bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression and Correlation of Hypoxia-inducible Factor-1α, Vascular Endothelial Growth Factor and Microvessel Density in Experimental Rat Hepatocarcinogenesis
Authors: Wang W , Xu G-L , Jia W-D , Wang Z-H , Li J-S , Ma J-L , Ge Y-S , Xie S-X , Yu J-H
Published: February 2013

An experimental rat hepatocellular carcinoma (HCC) model was established using diethylnitrosamine and N-nitrosomorpholine to induce carcinogenesis in Sprague-Dawley rats. During hepatocarcinogenesis, seven rats were sacrificed at 0, 4, 8, 12 and 16 weeks and 10 rats were sacrificed at 20 weeks. The levels of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) protein and mRNA were examined by immunohistochemistry, Western blot and semi-quantitative reverse transcriptase-polymerase chain reaction at different stages in the rat HCC model. Twenty weeks after induction of hepatocarcinogenesis, the expression of HIF-1α and VEGF protein and mRNA significantly increased compared with week 0. Microvessel density (MVD) increased considerably once liver cancer developed. There was a significant positive correlation between MVD and both HIF-1α and VEGF, and between HIF-1α and VEGF levels. These results suggest that HIF-1α and VEGF play important roles in tumour occurrence and development during rat hepatocarcinogenesis, possibly through promoting tumour angiogenesis.
Experimental Study of COX-2 Selective and Traditional Non-steroidal Anti-inflammatory Drugs in Total Hip Replacement
Authors: Li W , Lian Y-Y , Yue W-J , Yang Q , Yue Q , Meng Q-G , Zhao C-B
Published: February 2013

This study investigated the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on peri-operative blood loss during elective total hip replacement. Patients were randomized to receive enteric-coated diclofenac 50 mg ( n = 18), rofecoxib 12.5 mg ( n = 17) or placebo ( n = 16) administered orally three times daily for 2 weeks prior to surgery. Severe adverse effects resulting in discontinuation of trial participation occurred in six patients in the diclofenac group, five patients in the rofecoxib group and two patients in the placebo group; all drop-outs occurred at various times after surgery. Compared with placebo, peri-operative blood loss increased by 32% in the diclofenac group and by 7% in the rofecoxib group. Total mean ± SD blood loss was 1040 ± 136 ml in the diclofenac group, 844 ± 83 ml in the rofecoxib group and 789 ± 82 ml in the placebo group. Thus, administering a non-selective NSAID 2 weeks prior to elective total hip replacement significantly increases peri-operative blood loss.
Microvessel Density and Expression of Thrombospondin-1 in Non-small Cell Lung Cancer and Their Correlation with Clinicopathological Features
Authors: Chen ZJ , Le HB , Zhang YK , Qian LY , Li WD
Published: February 2013

Microvessel density and thrombospondin-1 (TSP-1) expression were analysed in 42 non-small cell lung cancer (NSCLC) specimens and 40 normal lung tissue specimens using immunohistochemistry. Microvessel density was significantly higher and TSP-1 expression significantly lower in NSCLC tissue compared with normal tissue. Significantly lower levels of TSP-1 expression and higher microvessel densities were found in late-stage NSCLC compared with early-stage NSCLC, and in those with lymph node metastasis compared with those without metastasis. A statistically significant inverse correlation was observed between TSP-1 expression and microvessel density in squamous cell carcinoma but not in adenocarcinoma. These results suggest a close relationship between microvessel density and NSCLC tumour progress, and that a high expression of TSP-1 may play an important role in inhibiting tumour occurrence and development. The lack of correlation between microvessel density and TSP-1 expression in adenocarcinoma suggests that the mechanism of tumour inhibition by TSP-1 varies according to histological type.
Measurement of Acetabular Anteversion in Developmental Dysplasia of the Hip in Children by Two- and Three-dimensional Computed Tomography
Authors: Li LY , Zhang LJ , Zhao Q , Wang EB
Published: February 2013

This study assessed the angle of acetabular anteversion (AA) in 66 children with developmental dysplasia of the hip (132 hips: 24 left, 25 right, 17 bilateral and 49 unaffected hips as controls). The AA was measured by two- and three-dimensional computed tomography (2D-CT and 3D-CT). Measurements were taken by three observers and repeated 2 weeks later by one of these observers. Intra- and inter-observer agreement was analysed using the intra-class correlation coefficient. For all hips, the mean AA (±SD) measured by 2D-CT versus 3D-CT was statistically significantly different (15.76 ± 5.23° versus 16.76 ± 4.43°, respectively). The mean (±SD) AA by 3D-CT in unaffected and affected hips was also statistically significantly different (13.92 ± 3.95° versus 18.44 ± 3.82°, respectively). A significant positive correlation between age at presentation and AA was found in affected, but not unaffected, hips. The 3D-CT showed better intra- and inter-observer agreement than 2D-CT for assessing AA hence is a more reliable measurement of AA. An increased AA is one component of anatomical abnormalities in developmental dysplasia of the hip and the abnormality appears to worsen with age.
Primary Small Cell Carcinoma of the Kidney with Tumour Thrombus Extension into the Inferior Vena Cava and Pulmonary Artery: A Case Report and Review of the Literature
Authors: Xu Gang , Chen Jimin , Zhang Zhewei
Published: February 2013

