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Soil microorganisms are important sources of N2O for the atmosphere. Peak emissions of N2O are often observed after wetting of soil. The simultaneous heterotrophic nitrifying and aerobic denitrifying bacteria with respect to N2O emission were studied to obtain more information about the microbiologcal aspects of peak emissions. Using acetamide as the C and N source, two strains of nitrifying and denitrifying bacteria were isolated, coded as XM1 and HX2,respectively. XM1 strain was Gram-negative chain-like bacilli, and the HX2 was Gram-negative cocci. In enrichment culture, N2O production of HX2 was 76 times more than XM1. Two strains could grow with glucose, mannitol or sodium tartrate as sole carbon source, respectively. They could nitrify with sodium nitrate or denitrify with ammonium sulfate as unique nitrogen source, and produce intermediate product nitrite. XM1 strain growth velocity and nitrite formation were obviously higher than HX2. The phylogentic analysis based on partial 16S rDNA showed that two isolated strains were the closest relative of Pseudomonas sp.99% sequence similarity. Under different WFPS (water-filled-pore-space) conditions, the aerobic autoclaved soil incubation trial showed that, HX2 strain was suitable for growing in 30% WFPS, and N2O production was (36.01 +/- 2.48) ng/g which was 1.9 times than that in 60% WFPS. But XM1 was suitable for growing in 60% WFPS and almost had no N2O production. To investigate the nitrifying and denitrifying mechanisms of heterotrophic nitrifiers/aerobic denitrifiers should be useful for mastering the mitigation way of soil N2O emission in future.

Background: Antihypertensive drug discontinuation imposes a substantial health services burden but few studies have addressed the factors associated with their discontinuation in Chinese patients. This study evaluated the association between age, gender, and drug classes with antihypertensive discontinuation., Methods: From clinical databases, we included all adult patients prescribed an antihypertensive medication during January 2004 to June 2007 in one large territory of Hong Kong. We studied the factors associated with drug discontinuation within 180 days after the first prescription date by multivariable regression analysis., Results: From 93,286 eligible patients, 13.2% discontinued their antihypertensive prescriptions. Younger (<50 years; adjusted odds ratio (aOR) = 0.63 for patients aged 50-59 years; 0.52 for patients aged 60-69 years; 0.70 for those aged >or=70 years; all P < 0.001) and male patients (aOR = 1.05, P = 0.027) were more likely to have drug discontinuation. When compared with thiazide diuretics, patients prescribed beta-blockers were more likely (aOR = 1.67, P < 0.001) and patients prescribed calcium channel blocker (CCB) (aOR = 0.76, P < 0.001) and combination therapy (aOR = 0.73, P < 0.001) were less likely to have drug discontinuation. Stratified analyses in different age and gender groups reported similar results; except that only elderly male patients (aOR = 1.12, P = 0.002) and younger patients (aOR = 2.43 for patients aged <50 years, P < 0.001) prescribed beta-blocker were more likely to have drug discontinuation., Conclusions: Discontinuation of antihypertensive drug treatment in ethnic Chinese is more likely to occur in younger, male patients, or those prescribed beta-blockers. These data suggest that more meticulous monitoring of patient adherence is required in patients with these characteristics.

The transition from preantral to early antral stage is the penultimate stage of ovarian follicular development in terms of gonadotropin dependence and follicle destiny. Although oocyte-somatic cell communication is important in early follicular development, our knowledge of the precise role of the oocyte-derived growth differentiation factor (GDF)-9 during preantral follicle growth is incomplete. We examined whether and by what means oocyte-derived GDF-9 controls follicular development and steroidogenesis during the preantral to early antral transition, by a combination of in vitro gene manipulation (i.e. intraoocyte injection of GDF-9 antisense oligos) and preantral follicle culture. Intraoocyte injection of GDF-9 antisense suppressed rat preantral follicle growth in vitro, whereas GDF-9 enhanced follicular development. GDF-9 augmented testosterone production in preantral follicles. GDF-9 antisense suppressed androgen production and CYP17A1 mRNA expression in cultured follicles, a response attenuated by exogenous GDF-9. The nonaromatizable androgen 5alpha-dihydrotestosterone rescued the follicular growth arrest caused by GDF-9 down-regulation. The specific androgen receptor antagonist flutamide suppressed GDF-9-induced preantral follicle growth in vitro. The data suggest that GDF-9 plays an important role in promoting preantral follicle growth by up-regulating follicular androgen biosynthesis. GDF-9 is essential for CYP17A1 expression during follicular development from the preantral to the early antral stage.

To investigate the effect of hypothermia on the expression of apoptosis-regulating protein TIMP-3 after fluid percussion traumatic brain injury (TBI) in rats. 210 adult male Sprague Dawley rats were randomly assigned to the groups of TBI with hypothermia treatment (32 degrees C), TBI with normothermia (37 degrees C), and sham injured control. TBI model was induced by fluid percussion TBI device. Mild hypothermia (32 degrees C) was achieved by partial immersion in a water bath (0 degrees C) under general anesthesia for 4 hours. All the rats were killed at 4, 6, 12, 24, 48, 72h and 1w after TBI. The mRNA and protein level of TIMP-3 in both injured and uninjured hemispheres of each group were measured using RT-PCR and western blot techniques. In the normothermic group, TIMP-3 levels in both injured and uninjured hemispheres were significantly increased after TBI compared with those of sham injured animals (p < 0.01). In contrast, post-traumatic hypothermia significantly attenuated such an increase. According to the RT-PCR and western blot analysis, the maximum mRNA levels of TIMP-3 were reduced to 60.60%+/-2.30, 55.83%+/-1.80, 66.03%+/-2.10 and 64.51%+/-1.50 of the corresponding values in the normothermic group in injured and uninjured hemispheres (cortex and hippocampus) by hypothermia treatment, respectively (p < 0.01), while the respective maximum protein levels of TIMP-3 were reduced to 57.50%+/-1.50, 52.67%+/-2.20, 60.31%+/-2.50and 54.76%+/-1.40 (p < 0.01). Our data suggests that moderate F-P brain injury would significantly upregulate TIMP-3 expression, while such an increase could be efficiently suppressed by hypothermia treatment.

Clinical randomized controlled trials (RCTs) suggest that mild hypothermia may improve the outcome of severe traumatic brain injured patients with intracranial hypertension when cooling is maintained for longer than 48 h. However, the results are not yet conclusive, and more RCTs are required. Mild hypothermia significantly decreases intracranial pressure (ICP) values when refractory intracranial hypertension cannot be controlled by conventional measures in patients with severe traumatic brain injury (TBI). Prolonged mild-to-moderate hypothermia may be associated with high incidence of pneumonia and hypokalemia, which should be prevented.

