Objective To explore the clinical outcomes of vestibular rehabilitation therapy(VRT) in the treat‐ment of patients with balance disorders .Methods Seventy -six patients were diagnosed with vertigo based on the principle of single and double side targeted rehabilitation ,and were divided into four groups randomly .Group A of 29 cases received unilateral simple drug treatment only ,group B of 29 cases received unilateral drug treatmeat com‐bined with vestibular rehabilitation therapy ;bilateral simple drug treatment for the 9 cases in group C ,group D of 9 cases accepted bilateral drug treatment combined with vestibular rehabilitation therapy .Group A and C were the control groups while B and D were experimental groups .All cases were retrospectively analyzed to compare vestibu‐lar rehabilitation therapy combined with drugs treatment with the simple drug treatment group .Results The effects in all patients were better after treatment .The VSI scores four weeks after treatment in four groups were signifi‐cantly lower than that of before treatment .The BBS score after treatment of experimental groups were significantly higher than those of in the control groups .The Fukuda step experiment effects were better than the control group . All the above comparisons had a statistical significance(P< 0 .01) .Conclusion The clinical efficacy of normative vestibular rehabilitation exercise is satisfactory .

The genes for TEM and aminoglycoside-modifying enzymes (AMEs) in Acinetobacter baumannii were studied to provide molecular biological support for monitoring their drug resistance.MethodsTwenty strains of Acinetobacter baumannii were clinically isolated from the period of August, 2002 to Feburary, 2004. The drug resistance of these strains to thirteen kinds of antimicrobial agents was tested by microdilute test. The TEM and AMEs genotypes of these strains were analyzed by polymerase chain reaction and verificated by DNA sequencing .Results All twenty strains were sensitive to Imipenam and Meropenem. The resistant rates of the twenty strains to Piperacillin/ Tazobactam, cefepime and ceftazidime were 45.0%, 65.0% and 70.0%, respectively. The resistant rate to aminoglycosides antibiotics was 75.0%. The resistant rates to other antimicrobial agents were greater than 65.0%. The positive rate of genotype TEM, aac(3)-Ⅰ, aac(3)-Ⅱ aac(6”)-1 and ant(3”)-Ⅰ were 45.0%, 55.0%, 15.0%, 35.0%, and 60.0%, respectively. The genotypes of SHV, AmpC DHA and AmpC MIR were all tested negative.Conlusions The multiple-drug-resistance of Acinetobacter baumannii isolated from Tongde Hospital was a serious issue.There were high percentages of TEM and AMEs genotypes. Because of the imperfection frame of the primer,some familiar genes just like OXA,VER and PER were not experimented. We shall further discuss the drug resistance of the third/fourth generations cephalosporin.

Objective To investigate the feasibility of abdominal aorta or common iliac artery occlusion by balloon catheter dilatation to decrease blood loss and promote operation safety during resection of sacral tumors and hip bone metastatic tumors. Methods From March 2003 to March 2005, 4 cases each of high level sacral tumors (3 of giant cell tumor and 1 of chordoma) and hip bone metastatic tumors (3 of lung cancer and 1 of osteosarcoma ) were resected after occlusion of the distal abdominal aorta or unilateral common iliac artery with balloon catheter dilatation in reducing intraoperative hemorrhage, the blocking time were 40 to 70 mins each with an interval of 15 to 20 mins. A balloon catheter was introduced through femoral artery at radiographic department one hour before the index operation. The balloon catheter was positioned proximal to the bifurcating of common iliac artery in lower abdominal aorta between superior mesenteric artery and renal artery confirmed by arteriography, or located in affected side common iliac artery. Results After the occlusion of abdominal aorta or unilateral common iliac artery, there was much less intraoperative hemorrhage (the amount of bleeding, 100 to 300 ml) and needed no hemostasis during the resection and curettage of the tumors. It possessed the similar effects as using the tourniquet in the operations of the extremities. The operating field was clean and the anatomic structures were exposed clearly. It was easy to define the boundary of the tumors and enable to perform complete tumor excisions and reduce contamination in the operative field. All the patients had smooth blood pressures during the operations. 1 case of sciatic nerve paralysis occurred in sacral giant cell tumor postoperation, but recovered 3 weeks later. Conclusion Occlusion of major blood supply arteries with balloon catheter dilatation can effectively reduce operative hemorrhage during the resection of sacral and hip tumors and it can promote the safety of the operations.

Purpose To evaluate short term visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age related macular degeneration (AMD). Methods Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne. Results The visual acuity of all the treated eyes at the follow up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes. Conclusion PDT with Visudyne achieved short term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patients with AMD.

