Objective To determine the methods and results of treating traumatic pseudoaneurysms in siphon segment of internal carotid artery(ICA)by interventional therapy.Methods Twelve cases of traumatic pseudoaneurysms in siphon segment of internal carotid artery were treated.The collateral circulation of Willis circle was observed after DSA.Different methods of treatment were applied according to the collateral circulation of Willis circle.Ten cases were treated by occlusion of ICA completely,1 case was embolized by guglielmi detachable coil(GDC)only.Results Nine of 12 treated by occlusion of ICA were cured.In the 3 cases who had poor collateral of Willis circle,one was cured by GDC embolization alone;one died 48 hours later after ICA occlusion though his consciousness and the activity of extremities were normal during the temporary balloon test occlusion(BTO)of ICA.One died during the training to improve the collateral of the Willis circle.Conclusion ICA embolization is feasible for treatment of traumatic pseudoaneurysms in siphon segment of internal carotid artery after evaluating the collateral circulation of Willis circle.

A set of system for in vitro testing and analyzing the 3D motion in the cervical spine specimen before and after the ACP's (anterior cervical plates) implantation is introduced in this paper. Six porcine specimens with C3 - C6 mounted by the custom clamp were used to mimic human physiological cervical motions. A non-contact real-time measurement system based on CCD was used to track segmental cervical motion signals during the motion. A Matlab program based on multibody dynamics was processed to give the angle changes between adjacent vertebras during the motion. The experimental results show that the methodology can appraise the clinical properties of the ACP effectively.
Animals ; Biomechanical Phenomena ; Cervical Vertebrae ; physiology ; surgery ; Range of Motion, Articular ; physiology ; Spinal Fusion ; methods ; Swine ; Treatment Outcome

Objective To observe effect of arginine on wound healing of diabetic rats.Meth- ods Forty male Lewis rats were equally and randomly divided into diabetic group and normal control group.The diabetic group were rendered with diabetic by using intraperitoneal(IP)streptozotocin seven days prior to surgery and underwent a dorsal skin incision with implantation of polyvinyl-alcohol sponges. Either of two groups were subdivided into arginine treatment group and saline treatment group,10 rats in each group,of which the arginine treatment group received arginine at 1 g/kg per day by IP injection, while the saline treatment group received saline injection only.Animals were sacrificed 10 days post wound to observe antibreakage tension,hydroxyproline content and mRNA expression of procollagenⅠandⅢ.Results Diabetic wounds had greatly decreased breaking strengths compared with controls. Arginine significantly enhanced wound breaking strengths,increased wound hydroxyproline levels and ele- vated mRNA for procollagenⅠandⅢin both diabetic and control animals as compared to their saline-trea- ted counterparts.Conclusion Arginine can effectively promote healing of diabetic wounds in rats.

OBJECTIVETo evaluate the efficacy and safety of the combination therapy of tamsulosin and solifenacin for mild and moderate benign prostatic hyperplasia (BPH) with overactive bladder (OAB).

METHODSWe randomly divided 166 patients with BPH and concomitant OAB into a mild obstruction symptom group (n = 88) and a moderate obstruction symptom group (n =78), 48 of the former group treated with 0. 2 mg tamsulosin + 5 mg solifenacin and the other 40 with 0. 2 mg tamsulosin; 36 of the latter group treated with 0. 2 mg tamsulosin + 5 mg solifenacin and the other 42 with 0. 2 mg tamsulosin, all administered once daily for 12 weeks. We obtained the International Prostate Symptom Score (IPSS), urine storage period symptom score (USPSS), voiding symptom score (VSS), Qmax, residual urine volume, OAB symptom score (OABSS) and adverse reactions, and compared them among different

