Objective To study the effect of baclofen and physical therapy on spasticity after cerebral traumatic injury.Methods20 Patients accepted Baclofen and physical therapy for 3～6 months.Blood and urine routine test,hepatic and renal function were monitored before and every 2 months after treatment.Modified Ashworth scale and Modified Barthel Index(MBI)were used for evaluation.ResultsTheir muscular tension was significantly improved(P<0.01)after treatment,as well as the MBI(P<0.01).1 case was very effective,9 cases were effective,8 cases were improved,2 cases were not effective.No side-effect was observed.ConclusionBaclofen and physical therapy is effective on spasticity after cerebral traumatic injury,especially intervening at the early stage.

AIM:To report the safty and efficiency of intravitreal injection of bevacizumab (Avastin) in patients with macular edema (ME) due to branch retinal vein occlusion (BRVO).METHODS: A consecutive series of patients with ME due to BRVO who were treated with intravitreal bevacizumab injection (2.5g/0.1L) were retrospectively studied. Patients underwent complete ophthalmoscopic examination, including Snellen visual acuity testing, optical coherence tomography (OCT) imaging, and/or flurescence angiographic testing at baseline and follow-up visits.RESULTS: There were 32 eyes of 32 consecutive patients who received at least one intravitreal bevacizumab injections (range from 1 to 3). The mean length of follow-up was 4.7 (range from 3 to 8) months. The mean visual acuity improved from 20/200- at baseline to 20/100- at 1 month and 20/100+ at 3 months and last follow-up (P＜0.01). The mean central 1mm macular thickness was 483μm at baseline and decreased to 275, 314,and 301μm at 1 month,3 months, and last follow-up (P＜0.01)respectively.No adverse side effects were observed following injections in any eyes.CONCLUSION: Intravitreal bevacizumab (Avastin) showed a marked decrease in ME secondary to BRVO, improvement in visual acuity and lack of adverse side effects.

