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Malignant brain tumors consist of malignancies originated primarily within the brain and the metastatic lesions disseminated from other organs. In spite of intensive studies, malignant brain tumors remain to be a medical challenge. Patient-derived organoid (PDO) can recapitulate the biological features of the primary tumor it was derived from and has emerged as a promising drug-screening model for precision therapy. Here we show a proof-of-concept based on early clinical study entailing the organoids derived from the surgically resected tumors of 26 patients with advanced malignant brain tumors enrolled during December 2020 to October 2021. The tumors included nine glioma patients, one malignant meningioma, one primary lymphoma patient, and 15 brain metastases. The primary tumor sites of the metastases included five from the lungs, three from the breasts, two from the ovaries, two from the colon, one from the testis, one of melanoma origin, and one of chondrosarcoma. Out of the 26 tissues, 13 (50%) organoids were successfully generated with a culture time of about 2 weeks. Among these patients, three were further pursued to have the organoids derived from their tumor tissues tested for the sensitivity to different therapeutic drugs in parallel to their clinical care. Our results showed that the therapeutic effects observed by the organoid models were consistent to the responses of these patients to their treatments. Our study suggests that PDO can recapitulate patient responses in the clinic with high potential of implementation in personalized medicine of malignant brain tumors.

To investigate the role and mechanism of thymosin beta 4 (Tβ4) in oxidative stress injury of spinal cord-derived neural stem/progenitor cells (NSPCs) induced by hydrogen peroxide (HNSPCs were isolated from Sprague-Dawley (SD) adult male rats, and divided into control group (untreated NSPCs cells), HThe expression of Tβ4 was decreased in HTβ4 attenuates H

Objective To assess the value of pleural effusion volume (PEV) quantified on chest computed tomography (CT) in patients with early stage acute pancreatitis (AP). Methods Data of PEV, and C-reactive protein (CRP) levels as well as Ranson, bedside index of severity in acute pancreatitis (BISAP), Marshall, acute physiology and chronic health evaluation II (APACHE II), CT severity index (CTSI), and extra-pancreatic inflammation on computed tomography (EPIC) scores in patients with AP were collected. Duration of hospitalization, severity of AP, infection, procedure, intensive care unit (ICU) admission, organ failure, or death were included as the outcome parameters. Results In 465 patients, the mean PEV was 98.8 ± 113.2 mL. PEV showed strong and significant correlations with the CRP levels, duration of hospitalization as well as the Ranson, BISAP, Marshall, APACHE II, CTSI, and EPIC scores (p

Sex and age may affect the pathogenesis of coronary heart disease, such as cardiovascular risk factors, treatment and prognosis, but this information is not well known.This was a single-center retrospective cohort study. Patients with unstable angina pectoris between January 2013 and June 2018 were included and stratified into 4 age groups (55, 55-64, 65-74 and ≥75 years). The cardiovascular risk factors profile, treatment and in-hospital prognosis differences by sex and age were explored.This study included 5,908 patients (2,198 women). The women were older than the men (mean age 67 vs. 62 years). Approximately 2 of 3 patients had ≥3 cardiovascular risk factors. Men were more likely to be smokers, and women had a higher level of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Hypertension, diabetes and chronic kidney disease were more frequent in women ≥ 65 years old than in similarly aged men. Men and women less than 65 years of age had more frequent family history of coronary heart disease, higher body mass index, higher fasting plasma glucose, and higher lipid levels, especially for patients55 years of age. More women tended to receive medical therapy than men (51.6% vs. 42.8%, P0.01). The overall incidence of in-hospital major adverse cardiovascular events was higher in men than in women (4.1% vs. 2.6%, P0.05), whereas there was no sex difference in the in-hospital cardiac mortality (0.2% vs. 0.2%, P0.05).Women had higher cholesterol levels, and were less likely to undergo revascularization therapy than similarly aged men, and elderly women had a higher prevalence of hypertension, diabetes, and chronic kidney disease than elderly men. In-hospital major adverse cardiovascular events were lower in women than in men; however, there was no sex difference in the in-hospital cardiac mortality.

Purpose To prospectively assess safety and efficacy of prostatic artery embolization (PAE) with bleomycin-eluting microspheres for benign prostatic hyperplasia (BPH) in a canine model. Materials and Methods Twelve adult male beagles (mean age, 1.6 y ± 0.2; range, 1.2–2.0 y) were randomly assigned to group A (n = 6; PAE with bleomycin-eluting 30–60-μm HepaSphere microspheres) and group B (n = 6; PAE with bland 30–60-μm HepaSphere microspheres) between April 2017 and November 2018. Plasma bleomycin concentration in group A was measured within 7 days. Prostate volume (PV) and ischemic volume after PAE were measured by magnetic resonance imaging. Prostates and adjacent organs were harvested after the last magnetic resonance study and histopathologically examined. Results Plasma bleomycin concentration peaked at 10 minutes at 2,055.0 ng/mL ± 606.1 and lasted for 1,440 min at low levels after PAE. PV reduction percentage was greater in group A than in group B at 1 month (74.1% ± 4.3 vs 63.7% ± 3.5; P = .006) and 3 months (61.5% ± 6.7 vs 46.1% ± 3.8; P = .001) after PAE. Proportion of prostate ischemic volume was greater in group A than in group B (75.3% ± 3.0 vs 62.0% ± 7.1; P = .006) at 1 month after PAE. Proportion of prostate ischemic volume at 1 month positively correlated with PV percentage reduction at 3 months in group A (r = 0.840, P = .036) and group B (r = 0.844, P = .035). There were no complications or nontarget embolization to surrounding organs after the procedures. Conclusions In a canine model, PAE with bleomycin-eluting microspheres was feasible and well tolerated and caused ischemic necrosis and reduction in PV.

Familial dilated cardiomyopathy (FDCM) is characterized by high genetic heterogeneity and an increased risk of heart failure or sudden cardiac death in adults. We report the case of a 62-year-old man with a 2-month history of shortness of breath during activity, without paroxysmal nocturnal dyspnea. The patient underwent a series of examinations including transthoracic echocardiography, coronary arteriography, transesophageal echocardiography, and myocardial perfusion imaging. After excluding secondary cardiac enlargement, he was diagnosed with dilated cardiomyopathy (DCM). His sister had also been diagnosed with DCM several years before. Genetic sequencing analysis revealed that the patient, his sister, and his son all had the same mutation in the desmin gene ( DES) (chr2-220785662, c.1010C>T). Genetic testing confirmed a heterozygous DES mutation contributing to FDCM. In this case, the etiology of the patient’s whole-heart enlargement was determined as FDCM with DES gene mutation. This is the first report to describe DES c.1010C>T as a cause of FDCM.

Percutaneous endoscopic lumbar discectomy (PELD) has been widely used, before which foraminoplasty is necessary to widen the foramen for subsequent procedures. However, the learning curve of this technology is high, as the use of traditional reamers requires repeated intraoperative fluoroscopy. We sought to compare the clinical outcomes by using the visualized and traditional reamers in PELD foraminoplasty for the treatment of lumbar disc herniation.Eighty patients with lumbar disc herniation who were treated with PELD between 1 January 2017 and 1 January 2019 were retrospectively reviewed. The patients were randomly divided into 2 groups (40 patients in the Visualized Bone Reamer group) and (40 patients in the Traditional Bone Reamer group). Intraoperative fluoroscopy time, cannulation introduction time, visual analog scale, and Macnab criteria score were compared between the 2 groups.The mean follow-up durations were 17.41 ± 1.47 and 18.37 ± 1.69 months in the visualized and traditional groups, respectively. The average cannulation introduction time and intraoperative fluoroscopy times in the visualized group is significantly lower than those in traditional group (29.20 ± 3.31 vs. 39.85 ± 3.98 minutes, P0.001; and 12.30 ± 2.38 vs. 20.65 ±3.51 seconds, P0.001, respectively). One patient in the traditional group required reoperation, and no complications occurred in the visualized group. There were no severe durotomies or vascular or visceral injuries.Full-endoscopic foraminoplasty using a visualized reamer is safe and effective and can decrease intraoperative fluoroscopy time in PELD.

