bluuebunny/crossref_metadata_2025 huggingface dataset:
Trigeminal Neuralgia Caused by a Choroid Plexus Papilloma of the Cerebellopontine Angle: Case Report and Review of the Literature
Authors: Jia DZ , Zhou MD , Jiang YQ , Li G
Published: February 2013

This report describes a 59-year old woman with a rare choroid plexus papilloma of the cerebellopontine angle presenting with trigeminal neuralgia. The patient was admitted complaining of a 12-year history of paroxysmal lancinating pain throughout the right side of her face. Treatment with carbamazepine, Chinese medicine and a peripheral neurectomy had not relieved the pain. At operation, a 0.5 × 0.5 × 0.5 cm neoplasm was found in the cerebellopontine angle, which was firmly adherent to the roots of the seventh and eighth cranial nerves and the brainstem. There was no apparent tumour bulk or vascular compression around the trigeminal nerve root entry zone. Subtotal tumour excision and selective partial rhizotomy were performed. The patient's facial pain gradually resolved. Involvement of the trigeminal nucleus in the brainstem by the cerebellopontine angle tumour is suggested as the possible cause for trigeminal neuralgia in this case.
Prevalence and Prognostic Significance of FLT3 Gene Mutations in Patients with Acute Leukaemia: Analysis of Patients from the Shanghai Leukaemia Co-operative Group
Authors: Wang W , Wang X-Q , Xu X-P , Lin G-W
Published: February 2013

This study was designed to evaluate the prevalence of fms-like tyrosine kinase-3 (FLT3) gene mutations in the World Health Organization classified subtypes of acute leukaemia (AL), and their prognostic significance in terms of complete remission (CR), leukaemia-free survival (LFS) and overall survival (OS). Of 468 patients, 374 (79.9%) had acute myeloid leukaemia (AML) and 83 (17.7%) had acute lymphoblastic leukaemia (ALL). Among the AML patients, a FLT3 internal tandem duplication (FLT3/ITD) mutation was present in 59 cases (15.8%), whereas a FLT3/D835 mutation was detected in 15 cases (4.0%). Conversely, in the ALL patients, no FLT3/ITD mutations were detected and a FLT3/D835 mutation was found in only two cases (2.4%). The FLT3/ITD mutation was associated with a lower CR rate compared with those with no mutations (52.3% versus 71.1%) and with a shorter median OS (9 versus 18 months) in AML patients. In conclusion, the FLT3/ITD mutation occurred frequently in AML and was associated with a lower CR and shorter median OS. In contrast, FLT3/D835 mutations were not of prognostic value.
Positive Association of Serum Levels of Pigment Epithelium-Derived Factor with High-Sensitivity C-Reactive Protein in Apparently Healthy Unmedicated Subjects
Authors: Umei H , Yamagishi S-I , Imaizumi T
Published: February 2013

Pigment epithelium-derived factor (PEDF), a glycoprotein with neuronal differentiating activity, possesses antiinflammatory properties both in cell culture and animal models. However, the relationship between serum levels of PEDF and high-sensitivity C-reactive protein (hs-CRP), one of the representative biomarkers for inflammation in humans, is largely unknown. This study investigated whether serum PEDF levels were associated with hs-CRP in 120 apparently healthy unmedicated Japanese subjects (93 males, 27 females; mean age 58.0 years). All subjects underwent a complete history and physical examination, including blood chemistries, anthropometric and metabolic variables. Multiple regression analysis found that serum hs-CRP, creatinine and triglyceride levels, and the homeostasis model assessment of insulin resistance (HOMA-IR) and body mass index were significantly and independently associated with serum PEDF levels. It is concluded that, serum levels of PEDF are associated with serum levels of hs-CRP independently of anthropometric, metabolic and renal function variables. The results also suggest that serum PEDF levels may be elevated as a counter-system against subclinical inflammation.
Correlation between Thymidylate Synthase Gene Variants, RNA and Protein Levels in Primary Colorectal Adenocarcinomas
Authors: Kristensen MH , Weidinger M , Bzorek M , Pedersen PL , Mejer J
Published: February 2013

This study was designed to compare thymidylate synthase (TS) genotype, mRNA and protein levels in primary colorectal adenocarcinoma, and to examine the correlation between microsatellite instability (MSI) and TS expression. The TS genotype of 68 patients with colorectal cancer was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis in peripheral blood mononuclear cells and tumour tissue. The TS mRNA levels in tumour tissue were measured by reverse-transcription PCR, and TS protein levels and MSI status were assessed using immunohistochemistry. Significantly higher mRNA and protein levels were observed in patients with the TS 3R/3R versus the 2R/2R and 2R/3R genotypes. There was no correlation between TS single nucleotide polymorphism and TS expression. Individuals homozygous for the six base-pair insertion in the 3′-untranslated region had significantly higher TS mRNA levels than heterozygous and homozygous wild type individuals. The TS mRNA and protein levels were significantly higher in microsatellite unstable tumours compared with microsatellite stable tumours. There was a significant association between the number of TS enhancer region repeats (in blood) and intratumoural TS mRNA and protein levels. A larger case series investigating the role of TS gene polymorphisms as predictors of sensitivity to 5-fluorouracil-based chemotherapy is required.
Tissue-Specific Pattern of Angiotensin-Converting Enzyme 2 Expression in Rat Pancreas
Authors: Fang HJ , Yang JK
Published: February 2013