Background: International guidelines on management of hypertension recommend any major classes of antihypertensive drugs. However, the low prescribing rate of thiazides has been attributed to concerns about electrolyte disturbances and studies between antihypertensive drug classes and hyponatremia/hypokalemia among Chinese patients were scarce., Methods: From clinical databases we included 2,759 patients who received their first-ever antihypertensive monotherapy from January 2004 to June 2007 in a large territory of Hong Kong. We studied the plasma sodium and potassium levels 8 weeks after prescriptions and factors associated with hyponatremia and hypokalemia by multivariable regression analyses., Results: Among major antihypertensive drug classes, thiazide users had the lowest sodium level (139.6 mEq/l, 95% confidence interval (CI) 139.3, 140.0, P < 0.001) and patients-prescribed calcium channel blockers (CCBs; 3.92 mEq/l, 95% CI 3.89, 3.95) or thiazide diuretics (3.99 mEq/l, 95% CI 3.93, 4.04) had the lowest potassium levels (P < 0.001). Multivariate analysis reported that advanced age (> or =70 years, odds ratio (OR) 7.49, 95% CI 2.84, 19.8, P < 0.001), male gender (OR 2.38, 95% CI 1.45, 3.91, P < 0.001), and thiazide users (OR 2.42, 95% CI 1.29, 4.56, P = 0.006) were significantly associated with hyponatremia, while renin-angiotensin system (RAS) (OR 0.31, 95% CI 0.13, 0.73, P = 0.008) and beta-blockers (BBs) (OR 0.35, 95% CI 0.23, 0.54, P < 0.001) users were less likely to present with hypokalemia. However, the proportions having normonatremic (95.1%) and normokalemic (89.4%) levels were high., Conclusions: In view of the low prevalence of hyponatremia and hypokalemia associated with thiazides, physicians should not be deterred from prescribing thiazide diuretics as first-line antihypertensive agents as recommended by most international guidelines.

In this investigation, we evaluated the effect of post-traumatic mild hypothermia on cell death in the hippocampus after fluid percussion traumatic brain injury (TBI) in rats. Adult male Sprague-Dawley rats were randomly divided into three groups (n = 40/group): TBI with hypothermia treatment (32 degrees C), TBI with normothermia (37 degrees C), and sham injury. The TBI model was induced by a fluid percussion TBI device. Mild hypothermia (32 degrees C) was achieved by partial immersion in a water bath (0 degrees C) under general anesthesia for 4h. All rats were killed at 24 or 72h after TBI. The ipsilateral hippocampal CA1 in all rats were analyzed by hematoxylin and eosin staining, terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate-biotin nick end labeling (TUNEL), and 4',6-diamidino-2-phenylindole (DAPI) staining for determining cell death. Caspase-3 expression was examined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. At 24h, based on TUNEL and DAPI results, the cell death index was 28.80 +/- 2.60% and 32.10 +/- 1.40% in the normothermia TBI group, while reaching only 14.30 +/- 2.70% and 18.40 +/- 2.10% in the hypothermic TBI group (p < 0.01). Based on RT-PCR and Western blotting results, the expression of caspase-3 was 210.20 +/- 5.30% and 170.30 +/- 4.80% in the normothermic TBI group, while reaching only 165.10 +/- 3.70% and 130.60 +/- 4.10% in the hypothermic TBI group (p < 0.05). At 72h, based on TUNEL and DAPI results, the cell death index was 20.80 +/- 2.50% and 25.50 +/- 1.80% in the normothermic TBI group, while reaching only 10.20 +/- 2.60% and 15.50 +/- 2.10% in the hypothermic TBI group (p < 0.01). Based on RT-PCR and Western blotting results, the expression of caspase-3 was 186.20 +/- 6.20% and 142.30 +/- 5.10% in the normothermic TBI group, versus only 152.10 +/- 3.60% and 120.60 +/- 3.90% in the hypothermic TBI group (p < 0.05). Based on our findings, we conclude that post-traumatic hypothermia significantly attenuates cell death within the hippocampus following fluid percussion injury. Taken together with other studies, these observations support the premise that post-traumatic mild hypothermia can provide cerebral protection for patients with TBI.

Soft tissue clear cell sarcoma usually occurred in the end of the limbs, especially foot and ankle. Soft tissue clear cell sarcoma occurring in the torso and head and neck were even fewer. In this article, parapharyngeal soft tissue clear cell sarcoma was reported.

Background: To explore the dose-response effects of topical administration of nimodipine on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits., Methods: The CVS model was established by injection of fresh autologous nonheparinized arterial blood into the subtemporal area of basilar cisterns. The 24 CVS animals were randomly divided into 4 groups, group I (n=7): nimodipine original stock solution/normal saline=1/19 (0.01 mg/mL); group II (n=6): nimodipine original stock solution/normal saline=1/9 (0.02 mg/mL); group III (n=5): nimodipine original stock solution/normal saline=1/4 (0.04 mg/mL); and group IV (n=6) with no nimodipine, but 5% ethanol dissolved in normal saline as the control group. The operative area was administrated with nimodipine at different concentrations or alcohol-saline at 3 days after SAH. The blood flow velocity of middle cerebral artery was measured at 5, 15, 30, and 60 minutes after topical administration of nimodipine by transverse cerebellar diameter monitoring., Results: Blood flow velocity of middle cerebral artery in group II (0.02 mg/mL) and in group III (0.04 mg/mL) significantly decreased at 60 and 15 minutes, respectively, after topical administration of nimodipine (P<0.05), and even more significantly at 30 and 60 minutes after topical administration of nimodipine in group III (0.04 mg/mL) (P<0.01)., Conclusion: Topical administration of nimodipine at the concentrations of 1:5 (0.04 mg/mL) and 1:10 (0.02 mg/mL) significantly alleviates CVS after SAH, which indicates that topical administration of nimodipine may be useful for CVS of patients with SAH during surgical clip of intracranial aneurysms.

The development of mature ovarian follicles is greatly dependent on healthy thecal angiogenesis. Recent experimental evidence showed that thyroxine (T4) treatment promoted ovarian follicle development in immature hypothyroid (rdw) rats. However, an involvement of thyroid hormone in ovarian follicular angiogenesis has not yet been demonstrated. By morphological and molecular approaches, the present studies demonstrated that antral follicles in untreated, T4- or equine chorionic gonadotropin (eCG)-treated rdw rats were mainly small and/or atretic, and presented a poorly developed thecal microvasculature with ultrastructural evidence of diffuse quiescent or degenerative thin capillaries. However, T4 together with eCG increased the number of large antral and mature follicles with numerous activated capillaries and ultra-structural evidence of rich and diffuse angiogenesis in the theca layer. While T4 alone significantly increased mRNA expression of vascular endothelial growth factor (VEGF) and tumor necrosis factor alpha (TNFalpha), it decreased that of fetal liver kinase compared with those in the untreated group. Combined treatment of T4 and eCG markedly increased mRNA abundance of not only VEGF and TNFalpha, but also basic fibroblast growth factor. These data suggest that T4 may promote ovarian follicular angiogenesis in rdw rats by up-regulating mRNA expression of major angiogenic factors.

During ovarian folliculogenesis, the vast majority of follicles will undergo atresia by apoptosis, allowing a few dominant follicles to mature. Mammalian hyaluronidases comprise a family of six to seven enzymes sharing the same catalytic domain responsible for hyaluronan hydrolysis. Interestingly, some of these enzymes have been shown to induce apoptosis. In the ovary, expression of three hyaluronidases (Hyal-1, Hyal-2, and Hyal-3) has been documented. However, their precise cellular localization and role in ovarian regulation have not yet been defined. We herein investigated the possible involvement of these enzymes in ovarian atresia. First, we established a mouse model for ovarian atresia (gonadotropin withdrawal by anti-equine chorionic gonadotropin treatment) and showed that the mRNA levels of Hyal-1, Hyal-2, and Hyal-3 were significantly increased in apoptotic granulosa cells as well as in atretic follicles. Second, using ovaries of normally cycling mice, we demonstrated the correlation of Hyal-1 mRNA and protein expression with cleavage of caspase-3. In addition, we showed that expression of all three hyaluronidases induced apoptosis in transfected granulosa cells. Significantly, the induction of apoptosis by hyaluronidases was independent of catalytic activity, because enzymatically inactive Hyal-1 mutant (D157A/E159A) was as efficient as the wild-type enzyme in apoptosis induction. The activation of the extrinsic apoptotic signaling pathway was involved in this induction, because increased levels of cleaved caspase-8, caspase-3, and poly-ADP-ribose polymerase (PARP) were observed upon hyaluronidase ectopic expression. Our present findings provide a better understanding of the role of hyaluronidases in ovarian functions, showing for the first time their involvement in follicular atresia.

