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Objective To explore the relation between the changes of respiratory muscle strength and both the changes of pulmonary function and the severity of myasthenia in patients with myasthenia gravis (MG). Methods We measured the respiratory muscle strength (maximal inspiratory pressure [PIM], maximal expiratory pressure [PEM] and P0.1) and pulmonary function (vital capacity [VC],maximal voluntary ventilation [MVV], peak flow [PF], R5 and R20) of 50 patients with type Ⅱ MG (group B), 16 patients with type Ⅰ MG (group A) and 30 healthy controls (group C). In addition, we analyzed the correlation between the pulmonary function and both the changes of respiratory muscle strength and the severity of myasthenia in group B. Results Comparison with group C, patients in group A had significantly decreased level of MW and P PIM, and statistically increased level of R20 and R5 (P<0.05);additionally, the level of VC, MW, PF, PIM and PEM, in group B decreased markedly with R20 increased markedly only as compared with that in the controls (P<0.05). Patients in group B showed significantly decreased level of PIm and PEM, and increased level of R20 and R5 as compared with the patients in group A (P<0.05). The level of PIM< PEM. MW and VC in group B was positively correlated to the absolute scores of severity of myasthenia in patients with type II MG (r=0.550, P=0.002; r=0.653, P=0.000; r=0.511,P=0.000; r=0.353, P=0.010). The level of PIM had positive correlation with the level of MW, VCand PF, so was the level of PEM. Positive correlation was also found between the level of PIM and PEM.Conclusions PatientswithtypeIMGinthe early stagemaynotmanifested ashavingmyasthenia,buthad weak strength and tolerance of respiratory muscle, thus, the level of MW, PIM,R10 and R5 might be the sensitive indexes in its early diagnosis. Changes of pulmonary function and respiratory muscle strength in patients with type Ⅱ MG were more obvious as compared with those in patients with type Ⅱ MG and these changes were positively correlated to the absolute scores of severity of myasthenia, which were consistent with the respiratory muscle strength and ventilatory function defects.
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Objective To investigate the effect of CoCl2-induced hypoxia on the expressions of hypoxia-inducible factor-1α(HIF-lα),glucocorticoid receptor(GR)and opiomelanocortin(POMC)in AtT-20 cells.Methods AtT-20 cells were exposed to different concentrations(25,50,100,and 200 μmol/L)of CoCl2 to induce hypoxia.MTT assay was employed to assess the changes in the cell proliferation after the exposure,and real-time PCR and Western blotting were performed to detect the expressions of HIF-1α,GR and POMC genes at both the mRNA and protein levels.Results Compared with the cells in normoxic conditions,the AtT-20 cells exposed to CoCl2 treatment at 25,50,and 100 μmol/L for 24 and 48 h showed obviously enhanced cell proliferation.CoCl2 significantly increased the mRNA and protein expressions of HIF-1α,GR and POMC genes in a dose-dependent manner(P<0.05).Conclusion CoCl2-induced hypoxia up-regulates the mRNA and protein expressions of HIF-1α,GR and POMC genes in AtT-20 cells.