Objective To study the clinical results and safty of photodynamic therapy (PDT) after single and multi treatments of patients with subfoveal choroidal neovascularization (CNV) caused by wet age related macular degeneration (AMD). Methods From July, 2000 to July, 2001, 20 wet AMD patients (31 eyes) 47 88 years old (mean 68.2 years old) with best corrected visual acuity from FC/10 cm to 0.6 diagnosed through optic coherence tomography (OCT), fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were treated with PDT. All cases were assigned to benzoporphyrin derivative mono acid (BPD) (6 mg per square meter of body surface area), administered via intravenous infusion of 30 ml over 10 minutes. Fifteen minutes after the start of the infusion, a laser light at 689 nm (Zeiss company, German) delivered 50 J/cm 2 at an intensity of 600 mW/cm 2 over 83 seconds on CNV. Visual acuity, photochrome of ocular fundus, OCT, FFA, ICGA were used to evaluate the effects of photodynamic therapy with BPD. Follow up of these patients was planned 1 2 week and every 3 month after PDT. Once the lesion area progressed, PDT was applied again. Tweenty cases (31 eyes) were followed up from 3 to 18 months (average 12 month).In 1 affected eye, PDT was applied fow 4 times, 4 eye for 2 times, and the other 26 eyes for 1 time. Results The visual acuity in 13 (41 9%) eyes was improved ( increase≥2 lines) after PDT. Stabilized (?1 line) in 17 (54 8%) eyes and decreased 2 lines (attributed to the recur of CNV ) in 1 (3 2%) eye. After PDT, the fundus haemorrhage and fluid leakage reduced. FFA and ICGA showed. cessation and obvious reduction of fluorescein leakage from CNV in all patients 2 weeks after photodynamic therapy, and retreatment decreased the leakage step by step. Fluorescein leakage from at least a portion of the CNV reappeared by 1 3 month after treatment in some cases. OCT also showed the reduction of the size of CNV, moreover, the edema of surrounding retina and choriodal and serous neural epithelial detachment recovered obviously. No side affect during and after PDT was noticed. Conclusions PDT with BPD can achieve short term effect on part or total cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in patients with age related macular degeneration, retreatment of PDT was also effective.

Objective To summarize the clinical results and safety of photodynamic therapy (PDT) through 4 years after single and multi-treatments of patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Clinical data of 73 AMD cases (95 eyes) diagnosed through fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT), treated with PDT were reviewed and analyzed in this hospital from June 2000 to June 2004. The changes of best corrected visual acuity (BCVA), fundus pictures, FFA, ICGA and OCT were compared before and after PDT. Follow-up time varied from 3 months to 4 years (mean, 2 years). Results The mean age of 73 patients was 67.8 years old. The BCVA was from (CF/10 cm) to 1.0. At the final follow up, the BCVA was improved (increase≥2 lines) in 39 eyes (41.1%), stabilized (?1 line) in 51 eyes (53.7%) and decreased 2 lines in 5 eyes (5.3%). Fundus hemorrhage and exudation reduced after PDT. FFA and ICGA showed CNV complete closure in 58 eyes (61.05%), partial closure in 6 eyes (6.32%), CNV incomplete closure in 22 eyes (23.16%) and recurrence in 9 eyes (9.47%). After once PDT of 12 eyes with early-stage AMD, the BCVA improved (from 0.6 to 1.5), CNV completely closed, and the OCT showed disappearance of macular edema and neursensory retinal detachment. No CNV recurred in our four years follow-up observation and the BCVA of the patients remained stable. The mean number of PDT treatment was 1.8 per eye in 95 cases. No serious local or systemic complications were encountered. Conclusions Single or multiple sessions of PDT can acheive long-term safety and efficacy. For early-stage AMD patients with minimally classic CNV, PDT can completely make CNV closed and reduce the risk of visual loss.

Aim To develop a molecular biologic technique for detection of chlamudia pneumoniae with nested polymeyase chain reaction (nPCR) .Methods Nested primers were synthesized according to a cloned C.pneumoniae 474- bp Pst I fragmert. Results The 378bp DNA fragments were amplified from C. pneuomoniae with nPCR. None of the C. trachomatis, C. psittaci, other organisms and etc. Strains tested were amplified by the nPCR. The direct sequening of 3 sample products with nPCR are quite same as C. pneumoniae (CWL-29 ) . The sensitivity of nPCR is higter than PCR. Conclusions This method is not only sensitive.specific and rapid, but also provides an etiological basis for cdiagnosis of C.pneumoniae infection.

