[Effect of equal temperature bladder irrigation in patients with transurethral resection of prostate: A meta-analysis].

OBJECTIVE: To evaluate the effect of equal temperature bladder irrigation on bladder spasm, postoperative bleeding, vital signs and discomfort of chills in patients of transurethral resection of prostate using meta-analysis. METHODS: Several electronic databases included Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM) were searched systematically for published randomized controlled trial about equal temperature bladder irrigation in patients with transurethral resection of prostate before November 20, 2019. Two reviewers selected independently the literature in the light of the inclusion and exclusion criteria, assessed the risk of bias by quality assessment and extracted data which were consisted of clinical efficacy indexes, such as incidence of bladder spasm, severity of bladder spasm, incidence of tube plugging, amount of bladder flushing fluid, time of bladder flushing, heart rate, systolic pressure, diastolic pressure, and incidence of chills. Data were pooled using fixed-effects model or random-effects model, and the summary effect measure was calculated by risk ratio (RR) or mean difference (MD) and 95% confidence interval (95%CI). Meta-analysis was performed by Review Manager 5.3 Software. RESULTS: In the study, 13 randomized controlled trails met the requirement with a total of 2 033 patients of transurethral resection of prostate were included, of whom 1 015 were carried out with equal temperature bladder irrigation and 1 018 with room temperature bladder irrigation. The results of meta-analysis showed that incidence of bladder spasm [RR=0.51, 95%CI (0.45, 0.57), P < 0.001], severity of bladder spasm [MD=-1.61, 95%CI (-2.00, -1.23), P < 0.001], incidence of urinary blockage [RR=0.29, 95%CI (0.19, 0.44), P < 0.001], dosage of bladder irrigation [MD=-6.75, 95%CI (-7.33, -6.17), P < 0.001], time of bladder rinse [MD=-7.60, 95%CI (-11.91, -3.29), P < 0.001], heart rate [MD=-13.68, 95%CI (-15.19, -12.17), P < 0.001], systolic pressure [MD=-29.26, 95%CI (-31.92, -26.59), P < 0.001], diastolic pressure [MD=-29.36, 95%CI (-31.75, -26.98), P < 0.001], incidence of chills and discomfort [MD=0.37, 95%CI (0.31, 0.44), P < 0.001] in equal temperature group of the patients with transurethral resection of prostate had significantly statistical difference compared with room temperature group. CONCLUSION: Based on current available evidence, equal temperature bladder irrigation reduced the incidence of bladder spasm and urinary blockage, relieved bladder spasm, reduced dosage and time of bladder irrigation, and hardly affected normal vital signs and increased the patient' s comfort.

[Clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter].

Objective: To explore the clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter. Methods: The retrospective observational study was conducted. From December 2018 to December 2021, 23 patients with sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter who met the inclusion criteria were admitted to Ganzhou People's Hospital, including 16 males and 7 females, aged 45 to 86 years. The size of pressure ulcers in ischial tuberosity ranged from 1.5 cm×1.0 cm to 8.0 cm×5.0 cm, and the size of pressure ulcers in greater trochanter ranged from 4.0 cm×3.0 cm to 20.0 cm×10.0 cm before debridement. After treatment of underlying diseases, debridement and vacuum sealing drainage for 5 to 14 days were performed. All the wounds were repaired by island posterior femoral composite tissue flaps, with area of 4.5 cm×3.0 cm-24.0 cm×12.0 cm, pedicle width of 3-5 cm, pedicle length of 5-8 cm, and rotation radius of 30-40 cm. Most of the donor site wounds were sutured directly, and only 4 donor site wounds were repaired by intermediate thickness skin graft from the contralateral thigh. The survival of composite tissue flaps, wound healing of the donor and recipient sites and the complications were observed. The recurrence of pressure ulcers, and the appearance and texture of flaps were observed during follow-up. Results: A total of 32 wounds in 23 patients were repaired by island posterior femoral composite tissue flaps (including 3 fascio subcutaneous flaps, 24 fascial flaps+fascio subcutaneous flaps, 2 fascial flaps+fascial dermal flaps, 2 fascial flaps+fascio subcutaneous flaps+femoral biceps flaps, and one fascial flap+fascio subcutaneous flap+gracilis muscle flap). Among them, 31 composite tissue flaps survived well, and a small portion of necrosis occurred in one fascial flap+fascio subcutaneous flap post surgery. The survival rate of composite tissue flap post surgery was 96.9% (31/32). Twenty-nine wounds in the recipient sites were healed, and 2 wounds were torn at the flap pedicle due to improper postural changes, and healed one week after bedside debridement. One wound was partially necrotic due to the flap bruising, and healed 10 days after re-debridement. Thirty-one wounds in the donor sites (including 4 skin graft areas) were healed, and one wound in the donor site was torn due to improper handling at discharge, and healed 15 days after re-debridement and suture. The complication rate was 12.5% (4/32), mainly the incision dehiscence of the flap pedicle and the donor sites (3 wounds), followed by venous congestion at the distal end of flap (one wound). During the follow-up of 3 to 24 months, the pressure ulcers did not recur and the flaps had good appearance and soft texture. Conclusions: The island posterior femoral composite tissue flaps has good blood circulation, large rotation radius, and sufficient tissue volume. It has a high survival rate, good wound healing, low skin grafting rate in the donor site, few postoperative complications, and good long-term effect in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter.

