Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

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The clinicopathologic features of intraductal papillary mucinous neoplasms of the pancreas
QIN Xinyu, LIU Fenglin
Front. Med.. 2007, 1 (2): 121-125.

Abstract   PDF (244KB)
Since first described in 1982, intraductal papillary mucinous neoplasm (IPMN) has been the preferred term to describe the proliferation of the pancreatic ductal epithelium. It is totally different from pancreatic carcinoma in epi demiology, histology, pathology and prognosis. According to the site of involvement, IPMNs are classified into three categories, i.e. main duct type, branch duct type, and combined type. Most branch duct IPMNs are benign, whereas the other two types are often malignant. A large branch duct IPMN and marked dilation of the main pancreatic duct indicate the presence of adenoma at least. The additional existence of large mural nodules increases the possibility of malignancy in all types. The prognosis is more favorable after complete resection of benign and non-invasive malignant IPMNs. Malignant IPMNs that become more aggressive after parenchymal invasion necessitate adequate lymph node dissection. On the other hand, asymptomatic branch duct IPMNs without mural nodules can be observed without the need for resection for a considerable period of time. Our review addresses available data, current understanding, controversy, and future directions about IPMNs.
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Development of splenic surgery in China
JIANG Hongchi, ZHAO Xianqi, GAO Yue
Front. Med.. 2007, 1 (2): 126-129.

Abstract   PDF (179KB)
Splenic surgery has enjoyed rapid progress for the past decades in China. Based on continuously solidifying theories and clinical practice, many advanced concepts with applicable clinical frameworks have been established, thus making splenic surgery an indispensable division in modern surgery. In this study, the authors try to give an overview of the developments in this field. Spleen function is a key issue that generally guides advances in splenic surgery. The old knowledge of the dispensable spleen  has been abandoned, while the exact role that it plays in the body continues to be unveiled. Now, standard grading for splenic injury and the respective guidelines for clinical management have been established, with the use of selective instead of indiscriminate splenectomy being accepted by most experts. Various spleen sparing operations have been developed, while many advanced techniques such as laparoscopy have been introduced to splenic surgery. Spleen transplantation has greatly advanced in China, even though there are still many unsolved mysteries in this field. Altogether, splenic surgery is a new and prosperous discipline, and it is a tremendous stage for young surgeons to be part of.
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To restrict indication for stenting of the inferior vena cava and liver transplantation in patients with Budd-Chiari syndrome
WANG Zhonggao
Front. Med.. 2007, 1 (2): 130-135.

Abstract   PDF (649KB)
The Budd-Chiari syndrome (BCS) used to be a very rare disorder and lacked a means of relieving. However, various shuntings and radical procedures have emerged in the last three decades with quite encouraging outcomes. Recent minimally invasive therapies, such as stenting of the inferior vena cava (IVC), are simple and easy to handle. However, it has been realized that the IVC stent may compromise the hepatic veins and cause catastrophic consequences, thus the indication for IVC stenting should be reevaluated and especially not to be overused. Instead, it should be applied by percutaneous transangiography (PTA) only, which may be repeated when necessary. The BCS in China predominantly belongs to the IVC type rather than the intrahepatic type in Western; the outcome from its conventional therapy, at least for the moment, is better than that of liver transplantation. It is thus suggested that, before liver transplantation is decided, the conventional means for managing BCS be considered. The final suggestion is to restrict the indication both for stenting of the IVC and liver transplantation. In this paper, ten examples are given with figures.
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Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China
YAN Lunan, ZENG Yong, WEN Tianfu, ZHAO Jichun, WANG Wentao, YANG Jiayin, XU Mingqing, MA Yukui, CHEN Zheyu, LIU Jiangwen, WU Hong
Front. Med.. 2007, 1 (2): 136-141.