Angiotensin-converting enzyme 2 (ACE2), a carboxypeptidase that is highly homologous to ACE, acts as a negative regulator for the renin-angiotensin system (RAS). Pancreatic RAS is thought to play important endocrine and exocrine roles in hormone secretion. Further exploration of this system is likely to offer new insights into the pathogenesis of pancreatic diseases such as diabetes mellitus. This study investigated the expression of ACE2 in rat pancreatic exocrine and endocrine tissue. Reverse transcription-polymerase chain reaction, immunoblotting and immunohistochemistry showed that ACE2 mRNA and protein were expressed in the pancreas. Immunoelectron microscopy demonstrated that ACE2 was expressed in both endocrine and exocrine pancreatic tissues. In the endocrine tissue, ACE2 was localized on the secretory granules. Double immunofluorescence labelling showed that ACE2 was co-localized with both insulin and somatostatin, while it was rarely co-localized with glucagon and pancreatic polypeptide. These findings suggest that ACE2 might play an important role in glucose homeostasis.
The L/N-Type Calcium Channel Blocker, Cilnidipine, Reduces Heart Rate and Albuminuria in Patients with Type 2 Diabetes
Authors: Tanaka M
Published: February 2013

This study was designed to investigate whether the L/N-type calcium channel blocker, cilnidipine, had a renoprotective effect compared with other calcium channel blockers. Twenty-five hypertensive patients with concomitant type 2 diabetes who had a urinary albumin-creatinine ratio (ACR) of 10 − 300 mg albumin/g creatinine and who had been treated with oral calcium channel blockers other than cilnidipine for more than 3 months were included. Patients' medication was changed to cilnidipine 10 mg/day or 20 mg/day without a washout period. Blood pressure and renal function were measured before and at 3 months after the new treatment. Heart rate was also determined as a marker for sympathetic nervous activity. After substitution of cilnidipine, blood pressure did not change significantly, but heart rate decreased significantly from 73.9 ± 7.1 beats/min to 72.0 ± 8.4 beats/min, and the log-transformed urinary ACR decreased to 82.9 ± 49.4% of baseline values. The changes in urinary ACR and heart rate showed a significant positive correlation. Thus, there was a strong indication that cilnidipine may exert its renoprotective effect by inhibiting sympathetic nervous activity.
A Pilot Study of the Clinical Relevance of the Relationship between the Serum Level of Pregnancy-Associated Plasma Protein a and the Degree of Acute Coronary Syndrome
Authors: You L , Li L , Zhang F , Xu Q , Ren J
Published: February 2013

Serum levels of pregnancy-associated plasma protein-A (PAPP-A), high-sensitivity C-reactive protein (hs-CRP) and tumour necrosis factor-α (TNF-α) were measured in 70 patients with acute coronary syndrome (ACS), comprising 18 with unstable angina (UA), 37 with acute myocardial infarction (AMI) and 15 with stable angina (SA); 15 healthy controls were also included. Levels of PAPP-A were significantly higher in the UA and AMI groups than in the SA and control groups. Levels of PAPP-A were similar in the SA and control groups, and higher in the ACS patients who were cardiac troponin T-negative (comprising UA and AMI patients) than in the control and SA groups. Levels of hs-CRP and TNF-α were significantly higher in the SA group than in the control group, significantly higher in the UA group than in the SA and control groups, and significantly higher in the AMI group than in all other groups. Levels of PAPP-A in ACS patients were positively correlated with levels of hs-CRP and TNF-α. It would seem, therefore, that PAPP-A is associated with inflammation and might be used to detect plaque instability and rupture before an increase in cardiac troponin T is detectable.
Early Onset of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) after Allogeneic Haematopoietic Stem Cell Transplantation: Case Report and Review of the Literature
Authors: Wei J , Xiao Y , Yu X , Zhou J , Zhang Y
Published: February 2013

Severe hyponatraemia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare but fatal complication following stem cell transplantation (SCT). This case report details a patient with early-onset SIADH after allogeneic haematopoietic SCT (allo-HSCT) and reviews the literature on risk factors for the development of this condition. The patient, who had chronic myelogenous leukaemia, developed acute graft-versus-host disease (GVHD) on day 5 after allo-HSCT, which was relieved promptly by steroids. On day 18, he presented with hyponatraemia, which was refractory. Despite intensive restriction of fluid and administration of hypertonic saline, his condition worsened and he died of multiple systemic organ dysfunction. A review of the literature reveals that early-onset SIADH following SCT is insidious, but progresses rapidly. The severity of the disorder is underestimated because of the non-specific clinical features and the lack of effective treatment. Myeloablative conditioning and acute GVHD are two major important predisposing factors in SIADH.
Calponin Expression in Laryngeal Myoepithelial Carcinoma and Its Prognostic Implications: A Case Report and Literature Review
Authors: Mao YJ , Luo XM , Zhou SH , Zheng ZJ
Published: February 2013

A case report of laryngeal myoepithelial carcinoma (MEC) is presented and the literature concerning prognostic factors in MEC is reviewed. A 61-year old man was admitted to hospital with hoarseness and progressive dyspnoea. On examination, both vocal cords were fixed in the midline with a glottic fissure of only 3 mm. No tumour was seen, but the subglottis was not completely visible. A computed tomography scan showed a soft mass below the right vocal cord obstructing two-thirds of the larynx. On suspension laryngoscopy, a dull mass (1.5 × 1.5 cm) was seen below the right vocal cord, which was malignant on frozen biopsy. A total laryngectomy was performed and the patient received radiotherapy. He died of recurrence 25 months later. The tumour was positive for cytokeratin 14, S-100 protein and calponin. MEC of the larynx is extremely rare. The clinical behaviour of MEC is variable and prognostic factors have been poorly analysed. Calponin expression may be a prognostic factor, but other factors also affect the outcome in MEC.
Scientific Publications in Pharmacology and Pharmacy Journals from Chinese Authors in Various Parts of North Asia: A 10-year Survey of the Literature
Authors: Li G , Hu L-H , Liao Z , Cui H-C , Li Z-S
Published: February 2013