[Study on the pharmacodynamic activity of combinations with the new anti-tuberculosis drug pyrifazimine in vitro and in vivo in mouse].

Objective: To evaluate two-drug combination interaction between pyrifazimine(TBI-166) and anti-drug-resistant tuberculosis group A drugs Bedaquiline (BDQ), Moxifloxacin (MFX) and the new anti-tuberculosis drug Delamanid (DLM), SQ109, Q203, and PBTZ169 in vitro and in vivo in mouse, so as to provide basis for TBI-166 combination therapy. Methods: This study was performed from September 2020 to July 2021. The chessboard method was used to evaluate the interaction between TBI-166 and BDQ, MFX, DLM, SQ109, and PBTZ169. The time-killing kinetics method was used to evaluate the anti-tuberculosis activity of the two-drug combination with partial synergy. The BALB/c mouse acute infection model was used to evaluate the anti-tuberculosis activity at 4 and 8 weeks in the two-drug combination group (TBI-166+BDQ, TBI-166+SQ109, TBI-166+PBTZ169, TBI-166+Q203) and monotherapy groups (TBI-166, BDQ, SQ109, PBTZ169, Q203). Data analysis was performed using an independent sample t-test. Results: After TBI-166 combined with anti-tuberculosis drugs, MIC was reduced to 6.25% to 25.00% of TBI-166 monotherapy. After TBI-166 combined with BDQ, SQ109 and PBTZ169, the partial inhibitory concentration index (FICI) values were 0.53, 0.75 and 0.75, respectively; the time sterilization experiment showed that the viable population of Mycobacterium tuberculosis treated with two-drug combination of TBI-166 and BDQ, SQ109, PBTZ169 for 14 days decreased at least 3 log10 CFU/ml. In the mouse experiments, it was found that, the amount of viable bacteria in lung tissue of BDQ, SQ109 and PBTZ169 combined with TBI-166 groups was lower than that of the monotherapy group,respectively. The lung tissue culture of mice in the TBI-166+BDQ group was negative after 4 weeks of treatment, and the number of live bacteria in the lungs of the TBI-166+BDQ group was 1.49 log10CFU lower than that of the BDQ monotherapy group(P<0.01). Conclusion: In vitro and in vivo experiments in mice revealed that TBI-166 had synergistic anti-tuberculosis activity after being combined with BDQ, SQ109 and PBTZ169, respectively.

[Utility of GPR68 and TIL in TPF-induced chemotherapy and prognosis evaluation in middle-advanced hypopharyngeal squamous cell carcinoma].