Background Chicken is one of the economically important poultry species. ALV-J has emerged as a serious cause of mortality and suboptimal performance of domestic chickens. The changes in the virome may contribute to pathogenesis. Thus, it is important to investigate the effects of ALV-J infection on the composition of virome in chicken.Results Our results indicated that the chicken gut virome contained a diverse range of viruses, and at the order, family, genus, and species levels, there was a significant difference in virome between the ALV-J-infected chickens and controls. The predominant order was Herpesvirales, accounting for more than 96% of the chicken gut virome. Furthermore, the relative abundance of Caudovirales in the controls was higher than that in the AVL-J-infected chickens. At the family level, the relative abundance of Herpesviridae, Myoviridae, Alloherpesviridae, and Genomoviridae was significantly altered in the AVL-J-infected chickens compared with the controls. Additionally, the relative abundance of 15 genera showed a significant difference between the AVL-J-infected chickens and controls. Interestingly, the relative abundance of 366 species showed significant differences between the AVL-J-infected chickens and controls.Conclusions Our results indicated that the chicken gut virome contained a diverse range of viruses from invertebrates, vertebrates, plants, and phages. Furthermore, at the order, family, and genus levels, AVL-J infection significantly altered the chicken gut virome composition. The results will increase our understanding of the viral diversity and the changes in chicken virome, with implications in chicken health.

Background and Aim. Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. We aimed to compare the efficiency and outcomes of these two procedures in GV patients through meta-analysis. Methods. The PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched using the keywords: GV, bleeding, TIPS, and BRTO to identify relevant randomized controlled trials and cohort studies. The overall survival (OS) rate, imminent haemostasis rate, rebleeding rate, technical success rate, procedure complication rate (hepatic encephalopathy and aggravated ascites), and Child-Pugh score were evaluated. Randomized clinical trials and cohort studies comparing TIPS and BRTO for GV due to portal hypertension were included in our meta-analysis. Two independent reviewers performed data extraction and assessed the study quality. A meta-analysis was performed to calculate risk ratios (RRs), mean differences (MDs), and 95% CIs using random effects models. Results. A total of nine studies fulfilled the inclusion criteria. There was a significant difference between TIPS and BRTO in the OS rate (RR, 0.81 (95% CI, 0.66 to 0.98); P=0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P<0.00001). TIPS had a higher incidence rate of hepatic encephalopathy (RR, 16.11 (95% CI, 7.13 to 36.37); P<0.00001). There was no significant difference between TIPS and BRTO in the immediate haemostasis rate (RR, 0.99 (95% CI, 0.89 to 1.10); P=0.84), technical success rate (RR, 1.06 (95% CI, 0.98 to 1.16); P=0.16), aggravated ascites rate (RR, 0.60 (95% CI, 0.33 to 1.09); P=0.10), or Child-Pugh change (MD, 0.22 (95% CI, −0.21 to 0.65); P=0.31). Conclusions. In this meta-analysis, BRTO brought more benefits to patients, with a higher OS rate and lower rebleeding rate. BRTO is a feasible method for GVB.

Depressive disorder is a kind of affective disturbance disease. Emerging evidence has suggested that inflammation may contribute to the pathologic process of depressive disorder. Senegenin (SEN), a major bioactive constituent in Polygala tenuifolia Willd, has much bioactivity including anti-inflammatory and neuroprotection effects. However, the mechanism of its anti-depressant effect in mice remains unknown. This study aimed to explore the anti-depressant effects of SEN on behavioral changes and inflammatory responses in mice induced by chronic un-predictable mild stress (CUMS). SEN treatment remarkably ameliorated CUMS-induced behavioral abnormalities, such as improving locomotor activity, decreasing immobility time in Tail suspension test (TST) and Forced swimming test (FST), and increasing sucrose intake in Sucrose preference test (SPT). Additionally, SEN improve protein levels of Brain-derived neurotrophic factor (BDNF) and Neurotrophin-3 (NT-3) expression. In response to stress, p65 was activated to promote production of pro-IL-1β, and then cleaved to mature IL-1β by NOD-like receptor protein 3 (NLRP3) inflammasome pathway in hippocampus of CUMS mice. After SEN treatment, protein activation related to NLRP3 inflammasome pathway was down-regulated, which inhibited IL-1β secretion. These results demonstrate that SEN plays an important role in treatment CUMS-induced depression in mice, possibly via suppression of pathway activation associated with NLRP3 inflammasome.

The precise mechanisms underlying neuronal injury in Parkinson's disease (PD) are not yet fully elucidated; however, evidence from the in vitro and in vivo PD models suggest that mitochondrial dysfunction may play a major role in PD pathogenesis. Alpha lipoamide, a neutral amide derivative of the lipoic acid, is a better cofactor for mitochondrial dehydrogenase with a stronger protective effect on mitochondria than lipoic acid. Identification of these protective effects of alpha lipoamide on mitochondria, together with the evidence that mitochondrial dysfunction plays a critical role in PD, we speculate that alpha lipoamide may exert a protective effect in PD by regulating the mitochondrial function. The present study investigated the neuroprotective effects of alpha lipoamide in an animal model of PD induced by 6-hydroxydopamine (6-OHDA). The results demonstrated that alpha lipoamide could significantly antagonize the 6-OHDA-induced behavioral damages; restore ATP levels in the midbrain; and also improve the fragmentation, vacuolization, and morphology of the mitochondria. The results of Western blot indicated that alpha lipoamide significantly restored the number of dopaminergic neurons in midbrain and substantially recovered the balance between mitochondrial fission, fusion, and transport. In conclusion, the results demonstrated that alpha lipoamide might exert a significant neuroprotective effect in the animal model of PD by regulation of the dynamic properties of mitochondria.

Saikosaponin D (SSD), a major bioactive component isolated from Radix Bupleuri, has been reported to exert neuroprotective properties. The present study was designed to investigate the anti-depressant-like effects and the potential mechanisms of SSD. Behavioural tests including sucrose preference test (SPT), open field test (OFT) and forced swim test (FST) were performed to study the antidepressant-like effects of SSD. In addition, we examined corticosterone and glucocorticoid receptor (GR) levels to evaluate hypothalamic-pituitary-adrenal (HPA) axis function. Furthermore, hippocampal neurogenesis was assessed by testing doublecortin (DCX) levels, and neurotrophic molecule levels were also investigated in the hippocampus of rats. We found that unpredictable chronic mild stress (UCMS) rats displayed lost body weight, decreased sucrose consumption in SPT, reduced locomotive activity in OFT, and increased immobility time in FST. Chronic treatment with SSD (0.75, 1.50 mg/kg) remarkably ameliorated the behavioral deficiency induced by UCMS procedure. SSD administration downregulated elevated serum corticosterone levels, as well as alleviated the suppression of GR expression and nuclear translocation caused by UCMS, suggesting that SSD is able to remit the dysfunction of HPA axis. In addition, Western blot and immunohistochemistry analysis showed that SSD treatment significantly increased the generation of neurons in the hippocampus of UCMS rats indicated by elevated DCX levels. Moreover, hippocampal neurotrophic molecule levels of UCMS rats such as phosphorylated cAMP response element binding protein (p-CREB) and brain-derived neurotrophic factor (BDNF) were raised after SSD treatment. Together, Our results suggest that SSD opposed UCMS-induced depressive behaviors in rats, which was mediated, partially, by the enhancement of HPA axis function and consolidation of hippocampal neurogenesis.

