bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Experimental Effectiveness of Astragali Compound in the Treatment of Chronic Viral Hepatitis B
Authors: Tang LL , Sheng JF , Xu CH , Liu KZ
Published: February 2013

Chinese herbs are widely used in the treatment of chronic viral hepatitis B. The effectiveness of 2 months' treatment with Astragali compound (AC), containing Radix Astragali and adjuvant components, was studied for the treatment of chronic viral hepatitis in 116 patients; 92 patients were given other drugs in regular clinical use for viral hepatitis (controls). The clinical efficacy of AC was significantly better in AC-treated patients than in controls. Negative seroconversions of hepatitis B virus (HBV) antigen e and HBV DNA were also significantly higher in AC-treated patients than in controls. Of eight duck viral hepatitis B models infected with duck hepatitis B virus (DHBV) and treated with AC, three showed negative seroconversion of DHBV DNA and serum DHBV DNA levels significantly decreased after AC administration compared with the controls; DHBV DNA was negative in biopsied liver tissue by in situ hybridization and immunohistochemistry in two ducks treated with AC. Pathological changes were milder in AC-treated ducks than in controls. These results indicate that AC may promote recovery from viral hepatitis and inhibit HBV replication.
Infrared Thermography Based on Artificial Intelligence as a Screening Method for Carpal Tunnel Syndrome Diagnosis
Authors: Papež B Jesenšek , Palfy M , Mertik M , Turk Z
Published: February 2013

This study further evaluated a computer-based infrared thermography (IRT) system, which employs artificial neural networks for the diagnosis of carpal tunnel syndrome (CTS) using a large database of 502 thermal images of the dorsal and palmar side of 132 healthy and 119 pathological hands. It confirmed the hypothesis that the dorsal side of the hand is of greater importance than the palmar side when diagnosing CTS thermographically. Using this method it was possible correctly to classify 72.2% of all hands (healthy and pathological) based on dorsal images and > 80% of hands when only severely affected and healthy hands were considered. Compared with the gold standard electromyographic diagnosis of CTS, IRT cannot be recommended as an adequate diagnostic tool when exact severity level diagnosis is required, however we conclude that IRT could be used as a screening tool for severe cases in populations with high ergonomic risk factors of CTS.
Multicentre, Double-blind, Randomized Study of Mitiglinide Compared with Nateglinide in Type 2 Diabetes Mellitus Patients in China
Authors: Gao X ,   Mitiglinide versus Nateglinide Comparison Study*
Published: February 2013

This study investigated the non-inferiority of mitiglinide 10–20 mg versus nateglinide 120 mg, given orally three times daily for 20 weeks, in 291 Chinese type 2 diabetes mellitus (DM) patients in whom adequate blood glucose control had not been achieved by diet and exercise. Mitiglinide was started at 10 mg three times daily for 12 weeks and thereafter could be increased to 20 mg three times daily, depending on symptoms. In the mitiglinide and nateglinide groups the change in glycosylated haemoglobin (HbA1c) from baseline to week 12 was −0.53 ± 1.08% and −0.58 ± 1.04%, respectively, and further decreased by −0.77 ± 1.06% and −0.71 ± 1.12%, respectively, at week 20 compared with baseline. The intergroup difference (95% confidence interval) of HbA1c was 0.05% (−0.19, 0.30) at week 12 and 0.06% (−0.31, 0.19) at week 20. Similar changes in HbA1c were seen in patients whose baseline value was < 8.0% as well as in those aged ≥ 60 years. Comparable reductions in other blood glucose variables were noted in the two groups. Adverse events in the mitiglinide and nateglinide groups were noted in 54.5% and 57.9% of patients, respectively. In conclusion, mitiglinide 10–20 mg three times daily provided similar blood glucose control to nateglinide 120 mg three times daily in type 2 DM patients, including the elderly and patients with mild diabetes mellitus.
Comparison of the Clinical and Immunohistochemical Features, Including Anaplastic Lymphoma Kinase (ALK) and p53, in Inflammatory Myofibroblastic Tumours
Authors: Jiang You-Hua , Cheng Bo , Ge Ming-Hua , Cheng Ye , Zhang Gu
Published: February 2013

This retrospective study evaluated 15 cases of inflammatory myofibroblastic tumours (IMTs) to determine histological atypicality, clinicopathological features, outcomes, and expression of anaplastic lymphoma kinase-1 (ALK1) and p53, to assess potential pathological prognostic indicators. Nine patients with complete follow-up had no evidence of recurrence, including two with recurrent disease who were treated with additional surgery. Six patients had local recurrence and distant metastasis. Six (40.0%) tumours showed cellular atypicality. Significant correlations were found between histological atypicality and recurrence and metastasis. Recurrence was documented in 25.0% of ALK-positive and 63.6% ALK-negative IMTs, whereas metastasis was confined to the ALK-negative group. Recurrence and metastasis were documented in 50.0% and 25.0% of p53-positive IMTs, respectively, and in 57.1% and 57.1%, respectively, of the p53-negative IMTs. The IMT cases had high recurrence and metastasis and there were significant correlations between histological atypicality and recurrence and metastases, and between absence of ALK reactivity and recurrence. No correlation was found between p53 expression and any clinicopathological feature of IMT.
On-pump Coronary Artery Bypass Surgery in High-risk Patients Aged over 65 Years (EuroSCORE 6 or More): Impact on Early Outcomes
Authors: Erdil N , Nisanoglu V , Kaynak M , Fansa I , Eroglu T , Cihan HB , Battaloglu B
Published: February 2013

