2006年 · 第119卷第18期

Abstract：Background Activation of N-methyl-D-aspartate (NMDA) receptors and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors play an important role in the neurons death induced by ischemia.The mitigating effect of intravenous anesthetics on ischemic neuron injury is related to their influence on NMDA receptors. This study was performed to investigate the effect of ketamine-midazolam anesthesia on the NMDA and AMPA receptor subunits expression in the peri-infarction of ischemic rat brain and explore its potential mechanism of neuroprotection.This study was supported by National Natural Science Foundation of China (NSFC) (No.30200291).Methods Thirty Sprague Dawley (SD) rats were subjected to permanent middle cerebral artery occlusion under ketamine/atropine (100/0.05 mg/kg) or ketamine-midazolam/atropine (60/50/0.05 mg/kg) intraperitoneal anesthesia (n=15 each). Twenty-four hours after ischemia, five rats in each group were killed by injecting the above dosage of ketamine or ketamine-midazolam intraperitoneally and infarct size was measured. Twenty-four and 72 hours after ischemia, four rats in each group were killed by injecting the above dosage of ketamine or ketamine-midazolam intraperitoneally. After staining the brain tissue slices with toluidine blue, the survived neurons in the peri-infarction were observed. Also, the expression level of NMDA receptors 1 (NR1), NMDA receptors 2A (NR2A), NMDA receptors 2B (NR2B) and AMPA (GluR1 subunit) were determined by grayscale analysis in immunohistochemical stained slices.Results Compared with ketamine anesthesia, ketamine-midazolam anesthesia produced not only smaller infarct size [(24.1±4.6)% vs (38.4±4.2)%, P＜0.05], but also higher neuron density (24 hours: 846± 16 vs 756±24,P＜0.05; 72 hours: 882±22 vs 785± 18, P＜0.05) and lower NR2A (24 hours: 123.0±4.9 vs 95.0±2.5, P＜0.05; 72 hours: 77.8±4.1 vs 54.2±3.9, P＜0.05) and NR2B (24 hours: 98.5±2.7 vs 76.3±2.4, P＜0.05; 72hours: 67.2 ± 7.5 vs 22.2 ± 2.6, P＜0.05) expression level in the peri-infarction following ischemia.Conclusion The protective effects of ketamine-midazolam anesthesia on ischemic brain injury may relate to decreasing NR2A and NR2B expression。

Abstract：Background Blood oxygen level dependent functional magnetic resonance imaging (fMRI) and magnetoencephalography are new techniques of brain functional imaging which can provide the information of excitation of neurons by measure the changes of hemodynamics and electrophysiological data of local brain tissue. The purpose of this study was to study functional brain areas evoked by pure tones in healthy and sensorineural hearing loss subjects with these techniques and to compare the differences between the two groups.Methods Thirty healthy and 30 sensorineural hearing loss subjects were included in this study. In fMRI,block-design paradigm was used. During the active epoch the participants listened to 1000 Hz, sound pressure level 140 dB pure tones at duration 500 ms, interstimulus interval 1000 ms, which presented continuously via a magnetic resonance-compatible audio system. None stimulus was executed in control epoch. In magnetoencephalography study, every subject received stimuli of 1000 Hz tone bursts delivered to the bilateral ear at duration 8 ms, interstimulus intervals 1000 ms. Sound pressure level in healthy subjects was 30 dB; in sensorineural hearing loss subjects was 20 dB above everyone' s hearing threshold respectively. All subjects were examined with 306-channel whole-scalp neuromagnetometer.Results In fMRI, all subjects showed significant activations in bilateral Heschl's gyri, anterior pole of planum temporale, planum temporale, precentral gyri, postcentral gyri, supramarginal gyri, superior temporal gyri,inferior frontal gyri, occipital lobes and cerebellums. The healthy subjects had more intensive activation in bilateral Heschl's gyri, anterior pole of planum temporale, inferior frontal gyri, left superior temporal gyri and fight planum temporale than the hearing loss subjects. But in precentral gyri, postcentral gyri and occipital lobes,the activation is more intensive in the hearing loss subjects. In magnetoencephalography study, both in the hearing loss and the healthy subjects, the most evident audio evoked fields activated by pure tone were N100m,which located precisely on the Heschl's gyms. Compared with the hearing loss subjects, N100m of the healthy subjects was stronger and had longer latencies in fight hemisphere.Conclusions Under proper pure tone stimulus the activation of auditory cortex can be elicited both in the healthy and the sensorineural hearing loss subjects. Either at objective equivalent stimuli or at subjectively perceived equivalent stimuli, the auditory responses were more intensive in healthy subjects than hearing loss subjects. The tone stimuli were processed in a network in human brain and there was an intrinsic relation between the auditory and visual cortex. Blood oxygen level dependent fMRI and magnetoencephalography could reinforce each other。

