[Objective]To evaluate the diagnostic value of ultrasonography in patients with carpaltunnel syndrome (CTS) by measuring the thickness of transverse carpal ligament.[Method]Forty patients who had clinically and electrophysiologically confirmed as CTS underwent surgery and ultrasonographic examination by the same operator for the thickness of transverse carpal ligaments at the level of the hook of the hamate bone in transverse plane preoperatively.Twenty-four asymptomatic normal wrists served as control.Data of the ultrasonography and surgey from patients and the control groups were compared to determine the diagnostic parameters.[Result]The ultrasonographic thickness of transverse carpal ligaments in CTS patients was (0.42?0.08)cm at hamate hook leve and the data from surgey was (0.40?0.10).The data in control group was (0.29?0.07)cm.There was significant difference in the mean value of thickness of transverse carpal ligaments between the two groups at the same level.There was no significant difference between the data of CTS from surgey and ultrasonography.[Conclusion]Ultrasonography examination of the thickness of transverse carpal ligamentsis is a new and feasibile method in the diagnosis of carpal tunnel syndrome.

Objective To compare L 5 anterior roots which is mostly composed of somatic motor nerve fibers and S2 anterior roots which is mostly composed of parasympathetic nerve fibers as dynamic nerve on bladder reinnervation and functional reconstruction after spinal cord injury. Methods Randomly select one side as experimental side and the other side as control, then L 5-S2 anterior roots cross extrameningeal anastomosis in the experimental side and S2-S2 self extrameningeal anastomosis in the control side were performed in 5 dogs. The changes of bladder pressure, urethral pressure responsed to electrical stimulation of the anastomosis roots on each side were recorded in the mean time and the two groups data were compared after one year. Results There were no significant difference between the changes of bladder pressure, urethral pressure responded to the stimulation of left side and right sides anterior roots as the anastomosis operation performed. After one year, both of experimental sides L 5 and control sides S2 anterior roots established neural relationship with bladder detrusor and urethral sphincter. There were no significant difference in the change of bladder pressure responded to electrical stimulation of the anastomosis roots between experimental side (5.0?2.1) kPa and control side (4.6?1.8) kPa(P=0.17) as well. The change of urethral pressure responded to electrical stimulation of the anastomosis roots between experimental side (4.2?1.7)kPa and control side (4.4?1.6)kPa also has no significant difference(P=0.31). Conclusion In the treatment of bladder dysfunction after spinal cord injury, L 5 anterior root can serve a similar role as S2 on bladder functional reconstruction as a dynamic nerve.

Objective To explore the effect of external counterpulsation on the left ventricular systolic func-tion in patients with chronic congestive heart failure.Methods 300 patients with chronic congestive heart failure were selected as the research subjects,they were randomly divided equally into observation group and control group. 150 cases in the control group were given routine drug treatment,150 cases in the observation group were treated with extracorporeal counterpulsation treatment on the basis of the control group.The brain natriuretic peptide (BNP), 6 min walking distance and left ventricular systolic function were observed before and after treatment in the two groups.The adverse reactions and clinical efficacy of the two groups were compared.Results After treatment, 6 minutes walking distance,left ventricular systolic function of the observation group were (4.712 ±35.8 )m, (48.6 ±7.6)%,which were significantly better than those of the control group [(43.16 ±3.37)m,(42.7 ± 5.2%),t =0.875,1.367,all P <0.05].The BNP level of the observation group (438.9 ±386.5)fmol/mL was sig-nificantly lower than (675.2 ±438.7)fmol/mL of the control group(t =1.256,P <0.05).The adverse reactions of the two groups had no significant difference (P >0.05).Conclusion External counterpulsation technology in the treatment of patients with chronic congestive heart failure has significant clinical effect,can improve the left ventricular systolic function in patients,it is worthy of clinical application.