Renal small cell carcinoma is a rarely seen malignant neoplasm with high propensity for distant metastasis and aggressive behaviour showing combined characteristics of neuroendocrine and epithelial neoplasia in terms of immunohistochemistry and ultra-structure. To the best of our knowledge this is the first report of primary small cell carcinoma of the left kidney with tumour thrombus extending to the inferior vena cava and pulmonary artery to undergo left radical nephrectomy and tumour thrombectomy under extracorporeal circulation and deep hypothermic circulatory arrest. The patient was a 33-year old male. He was discharged from hospital 10 days following the procedures and remained alive at the time of writing, over 7 months after discharge. Light microscopy, immunohistochemistry and the survival outcome of this case are presented and these are discussed in the context of a review of similar cases in the current literature. This case demonstrated that, in the absence of distant metastases, renal small cell carcinoma with tumour thrombus does not contraindicate surgery.
Simvastatin Reduces OX40 and OX40 Ligand Expression in Human Peripheral Blood Mononuclear Cells and in Patients with Atherosclerotic Cerebral Infarction
Authors: Liu B , Yu G , Yang Z , Sun L , Song R , Liu F , Xin Y , Zhang L
Published: February 2013

This study investigated the effect of simvastatin on the expression of OX40 and OX40 ligand (OX40L) in vitro and in vivo. OX40 and OX40L mRNA and protein levels were measured in human peripheral blood mononuclear cells, using reverse transcription–polymerase chain reaction and Western blot, respectively, in response to simvastatin alone or given in combination with interferon-γ, mevalonate or GW9662, a peroxisome proliferator-activated receptor-γ (PPAR-γ) antagonist. Simvastatin induced down-regulation of OX40 and OX40L mRNA and protein in a concentration-dependent manner, and antagonized the interferon-γ-induced increase in OX40 and OX40L mRNA and protein levels. Mevalonate, but not GW9662, reversed the simvastatin-induced down-regulation of OX40 and OX40L expression, indicating that these effects were mediated through the mevalonate pathway. Serum levels of soluble OX40L and matrix metalloproteinase 9 levels were significantly reduced in patients with atherosclerotic cerebral infarction who were treated for 6 months with routine therapy plus simvastatin ( n = 46) compared with patients receiving routine therapy alone ( n = 30). These findings improve our understanding of the anti-inflammatory and immunomodulatory properties of simvastatin treatment for atherosclerotic disorders.
Significance of Phosphatase and Tensin Homologue (PTEN), O6-Methylguanine-DNA Methyltransferase (MGMT), and DNA-dependent Protein Kinase Catalytic Subunit (DNA-PKcs) Protein Expression in Gynaecomastia
Authors: Zhu L , Liu Z , Yang J , Cai J
Published: February 2013

This study was designed to investigate the pathogenesis of gynaecomastia by measuring phosphatase and tensin homologue (PTEN), O6-methylguanine-DNA methyltransferase (MGMT) and DNA-dependent protein kinase catalytic subunit (DNA-PKcs) protein in breast tissue specimens from 68 patients with gynaecomastia and 24 normal male controls using immunohistochemical staining. The gynaecomastia cases were divided into three different histological types: florid, intermediate and fibrous. The PTEN, MGMT and DNA-PKcs proteins were detected in both gynaecomastia and normal breast tissue, but the levels of immunohistochemical staining of each protein were significantly lower in gynaecomastia breast tissue than in normal breast tissue. There were also significant differences in the levels of immunohistochemical staining for the three proteins according to gynaecomastia histological type. These results suggest that abnormally low levels of PTEN, MGMT and DNA-PKcs protein in gynaecomastia breast tissue may play a role in the development of gynaecomastia. Further research is required to elucidate fully their individual roles in the pathophysiology of gynaecomastia.
Impaired Fibrinolytic and Blunted Nitric Oxide Response to Phlebotomy in Cigarette Smoking Healthy Blood Donors
Authors: Buyukhatipoglu H , Tiryaki O , Usalan C
Published: February 2013

This study was designed to investigate the effects of smoking on endothelial function in 88 healthy blood donors: 48 smokers and 40 non-smokers. Two markers of endothelial dysfunction, plasminogen activator inhibitor-1 (PAI-1) and nitric oxide (NO) levels, were measured at baseline and after phlebotomy. It has been proposed that phlebotomy acutely activates the renin–angiotensin–aldosterone system, thereby activating endothelial activity and increasing PAI-1 and NO expression. At baseline there were no significant differences between smokers and non-smokers in terms of PAI-1 expression and NO levels. After phlebotomy, both PAI-1 and NO levels were significantly increased in both groups. The increase in PAI-1 was more pronounced in smokers and the increase in NO was more pronounced in non-smokers. These findings suggest that smoking causes endothelial dysfunction, even in healthy smokers, which may remain silent until a clinically evident disorder develops.
High-dose Propofol Triggers Short-term Neuroprotection and Long-term Neurodegeneration in Primary Neuronal Cultures from Rat Embryos
Authors: Berns M , Seeberg L , Schmidt M , Kerner T
Published: February 2013

This study investigated the effects of propofol on primary neuronal cultures from rat embryos. Primary cortical neuronal cultures were prepared from Wistar rat embryos (E18). The viability of cells exposed to 0.01, 0.1 or 1 mg/ml propofol for up to 48 h was assessed using a methyltetrazolium assay. In order to evaluate the role of γ-aminobutyric acid-A (GABAA) receptors, cells were also pre-incubated with the GABAA-receptor antagonists, gabazine and picrotoxin. Propofol at a concentration of 1 mg/ml significantly reduced cell viability after 12 h. In contrast, this concentration led to a significant increase in cell viability at 3 and 6 h. The GABAA-receptor antagonists did not influence the neurodegenerative effect of propofol but abolished its neuroprotective effect. DNA fragmentation as a marker of apoptosis was elevated after 24 h propofol treatment. These results confirm that high doses of propofol can cause GABAA-receptor triggered neuroprotection and a subsequent time-dependent, but GABAA-independent, neurodegeneration in primary cortical neurons.
A Comparison of Two Rehabilitation Protocols after Simultaneous Bilateral Total Knee Arthroplasty: A Controlled, Randomized Study
Authors: Liu PL , Li L , Zhang YK , Li M , Kane K , Wang YH , Lin JX , Ding M , Wang SF , Zhou L , Hu K
Published: February 2013

