Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.

The myocardial nutrition after myocardial revascu-larization was studied in 14 rabbits with the aid of Nd-YAG laser, before Ligation of the anterior descending branch of the left coronary artery (only ligated LAD in 4 rabbit), the rabbits were seperatively Killed 3 or 5 weekafter operating. Myocardial samples were abtained in the parti of 0 - 2,2 - 4,4 - 6mm from laser hole. Sample numbers were 30 in myocardial revascularization group (MRG); 20 in myocardial Infarction group(MIG); 20 in normal group (NG). Amount of ATP and CP in myocar-dia were determined with luciferase. Resalts.ATP and CP near laser holes were normal 3 week late. This far from laser holes was lower than that of normal myocardia 5 week late. Recover of CP amount was slower than that of ATP amount. Inclusion, myocardial revascularization can play role in myocardial nutrition.

The paper states the superiority of optimizing the teaching effect of clinical medicine by making use of information technology,analyzes the problems of information technology in optimizing the classroom teaching of clinical medicine,discusses the strategy of teaching with information technology in the aspect of classroom teaching structure,and thus reaches the effect of improving teaching efficiency and quality.

Objective To discuss the repair methods for the cartilage defects of the knee joint. Methods The cylindrical osteochondral grafts were harvested from the non-weight-bearing area of the knee joint and then transplanted to the cartilage defects in 6 patients with cartilage defects of the knee joint. Results The clinical symptoms of all the patients followed up for 2-24 months disappeared and the joint mobility recovered to normal. A follow-up MRI showed consistent cartilage coverage and the excellent position of the cylindrical osteochondral grafts. Conclusions The osteochondral autograft is a practical surgical method because it is characterized by less trauma, simple performance and good maintenance of the curvature of the articular surface.

Cytoskeletal Proteins ; biosynthesis ; genetics ; physiology ; Humans ; Neoplasm Metastasis ; Neoplasms ; pathology ; Signal Transduction

Endoscopy ; methods ; Humans ; Neck ; surgery

BACKGROUND:Interlocking intramedullary nailing exhibits unique superiority in treatment of multi-segment radial fracture,bone nonunion,and osteoporotic fracture. However,distal interlocking screw placement would injury the deep branch of radial nerves. OBJECTIVE:To analyze the anatomical characteristics of the deep branch of radial nerves during radial interlocking intramedullary nailing. DESIGN,TIME AND SETTING:An observational measurement was performed at the laboratory of Department of Orthopedics,Second Affiliated Hospital of Soochow University between November and December 2002. MATERIALS:A total of 44 pieces of fresh adult cadaver forearm specimens were provided by Department of Anatomy,Soochow University,China. A vernier caliper was purchased from Henan Yuanyang Zhenhua Instrument Factory,China. METHODS:The deep branches of radial nerve of 44 fresh forearm specimens were exposed. The lateral epicondyle of humerus was joined to the Lister tubercle of radius. The line passed through 6 horizontal planes,which were as follows in sequence:0,1.0,1.5,and 2.0 cm lower than the articular surface of radial head respectively,the horizontal planes of the deep branch of radial nerve entering the supinator and winding across the radius. The crossed points were named points A,B,C,D,E,and F accordingly. MAIN OUTCOME MEASURES:The distance between the deep branch of radial nerve and fixed points B,C,and D was measured separately when the forearm was kept in pronation,neutral and supination positions. RESULTS:The distance between the deep branch of radial nerve and fixed points B,C,D became nearer and nearer in the sequence of B,C,and D. With the forearm in pronation,neutral and supination positions in sequence,each fixed point became farther and farther from the deep branch of radial nerve. CONCLUSION:When interlocking intremedullary nailing is used to fix radius,it is relatively safe to keep the forearm in neutral and flexion positions,and drilling and insertion of distal interlocking screw at 1.5 cm lower the articular surface of radial head from the posterolateral to anteromedial approach should be selected.

Objective To compare the efficacy of different antibiotics strategy,introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus thirdgeneration cephalosporin on peritoneal dialysis (PD)-related peritonitis.Methods All episodes of PD -associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital.According to their empiric antibiotics scheme,episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated).Multivariable logistic regression model was used to explore the influence of different emnpiric antibiotics scheme on peritonitis outcome.Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9± 1.1 mmol/L) than those in group A.In group A,the percentage of gram-positive bacteria was similar to group B (43.2％ vs 43.3％,P =0.96),but gram-negative bacteria was numerically lower (16.9％ vs 24.7％,P =0.08).Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR =1.07,95％ CI(0.45,2.56),P=0.87].Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.

Objective To investigate the protective efficacy of anisodamine against heart injury after ischemia reperfusion in patients with right coronary artery acute myocardial infarction during percutaneous coronary intervention,and to explore the possible mechanism. Methods Totally 80cases with ST elevation myocardial infarction (STEAMI) were received primary percutaneous coronary intervention (PCI).All patients were randomly divided into 2 groups:anisodamine group (40 cases),5 mg anisodamine was administered when the blood flow recovery after the balloon extension,and control group (40 cases) received saline. The rhythm and rate of heart were observed through the electrocardiogram (ECG) monitor in 30 min after the blood flow recovery.The pressure of aorta were observed through the pressure sensor connected to aorta through catheter.TIMI flow grade (TFG)and corrected TIMI frame count (cTFC) were used to evaluate coronary flow during PCI.Electrocardiography was performed to analysis ST segment resolution 30 min and 24 h after PCI.Venous blood was obtained before and 30 min,1 h,2 h,4 h,24 h and 48 h after PCI to test the levels of superoxide dismutase (SOD),malonyldialdehyde (MDA),creatine kinase isozymes (CKMB) and cardiac troponin I(cTNI) in plasma. Results There were 20 cases(50.0％)of sinus bradycardia,7cases(17.5 ％) of high degree atrioventricular block (AVB),20 cases (50.0 ％ )of frequent ventricular premature,14 cases (35.0％) of paroxysmal supraventricular tachycardia, 5 cases (12.5％) of ventricular fibrillation,19 cases(47.5 ％) of hypotension,3 cases (7.5 ％)of no-reflow phenomenon in anisodamine group which were lower than control group,31 cases (77.5％)of sinus bradycardia,14 cases(35.0％) of high degree AVB,17 cases(72.5％) of paroxysmal supraventricular tachycardia,8 cases (42.5％) of ventricular fibrillation,30 cases (75.0％) of hypotension,6 cases of no-reflow phenomenon (P＜0.05).There were more ST fall＞50％ after rise in anisodamine group than control group after PCI 30 min,but no difference was found after 24 h. The CKMB and cTNI peak value occurred earlier in anisodamine group than control group (P＜0.05).The level of SOD was increased,MDA decreased in anisodamine group compared with control group after PCI 30 min and 24 h (both P＜0.05). Conclusions The use of anisodamine as the blood flow recovery after the balloon extension can reduce no-reflow phenomenon,various of arrhythmia and hypotension during PCI.The underlying mechanism involves the inhibition of oxygen radicals and the improvement of microcirculation.