OBJECTIVEUsing regional assignment to forked method to study lumbar intervertebral disc hemiation (bugle, hernia, prolapse) dependablity and reason of lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation.

METHODSFrom March 2005 to October 2006, 120 patients of match condition from orthopaedics dept and rehabilitative dept of the Boai hospital of Longyan were studied. All patients were equally divided into two groups according to whether or not accompany with symptom of lumbar intervertebral disc herniation. There was not statistical difference in sex, age, course of disease, segment of intervertebral disc between two groups. Sixty patients of symptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. Sixty patients of asymptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. The age was 20-59 years old with an average of 38.5 years. Using regional assignment to give a mark respectively for every group. The sagittal diameter index (SI), anterior diastema of flaval ligaments, the width of superior outlet of latero-crypt, anteroposterior diameter of dura sac were respectively measured by sliding caliper. CT value and protrusible areas were respectively evaluated by computer tomography. Adopting mean value to measure three times.

RESULTS(1) There were not statistical difference in SI, CT value, hernia areas, anteroposterior diameter of dura sac between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). There were statistical difference in the width of superior outlet of latero-crypt, anterior diastema of flaval ligaments between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). (2) There were statistical difference in protrusible type,protrusible segment between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation).

CONCLUSIONThere were not necessary relationship between in protrusible size, location, type, compression degree and clinical symptom. This paper may support the mechanism of lumbar intervertebral dise herniation that associated with the following the three aspects: (1) spinal reserve capacity (SRC); (2) involved nerve roots escaping from herniated disc compression and its elastic lengthening function; (3) hypoxia symptosis and anti-ischemia injury compensation of involved nerve roots.

Adult ; Female ; Hernia ; diagnostic imaging ; pathology ; Humans ; Intervertebral Disc Displacement ; diagnostic imaging ; pathology ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Prolapse ; Tomography, X-Ray Computed

OBJECTIVETo compare the effects of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variation and plasma nitric oxide (NO) and endothelin (ET) in elderly hypertensive patients.

METHODSA total of 61 elderly patients with grade 2 or 3 hypertension were randomized into valsartan + amlodipine (the amlodipine group, n = 31) or valsartan + hydrochlorothiazide (the hydrochlorothiazide group, n = 30) group. Blood lipids, fasting plasma glucose and uric acid were determined before the treatment. 24-hour dynamic blood pressure, NO and ET were monitored at baseline, 8 and 16 weeks after treatment.

RESULTS24 hours blood pressure and daytime blood pressure were similar between two groups at all 3 time points. At 16 weeks, morning systolic blood pressure surge was significantly lower in amlodipine group than in hydrochlorothiazide group [(22.6 ± 8.8) mm Hg (1 mm Hg = 0.133 kPa) vs. (26.3 ± 13.7) mm Hg, P < 0.05]. 24 hours systolic blood pressure variability (SBPV) decreased progressively in both groups [the amlodipine group: (12.5 ± 2.8) mm Hg vs. (10.2 ± 2.2) mm Hg vs. (8.8 ± 1.6) mm Hg, P < 0.01; the hydrochlorothiazide group: (12.5 ± 2.5) mm Hg vs. (10.7 ± 2.2) mm Hg vs. (9.6 ± 2.0) mm Hg, P < 0.01]. Daytime SBPV also decreased progressively in both groups [the amlodipine group: (12.2 ± 3.0) mm Hg vs. (10.1 ± 2.3) mm Hg vs. (8.4 ± 1.9) mm Hg, P < 0.01; the hydrochlorothiazide group: (11.8 ± 2.7) mm Hg vs. (10.4 ± 1.9) mm Hg vs. (9.6 ± 2.2) mm Hg, P < 0.01]. 24 hours diastolic blood pressure variability (DBPV) was significantly reduced post therapy in the amlodipine group [(15.5 ± 3.4) mm Hg vs. (13.0 ± 3.5) mm Hg vs. (12.3 ± 2.5), P < 0.01] but not in the hydrochlorothiazide group. NO increased progressively [(27.3 ± 13.6) µmol/L vs. (47.2 ± 16.3) µmol/L vs. (69.5 ± 18.9) µmol/L in the amlodipine group, P < 0.01; (33.5 ± 13.9) µmol/L vs. (49.7 ± 21.9) µmol/L vs. (66.7 ± 24.7) µmol/L in the hydrochlorothiazide group, P < 0.01] and ET decreased progressively [(45.3 ± 8.0) ng/L vs. (37.4 ± 3.9) ng/L vs. (34.2 ± 4.4) ng/L in the amlodipine group, P < 0.01; (46.6 ± 10.4) ng/L vs. (37.0 ± 5.4) ng/L vs. (36.1 ± 8.2) ng/L in the hydrochlorothiazide group, P < 0.01] in both groups.

