Objective To observe the effect of transcranial low frequency electrical stimulation on the contents of monoamines in ischemic area of rats with middle cerebral artery occlusion(MCAO).MethodsPermanent MCAO model of Wistar rat was established with silk thread enveloped with polyammoniacum.The ischemic areas received various intensity of transcranial low frequency electrical stimulation for 1 hour in rats underwent 1 hour of ischemia.Then the affected tissue was processed with fluorospectrophotometry to determine the contents of dopamine(DA),noradrenalin(NE) and 5-hydroxytryptamine(5-HT).ResultsCompared with the sham-operation group,the contents of DA,NE and 5-HT in ischemic area of MCAO model rats decreased obviously(all P<0.01),while all three monoamines investigated in the sham-operation group with transcranial low frequency electrical stimulation had no significant change.In the MCAO groups stimulating with lower(10 V) and middle(30 V) intensity transcranial low frequency electrical field,the contents of DA,NE and 5-HT in ischemic area had no significant increase.But in the MCAO group stimulating with high(50 V) intensity transcranial low frequency electrical field,the contents of DA,NE and 5-HT in ischemic area increased significantly(P<0.05).ConclusionSome degree of intensity transcranial low frequency electrical field stimulation can increase the contents of DA,NE and 5-HT in ischemic area of rats subjected to MCAO.

Objective Discussion of the role/effect of an incentive mechanism in encouraging proactive reporting of adverse events in hospital.Methods Applying an incentive mechanism to encourage medical staff to report on adverse events found in their hospitals.Incentives in question include financial rewards.alleviation or cancellation of some penalties for medical defects.These measures were followed by a comparison between the number and types of proactive reporting on adverse events with those prior to such measures.in addition to typical case studies.Results Comparison of the figures during Jan.August,2007 and those during the sanqe period in 2008 after the incentive mechanism was in place found significant changes.For example,cases of proactive reporting rose from 34 to 176.Most significant changes were found in even types including medical malpractice.For medical disposal events,the number of events rose from 5 in 2007 to 10 in 2008;events in medical technical inspections from 0 to 24 cases;and that of patients identification from 2 to 14.These figures were followed by typical case analysis and improvements.Conclusion Such all incentive mechanism has significantly increased the number of proactive reporting on adverse events in hospitals,changing the types of such reporting to stand out malpractice related events,and enhancing the reporting to improve quality of care in hospitals.

Objective To summarize the techniques of anatomical liver resection for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of 125 patients with solitary HCC who underwent anatomical liver resection at the Zhongshan Hospital from January 2005 to December 2006 were retrospectively analysed.The inflow and outflow of hepatic segments to be resected were selectively clamped,then the main branches of portal vein and hepatic artery were ligated,and the ischemic hepatic segments were resected en bloc.Kelly forceps were used to crash and clamp the liver cut surface.The stumps of left and right hepatic ducts were continuously sutured with Prolene sutures.For tumors with the size above 10 cm in diameter,hepatectomy with anterior approach and liver hanging maneuver were adopted.Bile leakage was checked by injecting methylene blue or covering a gauze on the liver cut surface.Results The mean blood loss of all patients was 250 ml(100-6000 ml),and 32 of them needed blood transfusion.The morbidity was 23%(29/125).No patient died within 30 days after the operation,and 6%(5/83)of patients were found with residual tumor by postoperative arteriography.Conclusion Anatomical liver resection may improve the safety of operation,prevent the injury of great vessels and thus improve the efficacy.

OBJECTIVETo determine the outcome of combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation for the management of unstable Hangman's fractures.

METHODSSixteen cases of unstable Hangman's fractures were retrospectively reviewed through X-ray, MRI and three dimensional CT scans. Pre- and postoperative radiographs were measured for translation and angulation of C2,3. Skull traction under extension poison was conducted in all the patients right after their admission. Then anterior C2,3 discectomy followed by interbody fusion, either with iliac autograft or with box cage, and locking plate fixation were performed in each case. Because dissatisfied reduction, mainly residual large fracture gap or kyphosis, was found by the C-arm fluoroscopy during operations, posterior compressive C2 pedicle screw fixation was performed in one stage. According to the Levine-Edwards classification, there were 12 cases of type II, 2 of type I a and 2 of type III in this group.