To introduce a new modification to simplify the neuroprosthesis of sacral anterior root stimulated micturition for Chinese patients with spinal cord injury (SCI). Spinal cord was transected at T 10 in six dogs and they were randomly divided into 2 groups. In dogs of group I, bilateral L 7 ～S 3 posterior rhizotomy (complete de afferentation, SDAF) was performed. In animals of group II bilateral L 7 , S 2 , S 3 posterior rhizotomy plus bilateral S 1 anterior rhizotomy (partial de afferentation combined with partial de efferentation) were performed. Cystometrogram (CMG) was carried out weekly after the operations. For clinical studies, ten patients with complete SCI above cone were included. Intraoperative electrical stimulation of each individual S 2 ～S 4 roots was carried out and bladder pressure changes were recorded simultaneously. The results showed that the dogs in group II manifested a similar CMG to that of group I, indicating that a flaccid bladder with good compliance and storing function was resulted. For parasympathetic innervation to bladder detrusor in Chinese, it had been found that S 3 root was the most frequent (100%) and the most efficacious (52 2%) contributor, S 4 ranked the second frequent (90%) and a lesser but still significant efficacious (44 9%), and S 2 the least frequent (25%) and the minimal contributor (2 9%). It suggested that using one cable with two electrodes placed on the anterior roots of S 3 and S 4 bilaterally, combined with severance of S 3 and S 4 posterior roots as de afferentation, or plus division of anterior root of S 2 as de efferentation, could restore both voiding and storing function of the bladder in Chinese SCI patients. This new modification has the advantages of reducing the cost of neuroprosthesis and broadening of its indication

Objective To elucidate whether taking Ⅱ b/Ⅲ a receptor antagonist instead of oral antiplatelet drugs during perioperative in patients with drug-eluting stent implantation undergoing non-cardiac surgery would play a preventive role of stent thrombosis,without increasing surgical bleeding.Methods Six patients aged 60 -75 years old with drug-eluting stent implantation within 1 year taking dual antiplatelet drugs without any chest pain,and whose heart function classification for two (NYHA) were enrolled.They underwent surgical treatment due to ineffective conservative treatment of surgical disease,5 days before surgery intravenous infusion tirofiban 0.1 μg/( kg · min) micro pumps continuously instead of oral dual antiplatelet drugs,2 hours before surgery stop tirofiban and re-application of tirofiban 0.1 μg/( kg · rain) after surgery in the intensive care unit,and replacing tirofiban with oral dual antiplatelet as soon as possible according to the situation.Analyze cardiovascular events,especially stent thrombosis events and seriously bleeding,tirofiban adverse drug events during perioperative.Results Six patients have no perioperative malignant ischemic ventricular arrhythmia,angina,myocardial infarction,sudden cardiac death,no massive bleeding and adverse drug reactions.Conclusion Substitution of oral dual antiplatelet drugs for Ⅱ b/Ⅲ a receptor antagonists to prevent stent thrombosis treatment during perioperative in patients with drug-eluting stent implantation undergoing non=cardiac surgery may be feasible and safe,but needs to be further confirmed through large sample of randomly controlled trials.

ObjectiveTo explore the effects of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/nuclear factor-kappa B (NF-κB) signal pathway on the process of follicle-stimulating hormone (FSH) facilitating cell proliferation and invasion in human epithelial ovarian cancer. Methods Ovarian cancer cell lines SKOV3 and 3AO were cultured to exponential phase,then assigned to control group,FSH group,LY294002 group and FSH + LY294002 group,respectively.Cells were treated with different concentration of FSH and LY294002,respectively.The effects of FSH on cell proliferation were observed by methylthiazolyl tetrazolium (MTT).Morphological changes were observed by phase contrast microscope.The ability of cell invasion was investigated by transwell invasion assay.The expression of FSH receptor (FSHR),Akt1/2,phosphorylated-Akt (p-Akt) and NF-κB p65 protein were detected by western blot.Results( 1 ) FSH could promote the proliferation of SKOV3 and 3AO cells.When the cells were treated with 40 U/L FSH for 48 hours (SKOV3) and 24 hours (3AO),compared with those in control groups,they reached the highest proliferation rate (P ＜ 0.05 ),respectively.(2) The morphology of SKOV3 and 3AO cells in four groups:in control group,SKOV3 cells were short spindle and 3AO cells were long spindle,the nuclei of them were both roundness or oval,the cytoplasm were bright.In FSH group,the cells changed to slightly longer or polygonal,they were full in shape,meanwhile,the cell intensity were higher than control group.In LY294002 group,some cells changed from spindle to round,and began to shrink.The cell intensity diminished.The morphology of FSH + LY294002 group was similar with control group,but the cell intensity was lower than that in FSH group.(3)The number of SKOV3 cell that passed through the membrane in control group,FSH group,LY294002 group and FSH + LY294002 group was (26 ± 6),( 118 ± 19),( 18 ± 5) and ( 38 ± 7 ),respectively.The number of 3AO cell was ( 19 ± 4 ),( 134 ± 20),(12 ±3) and (58 ± 11 ),respectively.The results showed that the number of cells in FSH group was significantly higher than that in control group ( P ＜ 0.05 ),while the number of cell in FSH + LY294002 group was significantly fewer than that in FSH group (P ＜ 0.05 ).(4) There was no significant difference in the expression of FSHR and Akt1/2 between FSH group and control group (P ＞ 0.05 ),but FSH increased the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm in SKOV3 and 3AO cells,there were significant differences compared with control group ( P ＜ 0.05 ).LY294002 reversed the effects of FSH on increasing the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm,there were significant differences among LY294002 group,FSH + LY294002 group and FSH group (P ＜ 0.05 ).ConclusionThe effects of FSH on proliferation and invasion of ovarian cancer cell lines SKOV3 and 3AO may be realized by regulating the activity of NF-κB in PI3K/Akt signal pathway.