Objective: To evaluate the roles of G Protein-Coupled Receptor 68 (GPR68) and tumor infiltrating lymphocytes (TIL) in TPF-(paclitaxel, cisplatin and 5-fluorouracil) induced chemotherapy for middle-advanced hypopharyngeal squamous cell carcinomas. Methods: A total of 31 patients with middle-advanced hypopharyngeal squamous cell carcinoma before TPF-inducted chemotherapy were enrolled from September 2012 to November 2017 in Beijing Tongren Hospital, Capital Medical University, including 28 males and 3 females, aged 43 to 71 years old. The expression of GPR68 and tumor infiltrating CD4+and CD8+T cells before chemotherapy was detected by immunohistochemical staining, and the relationships between GPR68 expression and clinical features, chemotherapy efficacy and overall survival (OS) were analyzed using t-test. Results: After 3 cycles of chemotherapy, there were 4, 14, 10 and 3 patients respectively with complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). The positive rates of GPR68 and CD8 were 25% and 40% respectively in the effective group (CR+PR), while 50% and 15% in the ineffective group (SD+PD), with statistically significant differences between two groups (t=5.17 and 12.86,P<0.001). Linear regression analysis showed that GPR68 was negatively correlated with CD8+T cells (r=-0.64,P<0.001). There was no significant correlation between the CD4 expression and TPF efficacy (P>0.05). The mean OS was 12.5 months in patients with high-expressed GPR68 and 25.0 months in patients with low-expressed GPR68, with a statistically significant difference (P=0.005). And mean OS was 25.0 months in patients with high-expressed CD8 and 14.5 months in low-expressed CD8, with a statistically significant difference (HR=2.58, P=0.019). Cox regression analysis showed that GPR68 and CD8+T cells were significant prognostic factors (OR(95%CI)=3.27(2.46-5.97) and 1.53(0.78-1.82), all P<0.05), while CD4 had no significant effect on prognosis (P>0.05). Conclusion: GPR68 and CD8+T cells are expected to be biomarkers for evaluating the efficacy and prognosis of TPF-induced chemotherapy in patients with middle-advanced hypopharyngeal squamous cell carcinoma.

[Clinical characteristics of crystal deposits in joints and tendons in patients with gout].

OBJECTIVE: To explore the abnormal manifestations and clinical features of patients with gout according to the location of crystal deposits: in articulars or in tendons. METHODS: A total of 105 patients with gout who were continuously treated in the Department of Rheumatology and Immunology of Peking University People's Hospital from June 2019 to December 2019 were selected and their knees, ankles, toes and painful joints and tendons were examined by high-frequency ultrasound. Then we grouped them according to the presence or absence of sodium urate crystals and the location of the crystals, collected their clinical data, and analyzed the clinical characteristics. RESULTS: Among the 105 patients, 25 patients had no crystal deposits in the joints or tendons (as the non-crystal group), 43 patients had intra-articular crystals (as the joint group), and 37 patients had intra-tendon crystals with or without intra-articular crystals (as the tendon group). Among them, the most involved part of sodium urate crystals deposited in the joints was the metatarsophalangeal joint (29 cases, 67.4%), followed by knee joints (10 cases, 23.2%), ankle joints (9 cases, 20.9%). The most involved part of sodium urate crystals deposited in the tendon was the quadriceps tendon (16 cases, 43.2%), followed by the Achilles tendon (13 cases, 35.1%), the patellar tendon (12 cases, 32.4%), and the three heads of brachii tendons (5 cases, 13.5%). The three groups were compared using multi-sample analysis of variance/multi-sample rank sum test. Age, age of first increase in uric acid (UA), serum glucose (Glu) level and C reactive protein (CRP) were all significantly different. After multiple comparisons, compared with the non-crystal group, age, the age of first increase in uric acid, and CRP were significantly higher in the tendon group. There was no significant difference between the non-crystal group and the joint group. There was no significant difference between the tendon group and the joint group. CONCLUSION: In patients with gout, it is common for ultrasound to find crystals deposited in joints or tendons. The most commonly affected parts include the metatarsophalangeal joint, knee joint, ankle joint, quadriceps tendon, Achilles tendon, patellar tendon, and triceps tendon. There were significant differences among the three groups in age, age of first increase in uric acid, CRP and blood glucose, and the proportion of urinary calculi in patients with crystal deposits was significantly higher than those without crystal deposits.

Prevalence and risk factors of pulmonary embolism in acute exacerbation of chronic obstructive pulmonary disease and its impact on outcomes: a systematic review and meta-analysis.

