BACKGROUND: Low-frequency ultrasound combined with Tongluo Zhitong herbs can effectively relieve pain and improve joint function of patients with osteoarthritis, but the underlying mechanisms are still unclear.OBJECTIVE: To investigate the effects of low-frequency ultrasound combined with Tongluo Zhitong herbs on urokinase-type plasminogen activator (uPA) and inflammatory cytokines of osteoarthritis rabbits and the related mechanisms.METHODS: Forty rabbits were randomly divided into four groups: normal, model, control, and experimental groups. The normal group was treated with normal feeding, not for any processing. For the other three groups, papain was injected into the rabbit knee articular cavity to establish osteoarthritis models. One week later, the experimental group was treated with low frequency ultrasound combined with Tongluo Zhitong herbs for 3 weeks, the control group treated with the same volume of normal saline, and the model group received no intervention. The levels of inflammatory cytokines in the serum and synovial fluid were measured, the histological changes of synovial tissues and articular cartilage were evaluated using Mankin's score, and the expression levels of uPA and its receptor were determined by western blot assay.RESULTS AND CONCLUSION: The levels of inflammatory cytokines in the model group were significantly higher than those in the normal and experimental groups (P < 0.05). The Mankin's scores of synovial tissue in the experimental group were significantly lower than those in the model and control groups (P < 0.05), while Mankin's scores of the cartilage tissue had no significant difference between the experimental and model groups (P > 0.05). Compared with the model group, in the experimental group, the expression levels of uPA and its receptor were significantly downregulated,and the expression of uPA inhibitor was notably upregulated. These data show that low-frequency ultrasound combined with Tongluo Zhitong herbs attenuates inflammatory reaction in the synovial tissues, by inhibiting the formation of joint fluid and production of inflammatory cytokines, which is an effective treatment for knee osteoarthritis.

One hundred patients with type 2 diabetic neuropathy were divided into L-carnitine group and control group with 50 eases in each group. Data showed significant improvements in clinical symptoms scores, visual analogue scale and quantitative sense test after 16-week L-earnitine treatment (all P < 0.05). The study demonstrates that L-earnitine has affirmative effect on patients with diabetic neuropathy, especially in alleviating pain.

Objective To evaluate and compare the clinical outcomes of concurrent chemoradiotherapy with different radiation doses for esophageal carcinoma. Methods 78 cases of esophageal carcinoma receiving primary definitive treatment in our department between May 1 , 2005 to June 31 2007 were analyzed retrospectively. The patients with esophageal carcinoma were divided into high- ( > 50 Gy, median dose of 64 Gy) and low-dose (50 Gy) groups according to their prescription doses (n = 35, 43, respectively). Chemotherapy regimen consisted of cisplatin (75 mg/m2, d1) and 5-FU (500 ~ 600 mg/m2, D2 ~ 5) starting at days 1, 28, 49 and 70 after the beginning of radiotherapy with 2 ~ 4 cycles. The two groups were compared in terms of the early treatment outcomes, the side effects and survival rates. Results The 1,3 and 5-year survival rates for the high and low dose groups were 71.4%, 34.3%, 25.7%and 76.7%, 41.9%, 30.2%, respectively. The median survival time was 19 and 22 months respectively without statistical difference. The high dose group was more likely to have higher incidence rate of grade Ⅲ to Ⅳ myelosuppression in spite of the statistical difference. The high dose group had significantly higher incidence of esophagitis than did the low dose group (P=0.040). Conclusion For esophageal carcinoma with only indications of concurrent chemoradiotherapy, te low dose radiation (50 Gy) has comparable outcomes and less side effects compared with the high dose radiation (>50 Gy).

Objective To evaluate the concept of artery first and total mesopancreatic excision in radical resection of pancreatic head carcinoma through both anterior and posterior approaches.Method The anterior approach was to identify the superior mesenteric artery (SMA) and the posterior approach to confirm the possibility of negative margin at the origin of SMA,on the posterio-lateral vascular wall of superior mesenteric vein (SMV) and the supposed posterior of the mesopancreas.The resection scope were with the celiac trunk and common hepatic artery as the upper boarder,the SMA as the left boarder,the inferior mesenteric vein (IMA) level as the lower boarder,to achieve a complete mesopancreatic excision,namely the en bloc resection of all the involved nerve,the lymph tissue and vascular tissue along the right side of the axial composed by SMA and celiac trunk.Results Of the 15 patients,11 had radical Whipple procedure,among which 2 had a combining SMV resection and reconstruction.1 case suffered from delayed gastric emptying and 2 cases from bile leakage.There was no mortality.The postoperative pathology reported carcinoma in all 11 cases,with duodenum and low bile duct involved in 4 cases,with the duodenum involved in 6 cases,no surrounding tissue involvement was identified in 1 case.Nerve involvement was found in 7 (7/11),vascular involvement in 10 (10/11),and lymphnode metastasis was (2.5 ± 3.8/12.9 ± 4.9).Conclusions The radical resection of pancreatic head carcinoma using the concept of artery first and the total mesopancreatic excision is helpful for an early evaluation of the possibility of radical resection and guarantees negative margins.