Abstract   PDF (215KB)
The aim of this paper is to report the authors  experience in performing adult-to-adult living donor liver transplantation (LDLT) by using a modified technique in using grafts of the right lobe of the liver. From January 2002 to September 2006, 56 adult patients underwent LDLT using right lobe grafts at the West China Hospital, Sichuan University Medical School, China. All patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein (RHV) and the tributariers of the middle hepatic vein (MHV) by interposing a vessel graft, and by anastomosing the hepatic arteries and bile ducts. There were no severe complications or deaths in all donors. Fifty-two (92.8%) recipients survived the operations. Among the 56 recipients, complications were seen in 15 recipients (26.8%), including hepatic vein stricture (one case), small-for-size syndrome (one case), hepatic artery thrombosis (two cases), intestinal bleeding (one case), bile leakage (two cases), left subphrenic abscess (one case), renal failure (two cases) and pulmonary infection (five cases). Within three months after transplantation, four recipients (7.14%) died due to smallfor-size syndrome (one case), renal failure (one case) and multiple organ failure (two cases). All patients underwent direct anastomoses of the RHV and the inferior vena cava (IVC), and in 23 cases, reconstruction of the right inferior hepatic vein was also done. In 24 patients, the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow. Trifurcation of the portal vein was seen in nine cases. Thus, veno-plasty or separate anastomoses were performed. The graft and recipient body weight ratios (GRWR) were between 0.72% and 1.43%, and in three cases it was <0.8%. The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86% and 71.68%, among which four cases had <40%. No small-for-size syndrome  occurred. With modification of the surgical technique, especially in the reconstruction of the hepatic vein to provide sufficient venous outflow, living donor liver grafts in adults using the right lobe of the liver can become a relatively safe procedure and prevent the small-for-size syndrome .
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Comparison of CT-guided aspiration to key hole craniotomy in the surgical treatment of spontaneous putaminal hemorrhage: a prospective randomized study
ZHAO Jizong, WANG Dejiang, WANG Shuo, YUAN Ge, KANG Shuai, JI Nan, ZHAO Yuanli, YE Xun, ZHOU Liangfu, ZHOU Dingbiao, WANG Renzhi, WANG Mei
Front. Med.. 2007, 1 (2): 142-146.

Abstract   PDF (269KB)
This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage (SPH): computed tomographic-guided aspiration (CTGA) and the key-hole approach (KHA). The indications of the two approaches are also explored. From September 2001 to 2003, a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis. All cases had three-month follow-up data. The study was designed in a single-blinded manner to compare the efficacies of the different approaches. There were 563 cases in the CTGA group, 165 in the KHA group, and 217 cases in the conventional open craniotomy (COC) group. In the CTGA and KHA groups, the mortalities at one month after operation (M1m) were 17.9% and 18.3%, respectively, while the mortalities at three months after operation (M3m) were 19.4% and 19.4%, respectively (P>0.05). The postoperative complications due to CTGA (23.7%) were not significantly different from those due to KHA (25.7%) (P = 0.420). The M3m of patients with Glasgow coma scale (GCS) "d8 was 3.45 and 4.0 times as much as those with GCS>8, respectively. The M3m of patients with complications was 3.92 times as much as those without complications. The M3m of patients with hemorrhage volume "e70 mL was 2.67 times as much as those <70 mL. The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity, but CTGA could be the first choice for those with bleeding volumes "d50mL, while KHA is the first choice for those with bleeding volumes >50 mL.
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Absence of FHIT expression is associated with apoptosis inhibition in colorectal cancer
CAO Jie, LI Wanglin, XIA Jie, TANG Weibiao, WANG Hui, CHEN Xiwen, XIAO Huanqing, LI Yuyuan, CHEN Xiaoping, DU Hong, CHEN Shanming
Front. Med.. 2007, 1 (2): 147-156.