BACKGROUND Diabetes mellitus-induced erectile dysfunction is a common diabetic complication, and new therapeutics and the pathogenesis of diabetes mellitus-induced erectile dysfunction need to be investigated. OBJECTIVES The aim was to investigate the pathogenesis of diabetes mellitus-induced erectile dysfunction and the pharmacological mechanism of simvastatin treatment in diabetes mellitus-induced erectile dysfunction model rats. MATERIALS AND METHODS A total of 86 male Sprague Dawley rats aged 8 weeks old were used in this study. The rats were divided into three groups: control (normal), diabetes mellitus-induced erectile dysfunction (streptozotocin-injected), and diabetes mellitus-induced erectile dysfunction + simvastatin (sim). Each group was subdivided into two subgroups for in vitro and in vivo analyses. A bioinformatics method was used to detect differences in gene expression in the corpus cavernosum between normal and diabetes mellitus-induced erectile dysfunction rats. Erectile function was measured by a cavernous nerve electrostimulation test. Corpus cavernosum fibrosis was assessed by Masson staining and Western blotting. Immunofluorescence and Western blotting were performed to explore the differential expression of autophagy-related genes and the AMPK-SKP2-CARM1 pathway genes in rat cavernous smooth muscle cells and the corpus cavernosum. The autophagosomes of the corpus cavernosum tissue were observed by transmission electron microscopy. RESULTS Autophagy-related genes and pathways (the AMPK and FoxO pathway) were identified by bioinformatics analysis and confirmed at the protein level. Simvastatin, an AMPK agonist, was used to treat diabetes mellitus-induced erectile dysfunction rats for 8 weeks, demonstrating that erectile function was improved for 80.5% (P

Endoplasmic reticulum (ER) stress is involved in the development of several liver diseases and tumors. This study investigated the underlying mechanisms of α-naphthyl isothiocyanate (ANIT)-induced liver injury with cholestasis in mice and found ER stress contributes to the injury. All animals were randomly divided into three groups. In the ANIT-intoxicated group, mice were intragastrically given 100mg/kg ANIT (dissolved in corn oil), while the other groups received an equal volume of vehicle as control. After 24 and 48h of ANIT administration, blood samples and liver tissues of all animals were collected for serum biochemistry and hepatic histopathological examinations to evaluate liver injuries with cholestasis. Hepatocellular apoptosis was assessed by the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. The expression of hepatic ER stress-related markers was determined by real-time PCR, immunohistochemical assay and Western blot. ANIT was found to significantly induce liver injury with cholestasis compared with control mice as evidenced by the increase of serum transaminases and total bilirubin (TBil), and histopathological changes in mice. ANIT remarkably induced hepatocellular apoptosis, upregulated the expression of caspase-9 and cytochrome c, and inhibited the gene and protein expression of proliferating cell nuclear antigen (PCNA). The gene expression of ER stress-related markers, including glucose-regulated protein 78 (GRP78), protein kinase R-like ER kinase (PERK), eukaryotic initiation factor 2α (eIF2α), inositol requiring enzyme-1α (IRE-1α) and activating transcription factor 6 (ATF6) was upregulated by ANIT in mice. ANIT also upregulated the protein expression of GRP78 and activated the phosphorylation of IRE1. These results suggested that ANIT induced liver injury with cholestasis partly due to its ability to activate the ER stress pathway.

Endoplasmic reticulum (ER) stress is known to be involved in the development of several metabolic disorders, including non-alcoholic fatty liver disease (NAFLD). Tetracycline can cause hepatic steatosis, and ER stress may be involved in tetracycline-induced fatty liver. Our previous study showed that bicyclol has been proven to protect against tetracycline-induced fatty liver in mice, and ER stress may also be involved in bicyclol’s hepatoprotective effect. Therefore, this study was performed to investigate the underlying mechanisms associated with ER stress and apoptosis, by which bicyclol attenuated tetracycline-induced fatty liver in mice. Bicyclol (300 mg/kg) was given to mice by gavage 3 times. Tetracycline (200 mg/kg, intraperitoneally) was injected at 1 h after the last dose of bicyclol. At 6 h and 24 h after single dose of tetracycline injection, serum ALT, AST, TG, CHO and hepatic histopathological examinations were performed to evaluate liver injuries. Hepatic steatosis was assessed by the accumulation of hepatic TG and CHO. Moreover, hepatic apoptosis and ER stress related markers were determined by TUNEL, real-time PCR, and western blot. As a result, bicyclol significantly protected against tetracycline-induced fatty liver as evidenced by the decrease of elevated serum transaminases and hepatic triglyceride, and the attenuation of histopathological changes in mice. In addition, bicyclol remarkably alleviated hepatic apoptosis and the gene expression of caspase–3, and increased the gene expression of XIAP. The gene expressions of ER stress-related markers, including CHOP, GRP78, IRE-1α, and ATF6, which were downregulated by bicyclol pretreatment in tetracycline-injected mice. These results suggested that bicyclol protected tetracycline-induced fatty liver partly due to its ability of anti-apoptosis associated with ER stress.

An ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method was developed to determine liensinine in rat plasma using carbamazepine as the internal standard (IS). Sample preparation was accomplished through a protein precipitation procedure with acetonitrile to 0.1ml plasma sample. The analyte and IS were separated on an Acquity UPLC BEH C18 column (2.1mm×50mm, 1.7μm) with the mobile phase of acetonitrile and 0.1% formic acid in water with gradient elution at a flow rate of 0.40ml/min. The injection volume was 6μl. The detection was performed on a triple quadrupole tandem mass spectrometer equipped with electrospray ionization (ESI) by multiple reactions monitoring (MRM) of the transitions at m/z 611.6→206.2 for liensinine and m/z 237.1→194.2 for IS. The linearity of this method was found to be within the concentration range of 10-1000ng/ml with a lower limit of quantification of 10ng/ml. Only 3.0min was needed for an analytical run. The matrix effect was 93.8-107.4% for liensinine. The intra- and inter-day precision (RSD %) were less than 9.9% and accuracy (RE %) was within ±10.5%. The recovery ranged from 76.2 to 86.8%. Liensinine was sufficiently stable under all relevant analytical conditions. The method was also successfully applied to the pharmacokinetic study of liensinine in rats. The pharmacokinetic parameters were demonstrated as followed: t1/2 was 8.2±3.3h, Cmax was 668.4±156.9ng/ml, and AUC0→∞ was 1802.9±466.4ng/mlh.

Aging is associated with a progressive decline in muscle strength, muscle mass and impaired physical function, which reduces mobility and impairs quality of life in the elderly population. The 6–12 months of exercise can enhance the muscle strength, but these improvements can only be maintained for a short period. In this study, we investigated the effects of long-term Tai Chi (TC) exercise on muscle strength of lower extremities. A cross-sectional study was conducted in 205 long-term TC practitioners (age: 60–89 years) and 205 age and gentle matched controls who did not practice TC. Each of the activity group was further divided into three distinct age groups: G1, 60–69 years; G2, 70–79 years; and G3, 80–89 years. Hand-held dynamometery was used to measure the maximum isometric strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in both sides of the participants. Unpaired t tests were performed to compare the difference of strength between the TC and non-Tai Chi (NTC) groups. Multivariate analysis of variance (MANOVA) was used to compare the lower muscle strengths among the different age groups in the TC and NTC groups. Pearson’s correlations were used to quantify the linear relationship between the months of TC practice and lower limbs muscle strength. The inter-rater reliabilities of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings were intraclass correlation coeffificient (ICC) (1,1) = 0.895 (0.862–0.920), ICC (2,2) = 0.905 (0.874–0.928), ICC (3,3) = 0.922 (0.898–0.941) and ICC (4,4) = 0.930 (0.908–0.947). The strength of the muscles in the TC group did not differ among different age groups (P>0.05). The strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings in TC group was higher than that in the NTC group (P

Forensic DNA analysis of sexual assault evidence requires unambiguous differentiation of DNA profiles in mixed samples. To investigate the feasibility of magnetic bead-based separation of sperm from cell mixtures using a monoclonal antibody against MOSPD3 (motile sperm domain-containing protein 3), 30 cell samples were prepared by mixing 10(4) female buccal epithelial cells with sperm cells of varying densities (10(3), 10(4), or 10(5) cells/mL). Western blot and immunofluorescence assays showed that MOSPD3 was detectable on the membrane of sperm cells, but not in buccal epithelial cells. After biotinylated MOSPD3 antibody was incubated successively with the prepared cell mixtures and avidin-coated magnetic beads, microscopic observation revealed that each sperm cell was bound by two or more magnetic beads, in the head, neck, mid-piece, or flagellum. A full single-source short tandem repeat profile could be obtained in 80% of mixed samples containing 10(3) sperm cells/mL and in all samples containing ≥10(4) sperm cells/mL. For dried vaginal swab specimens, the rate of successful detection was 100% in both flocked and cotton swabs preserved for 1 day, 87.5% in flocked swabs and 40% in cotton swabs preserved for 3 days, and 40% in flocked swabs and 16.67% in cotton swabs preserved for 10 days. Our findings suggest that immunomagnetic bead-based separation is potentially a promising alternative to conventional methods for isolating sperm cells from mixed forensic samples.

