Objective To explore indications, ablated targets, efficacy and complications of microelectrode-guided thalamotomy and pallidotomy for treating Parkinson's disease(PD). Methods The clinical date of 225 PD patients underwent microelectrode guided thalamotomy and/or pallidotomg were retrospectively analyzed with UPDRS scores. Results The outcome of operation was excellent.The rate of improvement for tremor, rigidity, gait, balance and bradykinesia were 98 0%, 89 0%, 72 8%, 70 5% and 47 8% respectively. Postoperative motor UPDRS scores of both "on"/"off"states significantly decreased by 54 4% and 62 6% respectively. The frequency of post-operative complications was such as the following: bleeding caused by puncturing (0 48%),transient hiccup(6 7%), temporary dysarthria(5 5%), transient somnolence(10 0%) and mental disorder(4 5%). There were no severe and permanent complications. Conclusions The thalamotomy and/or pallidotomy guided by the microelectrode were the effective and safe method for treatment of PD, but the indications of this surgery should be well familiarize. The ablated target selection and its precise localization were of key importance for a better outcome.

OBJECTIVE:To provide recommendation for the clinic on the optimal application concentration of potassium permanganate collyria.METHODS:3different concentrations of potassium permanganate collyria were prepared,the local ir-ritation of2of which on eyes of115conjunctivitis cases receiving conjunctival sac irrigation and the effects of the3different concentrations of potassium permanganate collyria on the comfort degree,corneal epithelium and bacterial colonies before and after eye irrigation of18pairs of oculus normalis receiving conjunctival sac irrigation were observed.RESULTS:Of the total115conjunctivitis cases,98(about85%)complained to have severe irritation;8cases(about7%)felt unbearable because of the strong irritation.Degree of comfort decreased with the elevation of concentration of collyria,while failed to have any effect on corneal epithelium and the numbers of bacterial colonies before and after irrigation.CONCLUSION:The recommended concentration of100ml∶1.5mg of potassium permanganate collyria for the irrigation of conjunctival sac in the clinic.

【Objective】 The characteristics of syndrome patterns of osteoporosis(OP) in traditional Chinese medicine (TCM) were investigated by cluster analysis,thus to supply evidences for the prevention and treatment of OP.【Methods】The data of 246 OP patients collected by four diagnostic methods were classified into items by cluster analysis.Thenthe principal component analysis was usedtosummarizethe TCMsyndrome patters of OPbyanalyzing the representativeness of eachitem.【Results】Forty-sevenitems were obtained after cluster analysis,andtheitems of short of breath withreluctancetotalk,lassitude and weakness,soreness of thelower back,white coating,vertigo,pale and enlargedtongue had a higher incidences.Whenthe items of OP were classified into four patterns of deficiency of liver and kidney yin,deficiency of spleen and kidney yang,deficiency of Qi and blood,and Qi stagnation and blood stasis,the patterns distribution was clear and had a good representiveness.The patterns of deficiency of liver and kidney yin,and deficiency of spleen and kidney yang had higher incidences of 34.7 %and 30.1 %respectively.【Conclusion】OP classifiedintofour patterns of deficiency of liver and kidney yin,deficiency of spleen and kidney yang,deficiency of Qi and blood,and Qi stagnation and blood stasis is practical in clinic,and most of OPpatients have the manifestations of kidney deficiency.

OBJECTIVE: To investigate the clinical features and medication of unilateral idiopathic vocal fold paralysis. METHOD: Thirty-nine of medical treated patients with unilateral idiopathic vocal fold paralysis were retrospectively studied, and relevant literatures were reviewed. RESULT: After 4 to 19 days of medical therapy, 9 patients were cured, the vocal fold movement of 18 sufferers were improved, and 12 pantients were not healed. CONCLUSION Unilateral idiopathic vocal fold paralysis is common, and the treatment efficacy of medicine is almost the same with others. Unilateral idiopathic vocal fold paralysis is a disease with spontaneous recovery, which should be followed up.
Humans ; Retrospective Studies ; Treatment Outcome ; Vocal Cord Paralysis ; drug therapy ; Vocal Cords ; physiopathology

ObjectiveTo evaluate the effect and safety d sorafenib in treatment of patients with metastatic renal cell carcinoma.Methods40 patients with metastatic renal cell carcinoma,were given sorafenib tablets methanesulfonate treatment,the initial dose of 800mg/d,bid,continuous administration of 21d,stopping 7d,The adverse reactions,efficacy and immunohistochemistry results were observed.Results40 cases with metastatic renal cell carcinoma were not found complete remission (CR) and partial remission (PR) ; The 32 cases in stable disease (SD)(80.0％ ) and 8 cases ( 20.0％ ) in PD; The incidence of 28 cases ( 70.0％ ) in digestive system; The expression of positive rate 30.5％ of local in connexin 32,Cx32 was significantly lower than that 1.2％ in metastatic renal cell carcinoma( x2 =8.123,P ＜0.01 ),The expression of Cx32 was negatively correlated with the clinical stage( r =-0.419,P ＜0.05 ) ;The expression positive rate of vascular endothelial growth factor(VEGF) in renal cell carcinoma was significantly higher than 18.5％ in normal renal tissue( x2 =8.723,P ＜ 0.01 ) ; The expression positive rate 72.0％ in the limitations of renal cell carcinoma and metastatic renal cell carcinoma 89.1％ was not statistically significant( x2 =1.978,P ＞ 0.05 ).ConclusionSorafenibin for advanced kidney cancer had better disease control effect,and was new choice for treatment of metastatic renal cell carcinoma.