The amount and quality of pharmacology and pharmacy research by authors from China was investigated by comparing published articles from 136 international journals (1998 − 2007) by authors from mainland China, Hong Kong and Taiwan. The number of articles, clinical trials, randomized controlled trials, case reports, impact factors, number of citations and number of articles published in top general medicine journals were compared. The total number of articles increased significantly between 1998 and 2007 (from 324 to 2536 per year). In total, there were 12 021 articles: 7576 from mainland China, 3267 from Taiwan and 1178 from Hong Kong. The accumulated impact factor of the articles from mainland China (16 688.94) was much higher than for those from Taiwan (8726.92) and Hong Kong (3161.22) but, among the three regions, Hong Kong had the highest mean impact factor and the most articles published in top general medicine journals.
Mini-subvastus versus a Standard Approach in Total Knee Arthroplasty: A Prospective, Randomized, Controlled Study
Authors: Pan W-M , Li X-G , Tang T-S , Qian Z-L , Zhang Q , Zhang C-M
Published: February 2013

This prospective randomized study compared the clinical and radiological results of primary total knee arthropasty (TKA) using a mini-subvastus approach (group I; n = 35) or a standard approach (group II; n = 33). A posterior-stabilized prosthesis was used in both groups by the same surgeon. Mean follow-up was 18 months (range 14 − 26 months). Patients in group I lost less blood and experienced less pain 1 day post-operatively. They achieved an active straight leg raise earlier and underwent less lateral retinacular releases. Functional outcome and the range of knee movements were significantly better in group I up to 9 months post-operatively, but there was no significant difference between the groups at 1 year post-operatively or at final follow-up. Reduced access and visibility in group I prolonged the operation time and resulted in five technical errors on radiographic evaluation. Based on these results, the authors currently only use the mini-subvastus approach for minimally invasive TKA in selected cases.
CD8/MHC-I Complex is Specific but Not Sensitive for the Diagnosis of Polymyositis
Authors: Dai T-J , Li W , Zhao Q-W , Zhao Y-Y , Liu S-P , Yan C-Z
Published: February 2013

This study aimed to investigate immunostaining patterns for major histocompatibility complex class I (MHC-I) in different types of myopathies and to assess the diagnostic value of CD8/MHC-I complex for definite polymyositis. The study included 20 cases of definite polymyositis, 20 cases of dermatomyositis and 10 cases of dystrophies with muscle inflammation (inflammatory muscular dystrophy). Immunohistochemical staining with MHC-I antibody demonstrated the presence of MHC-I along the sarcolemma of scattered or small groups of non-necrotic fibres in both polymyositis and inflammatory muscular dystrophy, whereas intense sarcolemmal immunostaining for MHC-I was diffusely present in almost all fibres in dermatomyositis. Double immunofluorescence labelling for CD8 and MHC-I detected the CD8/MHC-I complex in 20% of polymyositis cases with mononuclear cell infiltrates. No CD8/MHC-I complex was found in the dermatomyositis or inflammatory muscular dystrophy cases. The results suggest that MHC-I detection alone cannot be used as a reliable diagnostic test to differentiate polymyositis from dystrophies with secondary muscle inflammation. The CD8/MHC-I complex, although showing high specificity, is neither a sensitive nor an easy-to-handle diagnostic test for polymyositis.
CD20-positive T-cell Lymphoma with Indolent Clinical Behaviour
Authors: Xiao W-B , Wang Z-M , Wang L-J
Published: February 2013

T-cell lymphomas that are positive for CD20 are very rare and most reported cases have demonstrated an aggressive clinical course. An unusual case of a 57-year old female who presented with recurrent enlarged lymph nodes for 12 years is reported. The lymph nodes from both 1995 and 2007 showed effacement of the lymph node architecture by a diffuse and dense infiltrate of small lymphoid cells. In terms of T- and B-cell markers, these small lymphoid cells were immunohistochemically positive for CD2, CD3, CD5, CD43, CD45RO and CD20, and were negative for PAX5, CD79a and cyclin D1. Molecular genetic analysis showed T-cell receptor-γ chain gene rearrangement. Recognition of this type of CD20-positive T-cell lymphoma is important for ensuring a correct diagnosis so that the patient can be offered the most appropriate therapy. The indolent behaviour of the present case is unusual and awaits further clinical follow-up and laboratory investigation.
Clinical Outcomes of Ovulation Induction with Metformin, Clomiphene Citrate and Human Menopausal Gonadotrophin in Polycystic Ovary Syndrome
Authors: Cheng J , Lv J , Li CY , Xue Y , Huang Z , Zheng W
Published: February 2013