CONCLUSIONValsartan in combination with amlodipine or hydrochlorothiazide can both effectively lower BPV in elderly hypertensive patients and improve the vascular endothelial function and the former regimen is more suitable for elderly hypertensive patients.

Aged ; Amlodipine ; therapeutic use ; Blood Pressure ; drug effects ; Drug Therapy, Combination ; Female ; Humans ; Hydrochlorothiazide ; therapeutic use ; Hypertension ; drug therapy ; physiopathology ; Male ; Middle Aged ; Tetrazoles ; therapeutic use ; Treatment Outcome ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

OBJECTIVETo compare the effect of different antegrade pulmonary blood flow on the further development of pulmonary artery after Glenn procedure in cyanotic congenital heart defects (CHD) patients.

METHODSBetween October 2000 and December 2006, 132 CHD patients with decreased pulmonary artery blood flow underwent bidirectional Glenn shunt, among them 18 patients received intraoperative lung biopsy. Patients were divided into two groups according to their different sources of antegrade pulmonary blood flow: antegrade arterial blood flow group (n = 33) and antegrade venous blood flow group (n = 99). The percutaneous oxygen saturation (SpO2), hemoglobin (Hb) concentration, and hemotocrit (Hct) value were examined and recorded before and after operation. The diameters of left pulmonary artery (LPA) and right pulmonary artery (RPA) were measured with two-dimensional echocardiography and the results were used to calculate the pulmonary artery index (PAI). The method of half-quantitative morphometric technique and an image analyzer were used to measure the following indicators of pulmonary microvessels: the percentage of media thickness (MT%), the percentage of media section area (MS%), vascular numbers of per square centimeter (VPSC), and mean alveolar number (MAN).

RESULTSBefore the operation, obvious cyanosis was found in both groups, while SpO2, Hct, and Hb were not significantly different (P > 0.05). LPA, RPA, and PAI were not significantly different between two groups (P > 0.05). The MT% and MS% in antegrade venous blood flow group were significantly less than those in antegrade arterial blood flow group (P < 0.05), but VPSC and MAN were not significantly different (P > 0.05). After Glenn procedure, hypoxia and cyanosis were remarkably improved in both two groups. There was a significantly negative correlation between SpO2 and Hct (r = -0.49, P < 0.01) or Hb (r = -0.196, P < 0.01 ). The PAI increased by 22% in antegrade arterial blood flow group and 44% in antegrade venous blood flow group (P < 0.05). The diameters of LPA and RPA in antegrade venous blood flow group were significantly larger than those in antegrade arterial blood flow group (P < 0.05) and the growth of RPA in antegrade arterial blood flow group was not significant.

CONCLUSIONA better pulmonary artery growth occurs in the patients of pulmonary stenosis after Glenn shunt than in those of pulmonary atresia, and it contributes to an earlier completion of Fontan procedure.

Blood Flow Velocity ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Infant ; Male ; Pulmonary Artery ; growth & development ; physiopathology ; surgery ; Pulmonary Veins ; physiopathology ; Treatment Outcome

OBJECTIVEIn order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group.

METHODSLung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis.

RESULTSThere were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision.

CONCLUSIONSThe density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.

Abnormalities, Multiple ; pathology ; Child, Preschool ; Ductus Arteriosus, Patent ; pathology ; Female ; Heart Septal Defects, Ventricular ; pathology ; Humans ; Infant ; Male ; Pulmonary Artery ; pathology ; Pulmonary Atresia ; pathology

