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Objective: To analyze the clinical effect of therapeutic plasma exchange (TPE) on 43 patients in the Three Gorges Area., Methods: Plasma was collected by machine and combined with low-molecular-weight dextran and albumin for use as a replacement fluid for TPE treatment of 43 patients suffering from various blood disorders, diseases of the nervous system, ABO incompatible allogeneic hematopoietic stem cell transplantation and kidney disease., Results: The volume of a single TPE was 1.6-2.0l, performed on average 2.3 times/case, and effective in 88.4% (38/43) of cases., Conclusion: TPE through the plasma collection machine is a well tolerated, economic and effective treatment., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Objective: The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods: We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results: This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females (p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients (p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions: Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China. [ABSTRACT FROM AUTHOR]

Combination therapy with parathyroid hormone (PTH) analogs and antiresorptive agents may be more effective than monotherapy for the treatment of osteoporosis. This study aimed to estimate the effectiveness and safety of this combination therapy for osteoporosis. MEDLINE, EMBASE, and Cochrane Library were searched from inception to May 1, 2018, including randomized controlled trials (RCTs) with a duration of at least 6 months on adults with osteoporosis treated with combination therapy versus monotherapy. Outcomes included fractures, bone mineral density (BMD) changes, and adverse events. A meta-analysis was performed using a random-effect model, to estimate risk ratios (RRs) for fractures, and mean differences (MDs) for BMD changes. A total of 19 RCTs and 2177 patients were included. Compared with monotherapy, combination therapy had an advantage of 36% (RR, 0.64; 95% confidence interval (CI), 0.42-0.98) regarding fracture risk reduction. It also appears to improve lumbar spine BMD by 4.06% (95%CI = 2.60-5.53) and total hip BMD by 1.89% (95%CI = 1.25-2.53). No RCT reported an increased risk of serious adverse events. Among patients with osteoporosis, combination therapy was superior to monotherapy regarding improvement of the lumbar spine and total hip BMD, without risk of serious adverse events. Combination therapy also had an advantage over monotherapy on fracture risk reduction. However, owing to the limited sample size, additional larger studies are required to confirm this benefit. [ABSTRACT FROM AUTHOR]

Summary: What is known and objectives: Different population pharmacokinetics (PPK) models of tacrolimus have been established in various populations. However, the tacrolimus PPK model in paediatric systemic lupus erythematosus (PSLE) is still undefined. This study aimed to establish the tacrolimus PPK model in Chinese PSLE. Methods: A total of nineteen Chinese patients with PSLE from real‐world study were characterized with nonlinear mixed‐effects modelling (NONMEM). The impact of demographic features, biological characteristics, and concomitant medications was evaluated. Model validation was assessed by bootstrap and prediction‐corrected visual predictive check (VPC). Results: A one‐compartment model with first‐order absorption and elimination was determined to be the most suitable model in PSLE. The typical values of apparent oral clearance (CL/F) and the apparent volume of distribution (V/F) in the final model were 2.05 L/h and 309 L, respectively. Methylprednisolone and simvastatin were included as significant. What is new and conclusion: The first validated tacrolimus PPK model in patients with PSLE is presented. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSMF), a potentially malignant oral cavity disorder that causes speech and mastication problems, lacks an established treatment regimen; moreover, no treatment can effectively reverse the course of OSMF. A meta‐analysis was conducted to investigate the efficacy of the peripheral vasodilator, pentoxifylline, in the treatment of OSMF. We searched five different databases for studies meeting our eligibility criteria (up to June 30, 2017). Statistical analyses were performed using RevMan 5.3 software. Three randomized controlled trials (247 OSMF patients) were selected. Pentoxifylline increased the objective sign maximal mouth opening (MMO; WMD: −4.59, 95% CI: −8.65, −0.53; p < 0.05) following short‐term (under 1 month; WMD: −1.94, 95% CI: −3.12, −0.77; p < 0.05) and long‐term (over 1 month; WMD: −5.44, 95% CI: −6.81, −4.07; p < 0.05) application. Pentoxifylline improved the subjective symptom burning sensation (WMD: −0.11, 95% CI: −0.17, −0.05; p < 0.05) only following long‐term application (WMD: 0.42, 95% CI: 0.18, 0.96; p < 0.05). The efficacy on MMO and burning sensation increased with time. Although OSMF lacks definitive treatment modalities, our meta‐analysis shows that pentoxifylline effectively improves the objective signs and subjective symptoms of OSMF and its therapeutic efficacy increases with time. [ABSTRACT FROM AUTHOR]

Reliable markers for the rapid discrimination of severe renal damage remain a vital concern for lupus nephritis (LN). To determine a better tool for kidney damage detection, the present study compared the evaluation ability of novel urinary cytokines and chemokines (namely urinary monocyte chemoattractant protein 1 (uMCP-1), tumor necrosis factor-like weak inducer of apoptosis (uTWEAK)) with traditional serum or urinary markers (namely urinary alpha 1-microgrobulin (uα1-MG), beta 2-microglobulin (uβ2-MG) and serum complement C3 (C3), complement C4 (C4), creatinine (Cr), blood urea nitrogen (BUN) and cystatin C (Cys C)) in discriminating LN renal damage. Correlations between markers with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) renal SLEDAI scores, biopsy activity index (BAI) and biopsy chronicity index (BCI) scores were evaluated. Receiver operating characteristic (ROC) curves were generated to evaluate a single or combined model in discriminating active renal involvement (rSLEDAI scores > 0) and patients with poor pathological outcome (BAI scores ≥ 7). uMCP-1 and uTWEAK possess higher correlation coefficients with renal damage and larger areas under ROC curves (AUCs) than other markers. A combined model of uMCP-1 and uTWEAK showed an AUC of 0.887, sensitivity of 86.67% and specificity of 80.00% to discriminate active LN, and an AUC of 0.778, sensitivity of 75.00% and specificity of 81.82% to discriminate LN with poor outcome, which are better than the utility of any markers individually. [ABSTRACT FROM AUTHOR]