Background: There is a scarcity of studies addressing the factors associated with impaired fasting glucose in Chinese patients with uncomplicated hypertension. We included 1,218 patients newly prescribed a single antihypertensive drug in the public primary healthcare setting in Hong Kong, where their fasting glucose levels were measured 6-7 weeks after the first-ever antihypertensive prescription., Methods: The odds ratios of having above borderline (> or = 6.1 mmol/l) and adverse (> or = 7.0 mmol/l) glucose levels, respectively, were studied according to patient age, gender, socioeconomic status, clinic types and antihypertensive drug classes by multivariable regression analyses., Results: The fasting glucose levels were statistically similar (p = 0.786) among patients prescribed thiazide diuretics (5.48 mmol/l, 95%, 5.38, 5.59), calcium channel blockers (5.46 mmol/l, 95% C.I. 5.37, 5.54), beta-blockers (5.42 mmol/l, 95% C.I. 5.34, 5.51) and drugs acting on the renin angiotensin system (RAS) [5.41 mmol/l, 95% C.I. 5.20, 5.61]. Multivariate analyses reported no significant associations between antihypertensive drug class and impaired fasting glucose. Elderly patients and male gender were significantly more likely to present with above borderline and adverse readings respectively., Conclusion: Clinicians should be aware of the increased risk of impaired fasting glucose in these groups, and use of thiazides should not in itself deter its use as a first-line antihypertensive agent among ethnic Chinese patients.

Background: Increasing use is being made of routinely collected electronic patient data in health services research. The aim of the present study was to evaluate the potential usefulness of a comprehensive database used routinely in the public healthcare system in Hong Kong, using antihypertensive drug prescriptions in primary care as an example., Methods: Data on antihypertensive drug prescriptions were retrieved from the electronic Clinical Management System (e-CMS) of all primary care clinics run by the Health Authority (HA) in the New Territory East (NTE) cluster of Hong Kong between January 2004 and June 2007. Information was also retrieved on patients' demographic and socioeconomic characteristics, visit type (new or follow-up), and relevant diseases (International Classification of Primary Care, ICPC codes)., Results: 1,096,282 visit episodes were accessed, representing 93,450 patients. Patients' demographic and socio-economic details were recorded in all cases. Prescription details for anti-hypertensive drugs were missing in only 18 patients (0.02%). However, ICPC-code was missing for 36,409 patients (39%). Significant independent predictors of whether disease codes were applied included patient age > or = 70 years (OR 2.18), female gender (OR 1.20), district of residence (range of ORs in more rural districts; 0.32-0.41), type of clinic (OR in Family Medicine Specialist Clinics; 1.45) and type of visit (OR follow-up visit; 2.39). In the 57,041 patients with an ICPC-code, uncomplicated hypertension (ICPC K86) was recorded in 45,859 patients (82.1%). The characteristics of these patients were very similar to those of the non-coded group, suggesting that most non-coded patients on antihypertensive drugs are likely to have uncomplicated hypertension., Conclusion: The e-CMS database of the HA in Hong Kong varies in quality in terms of recorded information. Potential future health services research using demographic and prescription information is highly feasible but for disease-specific research dependant on ICPC codes some caution is warranted. In the case of uncomplicated hypertension, future research on pharmaco-epidemiology (such as prescription patterns) and clinical issues (such as side-effects of medications on metabolic parameters) seems feasible given the large size of the data set and the comparability of coded and non-coded patients.

Objective: To investigate the expression of nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) in monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion., Methods: The monkeys were immediately removed brain after death in operation of group A (identical temperature perfusion group) and group B (ultraprofound hypothermia perfusion group). Immunohistochemical technique was used to determine frontal cellular expression of NGF and GDNF. Statistics were analyzed by ANOVA analyses with significance level at P < 0.05., Results: The expressions of NGF and GDNF in the group B were significantly higher than those in the group A (P < 0.05)., Conclusion: NGF and GDNF increased significantly in the monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion. It may be a protective mechanism for neuron survival and neural function recovery.

Objective: To determine differential gene expression of hippocampus in rats following complete cerebral ischemia with treatment of profound hypothermia compared to normothermia., Methods: Six rats got 5 minutes of complete cerebral ischemia with circulatory arrest and randomly divided into two groups: normothermia ischemia group (37 +/- 0.3 degrees C, n = 3) and profound hypothermia ischemia group (18 +/- 0.5 degrees C, n = 3). Affymetrix U34A rat arrays were applied to detect the difference of gene expression profile in hippocampus between the two groups., Results: Expression profiles of a total of 75 transcripts in the profound hypothermia ischemia group were statistically different from those of the normothermia ischemia group, and 33 of them were significantly up-regulated and other 42 were significantly down-regulated (p < 0.07)., Conclusions: Compared with normothermia, profound hypothermia had a significant effect on the gene expression profiles following complete cerebral ischemia, which may be involved in the mechanisms of cerebral protection by profound hypothermia.

Intestinal multiparasitism, the accuracy of different diagnostic techniques, and the influence of sampling effort were studied among 215 individuals in a Bulang village, Yunnan province, People's Republic of China. Behavioral, demographic, and socioeconomic data were obtained by questionnaire. Multiple stool specimens were examined by the Kato-Katz, Koga agar plate, Baermann, and ether-concentration methods. Eight helminth and 7 protozoa species were diagnosed. The prevalence of each of the 3 main soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) exceeded 85%. Blastocystis hominis was the most prevalent intestinal protozoan (20.0%). Over 80% of the individuals harbored 3 or more intestinal parasites concurrently. The infection intensities were predominantly light for hookworm and T. trichiura but moderate for A. lumbricoides. Examination of 3 instead of 1 stool specimen increased the sensitivity of helminth diagnosis, most notably for hookworm. Intestinal multiparasitism is rampant in this rural part of Yunnan province and calls for control measures.

Objective: To investigate the correlation between Pokemon gene and cisplatin mechanism., Methods: Human lung adenocarcinoma cells of the lines A549 and AGZY83-a, human lung squamous carcinoma cells of the line HE-99, and human giant cell lung cancer cells of the line 95D were cultured and cisplatin was added into the medium. Other lung cancer cells of the above mentioned lines were cultured in the medium without cisplatin and were used as control groups. RT-PCR and Western blotting were used to detect the mRNA and protein expression of Pokemon., Results: Pokemon mRNA and protein were expressed highly in all the 4 cell lines. The Pokemon gene expression did not changed significantly after cisplatin treatment groups. There were not significant differences in the mRNA and protein expression of Pokemon among the 4 experiment groups and the control groups (all P > 0.05)., Conclusion: Cisplatin has no effect on the Pokemon gene expression of the human lung cancer cells.

A case of multiple primary primitive neuroectodermal tumours (PNETs), which occurred at different levels of the spinal epidural space successively over a period of 8 months, is reported. A 24-year-old male, presenting with rapidly progressive paralysis, hyperthesia and a posterior epidural mass extending from T8 to T10 revealed by magnetic resonance imaging (MRI), exhibited a good recovery after initial emergency surgery. Lower back pain, chest pain and paralysis were subsequently reported. Spinal MRI in month 7 revealed a mass extending from T12 to L1 and another mass extending from T4 to T5 was detected epidurally in month 8. Additional operations were performed and radiotherapy was given. Pathological findings were consistent with PNETs and symptoms improved with treatment, particularly following each surgical excision.