BACKGROUND: Ketamine is a kind of frequently used general venous anesthesia drug in clinic, and the medication in vein or epidural cavum has analgesic effect. It is N-methyl-D-aspartic acid (NMDA) receptor noncompetitive antagonist, which can inhibit toxic effect of excitatory amino acids.OBJECTIVE: To observe effect of ketamine on apoptosis of dorsal horn astrocytes of spinal cord of rats induced by NMDA receptor over activation and explore its possible mechanism of action.DESIGN: Randomized controlled observation.SETTING: Department of Anesthesiology, Taihe Hospital Affiliated to Yunyang Medical College.MATERIALS: The experiment was conducted at Cell Biology Laboratory,Institute of Basic Medical Sciences, Yunyang Medical College between September 2003 and January 2005. Neonatal Wistar rats of two or three days were provided by Animal Experimental Center of Wuhan University. METHODS: Primary astrocytes in dorsal horn of T11-L6 spinal cord of Wistar rats were purified and cultured. Astrocytes were used in the experiment when its purity coefficient reached 98% assessed by gial fibrillary acidic protein. The cultured cells in 24-well plates were divided randomly into 6 groups (9 portions in each group): ①50 μL Hanks liquor was added into the control group. ②Amount of 100μmol/L was added into the NMDA group. ③Amount of 1 mmol/L was added into the ketamine group. ④100μmol/L NMDA + 0.1 mmol/L ketamine group. ⑤100 μmol/L NMDA + 0.5 mmol/L ketamine group. ⑥100μmol/L NMDA + 1 mmol/L ke tamine group. 1 mmol/L ketamine was clinical antalgic dosage. Activity of superoxide dismutase (SOD) and content of malondialdehyde (MDA) were examined after 24-hour culture. Content of Bcl-2 protein and change of morphology were observed with immunocytochemistry. Apoptosis of astrocytes was measured with flow cytometry. MAIN OUTCOME MEASURES: ① Counterstain cell staining and changes of morphology of Bcl-2 protein with immunohistochemical method and hematoxylin-esoin staining (HE). ②Apoptosis of astrocytes was detected with flow cytometry. ③Content of MDA and activity of SOD.RESULTS: ①Mean absorbance (A) of Bcl-2 as expression of Bcl-2 protein measured semiquantitatively: It was lower in the 100μmoL/L NMDA group than the control group, which had significant difference [0.054±0.021,0.108±0.039, respectively, P＜0.01]. It was higher in the 100 μmol/L NMDA + 1 mmol/L ketamine group than the 100 μmol/L NMDA group,which had significant difference [0.148±0.045, 0.054±0.021, respectively,P ＜ 0.01]. ②Apoptosis of astrocytes detected with flow cytometry: It was higher in the 100μmol/L NMDA group than the control group, which had significant difference [(25.26±6.13)%, (5.66±2.24)%, respectively, P＜0.01].It was lower in the 100μmol/L NMDA + 1 mmol/L ketamine group than in the 100μmol/L NMDA group, which had significant difference[(24.41±4.82)%, (25.26±6.13)%, respectively, P＜0.01]. ③Content of MDA and activity of SOD: 100 μmol/L NMDA made the content of MDA in astrocytes obviously increase , while the activity of SOD markedly decrease. 1 mmol/L ketamine remarkably decreased the content of MDA, distinctly increased the activity of SOD. This effectiveness had evidently dosage-effect relationship in clinical antalgic dosage, which had obviously difference as compared with that of the NMDA group (P ＜ 0.01 ). The differences between the 1 mmol/L ketamine group and the control group as well as between the 100 μmol/L NMDA + 0.1 mmol/L ketamine group and the NMDA group had insignificant difference.CONCLUSION: NMDA receptor over activation can induce apoptosis of a great number of astrocytes in spinal dorsal horn of rats. Suitable ketamine dramatically inhibits apoptosis, and its mechanism can enhance the expressionof Bcl-2 protein of astrocytes, at the same time inhibit the production of free radical and reinforce the activity of SOD.

Objective To investigate the qualitative diagnosis of salivary gland mass with contrastenhanced ultrasound(CEUS).Methods The CEUS manifestations in 78 cases with salivary gland mass were observed after intravenous bolus injection with contrast agent SonoVue and confirmed by histology.Results Among 78 salivary gland masses,there were 29 cases with pleomorphic adenomas (37.2％),19with Warthin's tumors (24.4 ％),7 with basal cell adenomas (8.9 ％),and 11 with the other benign masses (14.1％),12 with malignant tumors (15.4％).The intensity of contrast-enhanced masses,whether the enhanced mass margin was clear,whether the peripheral enhancement rim was complete and whether the mass was enlarged were the diagnostic criteria to differentiate the benign and malignant tumors.The accuracy,the sensitivity,specificity,positive predictive value and negative predictive value were 87.2％,95.2％,56.3％,89.4％,75.0％ respectively,and the results also displayed positive likelihood ratio and negative likelihood ratio were 2.178,0.085 respectively.Although they presented with the highest incidence among benign tumors,their CEUS manifestations showed remarkable statistical differences when the pleomorphic adenoma was compared with Warthin' s tumor and basal cell adenoma respectively in enhancement intensity(P ＜0.01) while there were no statistical differences between Warthin's tumors and basal cell adenomas (P ＞0.05).Conclusions CEUS manifestations of salivary gland mass were helpful to the differential diagnosis of various salivary gland tumors.