Abstract   PDF (1003KB)
The fragile histidine triad (FHIT) gene, a candidate tumor suppressor gene located at 3p14.2, has been shown to be involved in the carcinogenesis of many human tissues, including digestive tract tissues. However, the expression and the role of the FHIT in the initiation and the development of the colorectal cancer (CRC) are poorly understood. We have shown that the FHIT gene exhibits significantly decreased expression in human CRC compared to colorectal adenoma and normal colorectal tissue by tissue microarray (TMA). The positive rate of FHIT gene expression in normal colorectal tissue, adenoma and adenocarcinoma were 93.75%, 68.75% and 46.25%, respectively. We show this decreased expression to be significantly correlated with the progression of colorectal carcinoma (P<0.05) as well as with differentiation and lymph node metastasis (P<0.05). We detected two somatic alterations in the FHIT gene in human CRC. The presence of this mutation correlated significantly with decreased FHIT expression in the human CRC. In our present study we tested the hypothesis that the decreased FHIT expression resulted in apoptosis inhibition associated with abnormal expression of apoptosis related proteins. To test this hypothesis we did a series of experiments. In the first test, we assessed apoptosis status using a standard TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling) assay by comparing FHIT-positive CRC vs. FHIT-negative CRC. In the second experiment, the protein expression of the FHIT and other apoptosis related proteins (Bax, Bcl-2 and Survivin) were measured in human CRC by TMA. Our combined results demonstrate the mutation in the FHIT gene significantly reduced FHIT expression in human CRC. Both TUNEL and TMA experiments demonstrated significantly inhibited apoptosis by down-regulation of Bax and the up-regulation of Survivin and Bcl-2. Collectively, these studies identify the mechanism by which an important tumor suppressor gene, FHIT is inactivated specifically in human CRC contributing to our understanding of the mechanism of colorectal carcinogenesis.
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Clinical outcomes of ATP-tumor chemosensitivity assay directed chemotherapy in hepatocellular carcinoma
RAO Rongsheng, CHEN Wenxue, ZHOU Xinwen, ZHOU Zheng, LI Xiaojun, ZENG Zhiping
Front. Med.. 2007, 1 (2): 157-160.

Abstract   PDF (245KB)
This study aims to investigate the clinical response of ATP tumor chemosensitivity assay (ATP-TCA) directed chemotherapy regimens delivered via hepatic artery infusion in 104 cases of primary liver carcinoma (PLC). Tumor tissue was obtained via laparotomy and cultivated in vitro. This tissue was put through the assay to determine chemosensitivity. A single drug regimen of either 5-FU, MMC and ADM and a combination drug regimen were used. The treatment assigned was dependent on the result of the ATP-TCA. In the control group, 30 cases of diagnosed PLC were given the conventional three-combination drug. The two groups were evaluated after three courses of chemotherapy. The results are as follows. The overall response rate of sensitivity test ranged from 36% to 44% in the single drug therapy groups and 81% in the combination drug group. The clinical overall response rate was 75% in the treatment group and 56% in control group. The treatment group had better results than the control group as survival period over six months was 80% and over one year 44%. In the control group, survival period over six months was 60% and 30% over one year. In short, ATP-TCA directed chemotherapy shows better results for terminal stages of PLC in that you can decrease the dose of drugs thereby reducing the side-effects with possible improvements in therapeutic effects.
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Experimental study on the establishment and maintenance of brain death model with pigs
ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi
Front. Med.. 2007, 1 (2): 161-166.

Abstract   PDF (354KB)
It remains controversial that after the transplantation of using grafts from brain-dead donors, organs injury and rejection can influence the effects of transplantation. This study sought to explore methods of establishing a stable brain death (BD) model using Bama mini pigs and to maintain the brain-dead state for a comparatively long period to provide a model for investigating changes in brain death. Sixteen anesthetized Bama mini pigs were randomized into a control group (n = 5) and a BD group (n = 11). Intracranial pressure (ICP) was increased in a modified, slow, and intermittent way to establish BD. Respiration and circulation were sustained during the brain-dead state. Hemodynamic changes were monitored during the experiment. In the BD group, 10 pigs met the requirements for brain death and 1 died of cardiopulmonary complications following an increase in ICP. Brain death was maintained for more than 48 hours with artificial life support. During the experiment, the heart rate and blood pressure showed characteristic changes due to increased ICP. Prior to BD being established, a tic reaction  inevitably occurred. We used an improved method of increasing ICP to establish a stable BD model. The BD state could be maintained for more than 48 hours with effective respiratory and circulatory support. Disappearance of the tic reaction was considered to be one of the verified indexes for BD via encephalic pressure increase.
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Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation
SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei
Front. Med.. 2007, 1 (2): 167-172.