The results of on-pump coronary artery bypass graft (CABG) surgery in 166 high-risk elderly patients (EuroSCORE 6 or more; over age 65 years [mean 71.8 years]) were compared with 176 low-risk elderly patients (EuroSCORE below 6; over age 65 years [mean 68.8 years]). There was no significant difference in hospital mortality or number of grafts between the two groups. Rates of inotropic agent use, intra-aortic balloon pump insertion and atrial fibrillation, and the duration of intensive care unit and hospital stay were significantly higher in high-risk than low-risk patients. There were no significant differences in the incidence of major complications between the two groups. The results suggest that, in selected patients, on-pump CABG can be safely performed in high-risk patients over 65 years old with no effect on mortality.
Unilateral Transforaminal Lumbar Interbody Fusion: A Review of the Technique, Indications and Graft Materials
Authors: Xiao Y-X , Chen Q-X , Li F-C
Published: February 2013

Transforaminal lumbar interbody fusion (TLIF) is an alternative interbody fusion procedure in which interbody space is accessed via a path that runs through the far lateral portion of the vertebral foramen. TLIF reduces the potential complications of other approaches, including the transabdominal approach or posterior lumbar interbody fusion (PLIF), but still achieves clinical outcomes and circumferential fusion results comparable with PLIF. Operative indications for TLIF are contested among many spine experts. The optimal indications for using this technique are spondylolisthesis, degenerative disc disease with a specific discogenic pain pattern, lumbar stenosis with instability and recurrent lumbar disc herniation with radiculopathy. Various instrumentation techniques and graft materials are available to use in TLIF, and each option has benefits and disadvantages. Further research is needed, however, TLIF with one cage and excised local bone and augmented with a bilateral pedicle screw seems to be an effective and affordable treatment.
The Classification of Posterior Petrous Meningiomas and Its Clinical Significance
Authors: Qu FJ , Zhou XD , Wang XL , Li F , Lu XD , Liu YG , Zhong YH , Yang HA , Ni SL
Published: February 2013

This retrospective analysis of the clinical records of 42 patients was used to study the clinical significance of a classification system for posterior petrous meningiomas. According to clinical manifestations and radiological images, posterior petrous meningiomas were classified into three types: type I (cerebella type; 12 patients), tumours involved and compressed the cerebellum; type II (cranial nerve type; 16 patients), tumours involved the cranial nerves; and type III (combined type; 14 patients), tumours involved more than one structure such as the cerebellum, cranial nerves and the brain stem. All patients underwent microneurosurgery and the total resection rate was 90%. It was more difficult totally to resect type II and III tumours than type I tumours and the post-operative functional outcomes were worse. Microneurosurgical techniques and skills are critical to increase the total resection rate of posterior petrous meningiomas in order to decrease the mortality and disability rates.
Effects of Thiopental on Endothelium-Dependent Relaxation in Porcine Coronary Arteries
Authors: Dagtekin O , Gerbershagen HJ , Özgür E , Gaertner J , Fischer JH
Published: February 2013

This study investigated the effects of thiopental on endothelium-dependent relaxation (EDR), and especially the effects on nitric oxide-and prostacyclin-independent EDR. Fresh porcine coronary artery rings (4 mm long), were consecutively tested with and without 20 μg/ml thiopental in Krebs–Henseleit solution. Indomethacin (10 μmol/1) was used in all experiments to eliminate prostacyclin effects. Prostaglandin F2α (10 μmol/l) was used to induce contractions and bradykinin (10−10−10−5 M) was used to induce EDR. Experiments were also carried out using 300 μmol/1 N-nitro-l-arginine to block nitric oxide production and to assess the influence of thiopental on nitric oxide-and prostacyclin-independent EDR. Thiopental induced statistically significant increases in EDR at concentrations of 10−6−10−5 M bradykinin. Following nitric oxide production block, thiopental significantly reduced the relaxation response at concentrations of 10−8−10−5 M bradykinin. At a clinically relevant concentration of 20 μg/ml thiopental, a significant increase in EDR and a significant reduction in nitric oxide-and prostacyclin-independent relaxation was observed in porcine epicardial coronary arteries.
Methylation in p14ARF is Frequently Observed in Colorectal Cancer with Low-level Microsatellite Instability
Authors: Kominami K , Nagasaka T , Cullings HM , Hoshizima N , Sasamoto H , Young J , Leggett BA , Tanaka N , Matsubara N
Published: February 2013

Colorectal cancer (CRC) can be classified as high-level microsatellite instability (MSI-H), low-level MSI (MSI-L) and microsatellite stable (MSS) depending on levels of MSI. MSI-H CRC relies on a distinct molecular pathway due to the mismatch repair (MMR) deficiency and shows methylation in multiple gene promoters. The genetic pathway leading to MSI-L is unknown, although higher levels of promoter methylation are observed in this group compared with MSS CRCs. This study explored how promoter methylation affects MSI phenotype, by analysing the methylation status of eight CRC-related promoters, MSI phenotype and KRAS/BRAF mutations in a series of 234 CRCs. Promoter methylation of p14ARF was significantly related to MSI-L CRC with KRAS mutation. The MSI-H phenotype was related to methylation of MLH1 as expected, while the MSS phenotype was related to methylation of p16INK4a and O6-methylguanine-DNA methyltransferase, although this was not statistically significant. Thus, promoter methylation of p14ARF could be a significant alteration leading to CRC with MSI-L.
Selective Enrichment of Hepatocellular Cancer Stem Cells by Chemotherapy
Authors: Tan S , Chen JS , Sun LJ , Yao HR
Published: February 2013

