Latest Issue
Volume 26 ， Issue 4 ， 2011
- Abstract：Objective To observe the effects of PSD95 gene specific siRNAs on neuropathic pain relief, neuron viability, and postsynaptic calcium/calmodulin-dependent protein kinase IIα (CaMKIIα) phosphorylation in vitro and in vivo. Methods Gene-specific siRNAs of rat PSD95 were synthesized chemically for transfection. Adult male Sprague-Dawley (SD) rats were randomly divided into 3 groups: naïve group (n=6), sham group (n=6), and sciatic nerve chronic constriction injury (CCI) group (n=24). The CCI group was further divided into 4 groups (n=6 in each group), which were pretreated with normal saline, transfection vehicle, negative control siRNAs, and PSD95 gene specific siRNAs respectively. All the subgroups received corresponding agents intrathecally for 3 days, started one day before the CCI of sciatic nerve. Both mechanical allodynia and thermal hyperalgesia were measured on post-operative day 3 and 7. PSD95 gene silenced NG108-15 cells were further stimulated by glutamate, with the cell viability and the expression/phosphorylation of CaMKIIα measured by MTT cell proliferation assay and Western blot, respectively. Results The siRNAs decreased PSD95 mRNA level significantly both in vivo and in vitro. Neuropathic pain rats pretreated with PSD95 gene specific siRNAs exhibited significant elevation in the mechanical withdrawal threshold and paw withdrawal thermal latency, without affecting the baseline nociception. PSD95 gene silencing enhanced neuronal tolerance against the glutamate excitotoxicity, meanwhile the phosphorylation of CaMKIIα Thr286 was attenuated. Conclusion Pre-emptive administration of PSD95 gene specific siRNAs may attenuate the central sensitization CaMKIIα-related signaling cascades, leading to the relief of neuropathic pain.Keywords：PSD95;siRNAs;neuropathic pain;glutamate excitotoxicity;calcium/calmodulin-dependent protein kinase IIα4|2556|0Updated：2024-04-10
- Abstract：Objective To explore the contrast-enhanced ultrasonographic features for quantitative assessment of hepatic fibrosis. Methods 86 patients with chronic viral hepatitis B were enrolled in this study from March 2007 to August 2009. The patients were classified into 5 groups (S0-S4) according to fibrosis stage evaluated with ultrasound guided liver biopsy. New contrast-enhanced ultrasonography (CEUS) features including area under the time-intensity curve (TIC) of portal venous phase/hepatic arterial phase (Qp/Qa) and intensity of portal venous phase/hepatic arterial phase (Ip/Ia) were used to detect the blood supply ratio (portal vein/hepatic artery) in each group. Arrival time of portal vein trunk (Tp) and decreasing rate of TIC (β) were also analyzed. Results Qp/Qa and Ip/Ia decreased from S0 to S4, while Tp and β increased. These 4 features were significantly correlated with the degree of fibrosis (P<0.001) and were significantly different among the five groups (P<0.001). Sensitivity and specificity of Ip/Ia were 80% and 86% for groups ≥S1, 75% and 86% for groups ≥ S2, 71% and 84% for groups ≥ S3, and 76% and 80% for group S4, respectively. Sensitivity and specificity of Qp/Qa were 70% and 88% for groups ≥ S1, 80% and 76% for groups ≥ S2, 74% and 70% for groups ≥ S3, and 81% and 95% for group S4, respectively. Conclusion Ip/Ia and Qp/Qa could be adopted as reliable, non-invasive features for quantitative assessment of hepatic fibrosis.Keywords：hepatic fibrosis;contrast-enhanced ultrasonography;quantitative;non-invasive4|2604|0Updated：2024-04-10
- Abstract：Objective To study the influence of hepatocyte growth factor (HGF) antibody on the lung expression level of matrix metalloproteinases-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1). Methods Thirty male Wistar rats were randomly divided into 3 groups: control group, model group, and intervention group. Endotoxin was intratracheally infused in the model and intervention groups. HGF antibody was injected in the rats of the intervention group from day 1 to day 14, while the same volume of saline was injected in the control group. The rats were sacrificed on day 28 after endotoxin treatment. The amounts of MMP-9 mRNA and TIMP-1 mRNA were measured by reverse transcription-polymerase chain reaction, and protein expression levels of MMP-9 and TIMP-1 were measured by immunohistochem-istry. Results In the model group, both mRNA and protein expression levels of TIMP-1 were significantly increased, the same as MMP-9. In the intervention group, the increase of TIMP-1 was remarkably reduced compared with the model group, while the mRNA and protein expression levels of MMP-9 were still increased. Conclusion HGF activity may accelerate the repair of lung injury through contrary regulating the expression levels of TIMP-1 and MMP-9.Keywords：hepatocyte growth factor;matrix metalloproteinases-9;tissue inhibitor of metalloproteinases-14|2282|0Updated：2024-04-10