This study identifies factors affecting sleep patterns among thoracic surgery patients in the intensive care unit (ICU) and compares the perceptions of sleep-disturbing factors between nurses and patients.One hundred and fifty-two patients and 40 nurses were surveyed using the Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaires (for patients and nurses). All statistical analyses were carried out by SPSS, and the following statistical methods were used to evaluate the data: chi-squared test and logistic regression.Of 152 patients, 46.1 % reported poor sleep quality during their hospitalization; their PSQI total score was 6.95 ± 3.713. Of these, 69.1 % indicated that their sleep quality was poorer than before; 50.0 % of them changed their sleep patterns. Significant discrepancies exist between nurses and patients in the perceptions of sleep-disturbing factors of patients.Thoracic surgical patients' perceptions of their sleep in the ICU indicate poor sleep quality, which is decided by a variety of disturbing factors. Perceptions of these factors varied greatly between surveyed patients and nurses.

The subarachnoid space (SAS) lies between the arachnoid membrane and the pia mater of the human brain, normally filled with cerebrospinal fluid (CSF). Subarachnoid hemorrhage (SAH) is a serious complication of neurological disease that can have high mortality and high risk of disability. Computed tomography (CT) head scans are often used for diagnosing SAH which may be difficult when the hemorrhage is small or subtle. A computer-aided diagnosis system from CT images is thus developed to augment image interpretation. Supervised learning using the probability of distance features of several landmarks was employed to recognize SAS. For each CT image, the SAS was approximated in four steps: (1) Landmarks including brain boundary, midsagittal plane (MSP), anterior and posterior intersection points of brain boundary with the MSP, and superior point of the brain were extracted. (2) Distances to all the landmarks were calculated for every pixel in the CT image, and combined to construct a high-dimensional feature vector. (3) Using head CT images with manually delineated SAS as training dataset, the prior probabilities of distances for pixels within SAS and non-SAS were computed. (4) Any pixel of a head CT scan in the testing dataset was classified as an SAS or non-SAS pixel in a Bayesian decision framework based on its distance features. The proposed method was validated on clinical head CT images by comparison with manual segmentation. The results showed that the automated method is consistent with the gold standard. Compared with elastic registration based on grayscale information, the proposed method was less affected by grayscale variation between normal controls and patients. Compared with manual delineation, the average spatial overlap, relative overlap, and similarity index were, respectively, 89, 63, and 76% for the automatic SAS approximation of the 69 head CT scans tested. The proposed method was tested for SAH detection and yielded a sensitivity of 100% and a specificity of 92%. Automated SAH detection with high sensitivity was shown feasible in a prototype computer-aided diagnosis system. The proposed method may be extended for computer-aided diagnosis of several CSF-related diseases relevant to SAS abnormalities.

We assessed whether the admission fasting plasma glucose (FPG) levels were associated with all-cause mortality and left ventricular (LV) function in older patients with acute myocardial infarction (AMI). A total of 1854 consecutive patients were categorized into 4 groups: hypoglycemia, euglycemia, mild hyperglycemia, and severe hyperglycemia. The primary outcomes were in-hospital/3-year mortality and LV function. There was a near-linear relationship between FPG and Killip class. However, no significant correlation was found between FPG levels and LV ejection fraction. Both FPG levels and Killip classes were all independent significant predictors of mortality. Compared with the euglycemia group, both the hypo- and hyperglycemia groups were associated with higher in-hospital and 3-year mortality. In older patients with AMI, the FPG values had differential influences on LV function and mortality. There was a U-shaped relationship between FPG and in-hospital/3-year mortality, and a near-linear relationship between increased admission glucose levels and higher Killip classification.

OBJECTIVE To assess whether the relationship between abnormal fasting plasma glucose (FPG) levels and patient outcomes holds for both older men and older women with acute myocardial infarction (AMI). PATIENTS AND METHODS From April 1, 2004, to October 31, 2006, a total of 2016 consecutive older patients (age ≥65 years) presenting with AMI were screened. Of these patients, 1854 were consecutively enrolled in the study. Patients were categorized into 4 groups: the hypoglycemic group (FPG, ≤90.0 mg/dL [to convert to mmol/L, multiply by 0.0555]; n=443, 23.9%), the euglycemic group (FPG, 90.1-126.0 mg/dL; n=812, 43.8%), the mildly hyperglycemic group (FPG, 126.1-162.0 mg/dL; n=308, 16.6%), and the severely hyperglycemic group (FPG, ≥162.1 mg/dL; n=291, 15.7%). The primary outcomes were rates of in-hospital and 3-year mortality. RESULTS Female patients were older and had a higher incidence of diabetes mellitus but lower rates of smoking and use of invasive therapy. Men tended to have a higher frequency of hypoglycemia, whereas women tended to have a higher frequency of hyperglycemia. No significant difference was found in in-hospital (10.9% vs 9.1%; P =.36) or 3-year (24.5% vs 24.5%; P =.99) mortality between male and female patients, and FPG-associated mortality did not vary significantly by sex. CONCLUSION An increased FPG level was associated with a relatively higher risk of in-hospital mortality in men but not in women. Nonetheless, increased and decreased FPG levels at admission could predict higher mortality rates regardless of sex. There was a striking U-shaped relationship between FPG levels and in-hospital and 3-year mortality. The effect of abnormal FPG level on outcomes among older patients with AMI did not vary significantly by sex.

Background Hyperglycemia on admission is a predictor of an unfavorable prognosis in patients with ST-elevation Acute Myocardial Infarction (AMI). Data concerning associations between an elevated glucose level on admission and other in-hospital complications are still limited. Methods A total of 1,137 AMI patients with complete admission blood glucose level (ABGL) analysis were identified and stratified according to ABGL. Results A total of 16.1% patients had admission glucose level

Favre-Racouchot syndrome (FRS) is a disorder consisting of solar elastosis with the presence of multiple cysts and open comedones. Although the exact mechanism of the condition is not known, FRS has been specifically connected to sun exposure, smoking and radiation exposure. The histological changes present in FRS reveal an atrophic epidermis and large masses of keratinous material, causing follicular plugging, as well as solar elastotic changes and possible basophilic degeneration of connective tissue. Herein, we report an unusual case of FRS concurrent with chronic granulomatous reaction and review relevant published works.

The role of advanced glycation end products (AGEs) and its C-terminal truncated receptor (soluble receptor for advanced glycation end products, sRAGE) in ST-segment elevation myocardial infarction (STEMI) patients with or without diabetes is unknown. We compared their levels in patients with and without STEMI, as well as with and without diabetes. A prospective observational study was performed between December 2014 and December 2015. Study group included STEMI patients with coronary artery disease; control group included patients without coronary artery disease. Levels of AGEs and sRAGE were tested on Days 0, 2, and 5 after STEMI. Levels of creatine kinase-MB (CK-MB), cardiac troponin I, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were tested on Days 0, 1, 2, and 3. Patient's diabetic status was determined by medical history or oral glucose tolerance test. Compared to patients in the control group, STEMI patients showed elevated levels of AGEs and sRAGE. In the STEMI group, diabetic patients had higher levels of AGEs and sRAGE compared to nondiabetic patients. The level of AGEs correlated with peak level of CK-MB in the overall population of patients with STEMI and with peak level of NT-proBNP in diabetic patients with STEMI. Levels of AGEs and sRAGE were elevated after STEMI, especially among patients with diabetes. These markers could serve to indicate the severity of myocardial injury and cardiac insufficiency, and play a potential role in predicting the prognosis of patients with STEMI.