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<p><b>OBJECTIVE</b>To investigate the feasibility and clinical significance of sentinel lymph node (SLN) navigation limited surgery in early gastric cancer (EGC).</p><p><b>METHODS</b>Thirty-nine patients confirmed with EGC between January 2002 and December 2006 were randomly divided into tailored surgery group (20 cases) and conventional surgery group (19 cases). By combining the mapping agents of (99m)Tc labeled sulfur colloid solution and blue violet, SLN biopsy was conducted in tailored surgery group, in which a limited gastric resection with D0-D1 lymphadenectomy was performed in 17 cases with negative SLN examined by routine HE staining during operation; standard radical gastrectomy with lymphadenectomy (D2) was conducted in the other 3 cases with positive SLN and in all the cases of conventional surgery group. The diagnostic accuracy and false-negative rate of SLN status were calculated respectively. The operation outcome and postoperative complication and survival rate were compared between the two groups.</p><p><b>RESULTS</b>SLNs were detected in all 20 patients with a successful detection rate of 100% in tailored surgery group. The number of detected SLNs ranged from 1 to 3, with a mean of 2.2 per case. The diagnostic accuracy and false-negative rate was 95% and 5%, respectively. The hospital stay and recovery time of gastrointestinal functions in patients undergoing limited surgery were significantly shorter than in conventional surgery group and with similar postoperative survival and less complications.</p><p><b>CONCLUSIONS</b>SLN biopsy may provide an accurate diagnostic procedure for detecting lymph node metastasis in EGC. Patients with node-negative EGC receiving limited surgery are likely to benefit from minimally invasive approach with the similar survival as standard radical surgery.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios de Factibilidad , Gastrectomía , Métodos , Ganglios Linfáticos , Patología , Metástasis Linfática , Diagnóstico , Patología , Estadificación de Neoplasias , Biopsia del Ganglio Linfático Centinela , Neoplasias Gástricas , Patología , Cirugía GeneralRESUMEN
To develop an UPLC-UV method for the determination of aristolochic acid A in the aerial and underground parts of Asarum, an AcquityUPLC HSST3 column (50 mm x 2.1 mm ID, 1.8 microm) was used with the mobile phase of acetonitrile-0.1% FA and eluted in gradient mode. The flow rate was 0.5 mL min(-1), the detection wavelength was 251 nm, and the column temperature was 40 degrees C. The calibration curve was linear in the range of 18 - 1450 ng of aristolochic acid A with correlation coefficient of 0. 9999 and the minimum detective concentration was 18.25 ng mL (-1). The method developed is accurate and reproducible, and can be applied in the determination of aristolochic acid A in Asarum.
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Ácidos Aristolóquicos , Asarum , Química , Cromatografía Líquida de Alta Presión , Métodos , Estabilidad de Medicamentos , Componentes Aéreos de las Plantas , Química , Raíces de Plantas , Química , Plantas Medicinales , Química , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Espectrofotometría Ultravioleta , MétodosRESUMEN
<p><b>OBJECTIVE</b>To study the clinical features and treatments of jugular foramen neurinomas. The approximate approach and proper exposure regions of jugular foramen tumour were discussed in this paper.</p><p><b>METHODS</b>Fourteen cases of jugular foramen neurinomas were diagnosed by CT, MRI, DSA and 3D-CT reconstruction preoperatively. The tumours were resected by far lateral infra-temporal approach. The classification and relative operative approaches were discussed.</p><p><b>RESULTS</b>Among 14 patients, total removal were achieved in 8 cases, subtotal removal in 4 cases and partial removal in the other 2 cases. All patients got good recovering. No serious complications correlating the approaches occurred except one case of facial paralysis.</p><p><b>CONCLUSION</b>The far later infratentorial approach was suggested to be more suitable for surgery upon neurinomas of jugular foramen.</p>
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Angiografía de Substracción Digital , Neoplasias de los Nervios Craneales , Diagnóstico , Cirugía General , Craneotomía , Métodos , Estudios de Seguimiento , Imagenología Tridimensional , Imagen por Resonancia Magnética , Microcirugia , Neurilemoma , Diagnóstico , Cirugía General , Tomografía Computarizada por Rayos XRESUMEN