This study investigated the enrichment of cancer stem cells (CSCs) in hepatocellular carcinoma (HCC) by chemotherapy. SMMC-7721 cells were inoculated into mice treated with 0, 2, 5 or 10 mg/kg cyclophosphamide (CTX). Tissue from the resulting tumours was re-inoculated into CTX-treated mice two more times, thus producing three generations of tumour cells for each dose of CTX. Chromosome and fluorescence-activated cell sorting analyses were performed to determine the purity of the enriched cells. Sphere culture, colony formation and proliferation assays demonstrated that the self-renewal potential, proliferative activity and clonogenicity of the enriched cells in vitro increased with increasing chemotherapy dose and generation. The ability of the enriched cells to produce xenograft tumours in mice was also dependent on chemotherapy dose and generation. In conclusion, subjecting HCC cells to chemotherapy in vivo enriched the samples for HCC CSCs in a dose-and generation-dependent manner.
A Comparison of Proximal Femoral Nail Antirotation and Dynamic Hip Screw Devices in Trochanteric Fractures
Authors: Zou J , Xu Y , Yang H
Published: February 2013

This prospective, randomized study compared the functional outcome and complications associated with a proximal femoral nail antirotation (PFNA) device with those of a traditional extramedullary device, the dynamic hip screw (DHS), in patients with trochanteric fracture. A total of 121 patients were randomized to the PFNA group ( n = 58) or the DHS group ( n = 63). Perioperative information and complications were recorded, and assessments of functional outcome were made. The DHS group required a longer operative time and was associated with greater blood loss than the PFNA group. The re-operation rate was lower in the PFNA group compared with the DHS group, especially in patients with unstable fractures, although there was no statistically significant difference in the overall complication rate between the two groups. There were no significant differences in functional outcome between the PFNA and the DHS groups. In conclusion, the PFNA device is useful in the treatment of trochanteric fractures.
Discrimination between Sjögren's and Non-Sjögren's Sicca Syndrome by Sialoscintigraphy and Antibodies against α-Fodrin and Ro/La Autoantigens
Authors: Chen K-S , Jiang M-C , Li C-J , Liu O-K , Tsai C-SS
Published: February 2013

Both Sjögren's syndrome (SS) and non-Sjögren's syndrome (NSS) can present with the sicca symptoms of dry eyes and a dry mouth but they are distinct pathological entities that require diagnostic discrimination. This study included 82 sicca syndrome patients and examined the ability of sialoscintigraphy and antibodies against the autoantigens α-fodrin, Ro and La to discriminate between SS and NSS. A total of 30.8% of SS patients compared with 58.8% of NSS patients were α-fodrin positive. The prevalence of Ro positivity was 69.4% for SS patients compared with 0% for NSS patients. The prevalence of La positivity was 52.4% for SS compared with 0% for NSS patients. Sialoscintigraphy showed that more NSS patients had grade III salivary gland impairment compared with SS patients (64.7% versus 19.4%). These data suggest that using sialoscintigraphy in combination with measuring the levels of serum α-fodrin, Ro and La might be useful for SS and NSS discrimination.
Insulin with Chondroitinase ABC Treats the Rat Model of Acute Spinal Cord Injury
Authors: Yang Y-G , Jiang D-M , Quan Z-X , Ou Y-S
Published: February 2013

Traumatic brain injury is often associated with acute spinal cord injury (ASCI). Insulin and chondroitinase ABC (ChABC) are both therapeutically effective, but the combined therapeutic effect of insulin and ChABC is still not clear. A combination of insulin and ChABC were used to treat a rat model of ASCI. This combination therapy prevented neuronal cell death by improving motor function, increasing cell growth and inhibiting cell apoptosis in ASCI rats. Expression of growth-associated protein 43, a marker of axonal re-growth, increased after combined treatment with insulin and ChABC. These results may provide a basis for a future method of treating ASCI.
Up-Regulation of CXC Chemokine Receptor 4 Expression in Chronic Atrial Fibrillation Patients with Mitral Valve Disease May Be Attenuated by Renin–Angiotensin System Blockers
Authors: Wang XX , Zhang FR , Zhu JH , Xie XD , Chen JZ
Published: February 2013

This study characterized CXC chemokine receptor 4 (CXCR4) expression in patients with mitral valve disease and chronic atrial fibrillation (AF). Forty-eight patients with chronic AF formed two groups based on whether they were treated with or without renin–angiotensin system (RAS) blockers (AF + RAS group; n = 25, or AF – RAS group; n = 23). The controls comprised 17 mitral valve disease patients with sinus rhythm (SR group). CXCR4 mRNA and protein levels in the left atria were significantly higher in the AF – RAS and AF + RAS groups than in the SR group. CXCR4 expression was significantly lower in the AF + RAS group than the AF – RAS group. More CD34+ cells expressed CXCR4 in the AF – RAS and AF + RAS groups than in the SR group. Angiotensin II, collagen I and left atrial diameter significantly positively correlated with CXCR4 expression in the AF – RAS group. These results suggest that CXCR4 expression is up-regulated in chronic AF patients with mitral valve disease, is associated with atrial remodelling, and that these effects are attenuated by RAS blockers.
Intravenous Fentanyl is Exhaled and the Concentration Fluctuates with Time
Authors: Wang H , Li EY , Xu GW , Wang CS , Gong YL , Li P
Published: February 2013