Post-operative outcomes after simultaneous bilateral total knee arthroplasty in 115 patients randomly assigned to two rehabilitation protocols were compared. The traditional-protocol group performed a series of exercises on one leg and then repeated the same sequence on the other leg. The alternate-protocol group performed the same exercises, but alternated between legs with each individual repetition. Symptoms and function were assessed pre-operatively and at 1, 3, 6 and 12 months post-operatively. The alternate-protocol group had lower visual analogue pain scale scores in the early post-operative period, as well as higher Knee Society Scores and SF-12 physical and mental health summary scores after 1 and 3 months compared with the traditional-protocol group, but there were no differences between the two groups from 6 months post-operatively. There were no significant differences between the groups in terms of range of knee motion or incidence of deep vein thrombosis. The alternate-protocol for rehabilitation resulted in an early return to function and decreased pain levels following simultaneous bilateral total knee arthroplasty and was associated with the potential to produce more positive emotional states and earlier functional independence.
Influence of Borneol on In Vitro Corneal Permeability and on In Vivo and In Vitro Corneal Toxicity
Authors: Yang H , Xun Y , Li Z , Hang T , Zhang X , Cui H
Published: February 2013

This study examined whether borneol could enhance corneal drug permeability. Model drugs containing either synthetic or natural borneol were co-administered to isolated intact or de-epithelialized rabbit corneas and the apparent permeability coefficients were measured. Draize tests in rabbits and levels of isolated intact rabbit corneal hydration were used to measure in vivo and in vitro toxicity, respectively. Synthetic borneol (0.1%) increased corneal penetration of the lipophilic agents, indomethacin and dexamethasone, by 1.23 and 2.40, respectively, and of the hydrophilic agents, ofloxacin, ribavirin and tobramycin, by 1.87, 2.80 and 3.89, respectively. For natural borneol, the corresponding fold increases were 1.67, 2.00, 2.15, 2.18 and 3.39, respectively. Removing the epithelium attenuated the penetration-enhancing effects of borneol. Borneol (0.1%) did not damage corneal tissue. The ability of borneol to enhance drug penetration through the outer corneal layer, particularly for highly-hydrophilic drugs, suggests that further clinical investigation may be warranted.
Sodium Butyrate Induces Human Colon Carcinoma HT-29 Cell Apoptosis through a Mitochondrial Pathway
Authors: Wang L , Luo H-S , Xia H
Published: February 2013

Some tumours respond favourably to tumour necrosis factor-alpha (TNF-α). Despite this preferential sensitivity, resistance to TNF-α remains a clinical problem and more interest is now being focused on finding compounds that induce apoptosis through other pathways. Sodium butyrate (NaBt) has anti-tumour effects on colon cancer cells, inhibiting cell growth and promoting differentiation and apoptosis. In this study we investigated whether NaBt induced apoptosis in the human colon cancer cell line HT-29 and examined the intracellular mechanisms involved. Pre-incubation of cells with NaBt significantly increased apoptosis as measured by fluorescence activated cell sorter analysis and mitochondrial membrane potential determination. This effect could be blocked with the caspase inhibitors, z-VAD-fmk (pan-caspase inhibitor), z-DEVD-fmk (caspase-3 inhibitor) and z-LEHD-fmk (caspase-9 inhibitor), but not with z-IETD-fmk (caspase-8 inhibitor). Enhancement of caspase-3 and caspase-9 activities suggests that NaBt induces apoptosis via mitochondrial pathways not involving TNF-α.
Characteristic Genotypes of Vascular Endothelial Growth Factor are Susceptible to Ascites in Patients with Cirrhosis
Authors: Sohda T , Iwata K , Irie M , Takeyama Y , Nakane H , Morihara D , Kitamura Y , Yokoyama M , Shakado S , Watanabe H , Sakisaka S
Published: February 2013

This study was designed to investigate whether different vascular endothelial growth factor (VEGF) genotypes are associated with ascites formation in cirrhotic patients. Seventy cirrhotic patients were included in the study: 25 cirrhotic patients with ascites and 45 cirrhotic patients without ascites. Patient characteristics were investigated and compared between the two groups. With regard to VEGF genotype, 42 patients were C/C and 28 patients were T/T or C/T. The genotypes T/T or C/T were observed in 23 cases (51%) among the non-ascites group, but in only five cases (20%) among the ascites group. Serum levels of albumin and creatinine, and the VEGF genotypes were significantly different between the two groups. Multiple regression analysis showed that serum levels of creatinine and the VEGF genotypes were significantly correlated with ascites formation. Thus, it can be concluded that VEGF genotyping might be a valuable susceptibility marker for ascites formation in cirrhotic patients.
Clinical Value of Tumour Specific Growth Factor (TSGF) and Carbohydrate Antigen-125 (CA-125) in Carcinoma of the Endometrium
Authors: Yu B , Xu PZ , Wang QW , Zhou H , Zhou HX
Published: February 2013