OBJECTIVE: The current study aimed to pool data for the prevalence of pulmonary embolism (PE) in acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). We also aimed to assess the risk factors of PE and its impact on the outcomes of AE-COPD. MATERIALS AND METHODS: PubMed, Embase, and CENTRAL databases were searched up to 1st January 2021 for prospective, retrospective, and cross-sectional studies reporting the prevalence of PE in AE-COPD based on computed tomography (CT) data. RESULTS: Sixteen studies were included. Pooled data of 5035 patients indicated the prevalence of PE in AE-COPD to be 12.9% (95% CI: 8.9%-18.4%). In studies wherein, all patients underwent CT the prevalence was 19.4% (95% CI: 13.4%-27.4%). On the other hand, the prevalence of PE was 7.8% (95% CI: 3.7%-15.7%) in studies where CT was carried out only after screening patients based on study-specific diagnostic protocol. Multiple studies indicated that recent immobilization, increased D-dimer levels, lower limb edema, older age and the concomitant presence of deep vein thrombosis were independent risk factors for PE in AE-COPD. Pooled analysis indicated that PE was associated with a significantly increased risk of mortality (OR: 3.21 95% CI: 1.86, 5.54 I2=52% p<0.0001) and longer ICU/hospital stay (MD: 3.26 95% CI: 1.93, 4.58 I2=0% p<0.00001) in AE-COPD. CONCLUSIONS: The prevalence of PE in AE-COPD is estimated to be 12.9%. This figure, however, varies based on the PE workup protocol. Higher prevalence (19.4%) was noted when all patients underwent CT as compared to when a study-specific diagnostic protocol was followed (7.8%). Recent immobilization, increased D-dimer levels, lower limb edema, older age and the concomitant presence of deep vein thrombosis are important independent risk factors for PE in patients with AE-COPD. Patients diagnosed with PE have increased mortality and longer ICU/hospital stay as compared to non-PE patients.

[Comparison of endoscopic features between colorectal sessile serrated adenoma/polyp with or without cytologic dysplasia and hyperplastic polyp].

Objective: To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) and hyperplastic polyp (HP) by white light endoscope (WLE) and Image enhancement endoscope (IEE) . Methods: The data of 7 384 patients who underwent colonoscopy at the Center of Digestive Endoscopy, Peking University International Hospital from August 1, 2016 to February 29, 2018 were analyzed retrospectively. WLE and IEE[Fuji intelligent chromo endoscopy (FICE) or Blue Laser Imaging (BLI) ]were used to compare the morphological features of SSA/P with HP, SSA/P-CD(+)with SSA/P-CD(-). The diagnostic values of endoscopic features in SSA/P and SSA/P-CD(+)were analyzed. Results: A total of 3 401 polyps were detected in 7 384 patients, including 164 SSA/Ps (135 patients). During the same period, there were 270 HPs (223 patients) in accordance with the admission criteria. Compared with HP group, SSA/P group was more common in the right colon with a diameter>5 mm and more likely to be manifested as: Ⅱ-O pit pattern, surface mucus, cumulus-like surface, irregular morphology, VMV, redness, and also more likely to be associated with colon adenoma, colon cancer elsewhere in the colorectum. The differences were statistically significant (P<0.01). Compared with SSA/P-CD(-)group, SSA/P-CD(+)group was more common in the right colon with a diameter>5 mm and more likely to be manifested as: Ⅱ-O pit pattern, surface mucus, cumulus-like surface, irregular morphology, VMV. The differences were statistically significant (P<0.001). The differential diagnosis between SSA/P and HP was predicted by combining any two endoscopic morphological features (right colon, Ⅱ-O pit pattern, surface mucus, cumulus surface, irregular morphology, VMV, diameter>5 mm, at least 2 of 7 endoscopic features). The sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were 59.15%, 95.56%, 81.80%, 13.32 and 0.43, respectively. Similarly, the differential diagnosis between SSA/P-CD(+) and HP was predicted. The sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were 92.16%, 95.56%, 95.02%, 20.76 and 0.08, respectively. Conclusion: Comprehensive analysis of the WLE and FICE/BLI morphological features of the lesions can effectively distinguish SSA/P from HP, especially SSA/P-CD(+) from HP.

Protective effect of cyclosporine on inflammatory injury of renal tubular epithelial cells.