The aim of the study was to detect the echocardiographic sensitive indexes for prediction of the subclinical cardiac dysfunction and to evaluate the relation between Hemoglobin A1c (HbA1c) and myocardial acoustic densitometry as well as cardiac function.Fifty DM2 patients (48.5+/-8.6 years) without evident heart disease and 50 age- and sex-matched normal controls (47.6+/-8.8 years) were enrolled. Conventional echocardiography, tissue Doppler imaging and acoustic densitometry of both groups were measured. HbA1c of DM2 patients were determined.There were no significant differences in systolic indexes between the two groups. Mean LV myocardial early diastolic velocity Em and Em/Am were lower in DM group than control group. Mean LV myocardial late diastolic velocity Am and E/Em were higher in DM group than control group. IVS-IBS% and LVPW-IBS% were higher in DM group than control group. IVS-CVIB and LVPW-CVIB were lower in DM group than control group. HbA1c was negatively correlated with E/A (gamma=-0.310, P0.05), Em (gamma=-0.409, P0.01), Em/Am (gamma=-0.380, P0.01) and positively correlated with E/Em (gamma=0.488, P0.01). Significant positive correlation was present between HbA1c and IVS-IBS% (gamma=0.679, P0.01), LVPW-IBS% (gamma=0.666, P0.01).The diastolic dysfunction and abnormal myocardial acoustic densitometry exist before the systolic function damage in DM2 patients. Tissue Doppler imaging and ultrasonic integrated backscatter can be used as sensitive means for early assessing myocardial histological changes in DM2 patients. HbA1c is related with both diastolic dysfunction and acoustic densitometry.

Background Several studies have indicated that chronic kidney disease is independently associated with the presence of left ventricular hypertrophy ( LVH ). However, little clinical data are currently available regarding the detailed correlation between LVH and renal function in elderly patients with non–end‐stage renal disease. Methods and Results A total of 300 in‐ and outpatients (more than 60 years of age, non‐end‐stage renal disease), 251 with LVH and 49 without LVH , seen at Beijing Friendship Hospital from January 2000 to December 2010 were included in this retrospective study. One observation period of 12 months was used to detect rapid kidney function decline. The evaluations of cardiac structure and function were performed via echocardiography. The multivariable logistic analysis showed patients with LVH had a much higher risk of rapid kidney function decline than those without LVH . Additionally, the baseline left ventricular mass index was 140 (125–160) g/m 2 in the non–chronic kidney disease group, 152 (130–175) g/m 2 in the mild chronic kidney disease group (estimated glomerular filtration rate (eGFR)≥60 ml/min/1.73 m 2 ), and 153 (133–183) g/m 2 in the severe chronic kidney disease group (eGFR2 ), with a significant difference ( P =0.009). Conclusions Our data demonstrate that a high rate of renal function decline contributes to pathological LVH in non–end‐stage renal disease elderly patients and that LVH is positively associated with renal function decline followed by an increased risk of rapid kidney function decline.

Plastus (Stigmatochirus) menglaius sp. nov. is described from Yunnan, China. Color images of the habitus and aedeagu of the new species are included. A key to the subgenus Stigmatochirus of World species is provided.

Purpose: TRAP220 (thyroid hormone receptor-associated protein) functions as a coactivator for nuclear receptors and stimulates transcription by recruiting the TRAP mediator complex to hormone responsive promoter regions. Thus, TRAP220 enhances the function of thyroid/steroid hormone receptors such as thyroid hormone and oestrogen receptors. This study investigated the expression of TRAP220 mRNA and protein level in epileptic brains comparing with human control. Methods: We examined the expression of TRAP220 mRNA and protein levels in temporal lobes from patients with chronic pharmacoresistant epilepsy who have undergone surgery. Results: Expression of TRAP220 mRNA and protein was shown to be decreased significantly in the temporal cortex of the patients with epilepsy. Conclusions: Our work showed that a decrease in TRAP220 mRNA and protein levels may be involved in the pathophysiology of epilepsy and may be associated with impairment of the brain caused by frequent seizures.

Objective: In order to improve the prognosis of pancreatic cancer patients, it is crucial to explore novel tools for its early diagnosis. Here, we attempted to screen serum biomarkers to distinguish pancreatic cancer from non-cancer individuals. Methods: 47 serum samples from pancreatic cancer patients, 39 of whom had small surgically resectable cancers, were collected before surgery, and an additional 53 serum samples from age- and sex-matched individuals without cancer were used as controls. The surface-enhanced laser desorption/ionization (SELDI) ProteinChip was applied to analyze serum protein profiling. 54 samples (27 with pancreatic cancer and 27 controls) were analyzed in the training set by a decision tree algorithm to be able to separate pancreatic cancer from controls. A double-blind test was used to determine the sensitivity and specificity of the classification model. Results: A panel of six biomarkers was selected to set up a decision tree as the classification model. The model separated effectively pancreatic cancer from control samples, achieving a sensitivity of 88.9% and a specificity of 74.1%. The double-blind test challenged the model with a sensitivity of 80% and a specificity of 84.6%. Conclusion: The SELDI ProteinChip combined with an artificial intelligence classification algorithm shows great potential for the diagnosis of pancreatic cancer.

To evaluate whether the predictive value of admission hyperglycemia for mortality differs between diabetics and non-diabetics with acute coronary syndrome (ACS).A total of 1534 consecutive patients admitted with ACS to Central Control Unit of Beijing Friendship Hospital were analyzed. Among these patients, 1332 patients who had a venous plasma glucose record at admission were retrospectively enrolled and were stratified according to admission glucose levels with or without diabetes. The primary end point was in-hospital and 2-year all-cause mortality.In patients without a history of diabetes, 649 patients had glucose level ≤ 7.8 mmol/L(group A), 204 patients with 7.8-11.0 mmol/L (group B) and 142 patients11.0 mmol/L (group C). Of those with diabetes, 124 patients were in group A, 142 in group B and 126 in group C. By Cox regression analysis, admission hyperglycemia (group B, HR 1.48, P = 0.05; group C, HR 2.78, P0.001) was an independent predictor of long-term all-cause mortality in patients without diabetes. In patients with diabetes, blood glucose11.0 mmol/L (group C, HR 2.68, P0.001) also independently predicted long-term all-cause mortality.Compared with the diabetic patients, elevation of blood glucose at admission is common in ACS patients without definite history of diabetes. Admission hyperglycemia should be considered as a risk factor strongly correlated with in-hospital and 2-year all-cause mortality in patients with ACS.

The present study was designed to investigate the role of opioid receptors in the vasorelaxation effect of chronic intermittent hypobaric hypoxia (CIHH) in thoracic aorta rings and the underlying mechanism in rats. Adult male Sprague-Dawley (SD) rats were randomly divided into 2 groups: CIHH treatment group and control group. The rats in CIHH group were exposed to hypoxia in a hypobaric chamber (simulated 5 000 m altitude) for 28 days, 6 h per day. The rats in control group were kept in the same environment as CIHH rats except no hypoxia exposure. The relaxation of thoracic aorta rings was recorded by organ bath perfusion technique, and expression of opioid receptors was measured by Western blot. Results are shown as follows. (1) The acetylcholine (ACh)-induced endothelium-dependent relaxation of thoracic aorta in CIHH rats was increased obviously in a concentration-dependent manner compared with that in control rats (P0.05). (2) This enhancement of ACh-induced relaxation in CIHH rats was abolished by naloxone, a non-specific opioid receptor blocker (P0.05). (3) The expressions of δ, μ and κ opioid receptors in thoracic aorta of CIHH rats were up-regulated compared with those in control rats (P0.05). (4) The enhancement of CIHH on relaxation of thoracic aorta was reversed by glibenclamide, an ATP-sensitive potassium channel (KATP) blocker (P0.05). The results suggest that opioid receptors are involved in CIHH-enhanced ACh-induced vasorelaxation of thoracic aorta through KATP channel pathways.

To analyze the differentially expressed genes in the testicular tissues of men with unilateral cryptorchidism using cDNA gene chips.Probes were prepared with the mRNA extracted from the testes of 6 patients with unilateral cryptorchidism and 3 normal fertile men. Then the differential gene expression profiles of the two groups were detected with cDNA gene chips containing 45 034 genes. The differentially expressed genes were analyzed with Pathway and GO in the MAS system.Based on the ratio of3.0 or0.33, 346 differentially expressed genes were detected in the testis tissues of the patients with unilateral cryptorchidism, among which 60 were up-regulated and 286 down-regulated. The up-regulated genes were distributed mainly on chromosomes 1, 15, 5 and 19, associated with cell cycles, sperm motility, flagellar movement, DNA replication, and chromatin modification, while the down-regulated genes, mainly on chromosomes 1, 19, 16 and 11, related with spermatogenesis and anti-apoptosis.Unilateral cryptorchidism involves the variation of the expressions of multifunctional genes. The establishment of gene expression profiles of unilateral cryptorchidism in human testes may provide a new theoretical basis for analyzing the genetic factors of unilateral cryptorchidism and investigating the etiology of spermatogenic failure.