This study estimated the clinical value of tumour specific growth factor (TSGF) and carbohydrate antigen-125 (CA-125) in the diagnosis of endometrial carcinoma. Blood was collected from the peripheral and uterine veins of endometrial cancer patients, and serum TSGF and CA-125 levels were compared with those in uterine myoma patients (non-tumour controls) and normal women. Significantly higher levels of TSGF and TGSF-positive rates were observed in endometrial cancer patients versus non-tumour and normal controls. The sensitivity and specificity for detecting TGSF-positive rates in the endometrial carcinoma group were 64.9% and 62.5%, respectively. The TSGF levels in uterine blood were significantly higher than in peripheral blood and the TSGF-positive rate was also higher. The TSGF levels gradually increased with progression through the clinical stages and pathological grades of endometrial carcinoma. The sensitivity and specificity of combined TSGF and CA-125 for detecting endometrial cancer were 75.7% and 56.3%, respectively. It is concluded that there is an important correlation between serum levels of TSGF, CA-125 and endometrial cancer and that measurement of both TSGF and CA-125 combined would be of value in the diagnosis of endometrial carcinoma.
Antiproteinuric Effect of Angiotensinconverting Enzyme Inhibitors and an Angiotensin II Receptor Blocker in Patients with Lupus Nephritis
Authors: Kitamura N , Matsukawa Y , Takei M , Sawada S
Published: February 2013

Although the effects of angiotensin II receptor blockers (ARBs) on non-diabetic glomerulonephritis have been reported, studies of their effects on collagenvascular diseases, particularly lupus nephritis, are limited. In this retrospective, observational study, systemic lupus erythematosus (SLE) patients ( n = 7) with lupus nephritis and uncontrolled proteinuria were treated with an angiotensin-converting enzyme inhibitor followed by the ARB losartan (25–50 mg/day). Urinary protein excretion and renal function were evaluated. After 12 months of losartan, mean urinary protein excretion decreased significantly by 84.8%. Mean systolic and diastolic blood pressures also decreased significantly during the 12 months of losartan treatment, although not in normotensive patients. Complement 4, total complement activity and anti-dsDNA antibody levels, which are indices of SLE activity, and serum creatinine levels, which is an index of renal function, showed no change in response to losartan treatment. A more extensive evaluation of the effects of ARBs in patients with lupus nephritis and poorly controlled proteinuria is required.
Serious Antimicrobial Resistance Status of Pathogens Causing Hospital-acquired Lower Respiratory Tract Infections in North China
Authors: Wang Y , Zhang R , Li W , Feng Y , Leng T
Published: February 2013

Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.
Comparative Analysis of Protein Expression in Differentiated Thyroid Tumours: A Multicentre Study
Authors: Liang H-S , Zhong Y-H , Luo Z-J , Huang Y , Lin H-D , Luo M , Zhan S- , Su H-X , Zhou S-B , Xie K-Q
Published: February 2013

This study compared clinical features and protein expression profiles in differentiated thyroid tumours to identify protein markers with the potential for indicating malignancy status. Tissue microarrays were constructed using 119 thyroid tumour samples (45 papillary carcinomas, 26 follicular carcinomas, 48 adenomas). Generally, there was overexpression of proliferating cell nuclear antigen (PCNA), p53, matrix metalloproteinase (MMP)-7, Hector Battifora mesothelial-1 (HBME-1), MMP-2, pituitary tumour-transforming gene (PTTG) and human telomerase reverse transcriptase (hTERT) in malignant thyroid carcinomas, and overexpression of fragile histidine triad (FHIT), p16 and E-cadherin in thyroid adenomas. Multiple factor binary logistic regression analysis indicated that MMP-2, HBME-1, p16 and FHIT were independently related to differentiated thyroid tumours. Receiveroperating characteristics for these four factors showed HBME-1 as best for diagnostic accuracy. Sensitivity and specificity were enhanced using an HBME-1 and p16 cluster. HBME-1 expression was not significantly different for papillary and follicular carcinomas, whereas p16 expression was significantly specific.
Attention Deficit Hyperactivity Disorder in Children: Comparative Efficacy of Traditional Chinese Medicine and Methylphenidate
Authors: Lan Y , Zhang L-L , Luo R
Published: February 2013

Traditional Chinese medicine (TCM) is frequently used to treat attention deficit hyperactivity disorders (ADHD) in children in China. However, until now there has been no strong evidence to prove that TCM has better efficacy than western medicine. In this systematic study of 34 studies published in the Chinese literature, the effectiveness of TCM in treating ADHD in children was examined and compared with methylphenidate (MPH), which is widely used to treat ADHD. It was found that TCM may have equal or better effectiveness than MPH. However, the lack of high-quality clinical trials to support this conclusion means that it is not currently possible to recommend any particular kind of TCM preparation for treating ADHD in children.
Rosette-forming Glioneuronal Tumour of the Fourth Ventricle with Previous Intratumoural Haemorrhage: Case Report and Review of the Literature
Authors: Li YM , Li WQ , Pan Y , Lu YC , Long NY , Tao XF , Yu HY
Published: February 2013