This pilot study evaluated the effects of coadministration of metformin with clomiphene citrate (CC) and human menopausal gonadotrophin (HMG) in women with CC-resistant polycystic ovary syndrome (PCOS). Sixty women with PCOS were randomly assigned to receive 3 months' treatment with metformin or placebo together with CC and HMG. Transvaginal ultrasound was used to monitor follicular development and ovulation was induced by human chorionic gonadotrophin (HCG). The number of dominant follicles, the oestradiol level on the day HCG was given and the amount of HMG required were significantly lower in the metformin group than in the placebo group, whereas the mono-ovulatory rate and pregnancy rate in the third cycle were significantly higher. The cumulative pregnancy rate in the metformin group (43.3%) was higher than in the placebo group (20.0%), but this difference did not reach statistical significance. In conclusion, coadministration of metformin with CC and HMG reduced the amount of HMG required and increased the mono-ovulatory rate and pregnancy rate.
Clinicopathological Implications of Tumour-Associated Macrophages and Vascularization in Sinonasal Melanoma
Authors: Shi L , Lei D , Ma C , Xu F , Li Y , Wang Y , Cong N , Liu D , Pan XL
Published: February 2013

This study investigated tumour-associated macrophages (TAMs) and their effects on tumour vascularization in sinonasal melanoma (SNM). Data on 45 patients with SNM undergoing surgery were reviewed retrospectively. Tumour sections were analysed immunohistochemically for TAMs, microvessels, lymph vessels, and vasculogenic mimicry in both intra- and peritumoural areas. The density of intratumoural TAMs was associated with tumour thickness and with overall survival in SNM stages I and II but there were no correlations between micro- or lymph vessel density and TAM infiltration. Greater TAM infiltration was observed in tumour tissues with vasculogenic mimicry although this was not statistically significant. These data suggest that high intratumoural TAM infiltration is associated with tumour aggressiveness and a poor prognosis for SNM, and that activation of macrophages can be polarized by different micro-environments. TAMs could be potential prognostic indicators for patients with SNM.
Effect of Antegrade Graft Cardioplegia Combined with Passive Graft Perfusion in On-Pump Coronary Artery Bypass Grafting
Authors: Goncu MT , Sezen M , Toktas F , Ari H , Gunes M , Tiryakioglu O , Yavuz S
Published: February 2013

Patients undergoing on-pump coronary artery bypass graft (CABG) with proximal graft anastomosis were randomly divided into groups that received antegrade cardioplegic infusion only via the aortic root (group A) or antegrade cardioplegic infusion via the aortic root and additional cardioplegia via vein or free arterial grafts after completion of each distal anastomosis (group B). The group B patients also received bypass graft perfusion with warm arterial blood just after removal of the cross-clamp until the proximal graft anastomosis was completed. The need for defibrillation and inotropic support during separation from cardiopulmonary bypass (CPB), and total CPB time were significantly lower in group B than in group A. Group B also had significantly lower peak cardiac troponin I levels 12 h after operation compared with group A and this was more pronounced in subgroups with severe right coronary artery stenosis and poor left ventricular ejection fraction than in the whole population. It is concluded that antegrade graft cardioplegia and graft perfusion with warm blood during proximal graft anastomosis may improve myocardial protection.
Plasma Cathepsin L and Its Related Pro/Antiangiogenic Factors Play Useful Roles in Predicting Rich Coronary Collaterals in Patients with Coronary Heart Disease
Authors: Zhang J , Wang P , Huang Y-B , Li J , Zhu J , Luo X , Shi H-M , Li Y
Published: February 2013

Cathepsin L enhances angiogenesis by increasing extracellular matrix degradation and remodelling. This study investigated whether plasma cathepsin L could be used as a biomarker to predict collateral formation in patients with coronary heart disease (CHD). Patients with CHD ( n = 218; aged 67 ± 11 years) underwent coronary angiography and were categorized as having either ‘poor’ or ‘rich’ collaterals. Plasma cathepsin L, the proangiogenic placenta growth factor (PLGF) and the antiangiogenic factors, cystatin C and endostatin, were measured. Elevated cathepsin L and PLGF levels were independently and significantly associated with enhanced collateral formation in patients with CHD; subgroup analyses also showed a significant correlation in patients with diabetes and acute coronary syndrome. Plasma endostatin and cystatin C levels were not significantly correlated with coronary collateral formation. Plasma cathepsin L and PLGF, acting as important modulators of angiogenesis, could be used as biomarkers to predict coronary collateral formation in patients with CHD.
Efficacy of a Multimodal Analgesia Protocol in Total Knee Arthroplasty: A Randomized, Controlled Trial
Authors: Fu PL , Xiao J , Zhu YL , Wu HS , Li XH , Wu YL , Qian QR
Published: February 2013

A total of 100 osteoarthritis patients undergoing unilateral total knee arthroplasty were randomly assigned to receive either a multimodal analgesia protocol, comprising oral celecoxib and tramadol before and after surgery and intra-articular injection of large doses of morphine, ropivacaine, adrenaline and betamethasone during surgery (trial group), or oral and intra-articular placebo (control group). All patients received patient-controlled analgesia for 48 h after surgery. Morphine consumption up to 48 h after surgery was significantly lower in the trial than in the control group. Compared with the control group, the trial group had significantly lower visual analogue scale (VAS) scores for pain at rest from 6 h to 7 days after surgery and significantly lower VAS scores during activity from 24 h to 7 days after surgery. Active straight leg raise and active 90° knee flexion were achieved sooner and range of knee movement at postoperative days 1–15 were significantly greater in the trial group. Postoperative wound healing, infection, blood pressure, heart rate, rash, respiratory depression, urinary retention and deep vein thrombosis were similar in the two groups, but nausea and vomiting were significantly less frequent in the trial group.
Efficacy of Tamsulosin 0.4 mg/day in Relieving Double-J Stent-Related Symptoms: A Randomized Controlled Study
Authors: Navanimitkul N , Lojanapiwat B
Published: February 2013

