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.

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.

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.

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.

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

Endoscopy ; methods ; Humans ; Neck ; surgery

Objective To investigate the effects of remifentanil-indueed controlled hypoteusion (CH) on the cerebral oxygen metabolism in patients undergoing radical operation for gastric cancer. MethodsForty-two ASA Ⅰ or Ⅱ patients (26 male, 16 female) aged 30-64 yr with body nuts index < 30 kg/m2 undergoing elective radical operation for gastric cancer were randomly divided into 3 groups (n = 14 each): group R remifentanil-induced controlled hypotension; group N sodium nitroprusside-induced CH and group C normal BP. Radial artery was cannulated for continuous BP monitoring and blood sampling. A catheter was inserted into right internal jugular vein and advanced cephalad until jugular bulb for blood sampling. MAP, HR, ECG and SpO2were continuously monitored. Anesthesia was induced with midazolam 0.1 mg/kg, fentanyl 5 μg/kg, propofol 2 mg/kg and vecuronium 0.08 mg/kg and maintained with isoflurane (end-tidal concentration 1. 1% ), iv infusion of propofol (50-100 μg·kg-1·min-1 ) and remifentanil (0.1 μg·kg-1·min-1) and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 12 bpm, I: E 1:1.5) after tracheal intubation. End-tidal CO2was maintained at 30-35 mm Hg. CH was started after abdomen was opened. In group R the remifentanil infusion rate was increased from 0.1 μg·kg-1·min-1 in 0.05 μg·kg-1·min-1 increment every minute until the1 μg·kg-1min-1 in 0.5 μg·kg-1·min-1 increment every minute until the desired BP was achieved. MAP was reduced to 70% of the baseline value but never below 50 mm Hg. CH induction time and BP recovery time were recorded. Arterial and jugular bulb venous blood samples were obtained before induction of anesthesia (T0), immediately before induction of CH (T1), at 10 and 30 min of CH (T2,3) and 20 min after termination of CH (T4). The arterial and jugular bulb venous O2content difference (Da-jvO2) and cerebral O2extraction rate ( CERO2) were calculated. The difference between arterial and jugular bulb venous blood lactic acid concentration (Da-jvL) was also calculated. Results The CH induction time and BP recovery time were significantly longer in group R than in group N, but BP was stabler during CH in group R than in group N. Compared with group C, Da-jvO2, CERO2and Da-jvL were significantly decreased in group R, while CERO2and Da-jvL were significantly increased in group N. Conclusion Remifentanil can effectively induce CH and reduce cerebral O2consumption in patients undergoing radical operation for gastric cancer.

Objective To explore the effects of selective external biliary drainage (SEBD) on the liver function of rats with obstructive jaundice. Methods The rates of right hepatic lobe weight against body weight of SD rats in SEBD group and total external biliary drainage (TEBD) group were calculated at day 0, 1, 4, 7, 10 after external biliary drainage. The mRNA and protein expressions of multidrug resistance-associated protein 2 (MRP2) and bile salt export pump (BSEP) were detected by RT-PCR and Western blot. Results Compared with TEBD group, the rate of right hepatic lobe weight against body weight and mRNA and protein expression of MRP2 and BSEP were significantly higher in SEBD group (t=15.569, P <0.05 ; t =4.485, 7.143, 9.169, 5.178, P <0.05). Conclusions SEBD improves the liver function of rats with obstructive jaundice, which may be related to the compensatory increase of remnant liver volume and elevation of expression per volume of membrane transport proteins.

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.