To explore the influence of raising oxygen (dissolved oxygen) content on function of platelet concentrate, the platelet concentrate was prepared by a CS-3000 plus blood cell separator. Experiments were divided into 2 groups: test group and control group. After raising oxygen content in platelet plasma under sterile operation, the platelet samples of two groups were preserved in oscillator with horizontal oscillation at 22 +/- 2 degrees C. The platelet count, platelet aggregation rate, lactic acid content and CD62p expression level of platelet were detected on 0, 1, 2, 3, 4, 5 days of platelet preservation. The results showed that the platelet count and platelet aggregation rate decreased with prolongation of preserved time, while the lactic acid content and CD62p expression level of platelet increased gradually. Compared with control group, there were significant differences in aggregation rate of platelet preserved for 2-3 days, and in CD62p expression level of platelet preserved for 1-3 days, while significant difference was found in lactic acid content of platelet preserved for 1-3 days. It is concluded that raising content of oxygen in platelet plasma can provide more oxygen to compensate oxygen supply deficiency for platelet metabolism and improve the efficiency of platelet oxygenic metabolism and the quality of platelet during preservation.
Blood Platelets ; drug effects ; physiology ; Blood Preservation ; methods ; Humans ; Lactic Acid ; metabolism ; Oxygen ; pharmacology ; Platelet Aggregation ; drug effects ; Platelet Count ; Platelet Function Tests

OBJECTIVETo investigate the relationship between pulmonary pathological features and clinical physiology of congenital heart defects (CHD) with decreased pulmonary artery blood flow.

METHODSBetween July 2001 and May 2006, 18 patients with CHD with decreased pulmonary artery blood flow undergoing palliative or definitive repair and having lung biopsy intraoperatively were enrolled in this study. The patients' age was 0.4 - 8.0 years, and body weight was 6.0 - 20.0 kg. The method of semi-quantitative morphometric technique and an image analyzer were applied to measure the following indices of pulmonary microvessels: the percentage of media thickness (MT%), the percentage of media section area (MS%) and numbers of microvessels per square centimeter (VPSC). The diameters of left pulmonary artery (LPA) and right pulmonary artery (RPA) were measured with two-dimensional echocardiography. The percutaneous oxygen saturation (SpO(2)), hemoglobin concentration (HB) and hematocrit value (HCT) were examined and recorded preoperatively.

RESULTSThere was a significant negative correlation between SpO(2) and HCT or Hb (R(2) = 0.4914, P = 0.001 and R(2) = 0.5505, P < 0.001), the variation trend of these three variables was linked. There was a negative correlation between SpO(2) and the body weight (R(2) = 0.2208, P = 0.049), which is in accordance with clinical features of aggravated process of cyanosis and hypoxia. The morphological observation of lung biopsy specimens indicated that most of peripheral pulmonary arteries were distended, irregular and their walls were uneven, and "lake" type of pulmonary AV malformations were observed. There was a positive correlation between VPSC and the body weight or BSA (R(2) = 0.5472, P < 0.001 and R(2) = 0.5233, P = 0.001). There was a significant correlation between VPSC and LPA or RPA (R(2) = 0.4312, P = 0.003 and R(2) = 0.2463, P = 0.036). It was shown that the diameter of central pulmonary arteries could be a reflection of peripheral pulmonary artery growth. The diameter of LPA also correlated with the diameter of RPA (R(2) = 0.286, P = 0.022).

CONCLUSIONSFor patients with congenital heart defects with decreased pulmonary blood flow, the pulmonary pathological changes are the bases of their clinical physiologic features. It is suggested that they should be treated in their earlier stage of life.

Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; pathology ; physiopathology ; Humans ; Infant ; Lung ; blood supply ; Male ; Pulmonary Artery ; abnormalities ; pathology ; physiopathology

OBJECTIVETo evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer.

METHODSOne hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients.

RESULTSLateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age < or =40 years, infiltrative cancer, T34 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P < 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage I, II, III cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P < 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P < 0.05).

CONCLUSIONLateral pelvic lymph node metastasis is an important prognostic factor for low rectal cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Multivariate Analysis ; Pelvis ; pathology ; Prognosis ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVETo analyse the relationship between the quantitative structural study of lung and right ventricle outflow tract reconstruction in infants with tetralogy of Fallot.