Previous studies have reported that fentanyl is eliminated predominantly by hepatic biotransformation, and that some is eliminated unchanged in urine and stools. No reports have described the elimination of fentanyl via the lungs. In this study, exhaled gas samples from eight anaesthetized patients undergoing cardiac surgery were analysed using solidphase microextraction (SPME) coupled with gas chromatography–mass spectrometry (GC–MS). Results confirmed that fentanyl was exhaled by patients after intravenous administration, that the concentration of exhaled fentanyl fluctuated with time and peak concentrations were reached approximately 15-20 min after intravenous fentanyl administration. Thus, in addition to hepatic biotrans formation and elimination via urine and faeces, fentanyl is also eliminated unchanged by the lungs. The potential risk to operating theatre personnel from long-term exposure to low levels of exhaled anaesthetic agents following intravenous administration to patients during surgery warrants further research.
Association of Programmed Cell Death Factor 4 (PDCD4) with Hepatocellular Carcinoma and Smoking in a Chinese Male Population
Authors: Jiang Y , Zhang SH-H , Han G-Q , Qin CH-Y
Published: February 2013

Programmed cell death factor 4 (PDCD4) is one of the genes that has been found to be up-regulated during apoptosis and loss of PDCD4 expression has been found in many kinds of progressive carcinomas. The objective of this study was to investigate the interactions between PDCD4 and smoking status in hepatocellular carcinoma. This case-controlled study included 68 Chinese male patients with hepatocellular carcinoma who were classified as smokers or non-smokers according to their pack-years of smoking status. Samples were obtained from carcinoma and normal tissues and examined using Western blotting. The results indicated that levels of PDCD4 were significantly lower in hepatocellular carcinoma tissues compared with normal tissues and that, in normal tissue, PDCD4 levels in smokers were significantly lower than in non-smokers.
Reliability and Validity Testing of the SF-36 Questionnaire for the Evaluation of the Quality of Life of Chinese Urban Construction Workers
Authors: Qu B , Guo HQ , Liu J , Zhang Y , Sun G
Published: February 2013

The quality of life (QOL) of the Chinese ‘floating’ migrant population is of growing concern. Urban construction workers are the main migrant population in China, but there is little published research on their QOL. The reliability and validity of the 36-Item Short Form Health Survey (SF-36) questionnaire were assessed by conducting a population-based study of migrant construction workers in Shenyang, China. Two construction sites were randomly selected from each of the five districts of Shenyang City and 1200 copies of the questionnaire were distributed to rurally-registered, non-Shenyang workers aged ≥ 16 years at these sites. A total of 1125 questionnaires were evaluated. The overall Cronbach's a coefficient of the SF-36 questionnaire was 0.821 while the respective Cronbach's α coefficient for each dimension was > 0.70. Results showed that the SF-36 questionnaire demonstrated good reliability and validity, and that it can be used to measure QOL among Chinese migrant urban construction workers.
Use of Short Echo Time Two-Dimensional 1H-Magnetic Resonance Spectroscopy in Temporal Lobe Epilepsy with Negative Magnetic Resonance Imaging Findings
Authors: Shen J , Zhang L , Tian X , Liu J , Ge X , Zhang X
Published: February 2013

We evaluated short echo time two-dimensional 1H magnetic resonance spectroscopy (2D-1HMRS) with the point-resolved spatial selection (PRESS) protocol in temporal lobe epilepsy (TLE) patients with negative magnetic resonance imaging (MRI) findings and described the characteristics of 2D-1HMRS in the epileptic focus. Thirty-eight TLE patients with negative conventional MRI findings and 10 healthy controls were studied by 2D-1HMRS. A 128-channel prolonged video-electroencephalographic (EEG) method was used as the standard for epileptogenic focus localization to evaluate N-acetyl aspartate/(choline + creatine + phospho - creatine) (NAA/[Cho + Cr–PCr]), glutamate + glutamine/creatine (Glx/Cr–PCr) and myo-inositol/Cr–PCr ratios in patients with negative MRI findings. The 2D-1HMRS showed that 32/38 patients and all healthy controls had stable baselines and good signal-to-noise ratios. Compared with the healthy controls, 32 patients showed abnormal NAA/(Cho + Cr–PCr) ratios in the hippocampus and, in 25 of these patients, focus lateralization agreed with the EEG. It is concluded that short echo time 2D-1HMRS with the PRESS protocol can help find abnormalities in lateralization of temporal epilepsy in patients with negative MRI findings.
Recent Trends in the Distribution of Common Bile Duct Stones in Urban South Koreans
Authors: Choi JH , Kang NL , Choi SD
Published: February 2013

This retrospective, observational study was designed to analyse recent trends in the age distribution of westernized persons in South Korea with common bile duct stones (cholesterol, brown and black stones). Data on 253 patients who had received endoscopic surgery at a tertiary referral hospital in Daegu, the third largest South Korean city, were used to investigate the relationship between the numbers of patients with different types of common bile duct stones and age. There were strong correlations between age and the frequency of the three different types of common bile duct stones. The frequency of cholesterol stones decreased exponentially with increasing patient age, whereas the frequency of brown stones increased exponentially. Patients with black stones showed a Gaussian-like age distribution. Thus, the age-dependency of the frequency of these three common types of bile duct stones differed from one another within this patient population.
Preferences of Patients with Post-Menopausal Osteoporosis Treated with Bisphosphonates – the VIVA II Study
Authors: Payer J , Čierny D , Killinger Z , Šulková I , Behuliak M , Celec P
Published: February 2013