Objective To understand the correlation between insulin resistance(IR) and adrenal androgen excess in adolescents with polycystic ovary syndrome (PCOS). Methods According to BMI, 90 adolescents with PCOS were divided to groups of normal weight PCOS(NW-PCOS,33 cases,BMI<25.0 kg/m2) and obesity PCOS(OB-PCOS,57 cases, BMI≥ 25.0 kg/m2),and 15 normal weight healthy girls matched for age as controls.All patients had normal OGTT.Acute ACTH stimulating test was performed on patients, and cortisol (F), 17-hydroxyprogesterone(17-OHP), dehydroepiandrosterone(DHEA) during ACTH testing at 0 and 60 minute (steroid0 and steroid60) were determined. Results Compared with controls, NW-and OB-PCOS patients showed significantly greater levels of total testosterone (T), Luteotropic hormone(LH), FIns, 2 hIns, and HOMA-IR(P<0.01).The freqnencies of hirsuties and acne, and serum level of FIns, 2 hIns, and HOMA-IR were significantly higher and LH levels were much lower in the group of OB-PCOS than those in NW-PCOS(P<0.05 and P<0.01).ACTH stimulating test showed that PCOS patients had significantly higher levels of basal 17-OHP0, DHEA0, as well as 60-minute ACTH-stimulated levels (Steroid60) of 17-OHP60、DHEA60, and net increase of 17-OHP(Δ17-OHP)as compared with normal controls(P<0.05 and P<0.01).The 60-minute ACTH-stimulated levels of 17-OHP60, DHEA60,Δ17-OHP, and ΔDHEA were also higher in group of OB-PCOS than those in group of NW-PCOS(P<0.05 and P<0.01), and there were no obvious discrepancies in basal 17-OHP0, DHEA0 between OB-PCOS and NW-PCOS groups.Spearman correlation analysis showed that in group of OB-PCOS, HOMA-IR value was significantly associated with BMI, 17-OHP60, Δ17-OHP, DHEA60, ΔDHEA(P<0.05 and P<0.01); whereas in group of NW-PCOS, HOMA-IR was associated only with BMI(P<0.01). Conclusions The significantly higher basal and ACTH-stimulated levels of 17-OHP and DHEA indicates adrenal hyperresponsiveness in adolescents with PCOS.Adrenal androgen excess appears to be closely associated with insulin resistance in obese adolescents with PCOS

To observe the effect of intaspinal implantation of Schwann cells (SC) genetically modified with microgene pSVPoMcat on spinal cord injury (SCI) repair.120 SD rats were used to establish the hemisected spinal cord injury model at T 8 level,and they were divided randomly into three groups: genetically modified SC implantation group (group A),normal SC implantation group (group B) and control group without cell implantation (group C).One week after the operation ,combined behavioral score(CBS) and the cortical somatasensory evoked potential (GFAP) were measured and the expression of glial fibrillary acidic protein(GFAP) was examined by in situ hybridization and immunocytochemistry.Three months after the operation, all the rats were scanned with MRI and then were sacrificed.Neurofilament (NF) was examined with imunohistocytochemistry staining by using NF monoclonal antibody. Following were the results:(1) In group A,the number of cells expressed GFAP in injured sites was less than that in groups B and C.(2) MRI scanning showed that the SCI region almost recovered in group A but did not recover in group B.There was a malacie focus in SCI region in group C.This was corroborated by the NF staining.(3) The amplitudes of potential in the latent period in group A and B showed a tendency to recover,and it was consistent with CBS.The results suggested that the implantation of genetically modified SC with microgene pSVPoMcat could inhibit GFAP expression and promote the functional recovery of spinal cord injury in rats.

Objective To investigate the therapeutic effects of recombinant adeno-associated virual gene serotype 1(rAAV1) mediated transfer of sarcoplasmic reticulum Ca2+ ATPase(SERCA2a) on beagle dogs with heart failure(HF).Methods The chronic HF model was reproduced in beagle dogs by giving rapid right ventricular pacing(230 beats/min) for 30 days.A reduced rate(180 beats/min)was continued for another 30 days.Sixteen beagle dogs were divided into four groups(4 each): control group,HF group,HF+EGFP group and HF+SERCA2a group.After rapid pacing for 30 days,rAAV1-EGFP(1?1012vg/ml) and rAAV1-SERCA2a(1?1012vg/ml) were respectively delivered via intramyocardial routes,while no treatment was given to the animals in both control and HF groups.At the end of the study,haemodynamics,echocardiography and the protein expression of SRCA2a were measured respectively.The apoptosis index of cardiac myocyte was evaluated by TUNEL.Bax expression was assessed by immunohistochemistry.Results After gene transfer of SERCA2a in HF beagle dogs for 30 days,the heart function was improved along with an increase in SERCA2a expression.Left ventricular systolic function was significantly increased,including the left ventricular systolic pressure(LVSP),left ventricular maximal rate of pressure rise(LV+dp/dtmax),left ventricular maximal rate of pressure decline(LV-dp/dtmax,P