Objective To investigate the correlation between ankle-brachial index and ultrasonography in lower ex- tremities vascular in type 2 diabetic patients.Methods 218 type 2 diabetic patients were enrolled,and ankle-brachial index(ABI)measurements and uhrasonography in lower extremities vascular were performed in all patients.Lower extremi- ties vascular disease(LEVD)were divided into six species according to the uhrasonography results and scored in accord- ante with its serious degree,then investigate the correlation between ABI and uhrasonography results score.All patients were divided into deferent groups according to uhrasonography results and ABI range,and then compared their deference. Results The lower the ABI,the more serious of the LEVD showed by ultrasonography.ABI and ultrasonic inspection score was significantly negatively correlated(r=-0.65,P

OBJECTIVETo investigate the changing laws of serum high mobility group box 1 protein (HMGB1) in septic rats and intervention effect of Xuebijing on it.

METHODSLipopolysaccharide (LPS) (5 mg/kg BW) was intravenously injected into the tail vein of healthy male Wistar rats to prepare the sepsis rat model. In Experiment 1: 50 Wistar rats were randomly divided into three groups, i.e., the normal group (A, n=10); the LPS model group (B, n=10), the LPS +Xuebijing treatment group (C, n=30). Rats in the C group were further divided into three subgroups, i.e., 2 h before LPS injection (group C1), 2 h after LPS injection (group C2), and 8 h after LPS injection (group C3), 10 in each group. Blood samples were collected from the caudal vein to detect serum HMGB1 levels by Western blot at 4, 12, 24, 48, and 72 h after LPS injection. Experiment 2: 30 Wistar rats were equally divided into the LPS model group (D) and the LPS + Xuebijing treatment group (E), 15 in each group. They were treated as rats in the B group and the C1 group respectively. Five rats were sacrificed at 12, 24, and 48 h after LPS injection in the two groups. Blood as well as the tissue samples were harvested to measure such indices as ALT, AST, Cr, and BUN, as well as pathological changes of liver, lung, and kidney.

RESULTS(1) Compared with the A group, serum HMGB1 levels were higher at various time points in the B group (P < 0.05). Compared with the B group, serum HMGB1 levels at 12,24,48, and 72 h decreased in the C1, C2, and C3 groups. Besides, the decrease was more obvious at 24 h and 48 h.The decrement in the C3 group was less than that in the C1 and C2 groups (P < 0.05). (2) In the D group, ALT, AST, Cr, and BUN were significantly higher than those in the A group and reached the peak at 24 h (P < 0.05). Compared with the E group, AST, Cr, and BUN at 24 and 48 h, and ALT at each time point decreased significantly in the E group (P < 0.05). (3)The results of pathological section of liver, lung, and kidney showed local congestion and hemorrhage, cell edema/necrosis/degeneration, infiltration of inflammatory cells, damage of characteristic structures and so on; particularly serious lesion occurred at 24 and 48 h in the D group. The microscopic lesion was obviously alleviated in the E group than in the D group at corresponding time points.

CONCLUSIONSThe serum HMGB1 levels increased in septic rats, with late occurrence of peak value and longer duration of the high value. HMGB1 played an important role in excessive inflammatory response and multiple organ dysfunction. Xuebijing could reduce the serum levels of HMGB1, improve biochemical parameters, and attenuate severe inflammatory response of liver, lung, and kidney tissues in septic rats. Besides, the earlier use, the better effect obtained.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; HMGB1 Protein ; blood ; Male ; Rats ; Rats, Wistar ; Sepsis ; blood ; drug therapy

OBJECTIVETo discuss the resection pseudoarthrosis for pelvic malignant tumors around acetabular.

METHODSFrom May 1997 to June 2005, 25 patients with malignant tumors around acetabular were treated surgically with resection pseudoarthrosis. The series comprised 15 males and 10 females with an average age of 42 years old (range from 16 to 75 years old). There were 4 osteosarcomas, 12 chondrosarcomas, 1 Ewing's sarcoma, 1 neuroectodermal tumor, 1 myeloma, 1 malignant fibrohistiocytoma, 2 synovial sarcomas, and 3 metastases. Pseudoarthrosis was performed after resection of pelvic malignant tumors around acetabular. The affected side was protected postoperatively by skin traction with 2 - 3 kg weight for 6 to 8 weeks. After then, the patients walked gradually with a cane.