- Abstract：Objective To evaluate the efficacy and safety of low molecular weight heparin (LMWH) prophylaxis for venous thromboembolism (VTE) after lumbar decompression surgery. Methods Patients at high or the highest risk of VTE who underwent lumbar spine surgery in Peking Union Medical College Hospital from January 2004 to April 2011 were included in the present study. All the patients received a half dose of LMWH 6 hours after surgery followed by a full dose LMWH once per day until discharge. We recorded incidences of deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding complications, and medication side effects. Results Seventy-eight consecutive patients were eligible and enrolled in this study. The mean hospital stat was 8.5±4.5 days. No symptomatic DVT, PE, or major bleeding events were observed. One patient developed wound ecchymosis, another developed wound bleeding, four had mild hepatic aminotransferase level elevation, and one developed a suspicious allergic reaction. Conclusion LMWH may be applied as an effective and safe prophylaxis for VTE in high-risk patients undergoing lumbar decompression surgery.Keywords：venous thromboembolism;prophylaxis;low molecular weight heparin;lumbar decompression surgery4|2938|0Updated：2024-04-10
- Abstract：Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA). Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010. All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology. Among the 63 TA patients, 27 with neurological manifestations were included in the present study. All the patients were evaluated using standardized neurological examination, sonography, computed tomography (CT) angiography, and cerebral CT or magnetic resonance imaging. Results Dizziness and visual disturbance were the most common symptoms, which occurred in 20 (74.1%) and 16 (59.3%) patients respectively. Another common symptom was headache, observed in 15 (55.6%) patients. Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures. Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations. Conclusions Neurological manifestations are common symptoms in TA patients in the chronic phase, including dizziness, visual disturbance, headache, ischemic stroke, seizures, and some unusual ones such as RPES. We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.Keywords：Takayasu arteritis;neurological manifestation;epileptic seizures;reversible posterior en-cephalopathy syndrome4|3490|0Updated：2024-04-10
- Abstract：Objective To explore the diagnosis, classification, and management of uveal effusion syndrome (UES). Methods The clinical data of 10 patients diagnosed with UES in our hospital between 1990-2010 were extracted from hospital records and analyzed, including ophthalmologic examination, ophthalmologic ultrasonography, ultrasound biomicroscopy (UBM), fundus fluorescence angiography (FFA), indocyanine green (ICG) angiography, surgical procedures, and outcomes. Results The fundus examination of all impacted eyes showed bullous retinal detachment shifting with head position, confirmed by ultrasonography revealing retinal and choroidal detachment. UBM showed annular peripheral ciliochoroidal detachment in all cases. FFA was performed in 5 patients and revealed leopard spots without leakage from choroid into subretinal space. ICG angiograpy was performed in 3 patients and demonstrated diffused granular marked hyperfluorescence in the choroidal fluorescence in the very early phase, which increased with time and persisted until the late phase. Four eyes of 2 patients underwent full-thickness sclerectomies and 1 eye of 1 patient underwent subscleral sclerectomy, all of whom achieved reattachment of the retina without recurrence during 1-year follow-up. Conclusions Comprehensive preoperative evaluation, including ophthalmologic ultrasonography, computed tomography, and magnetic resonance imaging, is crucial for accurate classification of UES and selection of proper management strategy. Surgical treatment can achieve optimal clinical outcomes for type 1 and type 2 UES.Keywords：uveal effusion syndrome;idiopathic;classification;sclerectomy4|3238|0Updated：2024-04-10
- Abstract：Objective To evaluate the use of titanium mesh reconstruction after sternal tumor resection. Methods From January 2007 to January 2011, 14 patients with sternal tumors were admitted into Peking Union Medical Hospital. The clinical characteristics, surgical resection, and technique of reconstruction were reviewed. Results Of the 14 patients, 3 had a metastatic sternal tumor, the primary sites of which were as follows: hepatic carcinoma in one case (metastasis 19 years after operation), breast carcinoma in another case (metastasis 5 years after operation), and renal carcinoma in the other case (found simultaneously). Two patients showed local involvement of the sternum: 1 had thymic carcinoma, and the other had myofibrosarcoma. The remaining 9 patients had primary tumors: 4 were osteochondroma, 3 chondrosarcoma, 1 eosinophilic granuloma, 1 non-Hodgekin’s lymphoma. En bloc resection of the sternal tumor was performed in all the 14 patients. The defect was repaired with the titanium mesh adjusted to the shape of the defect and fixed with the stainless steel wire. Eleven patients were followed up for a period from 2 months to 4 years, during which no translocation or broken of the titanium mesh was observed. Conclusions Radical en bloc excision remains the treatment of choice for sternal tumors. Sternum defect reconstruction using titanium mesh as a rigid replacement proves appropriate and effective.Keywords：sternal tumor;en bloc resection;sternal reconstruction;rigid prosthetic replacement;titanium mesh4|3429|0Updated：2024-04-10
- Abstract：Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner’s syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative complications.Keywords：carotid body tumor;surgical therapy;postoperative complication5|2792|0Updated：2024-04-10
- Abstract：PNEUMOCYSTIS pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS). Although trimetho-prim-sulfamethoxazole (TMP-SMX) is the first line therapy for that condition given its efficacy, approximately one third of patients experienced dose-limiting toxicity.For cases of severe to moderate PCP, if TMP-SMX treatment fails or is contraindicated, primaquine combined with clindamycin or intravenous pentamidine is recommended as second line therapy. However, both primaquine and pentamidine are associated with severe adverse reactions and often unavailable at hospitals in China.As a result, other treatment options have been explored. Caspofungin, an echinocandin, has broad antifungal activity against a wide range of fungi including Candida and Aspergillus species. Cases of PCP patients treated with caspofungin have been reported, although conflicting conclusions have been arrived at. In addition, the use of caspofungin and clindamycin as the first line therapy for severe PCP in AIDS patients has not been reported yet. This article described an AIDS case with severe PCP, treated with the combination of caspofungin and clindamycin.Keywords：pneumocystis pneumonia;caspofungin;acquired immune deficiency syndrome;trimethoprim-sulfamethoxazole7|3699|0Updated：2024-04-10
- Abstract：RENAL cell carcinoma (RCC) in a solitary kidney presents a unique clinical challenge to urolo- gical surgeons. Partial nephrectomy (PN) or nephron-sparing surgery in this condition provides good oncological and renal fuctional outcomes with an acceptable complication rate.Long-term renal function remains stable in most patients with solitary kidneys after a reduction of more than 50% in renal mass.PN is a surgical procedure reserved for patients with a tumor in a solitary kidney, bilateral renal tumors, or renal function impairment.The challenge of preserving renal parenchyma is significantly complicated with the discovery of multiple masses in a solitary kidney because any subsequent complications may result in a significant decline in quality of life. Particularly in the case of postoperative renal failure, dialysis becomes necessary.Keywords：solitary kidney;partial nephrectomy;renal function4|2789|0Updated：2024-04-10
- Abstract：PACEMAKER lead infections are rare. There are only about 0.4%-1.1% of the patients who have been implanted permanent pacemakers suffering from serious infections which lead to endocarditis.Generally, removal of the infected pacemaker wire and lead, long-term anti-infection therapy, and implantation of a new pacemaker to another anatomic site are accepted approaches for these patients.Keywords：pacemaker lead;vegetation;Scopulariopsis sp;voriconazole4|3165|0Updated：2024-04-10
- Abstract：A TYPICAL chronic myeloid leukaemia (aCML), which shows both myeloproliferative and mye- lodysplastic features, is a type of myeloproliferative/myelodysplastic disease as defined by the World Health Organisation (WHO) classification of the myeloid neoplasms.Because of the presence of neutrophilic leukocytosis, aCML may resemble chronic myelogenous leukemia (CML). However, in contrast with CML, aCML does not have the Philadelphia chromosome or the bcr/abl fusion gene.Keywords：atypical chronic myeloid leukaemia;trisomy 13;karyotype4|3237|1Updated：2024-04-10
- Abstract：BRAIN ischemia stroke is a devastating disease, with more than 10% stroke patients either severely disabled or dead. Although rodent fil- ament middle cerebral artery occlusion (MCAO) model can mimic human brain ischemic stroke well, its wide use was restricted by difficulty in surgery, especially in ligating pterygopalatine artery (PPA).7|3145|0Updated：2024-04-10
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