Pityriasis rosea (PR), a skin rash, causes substantial discomfort in patients. There is a lack of effective therapies for PR. A combination of ultraviolet irradiation and indigo naturalis treatment has been shown to be a safe and effective regime for control of PR; however, the data have been largely inconsistent. Tis meta-analysis further evaluated the efficacy and safety of this combination in patients with PR. The PubMed, Embase, Cochrane Library, CNKI, VIP, and Wan Fang databases were searched for relevant RCTs of this combination therapy in patients with PR. A total of eight studies with a combined study population of 688 patients published between January 2006 and March 2016 were eligible for this meta-analysis. The RevMan 5.3 software was used for the meta-analysis. The regimen of compound indigo naturalis plus NB-UVB showed much better control of PR as compared to that achieved with use of compound indigo naturalis or NB-UVB alone in terms of cure rate or effective rate. However, no significant difference was observed between the two with respect to incidence of adverse effects. The analysis was affected by publication bias as revealed by funnel plot analysis. Further studies with large sample sizes are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Our aim was to differentiate IgG4-related sialadenitis, primary Sjögren syndrome, and chronic obstructive submandibular sialadenitis by analysing clinical, radiographic, and pathological features. Fifty-five patients, 50, and 50 were enrolled, respectively and their baseline characteristics and serological, sialographic, and pathological findings compared. The male:female ratio for IgG4-related sialadenitis was 1:1.2 for primary Sjögren syndrome 1:15.7, and for chronic obstructive submandibular sialadenitis1:0.92. Numbers with enlarged salivary glands were 55, 16, and 50; with xerostomia 26, 48, and 0; with a history of allergy 26, 4, and 6, and with coexisting systemic disease 12, 19, and 0 (p = 0.14). Mean (SD) serum IgG4 concentrations were 109.1 (97.9), 4.9. (1.9) g/L, and 5.3 (1.6) g/L, p < 0.001 in all cases. Sialography showed enlargement of the gland, dilatation of the duct, and slightly decreased secretory function in IgG4-related disease; obvious sialectasia and decreased secretory function in Sjögren syndrome; and dilatation of Wharton’s duct and filling defects in obstructive sialadenitis. Histopathological examination showed lymphoplasmacytic infiltration with storiform fibrosis, lymphoplasmacytic inflammation and lymphoepithelial lesions, and dilatation of the duct with epithelial metaplasia in the three groups, respectively. The number of IgG4-positive plasma cells was 123 (45)/HPF, 8 (3)/HPF, and 5 (4)/HPF, while the IgG4-/IgG-positive cell ratio was 71.7 (13.9)%, 4.6 (2.5)%, 18.9 (19.7)%, respectively (p < 0.001). The three conditions have different clinical, radiographic, and pathological features that provide important clues to the differential diagnosis. Serological and histological tests are important, and comprehensive consideration is necessary. [ABSTRACT FROM AUTHOR]

Aims Nonthermal plasma agents (reactive species and charged particles) are generally generated together. Previous studies of nonthermal plasma agents did not investigate the role of a microbial inactivation agent without interference from other agents. Consequently, the exact mechanism underlying their activity remains unclear. The present experiment was conducted to study the mechanism underlying Escherichia coli inactivation by nonthermal plasma. Methods and Results The mechanism underlying E. coli inactivation by charged particles was studied using pure argon plasma. Results showed that cell wall damage owing to strong electrostatic forces did not occur during direct current ( DC) plasma treatment with Ar or N2. Next, the inactivation effects of excited [ABSTRACT FROM AUTHOR]

Proteinuria is the hallmark of clinical manifestation of disease activity in lupus nephritis (LN) patients, which arises from direct or indirect podocyte injury. This study is to explore the relationship between intrarenal T cell infiltration and podocyte injury in lupus nephritis (LN), and to understand the potential mechanisms of podocyte injury induced by intrarenal T cells. Sixty renal biopsies from patients diagnosed with LN were included in the present study. Histological changes in LN patients were detected by light and electron microscopy. Podocyte-specific nephrin expression in renal tissues was detected by immunofluorescence. Infiltration of T cells (CD3+ cells), infiltration of macrophages (CD68+ cells) and the expression of osteopontin (OPN) in renal tissues were examined by immunohistochemical staining. Pearson or Spearman’s tests were used to perform correlation analysis. Morphologic lesions of podocytes were more severe in LN patients than in normal control subjects. Compared with normal control subjects, nephrin expression was significantly decreased in LN patients. The expression level of nephrin was significantly lower in active LN patients than in the inactive group of patients (P < 0.05). Compared with normal control subjects, the number of infiltrated intrarenal T cells and macrophages was significantly increased in LN patients. T cells were mainly distributed in renal interstitium, with very few being in glomeruli, while macrophages were mainly located in glomeruli. The number of intrarenal infiltrated T cells and macrophages in active LN patients was more than that in the inactive group (P < 0.05). Compared with normal control subjects, OPN expression in LN patients was increased significantly. The expression level of OPN in active LN patients was significantly higher than that in the inactive group (P < 0.05). Podocyte-specific nephrin was negatively correlated with 24-hour proteinuria, intrarenal T cells infiltration and intrarenal OPN expression in LN patients (P < 0.001). Intrarenal macrophages had significantly positive correlation with intrarenal OPN expression (P < 0.001). The present study provides possible links between intrarenal T cells, OPN, macrophages with reduced podocyte-nephrin and podocytopathy in systemic lupus erythematosus. In addition, infiltration of macrophages in glomeruli induced by OPN that is induced by T cells may be a crucial mechanism for podocyte injury. [ABSTRACT FROM AUTHOR]

BackgroundTo date, there has been no large-scale survey of geriatric depression (GD) involving both rural and urban areas in China using standardized assessment tools and diagnostic criteria. This study aimed to determine the 12-month and lifetime prevalence rates of GD and sociodemographic correlates in urban and rural regions of Beijing, China.MethodA total of 1601 elderly patients (aged ?60 years) were randomly selected and interviewed in Beijing using the Composite International Diagnostic Interview (CIDI 1.0). Basic sociodemographic and clinical data were also collected during the interviews.ResultsThe overall 12-month prevalence of GD was 4.33%, and the 12-month prevalence rates for men and women were 2.65% and 5.83% respectively. The overall lifetime prevalence of GD was 7.83%, and lifetime prevalence rates for men and women were 4.65% and 10.66% respectively. Female sex, lower educational level, monthly income, rural abode, and the presence of one or more major medical conditions were associated with increased risk of GD. Of the GD subjects interviewed, 25.2% were receiving some type of treatment, with only 4.7% preferring to seek treatment from mental health professionals.ConclusionsAlthough still relatively low by international standards, there is an increasing trend in the prevalence of GD in China. The low percentage of subjects treated for GD is a major public health concern that should be addressed urgently. [ABSTRACT FROM AUTHOR]

BackgroundIt remains unclear whether the topological deficits of the white matter network documented in cross-sectional studies of chronic schizophrenia patients are due to chronic illness or to other factors such as antipsychotic treatment effects. To answer this question, we evaluated the white matter network in medication-naive first-episode schizophrenia patients (FESP) before and after a course of treatment.MethodWe performed a longitudinal diffusion tensor imaging study in 42 drug-naive FESP at baseline and then after 8 weeks of risperidone monotherapy, and compared them with 38 healthy volunteers. Graph theory was utilized to calculate the topological characteristics of brain anatomical network. Patients’ clinical state was evaluated using the Positive and Negative Syndrome Scale (PANSS) before and after treatment.ResultsPretreatment, patients had relatively intact overall topological organizations, and deficient nodal topological properties primarily in prefrontal gyrus and limbic system components such as the bilateral anterior and posterior cingulate. Treatment with risperidone normalized topological parameters in the limbic system, and the enhancement positively correlated with the reduction in PANSS-positive symptoms. Prefrontal topological impairments persisted following treatment and negative symptoms did not improve.ConclusionsDuring the early phase of antipsychotic medication treatment there are region-specific alterations in white matter topological measures. Limbic white matter topological dysfunction improves with positive symptom reduction. Prefrontal deficits and negative symptoms are unresponsive to medication intervention, and prefrontal deficits are potential trait biomarkers and targets for negative symptom treatment development. [ABSTRACT FROM PUBLISHER]