The case is reported of a rosette-forming glioneuronal tumour of the fourth ventricle (RGTFV) in a 27-year-old male. Symptoms included headache, severe vomiting and clumsy walking that had progressively worsened over 14 days. Computed tomography and magnetic resonance imaging indicated a 3.0 × 2.5 × 2.0 cm solid-cystic mass in the fourth ventricle and obstructive hydrocephalus. The tumour showed evidence of previous intra-tumour haemorrhage, with heterogeneous enhancement after contrast administration. Complete excision of the lesion was performed. Signs of previous intra-tumoural haemorrhage were seen intra-operatively. The detailed clinical, radiological and pathological features in this patient are described and compared with existing literature on this type of tumour. Despite benign histological features and a reported favourable post-operative course, there is still limited clinical experience with this type of tumour, however intratumoural haemorrhage may result in morbidity and mortality. This report will help provide better characterization of this entity, improving the diagnosis and potentially reducing mortality in RGTFV.
Heterotopic Pancreas within Meckel's Diverticulum with Obscure then Massive Gastrointestinal Bleeding in a 12-year-old Child: Case Report and Review of the Literature
Authors: Xiao W-D , Chen W , Yang H
Published: February 2013

We report a case of a 12-year-old boy with heterotopic pancreas (HP) located in a Meckel's diverticulum (MD) and presenting as obscure gastrointestinal (GI) bleeding. Upper GI endoscopy and colonoscopy did not reveal the source of the bleeding, however, capsule endoscopy revealed a space-occupying lesion in the ileum. The patient developed massive bleeding and an emergency exploratory laparotomy was performed. A congested MD was discovered 100 cm from the ileocaecal valve using intra-operative endoscopy; the ulcerated tip of the diverticulum appeared to be the source of the bleeding. The MD and adjacent ileal segment were resected and an end-to-end anastomosis performed. Subsequent pathological examination revealed an ileal MD with HP tissue within the submucosa. The patient remains well, 12 months after the operation, with no evidence of recurrent bleeding. This case suggests that HP should be considered as one possible cause of obscure GI bleeding in children and capsule endoscopy is a valuable adjuvant tool in the diagnosis of HP in children.
Classification and Prediction of Outcome in Traumatic Brain Injury Based on Computed Tomographic Imaging
Authors: Zhu GW , Wang F , Liu WG
Published: February 2013

Traumatic brain injury (TBI) is a common and potentially devastating problem. The classification of TBI is necessary for accurate diagnosis and the prediction of outcomes. The increased use of early sedation, intubation and ventilation in more severely injured patients has decreased the value of the Glasgow Coma Scale for the purposes of classification. An alternative is the classification of TBI according to morphological criteria based on computed tomography (CT) investigations. This article reviews the current classification and prediction of outcomes in TBI based on CT imaging. Classifications based on the presence or absence of intracranial local lesions, diffuse injury, signs of subarachnoid or intraventricular haemorrhage and fractures or foreign bodies are considered, and their predictive value is discussed. Future studies should address the complicated issue of how optimally to combine CT characteristics for prognostic purposes and how to improve on currently used CT classifications to predict outcomes more accurately.
Drugs with Blocking Effects on the Renin–Angiotensin–Aldosterone System Do Not Improve Endothelial Dysfunction Long-Term in Hypertensive Patients
Authors: Sozen AB , Kayacan MS , Tansel T , Celebi A , Kudat H , Akkaya V , Erk O , Hatipoglu I , Demirel S
Published: February 2013

In essential hypertension, endothelial dysfunction has been documented many times and correlates with prognosis. The influence of the renin–angiotensin–aldosterone system (RAAS) on endothelial dysfunction has also been studied. The present study investigated the duration of the effects of RAAS-blocking drugs on endothelial function in 44 consecutive, never-treated, outpatients with mild to moderate hypertension. Patients (11 per group) received an angiotensin receptor blocker (ARB; irbesartan 300 mg/day or valsartan 160 mg/day) or an angiotensin-converting enzyme inhibitor (ACEi; fosinopril 10 mg/day or quinapril 20 mg/day). If target blood pressure (< 140/90 mmHg) was not achieved, 12.5 mg/day hydrochlorothiazide was added. Endothelial function, assessed by measuring brachial artery diameter, did not change significantly after 6 weeks, 1 year or 3 years of treatment in any group. Across all groups, endothelium-dependent and-independent vasodilation increased significantly after 6 weeks but, after 1 year, decreased below baseline and was at a similar level after 3 years; groups did not differ significantly. Both ACEi and ARB had similar effects on endothelial function; improvement occurred at the start of treatmentbut was not maintained. Endothelial dysfunction may be a resistant or irreversible feature of hypertension, requiring high doses of antihypertensive drugs and above-average patient compliance.
Effects of Endothelial Nitric Oxide Synthase, Interleukin-6 Gene Polymorphisms and Asymmetric Dimethylarginine Levels on Risk Factors and Lesion Sites in Peripheral Artery Disease
Authors: Tuygun AK , Keser M , Tuygun A , Ketenci B , Şensöz Y , Balci AY , Karaci AR , Kizilay M , Yurtseven N , Yekeler İ
Published: February 2013

This study investigated risk factors for atherosclerosis and their relationship with lesion sites. Patients ( n = 160) with peripheral artery disease (PAD) completed a questionnaire regarding risk factors for PAD. Endothelial nitric oxide synthase (eNOS) and interleukin (IL)-6 gene polymorphisms and asymmetric dimethylarginine (ADMA) levels were measured. Patients with coronary artery disease had significantly higher ratios of eNOS T/C and C/C genotypes, which include the C allele, than the T/T genotype. The IL-6 gene polymorphism distribution ratios for patients with over four risk factors were significantly different compared with other patients, with a higher rate of the C/C genotype. ADMA levels did not show any significant relationship to risk factors or polymorphism. Levels were, however, slightly higher in femoral lesion sites. The results support a model in which the C/C genotype of eNOS and IL-6 gene polymorphisms promote PAD development. The eNOS C/C genotype may have an independent effect, whereas the effects of the IL-6 C/C genotype are seen in conjunction with other risk factors.
Human Papillomavirus Type 16 Exists in Bacteria Isolated from Cervical Cancer Biopsies
Authors: Ma Zhenghai , Liu Lihong , Zhang Fuchun , Yu Meng , Wang Kai , Luo Jianmin , Liu Kaijiang , Chen Bangdang , Xu Lu
Published: February 2013