Oocyte-granulosa cell communication, mediated by paracrine factors, is essential for oocyte development. Kit ligand (KITL) is expressed in granulosa cells as soluble (KITL1) or membrane-associated (KITL2) proteins. However, the relative biopotency of each isoform during oocyte development is unknown. Our initial results showed that Kitl2 was down-regulated in cultured granulosa cells. To determine the effect of the two isoforms of KITL on oocyte growth, Kitl-deficient fibroblasts were transfected with constructs expressing either KITL1 or KITL2, and growing oocytes were isolated from 12-day-old mice and cultured on the transfected fibroblasts for 2 days. At the end of culture, oocyte diameters were measured, the incidence of spontaneous germinal vesicle breakdown (GVBD) was noted, and oocytes were analyzed for KIT receptor expression. Oocyte growth occurred only in the presence of the KITL2-producing fibroblasts, and suppression of KITL2 expression impaired oocyte growth. Up-regulation of KIT expression occurred in the presence of KITL2 but not KITL1. The presence of KITL2 inhibited spontaneous GVBD. Meiosis inhibitors did not attenuate the GVBD that occurred in the absence of KITL2, suggesting that this process reflects oocyte degeneration rather than meiotic progression. These results indicate that KITL2 is the principal KITL isoform required for oocyte growth and survival in vitro.

Traumatic subdural effusion (TSE) is one of the main associated complications of brain trauma. About half of the asymptomatic TSEs ultimately evolve into chronic subdural hematomas (CSDHs), most of which will be inevitably treated by surgical evacuation. With the emergence of subdural hydroma (SDH), rupture of bridge-veins, bleeding of the hydroma wall, hyperfunction of fibrinolysis and increasing protein content in the hydroma are some of the traditionally cited explanations of the pathogenesis of TSE evolving into CSHD. Despite intensive research and subsequent advances in surgical techniques of CSDH, a single treatment with measurable clinical impact on the evolution interruption has yet to be investigated. Compared with peripheral venous blood, inflammatory cytokines were elevated in TSE and CSDH demonstrated by a number of investigators. Neoformation of capillaries, vascular hyper-permeability, serum protein exudation and other characteristics of aseptic inflammatory reaction were observed. Meanwhile, steroid was applied to treat CSDH in several groups, which was generally used as an effective anti-inflammatory agent. Based on systemic thinking, we hypothesize that TSE and CSDH are different stages, with different appearances, of the same inflammatory reaction. The evolution from TSE into CSDH and propagation of CSDH seem to be the results of local aseptic inflammation. Our hypothesis holds potential as a target for therapeutic intervention.

Background: Tribendimidine is an anthelminthic drug with a broad spectrum of activity. In 2004 the drug was approved by Chinese authorities for human use. The efficacy of tribendimidine against soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) has been established, and new laboratory investigations point to activity against cestodes and Strongyloides ratti., Methodology/principal Findings: In an open-label randomized trial, the safety and efficacy of a single oral dose of albendazole or tribendimidine (both drugs administered at 200 mg for 5- to 14-year-old children, and 400 mg for individuals > or = 15 years) against soil-transmitted helminths, Strongyloides stercoralis, and Taenia spp. were assessed in a village in Yunnan province, People's Republic of China. The analysis was on a per-protocol basis and the trial is registered with controlled-trials.com (number ISRCTN01779485). Both albendazole and tribendimidine were highly efficacious against A. lumbricoides and, moderately, against hookworm. The efficacy against T. trichiura was low. Among 57 individuals who received tribendimidine, the prevalence of S. stercoralis was reduced from 19.3% to 8.8% (observed cure rate 54.5%, p = 0.107), and that of Taenia spp. from 26.3% to 8.8% (observed cure rate 66.7%, p = 0.014). Similar prevalence reductions were noted among the 66 albendazole recipients. Taking into account "new" infections discovered at treatment evaluation, which were most likely missed pre-treatment due to the lack of sensitivity of available diagnostic approaches, the difference between the drug-specific net Taenia spp. cure rates was highly significant in favor of tribendimidine (p = 0.001). No significant adverse events of either drug were observed., Conclusions/significance: Our results suggest that single-dose oral tribendimidine can be employed in settings with extensive intestinal polyparasitism, and its efficacy against A. lumbricoides and hookworm was confirmed. The promising results obtained with tribendimidine against S. stercoralis and Taenia spp. warrant further investigations. In a next step, multiple-dose schedules should be evaluated.

The purpose of this study was to improve our understanding of the molecular epidemiology of human Blastocystis, focusing on 239 randomly selected individuals in a single village in Yunnan province, China. Emphasis was placed on the relative frequency of different Blastocystis subtypes and underlying risk factors. We used a cross-sectional study design, by employing a pre-tested questionnaire to obtain demographic data and behavioural risk factors, and collected faecal samples for culture and subsequent identification of Blastocystis. DNA was extracted from Blastocystis isolates and the subtypes were identified using 7 subtype-specific sequenced-tagged site (STS) primers. Overall, 78 faecal samples were Blastocystis culture-positive (32.6%, 95% confidence interval: 26.7-38.6%). The majority (n=73, 93.6%) were single infections with one of the known subtypes, whereas 2 isolates consisted of 2 concurrent subtypes. The remaining 3 isolates could not be identified with the currently known STS primers. Risk factors for a Blastocystis infection were drinking unboiled water, consumption of raw water plants and pig ownership. The consumption of raw water plants was positively associated with subtype 1 infections, and drinking unboiled water with subtype 3 infections. In conclusion, human Blastocystis was common in this village in southwest China, and different subtypes were associated with distinct transmission routes or sources of infection, and hence Blastocystis subtypes might be linked to specific environmental compartments.

Gold punchwork and underdrawing in Renaissance panel paintings are analyzed using both three-dimensional swept source / Fourier domain optical coherence tomography (3D-OCT) and high resolution digital photography. 3D-OCT can generate en face images with micrometer-scale resolutions at arbitrary sectioning depths, rejecting out-of-plane light by coherence gating. Therefore 3D-OCT is well suited for analyzing artwork where a surface layer obscures details of interest. 3D-OCT also enables cross-sectional imaging and quantitative measurement of 3D features such as punch depth, which is beneficial for analyzing the tools and techniques used to create works of art. High volumetric imaging speeds are enabled by the use of a Fourier domain mode locked (FDML) laser as the 3D-OCT light source. High resolution infrared (IR) digital photography is shown to be particularly useful for the analysis of underdrawing, where the materials used for the underdrawing and paint layers have significantly different IR absrption properties. In general, 3D-OCT provides a more flexible and comprehensive analysis of artwork than high resolution photography, but also requires more complex instrumentation and data analysis.

Background: Strongyloides stercoralis is a neglected soil-transmitted helminth species, and there is a lack of parasitologic and epidemiologic data pertaining to this parasite in China and elsewhere. We studied the local occurrence of S. stercoralis in a village in Yunnan province, China, and comparatively assessed the performance of different diagnostic methods., Methodology/principal Findings: Multiple stool samples from a random population sample were subjected to the Kato-Katz method, an ether-concentration technique, the Koga agar plate method, and the Baermann technique. Among 180 participants who submitted at least 2 stool samples, we found a S. stercoralis prevalence of 11.7%. Males had a significantly higher prevalence than females (18.3% versus 6.1%, p = 0.011), and infections were absent in individuals <15 years of age. Infections were only detected by the Baermann (highest sensitivity) and the Koga agar plate method, but neither with the Kato-Katz nor an ether-concentration technique. The examination of 3 stool samples rather than a single one resulted in the detection of 62% and 100% more infections when employing the Koga agar plate and the Baermann technique, respectively. The use of a mathematical model revealed a 'true' S. stercoralis prevalence in the current setting of up to 16.3%., Conclusions/significance: We conclude that S. stercoralis is endemic in the southern part of Yunnan province and that differential diagnosis and integrated control of intestinal helminth infections needs more pointed emphasis in rural China.