OBJECTIVE: This study aims to explore the protective effect of cyclosporine on inflammation-induced renal tubular epithelial cells and its potential mechanism. MATERIALS AND METHODS: Human kidney-2 (HK-2) cells were induced by transforming growth factor-ß (TGF-ß) for constructing an inflammatory injury model. Cells were then treated with different concentrations of cyclosporine for further investigating the biological functions. Cell viability was detected via cell counting kit-8 assay (CCK-8). The cytotoxicity was detected via lactate dehydrogenase (LDH) release assay. Expression levels of cell damage factors and mammalian target of rapamycin (mTOR) pathway-related genes were detected via polymerase chain reaction (PCR), immunofluorescence and Western blotting, respectively. RESULTS: TGF-ß inhibited the viability of HK-2 cells, increased expressions of tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß) and apoptosis-related genes. Cyclosporine treatment greatly reversed the cell damage on HK-2 cells induced by TGF-ß. Expression levels of mTOR pathway-related genes were downregulated after cyclosporine treatment. CONCLUSIONS: Cyclosporine protects HK-2 cells from inflammatory injury via regulating mTOR pathway.

Proteomic analysis of mycelial proteins from Magnaporthe oryzae under nitrogen starvation.

Magnaporthe oryzae is an important model system in studies of plant pathogenic fungi, and nitrogen is a key nutrient source affecting microbial growth and development. In order to understand how nitrogen stress causes changes in mycelial proteins, we analyzed differentially expressed mycelial proteins from the M. oryzae virulent strain CH-63 using two-dimensional electrophoresis and mass spectrometry in complete medium or under nitrogen starvation conditions. A total of 975 ± 70 and 1169 ± 90 protein spots were detected in complete medium and under nitrogen starvation conditions, respectively. Forty-nine protein spots exhibited at least 2-fold up-regulation or down-regulation at the protein level according to PDQuest7.4. Moreover, 43 protein spots were successfully identified by matrix-assisted laser desorption/ionization-time-of-flight/time-of-flight mass spectrometry. Among these spots, 6 proteins were functionally unknown and 37 proteins were categorized into 5 groups according to their functions, including development, metabolism, biosynthesis, and biological process. These 37 proteins were further analyzed for their enriched metabolic pathways by KOBAS2.0, and 14 proteins were found to be involved in glycolysis, tricarboxylic acid cycle, and nitrogen metabolism. Taken together, the regulation of M. oryzae growth under the nitrogen starvation conditions appears to be complex because of the various proteins and enzymes involved.

Tetradecyl 2,3-dihydroxybenzoate promotes functional recovery after spinal cord injury in adult rats.

Tetradecyl 2,3-dihydroxybenzoate (ABG001) is a small molecule separated from gentian extract that has a similar effect to nerve growth factor. It is not clear whether it can promote functional recovery in animals suffering from a central nervous system injury. In order to explore the role of ABG001 in restoration of tissue structure and motor function of rats with spinal cord injury (SCI), ABG001 (0.4 mg/kg) was administered intraperitoneally. Subsequently, behavioral assessments and morphological studies were performed to detect recovery of hind limb motor function and neuroregeneration. The results showed that compared with DMSO group, the rats in the ABG treatment group had better performance in BBB score and grip strength test (P < 0.05), the area of necrosis was smaller (P < 0.05), GFAP expression was significantly reduced (P < 0.01), and Map-2 expression was significantly increased (P < 0.01). Additionally, after ABG treatment, the number of fluorogold positive cells transported reversely to red nucleus increased (P < 0.05). The results suggest that ABG001 can promote recovery of hind limb motor function in rats with SCI, which may be related to its functions of inhibiting glial cell proliferation and promoting neuroregeneration.

Prevalence of hypertension and associated risk factors in Dehui City of Jilin Province in China.

