cells ; cytology ; Transfection ; Wound Healing ; rac1 GTP-Binding Protein ; genetics ; metabolism

AIM To study the effects of Danggui Buxue Decoction total glycosides combined with Hirudo in the treatment of pulmonary fibrosis in rats and its mechanism.METHODS One hundred and twenty male SD rats were selected,eighteen of which were taken as normal group (normal saline),the remaining 102 rats were used to establish model for pulmonary fibrosis.Seventy-two modeled rats were randomly divided into model group (normal saline),Danggui Buxue Decoction total glycosides group (13 mg/kg),Hirudo group (Hirudo powder,4 g/kg) and combination group (Danggui Buxue Decoction total glycosides,13 mg/kg;Hirudo powder,4 g/kg),eighteen rats in each group with intragastric administration.RESULTS On the 7th,14th and 28th days after modeling,alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1 and PAI-1 expression levels in lung tissue,IL-4 and IL-17 expression levels in alveolar lavage fluid,hydroxyproline (HYP) content in lung tissue in the model group were significantly higher than those in the normal group (P ＜ 0.05).Alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1,PAI-1,IL-4,IL-17 expression levels and HYP content in the Danggui Buxue Decoction total glycosides group,Hirudo group and combination group were significantly lower than those in the model group (P ＜ 0.05).In the combination group,alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1,PAI-1,IL-4,IL-17 expression levels and HYP content were significantly lower than those in the Danggui Buxue Decoction total glycosides group and Hirudo group (P ＜ 0.05).CONCLUSION Danggui Buxue Decoction total glycosides combined with Hirudo have good therapeutic effects on pulmonary fibrosis in rats mainly by reducing TGF-β1,PAI-1 expression levels and HYP coment in lung tissue.

BACKGROUND: Whether remnant preservation can improve proprioception of knee joint remains a controversy. Direct detection of proprioceptor, nerve growth and electrophysiological changes in the grafting tendon of remnant preservation in anterior cruciate ligament reconstruction can objectively evaluate the effect of remnant preservation on proprioception recovery. OBJECTIVE: To establish the animal models of anterior cruciate ligament reconstruction with remnant preservation (femoral tensioning and augmented suture), with remnant preservation (graft passing remnant anterior cruciate ligament sheath) and without remnant, and to compare the differences in postoperative knee proprioception among methods. METHODS: Ninety-six New Zealand rabbits were randomly divided into control group, anterior cruciate ligament reconstruction groups with remnant preservation (femoral tensioning and augmented suture), with remnant preservation (graft passing remnant anterior cruciate ligament sheath) and without remnant (n=24/group). At 3, 6 and 12 weeks after surgery, electrophysiological examination of knee joint was performed. The mRNA expression of neurotrophic factor 3 was detected by real-time fluorescent quantitative PCR. The number of proprioceptor in graft tendon in the anterior cruciate ligament reconstruction groups was detected by hematoxylin-eosin staining and immunohistochemistry. RESULTS AND CONCLUSION: (1) At postoperative 3, 6 and 12 weeks, there were no significant differences in mRNA expression of neurotrophic factor 3, number of proprioceptor and electromyography hamstring among anterior cruciate ligament reconstruction groups (P＞ 0.05). (2) To conclude, there is no significant difference in the proprioception recovery of knee joint between anterior cruciate ligament reconstruction with and without remnant preservation.

OBJECTIVETo explore whether there is a relationship between gross tumor volume (GTV) and pathologic lymph node metastasis or prognosis of esophageal carcinoma, and to provide a new prognosis reference for esophageal carcinoma (EC).

METHODSSix hundred and seven patients received radical resection of thoracic esophageal carcinoma from May 2002 to June 2006 in our hospital, and their pre-operative CT images were transmitted to the three-dimensional conformal radiotherapy planning system by the network in digital format. Esophageal GTV targets were outlined and their GTV volumes were calculated. To analyze whether there is a relationship between GTV volume and pathologic lymph node metastasis or prognosis.

RESULTSIn the 607 cases of esophageal carcinoma, the GTV volume was (22.5 ± 16.8) cm(3) in 374 stage N0 EC patients, significantly different from that of (30.4 ± 20.1) cm(3) in 233 stage N1 EC cases (P < 0.001). There is a significant difference between the GTV volumes of the groups with and without lymph node metastasis (P < 0.05). There was a significant difference of the GTV volumes of EC patients with one lymph node metastasis and those with ≥ 4 lymph node metastasis (P < 0.05). There was a positive correlation between GTV volume and the number of lymph node metastasis (r = 0.230, P < 0.001). The 1-, 3-, 5-year survival rates since the surgery date were 83.8%, 53.5%, and 36.4%, respectively. There was a significant difference between the survival rates of stage N0 (48.5%) and stage N1 patients (18.2%, P < 0.001), and there was a significant difference between the survival rats of patients with 0, 1 and ≥ 2 lymph node metastasis (P < 0.01). Cox regression model analysis showed that GTV volume, number of lymph node metastasis, pathological type, and lesion site were independent prognostic factors (all P < 0.05).

CONCLUSIONThe GTV volume of esophageal carcinoma is positively correlated with the number of pathologic lymph node metastasis, and it is an independent prognostic factor for this cancer.

Adenocarcinoma ; diagnostic imaging ; pathology ; surgery ; Adult ; Aged ; Carcinoma, Small Cell ; diagnostic imaging ; pathology ; surgery ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; surgery ; Esophageal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Radiotherapy, Conformal ; Survival Rate ; Tomography, X-Ray Computed ; Tumor Burden