Objective: To compare the accuracy and operating features of 3D C-arm fluoroscopy-based and CT-based navigation systems in the lumbar pedicle punctures., Methods: A specimen of cadaveric lumbar trunk underwent lumbar pedicle punctures at the levels of L3, L4, and L5 under the guidance of the 3D C-arm fluoroscopy-based and CT-based navigation systems. During the procedure C-arm fluoroscopy was used to monitor the accuracy of the puncture. Generally, in comparison with the 3D C-arm fluoroscopy-based navigation system, the best operation route and protocol could be drawn up pre-operatively, matched registration needed to be renewed for each vertebra, and the images thus obtained were of high quality in CT-based navigation., Results: Both navigation systems had excellent accuracy in the guidance of lumbar pedicle punctures, and had different operating features., Conclusion: Both navigation systems had its special advantages. The operating process of the 3D C-arm fluoroscopy-based navigation system was more convenient and rapid, and suitable for percutaneous vertebral puncture. CT based navigation system had clearer pictures, especially for the osteoporotic vertebral bodies, and it had less requirements for the equipments.

The process of posttranslational modifications of IGF-II likely has important physiological consequences. In addition to mature IGF-II, glycosylated proIGF-II(156-amino acid peptide) and two glycosylated big IGF-II forms, IGF-II(1-104) and IGF-II(1-87), have been identified in the human circulation. Due to lack of an appropriate methodology, different IGF-II isoforms have not been demonstrated and characterized in the rat circulation, thus preventing a better understanding of the physiological and pathological roles of IGF-II. In the present study, we characterized each IGF-II form and assessed its content in the rat circulation throughout life time by using a highly sensitive Western blot analysis, which is void of the IGF binding protein interference and distinguished all IGF-II forms. For the first time, we demonstrated the presence of IGF-II variants, including proIGF-II, IGF-II(1-87), and mature IGF-II, in the rat circulation during postnatal life, challenging the current impression that IGF-II is absent from sera of adult rats. ProIGF-II is glycosylated and is the predominant form in the rat circulation. Endoproteolytic processing of proIGF-II was clearly activated in fetal, neonatal, and pregnant rats, likely reflecting its involvement in fetal development through the generation of specific forms of IGF-II (e.g. mature IGF-II) that are required for their distinct biological functions. Taken together, our data also suggest that serum IGF-II profiles may reflect underlying physiological conditions.

Objectives: To explore the frequency, clinical features and risk factors of venous thromboembolism (VTE) in hospitalized patients., Methods: The frequency, demographic features, and acquired and inherited factors of in-patient cases of VTE in Peking union medical college hospital from 1994 to 2004 were analyzed retrospectively., Results: Six hundred and seventy-two patients were enrolled. Among them, male to female ratio was 1.2 and the median age was 53 (14 - 92). Five hundred and eighty (86.3%) patients were at their first diagnosis with the peak ages between 40 and 50 for men and 50 and 60 for women. More common acquired risk factors were antiphospholipid antibody syndrome (APS) (32.0%), trauma / surgery (31.1%) and malignancies (17.1%). 35.7% of the patients had multiple acquired risk factors. Before the initiation of anticoagulation therapy, the activities of protein C (PC), protein S (PS) and antithrombin (AT) were measured in 94 patients. The deficiency of these three natural anticoagulants was 44.7%. Among the anticoagulant deficiencies, PC deficiency was the commonest one (13.8%). Combined deficiency of PC and AT accounted for 10.6%. 31.6% of the 94 patients had inherited plus acquired risk factors., Conclusions: Age for the first event of VTE in the men was about 10 years ahead of that in the women. The major acquired risk factors were APS, trauma/surgery and malignancies, and inherited risk factors were PC deficiency and PC + AT combined deficiencies. It seems that the coexistence of multiple risk factors plays an important role in triggering VTE.

Purpose of Review: The aim of this article is to review the current status of protective effects of mild-to-moderate hypothermia on traumatic brain injury., Recent Findings: More than 30 clinical studies have reported effects of therapeutic hypothermia on outcome of traumatic brain injury and cerebral ischemia. Only one clinical trial of short-term mild hypothermia did not show any effect in patients with severe traumatic brain injury. Long-term mild hypothermia may be useful for severe traumatic brain-injured patients., Summary: Mild-to-moderate hypothermia plays a significant role in cerebral protection after traumatic brain injury.

Objective: To evaluate the surgical outcome for acute central cervical spinal cord injuries without fracture and dislocation., Methods: A retrospective study was performed on 52 patients with acute central cervical cord injuries without fracture and dislocation from 2000 to 2005. All of patients underwent cervical anterior or posterior decompression, fusion and inter fixation. Spinal function was evaluated by ASIA (American Spinal Injury Association) guidelines. Pre- and post-operation ASIA scores were analyzed using liner correlation and regression. The neurological function was recorded during followed-up. The average follow-up was 29 months (range, 12 to 42)., Results: After operation, the ASIA scores increased significantly (P<0.01). Finally, ASIA motor, pin pricking and light touching scores of the 41 patients were 91 +/- 7, 107 +/- 6 and 107 +/- 6 respectively., Conclusion: Decompression and inter fixation for injured segment can make a stable and broad space for spinal cord, promoting early neurological recovery and long-term improvement.

To investigate the impact of enhanced UV-B radiation on respiration rate and N2O emission from soil-winter wheat system, outdoor pot experiments with simulating 20% supplemental of UV-B were conducted, and static dark chamber-gas chromatograph method were used. Results indicated that the enhanced UV-B radiation did not change the seasonal pattern of respiration rate and N2O emission. Enhanced UV-B radiation declined the rate of soil-winter wheat system's respiration but had no significant impact on N2O emission in turning-green stage. While enhanced UV-B radiation declined both respiration rate and the N2O emission in elongation-pregnant stage. From heading to maturity, the respiration rate and N2O emission from soil-winter wheat system were not found to be significantly difference under UV-B radiation compared with ambient conditions. A further analysis suggested that enhanced UV-B radiation declined significantly cumulative amount of N2O from soil-winter wheat system from wheat turning green to full heading stage, while no significant impact occurred from full heading to maturity.

We report a Doppler optical cardiogram gating technique for increasing the effective frame rate of Doppler optical coherence tomography (DOCT) when imaging periodic motion as found in the cardiovascular system of embryos. This was accomplished with a Thorlabs swept-source DOCT system that simultaneously acquired and displayed structural and Doppler images at 12 frames per second (fps). The gating technique allowed for ultra-high speed visualization of the blood flow pattern in the developing hearts of African clawed frog embryos (Xenopus laevis) at up to 1000 fps. In addition, four-dimensional (three spatial dimensions + temporal) Doppler imaging at 45 fps was demonstrated using this gating technique, producing detailed visualization of the complex cardiac motion and hemodynamics in a beating heart.

High-speed, high-resolution optical coherence tomography (OCT) imaging of the human retina is demonstrated using a frequency-swept laser at 850 nm. A compact external cavity semiconductor laser design, optimized for swept-source ophthalmic OCT, is described. The laser enables an effective 16 kHz sweep rate with >10 mm coherence length and a tuning range of approximately 35 nm full width at half-maximum, yielding an axial resolution of <7 micro m in tissue.