The effectiveness of bisphosphonate treatment for post-menopausal osteoporosis depends on patients adhering to the therapeutic regimen. We previously showed that patients prefer a once-monthly regimen and the present follow-up study aimed to analyse patients' motivation for this preference. Women with post-menopausal osteoporosis ( n = 2035) completed a questionnaire targeting their bisphosphonate treatment preferences. The majority had chosen the once-monthly regimen due to the comfort (69%) and simplicity (59%) of the treatment and the need to take fewer pills (55%). Friends, relatives and print media were highlighted as important sources of information and many patients indicated a need for more information about osteoporosis and its management. Gastrointestinal and muscular side-effects were reported by about one-third of the patients, but these were well tolerated. It is concluded that once-monthly bisphosphonate treatment was preferred due to improved quality of life and should be offered to all patients with post-menopausal osteoporosis.
Distal Trisomy of 10q with Distal Monosomy of 15q Due to a Paternal Translocation
Authors: Shunchang Sun , Luo FW , Song HW , He JB , Peng YS
Published: February 2013

Distal trisomy of 10q is a rare chromosomal abnormality. Distal deletions of the terminal long arm of chromosome 15 have rarely been described. We report on a male infant with low birth weight and microcephaly, a flat face with a spacious forehead, low-set ears, blepharophimosis, microphthalmia, a small nose, and a depressed nasal bridge. Microarray comparative genomic hybridization identified that he had the karyotype 46, XY, der (15) t (10;15) (q25.2;q26.2) pat, with chromosomal breakpoints at 10q25.2 and 15q26.2. This male neonatal case had an unbalanced translocation inherited from his father who was a balanced carrier with the karyotype 46, XY, t (10;15) (q25;q26). The neonate had a partial trisomy of the long arm of chromosome 10 with a partial monosomy of distal 15q. The clinical features were in agreement with previous descriptions and allowed us to propose a growth retardation phenotype for this neonate case.
Adamantinoma of the Tibia Treated with a New Intramedullary Diaphyseal Segmental Defect Implant
Authors: Mavrogenis AF , Sakellariou VI , Tsibidakis H , Papagelopoulos PJ
Published: February 2013

In this case report, a 75-year old male presented with a mass on the anterior surface of the mid-shaft of the right tibia. Imaging studies showed a well-circumscribed radiolucent lesion in the anterior tibial cortex, without soft tissue extension. Plain radiographs and computed tomography scan of the chest were negative. Histological diagnosis was consistent with adamantinoma, a rare primary bone tumour. Wide tumour resection of approximately 16 cm of the tibial diaphysis with a surrounding cuff of normal tissue was performed. The bone defect was reconstructed using an intramedullary diaphyseal segmental defect fixation system. At 26 months post-operatively the patient is alive with no evidence of local recurrence, distant metastases or implant failure. The intramedullary diaphyseal segmental defect fixation system is associated with excellent oncological and functional outcomes. Intra-operative modularity, ease of application, immediate post-operative stability and rapid rehabilitation are the major advantages of this diaphyseal prosthesis.
Risk Factors for Retinal Arteriolar Emboli in Coronary Artery Disease
Authors: Alp BN , Bozbuğa N , Alp M
Published: February 2013

This study determined the prevalence of retinal arteriolar emboli risk factors in 148 patients (86 males) diagnosed with coronary artery disease who required coronary artery bypass graft surgery (mean ± SD age 59.1 ± 12.9 years). The prevalence of smoking was 50.7%, hypertension was 49.3%, diabetes mellitus was 27.0% and obesity was 31.1%. Retinal arteriolar emboli were detected using binocular indirect ophthalmoscopy of both eyes. They were found in 10 patients (6.8%) and identified as the cholesterol type. Patients were divided according to their baseline low-density lipoprotein cholesterol (LDL-C) serum level; retinal arteriolar emboli were significantly more frequent in patients with LDL-C levels > 100 mg/dl. These results demonstrate that the prevalence of hypercholesterolaemia and high LDL-C were increased in patients with retinal arteriolar emboli. Identification and treatment of modifiable risk factors, such as high LDL-C and hypercholesterolaemia, might be beneficial in these individuals.
Effects of Sleep Deprivation on Human Postural Control, Subjective Fatigue Assessment and Psychomotor Performance
Authors: Ma J , Yao Y-J , Ma R-M , Li J-Q , Wang T , Li X-J , Han W-Q , Hu W-D , Zhang Z-M
Published: February 2013

This study aimed to investigate the effects of sleep deprivation on postural control, subjective fatigue assessment and psychomotor performance, and to assess the efficiency of an objective posturographic test as an indicator of mental fatigue. Postural sway using static posturography (Romberg's test), subjective fatigue assessment (Stanford Sleepiness Scale) and psychomotor performance (Sternberg dual-task test) were assessed in 12 subjects before and after 24 h of sustained wakefulness. After sustained wakefulness, the Romberg test parameters of circumference area and rectangle area with the eyes-closed, and standard deviation in the anterior–posterior direction with the eyes-open were significantly higher compared with baseline values (before sustained wakefulness). Subjective fatigue assessment scores were also significantly increased, while psychomotor performance was unchanged. Sleep deprivation can arouse a feeling of fatigue and can affect postural stability, hence an objective posturographic test score may be useful as an indicator of mental fatigue.
Conversion from Cyclosporin a to Sirolimus Retards the Progression of Chronic Allograft Nephropathy in the Long Term in a Rat Kidney Transplantation Model
Authors: He Z , Chen L , Qiu J , Li J , Zhao D , Chen G , Wang C
Published: February 2013

