Objective To investigate the effect of ropiyacaine combined with intra-spinal epidural anesthesia by using the same volume but different injection speed on anaesthetic level.Methods 80 cases of patients of ASA～Ⅱdegree suitable to use intra-spinal epidural combined anesthesia for gynecologic operation were selected and ran- domly divided into three groups,0.75 % ropivacaine 2mg(15mg)administered,group A the speed of injection was 10 seconds,group B injection speed was 20 seconds,group C injection speed was 30 seconds,the anaesthetic level reached T_(10).The time of highest level in spinal anesthesia,30 minutes after spinal anesthesia MAP,and number of cases need to add epidural drug were all recorded.Results The best effect of anesthesia was found in group B,the block level of anesthesia was satisfactory,blood dynamic was stable,and there was no need to add epidural drug.Conclusion The speed of 0.75 % ropivacaine 2ml spinal epidural combined with anesthesia was suitable at the speed of 20 seconds.

OBJECTIVETo study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.

METHODSFrom February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).

CONCLUSIONTreatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery

AIM:Targeting of focal adhesion kinase (FAK) gene,we aim to construct FAK shRNA lentiviral vector and to identify its function on the growth of leukemic cells.METHODS:FAK shRNA was chemically synthesized,and inserted into a GFP-lentiviral plasmid through molecular biology methods.After packaged and concentrated,the lentiviral-FAK-shRNA-vector was transduced into a human leukemic cell line.FAK gene expression was detected by reverse transcriptional PCR and Western blotting.Cell apoptosis was measured by Annexin V labeling.RESULTS:The results showed that FAK shRNA was successfully inserted into the lentival vector,and the infection efficiency varied from 10% to 25%.Compared to the control vector (lentival vector without FAK shRNA),FAK shRNA inhibited the expression of FAK mRNA and protein by 40% and 70%,respectively.Moreover,the results of apoptosis experiment showed that the percentages of Annexin V+ cells in control vector group and FAK shRNA group were (4.19 ? 0.36) % and (8.48 ? 0.58) % respectively,the difference was statistically significant (P

OBJECTIVETo investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs).

METHODSOne hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared.

RESULTSThe aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P <0.001). DIS was lower and SI was higher in IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P <0.001). Similar results were obtained when the aortic elasticity index were adjusted for body surface area and body mass index.

CONCLUSIONAbnormal aortic elasticity is a common finding in IAs patients and hypertension is closely related to the severity of aortic elasticity.

Adult ; Aged ; Aorta ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Elasticity ; Female ; Humans ; Intracranial Aneurysm ; physiopathology ; Male ; Middle Aged ; Ultrasonography

OBJECTIVETo evaluate the effects of cervical vertebrae degeneration on traumatic cervical cord injury.

METHODSFrom January 2009 to December 2010, 24 patients with cervical cord injury without obvious fractures and dislocations were treated with operation, and their data were retrospectively analyzed. Among them, 16 males and 8 females, aged from 46 to 70 years old with an average of 59.1 years. Patients were divided into light degeneration group (6 cases), moderate degeneration group (10 cases) and severe degeneration group (8 cases), according to the preoperative degenerative degree of cervical vertebrae. Preoperative neurological dysfunction and postoperative neurological recovery were compared according to the JOA scores of Japanese Orthopaedic Society; quality of life were evaluated according to SF-36 scale (36-item Short Form Health Survey, SF-36).

RESULTSAll patients were followed up from 4 to 16 months with an average of 12 months. The JOA score of light, moderate, severe degeneration group were 12.1 +/- 1.5, 10.3 +/- 1.8, 7.3 +/- 1.0, respectively; and were respectively increased to 16.3 +/- 1.0, 15.3 +/- 1.4, 13.0 +/- 2.3 at the 3 months after operation. Postoperative JOA score showed the improvement rate of mid-long-term neurological level was light degeneration group (89.8%) > moderate degeneration group (76.6%) > severe degeneration group (58.8%). The results of preoperative SF-36 scale showed light degeneration group > moderate degeneration group > severe degeneration group; there was significant difference in comparison of two groups (P < 0.05 ).