To evaluate the prevalence, awareness, treatment and control of hypertension and its risk factors in Dehui City of Jilin Province in China. The study was performed among 3778 subjects (male=1787) in Dehui City, Jilin Province of China. The subjects completed a standard questionnaire, biochemical tests and physical examinations. Logistic regression analyses were used to identify risk factors for hypertension. The prevalence of hypertension was 41.00% in this area. The awareness, treatment and the control of hypertension were 21.82, 15.56 and 1.10%, respectively, with city areas being significantly higher than rural areas. Significant risk factors for hypertension included age, sex, central obesity, alcohol consumption, family history of hypertension, dyslipidemia, education level and type of work. Further analysis showed that diabetes for urban participants and cigarette smoking for rural participants were risk factors but were not statistically significant at the multi-variate level. The prevalence of hypertension in Dehui Ctiy of Jilin Province is higher than in other areas of China. In addition, rates of awareness and treatment of the condition are much lower than in other populations, with the control rate only 1.10%.

First Report of Impatiens necrotic spot virus Infecting Phalaenopsis and Dendrobium Orchids in Yunnan Province, China.

In November 2007, leaves of 79 Phalaenopsis and two Dendrobium orchid plants in a nursery in Yunnan Province showed large chlorotic/necrotic ringspot symptoms. Eight symptomatic leaves from Phalaenopsis and two from Dendrobium were sampled and tested for Impatiens necrotic spot virus (INSV), Tomato spotted wilt virus (TSWV), Watermelon silver mottle virus (WSMoV), Groundnut bud necrosis virus (GBNV), Tomato chlorotic spot virus (TCSV), and Groundnut ringspot virus (GRSV) with double-antibody sandwich (DAS)-ELISA kits (Agdia Inc., Elkhart, IN). All samples were positive for INSV and negative for TSWV, WSMoV, GBNV, TCSV, and GRSV. Total RNA extracts were prepared from all ELISA-positive samples with the RNeasy extraction kit (Huashun Inc., Shanghai, China). Reverse transcription (RT)-PCR was carried out with specific primers to the INSV N gene (ZI2F, 5'-GTTTAGCCTTACCAAT-3' and ZI2R, 5'-TACCAACAACCGTGAA-3'), designed from a sequence of GenBank Accession No. AB109100. All ELISA-positive samples yielded an amplification product of the expected 539 bp as observed by gel electrophoresis in 1% agarose. Three clones from each isolate were sequenced and two N gene consensus sequences of the isolates from Phalaenopsis and Dendrobium were determined (GenBank Nos. GU289904 and GU289905, respectively). Nucleotide sequences of these two Chinese orchid isolates were 98 to 99% identical with sequences of isolates from the Netherlands, United States, Italy, and Japan (GenBank Nos. X66972, D00914, DQ425096 and AB109100, respectively). To our knowledge, this is the first report of INSV infecting Phalaenopsis and Dendrobium in Yunnan Province, although INSV has been reported in Oncidium in Yunnan Province previously (2), and the first time that INSV has been detected in Dendrobium. An investigation of the orchid nurseries looking for the thrips vector (1) of INSV was performed and a few thrips were found, suggesting that thrips may not be responsible for the observed prevalence of INSV in these nurseries. The orchids were imported from Taiwan and reproduced by tissue culture and it is possible that INSV found to be infecting orchids in these Yunnan nurseries may be from the infected source plant and was not eradicated completely through tissue culture. To reduce spread of INSV, virus-free tissue culture should be a priority for orchid production. References: (1). S. T. Koike and D. E. Mayhew. Orchids. Mag. Am. Orchid Soc. 70:746, 2001. (2). Q. Zhang et al. Plant Quarantine. 22:348, 2008.

A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma.

BACKGROUND: Gastrointestinal (GI) lipomas are benign, slowly growing, submucosal tumors, which may cause gastrointestinal bleeding, anemia, intussusception, and bowel obstruction. The aim of this study is to explore the safe and effective strategy for endoscopic removal of large GI lipomas. METHODS: During last 10 years, fifteen large and symptomatic GI lipomas were resected under endoscopy in our hospital. In them, two large lipomas with small stalk (< 2 m in diameter) were resected by polypectomy; ten large lipomas with base size greater than 2 cm in diameter were removed using a "subtotal resection." Three other large lipomas with small stalk (< 2 m in diameter) were resected by multistep resection. Endoscopic ultrasonography (EUS) and miniprobe endoscopic ultrasound were performed in six cases from January 2000 to July 2004 to confirm that those lesions were lipomas that were superficial to the muscularis propria. RESULTS: All 15 lesions were successfully removed and were histopathologically confirmed to be lipomas. No severe complications, such as perforation or hemorrhage, developed after endoscopic removal. No recurrence was observed after 1-8 years follow-up endoscopic examination. CONCLUSIONS: Various, large GI lipomas can be removed safely by electrosurgical snare resection under endoscopy following the guidance of the present therapeutic strategy.