RESULTSAmong 25 patients, 6 had complications (24%). At a follow-up ranging from 3 to 10 years, 11 patients died of lung metastases, 2 relapsed, 12 remained alive free of disease. There was an average crispation of 5 cm (range from 2.5 to 7.5 cm). The patients were functionally evaluated according to Enneking's MSTS criteria in 1993. The average MSTS functional score was 17 points (12 to 19 points). After 3 months postoperative, the patients could sit normally, walk with a cane, and even walk limpingly without cane.

CONCLUSIONSResection pseudoarthrosis for pelvic malignant tumors around acetabular results in good clinical results at the time of mid-term and long-term follow-up. And pseudoarthrosis is advisable especially for patients with malignant highly tumors around acetabular, poor soft tissue reconstruction condition, high risk for infection, poor economy.

Acetabulum ; Adolescent ; Adult ; Aged ; Female ; Femur Head ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pelvic Neoplasms ; surgery ; Young Adult

This paper introduced the work principle, execution, use and major characteristics of the remote hydraulic pressure control injection. Using Pascal principle, it is more accurate, convenient, cheap and safe. It could be used in all the fields of the medicine.
Equipment Design ; Injections ; Telemedicine ; instrumentation

Objective: To investigate the relationship between P27，P53 and PCNA expression in human gastric carcinoma tissues and clinicopathological parameters. Methods: The expression of P27，P53 and PCNA in 62 human gastric carcinoma tissues was examined with immunohistochemistry SP method. Results: Positive rates of P27，P53 and PCNA expression were 37.1％, 40.4%，83.9％. P27 expression was related with Bormann type, infiltrative depth, lymph node and distant metastasis and clinical stage. P53 expression was related with sex of patients, distant metastasis and clinical stage. PCNA expression was related with age of patients and infiltrative depth of tumor. P27 positive expression group was higher than negative group as to 5-year survival. P27 expression was in reverse relation with PCNA expression. Conclusion: The expression of P27, P53 and PCNA may be regarded as an important marker in judging malignant degree of gastric carcinoma,distant metastasis and prognosis.

OBJECTIVETo analyse the causes and resultes of intraoperative occurrence of an acetabular fracture in primary total hip arthroplasty and discuss propriate prevention and treatment of this problem.

METHODSBetween July 2004 and December 2006, 326 primary total hip arthroplasties were retrospectively reviewed and found that eleven patients (eleven hips) had sustained an intraoperative acetabular fracture involving 7 male and 4 female,aged from 37 to 71 years (mean 54 years). Analyzed the causes of fractures, the anatomic location, treatment and outcome of the fractures. Acetabular component designs were categorized and each design was analyzed for fracture risk.

RESULTSAmong 11 cases, the fractures occurrenced as setting the prosthesis in 6 cases, grinding and drilling in 3 cases, drawning hook in 2 cases. There were 5 cases of central type fracture, 3 of posterior-wall, 2 of anterior, 1 of posterior-upper. Nine of these patients (nine hips) had been followed-up for 12 to 29 months(mean 18 months). There were no heterotopic ossification, no dislocation, no deep venous embolism. All fractures were healing.

CONCLUSIONAcetabular fracture during primary total hip arthroplasty is a complication of acetabular fixation without cement, which should be think highly of. In the present series, retention of a stable cup is associated with uneventful osseous in growth and excellent early-term outcomes.

Acetabulum ; injuries ; surgery ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; Female ; Fractures, Bone ; complications ; surgery ; Humans ; Intraoperative Complications ; prevention & control ; surgery ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo compare the expressions of transforming growth factor alpha (TGFalpha), tumor necrosis factor alpha (TNFalpha), and vascular endothelial growth factor (VEGF) between pheochromocytoma (PHEO) tissues and normal adrenal medulla tissues.

METHODSThe mRNA expressions of TGFalpha, TNFalpha, and VEGF detected by RT-PCR, were compared between 22 PHEO tissues and 18 normal adrenal medulla tissues (according with the principle of medical ethnics). Immunohistochemistry staining was performed on 27 PHEO tissues and 14 normal adrenal medulla tissues. The comparisons of the protein expression of TGFalpha, TNFalpha, and VEGF were analyzed in both of PHEO tissues and normal adrenal medulla tissues.