To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise.The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries.Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%), followed by suicide (49, 24.3%) and accident (44, 21.8%). The majority of suicide-induced death were by falling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants.Studies on the morphology and its formative rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.

By studying the mode and morphologic character of high fall injuries on the scene, and exploring the injury situation of different heights, different fall ways and postures, to provide a reference for the forensic identification of high fall injury.All the high fall cases were statistically analysed according to their gender, age, ground-touching posture, fall height, site and type of the injury.Among 134 high fall cases, 98 were male and 36 were female with the age ranging from 2-71 years (37.6+/-16.9 on average), in which, 10-60 years old group consisted of 110 cases (82%). Most cases fell from windows or roofs (73%) and the touching objects were cement ground or shaft bottom of elevators. Among these cases, head injury was generally serious, followed by chest and abdominal injuries. The morphologic changes depend upon the height, nature, as well as the posture at the point while the body touches the ground.Morphologic study of high fall injury assists medicolegal physicians to make correct identifications of the cause and nature of high fall injuries.

There are few reports of robot-assisted pancreatic surgery. Our purpose was to report our surgical and clinical experiences and outcomes of 47 cases of robot-assisted pancreatic resection to show that minimally invasive pancreatic surgery is both feasible and effective.The medical records of 47 patients who underwent robot-assisted pancreatic resections for adenocarcinoma, cystic tumours or other pancreatic diseases at our institution by a single surgical team from March 2010 to December 2011 were retrospectively analysed.There were 32 females and 15 males with a mean age of 48.7 ± 15.4 years, of whom 13 patients had pathologically diagnosed malignancies, 25 had cystic tumours or chronic pancreatitis, three had solid pseudopapillary tumours of pancreas, and six had other lesions. Sixteen patients underwent pancreatoduodenectomy, 16 distal pancreatectomies (nine of which had spleen resections), 10 middle pancreatectomies, four Beger's procedure, and one had enucleation of a pancreatic lesion. The mean surgical time was 299.2 ± 133.5 (range 70-540) min and mean blood loss was 431.8 ± 309.0 (range 50-1100) ml. Nine patients required a blood transfusion (mean transfusion volume 597.2 ± 543.3 ml). There were no conversions to laparotomy. The mean hospital stay was 29.4 ± 9.1 (range 8-41) days. Pancreatic fistula occurred in 20 cases, anastomotic bleeding in three patients and anastomotic leakage in one patient. Two patients, one who received a PD and one who received a distal pancreatectomy, required a second surgery. All other complications were resolved with conservative management. Surgical margins were negative in all cases, with a postoperative histopathological diagnosis of malignancy. Eleven of the 13 patients with malignancies were alive and well without recurrence at the time of publication, while two patients died.Our series of 47 robot-assisted pancreatic resections adds further evidence that this technique is feasible and effective.

To analyze the cause of in-hospital death among acute myocardial infarction patients undergoing primary percutaneous coronary intervention (PPCI) in Beijing area to evoke better individualized preventive approach.In-hospital mortality and causes were analyzed based on database from Beijing percutaneous coronary intervention registry study (BJPCI Registry) in 2010.A total of 4660 PPCI patients from 48 hospitals were included. In-hospital mortality was 2.4% (n = 110). Cardiogenic shock (39.1%, 43/110), mechanical complications (28.2%, 31/110) and intervention-related complications [28.2%, 31/110: procedure related (n = 28), drug related (n = 3)] were the leading causes of in-hospital death. Five deaths was attributed to comorbidity related reason (4.5%, 5/110). The in-hospital mortality had no significant difference among hospitals of different grade or total annual PCI (all P0.05). In-hospital mortality was slightly higher in hospital with annual PPCI300 than in hospitals with annual PPCI ≥ 300 (2.9% vs. 1.8%, P0.05).Cardiogenic shock, mechanical complications and intervention-related complications are the main causes of in-hospital death among acute myocardial infarction patients receiving PPCI.

To compare the outcomes of anterior verus posterior instrumentation under different surgical procedures in the surgical management of thoracolumbar spinal tuberculosis (TB).Between January 2004 and December 2009, 241 adult patients with thoracolumbar spinal TB underwent radical debridement and strut grafting plus anterior or posterior instrumentation in single-stage or two-stages. The mean age was 39 years (range: 16 - 67). The mean follow-up period for 189 patients was 37 months (range: 22 - 72). Among them, 157 cases underwent3 weeks of chemotherapeutic regimen of isoniazid, rifampin, pyrazinamide and ethambutol and the remaining 32 were operated for neurological impairment after 6-18 h with the same chemotherapeutic regimen. Except for 8 patients with skip lesions undergoing hybrid anteroposterior instrumentation, anterior instrumentation was utilized in 74 patients (Group A) and posterior instrumentation in 107 patients (Group B).In both groups, local symptoms of all patients were relieved significantly 1-3 weeks postoperatively. And 10/14 cases (71%) in Group A and 14/19 cases (74%) in Group B with neurological deficits had excellent or good clinical outcomes (P0.05). The levels of erythrocyte sedimentation rates (ESR) returned from 43.6 mm/h and 42.4 mm/h preoperatively to normal at 8-12 weeks postoperatively. Kyphosis degrees were corrected by a mean of 11.5° in Group A and 12.6° in Group B (P0.01). The correction loss was 6.8° in Group A and 6.1° in Group B at the last follow-up (P0.01). Fusion rates of the grafting bone were 92.5% and 91.8% respectively at the final follow-up (P0.05). Severe complications did not occur.Either anterior or posterior instrumentation can obtain good results in correction and maintenance of deformity, clearance of foci, decompression of spinal cord and pain relief in the treatment of thoracolumbar spinal TB as long as the surgical indications are properly selected. Posterior instrumentation may be superior to anterior instrumentation in the correction and maintenance of deformity.

BACKGROUND/AIMS Left-sided portal hypertension (LSPH) is an uncommon clinical syndrome which may lead to bleeding from isolated gastric varices and pancreatitis is the most common etiology. Despite the particular rare incidence of LPSH caused by malignant tumor, the optimal management remains undefined. METHODOLOGY From January 2006 to December 2009, a total of 8 patients of left-sided portal hypertension caused by malignancies were admitted into the department of surgery of our hospital. Medical records of those patients were retrieved and analyzed, including etiologies, clinical presentations, diagnostic methods and surgical approaches. RESULTS Of current series, pancreatic tumors (5/8) and retroperitoneal tumors (3/8) were the primary etiologies. Those patients mainly presented with upper gastrointestinal bleeding or irregular left upper abdominal pain and isolated gastric varices became important clinical evidence. All those patients were performed multi-visceral resection. No recurrent upper gastrointestinal bleeding occurred during the follow-up period and three patients died 6, 18 and 21 months postoperatively. CONCLUSIONS Although LSPH caused by malignant tumor is uncommon and difficult to deal with, deliberate evaluation of preoperative CT images will ensure the success of an aggressive multi-visceral resection and the prognoses in those patients are relatively promising.

To construct a recombinant lentiviral vector for p38 MAPK and establish a human prostatic carcinoma cell line that stably expresses p38 MAPK.EGFP/p38 fusion gene was subcloned into the lentiviral vector pTYF- EF1α-IRES-EGFP. The recombinant lentiviral vector pTYF-EF1α-EGFP/p38 was indentified by restriction enzyme digestion, and packaged in HEK 293T cells using lipofectamintm2000 with the packaging plasmid psPAX2 and envelope plasmid pMD2.G. The viral titer was tested according to the expression level of GFP. The resulting recombinant lentiviral vector was transduced into human prostatic carcinoma DU145 cells, and stably transduced cells were selected by limiting dilution analysis. The intracellular expression level of total p38 was detected by Western blotting and the cell growth curve was drawn.DNA restriction enzyme digestion demonstrated that the recombinant lentiviral vector of the fusion gene EGFP/p38 (pTYF-EF1α-EGFP/p38) was constructed successfully. The recombinant lentiviral vector was packaged in 293T with a viral titer of 4.7×10(6) TU/ml. A stable cell line, EGFP/p38-DU145, was established, which stably expressed exogenous EGFP/p38 MAPK fusion protein as detected by Western blotting and showed a lowered growth rate compared to the control cells.We have successfully constructed a recombinant lentiviral vector of the fusion gene EGFP/p38 and established a stable cell line EGFP/p38-DU145. Overexpression of p38 has a significant inhibitory effect on the proliferation of DU145 cells in vitro.