Abstract   PDF (289KB)
An independent association between acute renal failure (ARF) and intra-abdominal hypertension (IAH) after liver transplantation has not been established previously. The aim of this retrospective study was to understand the role of IAH as an independent risk factor for ARF in the early postoperative period. This study involved 62 subjects who underwent liver transplantation. Intra-abdominal pressure (IAP) was measured in the first three days after surgery by using the urinary bladder technique. An IAP of at least 20 mmHg per day was defined as IAH. Clinical parameters between group IAH and group NO-IAH were compared in terms of the incidence of ARF, blood creatinine levels, blood urea nitrogen (BUN) levels, urine volume per hour and glomerular filtration gradient (GFG). Hemodynamic variations were recorded in the first three postoperative days between group ARF and group NO-ARF. The perioperative suspected risk factors of ARF were determined for statistical evaluation using correlation coefficients and logistic regression analysis. In group IAH, 45.8% patients developed ARF as against 7.9% in group NO-IAH; GFG was significantly lower at 0 72 h after surgery; and blood creatinine levels, BUN levels, urine volume per hour were significantly different at 24 72 h after surgery compared with group NO-IAH. The patients with ARF were not significantly different from those without ARF in terms of central venous pressure, pulmonary artery pressure and mean arterial pressure (MAP) in the first three postoperative days despite a significant increase in heart rate at 24 72h after operation. Postoperative IAH, intraoperative MAP and intraoperative blood transfusion volume of more than 15 U were found to be independent risk factors for ARF. IAH impaired renal function and was an independent risk factor for ARF after liver transplantation. Routine measurement should be taken to monitor IAP every eight hours postoperatively.
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An analysis of clinico-pathologic features of intraductal papillary mucinous neoplasm of the pancreas
LOU Wenhui, JIN Dayong, WANG Dansong, XU Xuefeng, KUANG Tiantao, QIN Xinyu
Front. Med.. 2007, 1 (2): 173-176.

Abstract   PDF (269KB)
The natural history and clinical manifestation of resected intraductal papillary mucinous neoplasm (IPMN) of the pancreas were elucidated, and based on this, a retrospective pancreatic database was reviewed to identify patients with IPMN who were surgically managed in our department from 1999 to June 2006. Pathologic rereview of each case was performed, and the clinico-pathologic features were examined. Student s T test and ?2 analysis were used to identify factors associated with malignancy. Fifty-one patients were identified. There were 33 males and 18 females. One patient s pancreas was unresectable, two patients underwent a total pancreatectomy, 42 patients had a pancreatecoduodenectomy and five patients had distal pancreatectomy. Main-duct type carcinoma was identified in 24 patients; branch-duct type in 15 patients, and mixed type in 12 patients. Invasive carcinoma was present in 35 patients. Weight loss and jaundice occurred more commonly in the invasive group. The average serum CA19-9 level was significantly higher in the invasive group (1542μ vs 94.5μ). The average diameter of the pancreatic duct was also wider in the invasive group (8.7 mm vs 4.3 mm). Significant predictors of malignant IPMNs included weight loss, jaundice, a high level of serum CA19-9, a large pancreatic duct and main-duct type carcinoma.
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Differential diagnosis of cervical nerve compression syndrome of the external intervertebral foramen
WANG Jinwu, NI Weifeng, XU Jianguang, ZHU Haibo, GUO Shangchun, ZENG Bingfang, ZHAO Binghui
Front. Med.. 2007, 1 (2): 177-180.

Abstract   PDF (259KB)
The aim of the present research is to study the mechanism of cervical nerve compression syndrome of the external intervertebral foramen and its differential diagnosis with cervical spondylosis. Diagnostic treatment with muscle relaxant, vasodilator, neurotrophic medicine and celecoxib (COX)-2 inhibitor were performed in 20 patients with cervical nerve compression syndrome of the external intervertebral foramen and 20 patients with cervical spondylosis confirmed by operation. Diagnostic local block therapy was performed additionally in cases showing little effect after diagnostic treatment. All the patients were followed up postoperatively for more than one year. Fifteen cases with cervical nerve compression syndrome of the external intervertebral foramen were healed by the diagnostic treatment. The other five cases had a short-term remission and there was no recurrence after diagnostic local block therapy. Diagnostic treatment led to short-term alleviation of the symptom in 20 cases with cervical spondylosis confirmed by operation, the results of which was far from satisfactory and operation was undertaken finally in all the 20 cases. The etiology of cervical nerve compression syndrome of the external intervertebral foramen lies in the compression of the cervical plexus, brachial plexus and cervical dorsal rami by the tendinous decussating fibers of the scalenus anticus, medius, minimus and the posterior muscles of the neck. Diagnostic treatment was propitious to differentiate cervical nerve compression syndrome of the external intervertebral foramen from cervical spondylosis.
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Visualization of vascular ultrastructure during osteogenesis by tissue engineering technique
ZHANG Kaigang, ZENG Bingfang, ZHANG Changqing
Front. Med.. 2007, 1 (2): 181-184.