Effect of dopamine depletion on DARPP-32 protein in ischemic rat striatum.

AIM: To study the effects of dopamine depletion on the phosphorylation level, intracellular distribution, and mRNA expression of DARPP-32 in the ischemic striatum and to elucidate the mechanisms underlying the ischemic injury. METHODS: A complex model of SN lesioning with 6-OHDA to deplete dopamine and four vessels occlusion for inducing forebrain ischemia was constructed in rats. DARPP-32 was investigated with autoradiogram, immunohistochemistry and in situ hybridization. RESULTS: The [32P]phosphate incorporation of DARPP-32 was reduced in vitro following ischemia. However, the [32P]phosphate incorporation, the numbers of positive neurons, and mRNA expression of DARPP-32 were increased in SN lesioning plus ischemic rats with denervated striatum. CONCLUSION: Dopamine depletion reduced the DARPP-32 phosphorylation in vivo following ischemia, and protected DARPP-32 immunoreactivity and mRNA expression level against the reduction induced by ischemia.

[The analysis and discussion of clinical features and treatment of tumor like Sjögren's syndrome in 46 cases].

OBJECTIVE: Manifestations and treatment of tumor-like Sjögren's syndrome(SS) is varying, it is difficulty to differentiate it from other diseases. The purpose of this paper was to identify the peculiarity of the manifestations and treatment of tumor like SS. METHODS: The data of 46 cases suffering from tumor like SS had been analyzed retrospectively and discussed with published articles about its clinical features and treatment. RESULTS: There were one or more than one masses in salivary gland, general manifestations were found in 46 cases, dry mouth 41%,dry eye 23%, autoantibody 17%. The result of treatment showed recurrence site of operation group was out of primary region, recurrence rate was 20%. Effective rate of drug group was about 81%,however, recurrence rate was up to 38%. Malignant change occurred in three cases. CONCLUSION: The local feature of tumor like SS is mass in salivary gland, general manifestations are accompanied in some patients. It presents chronic benign process, malignant change may occur in a few patients. Combined therapy should be taken reasonably, local with general, drug with operation. The diagnosis should be identified before treatment, drug therapy is used at first, and operation is adopted after failure of drug treatment.

Dopamine-glutamate interaction in rat striatal slices: changes of CCDPK II, PKA, and LDH activity by receptor-mediated mechanisms.

AIM: To study the effects of dopamine (DA) and glutamate (Glu) and their receptor agonists/antagonists on Ca2+/calmodulin-dependent protein kinase II (CCDPK II), cyclic AMP-dependent protein kinase A (PKA) activities and the LDH release in rat striatal slices, and to examine the interaction between DA and Glu transmitter systems in striatum. METHODS: The activities of CCDPK II, PKA, and the release of LDH were determined with the 32P-incorporation and colorimetry respectively in rat striatal slices. RESULTS: (1) Exogenous DA, D1 receptor agonist SKF 38393 and D2 receptor agonist LY 171555 reduced CCDPK II activity in striatal slices; Glu also inhibited CCPPK II activity in a concentration-dependent manner. NMDA receptor antagonist MK-801 could antagonize the inhibitory effect of SKF 38393 and LY 171555 on the CCDPK II activity. D1 and D2 receptor antagonists SCH 23390 and spiperone could also antagonize the decrease of CCDPK II activity induced by Glu; (2) DA and SKF 38393 markedly increased PKA activity in striatal slices, which was reduced by MK-801; (3) DA and Glu increased the release of LDH from the striatal neurons in a concentration-dependent manner. MK-801 antagonized the increase of LDH induced by DA. Spiperone, rather than SCH 23390, could reduce the release of LDH from striatal neuron in the presence of Glu. CONCLUSION: The interaction between DA and Glu transmitter systems is found in the regulation of the CCDPK II and PKA activities and cell function in the striatum.

