· AIM:To determine whether the multifocal visual evoked potential (mfVEP) can be used as a clinical method to assess the patients with optic nerve disease.· METHODS: Fifteen patients with optic nerve disease were examined in this study. All patients underwent visual acuity examination, slit-lamp inspection, ophthalmoscopy, Goldmann perimeter, fundus fiuorescein angiography, visual field and mfVEP. Although these patients with unilateral optic nerve damage,data from both eyes were included in the analysis.· RESULTS:In all patients the visual fields defect was demonstrated on the mfVEP and showed good correspondence in location of the scotoma. However, we also found some slight difference between visual field and mfVEP. In some locations, when the local visual fields were normal, mfVEP showed that its amplitude reduced. In reverse, when the local mfVEP seemed normal, visual field showed abnormity.· CONCLUSION:Multifocal visual evoked potential could be used as a clinical diagnosis option in patients with optic nerve disease. Local monocular damage to the optic nerve can be measured by an interocular comparison of the mfVEP.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Objective:To investigate the correlation and influence factors of three weak assessment scales in the evaluation of debilitating condition of elderly patients with coronary heart disease (CHD).Methods:120 cases with CHD in our hospital were chosen,the clinical material were collected.The Fried weak score,clinical weak score and EFS were assessed.The correlation of three weak assessment scales were analyzed.Results:Fried score,CFS score and EFS score determined 6 cases,8 cases and 14 cases patients with weak respectively,the incidence rate were 5.0％,6.7％ and 11.7％,which had no significant difference(P＞0.05).The linear correlation analysis indicated the Fried score,CFS score and EFS score had positive correlation(P＜0.05),which had consistency with CHD patients.The CFS score and EFS score had no significant correlation (P＞0.05).Cox regression analysis showed that the cultural level and grade of cardiac function,living conditions and sleep disorders were influencing factors of Fried scores(P＜0.05).Conclusion:Three weak assessment had consistence and different clinical value for the evaluation of weakness in CHD patients,the cultural level and grade of cardiac function,living conditions and sleep disorders were influencing factors of weakness in CHD patients.

OBJECTIVETo analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method.

METHODSThe clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function.

RESULTSAfter 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P < 0.05): the external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (P< 0.05).

CONCLUSIONTreatment of external fixation with limited internal fixation in the treatment of Pilon fracture of Rüedi-Allgower type III is effective and safe.

Adult ; Aged ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo study the factors influencing health of burn patients in rehabilitation period.

METHODSOne hundred and one patients hospitalized in burn department of Xiehe Hospital of Fujian Medical University from February 2008 to October 2008 were investigated by means of General Information Questionnaire, the Eysenck Personality Questionnaire, the Medical Coping Modes Questionnaire, and the Social Support Rating Scale. Their rehabilitation condition was scored according to the Abbreviated Burn-Specific Health Scale. Investigation data were processed by multiple linear regression analysis in order to find out the factors influencing rehabilitation of burn patients.

RESULTSPatients in this group were scored (57 +/- 16) points in physical function, rate [(actual score/possible highest score) x 100%, the same below] 71.1% (the lowest); (97 +/- 19) points in psychological function, rate 80.6%; (53 +/- 8) points in social function, rate 88.4% (the highest); (45 +/- 11) points in general health, rate 74.5%; (251 +/- 44) points in comprehensive health [standard score (314 +/- 55) points], rate 78.5% (upper middle). The factors included in the comprehensive health regression equation (F = 11.602, P < 0.001) were: monthly income, size of burn, number of operations, introverted/extroverted characteristics, living, degree of utilization of support, social support, and resignation. They accounted for 46.6% of the variance of comprehensive health.

CONCLUSIONSMonthly income, size of burn, introverted/extroverted characteristics, living, social support, and resignation are the main factors influencing the rehabilitation level of burn patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; psychology ; rehabilitation ; Female ; Humans ; Male ; Middle Aged ; Social Support ; Surveys and Questionnaires ; Young Adult

Objective To explore the possibility of basic fibroblast growth factor(bFGF)and epidermal growth factor(EGF)combined with striatal conditioned medium promoting the directional differentiation of rat bone marrow mesenchymal stem cells(BMMSCs)into dopaminergie neurons.Methods 1.Separation and culture of BMMSCs:BMMSCs were harvested from healthy adult Wistar rats for serial subcultivation.2.Preparation of Striatal conditioned medium:newborn Wistar rats within 24 hours were selected,and their brain tissues were removed to prepare striatal conditioned medium.3.Induced differentiation of BMMSCs:the 5th passage BMMSCs were collected and pre-induced in low glucose-Dulbecco's modified eagle medium(L-DMEM)containing bFGF and EGF.Twenty-four hours later,pre-induction liquor was replaced with striatal conditioned medium for further induced differentiation.4.Result assessment:the morphological changes of stem cells were observed under inverted phase microscope.The expression of neuron specific enolage(NSE)and tyrosine hydmxylage(TH)were identified by immunocytochemical technique.Results The cell body of rat BMMSCs contracted into round and spindle shape after induction by bFGF and EGF combined with striatal conditioned medium.Partial neuron-like cells with prominence could be found.Immunocytochemieal detection showed that the percentages of NSE and TH positive cells were(72.70±14.81)% and(34.50±15.93)%,respectively.Conclusion BMMSCs can be induced directionally into dopaminergiC neurons by bFGF and EGF combined with striatal conditioned medium in vitro.

OBJECTIVETo investigate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of severe acute pancreatitis (SAP) in rats.