This study investigated the association between infectious microbes and persistent infection with human papillomavirus type 16 (HPV-16) in cervical cancer. Bacterial strains (identified as Enterococcus, Staphylococcus, Bacillus and Corynebacterium, based on their partial 16S rDNA sequence) were HPV-16 positive from 12 out of 14 cervical cancer biopsies. Total DNA was isolated from the four bacterial strains, and HPV-16 genes and genome were detected using polymerase chain reaction (PCR) and Southern blotting. RNA transcripts for HPV-16 E6 and L1 genes were detected in total bacterial RNA samples using reverse transcription-PCR, and HPV-16 L1 protein expression was detected in bacterial cells by Western blotting and immunocolloidal gold electron microscopy. The presence of virus particles in bacterial cells was demonstrated by transmission electron microscopy. The results suggest that bacteria carrying HPV-16 could provide a potential explanation for how infectious microbes contribute to the progression from HPV-16 infection to cervical cancer.
Transplanted Bone Morphogenetic Protein/Poly(lactic-co-glycolic Acid) Delayed-release Microcysts Combined with Rat Micromorselized Bone and Collagen for Bone Tissue Engineering
Authors: Ji Y , Xu GP , Yan JL , Pan SH
Published: February 2013

This study was designed to optimize the preparation of delayed-release microcysts containing bone morphogenetic protein 2 (BMP-2) combined with poly(lactic- co-glycolic acid) (PLGA) and to investigate their osteogenic properties when combined with rat autologous micromorselized bone and collagen. Rat autologous micromorselized bone, collagen and BMP-2/PLGA delayed-release microcysts were implanted in various combinations into the rat gluteus maximus muscle sack model. The following post-operative measurements were made: general observations of the implant site, histological observations, osteogenesis measurements and alkaline phosphatase activity. Autologous micromorselized bone combined with collagen and BMP-2/PLGA delayed-release microcysts demonstrated significantly superior osteogenic properties than any of the other combinations of these three components. These findings suggest that micromorselized bone combined with collagen and BMP-2/PLGA delayed-release microcysts could reduce the quantity of BMP-2 and autologous bone required for these procedures, making their use feasible in human bone restoration.
Synergistic Effect of a Novel Focal Hyperthermia on the Efficacy of Rifampin in Staphylococcal Experimental Foreign-Body Infection
Authors: Zou G-Y , Shen H , Jiang Y , Zhang X-L
Published: February 2013

This study was designed to evaluate the efficacy of focal hyperthermia and rifampin in vitro and in vivo using a rabbit model of foreign-body infection by methicillin-resistant Staphylococcus aureus (MRSA). In vitro studies demonstrated bacterial re-growth and development of rifampin resistance after 24 h with rifampin alone, which was prevented under hyperthermic conditions. For the in vivo studies, rifampin was administered intraperitoneally every 12 h for 7 days to rabbits with MRSA-containing cages implanted into their flanks. When combined with hyperthermia at 39°C, 41°C and 43°C, rifampin significantly reduced in-cage bacterial counts by > 3.0 log10 colony forming units/ml compared with rifampin alone. Eradication of cage-associated infection was achieved more effectively when rifampin was combined with hyperthermia, with cure rates of 70-95% on day 10. Focal hyperthermia combined with rifampin prevented the emergence of rifampin resistance and maintained rifampin efficacy. These findings might have implications for orthopaedic surgery.
Clinical Significance of Telomerase Activity in Gastric Carcinoma and Peritoneal Dissemination
Authors: Hu X , Wu H , Zhang S , Yuan H , Cao L
Published: February 2013

Telomerase activity is responsible for telomere maintenance and is believed to be crucial in most cancer cells, but its significance in gastric cancer remains unknown. This observational study investigated whether there is a relationship between telomerase activity and the development of gastric cancer, and between telomerase activity and peritoneal dissemination. Telomerase activity was measured in primary gastric cancers and in peritoneal washings from the same patients, and findings were compared with those of conventional cytology and an immunoassay for cancer antigen 125 (CA125). Positive cytological examination and telomerase activity in peritoneal washings both correlated with the histological grade, depth of tumour invasion, area of serosal invasion and peritoneal metastasis. The detection of free cancer cells in peritoneal washings by the telomeric repeat amplification protocol/enzyme-linked immunosorbent assay (TRAP–ELISA) was significantly more sensitive than cytology or the CA125 immunoassay, suggesting that this could be used to diagnose early peritoneal dissemination.
Thyrotropin-Releasing Hormone Can Relieve Cancer-Related Fatigue: Hypothesis and Preliminary Observations
Authors: Kamath J , Yarbrough GG , Prange AJ , Winokur A
Published: February 2013