RESULTSAmong the patients with mild obstruction symptoms, the combination of tamsulosin and solifenacin achieved remark-groups. able improvement in IPSS, USPSS, Qmax and OABSS as compared with the baseline (P < 0.05), but made no significant difference in the residual urine volume (P > 0. 05) , while tamsulosin improved IPSS only (P < 0.05). The combination therapy exhibited an obvious superiority over tamsulosin alone in improving IPSS (9.7 micro 3.0 vs 15.8 micro 3.3), USPSS (8. 1 micro 1.7 vs 12.3 micro 3.1), Qmax ([18.6 micro 2.3] ml/s vs [14.2 micro 2.3] ml/s ), and OABSS (5.3micro 1.3 vs 9.7 micro 2.7) (P < 0.05), but there were no obvious differences in residual urine, urine routine test results and adverse events between the two therapies ( P > 0. 05). In those with moderate obstruction symptoms, the combination therapy significantly improved IPSS, VSS, Qmax and OABSS (P < 0.05) but not the residual urine (P > 0. 05) in comparison with the baseline. The tamsulosin therapy achieved obvious improvement in IPSS, VSS, Qmax, OABSS and residual urine. The combination therapy showed a better effect than tamsulosin only in OABSS (4. 8 +/-1.5 vs 6.5 +/-2.5, P < 0.05), but no significant differences from the latter in IPSS, Qmax, VSS, routine urine test results, and adverse

CONCLUSIONCombination therapy of tamsulosin and solifenacin is obviously safe and efficacious in the treatment (P > 0.05). events of both mild and moderate BPH with concomitant OAB, and it is superior to tamsulosin alone.

Aged ; Drug Therapy, Combination ; Humans ; Male ; Middle Aged ; Prospective Studies ; Prostatic Hyperplasia ; complications ; drug therapy ; Quinuclidines ; administration & dosage ; therapeutic use ; Solifenacin Succinate ; Sulfonamides ; administration & dosage ; therapeutic use ; Tetrahydroisoquinolines ; administration & dosage ; therapeutic use ; Urinary Bladder, Overactive ; complications ; drug therapy

OBJECTIVETo study the pathogenic bacteria of lower respiratory tract infection (LRTI), and age and gender distribution and drug resistance of the pathogenic bacteria in children.

METHODSSputum specimens for bacterial cultures were collected in sterile tubes from all of the children with LRTI who had been admitted to the Children's Hospital of Zhejiang University between August 2001 and July 2002. Antibiotic susceptibility tests were performed using the Vitek system, the Kirby-Bauer diffuse method and the Etest method after bacteria were identified.

RESULTSAmong the 4,238 patients with LRTI during the study period, 1,181 patients were bacteria-positive, with a positive rate of 27.9%. Streptococcus pneumoniae (S. pneumoniae) was the most common (222 strains), followed by Haemophilus influenzae (H. influenzae) (216 strains), Klebsiella pneumoniae (K. pneumoniae) (216 strains), Escherichia coil (E. coli) (169 strains) and Staphylococcus aureus (S. aureus) (89 strains). The isolation rate of S. pneumoniae in females was significantly higher than in males (6.2% vs 4.7%; P < 0.05). However, the isolation rates of K. pneumoniae and S. aureus in males were higher than in females (5.1% vs 4.1% and 2.5% vs 1.5%, respectively; P < 0.05). A higher incidence of LRTI due to S. pneumoniae and H. influenzae was found in the 1-3 years group, while the incidence of LRTI due to K. pneumoniae, E. coli, S. aureus and E. cloacae was higher in patients under 1 year of age. Antibiotic susceptibility tests showed that rates of penicillin non-susceptible S. pneumoniae, ampicillin resistant H. influenzae, oxacillin-resistant S. aureus and ESBL-positive K. pneumoniae and E. coli were 55.0%, 16.5%, 41.2%, 42.6% and 4.5%, respectively.

CONCLUSIONSS. pneumoniae, H. influenzae, K. pneumoniae, E. coli and S. aureus were common pathogens of LRTI in children. The infection rate varied with age and gender. Antibiotics for treating LRTI should be selected based on the drug susceptibility test.