RESULTSCompared with normal adrenal medulla tissues, the expressions of TGFalpha and TNFalpha mRNA and protein were higher in PHEO tissues, and VEGF145 mRNA expression was also higher in PHEO tissues, while there was no significant difference of the mRNA expression of VEGF121 and VEGF165 between these two tissues. Positive staining rates for VEGF of endothelial cells and tumor cells were higher in PHEO tissues than in normal adrenal medulla tissues. Expressions of the TGFalpha, TNFalpha, and VEGF protein were higher in extra-adrenal PHEO than in adrenal PHEO. The TNFalpha immunohistochemistry staining rate was higher in the malignant or multiple PHEO than in the benign or single PHEO.

CONCLUSIONSThe mRNA and protein expressions of TGFalpha, TNFalpha, and VEGF are higher in PHEO tissues than those in normal adrenal medulla tissues. Expressions of these cytokines vary in PHEO with different characteristic.

Adrenal Gland Neoplasms ; metabolism ; Adrenal Medulla ; metabolism ; Humans ; Pheochromocytoma ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Transforming Growth Factor alpha ; biosynthesis ; genetics ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics ; Vascular Endothelial Growth Factors ; biosynthesis ; genetics

OBJECTIVETo summarize the experience of diagnosis and treatment of esophageal leiomyoma.

METHODSClinical data of 52 patients with esophageal leiomyoma were analyzed from 1993 to 2002.

RESULTSAbout 54% patients in this group had difficulty of food intake. The diagnostic accuracy of gastrointestinal barium meal series, computed tomography, gastric endoscope and endoscopic ultrasonography (EUS) for esophageal leiomyoma was 64% 44% 27% and 90% respectively. All patients received operation, resection of esophageal leiomyoma by videothoracoscopy (VAS) and endoscope were performed in 6, 9 patients respectively. The remaining 37 patients received regular open operation,in whom 32 cases received enucleation of esophageal leiomyoma, 5 cases received partial esophageal resection and esophageal-gastric anastomosis. No serious complications occurred except only one case needed operation again because of bleeding.

CONCLUSIONEUS is an effective method for diagnosing esophageal leiomyoma. VAS and endoscopic treatment should be considered for suitable cases in order to reduce the trauma.

Esophageal Neoplasms ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Thoracoscopy ; Ultrasonography

OBJECTIVETo study the short-term results of metal on metal hip resurfacing arthroplasty (HRA) for the treatment of patients with ankylosing spondylitis (AS), to explore the indications and technology of this surgery.

METHODSFrom February 2006 to April 2008, 11 patients (15 hips) with ankylosing spondylitis were treated with metal on metal total hip resurfacing arthroplasty. Among them, 9 patients were male, and 2 patients were female, with an average age of 32.5 years (ranged from 16 to 53 years). The comparative study on preoperative and postoperative pain, range of motion, correction of deformity and function evaluation were performed. The preoperative and postoperative Harris scores were compared and the feasibility and technical difficulty were analyzed.

RESULTSTen patients were followed up for an average period of 16.2 months (ranged from 8 to 34 months) and 1 patient was lost. Pain disappeared in 10 patients. There were no heterotopic ossification, no femoral neck fracture, no dislocation, no infection and no revision in all patients. From preoperation to present, the mean flexion angle of hip was improved from preoperative 0 degrees to 75 degrees to postoperative 35 degrees to 105 degrees; the mean abducting angle of hip was improved from preoperative 0 degrees to 30 degrees to postoperative 15 degrees to 55 degrees; and the average Harris hip score improved significantly from (30.9 +/- 3.4) (2-47) to (85.1 +/- 3.1) (46-94). According to evaluation criteria, 10 hips got an excellent result, 3 good and 1 poor.

CONCLUSIONThe total hip resurfacing arthroplasty is an effective solution for the treatment of the younger and active patients with AS and it shows satisfactory short-term results. It is very significant to analysis the different conditions of patients so as to choose proper strategy.

Adolescent ; Adult ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Range of Motion, Articular ; Spondylitis, Ankylosing ; physiopathology ; surgery ; Young Adult

Adult ; Cartilage Diseases ; diagnosis ; etiology ; Female ; Humans ; Knee Joint ; surgery ; Menisci, Tibial ; surgery