Fatigue in cancer patients is highly prevalent, predominantly idiopathic, difficult to manage, and has a significant negative impact on quality of life. Thyrotropin-releasing hormone (TRH) exerts normotrophic, state-dependent therapeutic effects in a variety of experimental and clinical situations. To evaluate TRH as a treatment for cancer-related fatigue, an ongoing randomized, placebo-controlled, crossover pilot study of breast cancer patients has been initiated and this report presents preliminary observations conducted with three of these patients over 4 consecutive weeks, thereby involving a total of six TRH treatments and six saline controls. Global assessment using both subjective and objective parameters showed that TRH exerted clear anti-fatigue effects in four of the six TRH treatments. These responses were rapid in onset and persisted through the 24 h observation period. No anti-fatigue responses were seen in five of the six saline controls. No unexpected side-effects were seen with TRH administration. These initial findings support the proposal that TRH can ameliorate cancer-related fatigue.
Treatment of Chronic Idiopathic Urticaria with Levamisole: A Multicentre, Randomized, Double-Blind, Controlled Trial
Authors: Zhang H , Shan C , Hua Z , Zhao P , Zhang H
Published: February 2013

The objective of this study was to evaluate the efficacy of treating chronic idiopathic urticaria (CIU) with levamisole in combination with levocetirizine. This was a multicentre, randomized, double-blind, controlled trial that included 132 patients with active CIU who were treated for 6 weeks with either levocetirizine alone (control group; n = 65) or levamisole plus levocetirizine (treatment group; n = 67). Response to therapy was evaluated by measuring the efficacy rate. After 2 weeks of treatment, there was no significant difference in the efficacy rate between the treatment and control groups (54.84% and 42.37%, respectively). After 6 weeks of treatment, a statistically significant difference in the efficacy rate was observed between the groups (76.27% and 54.39% for the treatment and control groups, respectively). This study demonstrated that a combination of levamisole plus levocetirizine is more effective than levocetirizine alone and potentially provides a new, promising approach to the treatment of CIU.
World Health Organization Sub-Types, Initial Treatment Outcome and Prognostic Study of Unselected Adult Patients with Acute Myeloid Leukaemia in Shanghai: An Analysis of 623 Cases
Authors: Ma Y , Wang X , Xu X , Lin G
Published: February 2013

This study investigated the complete remission (CR) rate and survival of 623 newly diagnosed patients with acute myeloid leukaemia (AML) in Shanghai, China, classified according to World Health Organization and French–American–British criteria, and compared the differences in treatment effect with those reported in developed countries and those reported in Shanghai from 1984 to 1994. Total CR rate was 66.5%, median survival was 18 months and estimated survival at 3 years was 30.8%. The 3-year relapse rate was 55.1%. These data showed that the CR rate was similar to that achieved in studies from developed countries, but long-term survival was worse. The CR rate and survival were increased markedly compared with data previously collected in Shanghai (1984-1994). Induction chemotherapeutic regimens based on idarubicin, daunorubicin or homoharringtonine all had similar CR rates and survivals. Karyotype was the most important prognostic factor. Multilineage dysplasia in de novo AML was not an independent prognostic factor. Improvement in the long-term treatment effect in China is an important challenge for the future.
Angiographic Classification and Sclerotic Therapy of Maxillofacial Cavernous Haemangiomas: A Report of 204 Cases
Authors: Liu X-J , Qin Z-P , Tai M-Z
Published: February 2013

A total of 204 patients with maxillofacial cavernous haemangiomas were examined by digital subtraction angiography to investigate the factors affecting therapeutic outcome and to optimize treatment selection. Cavernous haemangiomas were classified as high-or low-drainage based on the nature of the draining veins. Patients were randomized to receive either embolization of the draining veins with absolute ethanol followed by bleomycin A5 hydrochloride intra-tumoural injection, or intra-tumoural injection only. In patients with high-drainage haemangiomas ( n = 140), there were significant improvements inthe complete cure rate and the overall effective rate in those who had received embolization prior to intra-tumoural injection compared with those who had received intra-tumoural injection only. In patients with low-drainage haemangiomas ( n = 64), there were no significant differences between the two treatment groups. It is concluded that embolotherapy of draining veins prior to hydrochloride injection is effective for treating high-drainage cavernous haemangiomas whereas bleomycin A5 hydrochloride injection alone is suitable for treating low-drainage cavernous haemangiomas.
Expression and Activation of Proline-Rich Tyrosine Kinase 2 (PYK2) in Peripheral Blood Mononuclear Cells from Patients with Systemic Lupus Erythematosus
Authors: Wang M , Zhang W , Zhang Y
Published: February 2013

This study analysed the expression and activation of proline-rich tyrosine kinase 2 (PYK2) in peripheral blood mononuclear cells (PBMCs) from 36 systemic lupus erythematosus (SLE) patients and explored whether activation of PYK2 correlates with disease activity or organ damage in SLE. Samples from 19 patients with rheumatoid arthritis (RA) and 15 healthy individuals were included as controls. There was a significant increase in both total PYK2 protein and its activated/phosphorylated form in PBMCs from patients with SLE, particularly in those with the complication of World Health Organization class IV lupus nephritis. There was a clear correlation between the activation of PYK2 and the level of serum complement, but no relationship was found between the activation of PYK2 and SLE Disease Activity Index (SLEDAI). As previous studies have shown that PYK2 provides important signals during the activation of lymphocytes, PYK2 could be a major contributor to the complex autoimmune pathogenesis of SLE.
Comparison of Entropy and Bispectral Index during Propofol and Fentanyl Sedation in Monitored Anaesthesia Care
Authors: Balci C , Karabekir HS , Kahraman F , Sivaci RG
Published: February 2013