Abstract：Background Lower fluence of 585-nm flashlamp-pumped pulsed dye laser has been successfully used as a nonablative technique in the treatment of wrinkles. The objective of this study was to evaluate the effect of the pulsed dye laser (585 nm) on the production of collagen and the mRNA expression of collagen related gene in fibroblasts in vitro.Methods Cultured fibroblasts were treated with a 585-nm flashlamp-pumped pulsed dye laser ( fluence 3 J/cm2,4 J/cm2, spot size 7 mm, pulse duration 450 μs). The production of collagen and the mRNA expression of transforming growth factor (TGF)-β1, SMAD2, SMAD3, SMAD4, SMAD7 and type I procollagen α1, α2 in fibroblasts were investigated by colorimetry or real time polymerase chain reaction.Results The production of collagen was significantly up-regulated after treatment with a 585-nm flashlamp-pumped pulsed dye laser with a fluence of 3 J/cm2 (P ＜0.001). The mRNA expression of TGF- β1,SMAD2, SMAD3, SMAD4, SMAD7 and procollagen I was significantly up-regulated after treatment with a 585-nm flashlamp-pumped pulsed dye laser with a fluence of 3 J/cm2 (P ＜0.001). No significant difference of mRNA expression of SMAD2, SMAD3, SMAD4, SMAD7 and type I procollagen was found between controls and fibroblasts treated with pulsed dye laser with a fluence of 4 J/cm2 (P ＞0.05).Conclusions Lower fluence (3 J/cm2) pulsed dye laser increased the collagen production in fibroblasts by up-regulating TGF-β1, SMAD2, SMAD3, SMAD4, SMAD7 and type I procollagen mRNA expression. These may be the reason it can be effectively used in the treatment of wrinkles。

Abstract：Background Sam68 plays an important role as a multiple functional RNA binding nuclear protein in cell cycle progress, RNA usage, signal transduction, and tyrosine phosphorylation by Src during mitosis. However, its precise impact on these essential cellular functions remains unclear. The purpose of this study is to further elucidate Sam68 functions in RNA metabolism, signal transduction regulation of cell growth and cell proliferation in DT40 cell line.Methods By using gene targeting method, we isolated a mutation form of Sam68 in DT40 cells and described its effect on cell growth process and signal transduction. Southern, Northern, and Western blot, phosphorylation and flow-cytometfic analyses were performed to investigate the Sam68 functions.Results A slower growth rate (2.1 hours growth elongation) and longer S phase (1.7 hours elongation) was observed in the Sam68 mutant cells. Serum depletion resulted in increased amounts of dead cells, and expansion of S phase in mutant cells. Upon B cell cross-linking, the maximal level of tyrosine phosphorylation on BLNK was observed to be significantly lower in mutant cells.Conclusions The proline rich domain of Sam68 is involved in cell growth control by modulating the function of mRNAs in S phase or earlier and the functions as an adaptor molecule in B cell signal transduction pathways。