CONCLUSIONCervical degeneration is an important pathologic basis and risk factor in traumatic cervical cord injury, and the degenerative degree will directly influence the injury degree and prognosis of neurological function, the clinical relationship between them should be sufficiently paid attention to.

Aged ; Cervical Vertebrae ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Injuries ; surgery ; Spinal Diseases ; complications

OBJECTIVETo evaluate the efficacy and the feasibility of bending rod reduction in situ technique in treating low lumbar burst fracture.

METHODSFrom March 2007 to June 2009, 21 patients with low lumbar burst fracture were retrospectively analyzed, 11 cases were in L3,6 in L4 and 4 in L5. There were 16 males and 5 females, ranging in age from 25 to 59 year with an average of 37.9 years. According to ASIA classification, nerve function was level A in 2 cases, level B in 2, level C in 10, level D in 4 and level E in 3. Pedicle screws were implanted and bending rod reduction in situ technique was applied through posterior approach. Radiographic and neurological scores were compared before and after operation.

RESULTSAll patients were followed up from 12 to 39 months with an average of 16.5 months. Radiographic examinations demonstrated that anterior height of fractured vertebral body was from 57.9% preoperatively to 94.1% postoperatively (P < 0.01 ); sagittal index was from 29.1 preoperatively to 0.240 postoperatively (P < 0.01). Spinal canal occupation ratio was from 49.6% preoperatively to 13.4% postoperatively (P < 0.01). Nerve function was level A in 2 cases,level B in 0, level C in 0, level D in 4 and level E in 15.

CONCLUSIONBending rod in situ technique could achieve 3-column reduction in 3-dimentionally at the same time, and reconstruct the stability of low lumbar.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery

OBJECTIVETo investigate the therapeutic efficiency of antiviral treatment with pegylated-interferon (Peg-IFN) for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) and to explore whether liver histopathological features or other factors influence the HBeAg seroconversion treatment response.

METHODSEighty HBeAg-positive CHB patients with diagnosis confirmed by liver puncture were treated with Peg-IFN(2a or 2b)body weight dose, once weekly). At treatment week 48, the rate of HBeAg seroconversion was determined and used to analyze the influence of liver histopathological features (liver biopsy assessment of: inflammation, graded G0 to G4; fibrosis stage, graded S0 to S4), sex, age, differential levels (pre-treatment baseline vs. week 48 post-treatment) of serum alanine transferase (ALT), and HBV DNA, by binary logistic analysis.

RESULTSAt week 48, the overall rate of HBeAg seroconversion was 30.0%. The rate of HBeAg seroconversion gradually advanced with increased liver inflammation (X2 = 8.435, P = 0.015): 9.09% of the 22 patients with G1; 31.58% of the 38 patients with G2; 47.30% of the 19 patients with G3; the one patient with G4. In contrast, the rate of HBeAg seroconversion showed a much weaker association with liver fibrosis (X2 = 5.917, P = 0.116). Only baseline HBeAg level, and no other baseline index, was significantly different between the patients who achieved HBeAg seroconversion and those who did not. Liver inflammation and baseline HBeAg level were identified as influencing factors of HbeAg seroconversion in response to Peg-IFN treatment.

CONCLUSIONPeg-IFN therapy induces a higher rate of HBeAg seroconversion in HBeAg-positive CHB patients with severe liver inflammation; histological analysis of pre-treatment liver biopsies may help to identify patients most likely to benefit from the antiviral regimen.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; pathology ; Humans ; Interferon-alpha ; therapeutic use ; Liver ; pathology ; Male ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Serologic Tests

Objective To observe the effects of Xingbi Wenmin Gel on serum levels of IL-4, TGF-β1 and nasal mucosa eosinophils (EOS) in allergic rhinitis (AR) rats; To discuss its mechanism of action. Methods Intraperitoneal injection of egg albumin and aluminum hydroxide based sensitized to ovalbumin challenge 2％ local AR model was established successfully. The experimental rats were randomly divided into normal group, model group, positive control group, and Xingbi Gel low-, medium-, and high-dosage groups. Each medication group was given relevant medicine for intervention. The rat symptom scores in each group were compared, and serum IL-4, TGF-β1, and nasal mucosa EOS counts were detected. Results Compared with the normal group, the serum levels of IL-4 and TGF-β1 in model group increased significantly (P<0.01), and the nasal mucosa EOS counts increased significantly (P<0.05). Compared with model group, the serum levels of IL-4 and TGF-β1 in Xingbi Gel medium-dosage group and positive control group decreased significantly (P<0.01), and the nasal mucosa EOS counts decreased significantly (P<0.05). Conclusion Xingbi Wenmin Gel may be effective through down-regulation of IL-4, TGF-β1 levels of inflammatory factors, and reduction of EOS infiltration in nasal mucosa.