Rationale and objectives: Alpha-1 adrenoceptor antagonists, such as prazosin, show promise in treating alcoholism. In rats, prazosin reduces alcohol self-administration and relapse induced by footshock stress and the alpha-2 antagonist yohimbine, but the processes involved in these effects of prazosin are not known. Here, we present studies on the central mechanisms underlying the effects of prazosin on yohimbine-induced reinstatement of alcohol seeking. Methods: In experiment 1, we trained rats to self-administer alcohol (12 % w/ v, 1 h/day), extinguished their responding, and tested the effects of prazosin, administered ICV (2 and 6 nmol) or systemically (1 mg/kg) on yohimbine (1.25 mg/kg)-induced reinstatement. In experiment 2, we determined potential central sites of action by analyzing effects of prazosin (1 mg/kg) on yohimbine (1.25 mg/kg)-induced Fos expression. In experiment 3, we determined the effects of doxazosin (1.25, 2.5, and 5 mg/kg), an alpha-1 antagonist with a longer half-life on yohimbine-induced reinstatement. Results: Yohimbine-induced reinstatement of alcohol seeking was reduced significantly by ICV and systemic prazosin (50 and 69 % decreases, respectively). Systemic prazosin reduced yohimbine-induced Fos expression in the prefrontal cortex, accumbens shell, ventral bed nucleus of the stria terminalis, and basolateral amygdala (46-67 % decreases). Doxazosin reduced yohimbine-induced reinstatement of alcohol seeking (78 % decrease). Conclusions: Prazosin acts centrally to reduce yohimbine-induced alcohol seeking. The Fos mapping study suggests candidate sites where it may act. Doxazosin is also effective in reducing yohimbine-induced reinstatement. These data provide information on the mechanisms of alpha-1 antagonists on yohimbine-induced alcohol seeking and indicate their further investigation for the treatment of alcoholism. [ABSTRACT FROM AUTHOR]

Cytoplasmic citrate serves as an important regulator of gluconeogenesis and carbon source for de novo lipogenesis in the liver. For this reason, the sodium-coupled citrate transporter (NaCT), a plasma membrane transporter that governs hepatic influx of plasma citrate in human, is being explored as a potential therapeutic target for metabolic disorders. As cytoplasmic citrate also originates from intracellular mitochondria, the relative contribution of these two pathways represents critical information necessary to underwrite confidence in this target. In this work, hepatic influx of plasma citrate was quantified via pharmacokinetic modeling of published clinical data. The influx was then compared to independent literature estimates of intracellular citrate flux in human liver. The results indicate that, under normal conditions, <10% of hepatic citrate originates from plasma. Similar estimates were determined experimentally in mice and rats. This suggests that NaCT inhibition will have a limited impact on hepatic citrate concentrations across species. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 43-year-old man who was diagnosed with Maffucci syndrome in which treatment using rapamycin to his multiple haemangiomas was not effective. It mentions the need for the syndrome to be treated at early detection and symptom relief using novel treatment options as rapamycin do not respond to the disease. It discusses Maffucci syndrome as nonhereditary, congenital, mesodermal dysplasia that shows multiple enchondromas and haemangiomas.

What is known and objective Opioid-induced constipation ( OIC) is one of the most common opioid-induced adverse effects. Pregnancy also predisposes to bowel dysfunctions due to the associated endocrine changes. Pregnant women are thus at greater risk of OIC. We review the non-pharmacologic and pharmacologic treatment options as a guide for achieving a clinically optimal strategy for the management of OIC during pregnancy. Methods The published literature was searched for current therapeutic options, including non-pharmacologic dietary modifications, laxatives, and the peripherally acting mu-opioid receptor antagonists ( PAMORAs). Each was assessed for efficacy and safety, particularly as they relate to pregnancy. Results and discussion Non-pharmacologic approaches such as dietary change are generally safe, but generally insufficient when used alone to control OIC in pregnancy. Laxatives (bulking, osmotic, stimulant) can be effective, but have potential adverse effects that might be particularly troublesome during pregnancy (e.g. electrolyte disturbances, dehydration, abdominal pain, and pulmonary oedema or hypermagnesaemia in the extreme). PAMORAs, which attenuate OIC without affecting opioid-induced analgesia, have been associated with only minimal side effects during the clinical studies to date. What is new and conclusions Conventional non-pharmacologic and pharmacologic options for the management of OIC in pregnancy are often suboptimal due to insufficient efficacy or adverse effects particularly troublesome during pregnancy. The PAMORA strategy appears to provide a safe and effective new option superior to conventional therapies for the management of OIC during pregnancy. [ABSTRACT FROM AUTHOR]

Aim To assess time to insulin initiation among patients with type 2 diabetes mellitus ( T2DM) treated with sitagliptin versus sulphonylurea as add-on to metformin. Methods This retrospective cohort study used GE Centricity electronic medical records and included patients aged ≥18 years with continuous medical records and an initial prescription of sitagliptin or sulphonylurea (index date) with metformin for ≥90 days during 2006-2013. Sitagliptin and sulphonylurea users were matched 1 : 1 using propensity score matching, and differences in insulin initiation were assessed using Kaplan- Meier curves and Cox regression. We used conditional logistic regression to examine the likelihood of insulin use 1-6 years after the index date for each year. Results Propensity score matching produced 3864 matched pairs. Kaplan- Meier analysis showed that sitagliptin users had a lower risk of insulin initiation compared with sulphonylurea users (p = 0.003), with 26.6% of sitagliptin users initiating insulin versus 34.1% of sulphonylurea users over 6 years. This finding remained significant after adjusting for baseline characteristics (hazard ratio 0.76, 95% confidence interval 0.65-0.90). Conditional logistic regression analyses confirmed that sitagliptin users were less likely to initiate insulin compared with sulphonylurea users [odds ratios for years 1-6: 0.77, 0.79, 0.81, 0.57, 0.29 and 0.75, respectively (p < 0.05 for years 4 and 5)]. Conclusions In this real-world matched cohort study, patients with T2DM treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add-on to metformin. [ABSTRACT FROM AUTHOR]