Abstract   PDF (380KB)
The aim of this paper was to observe and visualize the changes in osteoblasts by electron microscopy during osteogenesis using tissue engineering technique. We also studied the feasibility of improving tissue vascularization of th
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Pluripotent stem cells exhibiting similar characteristics can be isolated from human fetal bone marrow, heart, liver, muscle, lung, derma, kidney, and fat
FANG Baijun, SONG Yongping, LIN Quande, ZHAO Chunhua, SHI Mingxia
Front. Med.. 2007, 1 (2): 185-191.

Abstract   PDF (786KB)
Previously, we reported that a cell population derived from human fetal bone marrow (BM), termed here Flk1+CD34- postembryonic pluripotent stem cells (PPSCs) that have the characteristics of mesenchymal stem cells (MSCs), could differentiate into ectodermal, endodermal and mesodermal cell types at the single cell level in vitro, and that these cells could also differentiate into the epithelium of liver, lung, gut, as well as the hematopoietic and endothelial lineages after transplantion into irradiated non-obese diabetic/severe combined immunodeficient (NOD/SCID) mice. In this study, we further isolated pluripotent stem cells from human fetal heart, liver, muscle, lung, derma, kidney, and fat and then analyzed the characteristics and function of these stem cells. It was found that the phenotype of the culture-expanded pluripotent stem cells from different fetal tissues was similar to BM-derived Flk1+CD34- PPSCs, i.e. Flk1 and CD44 positive, GlyA, CD34, CD45, class I-HLA and HLA-DR negative. Morphologically, these cells were fibroblast-like and the doubling time was about 30 h. More importantly, culture-expanded pluripotent stem cells from all these fetal tissues were able to differentiate into cells with morphologic and phenotypic characteristics of adipocytes, osteocytes, neurons, glial cells and hepatocytes. These pluripotent stem cells with characteristics similar to fetal BM-derived Flk1+CD34- PPSCs can be selected and cultured from tissues other than the BM. This phenomenon may help explain the stem cell plasticity  found in multiple human tissues. In addition, as fetal BM-derived Flk1+CD34- PPSCs, these pluripotent stem cells from different fetal tissues had the capacity for self-renewal and multi-lineage differentiation even after being expanded for more than 40 population doublings in vitro. Thus, they may be an ideal source of stem cells for treatment of inherited or degenerative diseases.
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Clinical manifestations and outcomes in severe ulcerative colitis
YANG Xuesong, YAO Wei, LIU Wenbin, LI Jun, LU Yumin
Front. Med.. 2007, 1 (2): 192-195.

Abstract   PDF (262KB)
In order to evaluate the clinical manifestations and outcomes of severe ulcerative colitis (UC), we retrospectively reviewed 41 patients with severe UC from 144 consecutively hospitalized UC cases from 1988 to 2004. Data recorded included onset, symptoms, signs, laboratory results, endoscopic, radiologic and pathologic findings, the clinical treatment process and follow-up. Of these severe cases, 92.7% (38/41) had pancolitis. Clinically, 36.9% (15/41) were categorized as first onset type, 36.9% (15/41) were chronic persistent and 26.8% (11/41) were chronic recurrent. Steroids played a main role in the remission of severe UC (61.0%). Thirty-one cases (75.6%) were relieved by drug therapy. Seven cases (17.1%) progressed to the need for operation. An early age of onset, pancolitis, low hemoglobin and serum albumin levels, and the need for intravenous steroids tended to be associated with the need for surgery. In conclusion, most of the severe UC patients respond well to drug therapy, but for individuals who are unresponsive to drug therapy, or for those depending on steroids, after a reasonable duration of treatment, the necessity for surgery should be considered.
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Study on the action of resistin-induced human umbilical vein endothelial cell dysfunction
LI Zhizhen, LI Fangping, YAN Li, LI Feng, LI Yan, CHENG Hua, FU Zuzhi
Front. Med.. 2007, 1 (2): 196-199.