Background: The occurrence of violent trauma has recently increased, and it has become both a social and medical problem in China. We are the first to explore violent head trauma in China., Methods: Patients with violent head trauma were taken from all hospitalized patients with head trauma from January 2001 to December 2006 admitted to 11 hospitals in China. The rate, causes, age, sex, injury severity (GCS score), CT findings, management, outcome, and complications of patients with violent head trauma were retrospectively analyzed., Results: Two thousand two hundred fifty-four (9.46%) patients with violent head trauma were found among a total of 23816 hospitalized patients with head trauma at 11 hospitals. Violent head trauma was caused by blunt objects (n = 1260, 55.90%), sharp/cutting instruments (n = 271, 12.02%), gunshots (n = 10, 0.44%), and others (n = 713, 31.63%). Violent head trauma was more likely to be found men (n = 1890, 83.85%) and in persons aged 21 to 40 years (n = 1216, 53.95%). In 2254 patients with violent head trauma, scalpel injury was seen in 1277 cases, skull fracture in 786 cases, cerebral contusion in 285 cases, and intracranial hematomas in 898 cases. Five hundred eighty-nine (26.13%) patients had body violent trauma besides violent head trauma. A GCS score of 13 to 15 was found in 1869 (82.92%) patients, 9 to 12 in 166 (7.36%), and 8 or less in 219 (9.72%). One thousand forty-two patients got surgical treatment, and another 1212 received medical management. One thousand nine hundred thirty-one (85.67%) patients had good recovery, 141 (6.47%) had moderate deficits, 36 (1.65%) had severe deficits, 7 (0.32%) had PVS, 63 (2.89%) died, and for the other 76, records were lost., Conclusions: Violent head trauma is certainly both a social and medical problem now, which indicates that violence should be controlled and that the human right of social safety needs to be improved in China.

Background: Resection of anterior clinoidal meningiomas remains a major neurosurgical challenge. We determine the surgical technique for removal of tumor and improvement of patient's outcome., Methods: A retrospective analysis was performed on 26 consecutive patients with anterior clinoidal meningiomas who underwent surgical resection at the Department of Neurosurgery, Renji Hospital, from January 1999 to August 2006. All patients had surgery through the pterional or extended pterional approach. Microvascular Doppler probe was used to protect the internal carotid artery and its branching arteries during dissection of the tumor. Twenty-two of them had severe visual deficits preoperatively. The follow-up period ranged from 3 to 36 months (22.3 +/- 8.8 months)., Results: In this series, Simpson grade II resection in 16 cases (61.5%), Simpson grade III resection in 4 cases (15.4%), Simpson grade IV resection in 6 cases (23.1%) were achieved. Sixteen of the patients with preoperative visual impairment experienced significant improvement. No patients died. There was no evidence of tumor recurrence during follow-up., Conclusions: In the majority of patients, surgery is still the first choice for total resection of the tumors without major complications. Protection of nerves and blood vessels must be a priority concern during removal of tumors.

Objective: To compare the efficiency of transfection of marrow stem cells (MSCs) by using lentiviral vector and adenoviral vector., Methods: MSCs were obtained from the femur bone marrow of rat and cultured. Recombinant plasmid pHIV-CS-CG-PRE containing green fluorescent protein (GFP) gene, and package plasmids pRSV-Rev, pMDLg/pPRE, and pMD.G were infected into the human embryonic kidney cells of the line 293T. The rat MSCs were transfected with the DFP recombinant lentiviral particles, and flow cytometry was used to detect the expression of GFP 1, 3, and 5 weeks later. Full-length human bone morphogenetic protein = 2 (hBMP2) gene was searched out from the GenBank and isolated from human liver cDNA from a sample of liver tissue resected from a patient with liver rupture and then cloned. Thus the lentiviral vector with BMP-2 gene, pHIV-CS-CDF-CG-PRE-BMP-2 was constructed and transfected into 293 cells. Indirect immunofluorescence assay, ELISA, and Western blotting were used to detect the expression of hBMP2 gene., Results: After infected by the viral vectors the GFP expression was significantly better in the lentiviral vector-infected rMSCs than in the adenoviral vector-infected ones. FCM showed that the GFP expression rates of the lentiviral vector-infected rMSCs 1, 3, and 5 weeks after the infection were 90%, 83.2%, and 79% respectively, and he GFP expression rates of the adenoviral vector-infected rMSCs 1, 3, and 5 weeks after the infection were 71%, 0.13%, and 0.05% respectively, all significantly lower than on the former group. Indirect immunofluorescence assay, ELISA, and Western blotting showed that the recombinant lentivirus successfully expressed the target protein in the transfected 293T cells., Conclusion: Lentiviral vector with hBMP2 gene can be constructed successfully. The transfection efficiency of BMP2 gene by lentivirus is significantly higher than that of adenovirus.

Hypothermia has been demonstrated to protect the brain from ischemia or traumatic brain injury. Achieving profound hypothermia has relied on techniques requiring total body cooling, which may result in serious cardiovascular and pulmonary complications. A technique to selectively cool the brain could conceivably exert a marked protection on cerebral structures and provide a relatively bloodless operative surgical field without systemic complications. Accordingly, this approach was tried in 7 rhesus monkeys after induction of general anesthesia. The right internal carotid artery and both internal jugular veins were each occlusively cannulated and connected to a circulation pump. The left internal carotid artery, both external carotid arteries, and both external jugular veins were temporarily clamped to establish severe cerebral ischemia. Using a closed-circuit system, cooled Ringer's lactate liquid (4 degrees C) was infused through right internal carotid artery with outflow draining though both internal jugular veins. Cooled perfusate decreased cerebral temperature to the target temperature of 15 degrees C. Thereafter, pump flow was discontinued, and brains were rewarmed spontaneously, while the temporarily clamped carotid arteries and jugular veins were opened to resume normal cerebral blood circulation. Neurological functions were recorded daily and cerebral histology was examined at the conclusion of the experiment. Magnetic resonance (MR) scans were routinely taken before and 3 weeks after ischemia. In the normothermia control group of five rhesus monkeys, Ringer's solution at 37 degrees C was infused in the same manner as the cold solution with cerebral temperature maintained at 36.7 +/- 0.32 degrees C. Right cerebral temperature decreased from 36.5 +/- 0.49 to 15.5 +/- 2.29 degrees C, and simultaneously the left cerebral temperature decreased from 36.4 +/- 0.38 to 16.3 +/- 2.4 degrees C for 62.8 +/- 9.76 min during selective cerebral cooled Ringer's liquid perfusion. In contrast, rectal temperature was only reduced to 32.4 +/- 0.96 degrees C from a baseline of 37.2 +/- 0.76 degrees C. Internal jugular vein hematocrit was 38.2 +/- 0.31% before perfusion and 2.82 +/- 0.46% at the end of perfusion in profound hypothermia group; hematocrit was 39.7 +/- 0.62% before perfusion and 3.42 +/- 0.38% at the end of perfusion in the normothermia group. In the hypothermic group, neurological functions were normal during 6 months of follow-up, and microscopic examination of brain tissue did not show evidence of pathological changes in hippocampus or medulla. MR scans did not show any cerebral infarction. In contrast, none of the monkeys in normothermia group survived for more than several hours, and microscopic examination of the brain revealed extensive neuronal necrosis within the medulla. Selective cerebral profound hypothermia provides significant histologic and neurologic protection after severe cerebral ischemia. In addition, there were no major complications, and the operative field remained relatively bloodless in the profound hypothermic group.