Navigation surgery in the mandible has rarely been reported because of the complexities of navigating a mobile structure. In this article, we present a simple and novel strategy for removal of a foreign body in the mandible using a navigation system. A female diagnosed with a foreign body in the left mandible underwent navigation surgery using a BrainLAB system. We used a special open splint fabricated with acrylic resin to successfully perform the mandibular navigation. This strategy may be appropriate for many types of mandibular navigation surgery. [ABSTRACT FROM AUTHOR]

Newly synthesized erythromycin derivatives were screened for synergy with oxacillin and other β-lactam antibiotics against methicillin-resistant Staphylococcus aureus ( MRSA). MRSA ATCC43300 and some clinically isolated MRSA were used. Several erythromycin derivatives were found to possess high synergism with oxacillin against MRSA. The newly synthesized erythromycin derivatives were also tested for their inhibitory effects against MRSA, either separately or in combination with oxacillin, using serial broth dilution, disc diffusion, Etest strips, growth curves and time-kill curves. A representative derivative, SIPI-8294, could potentiate almost all β-lactam antibiotics tested against the model strain MRSA ATCC43300 from 4 to 128 times and had synergism with oxacillin against 12 of 16 clinical isolates of MRSA under one-fourth of the minimum inhibitory concentration ( MIC) of the compounds. This is the first report on the synergistic activity of these new erythromycin derivatives. These findings provide a new choice for the treatment of infection caused by MRSA and lead us to further study the synergistic mechanism. Significance and Impact of the Study This study is the first report on the synergy of anti-MRSA between new erythromycin derivatives and β-lactam antibiotics in vitro. The results show that although the erythromycin derivatives have poor anti-MRSA effects alone, they possess high synergism with oxacillin against MRSA ATCC43300 and clinically isolated MRSA. These novel compounds can significantly reduce the dosage of β-lactam antibiotics against MRSA, while this synergistic effect is different from the combination of β-lactams and β-lactamase inhibitors. The research may provide a new choice for the treatment of infection caused by MRSA and be useful to the research and development of new combination of medicines. [ABSTRACT FROM AUTHOR]

The dissolution process of penicillin in normal saline and isotonic glucose solution was reported using a microcalorimeter. Both the integral and differential heats of solution were measured. The quantitative relationships between the amount of heat released and the quantity of dissolved penicillin were established. Meanwhile, the kinetics and the half-life of the dissolution processes as well as the enthalpy of solution, the entropy of dissolution, and the free energy of dissolution were determined. The results showed that a change of the solvent from normal saline to isotonic glucose solution had little effect on the half-life of penicillin in the dissolution process, and there was no significant difference between the stabilities of penicillin in isotonic glucose solution and normal saline. Moreover, the dissolution process of penicillin in isotonic glucose solution followed the first-order kinetics. These results could provide a theoretical basis for the clinical applications of penicillin. [ABSTRACT FROM AUTHOR]

Clinical endometritis is an important disease of dairy cattle and results in decreased reproductive performance. This disease is caused by contamination of the uterus with a broad spectrum of microorganisms after calving. In this study, staphylococcal isolates from the uterus of dairy cows with clinical endometritis were tested for their distribution of superantigen (SAg) genes and antimicrobial resistance. Between the 127 staphylococcal isolates collected in this study, 10 species were identified. The predominant strain identified was Staphylococcus aureus (n=53), followed by Staphylococcus saprophyticus (n=38) and Staphylococcus chromogenes (n=22). PCR analysis demonstrated that most isolates (63.0 per cent) harboured at least one SAg gene. The most commonly observed SAg gene and genotype was selj (38.6 per cent) and sec-selj-seln (24.0 per cent), respectively. Most isolates were resistant to penicillin (79.5 per cent), ampicillin (71.7 per cent), erythromycin (56.7 per cent), and tetracycline (52.0 per cent). PCR analysis demonstrated that the antimicrobial resistance determinants ermA, ermB, ermC, tetK, tetM and blaZ were detected in 0 per cent, 44.4 per cent, 51.4 per cent, 68.2 per cent, 13.6 per cent and 86.1 per cent of the erythromycin, tetracycline and β-lactam resistant isolates, respectively. There were 22 (17.3 per cent of all isolates) coagulase-negative staphylococci shown to be methicillin resistant. In the methicillin-resistant isolates, significant resistances to ampicillin, erythromycin and penicillin were observed (P<0.01). The results of this study demonstrate that staphylococci recovered from dairy cows with clinical endometritis contain an extensive and complex prevalence of SAg genes. Significant resistances to antibiotics were also seen, highlighting the need for the rational appliance of antibiotics in veterinary medicine. [ABSTRACT FROM AUTHOR]

Background: Insulin-like growth factor binding protein-2 (IGFBP-2) is significantly increased in the serum of patients with malignant gliomas. High plasma IGFBP-2 levels are correlated with poor prognosis in glioma patients. However, the exact role of exogenous IGFBP-2 in gliomas is unclear.Methods and Results: Using the MTT cell viability assay, cell cycle analysis, and the transwell migration assay, it was demonstrated that IGFBP-2 treatment stimulated proliferation and invasion in U87 and U251 cell lines and primary SU3 glioma cells. Western blot analysis and immunofluorescence staining revealed that IGFBP-2 promoted ERK phosphorylation and nuclear translocation. Moreover, blocking ERK activation using the inhibitor PD98059 markedly reduced the effects of IGFBP-2 in glioma cells. As IGFBP-2 has an integrin-binding domain, the contribution of integrin β1 to these IGFBP-2-mediated processes was examined. Neutralisation or knockdown of the expression of integrin β1 inhibited IGFBP-2-induced ERK activation, cell proliferation, and cell invasion. Significantly, IGFBP-2 induced temozolomide resistance in glioma cells in an integrin β1/ERK-dependent manner.Conclusions: Exogenous IGFBP-2 induces proliferation, invasion, and chemoresistance in glioma cells via integrin β1/ERK signaling, suggesting that targeting this pathway could represent a potential therapeutic strategy for the treatment of gliomas. The identification of this pathway in glioma progression provides insight into the mechanism by which serum IGFBP-2 levels can predict the prognosis of glioma patients. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the effects of aescin treatment in a rodent model treated with an experimentally induced varicocele. Experimental varicocele was induced by partial ligation of the left renal vein of rats. Aescin administration was performed daily for 4 weeks after the varicocele induction. Seven weeks later, a contrast-enhanced ultrasound was performed of the rats' testis to assess testicular blood flow. The animals were sacrificed, and H&E staining was then used to evaluate testicular pathological changes and polymorphonuclear leucocytes density. Cauda epididymal sperm counts and motility were evaluated. Blood was collected for the measurement of follicle-stimulating hormone, luteinising hormone and testosterone. Contrast-enhanced ultrasound showed that there were significant decreases in testicular blood flow in the aescin-treated groups compared with those in control varicocele group. Testicular oedema was detected in those rats treated with a varicocele but without aescin, while no oedema was found in the experimental group. H&E staining showed dysfunctional spermatogenesis in both cohorts; however, polymorphonuclear leucocytes density was significantly reduced in aescin-treated groups. There was an increase in sperm counts of the aescin-treated groups. Our study demonstrated that aescin could exert therapeutical effects on reversal of testicular lesions in varicocele rats. [ABSTRACT FROM AUTHOR]