RESULTSFollow-up ranged 6-38 months, averaged 26 months. Fracture union and bone graft fusion were completed in an average of 4 months after operation. Complaints of neck pain and numbness of limbs disappeared in all patients after surgery, but range of neck motion decreased compared with normal people. Translation of C2 decreased from (4.2 +/- 1.4) mm preoperatively to (2.3 +/- 1.1) mm postoperatively, while angulation of C2,3 decreased from 8.6 degrees +/- 2.1 degrees preoperatively to 2.6 degrees +/- 1.0 degrees postoperatively. Both have statistical significance (P < 0.05). No implant failure or infection was observed.

CONCLUSIONSThe classification of Hangman's fracture should be modified in combination with MRI and CT scans to determine the stability of the fracture. Combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation is the treatment of choice for patients with unstable Hangman's fractures.

Adult ; Aged ; Axis, Cervical Vertebra ; injuries ; surgery ; Bone Nails ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Spinal Fusion ; methods

Objective To analyze the tendency of hospital based surveillance incidence rates of birth defects in Guangdong province to provide reference evidence for related intervention program. Methods Data from hospital based birth defects surveillance of Guangdong province during 1997-2007 were analyzed retrospectively. Results The overall surveillance rates of birth defects in Guangdong province showed an increasing trend form 98.9 per 10 000 birth in 1997 to 244.2 per 10 000 birth in 2007. Among the frequently seen birth defects, the rate of congenital heart diseases increased sharply, but the rates of congenital talipes equinovarus, polydactyly, cleft lip with/without cleft palate showed a slight increasing trend.It seemed that there was a significant difference between different maternal age interval and gender of the infants. Mother's illness, drug use, and exposure to environment harmful factors in early pregnancy stage, high maternal age, negative bearing history were the suspect risk factors for birth defects. Conclusion The increasing trend of surveillance rate of birth defects seemed to be comprehensively affected by the factors as: method being adopted, target and extension of birth defects surveillance, technology used for diagnosis, kinds of risk factor,and quality control on surveillance programs.

Objective To study the risk factors for fractures among hemedialysis patients. Methods 160 patients who received maintenance hemodialysis in our center had been followed from January of 2003 to December of 2007. Fractures were identified and the schedule of dialysis, laboratory values and medications were recorded. Results A total of 32 bone fratures occurred in 160 patients. Associated risk factors included age, sex, yeats on hemodialysis, cumulative time on hemofihration per week, prior renal transplant, history of medications, needs assistance to walk, serum calcium, phosphorus, Hb, PTH and B2-microglobulin. Conclusions Two main mechanisms may account for the increased fracture risk in HD patients: either a lower resistance of bone after relatively minor traumas or an increased propensity to falls. We should pay much attention to the patients with older age, female gender, longer cumulative time on HD, needs assistance to walk, a history of falls and higher PTH level.

OBJECTIVEIn order to investigate the roles of metalloproteinase in inflammatory bone destruction in ankylosing spondylitis (AS), and analyze the mechanism of preventing inflammatory bone destruction of Bushen Qiangdu decoction (BSQDD) in AS cases. Comparisons were made on the expressions of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) by peripheral blood mononuclear cells (PBMC) between AS patients and healthy controls. The effect of BSQDD was investigated on the expression and of MMP-9 and TIMP-1 produced by PBMC in AS patients.

METHODSFrom March 2005 to March 2006, 30 active AS cases of Kidney-asthenia, Du-cold and blood-stasis syndrome were selected as patients group in the China-Japan Friendship Hospital. There are 27 male patients and 3 female patients. The age range is from 16 to 45, averaging (30.8 +/- 8.8) years. Disease duration is from 0.5 to 10 years. Cases received three-month BSQDD treatment were considered as the treatment group. Twenty healthy persons were included in the control group. Serum and PBMC were separated. The PBMC were stimulated by PHA and PMA, and the supernatant was collected. The mRNA expression of MMP-9 and TIMP-1 in PBMC was analyzed by RT-PCR. The content of MMP-9 and TIMP-1 in serum and culture supernatant of PBMC were detected by ELISA.

RESULTSCompared with health control group, the serum concentration of MMP-9 and TIMP-1 in patients group before treatment increased (P<0.01, P<0.05), but the level of MMP-9 and TIMP-1 in the serum of patients after treatment decreased compared with pre-treatment cases (P<0.05). Furthermore,compared with health control group, PBMC of patients group before treatment expressed higher levels of MMP-9 and TIMP-1 both on transcript level and at protein level (P<0.01, P<0.05), and the expression levels of MMP-9 and TIMP-1 in PBMC in patients after treatment both on transcript level and at protein level was down-regulated compared with pre-treatment (P<0.01, P<0.05).