In a rat renal allograft model, the long-term effect of conversion from cyclosporin A (CsA) to sirolimus on recipient kidneys and growth factor expression were compared with continuous use or withdrawal of CsA. Kidneys from Fisher 344 rats were orthotopically transplanted into Lewis rats. Four Fisher 344 to Lewis allograft groups were treated post-transplant as follows: (i) CsA (transplant to week 8) then sirolimus (weeks 8-24); (ii) CsA (transplant to week 24); (iii) CsA (transplant to week 8) then vehicle (weeks 8-24); (iv) control vehicle (transplant to week 24). A fifth group underwent syngeneic isograft (Lewis to Lewis) with no drug treatment. Proteinuria was measured every 4 weeks and grafts harvested at 24 weeks for morphological and immunohistochemical analysis. Conversion from CsA to sirolimus resulted in a significant decrease in proteinuria at 24 weeks, a lower Banff sum score and lower expression of transforming growth factor mRNA compared with continuous use or withdrawal of CsA. In conclusion, conversion from CsA to sirolimus retarded progression of chronic allograft nephropathy in the rat model.
Mutations Found in the pncA Gene of Mycobacterium tuberculosis in Clinical Pyrazinamide-resistant Isolates from a Local Region of China
Authors: Zhang H , Bi L-J , Li C-Y , Sun Z-G , Deng J-Y , Zhang X-E
Published: February 2013

This study was designed to investigate the presence of mutations in the pncA gene, minimum inhibitory concentrations and pyrazinamidase activity of pyrazinamide-resistant Mycobacterium tuberculosis. In total, 47 M. tuberculosis clinical isolates from a local region of China were assayed. Pyrazinamidase activity was measured by pyrazinamide deamination to pyrazinoic acid and ammonia, and a 721 bp region, including the entire pncA open-reading frame, 104 bp of the upstream sequence and 59 bp of the downstream sequence, was determined by DNA sequencing of purified polymerase chain reaction products. Of the 47 isolates resistant to pyrazinamide, 44 lost pyrazinamidase activity and had pncA mutations that occurred mainly near pyrazinamidase's active or metal ion binding sites; nine of them have not been reported previously. Three pyrazinamide-resistant isolates carried the wild-type pncA sequence and retained pyrazinamidase activity. These results show the molecular mechanism of pyrazinamide resistance in China and may also contribute towards the prevention of tuberculosis in China.
The Effect of Exercise on Leptin, Insulin, Cortisol and Lipid Profiles in Obese Children
Authors: Karacabey K
Published: February 2013

This prospective, randomized study investigated the effect of exercise on leptin, insulin, cortisol and lipid profiles in obese children. A total of 40 obese boys aged 10-12 years with a body mass index (BMI) ≥ 30 kg/m2 were randomly separated into an exercise group ( n = 20) that underwent a 12-week aerobic exercise programme and a non-exercise (control) group ( n = 20). The BMI, low-density lipoprotein, cortisol, leptin and insulin levels were significantly lower in the exercise group after 12 weeks compared with baseline values, whereas high-density lipoprotein levels were significantly higher. In contrast, in the control group, low-density lipoprotein, cortisol and leptin levels were significantly higher after 12 weeks compared with baseline values while high-density lipoprotein levels were significantly lower. These findings indicate the importance of regular exercise in the regulation of body weight and protection against cardiovascular risk factors in obese children.
Amniotic Fluid Embolism: A Comparison between Patients Who Survived and Those Who Died
Authors: Matsuda Y , Kamitomo M
Published: February 2013

This study aimed to investigate comparative clinical courses for a series of women with amniotic fluid embolism (AFE) and to assess factors associated with patient survival. Clinical courses of nine patients with AFE in a single tertiary centre were reviewed. AFE was diagnosed when a woman presented with typical clinical symptoms accompanied by abnormal laboratory tests (including abnormal coagulation) or at autopsy when fetal debris was found in the maternal pulmonary arteries. Five patients survived and four died. The first clinical manifestations of AFE were variable; dyspnoea was noted in only four patients. Other signs were state of shock, abdominal pain and uterine atony. The mean ± SD interval between the onset of clinical manifestations and treatment was significantly shorter for survivors (48.0 ± 36.3 min) than for non-survivors (137.5 ± 49.7 min). The number of failed organs was significantly fewer for the survivors compared with the non-survivors. AFE was accompanied by a wide variety of clinical manifestations, but early diagnosis and treatment appeared to be the most critical factors associated with survival.
The Wound Healing Process: An Overview of the Cellular and Molecular Mechanisms
Authors: Velnar T , Bailey T , Smrkolj V
Published: February 2013

Wound healing remains a challenging clinical problem and correct, efficient wound management is essential. Much effort has been focused on wound care with an emphasis on new therapeutic approaches and the development of technologies for acute and chronic wound management. Wound healing involves multiple cell populations, the extracellular matrix and the action of soluble mediators such as growth factors and cytokines. Although the process of healing is continuous, it may be arbitrarily divided into four phases: (i) coagulation and haemostasis; (ii) inflammation; (iii) proliferation; and (iv) wound remodelling with scar tissue formation. The correct approach to wound management may effectively influence the clinical outcome. This review discusses wound classification, the physiology of the wound healing process and the methods used in wound management.
Ankle–Brachial Index Screening for Peripheral Artery Disease in Asymptomatic Patients between 50 and 70 Years of Age
Authors: Kravos A , Bubnič-Sotošek K
Published: February 2013