Study design:A retrospective comparative study.Objectives:To compare clinical outcomes of surgery or non-operated treatment for mild cervical spondylotic myelopathy (CSM) patients with intramedullary increased signal intensity (ISI) on T2-weighted imaging (T2WI) of magnetic resonance imaging (MRI), related factors that may affect prognosis were explored.Methods:Data from 91 patients treated from July 2008 to June 2011 were retrospectively analyzed. The Japanese Orthopedic Association (JOA) recovery ratio was used to compare outcomes of surgery and non-operated treatment. Correlation and multiple linear regression analyses were performed between JOA recovery ratio and age, disease course, segmental lordosis, total range of motion (ROM), segmental ROM, local slip, extent of spinal cord compression or ISI type.Results:Patients were divided into two groups by therapy methods: Group A (n=53, 33 males, age 36-68 years) underwent anterior cervical decompression and fusion surgery, average follow-up 30.68±8.19 months; Group B (n=38, 14 males, age 28-76 years) received non-operated treatment, average follow-up 34.08±9.05 months. There were no significant differences in clinical outcomes between the two groups. There were significant correlations between JOA recovery ratio and clinical course (P<0.01) or segmental lordosis (P<0.01). Patients with shorter disease course and larger segmental lordosis have better clinical outcomes as shown by multiple linear regression analysis.Conclusion:For mild CSM patients with ISI on T2WI-MRI, there are no significant differences in clinical outcome between surgery and non-operated treatment during the short-term follow-up. Patients with shorter disease course and larger segmental lordosis have better clinical outcomes than those with longer course and segmental kyphosis. [ABSTRACT FROM AUTHOR]

To characterize of the constituents in rat urine after oral administration of Radix Astragali decoction, a HPLC-DAD-MS/MS technique had been developed. Urine collected from 0 to 24 h, after administration, was purified using a C18 solid-phase extraction cartridge, and then detected by an on-line MS/MS detector. By comparing the retention times and MS/MS data with those obtained from authentic compounds and the published data, a total of 11 compounds including six flavonoids, one dipeptide, one triterpenoid and three of their metabolites in urine were identified. Compounds daidzein, genistein, quercetin, L-asparamide-D-phenylalanine, 4,2′,4′-trihydroxychalcone, Astragaloside-IV, daidzein sulfate, and kaempferol sulfate were for the first time detected by HPLC-MS/MS technique in urine. The present research results success-fully narrowed the range of effective constituents to be found in Astragalus membranaceus and would be useful for the following action mechanism research of this traditional Chinese medicine in treating various diseases. [ABSTRACT FROM AUTHOR]

Background: Supplementation of individual micronutrient is inadequate for maintaining bone function because single micronutrient can not contribute significantly a positive remodeling balance. Objective: We developed the highly integrated, stably dietary multi-micronutrients with good bioavailability and low adverse effect on the improvement of bone consolidation in osteoporosis. Methods: The trace element-codoped calcium phosphate (teCaP) particles were prepared in the modified body fluid and carefully evaluated. Rats, aged 3 months, were ovariectomized and when 6 month intervened with the conditioned, low, moderate, and high teCaP diets. Results: The teCaP particles showed highly dissolvable in stomach juice-mimicing acidic solutions. Three months after intervention, the body weight increase showed remarkable differences among the low teCaP diet (∼52 g), moderate teCaP diet (∼34 g) and high teCaP diet (∼23 g) group. In particular, the intake of moderate teCaP greatly improved the retention of trace elements in femural bone for better protection against the skeletal weakening, and resulted in a significant increase of bone mineral density (104.06%) in comparison with the conventional high calcium plus vitamin D3 diet (Control group). Conclusions: These investigations improve our understanding of micronutrient retention on bone consolidation in osteoporotic bone tissue, and also provide new mild wet-chemical approach to prepare potent nutritionally effective edible complements to synergistically relieve bone degeneration and prevent osteoporosis. [ABSTRACT FROM AUTHOR]

Background and Objectives A minipool solvent/detergent (S/D; 1% TnBP/1% Triton X-45; 31°C) process was developed for viral inactivation of plasma and cryoprecipitate used for transfusion. The goal of this study was to determine the rate and extent of inactivation of dengue virus (DENV) during this process. Materials and Methods DENV-1 was propagated using C6/36 mosquito cells to an infectivity titre close to 9 log and spiked (10% v/v) into individual plasma and cryoprecipitate samples from two distinct donors. Samples were taken right after spiking and during viral inactivation treatment by 1% TnBP-1% Triton X-45 at 31°C. DENV-1 infectivity was assessed on Vero E6 cells by a focus-forming assay (FFA). Culture medium and complement-inactivated plasma were used as experimental controls. Experiments were done in duplicate. Results DENV-1 infectivity was 7·5 log in spiked plasma and 7·1 and 7·3 log in spiked cryoprecipitate. There was no loss of DENV-1 infectivity in the spiked materials, nor in the controls not subjected to S/D treatment. No infectivity was found in plasma and cryoprecipitate subjected to S/D treatment at the first time-point evaluated (10 min). Conclusion DENV-1 was strongly inactivated in plasma and cryoprecipitate, respectively, within 10 min of 1% TnBP/1% Triton X-45 treatment at 31°C. These data provide a reassurance of the safety of such S/D-treated plasma and cryoprecipitate with regard to the risk of transmission of all DENV serotypes and other flaviviruses. [ABSTRACT FROM AUTHOR]

Summary Visceral fat is a risk factor for non-alcoholic fatty liver disease (NAFLD). A reduction in sex hormones is associated with increased abdominal fat. Thus, we investigated whether reduced testosterone (T) or oestradiol (E2) levels in men are associated with NAFLD and central obesity. The study involved a survey of 1,882 men between 20 and 60 years of age. We detected hepatic fat infiltration by ultrasound. Early morning serum was analyzed for total testosterone (TT), E2, sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Free testosterone (FT) was calculated using the Vermeulen method. In the studied population, the prevalence of NAFLD, FSH, LH and SHBG increased with age, TT and FT declined with age, and E2 remained stable. However, in the NAFLD group, TT remained stable, FT and E2 declined, and hepatic fat infiltration increased ( P < 0.001 for both). Using multivariate analysis, a correlation was found between E2 and NAFLD, with an odds ratio of 0.954 (95% confidence interval: 0.946-0.967). E2 is one of the protective factors against NAFLD in healthy men. T has no significant correlation with NAFLD. Further investigation would be required to assess the clinical consequences of reduced E2 in men with NAFLD, particularly for men whose TT remained stable. [ABSTRACT FROM AUTHOR]