Objective To investigate the pathogenesis of gallbladder chaotic dynamics after partial gastrec-tomy. Methods 140 cases operated by partial gastrectomy after 6 months were randomly examined, they in-cluded one group of 40 cases by Billroth type and the other 100 cases by Eiselsberg type. The ultrasonograph was applied to evaluate the function of gallbladder dynamics and radio-immunity method to determine the content of CCK at the time of having no food and 30 minutes after med. Results BV and RV of Eiselsberg group were bigger than Billroth Ⅰ obviously P<0.05. Gallbladder contraction rate displayed not well obvi-ously as too. The plasm level of CCK had no manifested distinctions in empty stomach cases of the 2 groups, but the increasing gradient plasm level of CCK in Billroth Ⅰ exceeded Eiselsberg type. Conclusions The pathogenesis of gallbladder chaotic dynamics after partial gastrectomy was correlated with the alterative type of partial gastrectomy, the reduction of CCK plasm level, the damage of anterior vagal trunk hepatic branches during the operations and so on led to the disorder of gallbladder emptying and induced cholecystolithiasis.

Objective To summarize the experience of diagnosis and treatment for peripancreatic pseudoanemysms.Methods The clinical data of 12 patients with peripancreatic pseudoaneurysm were analyzed retrospectively.Out of 12 patients,6 presented with abdominal or alimentary tract bleeding because of pseudoaneurysm rupture.Possible etiology included chronic pancreatitis (6 cases),severe acute pancreatitis (3 cases),postpancreatoduedenectomy (3 cases),developed after transarterial chemoembolisition for hepatic carcinoma (1 case) and 1 without any definitive cause.Results Interventional radiology as first therapeutic procedure was carried out in 10 patients including 9 endovascular coil embolizations and 1 stent graft placement for pseudoaneurysm from branch of SMA,and bleeding was controlled successfully in 5 patients with pseudoaneurysm rupture.2 patients underwent laparotomy as initial therapy.Three patients underwent surgeries after a failed embolisation,another underwent laparotomy and peritoneal lavage and drainage for pancreaticoenteric anastomotic leak complicated with abdominal infection.2 SAP patients underwent ultrasound guided drainage for peripancreatic abscess.2 after PD patients died,with mortality of 16.7％ (2/12).Conclusions Peripancreatic pseudoaneurysm carried a high and an unpredictable risk of rupture that warranted prompt interventional treatment or surgery.

0.05).After the EN,the level of blood total protein,albumin and prealbumin significantly increased(P

Objective To compare the bleeding volume during endoscopic sinus surgery in pa-tients with hypertension under total intravenous anesthesia or combination of intravenous with inhaled anesthesia.Methods Forty adult patients with hypertension (ASA Ⅰ or Ⅱ),male 25 and female 1 5,aged 35-54 years,agreed to be on electively endoscopic sinus surgery,were divided randomly into two groups(group A and group B,n =20 each).All patients were injected intravenously with fenta-nyl,propofol and cisatracurium during the induction of general anesthesia.During the maintenance stage of the general anesthesia,patients in group A were injected intravenously with propofol,and patients in group B were inhaled with sevoflurane until 5 minutes before the end of the operation.BIS was 40-60 during the operation in the two groups.After induction of anesthesia and tracheal intubation,ni-troglycerin and esmolol were given to adjust blood pressure and hypervolemic hemodilution was performed.. Bleeding volume and operation duration were recorded at the end of the operation.The arterial blood gas, blood lactate and coagulation function were monitored 30 minutes before the operation (T0 ),30 minutes (T1 )and 90 minutes after the operation beginning (T2 )and 30 minutes after the end of the operation (T3 ). Results Bleeding volume in group A was significantly less than that in group B (P <0.05).Fifteen minutes before the operation,the MAP of all the patients in two groups was controlled slowly to 60 mm Hg.Com-pare to those at T0 ,there was no significant difference in the arterial blood pressure,blood lactate and coag-ulation function at T1 ,T2 and T3 .Conclusion During the endoscopic sinus surgery with intravenous anes-thesia for patients with hypertension,the bleeding volume was less than that with inhalation anesthesia.

Aged ; Angina Pectoris ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; drug therapy ; Phytotherapy ; Vasodilator Agents ; therapeutic use