Asymptomatic peripheral arterial disease (PAD) can be easily identified using the ankle–brachial index (ABI). This study was designed to investigate the benefits of performing ABI in patients aged 50-70 years. A random sample of 107 patients was chosen and data on gender, age, risk factors and laboratory tests were collected and the ABI measured. Twenty (19%) patients were found to have PAD. Smoking, high total cholesterol, high triglycerides and diabetes mellitus were shown to be associated with a low ABI and the presence of PAD. Age, diabetes and smoking were identified as the strongest predictors of PAD. Having more risk factors for PAD also predicted a lower ABI. These results suggest that measuring ABI is not necessary in patients aged 50-70 years if they only have one risk factor, with the exception of patients with diabetes and those who smoke. In contrast, measuring ABI seems to be useful for patients with multiple risk factors for PAD, although additional studies are required.
Evaluating Patients' Health Using a Hierarchical Multi-Attribute Decision Model
Authors: Šušteršič O , Rajkovič U , Dinevski D , Jereb E , Rajkovič V
Published: February 2013

Evaluation of a patient's health status is an essential part of the healthcare process. For this purpose, Henderson's model of basic living activities (BLA) is often proposed as a set of criteria to be used in nursing. Despite its clarity and theoretical background, the model is only partially used in clinical practice. In this paper, we present the methodology for a hierarchical multi-attribute decision model to increase the practical efficiency of the BLA model. The result is a computerized model for the evaluation of a patient's health status. This model was tested in clinical practice by 17 nurses in two health centres in Slovenia and a strengths, weaknesses, opportunities and threats (SWOT) analysis was carried out. The strengths included providing a holistic understanding of the nature and level of the nursing problems, enriching the documentation and reducing the possibility of overlooking something important. As a part of electronic documentation, this computerized model supports systematic patient data gathering and evaluation.
Procalcitonin Levels as an Early Marker in Patients with Multiple Trauma under Intensive Care
Authors: Balci C , Sivaci R , Akbulut G , Karabekir HS
Published: February 2013

This prospective study investigated the levels of procalcitonin (PCT) and C-reactive protein (CRP) in patients with various types and severity of multiple trauma, and their relationship to trauma-related complications. Adult multiple-trauma patients ( n = 113) admitted to the intensive care unit (ICU) in the first 24 h after trauma were included. The Injury Severity Scores (ISS), and PCT and CRP levels were measured in the first 24 h (day 1), on day 7 and on the final day of their ICU stay. Survival at 30 days was recorded. Mean PCT and CRP levels were both significantly higher on day 7 compared with day 1 and the final assessment day in patients with an ISS > 20. Levels of PCT were significantly higher in cases with sepsis, severe sepsis or septic shock compared with cases who developed systemic inflammatory response syndrome (SIRS), however levels of CRP were significantly higher only in cases with severe sepsis or septic shock, but not in cases with sepsis alone. These data support the view that PCT levels may be a better indicator than CRP levels in the early diagnosis of septic complications in patients with multiple trauma.
Efficacy and Safety of an Intra-Operative Intra-Articular Magnesium/Ropivacaine Injection for Pain Control following Total Knee Arthroplasty
Authors: Chen Y , Zhang Y , Zhu Y-L , Fu P-L
Published: February 2013

Eighty patients with osteoarthritis who underwent unilateral total knee arthroplasty were randomly assigned to two groups: the trial group received an intra-operative intra-articular injection of magnesium sulphate and ropivacaine, and the control group received an injection of normal saline. All patients received patient-controlled analgesia with morphine for 48 h post-operatively. It was found that an intra-articular injection of magnesium sulphate and ropivacaine significantly reduced morphine consumption during the 0-24 h post-operative period and total 48-h postoperative morphine consumption. Pain scores at rest and during motion in the trial group were significantly lower than in the controls during the first 24 h post-operatively. The time to be able to perform a straight leg raise and to reach a 90° knee flexion was significantly shorter in the trial group compared with the controls. This study demonstrated that an intraoperative intra-articular magnesium sulphate and ropivacaine injection reduced the use of post-operative morphine.
Changes in Lymphocyte Subsets in the Peripheral Blood of Patients with Active Pulmonary Tuberculosis
Authors: Wu YE , Zhang SW , Peng WG , Li KS , Li K , Jiang JK , Lin JH , Cai YM
Published: February 2013

The aim of this study was to determine the percentage of lymphocyte subsets in peripheral blood in patients with active tuberculosis. A total of 21 patients with active tuberculosis and 15 healthy volunteers were included in the study. T-lymphocyte subsets, B-lymphocytes (CD19+ cells), natural killer (NK) cells and cells positive for costimulatory molecules CD28 and CD152 were evaluated using flow cytometry. Patients with tuberculosis had a significantly decreased percentage of CD3+ and CD3+CD4+ cells, and a significantly decreased ratio of CD3+CD4+ to CD3+CD8+ cells compared with healthy controls. In contrast, the percentage of B-cells (CD19+ cells), CD3+CD8+ cells, CD28+ cells, CD152+ cells, and subpopulations of CD4+CD152+, CD8+CD152+ and CD8+CD28+ T-cells were all significantly increased compared with healthy controls. There were no statistically significant differences in the percentages of NK cells or CD4+CD28+ cells between patients and controls. These results indicate that patients with active tuberculosis have altered lymphocyte homeostasis.
Effect of Maternal Stress on Fetal Heart Rate Assessed by Vibroacoustic Stimulation
Authors: Makino I , Matsuda Y , Yoneyama M , Hirasawa K , Takagi K , Ohta H , Konishi Y
Published: February 2013

