Elevated plasma level of matrix metalloproteinases-9 and its significance in patients with abdominal aortic aneurysms

Objective: To investigate the changes of the plasma level of MMP-9 (Matrix Metalloproteinase-9, MMP-9) in the patients with abdominal aortic aneurysms (AAAs) before and after the treatment, and evaluate the significance of MMP-9 in the pathogenesis of AAAs. Methods: Blood samples of 35 patients with AAAs and 10 patients with the arterial occlusive diseases (AODs) , which enrolled into the Vascular Surgery Center of Colonge University Hospital from February to August of 2002, were collected before and one month after surgical repair or less-invasive endovascular exclusion. The plasma concentrations of MMP-9 of all the collected samples were measured by means of enzyme-linked immunosorbent assay(ELISA), and compared between the two groups patients at different time point. Results: The mean plasma concentration of MMP-9 of AAAs was significantly higher than that of AODs prior to treatment [(90.3±9.1) ng/ml vs (23.6±7.3) ng/ml, P<0.05], and no apparent difference was showed in the patients with AODs [(23.6±7.3) ng/ml vs (25.3±5.8) ng/ml, P>0.05)] before and after the surgical bypass operation. However, in the patients with AAAs the plasma concentration of MMP-9 was apparently decreased one month after the surgical repair or endovascular exclusion compared with before [(28.6±8.4) ng/ml vs (90.3±9.1) ng/ml, P<0.05)]. No meaningful difference of the mean plasma MMP-9 concentration was seen between two groups after the both being successfully treated [(28.6±8.4) ng/ml vs (25.3±5.8) ng/ml, P>0.05]. Conclusion: Apparent elevation of plasma concentration of MMP-9 in the AAAs and its dramatic decrease after being treated implicated that MMP-9 might play an important role in the formation and development of AAAs. Meanwhile, to investigate the changes of MMP-9 level of AAAs could provide an practical way to facilitate the earlier diagnosis and long term surveillance for AAAs. More importantly, pharmacologic prevention and treatment of AAAs, in which the MMP-9 serves as effective target, might be possible in the future.

中耳压力治疗梅尼埃病的有关研究进展

梅尼埃病是一种以膜迷路积水为基本病理特征的内耳疾病,目前临床上药物、手术等治疗方法效果有限,而中耳压力治疗近年来新兴的一种无创、效果显著的治疗方法,本文就梅尼埃病的中耳压力治疗有关进展进行综述。

Evaluation of 5 versus 10 granulocyteaphaeresis sessions in steroid-dependent ulcerative colitis: A pilot, prospective, multicenter, randomized study

AIM： To evaluate the efficacy of 5 compared to ：tO granulocyteaphaeresis sessions in patients with active steroid-dependent ulcerative colitis. METHODS： In this pilot, prospective, multicenter randomized trial, 20 patients with moderately active steroid-dependent ulcerative colitis were randomized to 5 or 10 granulocyteaphaeresis sessions. The primary objective was clinical remission at wk 17. Secondary measures included endoscopic remission and steroid consumption.RESULTS： Nine patients were randomized to 5 granulocyteaphaeresis sessions （group 1） and 11 patients to 10 granulocyteaphaeresis sessions （group 2）. At wk 17, 37.5% of patients in group 1 and 45.45% of patients in group 2 were in clinical remission. Clinical remission was accompanied by endoscopic remission in all cases. Eighty-six percent of patients achieving remission were steroid-free at wk 17. Daily steroid requirements were significantly lower in group 2. Eighty-nine per cent of patients remained in remission during a one year follow-up. One serious adverse event, not related to the study therapy, was reported. CONCLUSION： Granulocyteaphaeresis is safe and effective for the treatment of steroid-dependent ulcerative colitis. In this population, increasing the number of aphaeresis sessions is not associated with higher remission rates, but affords a significant steroid-sparing effect.

气管插管喉部并发症

气管插管被用于解除上呼吸道梗阻、呼吸衰竭时的辅助通气、呼吸道管理和手术麻醉需要，但同时气管插管也可以引起多种喉部并发症，特别是长期插管的患者。本文对气管插管所致喉部并发症的类型、相关因素及防治方法进行综述。

CO2激光在治疗喉部疾病中的临床应用

CO2激光是近几十年来临床应用较广泛也较成熟的医用治疗手段，尤其在耳鼻咽喉头颈外科疾病中的应用越来越广泛，其在治疗喉部疾病中的应用已经有20年的历史。本文就CO2激光在治疗喉部良性病变、癌前病变及喉部恶性肿瘤中的应用做一综述。

Does vitamin D affect disease severity in patients with ankylosing spondylitis？

Background Vitamin D has been found to have a role in the function of the immune system. There have been a lot of studies investigating a relation between vitamin D and disease activity in ankylosing spondylitis （AS）. However, there have not been any studies arranging AS in groups according to vitamin D levels and determining any differences among these patients in terms of disease activity, functional status, quality of life, and other clinical parameters. The aim of this study is to compare 25-hydroxy-vitamin D3 （25（OH）D3） levels in AS patients with those in normal healthy subjects and to determine the relationship between 25（OH）D3 levels and AS disease activity, functional status, and quality of life. Methods Ninety-nine consecutive patients and 42 healthy volunteers were included in this study. After a comparison between the patient group and the control group, the patient group was divided into normal, insufficient and deficient subgroups according to the plasma 25（OH）D3 levels for another comparison. Results The differences in the 25（OH）D3 level between the patient and the control groups were statistically insignificant. The number of AS patients whose 25（OH）D3 levels were classified as normal, insufficient, and deficient were 34, 29, and 36, respectively. Erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, and Bath AS Disease Activity Index （BASDAI） scores were higher in the low （including insufficient and deficient） 25（OH）D3 level subgroups （P 〈0.05）. The Bath AS Functional Index （BASFI） and AS Quality of Life （ASQoL） scores were significantly different between the normal and the deficient subgroups （P 〈0.05）. Pain, BASDAI, ESR, and CRP were inversely correlated to the 25（OH）D3 levels （P 〈0.05）. Conclusions The plasma 25（OH）D3 levels may decrease in AS patients and this may negatively affect disease activity, functional status and quality of life.