Summary: This multicenter and randomized clinical trial showed that daily oral herbal formula Xian Ling Gu Bao (XLGB) was safe in postmenopausal women over a 1-year treatment. Those patients ( n ∼ 50) treated with XLGB at the conventional dose demonstrated a statistically significant increase in dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) at lumbar spine at 6 months and a numerically increased BMD at 12 months. Introduction: The aim of this study was to examine the safety and efficacy of a herbal formula XLGB in postmenopausal women (ChiCTR-TRC-00000347). Methods: One hundred eighty healthy postmenopausal women (≥60 years old) with BMD T-score ≤ −2.0 (lumbar spine or femoral neck) were recruited from four clinical centers to receive low-dose (conventional dose) XLGB (L-XLGB group, 3 g/day, n = 61) or high-dose XLGB (H-XLGB group, 6 g/day, n = 58) or placebo (CON group, n = 61). Women received daily calcium (500 mg) and vitamin D (200 IU) supplementation. Primary endpoints were lumbar spine BMD and safety; secondary endpoints were femoral neck BMD and bone turnover markers measured at baseline and at 6 and 12 months. Results: Of 180 women recruited, 148 completed the study. The compliance in each group was comparable. Prominent adverse events were not observed in either group. In the L-XLGB group at 6 months, lumbar spine BMD by DXA increased significantly from baseline (+2.11% versus CON +0.58%, p < 0.05), but femoral neck BMD did not; at 12 months, BMD in the L-XLGB group decreased from 6-month levels yet remained higher than baseline, but without difference from the CON group. There was no dose-dependent response. Bone turnover marker levels declined during the first 6 months after XLGB treatment. There was no significant difference in the overall incidence of side effects among treatment and control groups. Conclusion: XLGB over 1-year treatment at the conventional dose demonstrated safe and only a statistically significant increase in BMD at lumbar spine at 6 months in postmenopausal women. [ABSTRACT FROM AUTHOR]

Background Studies evaluating the effect of erythromycin on patients with acute upper gastrointestinal bleeding (UGIB) had been reported, but the results were inconclusive. Aims To compare erythromycin with control in patients with acute UGIB by performing a meta-analysis. Methods Electronic databases including PubMed, EMBASE and the Cochrane Library, Science Citation Index, were searched to find relevant randomised controlled trials (RCTs). Two reviewers independently identified relevant trials evaluating the effect of erythromycin on patients with acute UGIB. Outcome measures were the incidence of empty stomach, need for second endoscopy, blood transfusion, length of hospital stay, endoscopic procedure time and mortality. Results Four RCTs including 335 patients were identified. Meta-analysis demonstrated the incidence of empty stomach was significantly increased in patients receiving erythromycin (active group 69%, control group 37%, P < 0.00001). The need for second endoscopy, amount of blood transfusion and the length of hospital stay were also significantly reduced (all P < 0.05). A trend for shorter endoscopic procedure time and decreased mortality rate was observed. Conclusions Prophylactic erythromycin is useful for patients with upper gastrointestinal bleeding to decrease the amount of blood in the stomach and reduce the need for second endoscopy, amount of blood transfusion. It may shorten the length of hospital stay, but its effects on mortality need further larger trials to be confirmed. [ABSTRACT FROM AUTHOR]

We describe a modified stent-assisted coiling technique, named the semi-deployment technique, in the endovascular treatment of wide-neck aneurysms. Thirty-one consecutive patients with 31 wide-necked or fusiform intracranial aneurysms were treated with the semi-deployment technique. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcome and follow-up angiography were evaluated. In every case, the semi-deployment technique was successfully deployed. Immediate angiography demonstrated complete occlusion in 24 cases (77.4%), neck remnant in four cases (12.9%), and incomplete occlusion in three cases (9.7%). Procedural-related morbidity occurred in one patient (3.2%) but no procedural-related mortality. A favorable clinical outcome (Modified Ran-kin Scale score 0-2) was observed in 90.3% of the patients (average follow-up time, 23.1 months). No rehemorrhage of treated aneurysms occurred. Angiography follow-up was obtained in 22 cases (71.0 %). Three aneurysms (13.6 % of the follow-up angio grams) demonstrated recanalization. No delayed coil or stent migration was found. One patient had in-stent stenosis as a delayed complication. We found that the semi-deployment technique was helpful in the treatment of wide-neck aneurysms. [ABSTRACT FROM AUTHOR]

The article offers information on the Vilsmeier Synthesis of 3-chloroindole-2-carboxaldehydes. It reports on the practical and efficient synthesis of the compound where the Vilsmeier cyclization of the compound is found to provide an effective and more convenient approach for the construction of indole without any metal catalysts. It states that the compound derivatives play an important pharmacological role such as anti-HIV, antitumor, and anticancer activities. The compounds disadvantages are also presented where it displays low efficiency with some substrates and unsatisfactory yields.

Objective: We evaluated different dose effects of rIL-25 on acute ulcerative colitis. Materials and methods: Mice were fed 2.5% dextran sulfate sodium (DSS) for 5 days while infused i.p. with repeated doses of rIL-25 (0.2, 0.4 and 0.8 μg) in PBS or PBS only after every 24 h at the same time as the start of the DSS exposure. Clinical, macroscopical and microscopical assessment of colitis severity with survival study was performed. Colonic IL-25 expression and production of IFN-γ, IL-10 and IL-4 was also analyzed. Results: At a dose of 0.2 μg, colitis was aggravated with high mortality, better improvements were observed at a dose of 0.4 μg, and colitis-induced diarrhea was reversed at a dose of 0.8 μg. The expression of IL-25 was found to decrease in severe colitis. Moreover, IL-25 inhibited production of mucosal IFN-γ, induced increase in IL-10 but not IL-4. Conclusion: Improvements in DSS-induced colitis in response to IL-25 suggest IL-25's protective role by mechanisms including inhibition of IFN-γ with enhancement of anti-inflammatory release. [ABSTRACT FROM AUTHOR]

To compare the effective rates among one week, two week and four week treatment sessions of ozone therapy for lumbar disc herniation to provide a foundation for clinical decision-making. One hundred and eighty-seven lumbar disc herniation patients were divided into three groups, 103 cases for one week, 61 cases for two week and 23 cases for four week treatment sessions. The clinical curative effective rates in the three groups were 82.52%, 85.24% and 95.65% respectively. The effective rate among the three groups showed no significant difference at statistical analysis. Considering the cost-effectiveness of ozone therapy, increasing the treatment course does not enhance the curative effect. [ABSTRACT FROM AUTHOR]