This study was designed to determine whether maternal stress levels, state and trait anxiety levels, and stress hormones affect fetal heart rate (FHR) patterns after vibroacoustic stimulation (VAS) at 30 weeks of gestation. A total of 24 healthy pregnant women with a single fetus pregnancy were enrolled. Corticotropin releasing hormone (CRH) and adrenocorticotropic hormone in maternal plasma and cortisol, and chromogranin A in saliva were measured. The FHR patterns after VAS were divided into three types: type I, a long period of acceleration or one acceleration lasting > 1 min or at least two accelerations lasting > 15 s; type II, a biphasic response with acceleration followed by deceleration; and type III, no response or prolonged deceleration. In the high trait anxiety group, CRH levels were significantly higher than in the low trait anxiety group, and FHR patterns after VAS showed mostly a type II response pattern. These findings suggest that stress in pregnant women with high trait anxiety may influence FHR patterns after VAS.
The Relationship between Adipokines, Metabolic Parameters and Insulin Resistance in Patients with Metabolic Syndrome and Type 2 Diabetes
Authors: Lee JM , Kim SR , Yoo SJ , Hong OK , Son HS , Chang SA
Published: February 2013

This study was designed to investigate the relationship between adipokines in metabolic syndrome and insulin resistance. Sixty male and female subjects with or without metabolic syndrome and type 2 diabetes were included. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Compared with lean control subjects, patients with metabolic syndrome and type 2 diabetes had lower circulating levels of total adiponectin and high molecular weight (HMW) adiponectin, and higher levels of leptin and interleukin-6 (IL-6). Total and HMW adiponectin and the adiponectin/leptin (A/L) ratio were negatively correlated with HOMA-IR. After adjusting for age and sex, leptin, IL-6 and tumour necrosis factor-α (TNF-α) were positively correlated with HOMA-IR. After also adjusting for body mass index, HOMA-IR was found to be independently associated with leptin, A/L ratio and TNF-α levels. In conclusion, decreased total adiponectin and HMW adiponectin and increased leptin and IL-6 levels are characteristic of patients with metabolic syndrome and type 2 diabetes.
Effects of n-3 Polyunsaturated Fatty Acid Therapy on Plasma Inflammatory Markers and N-Terminal Pro-brain Natriuretic Peptide in Elderly Patients with Chronic Heart Failure
Authors: Zhao YT , Shao L , Teng LL , Hu B , Luo Y , Yu X , Zhang DF , Zhang H
Published: February 2013

Several previous studies have suggested that n-3 polyunsaturated fatty acids ( n-3 PUFA) can exert favourable effects in patients with heart failure, but the mechanisms involved are not fully understood. This study was designed to investigate the effects of n-3 PUFA on circulating inflammatory markers and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with heart failure. Seventy-six patients with heart failure were randomly assigned to receive 2 g/day of n-3 PUFA or placebo for 3 months. Treatment with n-3 PUFA significantly decreased plasma levels of tumour necrosis factor, interleukin-6, intercellular adhesion molecule 1 and NT-proBNP. Left ventricular ejection fraction showed a small, non-significant improvement. High-sensitivity C-reactive protein levels decreased significantly in smokers after n-3 PUFA treatment. Thus, n-3 PUFA can reduce levels of plasma inflammatory markers and NT-proBNP as biomarkers of risk stratification in patients with heart failure. n-3 PUFA may offer a novel therapy for heart failure.
Down-Regulation of SHH/BMP4 Signalling in Human Anorectal Malformations
Authors: Zhang J , Zhang ZB , Gao H , Zhang D , Wang WL
Published: February 2013

The sonic hedgehog homologue (SHH)/bone morphogenetic protein 4 (BMP4) signalling pathway is involved in the morphogenesis of many organ systems. This study was designed to investigate the expression of SHH/BMP4 pathway components in human anorectal malformations (ARMs) and the relationship between expression of their genes and the occurrence of ARMs. Expression of SHH, GLI family zinc finger 2 (GLI2) and BMP4 mRNA in the posterior wall of the terminal rectum in 40 patients with ARMs (15 high-type and 25 low-type) and 10 normal controls was assessed by reverse transcription-polymerase chain reaction. Levels of SHH, GLI2 and BMP4 proteins were assessed by immunohistochemistry and Western blotting. The expressions of SHH, GLI2 and BMP4 were significantly lower in patients with high-type compared with those with low-type anomalies and controls. Patients with low-type ARMs differed from controls only in the expression of GLI2 mRNA. It is concluded that down-regulation of the SHH/BMP4 signalling pathway may be related to the occurrence of high-type ARMs, but the mechanism responsible for low-type ARMs remains unclear.
Evaluation of POSSUM in Predicting Post-Operative Morbidity in Patients Undergoing Pancreaticoduodenectomy
Authors: Zhang Y , Fu L , Zhang Z-D , Li Z-J , Liu X-B , Hu W-M , Mai G , Yan L-I , Zeng Y , Tian B-L
Published: February 2013

The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) is a predictive scoring system for post-operative morbidity. The present study assessed the value of POSSUM in predicting post-operative morbidity following pancreaticoduodenectomy (PD). POSSUM scores were prospectively calculated for 265 consecutive cases of PD performed between 2005 and 2007. Expected morbidity was estimated based on POSSUM scores and was compared with observed morbidity. Patients were also stratified into one of four groups based on their individual POSSUM scores and subsequent risk of morbidity. Mean expected morbidity was 43.81% (116 cases) and mean observed morbidity was 39.62% (105 cases) (no statistically significant difference). It is concluded that the POSSUM scoring system has high value for predicting the risk of morbidity in PD patients.