OBJECTIVETo understand the predictive value of early monitoring BCR-ABL transcripts in patients with chronic myeloid leukemia (CML) after treatment with tyrosine kinase inhibitor (TKI), and to provides the information for early assessment of prognosis and treatment options.

METHODSBCR-ABL transcripts of 53 CML patients before and after TKI treatment were detected by using real-time quantitative RT-PCR. The relationship between BCR-ABL transcripts level after TKI treatment for 3 months and the later molecular response, progression and mutation was analyzed.

RESULTSThe median values of BCR-ABL transcripts in peripheral blood samples from 30 newly diagnosed patients were 43.99%, which was used as a baseline of BCR-ABL transcripts for molecular response evaluation. Of 53 patients, 31 (58.49%) had a BCR-ABL mRNA ≤ 4.40% (reduced more than 1 log) and 22 (41.51%) greater than 4.40% (reduced to less than 1 log) after 3 months of TKI treatment. The former 31 patients had a significantly higher 18-months cumulative incidence of major molecular response (MMR) (90.32% vs 18.18%, P=0.000) and 3-year cumulative incidence of complete molecular response (CMR) (48.39% vs 0, P=0.000) compared with the latter 22 patients. The lower BCR-ABL level was, the earlier MMR reached. The proportion of patients with a mutation in group of BCR-ABL mRNA>4.40% was significantly higher than that of BCR-ABL mRNA ≤ 4.40% (22.73% vs 0, P=0.021). The incidence of progression increased in group of BCR-ABL mRNA>4.40%, but the difference was not statistically significant (P=0.052).

CONCLUSIONIt is important for the prognosis evaluation of the patients to monitor the level of BCR-ABL transcripts at 3 months after TKI treatment, which might help to early optimization of treatment and to improve curative effect of CML patients.

Adult ; Aged ; Female ; Fusion Proteins, bcr-abl ; blood ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; drug therapy ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Protein Kinase Inhibitors ; therapeutic use ; RNA, Messenger ; genetics ; Treatment Outcome ; Young Adult

The ICR(Institute of Cancer Research)mouse infection model was constructed to study the pathogenicity of Sal-monella Telelkebir serotype,and the pathogenic identification of mouse isolates was carried out.Observe the bacterial excretion cycle,evaluate the pathogenicity of Salmonella serotype to mice,and calculate the LD50 by the changes in clinical characteris-tics,histopathology and tissue bacterial load of infected mice;by flight mass spectrometry,biochemical identification,serotype identification,molecular typing and other experiments,compared with human isolates;virulence gene analysis was carried out by PCR experiment and whole genome sequencing.The LD50 of Salmonella Telelkebir is 2.67 × 108 CFU/mL;curling and fluffing may occur 0.5 h after infection;autopsy of dead mice showed that the small intestine was severely congested,with more bubbles and fluid accumulation,cecal necrosis,liver apical degeneration and necrosis,necrotic foci on the surface of the kidney and spleen atrophy;the bacterial load of spleen,kidney,lung,liver and jejunum in mice reached its peak at 3 days after infection,while that of heart at 6 days;the bacterial excretion time of the high-dose group exceeded 100 days;The level of CD3 in tissues increased with increasing dose,with inflammatory cell infiltration,myocardial capillary dilation and hyperemia,large area of vacuoles,degeneration and necrosis of hepatocytes,obvious enlargement of splenic sinus,blurred zoning,thickening of glomerular basement membrane,partial exfoliation of ciliated epithelium,atrophy and exfoliation of jejunal villi;PCR and whole genome sequencing revealed Salmonella-related virulence genes such as cdtB,plt A and pltB.This study was the first to successfully establish the ICR mouse model of Salmonella Telelkebir,demonstrating that this serotype of Salmonella has some pathogenicity.