Abstract：Background Percutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) is regarded as the first choice for most patients with trigeminal neuralgia (TN) because of its safety and feasibility. However,neuronavigator-guided PRTTG has been seldom reported. The purpose of this study was to assess the safety and efficacy of neuronavigator-guided PRTTG for the treatment of intractable TN.Methods Between January 2000 and December 2004, 54 patients with intractable TN were enrolled into this study and were randomly divided into two groups. The patients in navigation group (n=26) underwent PRTTG with frameless neuronavigation, and those in control group (n=28) received PRTTG without neuronavigation.Three months after the operation, the efficacy, side effects, and complications of the surgery were recorded. The patients in the control group were followed up for 10 to 54 months (mean, 34±5), and those in the navigation group were followed up for 13 to 58 months (mean, 36±7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups.Results The immediate complete pain-relief rate of the navigation group was 100%, whereas it was 95% in the control. The proportion of sustained pain-relief rates at 12, 24 and 36 months after the procedure were 85%, 77%,and 62% in the navigation group, and 54%, 40%, and 35% in the control. Recurrences in the control group were more common than that in the navigation group. Annual recurrence rate in the first and second years were 15% and 23% in the navigation group, and 46%, 60% in the control group. No side-effect and complication was noted in the navigation group except minimal facial hypesthesia.Conclusion Neuronavigator-guided PRTTG is a safe and promising method for treatment of intractable TN with better short- and long-term outcomes and lower complication rate than PRTTG without neuronavigation。

Abstract：Background Since knee osteoarthrifis (KOA) is one of the common diseases, identification of its associated risk factors is of preventive significance. This investigation was designed to investigate the prevalence of KOA in Taiyuan, and identify the associated risk factors of KOA.Methods A population sample was surveyed of 2188 adults aged from 35 to 64 years, living in 6-story buildings without elevators. The protocol of Asia Pacific League of Associations for Rheumatology (APLAR)Community Oriented Program for Control of Rheumatic Diseases (COPCORD) core questionnaire was implemented. The data on knee pain and KOA were collected and analyzed. Variables such as sex, age, body mass index (BMI), waist circumference (WC), education level, and smoking history, were included in binary logistic regression model for further analysis.Results The prevalence rates of knee pain and KOA were 13.6% and 10.9%, respectively, significantly higher than those in Shantou of south China and similar to those in Beijing of north China. The prevalence of KOA was significantly higher in women than in men (18.3% versus 8.7% and 15.1% versus 6.3%), with a tendency of increase with age. The prevalence was increased more obviously in women after 40 years old and in men after 45 years old. BMI in KOA group was significantly higher than that in non-KOA group. Binary Logistic regression revealed that age, sex, and BMI were significantly associated with KOA, whereas no significant correlation was seen between KOA and other factors such as climbing stairs, WC, time length of occupation service, education level, smoking history and religious belief.Conclusion Geography, age, sex, and BMI might be the risk factors of KOA, but climbing stairs, WC, time length of occupation service, education level, smoking history and religious belief are not correlated with KOA.Prevention of KOA should be initiated before the middle-age, especially in female adults, and weight control is necessary.Other factors might also contribute to the development of KOA,but further study is needed to elucidate the role of these factors。

Abstract：Background Patients with heart failure were candidates for cardiac resynchronization therapy (CRT)regardless of underlying aetiology. This study observed the effect of CRT in patients with ischaemic or nonischaemic cardiomyopathy.Methods One hundred and forty-two patients with refractory chronic heart failure and left bundle branch block received cardiac resynchronization therapy, 91 men and 51 women, average age 60 years. Left ventricular ejection fraction (LVEF) was severely depressed (mean 29%), left ventricular end diastolic diameter (LVEDD)enlarged (mean 72 mm) and QRS width was lengthened (mean 147 ms). Ninety-eight had nonischaemic cardiomyopathy and 44 had ischaemic cardiomyopathy.Results After cardiac resynchronization therapy, the heart function was significantly improved. The mean LVEF increased from 29% to 36% after pacing. In patients with nonischaemic cardiomyopathy, the LVEF was improved from 28% to 37%, and in patients with ischaemic cardiomyopathy, the LVEF was improved from 30% to 36%. No significant difference of the improvement was found between the two groups (P＞0.05).Conclusions Cardiac resynchronization therapy could significantly improve cardiac function in patients with chronic heart failure regardless of the underlying heart disease。