METHODSSixty-four male SD rats were randomly divided into control group and SAP group, and in the latter group, SAP was induced by retrograde injection of 5% sodium taurocholate in the pancreaticobiliary duct. The rats were sacrificed at 1, 3, 6 and 12 h after the operation, and the severity of pancreatitis was assessed according to histological scoring. The serum levels of VEGF were examined with enzyme-linked immunosorbent assay, and the expression of VEGF in the pancreatic tissues was measured by SP immunohistochemistry. Another 30 SD rats were randomized into the control group, SAP group and SAP+recombinant rat VEGF injection group, and the vascular permeability of the pancreatic microcirculation was determined by Evans Blue leakage test.

RESULTSAt each of the time points for measurement, both the serum VEGF level and scores of pancreatic tissue injury were significantly higher in SAP group than in the control group (P<0.05). Compared with the control group, the expressions of VEGF in the pancreatic tissues of SAP group were significantly up-regulated following the operation (P<0.05). The vascular permeability of the pancreatic microcirculation significantly increased after the onset of SAP, and injection of recombinant rat VEGF significantly increased the leakage rate of Evans Blue.

CONCLUSIONVEGF may play an important role in the pathogenesis of pancreatitis and in causing edema and hemorrhage in SAP, and the level of serum VEGF may reflect the severity of pancreatic injury.

Acute Disease ; Animals ; Biomarkers ; Capillary Permeability ; physiology ; Male ; Pancreatitis ; metabolism ; pathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo investigate the protective effects of captopril against lung injury in a rat model of severe acute pancreatitis (SAP).

METHODSSeventy-two male SD rats were randomized into sham-operated group (SO group), SAP group and captopril intervention group (CAP group). Serum amylase and myeloperoxidase (MPO) activity in the lung tissue were examined at 1, 6 and 12 h after the operation. TNF-α and AngII in the lung tissue were detected by ELISA, and the histopathological changes of the pancreas and lung were observed microscopically.

RESULTSThe MPO activity , which was similar between SAP group and CAP group at 1 h, were significantly lowered in CAP group at 6 and 12 h (P<0.05). Serum amylase level and the levels of TNF-α and AngII in the lung tissue homogenate were all reduced significantly in CAP group as compared to those in SAP group (P<0.01). The pathological injury of the lung was obviously lessened in CAP group in comparison with that in SAP group.

CONCLUSIONCaptopril can ameliorate SAP-induced lung injury in rats.

Amylases ; blood ; Angiotensin II ; metabolism ; Animals ; Captopril ; pharmacology ; therapeutic use ; Disease Models, Animal ; Lung ; metabolism ; pathology ; Lung Injury ; etiology ; prevention & control ; Male ; Pancreatitis ; complications ; drug therapy ; Peroxidase ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo evaluate the effect of elevated basal follicle-stimulating hormone (FSH) on both the quantity and quality of oocytes and embryos and the clinical outcomes of pregnancy in women under 35 years of age.

METHODSA retrospective analysis was conducted for inspecting 294 in vitro fertilization-embryo transfer (IVF-ET) cycles in women under 35 years of age. According to the basal FSH levels, the women were divided into groups A, B, and C with basal FSH of 10-14.99, 15-19.99 and ≥20 IU/L, respectively, to compare the average number of oocytes retrieved, morphologies of the oocytes and embryos, and clinical outcomes of pregnancy.

RESULTSGroup A showed greater average numbers of oocytes collected, total embryos and good-quality embryos with a lower gonadotrophin dose required to achieve follicular maturity than groups B and C. The 3 groups showed no significant differences in the percentage of metaphase II oocytes, optimal embryos-blastomere number, normal fertilization rate, cleavage rate, good-quality embryo rate, implantation rate, pregnancy rates, live birth rate or miscarriage rate, but the pregnancy rates and live birth rate tended to decrease in women with basal FSH ≥15 U/L.

CONCLUSIONIn women below 35 years of age, an elevated serum FSH (especially one ≥15 U/L) indicates diminished ovarian reserve and reduced numbers of oocyte and embryo but not poor oocyte or embryos quality, and good clinical pregnancy rate can still be expected.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Female ; blood ; therapy ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Young Adult

OBJECTIVETo study the value of basal antral follicle count (AFC) and age in predicting ovarian response and clinical outcome of in vitro fertilization-embryo transfer (IVF-ET).

METHODSA total of 1319 oocyte retrieval cycles in women with an AFC&le;10 and complete IVF/ICSI cycles were analyzed retrospectively. According to the AFC, the patients were divided into groups A, B, and C with AFC&le;4, of 5-7, and of 8-10, respectively, and each was further divided into <38 years old group and ≥38 years old group. The oocytes retrieved, ovarian response, implantation rate, cancellations, pregnancy, pregnancy loss, and live births were evaluated.

RESULTSAs the AFC increased, the total gonadotrophin (Gn) dose increased and the follicles aspirated and oocytes retrieved decreased significantly (P<0.001). Patients below 38 years of age had a lower total Gn dose and more follicles aspirated and oocytes retrieved than older patients. An AFC>7 and age≥38 years was associated with significantly lower total Gn dose, greater number of follicles aspirated and oocytes retrieved, and lower pregnancy rate than an AFC&le;7 and age<38 years (P<0.05). Bivariate correlation and linear regression analysis identified AFC as the best single predictor of ovarian response in IVF. The pregnancy rate differed significantly between the 3 groups, and older patients (≥38 years) had higher early miscarriage rate.

CONCLUSIONAntral follicle count&le;7 or age≥38 years old with AFC&le;10 is the suitable threshold of diminished ovarian reserve in controlled ovarian stimulation for infertile women. Combination of AFC and age is the best predictor of ovarian response in IVF. Age has a better predictive value of pregnancy rate than AFC. AFC influences mainly the oocytes quantity, while age also affects oocyte quality.

Adult ; Age Factors ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Ovarian Follicle ; anatomy & histology ; cytology ; physiology ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies