International journal of clinical and experimental medicine最新文献

Objectives: To evaluate the therapeutic effects and complications of simplified pericardial devascularization for patients with portal hypertension.

Methods: By means of prospective study, 212 patients who underwent simplified pericardial devascularization (Group A) and 309 patients who underwent traditional pericardial devascularization (Group B) were followed up from 2003' to 2011'. Results were performed with the general condition of the patients and the incidence of complications to assess the value of the two operating methods.

Results: The operating time was 1.0-3.83 hours (mean 1.94 ± 0.32 hours) in Group A versus 1.67-4.50 hours (mean 2.86 ± 0.40 hours) in Group B. The amount of bleeding, postoperative hospital stay and hospitalization expenses were 110-500 ml (mean 224.81 ± 78.44 ml), 7-22 days (mean 10.41 ± 4.01 days) and 15700-27500 yuan with an average of 19300 ± 1600 yuan in Group A and 200-700 ml (mean 423.50 ± 85.19 ml), 9-32 days (mean 14.76 ± 4.52 days) and 18700-44500 yuan with an average of 23400 ± 2200 yuan in Group B. In September 2012', successful follow-up was completed for 438 patients, of which, 181 underwent the simplified devascularization with 31 patients lost (follow-up rate 85.4%). Meanwhile, 257 patients in Group B were followed up completely and 52 patients were lost (follow-up rate 83.2%). The follow-up time ranged from 1 to 9.5 years and the average time was 5.03 ± 2.13 years. The mortality, rebleeding rate, rate of hepatic encephalopathy, rate of ascites and the incidence of gastric fistula and (or) esophageal fistula were 6.1%, 6.1%, 1.7%, 8.3% and 0 in Group A versus 14.0%, 15.2%, 4.3%, 17.7% and 3.1% in Group B.

Conclusions: The final results suggested that simplified pericardial devascularization performed more effectively and conveniently than the traditional method, depending on the mitigated operative wound and the shortened operation time. We concluded that simplified pericardial devascularization was better in treatment of portal hypertension compared than the traditional method.

Metabolic syndrome is a cluster of disorders and great risk for cardiovascular diseases. We aimed to investigate association between severity of metabolic syndrome (MetS) and anthropometric measurements, and to evaluate correlation of MetS and its components with metabolic deterioration and inflammatory indexes. The cross-sectional study enrolled 1474 patients with obesity and overweight. The patients were grouped as MetS and Non-MetS, and were sub-grouped as group 1 (three criteria), 2 (four criteria) and 3 (≥ five criteria) according to NCEP ATP III. Mean age was 38.7 ± 11.9 years and BMI was 35.1 ± 6.3 kg/m(2). Lipid profile, anthropometric and blood pressure measurements, liver function tests, bioelectric impedance body fat compositions, insulin resistance and HbA1c, and spot urinary albumin-creatinine ratio were significantly different between groups of MetS and Non-MetS. Age, lipid profile, bioelectric impedance fat analyses, BMI, blood pressure values, glucose, insulin resistance, uric acid and hs-CRP levels were significantly different between groups of MetS component groups. ROC analysis revealed that hs-CRP was found to be more predictive for severity of metabolic syndrome components 3 and 4 (P=0.030); uric acid and visceral fat were more actual to predict severity of metabolic syndrome between 3 and 5 MetS components, (P=0.006) and uric acid was detected as more actual to predict severity of MetS between 4 and 5 components (P=0.023). In conclusion, uric acid, hs-CRP and visceral body fat composition were useful to predict to severity of MetS in primary care.

Aim: The aim was to evaluate the place of mean platelet volume (MPV) in predicting spontaneous miscarriage and to identify any differences in its values following miscarriage after biochemical and clinical pregnancy.

Material and method: We retrospectively evaluated the data of 305 spontaneous miscarriages and 168 control subjects. The miscarriage subjects were evaluated in two groups: miscarriage after biochemical pregnancy (n=79) (BA group) and miscarriage after clinical pregnancy (n=226) (CA group). Demographic and laboratory data of all subjects were statistically compared.

Results: No statistically significant difference was found between the miscarriage and control subjects in terms of demographic data and Hb, Htc, WBC, and Plt values. The mean platelet volume (MPV) value in the miscarriage group (8.99±1.47 fl) was statistically significantly lower than in the control group (9.66±1.64 fl) (P<0.001). A statistically significant difference was present between the BA, CA and control group, with the lowest MPV value in the BA group (8.64±1.34 fl, 9.11±1.49 fl, and 9.66±1.64 fl, respectively) (P<0.001).

Discussion: MPV was significantly lower in patients with miscarriage than the control group, and this was correlated with the gestational stage when the miscarriage occurred.

Background: A number of studies have been conducted to explore the association of XRCC1 polymorphisms with Breast cancer (BC) risk in Asians, but the results have been inconsistent. We therefore performed the present meta-analysis to explore the relationship in detail.

Materials and methods: Reported studies were searched from 1990 to October 15, 2014 in PubMed and Wan fang Med Online. We performed a meta-analysis of 13 published case-control studies fitting our eligibility criteria. These studies involved XRCC1 Arg399Gln polymorphisms in 4984 BC cases and 5744 controls in dominant (ArgArg vs. GlnGln+ArgGln), recessive (ArgGln+ArgArg vs. GlnGln), and co-dominant (ArgArg vs. GlnGln) inheritance models. The total odds Ratio (OR) and 95% CI were calculated and analyzed by Review Manager 5.2 and STATE 12.

Results: Overall, significantly increased BC risk was observed in any genetic model (dominant model: odds ration [OR] = 1.31, 95% confidence interval [CI] = [1.08, 1.58]; recessive model: OR = 0.63, 95% CI = [0.50, 0.81]; codominant model: OR = 2.52, 95% CI: [1.38, 4.60]) when all eligible studies were pooled into the meta-analysis. In further stratified analyses, no association was found between Arg399Gln polymorphism and BC risk in Chinese fewer than three hereditary models.

Conclusions: Our results suggest that the XRCC1 Arg399Gln polymorphism may be associated with increased Breast cancer risk among Asians, except Chinese population.

Purpose: To observe the therapeutic effect of folic acid in combination with adult neural stem cells on spinal cord injury and to investigate the possible mechanism.

Methods: A total of 120 Wistar rats were randomly assigned to six groups: normal, model, sham-surgery, folic acid injection, adult neural stem cell transplantation, and combination (folic acid injection + adult neural stem cells transplantation) groups. Morphology of neural stem cells was observed by inverted microscopy. Expression of CD105, CD45, CD44, and CD29 were detected by flow cytometry; expression of neuron-specific enolase and glial fibrillary acidic protein were determined by immunofluorescence. Motor coordination and integration capabilities were assessed using BBB scores; Morphology of spinal cord tissues was observed by hematoxylin-eosin staining and 5-bromodeoxyuridine immunohistochemistry. GDNF, BDNF and NT-3 expression in spinal cord tissues were determined by ELISA; while expression of the apoptosis-related proteins BCL-2, Bax and caspase-3 was detected using western blotting.

Results: Flow cytometry showed that the isolated cells were positive for CD44 and CD29 and negative for CD105 and CD45. Combination treatment significantly improved the behavior of model rats with spinal cord injury, attenuated inflammatory reaction of spinal cord tissues, restored injured nerve cells, and increased expression of GDNF, BDNF and NT-3 in spinal cord tissues, up regulated BCL-2 expression, and down regulated Bax and caspase-3 expression.

Conclusions: Folic acid in combination with adult neural stem cells significantly improved nerve function and plays a key role in maintaining microenvironment homeostasis in the neurons of rats with spinal cord injury.

We investigated the effect of synthesized retinoic acid-poly(ethylene glycol)-thiol gold nanoparticle conjugates on cervical carcinoma cells. Cervical cancer is the major cause of deaths for the women of reproductive age in the developing countries. Compared to retinoic acid, the nanoparticle conjugates exhibited better activity against cervical carcinoma. Selective delivery of gold nanoparticle conjugates to estrogen receptor positive cervical cancer cells with 6-fold enhanced drug potency was observed. Transfer of gold nanoparticles was found to be dominated by estrogen ligand and receptor. It appeared that retinoic acid nanoparticle conjugates were selectively taken and retained by the estrogen receptor alpha present in the plasma membrane. Thus IC50 values for RA-PEG-SH were significantly improvedon nanoparticle ligation. Cells on treatment with RA-PEG-SH-AuNPsshowed growth inhibition at 12 and 24 h after incubation. The IC50 for RA in RA-PEG-SH-AuNPs after 12 and 24 h were 3 and 1 μM, respectively. Thus, the use of RA nanoparticle conjugates can be a better strategy for cervical carcinoma treatment.

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Lupus nephritis (LN) is an important cause of morbidity and even mortality in patients with SLE. Some evidences suggest that neutrophil-lymphocyte ratio (NLR) associated with different inflammatory malignancies, ischemic injury and cardiovascular disease. Few scholars have investigated the relationship between NLR and SLE. This study aims to evaluate the role of NLR in SLE without nephritis and LN patients.

Methods: A total of 228 subjects were participated in this study. 79 diagnosed with SLE in patients group and 149 healthy age-and sex-matched in control group. In patient team, 20 of them were diagnosed with LN.

Results: The SLE without nephritis group showed significantly higher NLR than control group (control=2.00±0.76, SLE=4.26±3.38, P<0.001), and the NLR values of the patients with LN were higher than those of the patients without LN (SLE=4.26±3.38, LN=7.21±6.01, P<0.001). Receiver-operating characteristics analysis (ROC) of NLR to predict SLE showed that the area under the curve (AUC) was 0.757. The cutoff value using the ROC curve was 3.13 (sensitivity, 0.574; specificity, 0.926; 95% confidence interval (CI), 0.668-0.845; P<0.001). While ROC analysis of NLR to predict LN showed that the AUC was 0.828). Logistic regression analysis showed that SLE without nephritis and LN were independently related to NLR.

Conclusion: NLR is independently associated with SLE, and it may be a promising marker that reflects renal involvement in patients with SLE.

The prototyping of tissue-engineered bone scaffold (calcined goat spongy bone-biphasic ceramic composite/PVA gel) by 3D printing was performed, and the biocompatibility of the fabricated bone scaffold was studied. Pre-designed STL file was imported into the GXYZ303010-XYLE 3D printing system, and the tissue-engineered bone scaffold was fabricated by 3D printing using gel extrusion. Rabbit bone marrow stromal cells (BMSCs) were cultured in vitro and then inoculated to the sterilized bone scaffold obtained by 3D printing. The growth of rabbit BMSCs on the bone scaffold was observed under the scanning electron microscope (SEM). The effect of the tissue-engineered bone scaffold on the proliferation and differentiation of rabbit BMSCs using MTT assay. Universal testing machine was adopted to test the tensile strength of the bone scaffold. The leachate of the bone scaffold was prepared and injected into the New Zealand rabbits. Cytotoxicity test, acute toxicity test, pyrogenic test and intracutaneous stimulation test were performed to assess the biocompatibility of the bone scaffold. Bone scaffold manufactured by 3D printing had uniform pore size with the porosity of about 68.3%. The pores were well interconnected, and the bone scaffold showed excellent mechanical property. Rabbit BMSCs grew and proliferated on the surface of the bone scaffold after adherence. MTT assay indicated that the proliferation and differentiation of rabbit BMSCs on the bone scaffold did not differ significantly from that of the cells in the control. In vivo experiments proved that the bone scaffold fabricated by 3D printing had no acute toxicity, pyrogenic reaction or stimulation. Bone scaffold manufactured by 3D printing allows the rabbit BMSCs to adhere, grow and proliferate and exhibits excellent biomechanical property and high biocompatibility. 3D printing has a good application prospect in the prototyping of tissue-engineered bone scaffold.

Objective: To investigate whether LMNA gene mutation is associated with dilated cardiomyopathy (DCM) in Chinese Han Race children.

Methods: DNA was isolated from 78 patients with DCM and 100 healthy Chinese children who served as controls. 12 exons in the functional regions and the adjacent part of introns of the LMNA gene were amplified with polymerase chain reactions (PCR) and the PCR products were sequenced with DNA sequencer. We compared the DNA sequence with Blast software online PubMed website. The differences of allele and genotype between the groups were detected by χ(2) test.

Results: No disease-causing mutation in LMNA gene was found in all DCM patients. Three nonsense single nucleotide polymorphisms (SNPs) were identified. ① The first is c.1908C>T (H566H, rs4641) which was located at exon 10 of LMNA gene. It was found in 29 DCM cases and 15 control subjects. Compared to healthy controls, the frequency of TT and TC genotypes, and the C allele were significantly increased in DCM patients (P<0.05). ② The second was c.861C>T (A287A, rs5380) which was located at exon 5 of LMNA gene. It was found in 9 DCM cases and 2 control subjects. The frequency of TC genotype was significantly increased in DCM patients (P<0.05). ③ The third was c.1338C>T (D446D, rs5058) which located at exon 7 of LMNA gene. It was found in 8 DCM cases and 3 control subjects. The frequency of TC genotype was significantly increased in DCM patients (P<0.05).

Conclusion: The SNP of LMNA gene may be associated with the susceptivity of DCM in Chinese Han children.

Elderly patients are at high risk of mortality when they present with ST-elevation myocardial infarction (STEMI). However, the clinical outcomes of this sub-group undergoing primary percutaneous coronary intervention (PPCI) have not been well established, despite recent advances in both devices and techniques. In the present retrospective cohort study from a Chinese single center, we assessed the clinical outcomes and predictors of mortality in elderly patients (≥60 years) underwent with PPCI. The primary endpoints were immediate angiographic success and in-hospital procedural success. The secondary endpoints were all-cause death in hospital. Between January 2011 and December 2013, a total of 184 consecutive patients with acute STEMI underwent PPCI were enrolled. 116 (63.04%) patients were in the elderly group. Despite the difference in lesion complexity between groups, the immediate angiographic success rate was similar (93.97% in the elderly group, and 94.12% in the non-elderly group, P=0.966). The procedural success rate were not significantly different between the two groups (90.52% in the elderly group, and 94.12% in the non-elderly group, P=0.389). However, in-hospital mortality was statistically higher in elderly group than in the non-elderly group (8.62% Vs 1.47%, P=0.048). The major causes of death were cardiac shock and malignant arrhythmias (ventricular tachycardia and fibrillation). Our results indicate that PPCI in the elderly is feasible and has a high likelihood of immediate angiographic and procedural success.