Although the role of the TGF beta superfamily members in the regulation of ovarian folliculogenesis has been extensively studied, their involvement in follicular atresia is not well understood. In the present study, we have demonstrated for the first time that Nodal, a member of the TGF beta superfamily, is involved in promoting follicular atresia as evidenced by the following: 1) colocalization of Nodal and its type I receptor Activin receptor-like kinase 7 (ALK7) proteins in the granulosa cells was only observed in atretic antral follicles, whereas they were present in theca cells and granulosa cells of healthy follicles, respectively; 2) addition of recombinant Nodal or overexpression of Nodal by adenoviral infection induced apoptosis of otherwise healthy granulosa cells; 3) constitutively active ALK7 (ALK7-ca) overexpression mimicked the function of Nodal in the induction of granulosa cell apoptosis. Furthermore, overexpression of Nodal or ALK7-ca increased phosphorylation and nuclear translocation of Smad2, decreased X-linked inhibitor of apoptotic proteins (Xiap) expression at both mRNA and protein level and phospho-Akt content, as well as triggered mitochondrial release of death proteins Smac/DIABLO, Omi/HtrA2, and cytochrome c in the granulosa cells. Dominant-negative Smad2 significantly attenuated ALK7-ca-induced down-regulation of Xiap and thus rescued granulosa cells from undergoing apoptosis. In addition, whereas up-regulation of Xiap significantly attenuated ALK7-ca-induced apoptosis, down-regulation of Xiap sensitized granulosa cells to ALK7-ca-induced apoptosis. Furthermore, ALK7-ca-induced apoptosis was significantly attenuated by forced expression of activated Akt, and Akt rescued granulosa cells from undergoing apoptosis via proteasome-mediated ALK7 degradation. Taken together, Nodal plays an atretogenic role in the ovary where it induces granulosa cell apoptosis through activation of Smad2, down-regulation of the key survival molecules Xiap and phospho-Akt, as well as the activation of mitochondrial death pathway.

Ovarian follicular atresia represents a selection process that ensures the release of only healthy and viable oocytes during ovulation. The transition from preantral to early antral stage is the penultimate stage of development in terms of gonadotropin dependence and follicle destiny (survival/growth vs. atresia). We have examined whether and how oocyte-derived growth differentiation factor 9 (GDF-9) and FSH regulate follicular development and atresia during the preantral to early antral transition, by a novel combination of in vitro gene manipulation (i.e. intraoocyte injection of GDF-9 antisense oligos) and preantral follicle culture. Injection of GDF-9 antisense suppressed basal and FSH-induced preantral follicle growth in vitro, whereas addition of GDF-9 enhanced basal and FSH-induced follicular development. GDF-9 antisense activated caspase-3 and induced apoptosis in cultured preantral follicles, a response attenuated by exogenous GDF-9. GDF-9 increased phospho-Akt content in granulosa cells of early antral follicles. Although granulosa cell apoptosis induced by ceramide was attenuated by the presence of GDF-9, this protective effect of GDF-9 was prevented by the phosphatidylinositol 3-kinase inhibitor LY294002 and a dominant negative form of Akt. Injection of GDF-9 antisense decreased FSH receptor mRNA levels in cultured follicles, a response preventable by the presence of exogenous GDF-9. The data suggest that GDF-9 is antiapoptotic in preantral follicles and protects granulosa cells from undergoing apoptosis via activation of the phosphatidylinositol 3-kinase/Akt pathway. An adequate level of GDF-9 is required for follicular FSH receptor mRNA expression. GDF-9 promotes follicular survival and growth during the preantral to early antral transition by suppressing granulosa cell apoptosis and follicular atresia.

To study the influencing mechanisms of enhanced UV-B radiation on the emission of N20 from soil-wheat system, outdoor pot experiments with simulating 20% supplemental level of UV-B were conducted. Results indicate that the enhanced UV-B had no significant impact on the emission of N20 from soil-wheat system in turning- green stage, but declined the N2O flux and the rate of the system's respiration in elongation stage. The impact mechanisms of enhanced UV-B radiation on the N2O flux were to directly change the nitrogen metabolism process of wheat plant, such as significantly increasing soluble protein, total nitrogen and total phosphorus in wheat leaves. But the effects of UV-B radiation on soil N2O emission may be indirect, namely, UV-B treatment by working on wheat plant significantly increased the soil available nitrogen, soil microbial biomass C and N, and also changed the ratio of soil microbial C: N(from 5.0 to 6.8) in winter-wheat rhizosphere.

To compare the effect of long-term mild hypothermia versus short-term mild hypothermia on the outcome of 215 severe traumatic brain injured patients with cerebral contusion and intracranial hypertension. At three medical centers, 215 patients aged 18 to 45 years old with an admission Glasgow Coma Scale < or =8 within 4 h after injury were randomly divided into two groups: long-term mild hypothermia group (n = 108) for 5+/-1.3 days mild hypothermia therapy and short-term mild hypothermia group (n = 107) for 2+/-0.6 days mild hypothermia therapy. All patients had intracranial hypertension and frontotemporoparietal contusion with midline shift >1 cm confirmed on computed tomographic scan. Glasgow Outcome Scale at 6-month follow-up, 47 cases had favorable outcome (43.5%), and other 61 cases had unfavorable outcome (56.5%) in the long-term mild hypothermia group. However, only 31 cases had favorable outcome (29.0%), and other 76 cases had unfavorable outcome (71.0%) in the short-term mild hypothermia group (P < 0.05). The intracranial pressure significantly rebounded after rewarming in the short-term mild hypothermia group, but not in the long-term mild hypothermia (P < 0.05). Furthermore, the incidence of stress ulcer, epilepsy, pulmonary infection, intracranial infection did not significantly differ between the two groups (P > 0.05). Compared with short-term mild hypothermia, long-term mild hypothermia significantly improves the outcome of severe traumatic brain injured patients with cerebral contusion and intracranial hypertension without significant complications. Our data suggest that 5 days of long-term cooling is more efficacious than 2 days of short-term cooling when mild hypothermia is used to control refractory intracranial hypertension in patients with severe traumatic brain injury.

To describe the morphological characteristics of the ovarian follicle (F) capillary neoformation and regression, the angiogenic figures were studied by means of scanning electron microscopy of corrosion casts in developing and mature F of rabbit, pig, and cow. Developing F showed gradual neoformation of thecal capillaries characterized by budding and then sprouting, likely from preexisting interstitial vessels. Postcapillary venules frequently showed vasoconstriction rings (sphincters). Vasodilation followed capillary elongation. Mature F, in addition to vessel elongation and dilation, also presented infolding of dilated capillary walls, followed by capillary duplication and sinusoidalization. Periovulatory F mainly showed functional changes, such as capillary dilation, signs of iperpermeabilization, and ischemia, the latter being limited to the apical follicular area. Vessel regression was characterized by thinning of capillaries and presence of avascular areas within the atretic F wall at any stage. This study showed two main types of angiogenic patterns. (a) longitudinal elongation (in series, sprouting angiogenesis) characterizing the initial phase of F development and (b) parallel duplication (in parallel, infolding or intussusceptive angiogenesis), ending in capillary lateral replication or splitting, secondary to functional microvascular changes. Indirect evidence of the establishment of postcapillary resistances contributing to capillary remodeling, was also shown. It is concluded that the sequence of capillary neoformation in mammalian ovarian F occurs in six steps: (1) budding, (2) sprouting (and elongation), (3) dilation, (4) infolding (intussusception), (5) duplication (splitting and elongation), and (6) sinusoidalization. Capillary regression hits F at any stage and characterizes F atresia.