CONCLUSIONPBMC of AS patients had a higher potential capacity for MMP-9 and TIMP-1. BSQDD possibly prevented inflammatory bone destruction of AS through inhibiting production of MMP-9 and TIMP-1 produced by PBMC.

Adolescent ; Adult ; Case-Control Studies ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gene Expression Regulation ; drug effects ; Humans ; Leukocytes, Mononuclear ; drug effects ; metabolism ; Male ; Matrix Metalloproteinase 9 ; biosynthesis ; blood ; genetics ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Retrospective Studies ; Spondylitis, Ankylosing ; blood ; drug therapy ; genetics ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; biosynthesis ; blood ; genetics ; Young Adult

OBJECTIVETo establish the characteristic mode of HPLC fingerprint of Fufangteng combination formula for the quality control of this medicine.

METHOD10 batch certified products were selected to establish the characteristic mode of HPLC fingerprint of Fufangteng combination formula by chromatographic pattern matching and retention time correction.

RESULTThis characteristic mode of HPLC fingerprint can clearly differentiate the eligible Fufangteng products from the unqualified products.

CONCLUSIONThis method can provide thorough information for the quality control of Fufangteng combination formula.

Administration, Oral ; Astragalus membranaceus ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; isolation & purification ; Euonymus ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control

OBJECTIVESTo observe the effects of chlorotriptolide (T4) and triptonide (T7) on the chromosome aberration and micronuclei rates of bone marrow cell in male SD rats.

METHODSAntifertility doses of T4[80 micrograms/(kg.d)] or T7[317 micrograms/(kg.d)] were given to male rats per OS for 10 weeks. Bone marrow slides were then prepared and compared with the controls.

RESULTSThe chromosome aberration and micronuclei rates were not significantly different from those of the controls (P > 0.05).

CONCLUSIONSThe results were in accordance with our previous reports about the effects of T4 and T7 on the chromosome aberration and micronuclei rates of rat spermatogenic cells. At the antifertility doses, T4 and T7 did not show a mutagenic effect.

Animals ; Bone Marrow Cells ; drug effects ; metabolism ; Chromosome Aberrations ; chemically induced ; Diterpenes ; pharmacology ; Epoxy Compounds ; Infertility, Male ; chemically induced ; genetics ; Male ; Micronuclei, Chromosome-Defective ; drug effects ; Phenanthrenes ; Rats ; Rats, Sprague-Dawley ; Tripterygium ; chemistry ; Triterpenes ; pharmacology

OBJECTIVETo assess the effect of neoadjuvant chemotherapy and the factors related with pathological complete response (pCR) of neoadjuvant chemotherapy in breast cancer.

METHODSThe data of 159 primary breast cancer patients who had received neoadjuvant chemotherapy and operation with complete MRI data and histopathology evaluation in this center from January 2009 to December 2011 was analyzed. All the patients were female, aging from 28 to 70 years with a median of 50 years. The neoadjuvant chemotherapy regimens were based on anthracyclines or taxanes, and trastuzumab was used in almost half of the human epidermalgrowth factor receptor 2 positive patients. The response of neoadjuvant chemotherapy was comprehensively evaluated based on RECIST 1.1 and Miller-Payne grading system. SPSS 18.0 was used for statistical analysis.

RESULTSAmong the 159 patients, 10.1% patients had achieved complete response according to the MRI evaluation, and the rate of partial response, stable disease, and progressive disease was 65.4%, 24.5%, and 0 respectively. According to the Miller-Payne grading system, 27.7% patients had pathological response evaluated as G5 (pCR), and the response evaluated as G4, G3, G2, and G1 were 28.3%, 18.9%, 12.6%, and 12.6% respectively. The higher histological grade were correlated with pCR statistically (Z = -2.820, P = 0.005). Meanwhile strong expression of Ki67 (Z = -1.989, P = 0.047) and p53 (Z = -2.457, P = 0.014) were related to pCR in a significant statistically way.

CONCLUSIONSThe response of neoadjuvant chemotherapy can be predicted. The histological grade and the immunohistochemistry results of Ki67 and p53 are related to pCR of neoadjuvant chemotherapy for primary breast cancer. Basal-like breast cancer had a higher pCR statistically.

Adult ; Aged ; Anthracyclines ; administration & dosage ; Antibodies, Monoclonal ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoadjuvant Therapy ; Taxoids ; administration & dosage ; Tumor Suppressor Protein p53 ; metabolism