Objective To compare the efficacy of minimally invasive pereutaneous nephrosomy for complicated renal calculi between holimium laser hthotfipsy and ultrasonic lithotripsy.Methods 120 patients with renal calculi according to the different treatment methods,were divided into holimium laser lithotfipsy group 60 cases(group A)and tdtrasonic lithotripsy group 60 cases(group B).The index of operative time、hemoglobin drop blood transfusion rate、postoperative hospital stay、stone clearance rate were observed.Results Operative time(60.8±16.4)min,postoperative hospital stay(7.5±2.0)d in group A were shorter than[(80.5±18.5)min,(9.5±2.5)d]in group B (t=2.328,2.240,all P＜O.05);Hemoglobin decline(5.0%)in group A was lower than the(9.0%)in group B (x2=3.89,P＜0.05);Calculi clearance rate(81.7%)in the B group was highter than that(61.6%)in group B (x2=3.98,P＜0.05);Complication incidence of postoperative 10.O%in group A compared with group B 13.3%had no significant difference(x2=1.56,P＞0.05).Conclusion Percutaneous nephrostomy with ultrasonic lithotripter for complicated renal calculi had the advantages of mini-invasion,less operative time,less bleeding,and faster clearance calculi efficiency compared with laser lithotripsy.

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

ObjectiveTo evaluate the effects of exercise training on bone histomorphometry of ovariectomized rats.Methods46 SD rats were randomly divided into the normal control group (group A), ovariectomized group (group B) , estrogen supplement group (group C) and exercise training group (group D). The rats of group A had a sham operation, while that of other groups was ovariectomized. 3 months after operation, the rats had been treated for 3 months. The rats of group C were given estradiol, and the rats of group D were trained by exercise. The tibia sections were studied by histomorphometric analysis.ResultsThe values of the trabeclar area, trabeclar area%, trabeclar perimeter and trabeclar number of group D were significantly higher than that of group B. The values of the trabeclar separation, osteoclast number/mm2 and osteoclast number/mm of group D were the least in all groups, which had been ovariectomized. The values of the labeled perimeter % mineral apposition rate, bone formation rate of group D were superior to that of all groups.ConclusionThe exercise training can increase bone mass of ovariectomized rats, which had double effects of promoting bone formation and restraining bone absorption.

Objective To evaluate experience for early diagnosis of pulmonary tembolism alter thoracic injury or surgery. Methods The 9 patients after thoracic injury or surgery with highly-suspected pulmonary embolism underwent chest radiograph of X-ray, helical CT pulmonary angiography, electrocardiogram, radionuclide pulmonary ventilation perfusion imaging, D dimer assay and arterial blood gas analysis respectively and the clinic data and results were analyzed. Results All patients were diagnosed and recovered after 8 patients received thrombolytic therapy and another patient received anticoagulant therapy. Conclusion If there were some symptoms such as suddenly severe dyspnea, cyanosis, with/without chest pains and the feeling of fear to death unable to be explained by original disease on those patients alter thoracic injury or surgery, it's very important for pulmonary embolism to be recognized, and early diagnosis and quickly efficient treatment is the key to prevent death. Helical CT pulmonary angiography is a safe, cheap, noninvasive and effective method for the diagnosis of pulmonary embolism with high sensitivity and specificity.

BACKGROUND: Inappropriate size of tibia prosthesis wil affect the stability and long term curative effect of knee joint. Raising the tibia prosthesis bone coverage through preoperative analysis may further reduce the incidence of loosing and sinking of tibia prosthesis. OBJECTIVE: To select the appropriate prosthesis and maximize the tibia prosthesis bone coverage rate through the three dimensional reconstruction of CT and preoperative tibia osteotomy simulation among the patients preliminarily treated with total knee arthroplasty. METHODS: Total y 76 (84 knees) patients treated with total knee arthroplasty were enrol ed and randomly divided into test group (38 cases, 41 knees) and control group (38 cases, 43 knees). Al the patients in the test group were underwent CT scan and three-dimensional reconstruction of CT before operation. Preoperative tibia osteotomy was stimulated. The most appropriate tibia prosthesis was selected by comparatively analyzing the data of tibia osteotomy, and maximizing the tibial plateau prosthesis bone coverage. Three-dimensional reconstruction of CT was absence in the control group by contrast. Tibia plateau bone coverage of patients in these two groups after replacement was evaluated. The repair effect was evaluated during the fol ow-up. RESULTS AND CONCLUSION: Total y 75 patients were fol owed up for 13 to 56 months. One patient in the test group withdrew from the study because of periprosthetic fractures. Analyzing from the fol ow-up after replacement, tibia plateau prosthesis coverage rates of test group and control group were (89.87±4.14)%, (83.15±5.21)%respectively; New York Hospital for Special Surgery scores were respectively (87.48±8.69) points and (82.37±10.14) points, the difference was statistical y significant (P < 0.05). However, there were no significant differences in the range of motion and postoperative complications between test and control groups (P > 0.05). These results suggest that choosing the most appropriate type of tibia prosthesis by applying three-dimensional reconstruction of CT and preoperative tibia osteotomy on patients treated with total knee arthroplasty can improve tibial plateau prosthesis bone coverage rate and is conductive to achieve a satisfactory repair effect.