Abstract   PDF (327KB)
The aim of this paper was to investigate the effects of resistin on human umbilical vein endothelial cells (HUVECs), and to explore its role and mechanism of action in atherosclerosis. HUVECs were incubated with recombinant human resistin (0, 50, 100 ng/mL) for 24 h. ICAM-1, VCAM-1 and reactive oxygen species (ROS) were assayed by flow cytometer. ET-1, eNOS and iNOS mRNA expression were measured by semi-quantitative RT-PCR. Incubation of HUVECs with resistin resulted in an increase in ICAM-1 expression and ET-1 mRNA expression. However, resistin had no effect on VCAM-1 expression and ROS release. eNOS and iNOS mRNA expression were not altered by resistin stimulation. Adipokine resistin exerted a direct effect in promoting HUVEC dysfunction by promoting ICAM-1 and ET-1 expression. These data suggest that adipocyteendothelium cross-talk might play an important role in the pathogenesis of cardiovascular disease in diabetes mellitus.
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Inhibition of protein kinase B by Palmitate in the insulin signaling of HepG2 cells and the preventive effect of Arachidonic acid on insulin resistance
XIA Yanzhi, WAN Xuedong, DUAN Qiuhong, HE Shansu, WANG Ximing
Front. Med.. 2007, 1 (2): 200-206.

Abstract   PDF (401KB)
Elevated plasma levels of free fatty acids (FFAs) may contribute to insulin resistance (IR) that is characteristic of type 2 diabetes mellitus. In this study, we investigated the effects of two fatty acids, palmitate (PA) and arach
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Effects of intracerebroventricular NMDA and non-NMDA receptor agonists or antagonists on general anesthesia of propofol in mice
XU Aijun, TIAN Yuke, DUAN Shiming
Front. Med.. 2007, 1 (2): 207-210.

Abstract   PDF (283KB)
The effects of intracerebroventricular (icv) agonists and antagonists of N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy 5-methyl-4-isoxazole-propionic acid (AMPA) receptors on the general anesthesia of propofol were studied. A total of 144 Kunming mice, male and female with body mass of (22?3) g, were used. Part One of the Experiment: a total of 104 Kunming mice, male and female, were randomly divided into 13 groups. Intracerebroventricular artificial cerebral fluid (aCSF) or different doses of NMDA, AMPA, MK-801 or NBQX was injected immediately after intravenously administered propofol 25 mg/kg and the recovery time following the loss of righting reflex (LORR) was recorded. Part Two of the Experiment: a total of 40 Kunming female mice were divided randomly into 5 groups and injected with icv aCSF or NMDA, AMPA, MK-801 or NBQX after intraperitoneally administered propofol 50 mg/kg. The pain threshold of the mice was then investigated by hot-plate test (HPPT). NMDA (0.05 or 0.075?g, icv) or AMPA (0.05 ?g, icv) exhibited no effects on the LORR, but NMDA (0.1 μg, icv) or AMPA (0.075 or 0.1 ?g, icv) prolonged the LORR significantly compared with the aCSF group (P<0.05, P<0.01). The LORR of the 2 μg MK-801 group had no changes, while those of the 4 or 8 μg MK-801 groups were prolonged significantly. The LORR of the 0.5, 2 or 4 μg NBQX groups were all prolonged significantly. NMDA 0.05 ?g or AMPA 0.05 ?g decreased the pain threshold slightly but did not differ in effect compared with the aCSF group; 2 μg MK-801 or 0.5 μg NBQX both increased the pain threshold significantly. Our results indicate that propofol produces general anesthesia partly through an interaction with brain NMDA and AMPA receptors in mice.
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Ultramicrostructure and clinical implications of satellite foci in front of the head of pterygium
LIU Haixia, XIANG Nan, ZHOU Xiongwu, HU Weikun, LI Guigang, ZHANG Hong
Front. Med.. 2007, 1 (2): 211-214.