Comparison of entropy (state entropy [SE] and response entropy [RE]) with the bispectral index (BIS) during propofol sedation in monitored anaesthesia care (MAC) was carried out in patients undergoing hand surgery. Thirty candidates for elective hand surgery were pre-medicated with midazolam 0.06 mg/kg and atropine 0.01 mg/kg. Sedation was induced with intravenous propofol and fentanyl was also administered. The Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) was used to determine sedation level and pain was maintained at < 4 on a 0-10 verbal rating scale. The BIS, entropy, MOAA/S and pain values were recorded before initiation of sedation (control), during initiation of sedation, during surgery, and for 30 min after the end of surgery and anaesthesia. On initiation of sedation, entropy decreased more rapidly than BIS. At 10 min after initiation of sedation, the mean ± SD values for MOAA/S, BIS, RE and SE were 3.00 ± 0.36, 85.45 ± 0.15, 74.00 ± 0.60 and 72.02 ± 0.12, respectively. During recovery, BIS and RE and SE increased in parallel with MOAA/S. It is concluded that entropy monitoring is as reliable as BIS monitoring in MAC.
Impact of Obstructive Sleep Apnoea on Clinical Characteristics and Outcomes in Patients with Acute Coronary Syndrome following Percutaneous Coronary Intervention
Authors: Meng S , Fang L , Wang C-Q , Wang L-S , Chen M-T , Huang X-H
Published: February 2013

This study tested whether obstructive sleep apnoea syndrome (OSAS) influenced clinical characteristics and outcomes after successful percutaneous coronary intervention (PCI) in 123 consecutive patients with acute coronary syndrome (ACS). Patients with an apnoea–hypopnea index (AHI) ≥ 5 were considered as having OSAS. Carotid ultrasonography and echocardiography were performed, and C-reactive protein (CRP) and fibrinogen were measured. Co-existence of ACS and OSAS occurred in 76 patients (61.8%) and patients with OSAS had a greater interventricular septum thickness (IVST) and higher levels of CRP than non-OSAS patients. In an elderly subpopulation (≥ 75 years of age), two-vessel disease was significantly more common and fibrinogen levels were significantly higher in OSAS than non-OSAS patients. Carotid intima-media thickness (IMT) correlated with the AHI in ACS patients. In elderly ACS patients, IMT, Gensini score and fibrinogen correlated with AHI. Patients were followed up for 1 year for major adverse cardiac events (MACEs) and no significant difference in major MACEs was found after this period between OASAS and non-OSAS patients. This study indicates that OSAS is associated with inflammation and increased IVST in ACS patients after successful PCI and, in elderly ACS patients, also with CAD severity and enhanced blood coagulability.
Evaluation of Superoxide Dismutase Enzyme Activity of Polymorphonuclear Leucocytes, Erythrocytes and Thrombocytes in Patients with Chronic Myeloproliferative Disorders
Authors: Ceneli O , Haznedar R , Ongun CO , Altan N
Published: February 2013

This study aimed to investigate the activity of the antioxidant enzyme superoxide dismutase (SOD) in the three main cell types in chronic myeloproliferative disorders (CMPD) patients, i.e. polymorphonuclear leucocytes (PMNLs), erythrocytes and thrombocytes, prior to therapy. Patients with reactive neutrophilia (RN) and healthy volunteers were included as controls. The SOD activity of PMNLs was significantly decreased in CMPD and RN patients compared with healthy volunteers, whereas the SOD activity of erythrocytes was found to be significantly increased in patients with CMPD and RN compared with healthy volunteers. There were no significant differences in the SOD activity of thrombocytes between CMPD patients, RN patients or healthy volunteers. This study indicates that the activity of the SOD enzyme in two cell types is different in CMPD patients compared with healthy subjects. Thus, SOD activity may be altered dependent on cell type and due to specific cell function.
Evaluation and Comparison of Three Different Anti-Hepatitis C Virus Antibody Tests based on Chemiluminescence and Enzyme-Linked Immunosorbent Assay Methods used in the Diagnosis of Hepatitis C Infections in Turkey
Authors: Kesli R , Ozdemir M , Kurtoglu MG , Baykan M , Baysal B
Published: February 2013

The routine diagnosis of hepatitis C virus (HCV) infection is based on the detection of anti-HCV antibodies by two main methods (enzyme immunoassay [EIA] and chemiluminescence immunoassay [CIA]) but false-positives are a problem. We investigated three anti-HCV tests: two CIAs (Cobas® e 601 and Architect® i2000SR); and one EIA (Ortho® HCV 3.0). Two other anti-HCV tests were also performed as supplementary and confirmatory tests, respectively: a recombinant strip immunoblot assay (RIBA HCV 3.0 SIA) and a reverse transcriptase polymerase chain reaction-based assay for HCV-RNA. After discriminating the false-positive results, the true anti-HCV seropositivity rate in 7156 serum samples was 0.91%. The seropositivity and false-positive rates for the Cobas® e 601, Architect® i2000SR and Ortho® HCV 3.0 anti-HCV tests were 1.9% and 0.99%, 1.2% and 0.29%, and 0.87% and 0.01%, respectively. The mean level of HCV-RNA was 3399 × 103 IU/ml. Critical levels for false-positivity for HCV-RNA were a cut-off index of 200 for Cobas® e 601, a signal/cut-off (S/CO) of 5 for Architect® i2000SR and an S/CO of 1.2 for Ortho® HCV 3.0. Positive and negative results for the RIBA HCV 3.0 SIA assay all accorded with the HCV-RNA assay, except for 23 (17%) ‘indeterminate’ results, all of which were negative with the HCV-RNA assay. In conclusion, to eliminate doubts related to false-positive findings in the initial HCV screening tests, additional confirmatory HCV-RNA assay should be performed.