Primary percutaneous coronary interventions (PCI) have been proposed as a novel superior management strategy in patients with ST elevation myocardial infarction (STEMI). This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, the neutrophil/lymphocyte (N/L) ratio is a predictor of long-term prognosis.We analyzed 551 consecutive STEMI patients treated with primary PCI at a single university center. Patients were stratified according to quartiles of the mean neutrophil/lymphocyte ratio.Kaplan-Meier survival analysis showed a cumulative eight-year survival of 94.2% in the first quartile, 92.0% in the second quartile, 91.3% in the third quartile, and 75.4% in the fourth quartile (P0.001 by log rank). Relative to patients in the other three lower N/L ratio quartiles, patients in the highest quartile were more than four times more likely to die during hospitalization (P0.001) and during long-term follow-up (P0.001). By multivariate Cox regression analysis including baseline demographic, clinical, and angiographic covariables, the N/L ratio in the highest quartile remained an independent predictor of mortality (hazard ratio 2.38, 95% confidence interval (CI) 1.42 to 3.98; P = 0.001).The neutrophil/lymphocyte ratio is a strong independent predictor of long-term mortality after ST elevation myocardial infarction treated with very early revascularization.

By measuring left ventricular diastolic function and arterial stiffness, this study aims to probe into the effect of diabetes mellitus (DM) on left ventricular diastolic function and arterial stiffness, and evaluate the correlation between left ventricular diastolic function and arterial stiffness.Seventy-six inpatients were enrolled. According to their coronary angiography, OGTT test results and past history of DM, patients were divided into controlled, CHD (coronary heart disease with no DM), and CHD + DM groups. Through invasive hemodynamic monitoring during left ventricular angiography, left ventricular end-diastolic pressure (LVEDP) and tau index were collected. Carotid-femoral pulse wave velocity (c-f PWV), reflected wave augmentation index (AIx@75) and other data reflecting the degree of arterial stiffness were collected bedside with non-invasive means. SPSS 18.0 was used for statistical analysis.No significant difference was found between groups for LVEDP, tau index, and AIx@75. In terms of c-f PMV, The CHD + DM group (8.79 ± 1.59) cm/s differed significantly from the CHD group (7.43 ± 1.42) cm/s and the controlled group (6.83 ± 1.14) cm/s. No correlations were found between c-f PMV and LVEDP or tau index. A positive correlation was found between AIx@75 and tau index.Compared with the controlled group and CHD patients with no DM, CHD + DM patients show worse arterial stiffness with no difference in ventricular diastolic function. There is a positive correlation between arterial stiffness and diastolic dysfunction.

The induced expression of heme oxygenase-1 (HO-1) in donor islets improves allograft survival. Cobalt protoporphyrin (CoPP) could significantly enhance the expression of HO-1 mRNA and protein in rat islet safely. Our work was to study how to protect pancreatic islet xenograft by CoPP-induction.Islet xenografts treated with CoPP-induction and CoPP + Zinc protoporphyrin (ZnPP) in vitro and in vivo were randomly transplanted into murine subrenal capsule; then the graft survival time was compared by blood glucose level and pathological examination and meanwhile the interferon γ (IFN-γ), tumor necrosis factor α (TNF-α), interleukin 10 (IL-10) and IL-1β level in serum and their mRNA and HO-1 mRNA and protein expression were examined.Islets with CoPP-induction under low- and high-glucose stimulation exhibited much higher insulin secretion compared with other three groups. CoPP-induction could increase higher expression of HO-1 (mRNA: 3.33- and 76.09-fold in vitro and in vivo; protein: 2.85- and 58.72-fold). The normoglycemia time in induction groups ((14.63 ± 1.19) and (16.88 ± 1.64) days) was significantly longer. The pathological examination showed less lymphocyte infiltration in induction groups. The IL-10 level and its mRNA in induction groups were significantly higher.The HO-1 induced by CoPP would significantly improve function, prolong normoglycemia time and reduce lymphocyte infiltration. Meanwhile CoPP-induction in vivo had more beneficial effects than in vitro. Its mechanism could be related to immune-modulation of IL-10.

Peroxisome proliferator-activated receptor-gamma (PPARgamma) is a member of the nuclear hormone receptor superfamily which affects organic fibrosis. The aims of the study were to approach the effects of activation of the PPARgamma signal pathway on cardiac fibrosis in diabetic rats, and also the effects on cardiac remodeling and function. Type 1 diabetic models were used in the study. All the animals were divided into 3 groups: I: control group; II: diabetic group; III: diabetes+Pioglitazone (Piog, a PPARgamma ligand) administration group. After 14 weeks of feeding, general condition, fibrosis indices, echocardiography and interventricular pressures parameters were detected. At the 14th week, compared with group I, the hydroxyproline concentration in group II significantly increased, and CO I and III distribution was more obvious by sirius red staining. Reduction of LVSP (left ventricular systolic pressure) and increase of LVEDP (left ventricular end-diastolic pressure) were also significant in group II. But these situations were changed by the administration of Piog in group III. Furthermore, results of RT-PCR and immunohistochemistry showed that Piog administration reduced angiotensin II type 1 receptor (AT1-R) expression in diabetic models. Hence, activation of the PPARgamma signal pathway could repress cardiac fibrosis in diabetic rats, and partly improve cardiac remodeling and function by down-regulating activity of RAS at the receptor level.

To evaluate the surgical indications and clinical effectiveness of different operative procedures in the treatment of lower lumbar tuberculosis.From June 2001 to Oct 2008, 72 patients with lower lumbar tuberculosis were treated by different operative procedures. Including 38 males and 34 females, with an average age of 38.5 years old ranging from 16 to 70 years. The average duration of symptom was 6.8 months (ranging from 4 months to 2 years). A single vertebrae was involved in 10 patients,two contiguous vertebrae in 50 cases and three vertebrae in 12 cases. The average preoperative lordotic angle was 13.1 degree (ranging from -5.0 degrees to 34.0 degrees). Three different operative procedures included: (1) posterior debridement and posterolateral fusion and posterior instrumentation in 28 patients; (2) anterior radical debridement and anterior fusion and anterior instrumentation in 32 patients; (3) image-guided percutaneous drainage (PCD) of tuberculous abscesses in 12 patients. The selection of the procedure was made according to the degree of the lesions. The resolution of inflammatory process, bony fusion, correction of sagittal angles and JOA scores were used for evaluating the result of the surgery and the complications were analyzed.All patients were followed up from 1.5 to 8.0 years (means 3.6 years). PCD was an effective treatment in 11 out of the 12 patients, one required surgical debridement and fusion. Among them, 57 (95%, 57/60) patients were treated by open operation showed successful bony fusion. The complications maily included common iliac vein injury in 3 patients, dural tear in 2 patients, they were all cured by intro-or postoperative treatment. The average immediate post-operative lordotic angle was 27.3 degree (35.0 degrees to 16.0 degrees), the average lordotic angle was 25.6 degree (33.0 degrees to 15.0 degrees) at final follow-up. Preoperatively and at final follow-up, JOA scores were respectively (15.2 +/- 3.4), (25.6 +/- 2.4) (P0.01).Different operative procedures should be selected to treat lower lumbar tuberculosis according to the degree of lesions. Aggressive surgical treatment was found helpful in the resolution of inflammatory process and correcting the loss of lordosis, preventing progression of kyphosis.