This study evaluated the efficacy of tamsulosin in improving stent-related symptoms and quality of life in patients with in-dwelling double-J ureteral stents. A total of 42 patients (15 males and 27 females) with ureteral stent placement following ureteroscopy, percutaneous nephrolithotomy or balloon dilatation, were prospectively randomized into two groups of 21 patients. Group I received 0.4 mg tamsulosin once daily for 4 weeks and group II was a non-placebo, non-treatment control. All patients completed the International Prostate Symptom Score (IPSS) and SF-36 questionnaires at 2 and 4 weeks post-operatively. The IPSS scores for irritative and obstructive symptoms were significantly lower in group I than group II at both 2 and 4 weeks. Among the eight domains of SF-36, role limitation due to physical health and bodily pain was significantly better in group I at 2 and 4 weeks. General health was also significantly better in group I at 2 weeks. Tamsulosin improved both urinary symptoms and quality of life without causing serious side-effects.
Impact of Modified Treatment in Echocardiographically Confirmed Pseudo-Pulseless Electrical Activity in Out-of-Hospital Cardiac Arrest Patients with Constant End-Tidal Carbon Dioxide Pressure during Compression Pauses
Authors: Prosen G , Križmarić M , Završnik J , Grmec Š
Published: February 2013

This study evaluated the ability of focused echocardiography (FE) and capnography to differentiate between pulseless electrical activity (PEA) and pseudo-PEA in out-of-hospital cardiac arrest, and the potential survival benefits with modified treatment. In PEA patients with stable end-tidal carbon dioxide pressure ( PetCO2) during the compression pause and concomitant FE showing cardiac kinetic activity, the compression pause was prolonged for 15 s and an additional 20 IU vasopressin was administered. If pulselessness persisted, compressions were continued. Fifteen of the 16 patients studied (94%) achieved restoration of spontaneous circulation (ROSC); eight patients (50%) attained a good neurological outcome (Cerebral Performance Category 1–2). In an historical PEA group with stable PetCO2 values ( n = 48), ROSC was achieved in 26 patients (54%); four patients (8%) attained Cerebral Performance Category 1–2. Echocardiographical verification of the pseudo-PEA state enabled additional vasopressor treatment and cessation of chest compressions, and was associated with significantly higher rates of ROSC, survival to discharge and good neurological outcome.
Effect of High-Dose Vitamin C on Oxygen Free Radical Production and Myocardial Enzyme after Tourniquet Ischaemia–Reperfusion Injury during Bilateral Total Knee Replacement
Authors: Lee JY , Kim CJ , Chung MY
Published: February 2013

This study investigated the effects of high-dose vitamin C on oxygen free radical production and cardiac enzymes after tourniquet application and ischaemia–reperfusion injury during bilateral total knee replacement (TKR) in elderly patients. In the vitamin C (VC) group (VC group, n = 16), during surgery, patients received a priming bolus of 0.06 g/kg vitamin C with 100 ml saline followed by 0.02 g/kg vitamin C mixed with 30 ml saline, intravenously. The control group ( n = 16) received no intra-operative vitamin C. In the VC group, malondialdehyde levels were lower, and arterial oxygen tension and mean blood pressure were higher, than in controls after post-operative deflation of both knee tourniquets. Troponin I levels were lower in the VC group than in controls 8 h post-operation. Administering high-dose vitamin C during bilateral TKR could prevent oxygen free radical production and a decline in arterial oxygen tension and mean blood pressure induced by ischaemia–reperfusion injury, thereby protecting the myocardium.
The Effects and Mechanism of Xenogeneic Adipocyte Vaccine for the Prevention of Obesity in Rats
Authors: Lai Q-G , Jiang B-Q , Zhou X-H , Xu X , Gao Z-N , Yuan K-F
Published: February 2013

The objectives of this study were to observe the effects of immunization with mouse mature adipocytes for the prevention of obesity in rats and to investigate their mechanism of action. Mouse mature adipocytes (3T3-L1) were injected as a vaccine into the abdominal cavity of rats. Control rats were injected with fibroblast cell lines (MRC-5 or NIH/3T3) or with 0.9% saline. Rats were fed a high calorie diet and body weight changes were used to evaluate obesity prevention. Immuno histochemical and immunofluorescence assays were used to investigate the mechanism of action. Results showed that obesity in rats can be prevented by immunization with xenogeneic mature mouse adipocytes. Body weight gain was inhibited in rats in the treatment group but not in the control groups and was statistically significant between the groups over the 19-week observation period. The assays demonstrated the presence of auto antibodies in rat adipocytes. It was concluded that vaccines of xenogeneic adipocytes can effectively prevent obesity in rats.
Trauma Scores and Neuron-Specific Enolase, Cytokine and C-Reactive Protein Levels as Predictors of Mortality in Patients with Blunt Head Trauma
Authors: Sogut O , Guloglu C , Orak M , Sayhan MB , Gokdemir MT , Ustundag M , Akkus Z
Published: February 2013

This study evaluated serum neuron-specific enolase (NSE), cytokine and high-sensitivity C-reactive-protein (hs-CRP) levels, along with the Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS), as predictors of mortality in the early post-traumatic period, in 100 Turkish patients with blunt head trauma. Overall patient mortality was 27%. There was a significant association between age and mortality, and mortality was negatively correlated with GCS and RTS. Head injury severity (GCS) was significantly related to NSE, hs-CRP, interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α levels. Mortality correlated positively with IL-6, IL-8, TNF-α and hs-CRP levels. NSE, hs-CRP, IL-6, IL-8 and TNF-α levels were significantly higher in non-survivors compared with survivors. GCS score ≤ 8, younger age and NSE levels were significant independent predictors of mortality. During the early post-traumatic period, NSE may be an objective alternative criterion to the GCS, in the management of patients with blunt head trauma.
Effect of Remifentanil on Arterial Oxygenation during One-Lung Ventilation
Authors: Ryu CG , Min SW , Kim JH , Han SH , Do SH , Kim CS
Published: February 2013