Abstract：Background Human umbilical cord blood contains an abundance of immature stem/progenitor cells, which may participate in the repair of hearts that have been damaged by myocardial infarction (MI). This study aimed to evaluate the effects of human umbilical cord blood mononuclear cells (hUCBC) transplantation on cardiac function and left ventricular remodeling in rat model of MI.Methods Forty-five male Wistar rats were randomized into three groups: MI or control group (n＝15), MI plus cell transplantation (n＝15), and sham group (n＝15). Acute myocardial infarction (AMI) was established by ligating the left anterior descending artery, thereafter, hUCBC were implanted into the marginal area of infarcted myocardium. In MI/control group, DMEM was injected instead of hUCBC following the same protocol. Left ventricular function assessment was carried out by echocardiography and invasive hemodynamic measurements one month post MI. All rats were sacrificed for histological and immunochemical examinations.Results The transplanted hUCBC survived and engaged in the process of myocardial repair in the host heart.Echocardiography demonstrated that left ventricular function improved significantly in the rats that underwent cell transplantation. Hemodynamic studies found a significantly decreased left ventricular end-diastolic pressure (LVEDP) [(21.08±8.10) mmHg vs (30.82±9.59) mmHg, P＜0.05], increase in +dp/dtmax [(4.29± 1.27)mmHg/ms vs (3.24±0.75) mmHg/ms, P＜0.05), and increase in -dp/dtmax [(3.71 ±0.79) mmHg/ms vs (3.00±0.49) mmHg/ms, P＜0.05] among MI group with hUCBC transplantation when compared with MI/control group.Masson's trichrome staining revealed that the collagen density in the left ventricle was significantly lower in rats of transplantation group than that in the MI control groups [(6.33±2.69)% vs (11.10±3.75)%, P＜ 0.01]. Based on immunostaining of α-actin, the numbers of microvessels were significantly (P＜0.01) increased at the boundary of infarction site. Similarly higher mRNA expression of vascular endothelial growth factor (VEGF) 164 and VEGF188 were found at 7- and 28-day post cell transplantation in MI group with hUCBC transplantation when compared with MI/control group.Conclusions Transplanted hUCBC can survive in host myocardium without immunorejection, significantly improve left ventricular remodeling after AMI and promote a higher level of angiogenesis in the infarct zones.All these factors beneficially affect cardiac repair in the setting of MI. Therefore human umbilical cord blood may be potential source for cell-based therapy for AMI。

Abstract：Background Platelet-rich plasma (PRP) is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet.This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral (BPBM) graft in the treatment of human intrabony defects.Methods Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM (test group, n=9) or with BPBM alone (control group, n=8). Clinical parameters were evaluated including changes in probing depth, relative attachment level (measured by Florida Probe and a stent), and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography (DSR).Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction: (4.78 ± 0.95) mm versus (3.48±0.41) mm (P＜0.01); clinical attachment gain: (4.52± 1.14) mm versus (2.85 ±0.80) mm (P＜0.01);bone probing reduction:(4.56±1.04) mm versus (2.88±0.79) mm (P＜0.01); and defect bone fill: (73.41±14.78)% versus (47.32±11.47)% (P＜0.01). DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group: gray increase (580 ±50) grays versus (220 ± 32)grays (P=0.0001);area with increased gray were (5.21±1.25) mm2 versus (3.02±1.22) mm2 (P=0.0001).Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP,and a larger sample size is needed。