Abstract   PDF (301KB)
In our previous studies, grey satellite foci were found in the front of heads of pterygia. This research was designed to investigate the ultramicrostructure and clinical implications of these satellite foci. The satellite foci were observed and counted under slit lamp biomicroscope. The patients with eye pterygia were divided into groups in terms of occupation, sex, age, length of history, grade of congestion, and size of the heads. The SPSS 13.0 software was used for statistical analysis. The cap areas and satellite foci were ultramicrostructurally examined. Among the total 62 eyes with pterygium, satellite foci were found in 34. The overall incidence of satellite foci was 54.8%. There were no significant differences in incidence among the subjects of different sex, age, and length of history. There were significant differences in incidence among the patients of different occupation, grades of congestion, and size of heads. Higher grades of congestion, outdoor occupations and larger pterygium heads were associated with higher incidence of satellite foci. High grades of congestion and bigger heads were also correlated with the number of satellite foci. Length of history bore no correlation with number of satellite foci. Histologically, the components of the cap areas and the foci were identical, with both consisting of mass of active fibroblasts. The activated fibroblasts existed in the natural tissue planes between Bowman s layer and basal cell layer. The fibroblasts in the satellite foci and the cap areas of a pterygium show some features of tumor cells and may play a vital role in the development and progression of a pterygium. The presence and amount of satellite foci around a pterygium can be used as an indicator for the speed of its growth.
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Serologic study on the outbreak of acute upper respiratory tract infections caused by adenovirus 3
JIANG Lufang, JU Liwen, LIN Yuzun, ZHOU Liandi, YU Shunzhang, JIANG Qingwu, JIANG Renjie
Front. Med.. 2007, 1 (2): 215-218.

Abstract   PDF (269KB)
From April to June, 2004, an outbreak of acute upper respiratory tract infections (AURTI) occurred in the north area of Jiangsu Province, China. Twenty throat swabs were collected with 13 of them presenting an adenovirus (Ad)-like cytopathogenic effect on HEp-2. These were verified as Ad by the electron microscope, direct immunofluorescence assay and Ad primer-mediated PCR. Moreover, they were identified as adenovirus type 3 (Ad3) by type-specific PCR and sequencing of the amplification products. Subsequent serologic studies were carried out to finally diagnose and document the outbreak. The neutralization test of paired serum of six in nine cases show obviously increased antibodies titers. The positive rate of IgM, IgG and recovery phase neutralization antibodies of the cases were 3.7%, 44.4% and 59.5% respectively while those of the controls were 0%, 8.3% and 33.3% respectively. The P values of Chi-Square were 0.510, 0.018 and 0.226 respectively. The concordance between IgG detected by ELISA and neutralization anti bodies detected by the neutralization test was 61.4% and the P value of Kappa was 0.070. By the serologic study, we can definitively diagnose that this outbreak of acute respiratory infections was caused by Adenovirus 3.
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Studies on exposure status of inhabitants to water-arsenic valence states in areas with endemic arsenism in the Datong basin in Shanxi
LI Jun, CHENG Xiaotian, WANG Zhenghui, WEN Xinping, HAN Lingling, SANG Zhiping, ZHANG Jie, DUAN Hushun, LIANG Binfeng, GAO Jianguo
Front. Med.. 2007, 1 (2): 219-222.

Abstract   PDF (276KB)
This study aimed to describe the distribution of water-arsenic (As) valence states and its relationship to areas with endemic arsenism in the Datong basin. Drinking water samples of patients with endemic arsenism and a control group were examined using hydride generation atomic fluorescence spectrometry (HG-AFS). We analyzed the data using SPSS10.0 for Windows. The As(III)/As ratio was 52.1% in the water sample, exceeding the national standard of 0.05 mg/L. The As(III)/As ratio significantly varied among the different stages in the disease-state groups, and with the control group (?2 = 22.4, P<0.01). The As(III)/As(V) ratio significantly varied in the four groups (?2 = 26.19, P<0.01), with a tendency to increase along with the seriousness of the disease state. The most common type of drinking water arsenic valence state was As(III) in the endemic disease-areas. Endemic arsenism was positively correlated with As(III). This led us to conclude that the fraction of each water-arsenic valence state should be studied when determining the arsenic content of drinking water.
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Relationship between selenium concentration in child hair and the distribution of Kashin-Beck Disease in Tibet, China
LI Shunjiang, YANG Linsheng, WANG Wuyi, LI Yonghua, LI Hairong, XIRAO Ruodeng
Front. Med.. 2007, 1 (2): 223-225.