This study was designed to assess the dose-related effects of remifentanil on arterial oxygenation during one-lung ventilation (OLV) under total intravenous anaesthesia with propofol. A total of 104 patients scheduled for elective lung resection surgery requiring OLV were randomly assigned to one of four groups with a target effect-site concentration (Ce) of remifentanil of 0.5, 1, 2 or 4 ng/ml. Patients were anaesthetized with propofol and remifentanil in 100% oxygen. Arterial blood gas analysis was performed after 15 min of two-lung ventilation (TLV15, baseline) and after 15 and 30 min of OLV (OLV15 and OLV30). Mean arterial oxygen tension (PaO2) decreased significantly at OLV15 and OLV30 compared with baseline in all groups, but was comparable in the four groups at each time point, suggesting that remifentanil infusion with a Ce ≤ 4 ng/ml can be successfully used for anaesthesia with propofol during OLV in lung surgery without any significant changes in PaO2.
Evaluation of Iloprost to Prevent Vasospasm in Coronary Artery Bypass Grafts
Authors: Ege T , Gur O , Karadag CH , Duran E
Published: February 2013

This study assessed the efficacy of iloprost in relieving vasospasm in coronary artery bypass grafts. Radial artery (RA), left internal thoracic artery (LITA) and saphenous vein (SV) grafts were taken from 20 patients (13 men and seven women, mean age 63.8 years [range 48 − 74 years]) scheduled to undergo coronary artery bypass grafting. Ten 3 mm vascular rings were cut from each graft and kept under tension for at least 60 min. They were kept alive with 37°C oxygenated Krebs solution. Smooth muscle contraction was achieved with phenylephrine before iloprost was administered every 2 min, starting at a concentration of 10−9 mol/l and increasing in logarithmic increments to a concentration of 10−5 mol/l. The vasodilation response to iloprost started in all samples at a concentration of 10−9 mol/l and increased with each incremental increase in iloprost concentration up to 10−5 mol/l. These data suggest that local administration of iloprost has a role in relieving graft vasospasm during harvesting and preparation for coronary artery bypass grafting.
Autonomic Changes in Preoperative Uncomplicated Diabetic Patients with Postural Changes
Authors: Yun WH , Min SW , Huh J , Ro YJ , Kim CS
Published: February 2013

Diabetic autonomic neuropathy is a critical complication frequently encountered in anaesthetic and surgical practice. Power spectral analysis is a noninvasive tool for monitoring frequency analysis of heart rate variability (HRV) and autonomic control of the heart. This study examined HRV changes in preoperative diabetic patients without overt signs of autonomic dysfunction and in matched controls ( n = 18 per group). HRV values at −15°, 0°, 15°, 45° and sitting positions were compared between groups and for each position. HRV in diabetic patients was lower than in controls at all positions (absolute units). Low-frequency power (normalized units) and the low-frequency/high-frequency ratio increased significantly at 45° and in sitting positions in controls but not in diabetic patients. Pre-existing autonomic derangements in diabetic patients without overt clinical symptoms can be aggravated by high-degree tilting or sitting positions. Consequently, great care should be taken during the intra- and perioperative management of these patients.
The Effect of Flurbiprofen as Prophylactic Analgesic before Hysterosalpingography
Authors: Guzel AI , Kuyumcuoglu U , Erdemoğlu M
Published: February 2013

Hysterosalpingography (HSG) is associated with pain during the four-step procedure. This prospective, double-blind, randomized, placebo-controlled study was conducted to investigate the effect of the analgesic flurbiprofen, administered prior to HSG, in 60 women. Thirty women were randomized to receive 100 mg of flurbiprofen, orally, 1 h prior to HSG and a further 30 women were randomized to receive placebo. Injection of contrast medium was more painful than the other steps in the HSG procedure in both groups; however, there was no significant between-group difference in terms of pain experienced in the individual steps of HSG. Pain scores at 5 and 30 min after the procedure were compared between the two groups. There was a significant decrease in the visual analogue scale pain score in the flurbiprofen-treated group compared with the placebo-treated group at both time points. Thus, the authors recommend flurbiprofen as a prophylactic analgesic to be administered before HSG procedures.
Differential Gene Expression Profiling of Oesophageal Squamous Cell Carcinoma by DNA Microarray and Bioinformatics Analysis
Authors: Li JD , Feng QC , Li JS
Published: February 2013

Differential gene expression profiling was carried out on primary tumour tissues and adjacent non-neoplastic tissues from patients with oesophageal squamous cell carcinoma (ESCC). RNA extracted from ESCC tissues and matched normal oesophageal epithelium of four ESCC patients was analysed using whole-genome microarrays. Bioinformatics analysis was also carried out to ascertain which genes and pathways may be important in the carcinogenesis of ESCC. A total of 570 genes were identified that differed significantly in expression: 303 genes were up-regulated and 267 genes were down-regulated in ESCC tissues compared with normal oesophageal epithelium. Gene ontology analysis showed that the primary molecular functions of these genes were related to the extracellular region, collagen and endopeptidase inhibitor activity. Pathway analysis revealed seven pathways or networks highly associated with the differential expression profile. Gene set analysis showed that the POD1_KO_UP gene set was significantly enriched, containing 15 matching genes. Thus, a large number of genes are involved in the carcinogenesis of ESCC and participate in various cell processes and pathways.
Urinary Excretion and Renal Production of Hepatocyte Growth Factor in Children with Henoch–Schönlein Purpura
Authors: Ding W , Sun S , Zhen J , Yu Y , Wang Y
Published: February 2013