ObjectiveTo investigate the effects of chitosan/PVA nerve conduits which used for repairing sciatics nerve defect in rats.MethodsTwenty-seven rats were divided into 3 groups randomly,with 9 rats in each group. Firstly, the 15mm defects in the left sciatic nerves were made in the rats and were respectively repaired with chitosan/PVA conduits graft (group A), the silicon conduits graft (group B),and autografts (group C). At 12 weeks after the operations, the left sciatic nerves were taken out, and the comparative evaluation was made on the repairing effects by wet weight of gastrocnemius and soleus muscles, histological examination,computerized imaging analysis and True Blue retrograde tracing. ResultsThe wet weight of gastrocnemius and soleus muscles showed no significant difference between the chitosan/PVA graft and autograft groups (P ＞ 0.05). The wet weight of gastrocnemius and soleus muscles in significant difference between the chitosan/PVA graft and the silicon group at 12 weeks after the operation(P ＜ 0.05). The nerve fiber density showed no statistically significant differences between the chitosan/PVA and autograft groups(P＞ 0.05).The regenerative nerve fiber in group B had normal morphological and structural characters under transmission electron microscope.True Blue-labeled neuron cell bodies were found within both anterior horn of gray matter in the spinal cord and dorsal root ganglions (DRGs) ipsilateral to the operated side of the tested rats on illumination with ultra-violet light 1 week after the injection of True Blue.Conclusion Chitosan/PVA nerve conduit can effectively promote the nerve regeneration and myelinization of rat sciatic nerve, which is expected to substitute for autograft to repair nerve defects succesfully.

The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.

Objective To investigate the expression of Th1/Th2 cytoki nes in early symptomatic syphilitic lesions and its relationship with the sero-c onversion of RPR test in patients with syphilis. Methods The expression of Th1/Th2 cytokines in lesions from 30 patients with early symptomatic syphilis was i mmunohistochemically detected with ABC method. The serum titers of RPR test in t hese patients were measured in 1, 3, 6, 9 and 12 months after routine benzathine penicillin treatment. Results Among 10 cases of primary syphilis, the express ion of both Th1 and Th2 cytokines in the lesions was found in 9 cases, while onl y Th1 cytokine expression was observed in the remainder case; and the sero-conve rsion of RPR test occurred in all 10 cases during the follow-up period. Among 20 cases of secondary syphilis, Th1/Th2 cytokines expressed in the lesions in 16 c ases, and only Th2 cytokines expressed in 4 cases; and the sero-conversion of RP R test was found in 12 cases during the follow-up period. The expression of Th1 cytokines in early syphilitic lesions was positively correlated with the sero-co nversion of RPR test. The higher the expression of IFN- the more likely the s ero-conversion of RPR test. Conclusion The early activation and persistence of the expression of Th1 cytokines may play an important role in the clearance of pathogens.

OBJECTIVE: To investigate the utilization status of antibiotics in rural area of Ningbo and to put forward improvement measures.METHODS: The data regarding the utilization of antibiotics were obtained by questionnaire survey and the on-the-spot investigation among the randomly selected 52 township hospitals,451 village clinics,and 117 drugstores in Ningbo.RESULTS: The irrational drug utilization phenomena were widespread in township hospitals,village clinics,and drugstores in Ningbo,which involved technical problems as well as administrative loophole,and manifested as insufficient etiology evidence,nonstandard dosage regimen,unclear indications for preventive medication or combined uses of antibiotics,and lack of effective drug control measures etc.CONCLUSION: The irrational drug utilization phenomena are widespread in rural area of Ningbo,which should be given proper intervention.