Adolescent ; Bacteria ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Microbial Sensitivity Tests ; Respiratory Tract Infections ; microbiology ; Seasons

OBJECTIVE: To study the role of Haemophilus influenzae(Hi) in pneumonia and that of PCR in the diagnosis of Hi pneumonia. METHODS: Hi genus-specific PCR, Hib type-specific PCR and selective Hi culture media were used to detect 83 samples of deep nasal pharyngeal aspiration (NPA), 51 sera from 83 children younger than 3 years with pneumonia and 37 samples of pharyngeal swabs from healthy children. RESULTS: Of 83 NPA samples, 20(24.1 %) were positive by culture, 36 (43.4 %) positive by Hi-PCR and 19 (22.9 %) positive by Hib-PCR.Six out of 51 sera were positive by Hi-PCR and Hib-PCR, but none positive by culture. Of 37 pharyngeal swabs from healthy children, 3 ( 8.1 %) were positive by culture, 6 ( 16.2 %) positive by Hi-PCR and none positive by Hib-PCR. CONCLUSION: Hib-PCR is more appropriate for detecting NPA samples from children with pneumonia because of the high rate of non-typeable Hi carriers in healthy children.

Objective:To observe the impact of diabetes mellitus (DM)on pacing parameters and postoperative com-plications in patients With implantation of permanent artificial cardiac pacemaker.Methods:A total of 80 patients With sick sinus syndrome,Who received implantation of permanent artificial cardiac pacemaker from Jun 2008 to Jun 2011,Were enrolled.According to complicated With DM or not,they Were divided into DM group (n=40)and non-DM control group (n=40).Pacing parameters and postoperative complications Were compared betWeen tWo groups.Results:There Were no significant difference in atrial and ventricular pacing threshold,sensing and of pace-maker impedance in baseline betWeen tWo groups (P>0.05).All parameters of pacemaker increased in tWo groups after implantation 12 months;compared With non-DM control group,there Were significant increase in pacing threshold [atrial:(0.59±0.23)V vs.(0.67±0.25)V,ventricular:(0.47±0.28)V vs.(0.54±0.35)V],sens-ing [atrial:(2.33±1.16)mV vs.(2.92±1.36)mV,ventricular:(12.21±4.82)mV vs.(12.77±5.36)mV], impedance [atrial:(537.12±115.32)Ωvs.(662.48±235.26)Ω,ventricular:(602.48±222.46)Ωvs.(762.41± 235.38)Ω]of pacemaker in DM group,P<0.05 or <0.01;and incidence rate of postoperative complications (12.5%)in DM group Was significantly higher than that of non-DM control group (5%),P<0.05.Conclusion:Electrocardiographic reconstruction is more severe in SSS patients complicated DM,in these patients postoperative complication incidence significantly elevates.

OBJECTIVETo review clinical features of four male patients with glutaric academia type I and screen glutaryl-CoA dehydrogenase (GCDH) gene mutations.

METHODSThe 4 patients underwent brain computer tomography (CT) and magnetic resonance imaging (MRI) analyses. Blood acylcarnitine and urine organic acid were analyzed with tandem mass spectrometry and gas chromatographic mass spectrometry. Genomic DNA was extracted from peripheral blood samples. The 11 exons and flanking sequences of GCDH gene were amplified with PCR and subjected to direct DNA sequencing.

RESULTSAll patients have manifested macrocephaly, with head circumference measured 50 cm (14 months), 47 cm (9 months), 46 cm (5 months) and 51 cm (14 months), respectively. Imaging analyses also revealed dilation of Sylvian fissure and lateral ventricles, frontotemporal atrophy, subarachnoid space enlargement and cerebellar vermis abnormalities. All patients had elevated glutarylcarnitine (5.8 umol/L, 7.5 umol/L, 8.3 umol/L and 7.9 umol/L, respectively) and high urinary excretion of glutaric acid. Seven mutations were identified among the patients, among which c.146_149del4, IVS6-4_Ex7+4del8, c.508A>G (p.K170E), c.797T>C (p.M266T) and c.420del10 were first discovered.

CONCLUSIONMacrocephaly and neurological impairment are the most prominent features of glutaric academia type I. Blood tandem mass spectrometry and urine gas chromatographic mass spectrometry analysis can facilitate the diagnosis. The results can be confirmed by analysis of GCDH gene mutations.

Amino Acid Metabolism, Inborn Errors ; diagnosis ; genetics ; metabolism ; Amino Acid Sequence ; Base Sequence ; Brain Diseases, Metabolic ; diagnosis ; genetics ; metabolism ; Glutaryl-CoA Dehydrogenase ; deficiency ; genetics ; metabolism ; Humans ; Infant ; Male ; Molecular Sequence Data ; Mutation ; Sequence Alignment

OBJECTIVETo observe the effect of L-arginine on diabetic rats.