Bronchial asthma is a reversible obstructive airway disease characterized by persistent airway inflammation and airway remodeling, with eosinophil infiltration of the airway walls as the predominant feature. However, our previous work1,2 and other reports3,4 have demonstrated that neutrophil predominant inflammation is present in a subgroup of asthmatics, particularly severe asthmatics, and patients with airway neutrophilia are less responsive to glucocorticoid therapy. The mechanisms underlying airway neutrophilia in asthma are still under investigation, but interleukin (IL)-8 as an important neutrophil chemokine may play an important role。

13C-methacetin breath test was used for the evaluation of liver function, as for quantitative data could be achieved using this method, it had the characteristics of safety,quantification, and repetition and got recognition gradually through the world.1,2 We began this 13C-methacetin test to assess liver function of patients with cirrhosis from January 2002. The aim of this study was to explore the characteristic of this test for liver function evaluation and explore the correlation of this method with some clinical liver biochemical parameters and Child-Pugh score。

Currently, surgery-oriented treatment plays a major role in the treatment of ovarian cancer patients. But 5-year survival rate of patients is still around 30%. One of the main reasons for the Iow survival rate is the drug resistance of tumor cells against chemotherapy.1,2 The function of antiapoptosis in the course of initiation and progress of cancer has a close relationship with drug resistance of tumor cells. Survivin is a new discovered anti-apoptosis gene, its expression levels correlating with more aggressive disease and poor clinical outcome in many of these tumors. It has been reported that survivin is expressed during fetal development and in cancer tissues.3 Furthermore,survivin overexpression, by disrupting the balance between cell proliferation/differentiation and apoptosis, may relate with the resistance to a variety of apoptotic stimuli, including chemotherapy.4,5 We designed antisense oligonucleotides of survivin to treat the drug-resistant human ovarian carcinoma cell line COC1/DDP, and studied its effects on inducing COC1/DDP apoptosis. The purpose of this study was to find a novel approach to improve the sensitivity of ovarian carcinoma chemotherapy。

Diabetes mellitus (DM) has been regarded as an equivalent risk factor as coronary artery disease1 and is present in nearly 25% of patients who receive percutaneous coronary intervention (PCI).2 DM is shown as an adverse predictor for major adverse cardiac events (MACE) after PCl in bare metal stent (BMS) era.3 Recently, clinical trials have demonstrated the favorable tendency of using drug-eluting stents (DES) in treating diabetic patients with coronary artery disease.4,5 This study compared the clinical outcomes between the diabetic patients receiving DES with those receiving BMS in China。

Qfever is a worldwide zoonosis and its agent is Coxiella burnetii (C. burnetii).1 There are two forms of Q fever: acute and chronic. Acute Q fever is caused by primary infection with C. burnetii and its main clinical features are high fever, granulomatous hepatitis and atypical pneumonia.2,3 Acute Q fever is extremely prone to develop chronic infection if it is improperly treated. Endocarditis is the main characteristic of chronic Q fever and it accounts for 3% to 5% of all cases of endocarditis.4,5

To the Editor: A recent article entitled "HIV-1 DNA vaccine with adjuvant cytokines induces specific immune responses against HIV-1 infection in mice"was published in the Chinese Medical Journal.1 The authors descriptively analyzed the adjuvant potential of an interleukin-12 (IL-12), interleukin-18 (IL-18),regulated on activation of normal T-cell expressed and secreted factor (RANTES), macrophage inflammatory protein 1 alpha (MIP-1α) or stromal cell derived factor 1 (SDF-1) plasmid when coimmunized with an HIV Gag gene-based DNA vaccine. Consequently the authors believed that IL-12, IL-18, or SDF-1 plasmid DNA potentially serves as immune adjuvants in combination with therapeutic HIV-1 DNA vaccine. The RANTES,MIP-1α plasmid DNA potentially serves as immune adjuvants in combination with HIV-1 prophylactic vaccine. Although the experiment allows us to consider such a coinoculation strategy as one of the means against HIV-1 infection, some special attentions should be highlighted。