METHODSLung biopsies were taken during the operations in 16 infants suffered from tetralogy of Fallot. Autopsy specimens were obtained from 5 infants died of non-cardiovascular diseases as normal control group. All patients underwent one staged repair. The techniques of right ventricular outflow tract reconstruction included pulmonary valve commissurotomy (n = 3), transanular pericardial patch (n = 4), and transannular homologous monocuspid valve patch (n = 8); homograft was used in one patient because of the abnormal coronary artery. The diameters of main pulmonary artery (MPA), left pulmonary artery (LPA), and right pulmonary artery (RPA) were measured during operation. The tissue was fixed with buffered formalin and routinely impregnated in wax. Sections were stained by hematoxylin-eosin, and Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters of the small pulmonary arteries were obtained, including percentage of media thickness (% MT), percentage of media section area (% MS), numbers of pulmonary small artery per square centimeter (APSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (% PPA), and alveolar/ small arterial ratio per unit area (AAR) by a computer-based image processor for quantitative analysis.

RESULTSIn the TOF group, % MT, % MS, and APSC significantly decreased, while MLI and AAR significantly increased (P < 0.05, compared with the control group). APSC decreased in turn after separately using three different techniques of right ventricular outflow tract reconstruction (i. e. pulmonary valve commissurotomy, transannular pericardium patch, and transannular homologous monocuspid valve patch), which was paralleled with the diameters of MPA, LPA, and RPA. RPA correlated with APSC (r = 0.754, P = 0.001).

CONCLUSIONSThe development of pulmonary small arteries and alveoli are directly affected by the diminished pulmonary flow in infants with tetralogy of Fallot. Right ventricle outflow tract reconstruction may be indicated according to the developmental degree of central pulmonary artery.

Biopsy, Needle ; Child, Preschool ; Heart Ventricles ; surgery ; Humans ; Infant ; Lung ; pathology ; Reconstructive Surgical Procedures ; methods ; Tetralogy of Fallot ; pathology ; surgery

AlM: To measure the retinal electrical activities in patients with diabetic retinopathy ( DR ) by applying multifocal electroretinogram ( mf-ERG) and evaluate the degree of visual damage at different stages of DR
METHODS:Thirty cases ( 30 eyes ) aged 50 ~70 years old, excluding other diseases, were as normal group, and 99 cases ( 99 eyes ) diagnosed with type 2 diabetes were as experiment group. The cases received mf-ERG examination in the standard state, respectively. The results were statistically analyzed
RESULTS: For DR patients with early and background stage, the reaction density of mf - ERG P1 wave decreased as the disease worsened, significantly reduced in non - proliferating stage and decreased more significantly in the background of the stage Ⅲ. This showed that in the macula, electrical activity had weakened before the retina without visual or morphological changes, and with the development of the disease, the electrical activity decreased more obviously.
CONCLUSlON:mf-ERG can evaluate the severity of DR, especially suit in the early and background period of DR.

Objective To investigate the expression of matrix metalloproteinase 7(MMP-7) mRNA in LOVO cells of colon cancer induced by TF/F Ⅶ a and its signal pathway.Methods We transfected LOVO cells stably with RNAi plasmid targeting to tissue factor to get TFRNAi LOVO cells and detected efficiency of interference in TFRNAi LOVO cells based on Western blot analysis;Expression of MMP-7 was evaluated in LOVO cells treated with 100 nmol/L FⅦa in 0 h、4 h、8 h、12 h、24 h based on RT-PCR and Northern blot.Expression of MMP-7mRNA was determined in quiescent LOVO cells treated with different doses of FⅦa(0 nmol/L、10nmol/L、50 nmol/L、100 nmol/L、200 nmol/L)for 8 h based on Northern blot.Quiescent LOVO cells were treated for 0 h、4 h、8 h、12 h、16 h、24 h with 100 nmol/L FⅦa to evaluate the expression of p-P38;The expression level of MMP-7mRNA induced by 100 nmol/L FⅦa for 8 h in LOVO cells blocked by 10retool SB203580 0.5 h previously and in TFRNAi LOVO cells were measured by Northern blot.Results Northern blot analysis revealed that FⅦa markedly increased the expression of MMP-7mRNA in a time-and dose-dependent manner.Western blot analysis confirmed that FⅦa stimulates p-P38 in a time-dependent manner.SB203580 block 59.2% expression of MMP-7mRNA in LOVO cells induced by TF/FⅦa.In TFRNAi LOVO cells,the expression of MMP-7mRNA induced by TF/FⅦa was 48% less than that in normal LOVO cells.Conclusions TF/FⅦa Complex induces the expression of MMP-7mRNA in LOVO cells in vitro,possibly through P38 pathway.