Abstract   PDF (257KB)
The focus of this study is to determine the relationship between selenium (Se) concentrations in child hair and the distribution of Kashin-Beck disease (KBD) in Tibet. The hair of children in typical KBD-affected areas and non-disease areas was collected, and its Se concentrations were measured by atomic fluorescent spectrometry. The Se concentrations in child hair were (0.13±0.04) and (0.18±0.07) µg/g respectively in KBD areas and non-disease areas respectively, which are significantly different. In areas supplemented with Se in Tibet, the Se concentration of hair in KBD- affected areas was higher than that in non-diseased areas, being (0.28±0.03) and (0.18±0.04) µg/g respectively. There is a close relationship between the Se concentrations in hair and KBD distribution. Se supplement increase the Se concentrations in the human body. Appropriate Se supplementation is important to prevent KBD in Tibet.
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Effects of modafinil on vestibular function during 24 hour sleep deprivation
ZHAN Hao, XIE Sujiang, JIA Hongbo, WEI Sihuang, JING Baisheng
Front. Med.. 2007, 1 (2): 226-229.

Abstract   PDF (299KB)
The aim of this research was to investigate the effects of modafinil, a new wake-promoting agent, on vestibular function during 24 h sleep deprivation (SD) so as to provide experimental evidence for the rational use of this drug among air crew. Eight young, healthy male volunteers were exposed to two 24 h periods of continuous wakefulness during the crossover experiment. Initially, 200 mg dose of modafinil was given, and one week later, a matching placebo was administered. The SD time started from 08:00 of the first day to 08:00 of the second day. Drugs were given at 0:00 on the second day. Vestibular function was tested at 21:00 on the first day and 1, 3, 5, 7 h after drug administration. The accuracy of saccade tracking and gains in visual-vestibular optokinetic reflex (VVOR) and optokinetic nystagmus (OKN) in the placebo group decreased during 24 h SD, especially at 01:00 05:00 on the second day, while OKN gains in the modafinil group increased significantly. There were no significant differences in the other vestibular functional indices between the modafinil group and placebo group. The 24 h SD can influence vestibular function to a certain degree, but modafinil may improve OKN.
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Association study on GNB3 gene polymorphism with essential hypertension in Xinjiang Uygur group
JING Jianying, WANG Dan, WANG Xiaofeng, JIN Jianzhong, JIN Li, JIAO Yi, WEN Hao, LIN Renyong
Front. Med.. 2007, 1 (2): 230-233.

Abstract   PDF (295KB)
The relationship between the tenth exon C825T of G-protein β3 subunit (GNB3) genetic polymorphism and hypertension in the Uygur population of China was investigated. A nested case-control study (n = 738) was carried out. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to genotype GNB3 C825T polymorphism in 354 hypertensive (HT) and 384 normotensive (NT) Uygur subjects. The distributions of GNB3 C825T genotypes were CC (27.2%), TT (42.9%), and CT (29.9%) in the hypertensive subjects and CC (27.7%), TT (42.4%), CT (29.9%) in the normotensive subjects. There were no significant differences in the genotype distributions between the two groups (?2 = 0.0262 P = 0.99). The T allele was 51.4% in hypertensive subjects and 51.2% in normotensive subjects, which, between the two groups, was not a significant difference (?2 = 0.0016 P = 0.97). Further analysis shows that there is no association between C825T genotypes and age, body mass index (BMI), Glucose (GLU), Triglyceride (TG), Cholesterol (CHO), systolic blood pressure (SBP) and diastolic blood pressure (DBP). No evidence was found to suggest an association between GNB3 C825T polymorphism and hypertension in the Uygur population of China.
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