Relevance between striatal expression of Fos, proenkephalin mRNA, prodynorphin mRNA and rotation induced by l-stepholidine in 6-hydroxydopamine-lesioned rats.

AIM: To study that l-stepholidine (SPD) regulates the expression of proenkephalin (PENK) and prodynorphin (PDYN) mRNA and Fos in the striatum after rotational test in the 6-hydroxydopamine (6-OHDA)-lesioned rats. METHODS: PENK and PDYN mRNA levels were examined with in situ hybridization, and Fos expression was detected with immunocytochemistry. The data were semi-quantified with image analyzer. RESULTS: (1) Following repeated SPD treatment, the rotation was kept on high activity in the 6-OHDA-lesioned rats. (2) SPD significantly elicited Fos expression in both sides of striatum, particularly in the denervated one. Repeated administration of SPD, Fos expression declined on both sides, particularly in the intact one. (3) In the denervated striatum of 6-OHDA-lesioned rats, the PENK mRNA level was extremely increased vs that in the intact striatum. This high level of PENK mRNA was significantly reduced by 7-d treatments of SPD. SPD also reduced the level of PENK mRNA in the intact striatum. However, the level of PDYN mRNA did not show significant change in both sides of striatum after denervation or SPD treatment. CONCLUSION: In the 6-OHDA-lesioned rats, the rotation induced by SPD was kept on a high activity, which was in pace with the inducement of Fos expression and the reduction of expression of PENK mRNA in the denervated striatum. But then the lesion and SPD treatment had no remarkable effect on the expression of PDYN mRNA.

Antagonistic effect of l-stepholidine on striatal ischemic injury in rat.

AIM: To elucidate the protection of l-stepholidine (SPD) on neuronal morphology and function against the striatal ischemic injury in rat. METHODS: The forebrain ishemia to Sprague Dawley rats was induced with four-vessel occlusion. Histological examination was performed on the dorsolateral striatum with cresylviolet stain. In striatal slices of rat as an in vitro ischemic model, the activity of calcium/calmodulin-dependent protein kinase II (CCDPK) and lactate dehydrogenase (LDH) was examined by the method of 32P-incorporation and colorimetry, respectively. RESULTS: In the SPD-treated groups, most of the neurons in the striatum kept the normal morphological appearance after 30-min ischemia followed by 6-h or 12-h reperfusion. The number of neurons was much more in SPD groups than that in vehicle group. The sparse and abnormal neurons were observed in the vehicle group. SPD attenuated the ischemic effect on the CCDPK activity in striatal slices. In addition, SPD inhibited the leakage of LDH from neurons induced by ischemia in incubated striatal slices. CONCLUSION: SPD protected striatal neurons against ischemic injury and antagonized the inhibitory action on CCDPK activity induced by ischemia. SPD reduced the leakage of LDH from striatal neurons induced by ischemia.

[Detection of clinical diagnosis and different symptoms of Sjogren's syndrome by traditional chinese medicine (TCM)]

OBJECTIVE:To search for the appropriate diagnostic criteria of SS and confirm the differentiation of SS.METHODS:The European di agnostic criteria has been used in clinic work for about two years,and differentiated the symptoms of SS by TCM. The specialty and relationship between them was made an inquiry.RESULTS:The European criteria set for SS offers the clinic work a practical method to correctly classify the patients suspected of having this disorder. It refers to the signs and symptoms caused by the insufficiency of spleen-qi with deficiency of liver-yin and kidney-yin.CONCLUSION:It has been further proved for easy to make up the diagnostic of SS and its treatment using traditional chinese medicine.

[Experimental research on animal model and treatment of Sjogren's syndrome by traditional chinese medicine (TCM)]

OBJECTIVE:To confirm the function of SS Syrup used in our department. METHODS: Under the basis of TCM and differentiation symptoms of SS,the animal model was established and applied to test the function of SS syrup.There are three indices to be observed,weight change,volume of drinking water daily,cAMP change. RESULTS: The three observed indices of dificiency symptom model had been rectified by SS syrup. CONCLUSION: SS syrup has two main functions:(1)reinforcing of the spleen and tonifying qi;(2)nourishing liver-yin and kidney-yin as well as removing pathogentic heat and fire.