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

Objective To investigate the distribution and sequence conservation of Hap adhensin encoding gene (hap) in clinical isolates of nontypeable Haemophilus influenzae (NTHi), to screen out and identify the predominant T-and B-cell (T-B) combined antigenic epitopes on Hap protein and to analyze their immunogenicity.Methods Sequence conservation of hap genes in NTHi strains and T-B combined antigenic epitopes were predicted using bioinformatic softwares.PCR was used to amplify the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap gene (hap-5′-156 and hap-3′-855) and the amplified products were sequenced.Phage display systems of seven T-B combined antigenic epitopes located on the 55 aa segment at N-terminal and the 285 aa segment at C-terminal of Hap protein (Hap-N52 and Hap-C285) were constructed.Western blot assay and ELISA were performed to detect the antigenicity and immunoreactivity of different T-B combined epitopes displayed by recombinant phage PⅢ protein (rPⅢ).Results Hap protein encoded by the hap gene in NTHi was located on membrane surface.Sequences of the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap genes extracted from different NTHi strains were relatively conservative, but many mutations were found in sequences at the middle regions of these hap genes.All of the 56 NTHi strains carried hap-5′-156 and hap-3′-855 segments and shared 92.3％-100％ identities in nucleotide and amino acid sequences of these segements.Hap-N5-24 in the Hap-N52 segment as well as Hap-C4-27, Hap-C28-47, Hap-C114-129, Hap-C150-173, Hap-C200-227 and Hap-C241-267 in the Hap-C285 segment was predicted as the T-B combined antigenic epitope with a higher score and less mutations.Results of Western blot assay and ELISA confirmed that the rPⅢ-displayed Hap-C4-27 and Hap-C150-173 epitopes presented clear hybridization bands with NTHi antisera, and 96.9％ (63/65) and 92.3％ (60/65) of serum samples from children with NTHi infection were positive for antibodies against Hap-C4-27 and Hap-C150-173 epitopes, respectively.Conclusion The gene of hap is widely distributed in clinical isolates of NTHi.Moreover, sequences of the 156 pb segment at 5′-end and the 855 bp segment at 3′-end of hap gene are conservative.Hap-C4-27 and Hap-C150-173 are the predominant T-B combined antigenic epitopes on Hap protein, suggesting that they can be used as epitope candidates for developing multiple antigenic peptide vaccines against NTHi.

Objective To analyze the clinical characteristics of children with knee joint diseases and discuss the curative effect of arthroscopy.Methods Eighty-nine children with knee joint diseases in Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical University from October 2012 to October 2015 were selected,and they were given knee arthroscopic surgery according to the disease types and characteristics,such as meniscal suture,suture plus angioplasty and synovectomy etc.All the symptoms,signs and the joint functions were recorded preoperatively and postoperatively.At the end of follow-up,surgical results were analyzed according to Lysholm score and International Knee Documentation Committee Knee evaluation form (IKDC) classification standard.Results The patients with discoid meniscus tear were the most,accounting for 55.55％ (55/99 knees).All patients were followed up for 6-30 months(the average time was 21 months) to find that all symptoms were relieved or disappeared within 1 year after operation.The outcome was evaluated according to the Tegner knee function:76 knees (76.76％) were markedly effective,16 knees (16.16％) were effective,6 knees (6.06％) were invalid and 1 knee (1.01％) was poor,and the excellent rate was 92.92％.The curative effect was evaluated according to Lysholm knee function score and IKDC score at the last follow-up.The Lysholm score in preoperation [(52.46 ± 4.79) scores] improved to (96.52 ± 3.97) scores in postoperation,and the difference was significant (t =-36.24,P ＜ 0.05);the IKDC score in preoperation [(46.52 ± 10.25) scores] improved to (90.67-± 5.89) scores in postoperation,and the difference was significant (t =-50.69,P ＜ 0.05).There was no joint infection,blood vessel or nerve damage and so on.Conclusions Meniscus tear is common in children with knee joint diseases,and most common is discoid lateral meniscus tear,and arthroscopy can have satisfactory outcome,with no obvious complications.Therefore,arthroscopic surgery is an ideal method for surgical treatment of children with knee joint disease.

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 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.

ObjectiveTo explore the relationship between fat content of postmenopausal osteoporosis patients and bone mineral density (BMD).Methods144 female osteoporotic patients with the age of 50～75 years were choosen from guangdong province from October 2010 to January 2011.According to TCM syndrome differentiations,these patients were divided into kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group and Qi stagnancy and blood stasis group.Four groups of patients were performed total body fat content detection.The data were analyzed by software SPSS 16.0.ResultsComparing of L1～4 average BMD in four groups showed:BMD of Kidney Yang deficiency group was maximum,followed by spleen and kidney Yang deficiency group,and the BMD of Qi stagnancy and blood stasis group was minimum.Comparison between the four groups showed statistical significance (P＜0.05).Comparing of body fat content Iin the four groups showed:the body fat content in the kidney Yang deficiency group was minimum,followed by spleen and kidney Yang deficiency group,and body fat content in Qi stagnancy and blood stasis group was maximum.Pair-comparison in kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group showed no statistical significance (P＞0.05).While these three groups showed statistical difference when comparing with Qi stagnancy and blood stasis group (P＜0.05).The body fat content and L1～4 average BMD had negative correlation.ConclusionOsteoporosis in Qi stagnancy and blood stasis group was more serious than the other three other groups.Fat content was negatively related with bone density.

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.