METHODSForty adult male Lewis rats were randomized equally into diabetic and normal control groups, and the former rats were treated intraperitoneally with streptozotocin to induce diabetes mellitus. Seven days later, half of the diabetic and normal rats were injected intraperitoneally with L-arginine at the daily dose of 1 g/kg, while the remainder were given saline instead. All the rats were euthanized on 10 days after L-arginine or saline treatment, and their body weight, plasma protein, arginine and sugar, food and water intake were analyzed.

RESULTSDiabetic rats had obviously decreased body weight, plasma protein and arginine but increased blood sugar and food and water intakes in comparison with the control rats. L-arginine significantly increased plasma protein and arginine, decreased food and water intakes, but failed to prevent weight loss and blood sugar increment in diabetic rats as compared to their saline-treated counterparts. L-arginine supplementation did not result in any changes other than arginine elevation in the control rats.

CONCLUSIONL-arginine supplementation can partially improve polydipsia and polyphagia and increase plasma protein in diabetic rats.

Animals ; Arginine ; administration & dosage ; blood ; therapeutic use ; Blood Glucose ; metabolism ; Blood Proteins ; metabolism ; Body Weight ; drug effects ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; physiopathology ; Drinking ; drug effects ; Eating ; drug effects ; Injections, Intraperitoneal ; Male ; Rats ; Rats, Inbred Lew

OBJECTIVETo investigate the serotypes and antibiotics-resistance patterns of Haemophilus influenzae isolated from children in Hangzhou.

METHODSIsolates were identified with api-NH card. Serotypes were determined with slide agglutination method. The sensitivities of 13 antibiotics against 247 strains of Haemophilus influenzae were determined in vitro with Kirby-Bauer diffusion methods and MICs of ampicillin were determined with E-test. Nitrocefin test was used to detect beta-lactamase.

RESULTSOf the 247 strains isolated from children during the period from August 2001 to July 2002, 153 strains were non-typable, while 94 strains (38.1%) were typable and 90.4% and 1.1% of them belonged to type d and type b, respectively. Higher incidence of typable Haemophilus influenzae was found in male than in female children and the difference was significant (chi(2) = 5.30, P < 0.05), while between upper and lower respiratory tract infected children the difference was not statistically significant (chi(2) = 3.60, P > 0.05). Forty-one isolates (16.6%) were beta-lactamase-positive and 14 strains could not grow on medium in antibiotics sensitivity test. Of all 233 isolates tested successfully, 85.4% were susceptible to ampicillin, and the sensitivity rate to cefaclor, ceftriaxone, cefotaxime, imipenem, rifampin, clarithromycin, and chloramphenicol were as high as 98.7%, 99.6%, 99.6%, 99.6%, 98.7%, 91.0%, and 90.6%, respectively. All strains were sensitive to amoxicillin/clavulanic acid, ampicillin/sulbactan and ofloxacin, while 107 strains (45.9%) were resistant to trimethoprim-sulfamethoxazole, followed by that of tetracycline (14.6%). Resistance to ampicillin and trimethoprim-sulfamethoxazole in typable isolates was statistically significantly higher than in non-typable strains. Twenty-six strains (10.5%) were multi-resistant isolates and the multi-resistance rate in beta-lactamase-positive strains were significantly higher than that in beta-lactamase-negative strains (chi(c)(2) = 146.8, P < 0.001).

CONCLUSIONNon-typable Haemophilus influenzae was the most common type in clinical strains isolated from children in Hangzhou, while type d was the overwhelming type and type b was uncommon in typable isolates. Incidence of typable isolates was higher in male than in female children, and it was apt to intergrow with other species of pathogenic bacteria. The proportion of beta-lactamase-positive strains was not high and ampicillin or other beta-lactam actibiotics were still the treatment of choice for infections with Haemophilus influenzae.

Anti-Bacterial Agents ; pharmacology ; Child ; China ; Drug Resistance, Multiple, Bacterial ; Haemophilus Infections ; microbiology ; Haemophilus influenzae ; classification ; drug effects ; isolation & purification ; Humans ; Microbial Sensitivity Tests ; Serotyping