Purpose: Roux-en-Y biliojejunostomy has been frequently used in the management of benign biliary disease. The aim of this study was to summarize one institute’s experiences in prevention and management of subsequent complications of Roux-en-Y biliojejunostomy. Methods: A retrospective analysis was carried out for patients who underwent reoperation after Roux-en-Y biliojejunostomy from February 1990 through June 2004. Operation history, laboratory test data before the last operation, and images were collected. Results: Sixty-one patients, aged 36–60 years and with a 3.5-year average operation interval, were involved in the study. Anastomotic stricture (47, 80.3%), recurrent calculi (36, 60.7%), and biliary tract infection (all) were the most common complications after Roux-en-Y biliojejunostomy. Other complications (such as calculi of the intrahepatic duct or intrahepatic duct stricture, malformed or twisted jejunum loop, too long or too short proximal jejunum, disappearance of the normal form of anastomosis, and adhesion of the intestinal loop) were also detected by laparotomy. Conclusion: Calculus, stricture, and infection arise as a result of each other. Lessening of the anastomotic stricture, fluent drainage of the distal jejunum below the anastomosis, and relieving pressure of gastrointestinal tract are pivotal in decreasing subsequent complications after Roux-en-Y biliojejunostomy. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Although skin tests are usually employed to evaluate current penicillin allergy status, a negative result does not exclude hypersensitivity. There is a need for accurate in vitro tests to exclude hypersensitivity. A radioallergosorbent test (RAST) is a potentially good supplementary approach, but there is little information on the suitability of this method to diagnose penicillin hypersensitivity in subjects with a negative skin test to benzylpenicillin. Methods: A total of 133 patients with a negative skin test to benzylpenicillin G (PG) and all of whom developed allergic reactions to PG were studied. RAST was used to detect eight kinds of specific IgE antibodies to penicillins in serum, which included four kinds of major and minor antigenic determinants to four penicillin drugs. The combination sites for the specific IgE antibodies were studied by RAST inhibition test. Results: The rate of positive reactions for the specific IgE antibodies was 59·40% (79/133). Of the eight kinds of antigenic determinants, the positive rates for specific IgE against the major and minor determinants were 39·10% (52) and 42·86% (57) respectively. Of the four drugs, positive cases only to PG were 10 (7·5%), were significantly fewer than the cross-reacting positive cases (36) to PG ( P < 0·01). In the RAST inhibition studies all drugs exhibited good inhibitory potencies, and in some instances the side-chain of the penicillins could induce specific responses with a variable degree of cross-reactivity among the different penicillins. Conclusion: Radioallergosorbent test is a good complementary test in persons who are skin-test negative with PG, and the sensitivity of RAST increaes with increasing specificity of IgE antibodies to be detected. 6-APA and the groups, making part of the different side-chains on penicillins, all contributed to the cross-reactivity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of this study was to summarise data about endovascular stent-graft placement for patients with type B aortic dissection (type B-AD) in China. Methods: All published series in Chinese on endovascular stent-graft placement for type B-AD from 1999 through 2008 were identified. Thirty-five studies, involving a total of 1498 patients, were included in this review. Results: Procedure success was reported in 89.4±1.7% of the patients. Overall complications were reported in 16.6±1.2% of the patients. Major complications were reported in 1.7±0.2%, with neurological complications in 0.5±0.1%. In-hospital mortality was 2.0±0.4%. The mean follow-up was 24.0±16.1 months. Conclusion: Endovascular stent-graft placement is technically feasible with high procedure success and relatively low complication rate in selected patient groups with type B-AD. Both short- and mid-term outcomes appear to be favourable. [Copyright &y& Elsevier]

To investigate the effects of altered collagen II (CII) peptide ligands in collagen-induced arthritis (CIA), CIA rats were subcutaneously injected with an altered CII263–272 peptide ligand (APL, 100, 10, and 1 μg/dose, six dose each, twice a week), which had been identified by us as an inhibitory effect on CII-specific T-cell activation in vitro in rheumatoid arthritis (RA). Clinical, radiographic, and histologic scores were evaluated. Serum level of interferon (IFN)-γ was assessed by enzyme-linked immunosorbent assay, and the numbers of interleukin (IL)-4-producing cells in vitro in memory responses to the APL were determined by enzyme-linked immunospot. The results showed significantly reduced arthritis scores in CIA rats treated with 100 μg/dose of APL compared with those treated with phosphate buffered solution (PBS) and control peptide. The mean radiographic and histologic scores were also markedly lower in APL-treated CIA rats. On day 35 after immunization, a significantly lower level of IFN-γ in serum was found in APL-treated rats, accompanied by increased numbers of IL-4-producing cells, indicating that APL treatment skewed the T helper (Th)1/Th2 balance toward Th2-type response in vivo. Altered CII263–272 peptide ligand immunization induces inhibition of CIA through a shift toward Th2-type response, suggesting that altered CII peptide might be a potential therapeutic target for RA. [ABSTRACT FROM AUTHOR]

Background: Many dieters lose and regain weight many times. It is unclear whether weight cycling is associated with adverse metabolic alterations or becomes more difficult with each attempt. Methods: From 1988 to 2000, 2474 obese patients enrolled in our outpatient weight loss programme using a very low-calorie diet. Caloric intake consisted of meal replacement supplying 700–800 cal/day. Results: Our search distinguished 480 patients who had restarted the weight reduction programme at least once and up to four times (restarts). All subjects remained on the programme for 2 weeks or more each time. Mean initial weight loss was 21.3 kg for women and 28.8 kg for men. Rate of weight loss on first restart was not different from initial weight loss for women [1.6 vs. 1.4 kg/week; not significant (NS)] or for men (2.2 vs. 2.1 kg/week; NS). Of the 480 patients, 85 women and 51 men entered the programme three times. Rate of weight loss was similar for all three entries (1.4, 1.6 and 2.1 kg/week for first, second and third entry in women, NS; 2.1, 2.1 and 2 kg/week for men, NS). Only 20 women and 18 men entered the programme four times. The rate of weight loss was again similar for both men (NS) and women (NS) during each re-entry. Cardiovascular risk factors including lipid profile and blood pressure were not adversely affected by weight cycling. In fact, lipid levels were lower at each restart. Conclusions: The present study refutes the hypothesis that repeated dieting makes further dieting efforts more difficult. [ABSTRACT FROM AUTHOR]