This study measured urinary excretion and renal levels of hepatocyte growth factor (HGF) in children with Henoch–Schönlein purpura (HSP), examining the relationship between HGF, proteinuria and renal pathological changes. Seventy-eight patients with HSP aged 6 − 18 years were divided into three groups, based on urinary albumin excretion rate. Urinary HGF concentration was measured by enzyme-linked immunosorbent assay. Renal biopsies were performed in 22 patients; renal levels of HGF protein were determined immunohistochemically. Compared with controls, urinary HGF was significantly increased in patients with normoalbuminuria and microalbuminuria, especially in those with microalbuminuria; no differences were observed between patients with macroalbuminuria and controls. Little or no HGF was present in normal kidney, but HGF was present in renal tissue in all HSP patients, particularly those with microalbuminuria. Urinary HGF was strongly correlated with the presence of renal HGF. These results suggest that HGF is associated with proteinuria and renal pathological changes in children with HSP. The detection of urinary HGF in children with HSP may be a non-invasive, effective, method for early diagnosis of renal injury.
Effect of Thymosin-α1 on T-helper 1 Cell and T-helper 2 Cell Cytokine Synthesis in Patients with Hepatitis B Virus e Antigen-positive Chronic Hepatitis B
Authors: Jiang Y-F , Ma Z-H , Zhao P-W , Pan Y , Liu Y-Y , Feng J-Y , Niu J-Q
Published: February 2013

Thymosin-α1 (TA1) has been shown to be effective treatment for chronic hepatitis B virus (HBV) infection. This study investigated the immune response after TA1 monotherapy in 25 HBV e antigen (HBeAg)-positive patients randomized to receive either 1.6 mg active TA1 (group A), 1.6 mg recombinant TA1 (group B) or 3.2 mg recombinant TA1 (group C) monotherapy for 52 weeks. The percentages of T-helper 1 (Th1) cytokine-producing T-cells (interleukin-2 [IL-2], interferon-γ [IFN-γ], tumour necrosis factor-α) and Th2 cytokine-producing T-cells (IL-4) were analysed using flow cytometry. In all patients treated with TA1, cytokine levels and the proportion of peripheral blood mononuclear cells producing these cytokines were significantly increased, compared with baseline and healthy controls. The proportions of each cytokine-producing cell increased gradually over time and were restored to normal levels, and proportions of IFN-γ and IL-4-producing cells reached higher levels than in normal (healthy) controls. The results showed that treatment with TA1 increased cytokine production, especially IFN-γ, and higher-dose TA1 exhibited better efficacy against HBV, compared with other treatments studied.
Differential Levels of Cytokines and Soluble Fas Ligand between Tuberculous and Malignant Effusions
Authors: Cui H-Y , Zhang Q , Su B , Li W , Tang S-J
Published: February 2013

Tuberculous pleurisy, which is characterized by an extensive inflammatory exudate in the pleural space, is a common manifestation of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis infection but is difficult to diagnose. This study compared concentrations of three cytokines (interferon-γ and interleukin [IL]−2 and −4) and soluble Fas ligand in serum and pleural effusions from 36 patients with tuberculous pleurisy, 30 with malignant pleurisy and 30 healthy volunteers. Interferon-γ concentration was significantly higher in serum and pleural effusions, and the concentration of soluble Fas ligand was significantly higher in pleural effusion, from patients with tuberculous pleurisy than in those with malignant pleurisy. Levels of IL-2 and IL-4 were also raised in serum, but failed to reach statistical significance. Interferon-γ and soluble Fas ligand levels were significantly higher in pleural effusion than in serum. Pleural soluble Fas ligand concentrations correlated linearly with those of interferon-γ in patients with tuberculous pleurisy. These findings suggest a predominant T-helper-1 response to M. tuberculosis infection.
Immunological Effects of Laparoscopic and Open Cholecystectomy
Authors: Li F , Wu HY , Tang QF
Published: February 2013

This prospective, randomized, controlled study evaluated plasma levels of interleukin-18 (IL-18) and monocyte chemotactic protein-1 (MCP-1) in patients undergoing cholecystectomy. Forty patients were randomized to undergo laparoscopic cholecystectomy (LC) or open cholecystectomy (OC). Plasma concentrations of IL-18 and MCP-1 were measured before anaesthesia (T0), before operation (T1), 30 min after the start of the operation (T2) and at the end of the operation (T3). Compared with T0, the IL-18 concentration was significantly increased at T2 and T3 in both groups. In addition, the MCP-1 concentration was significantly increased at T3 compared with T0 in the LC group. Both the IL-18 and MCP-1 concentrations were significantly lower in the OC group than in the LC group at T3. It is suggested that carbon dioxide pneumoperitoneum may cause immunodepression, that epidural anaesthesia can attenuate the stress response, and that IL-18 and MCP-1 are sensitive markers for evaluating the patient's immune function.
The Bowel Function Index for Evaluating Constipation in Pain Patients: Definition of a Reference Range for a Non-Constipated Population of Pain Patients
Authors: Ueberall MA , Müller-Lissner S , Buschmann-Kramm C , Bosse B
Published: February 2013