<p><b>BACKGROUND</b>Schwannoma is the tumor arising mainly from the cranial and spinal nerves. Bilateral vestibular schwannoma is the hallmark of neurofibromatosis type 2 (NF2). The NF2 gene has been cloned with comprehensive analysis of its mutations in schwannoma. However, most studies focused on vestibular schwannoma. There are differences in proliferation of tumor cell and ultrastructure between vestibular and spinal schwannomas. It is unknown whether genetic alterations in vestibular schwannoma are different from those in non-vestibular schwannoma. We analyzed the loss of heterozygosity (LOH) on chromosome 22 in patients with sporadic schwannoma including vestibular and spinal schwannomas and correlated this genetic alteration with tumor proliferation.</p><p><b>METHODS</b>In 54 unrelated patients without clinical NF1 or NF2, 36 patients had sporadic vestibular schwannoma, and 18 dorsal spinal root schwannoma. Four highly polymorphic linkage to NF2 gene microsatellite DNA markers (D22S264, D22S268, D22S280, CRYB2) were used to analyze LOH. The proliferative index was evaluated by Ki-67 and proliferative cell nuclear antigen (PCNA) immunostaining. Student's t test was used to analyze the difference of the proliferative index between schwannoma with LOH and that without LOH. The difference of the frequency of LOH in vestibular and spinal schwannomas was investigated by the chi-square test.</p><p><b>RESULTS</b>Twenty-three schwannomas (42.6%, 23/54) showed allele loss. The frequency of LOH in vestibular schwannoma was significantly higher than that in spinal schwannoma (chi2 = 5.14, P < 0.05). The proliferative index of schwannoma with LOH was significantly higher than that without LOH (tki-67 = 2.97, P = 0.0045; tPCNA = 2.93, P = 0.0051).</p><p><b>CONCLUSIONS</b>LOH on chromosome 22 is a frequent event in the tumorigenesis of sporadic schwannoma. And, there is a correlation between LOH on chromosome 22 and proliferative activity in schwannoma. The frequency of LOH in vestibular schwannoma is significantly different from that in spinal schwannoma.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proliferación Celular , Cromosomas Humanos Par 22 , Genes de la Neurofibromatosis 2 , Pérdida de Heterocigocidad , Neurilemoma , Genética , Patología , Neuroma Acústico , Genética , Neoplasias de la Médula Espinal , Genética , Raíces Nerviosas EspinalesRESUMEN
<p><b>OBJECTIVE</b>To elucidate the role of S-100B and neuron specific enolase (NSE) in predicting the outcomes of patients with severe head injury.</p><p><b>METHODS</b>Forty patients with severe head injury were included in this study. The serum concentrations of S-100B and NSE were measured within 12 hours after head injury to investigate the correlation between serum levels of S-100B and NSE and outcome. Validity of both S-100B and NSE in outcome prediction was assessed with Receiver Operator Characteristic (ROC) curve.</p><p><b>RESULTS</b>The serum concentrations of S-100B and NSE of both groups, with favorable or unfavorable outcomes, were significantly higher than those of the normal group. The serum concentrations within 12 hours after head injury were closely correlated with the prognosis. Furthermore, according to the ROC curves of S-100B and NSE, S-100B was found better in predicting outcomes than NSE.</p><p><b>CONCLUSIONS</b>S-100B and NSE may play important roles in outcome prediction after severe head injury. Moreover, S-100B is clearly superior to NSE in terms of predictive value and appears to be a more promising serum marker in outcome prediction after severe head injury.</p>
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Femenino , Humanos , Masculino , Traumatismos Craneocerebrales , Sangre , Escala de Consecuencias de Glasgow , Factores de Crecimiento Nervioso , Fosfopiruvato Hidratasa , Sangre , Pronóstico , Curva ROC , Subunidad beta de la Proteína de Unión al Calcio S100 , Proteínas S100 , Sangre , Resultado del TratamientoRESUMEN
Objective To evaluate the therapeutic and adverse effects of metallic intratracheal stent placement in relapsing polychondritis with severe tracheobronchial malacia.Methods Five tracheal stents had been implanted in three patients with traeheobronchial malacia.One patient was implanted with two tubular steuts in trachea and one“Y”shaped stent for bilateral bronchi.Another patient used a tubular stent in total tracheal segment.The last patient used a tubular stent in the upper segment of trachea.Results All the stents were implanted successfully with obvious improvement of dyspnea after the treatment. Conclusions Metallic intratracheal stent placement can really relieve symptoms and improve the life quality in patients with tracheobronchial malacia caused by relapsing polychondritis.