There are few articles in the literature comparing outcomes between anterior and posterior instrumentation in the management of thoracic and lumbar spinal tuberculosis (TB).Between January 2004 and December 2009, 217 adult patients, average age 39 (range 16-67) years with thoracic and lumbar spinal TB were treated by anterior radical debridement and fusion plus instrumentation, anterior radical debridement with fusion and posterior fusion with instrumentation, posterolateral debridement and fusion plus posterior instrumentation or transpedicular debridement and posterior fusion with instrumentation in a single- or two-stage procedure. We followed up 165 patients for 22-72 (mean 37) months. Of these, 138 underwent more than three weeks chemotherapy with isoniazid, rifampin, pyrazinamide and ethambutol, and the remaining 27 underwent operation for neurological impairment within six to 18 hours of the same chemotherapy regimen. In no case did relapse occur. Apart from eight patients with skip lesions treated by hybrid anterior and posterior instrumentation, anterior instrumentation was used in 74 patients (group A) and 83 patients (group B) were fixed posteriorly.In both groups, local symptoms were relieved significantly one to three weeks postoperatively; ten of 14 patients (71%) in group A and 14 of 19 (74%) in group B with neurological deficit had excellent or good clinical results (P0.05). Erythrocyte sedimentation rates (ESR) returned from 43.6 mm/h and 42.7 mm/h, respectively, preoperatively to normal levels eight to 12 weeks postoperatively. Kyphosis degree was corrected by a mean of 11.5° in group A and 12.6° in group B, respectively (P0.01). Correction loss was 6.8° in group A and 6.1° in group B at the last follow-up (P0.01). Fusion rates of the grafting bone were 92.5% and 91.8%, respectively, at final follow-up (P0.05). Severe complications did not occur.These results suggest that both anterior and posterior instrumentation attain good results for correction of the deformity and maintaining correction, foci clearance, spinal-cord decompression and pain relief in the treatment of thoracic and lumbar spinal TB providing that the operative indication is accurately identified. However, the posterior approach may be superior to anterior instrumentation to correct deformity and maintain that correction.

Diabetic nephropathy is a major cause of renal failure in diabetes mellitus (DM). It has been known that renin-angiotensin system (RAS) blockers have a renal protective effect. This study aimed to investigate whether treatment with angiotensin II receptor blocker, olmesartan, could modify renal hemodynamic variables and vascular structural properties, then attenuate renal injury in streptozotocin (STZ)-induced DM rats.DM was induced in male Wistar rats by intraperitoneal administration of STZ. The rats were then randomized to a DM group and an olmesartan treatment (OLM + DM) group. The normal group (non-DM) were administered only citrate buffer. At the end of the 14th week, blood glucose, kidney weight/body weight and urinary protein-to-creatinine ratio were determined. Further, the flow-pressure and pressure-glomerular filtration rate (GFR) relationships were determined for maximally vasodilated, perfused kidneys. From the relationship, 3 indices of vascular structural properties were estimated: slope of flow-pressure (minimal renal vascular resistance, reflecting overall luminal dimensions of preglomerular and postglomerular vasculature), slope of pressure-GFR (glomerular filtration capacity against pressure) and threshold pressure for beginning filtration at pressure-GFR (preglomerular to postglomerular vascular resistance ratio). Kidneys were then perfusion fixed for histological analysis. The renal histopathology was observed by light microscopy.The body weight of DM rats was lower than that of non-DM rats. Blood glucose, kidney weight/body weight, urinary protein-to-creatinine ratio were significantly greater in DM rats than in non-DM rats. The parameters such as kidney weight/body weight, urinary protein-to-creatinine ratio in OLM + DM rats had dramatically decreased compared with those in DM rats. However, the treatment with olmesartan had no effect on blood glucose levels. The slope of flow-pressure relationship was greater in DM rats than that in non-DM rats (P0.05). But the slope of the pressure-GFR relationship was lower in DM rats than that in non-DM rats (P0.05) with the x-intercept of the line similar between the two groups. The slope of the flow-pressure relationship was decreased in DM rats group treated with olmesartan (P0.05). Moreover, olmesartan significantly increased the slope of the pressure-GFR relationship in DM rats (P0.05). The x-intercept of the pressure-GFR relationship reduced following olmesartan in DM rats.Treatment with olmesartan reduced urinary protein-to-creatinine ratio independent of blood glucose and increased average renal vessel lumen diameter in the perfused kidneys of STZ-induced DM rats, predominantly in preglomerular vessels, and then improved renal excretory capability. These findings were consistent with remodeling of the preglomerular vasculature in our hisological measurements.

To determine whether the combination of traditional risk factors and quantitative coronary angiography (QCA) assessment could provide accurate prognostic information on a population-based study including 1137 adults with subclinical artherosclerosis and with coronary risk factors.Participants underwent coronary angiography examination before the minimal stenotic diameters, segment diameters, percent stenosis, plaque areas. Other parameters were analyzed by the computer-assisted Coronary Angiography Analysis System. The Framingham Risk Score for each participant was assessed. During the 1 year follow-up period, all kinds of endpoint cardiovascular events were screened. Endpoint events were defined as death from coronary heart disease, nonfatal myocardial infarction (MI) or unstable angina pectoris.During the 1 year of follow-up period, a total of 124 participants developed an endpoint event, which was significantly associated with the Framingham Risk Score, calcium of plaques and the plaque areas (all Ps0.05). The QCA score incorporated with the QCA parameters was related to the endpoint events. The Framingham Risk Score was combined with QCA score through logistic regression for prediction of end-point events. Data from the ROC analysis showed the accuracy of this prediction algorithm was superior to the accuracy when variables themselves were used. The event-free survival rate was inferior to the control group in participates under high risk, when being screened with this prediction algorithm (P0.05).The risk of cardiovascular attack in subclinical artherosclerosis individual seemed to be associated with the Framingham Risk Score, calcium of plaques and the plaque areas. When the traditional risk factors (the Framingham Risk Score) were combined with QCA, the new method could provide more prognostic information on those adults with subclinical artherosclerosis.

To describe a new variation of the recurrent laryngeal nerve (RLN) at its entry to larynx.A retrospective study including 3 078 consecutive cases received thyroidectomy was performed from January 1998 to December 2008. The age ranged from 15 to 82 years, 2 395 cases were female and 683 cases were male. A total of 4 241 RLNs were exposed successfully for avoiding the injury of the nerve. A kind of variation of the RLN was reported in this study.Forty-four varied RLNs were identified at the entry into the larynx (1.0%, 44/4241). Variation happened at the truck or the branches of RLN entering the larynx far from the posterior cricothyroid joints. The distance from the entry to the back of cricothyroid joints was over 5 mm. Among these, eight RLNs (23.5%, 8/34) walked distally from the dorsal cricothyroid joint without extra laryngeal branches and entered the larynx at the abnormal point. There were four different kinds of sub-variations identified: type I: there was no branch in RLN and the varied RLN entered the larynx far from the posterior cricothyroid joints, total 35 cases (79.6%, 35/44); type II: there were two branches in RLN, one branch entered the larynx at the posterior cricothyroid joints and the other far from the posterior cricothyroid joints, total 5 cases (11.4%, 5/44); type III: there were two branches in RLN, and both branches entered the larynx far from the posterior cricothyroid joints, total 3 cases (6.8%, 3/44); type IV: there were three branches in RLN, the lateral branch of the varied RLN entered the larynx far from the posterior cricothyroid joints, total 1 case (2.2%, 1/44). Four varied RLNs were injured during the operation (9.1%, 4/44).The variation of RLN reported in this study is more dangerous and should be paid more attention to lower the injury of the nerve.

To evaluate the feasibility and surgical procedure of bone grafting with elastic trephine.A total of 42 cases of thoracolumbar fracture received pedicle screw fixations by combining bone grafting with elastic trephine through pedicle of fractured vertebra. The ratios of the altitude of traumatic vertebra to normal altitude, kyphosis Cobb angle and sagittal index were measured by preoperative and postoperative X-ray images.A follow-up visit of 12-26 months (average: 14.8) showed that the dislocations of vertebrae were corrected and fusions completed. Proportion of the height of anterior edge of traumatic vertebra to normal height was (53.89 ± 6.57)% at pre-operation, (92.31 ± 11.25)% at post-operation and (91.39 ± 10.28)% at an one-year follow-up (P0.05). The kyphosis was (23.19 ± 5.74)° Cobb angle at pre-operation, (4.92 ± 1.03)° at post-operation and (5.13 ± 1.41)° at an one-year follow-up (P0.05). In contrast with 86% (78%-97%) on average at post-operation, the pre-operative sagittal index was 54% (32%-66%) on average.Application of bone grafting with elastic trephine can reconstruct the altitude of injured vertebral body, increase the compressive stability of anterior column as well as effectively correct the kyphosis deformity. With a convenient application, elastic trephine plays a variety of roles in both auxiliary reduction and bone grafting reconstruction.