Opioid-induced constipation (OIC) is a severe, persisting side-effect of opioid therapy. The Bowel Function Index (BFIa, numerical analogue scale 0 − 100), calculated as the mean of three variables (ease of defaecation, feeling of incomplete bowel evacuation, and personal judgement of constipation) was developed to evaluate bowel function in opioid-treated patients with pain. This clinician-administered tool allows easy measurement of OIC from the patient's perspective. The purpose of this investigation was to define a reference range reflecting BFI values in non-constipated chronic pain patients who were recruited into a cross-sectional survey and asked for their perceptions of constipation. The BFI scores were assessed and compared with those of patients with confirmed OIC obtained from two previously published trials. Results were analysed and a reference range of BFI values of 0 − 28.8, into which 95% of non-constipated chronic pain patients fell, was defined. This permits discrimination between chronic pain patients with, or without, constipation.
Pathological Features and Prognosis in Chronic Hepatitis B Virus Carriers
Authors: Lu ZH , Chen W , Ju ZC , Pei H , Yang XJ , Gu XB , Huang LH
Published: February 2013

This retrospective study examined 220 Chinese chronic hepatitis B virus carriers over 5 years. After initial liver biopsy, liver function tests and serological analysis, patients underwent further tests of liver function and hepatitis B seromarkers at 6-month intervals. Second and third liver biopsies were performed in 56 and 23 patients, respectively. Liver pathology was classified according to inflammatory activity (G0 – G4) and degree of fibrosis (S0 – S4). A significantly greater proportion of hepatitis B e antigen antibody-positive patients had a more severe level of inflammation and fibrosis than patients who were hepatitis B e antigen (HBeAg)-positive. Abnormal inflammation (≥ G2) occurred in 122 (55.5%) patients. Hepatitis B reactivation occurred in 35 (15.9%) patients: 33 had obvious liver inflammation at the initial biopsy (≥ G2) and only two had a low level of liver inflammation (G0 – G1). The hepatitis B reactivation rate was significantly related to age but not to gender. Hepatitis B surface antigen clearance was 1.55% per year and HBeAg seroconversion was 5.36% per year. In conclusion, hepatitis B reactivation was closely correlated with age and the level of liver inflammation.
A Modification of the Trans-Oesophageal Echocardiography Protocol can Reduce Post-Operative Dysphagia following Cardiac Surgery
Authors: Chin J-H , Lee E-H , Choi D-K , Choi I-C
Published: February 2013

Use of intra-operative trans-oesophageal echocardiography (TEE) is an independent risk factor for post-operative dysphagia. This study investigated whether modifying the TEE probe-placement protocol could reduce the incidence of post-operative dysphagia. In group I ( n = 100), the TEE probe was inserted after anaesthetic induction and remained in place until the completion of surgery. In group II ( n = 100), the TEE probe was inserted after anaesthetic induction, the heart was examined, then the probe was removed. The probe was inserted again before weaning from cardiopulmonary bypass and then immediately removed after examination. The incidence of dysphagia was significantly higher in group I than in group II patients (51.1% versus 28.6%). Multivariate regression analysis showed that the length of time that the TEE probe was in the oesophagus was an independent predictor of dysphagia. Modification of the TEE protocol in this way can reduce the incidence of post-operative dysphagia in cardiac surgery patients.
Effects of Dicalcium Silicate Coating Ionic Dissolution Products on Human Mesenchymal Stem-Cell Proliferation and Osteogenic Differentiation
Authors: Li H-W , Sun J-Y
Published: February 2013

This study investigated the effects of ionic dissolution products released from dicalcium silicate (DS) coatings on human mesenchymal stem cells (hMSC), cultured in the presence or absence of the dissolution products, with or without osteogenic supplements (OS). DS+ medium promoted cell proliferation during the first 4 days, but then inhibited proliferation. DS+OS− medium increased alkaline phosphatase (ALP) activity on day 14, and upregulated runt-related transcription factor 2 and osteonectin mRNA on days 7 and 14, respectively. The addition of osteogenic supplements (DS+OS+) led to a significant increase in ALP activity from days 7 to 21, upregulation of osteogenic markers on day 14, and formation of more mineralized nodules on day 28. The results demonstrated that the ionic dissolution products from DS coating alone can partly induce osteogenic differentiation of hMSC, and that the addition of osteogenic supplements further enhances osteoblast-specific gene expression and mineralization in hMSC.
A Method of Utrophin Up-Regulation through RNAi-Mediated Knockdown of the Transcription Factor EN1
Authors: Wang Q , Cao D-H , Jin C-L , Lin C-K , Ma H-W , Wu Y-Y
Published: February 2013

The aim of this study was to induce up-regulation of the dystrophin-related gene UTRN that encodes the protein utrophin, to determine whether this could compensate for the lack of dystrophin function in Duchenne muscular dystrophy. The human UTRN promoter, which contains two putative binding sites for homeobox protein engrailed-1 (EN1), was analysed. It was found that EN1 binding site 2 in the UTRN gene promoter directly interacted with transcription factor EN1 in vitro. Chromatin immunoprecipitation assays of the EN1– UTRN promoter complex from rhabdomyosarcoma and HeLa cell lines confirmed that endogenous EN1 interacted with this region in vivo. The findings suggest that EN1 directly interacts with the UTRN promoter. Small interfering RNA was used to inhibit EN1 gene expression. Higher utrophin mRNA levels were observed in EN1-inhibited cells compared with controls. The increase in utrophin mRNA in rhabdomyosarcoma cells and HeLa cells may have resulted from inhibition of EN1 expression.