Hedgehog (Hh) signaling pathway is crucial in growth and patterning during embryonic development. Recent data have shown an association of its activation with cancer formation and maintenance. A ligand-dependent activation, where Hh components (SHH, PTCH1, Smo and GLi1) are aberrantly expressed with PTCH1 being a negative feedback regulator, is a newly identified mechanism for pancreatic carcinogenesis. In this study, we developed a cell-specific cytotoxic model for the treatment of human pancreatic cancer (HPC) in which expression of antisense Smo (SAS) was under the control of the PTCH1 promoter (ptch/p) delivered by an adenoviral vector (Ad-ptch/p-SAS). We observed that the cell-specific cytotoxicity in HPC cells depended on the expressions of inherent PTCH1, Smo and GLi1 in the target cells in which the Hh pathway was presumed to be activated. Fluorescence-activated cell sorting analysis indicated that the cell death was apoptosis. Western blot showed that Smo protein in the infected cells significantly decreased. Furthermore, an in vivo experiment demonstrated that such Hh activity-cell-specific cytotoxicity was achieved by daily intratumoral injection of Ad-ptch/p-SAS (109 plaque-forming unit) for 5 days. Our study suggests that targeting at the Hh signaling pathway may be an effective novel gene therapeutic strategy alone or in combination with other agents for the treatment of pancreatic cancer.Gene Therapy (2006) 13, 1587–1594. doi:10.1038/sj.gt.3302816; published online 6 July 2006 [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is an autoreactive T cell mediated autoimmune disease. Immunization with inactivated autoreactive T cells may induce idiotype anti-idiotypic reaction to deplete specific subsets of autoreactive T cells involved in SLE. Six SLE patients unsuitable or refused to use immunosuppressants were treated with T cell vaccination. Their clinical manifestations and laboratory parameters including mixed lymphocyte reactions were evaluated. Autoreactive T cell clones were derived from peripheral blood mononuclear cells of the patients and 1 × 107 irradiated T cells were inoculated subcutaneously at 0, two, six and eight weeks, respectively. The enrolled patients were followed up for 32–40 months at an interval of three to six months. The clinical characteristics and laboratory abnormalities improved after inoculation without increasing the dose of corticosteroids and immunosuppressants in most patients. SLE disease activity index (SLEDAI) scores decreased. Proliferative responses against the T cell vaccine were observed in four of six patients. At the time of this report, the six patients remain in clinical remission. No significant side effect from the vaccination was noticed during the follow-up period. The results of this pilot study indicate that T cell vaccination is a safe and effective treatment in SLE. [ABSTRACT FROM AUTHOR]

Background: Patients with depression are often not prescribed antidepressants for an adequate period of time.Aims: The impact of antidepressant prescribing patterns on the risk of relapse or recurrence of depression is examined.Method: The MediPlus UK Primary Care Database was used to identify patients treated for depression with a selective serotonin reuptake inhibitor (SSRI). Records were used to construct hierarchical prescription patterns (less than 120 days, switching/augmentation, upward titration, or stable use) as indicators for the occurrence of relapse or recurrence of depression.Results: Patients with stable use experienced the lowest risk of relapse or recurrence. Factors significantly associated with increased risk include prior use of anxiolytic medications, more comorbid conditions and younger age.Conclusions: The SSRI prescription pattern most consistent with recommended depression treatment guidelines was associated with the lowest risk of relapse or recurrence. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 27-year-old man with a history of asymptomatic lumps in the right neck and axilla. He was diagnosed with Hodgkin lymphoma presenting with angiokeratoma corporis diffusum (ACD), a member of vascular lesions characterized by superficial vascular ecstasia with secondary epidermal reaction changes. The paraneoplastic skin manifestation of the case also discussed.

Introduction/Background Intervention time and course of the treatment of isokinetic strength training have a different impact on walking function in elder stroke patients with hemiplegia. Material and method Picking up 63 elder stroke patients from department of rehabilitation in the first hospital of Jilin university with hemiplegia and randomly divided into A group, B group and C intervention group. On the basis of routine rehabilitation therapy, the patients in A group were given isokinetic strength training in the first 4 weeks. After 4 weeks, the patients were given general anti-muscular strength training. In B group, the patients were given normal resistance training at first 4 weeks, after 4 weeks to give isokinetic strength training. The C group of patients were given 8 weeks isokinetic strength training. Using PT, BBS, FMA, FAC, and MBI to evaluate the function before treatment, at 4 and 8 weeks. Results After 4 weeks of treatment, the PT, BBS, FMA, FAC and MBI scores of A group were (31.47 ± 9.65/45.68 ± 11.86), (38.42 ± 8.03), (15.23 ± 3.65), (2.31 ± 0.51), (52.19 ± 11.43), and the scores of C group were (32.82 ± 8.52/46.37 ± 12.02),(37.86 ± 7.73), (14.91 ± 3.58), (2.26 ± 0.53), (51.88 ± 10.93), which were significantly better than those of B group ( P < 0.05), but there was no significant difference between the A and C group ( P > 0.05). After 8 weeks, the scores of the three groups were significantly improved compared with after four weeks treatment ( P < 0.05). The PT, BBS, FMA, FAC and MBI scores of A group were (35.61 ± 9.72/53.48 ± 14.63), (42.29 ± 8.61), (19.37 ± 4.05), (3.57 ± 0.63), (63.76 ± 12.15), and the scores of C group were (44.71 ± 12.34/58.86 ± 15.20), (46.37 ± 9.02), (22.19 ± 4.24), (4.02 ± 0.68), (70.23 ± 13.19), which were significantly better than those of B group ( P < 0.05), and the C group were significantly better than A group, the difference was statistically significant ( P < 0.05). Conclusion Early, whole course intervention of isokinetic strength training can be more effective in improving muscle strength, walking function and ADL of the elder stroke patients with hemiplegia. [ABSTRACT FROM AUTHOR]

Aim: To determine the efficacy of dual Y-shaped covered airway stents to treat thoracic stomach-right main bronchus fistulae.Material and Methods: Fifteen patients who developed thoracic stomach-right main bronchus fistula after oesophageal cancer resection and postoperative irradiation were retrospectively analysed. All fistulae were close to the right upper lobe bronchus. Two Y-shaped covered airway stents were designed for each patient. Under radiographic guidance, one stent was placed from the right main bronchus into the bifurcation of upper lobe and intermediate bronchus, the other was placed from the trachea into both main bronchi.Results: All fistulae were closed immediately after stenting. All patients could eat a semi-solid diet. The symptom of coughing while lying down resolved in all patients, and no complications, such as airway bleeding or pneumothorax, occurred. The average survival time was 26.65 months (range 2-40 months, 11 patients were still alive at the study end). Two patients died of tumour recurrence. Another two patients died of pulmonary infections. In one of these patients, there was a long delay between symptom onset and stenting. In the other patient, a small rupture occurred in the silicone membrane covering the stent, which allowed the leakage of gastric contents into the lung.Conclusion: Dual Y-shaped covered airway stent placement is feasible and safe to treat thoracic stomach-right main bronchus fistulae. Improvements to the material covering the stents is required. [ABSTRACT FROM AUTHOR]