Background & Objective: Hepatocyte growth factor (HGF) specifically binds to its receptor c-met, activates a complex set of intracellular pathways, and plays important roles in regulating tumor invasion, metastasis, and angiogenesis. HGF and c-met are overexpressed in ovarian cancer. This study was designed to investigate the role of HGF in ovarian cancer invasion and its signal transduction pathway., Methods: HGF-induced invasion of ovarian cancer cell line SKOV3 was analyzed with Boyden chamber invasion assay. The expression changes of c-met and matrix metalloproteinase-9 (MMP-9) in SKOV3 cells before and after treatment with HGF and nuclear factor kappaB (NF-kappaB) inhibitor pyrrolidine dithiocarbamate (PDTC) were measured by real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blot, and flow cytometry. The expression of NF-kappaB in SKOV3 cells was evaluated by immunocytochemistry and Western blot., Results: The invasive cells were significantly more in HGF group than in control group and PDTC plus HGF group (343+/-13 vs. 167+/-11 and 241+/-10, P<0.01). HGF promoted the expression of MMP-9 mRNA by 5.66+/-0.10 folds, but had no effect on c-met mRNA expression; PDTC suppressed the HGF-driven expression of MMP-9 mRNA by 2.75+/-0.80 folds. The positive rates of c-met and MMP-9 were significantly higher in HGF-treated cells than in control cells [(96.6+/-2.0)% vs. (73.3+/-2.4)%, P<0.01; (74.6+/-4.4)% vs. (16.0+/-2.9)%, P<0.01]. The protein levels of c-met and MMP-9 were significantly higher in HGF-treated cells than in control cells (2.84+/-0.18 vs. 1.65+/-0.19, P<0.01; 2.94+/-0.13 vs. 0.54+/-0.18, P<0.01). PDTC significantly suppressed the HGF-driven expression of MMP-9 protein: the positive rate and protein level of MMP-9 were (25.8+/-3.7)% and 0.87+/-0.14 (P<0.05). HGF promoted the expression of NF-kappaB protein in a time-dependent manner. The expression peak appeared 1 h after treatment with HGF (from 0.42+/-0.11 to 1.16+/-0.21, P<0.01). PDTC significantly inhibited the HGF-driven expression of NF-kappaB protein (0.38+/-0.12, P<0.01)., Conclusion: HGF might stimulate the invasion of SKOV3 cells by up-regulating the expression of MMP-9 via NF-kappaB pathway.

Background and Purpose: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies. We tried to elucidate the possible prognostic factors., Methods: A retrospective review was conducted of ATC patients in National Taiwan University Hospital from 1978 to 2003. Their demographic characteristics, clinical presentations, laboratory data and treatment modalities were reviewed. Possible prognostic factors for survival were evaluated., Results: Forty-five patients (14 males and 31 females) of mean age 61.9 +/- 12.6 yr were included in this study. The median survival time was 94 days (range 6 to 776 days). The overall survival rate was 27% at 6 months and 10% at 1 yr. Thirty-two patients receiving intervention regimens had a median survival of 106 days, while 13 patients receiving palliative therapy had a median survival of 39 days. The difference in survival is statistically significant (logrank test, p = 0.017). Adjusted with sex and age, increment in white blood cell count (per 10(9)/l) and serum albumin (per 1.0 g/l) had a hazard ratio of 1.12 (Cox regression, p < 0.001) and 0.92 (p = 0.041), respectively. Patients with leukocytosis [white blood cell (WBC) count > 10(10)/l] or hypoalbuminemia (serum albumin < 35 g/l) had significant shorter survival than patients without leukocytosis or hypoalbuminemia (logrank test p = 0.008 and p = 0.032, respectively). Patients with serum T4 levels lower than 64.35 nmol/l had significantly shorter survival than patients without hypothyroxinemia (median survival 24 vs 128 days, logrank test, p = 0.004)., Conclusions: ATC is an aggressive malignancy. Leukocytosis, hypoalbuminemia and hypothyroxinemia indicated poor prognosis. Survival time might be prolonged if intervention treatment is tolerable.

We demonstrate high resolution, three-dimensional OCT imaging with a high speed, frequency swept 1300 nm laser source. A new external cavity semiconductor laser design, optimized for application to swept source OCT, is discussed. The design of the laser enables adjustment of an internal spectral filter to change the filter bandwidth and provides a robust bulk optics design. The laser generates ~30 mW instantaneous peak power at an effective 16 kHz sweep rate with a tuning range of ~133 nm full width. In frequency domain reflectometry and OCT applications, 109 dB sensitivity and ~10 microm axial resolution in tissue can be achieved with the swept laser. The high imaging speeds enable three-dimensional OCT imaging, including zone focusing or C-mode imaging and image fusion to acquire large depth of field data sets with high resolution. In addition, three-dimensional OCT data provides coherence gated en face images similar to optical coherence microscopy (OCM) and also enables the generation of images similar to confocal microscopy by summing signals in the axial direction. High speed, three-dimensional OCT imaging can provide comprehensive data which combines the advantages of optical coherence tomography and microscopy in a single system.

It has been shown that the stromal-cell population found in bone marrow can be expanded and differentiated into cells with the phenotypes of bone, cartilage, muscle, neural, and fat cells. However, whether mesenchymal stem cells (MSCs) are present in human umbilical-cord blood (UCB) has been the subject of ongoing debate. In this study, we report on a population of fibroblastlike cells derived from the mononuclear fraction of human UCB with osteogenic and adipogenic potential, as well as the presence of a subset of cells that have been maintained in continuous culture for more than 6 months. These cells were found to express CD29, CD44, CD90, CD95, CD105, CD166, and MHC class, but not CD14, CD34, CD40, CD45, CD80, CD86, CD117, CD152, or MHC class II. We also compared gene expression after gene transfer using lenti- and adenoviral vectors carrying the green fluorescence protein to the MSCs derived from UCB because a reliable gene-delivery system is required to transfer target genes into MSCs, which have attracted attention as potential platforms for the systemic delivery of therapeutic genes. The lentiviral vectors can transduce these cells more efficiently than can adenoviral vectors, and we maintained transgene expression for at least 5 weeks. This is the first report showing that UCB-derived MSCs can express exogenous genes by way of a lentivirus vector. These results demonstrate that human UCB is a source of mesenchymal progenitors and may be used in cell transplantation and a wide range of gene-therapy treatments.

Objective: To investigate the clinical reliability and feasibility of target-controlled infusion (TCI) with different plasma concentration remifentanil and propofol., Methods: Thirty ASA I-II patients, > or =65 years old, undergoing selective lower abdominal operation were divided into 3 groups, group A with anesthesia using propofol combined with epidural block, group B with anesthesia using propofol and remifentanil (plasma concentration 4 microg/L), group C with anesthesia using propofol and remifentanil (plasma concentration 7 microg/L). BIS value, heart rate, blood pressure, heart rate variability and so on, were recorded during anesthesia and operation. Radial arterial blood samples for analysis of plasma concentration of propofol were taken during operation., Results: (1) The intubation response of groups B and C was lower than that of group A . (2) The depth of anesthesia was enough during operation (BIS value=45-60). (3) TCI propofol combined with remifentanil didn't lengthen the awaking time of patients; (4) MDPE of target-controlled infusion using propofol with Marsh parameters was 11.17%, MDAPE was 12.16% in Chinese elderly patients., Conclusion: Remifentanil with plasma concentration of 4 and 7 microg/L combined with propofol could be safely used during clinical anesthesia of old patient, but monitoring must be strengthened during induction when plasma concentration of remifentanil was 7 microg/L. TCI propofol with Marsh parameters could be applied to Chinese elderly patients safely and efficiently.