Adult ; Carotid Artery, External ; anatomy & histology ; Humans ; Hypoglossal Nerve ; anatomy & histology ; Tongue ; anatomy & histology ; blood supply ; innervation

The tools used for the literature quality evaluation are introduced. The common evaluation tools that are publicly and extensively used for the evaluation of clinical trial literature quality in the world are analyzed, including Jadad scale, Consolidated Standards of Reporting Trials (CONSORT) statement and Grades of Recommendations Assessment, Development and Evaluation (GRADE) system and the others. Additionally, the present development, updates and applications of these tools are involved in analysis.
Biomedical Research ; standards ; Evaluation Studies as Topic ; Humans ; Publications ; standards ; Quality Control

Objective By analyzing the graph features of fundamental frequency at different rates of/i/with continuously variable pitch and loundness made by normal adults,we could explore that the rate and gender have some impact on the graph to lay the foundation of regulating the clinical maximum counting ability.Methods Nor-mal adults of 51 (25 males,26 females were included).After each deep breathing,the subjects respectively took sustained speech/i/ with continuously variable pitch and lounolness twice at different rates of fast,medium and slow speed.Some parameters were measured byDoctor Speechat different rates of the tone/i/:Total time(T), Mean time standard deviation (MTSD),Mean wave crest (MWC),Mean wave trough (MWT),Mean frequency range (MFR),Mean frequency range standard deviation (MFRSD),comparing the speed having some effect on those above parameters with gender.ResuIts ①With the increasing rate of speech,the tone/i/of T (P<0.001), MFR (P<0.01)and MTSD (P<0.001)were significantly decreased,MWT significantly increased (P<0.001), While the MWC and MFRSD did not change significantly (P>0.05 ).②The tone /i/ of T (P>0.05 )were not effected by gender,female's MWT (P<0.001),MWC (P<0.001),MFR (P<0.001),MFRSD (P<0.01)were obviously higher than male's,while female's MTSD were significantly larger than male's (P<0.01).ConcIusion We should consider the impact of rate of speech and gender in clinical tests and values of MCA.The maximum counting capacity can be respectively tested at three different rates of speech for each subject,but only are the tone/i/of fun-damental frequency graphs with MWT,MWC,MFR,and MFRSD in normal range with corresponding speed and gender,can we get the value or can the value be valid.

OBJECTIVETo explore the tumor growth inhibition of gamma secretase inhibitor MRK003 on human multiple myeloma xenograft mice by inhibition of AKT and Notch1 expression.

METHODSNOD/SCID mice were injected with human multiple myeloma cell lines RPMI8226 to establish a xenograft mouse model. Mice were randomized into two groups：the experimental group were injected with MRK003 at a dose of 5 mg× kg⁻¹×d⁻¹ for 14 days; the inhibitor was replaced by an equal saline in the control group. Mice were sacrificed by cervical dislocation on the next day after the last injection and tumor tissue was removed to detect the expression of Notch1 and AKT by immunohistochemistry.

RESULTSAfter subcutaneous injection with RPMI8226, mice had tumor formation in 5-7 days and the largest tumor block in 10-12 days. Before RPMI8226 injection, the mean sizes of tumor block in the experimental and the control groups were 509.2 mm³, 511.2 mm³(P>0.05). 9 days after injection, the mean sizes of tumor tissue in the experimental and the control groups were 636.6 mm³, 691.2 mm³(P<0.01). On the next day after the last injection, the tumor sizes of the experimental and the control groups were 683.5 mm³ and 1798.7 mm³(P<0.01). The size of tumor block in the experimental group was significantly smaller than that of the control group(P<0.01). Immunohistochemistry staining showed that the positive expression rates of Notch1(11.1%, P<0.01) and AKT(13.3%, P<0.01) in experimental group were significantly decreased compared with the control group(Notch1: 95.6%; AKT: 93.3%). Western blot results showed that Notch1 and AKT protein in experimental group were significantly lower than those in the control group.

CONCLUSIONMRK003 could inhibit the tumor growth of human multiple myeloma xenograft mice by downregulated expression of Notch1 signaling pathway.

Amyloid Precursor Protein Secretases ; antagonists & inhibitors ; Animals ; Cell Line, Tumor ; Cyclic S-Oxides ; pharmacology ; Humans ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Multiple Myeloma ; drug therapy ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Receptor, Notch1 ; metabolism ; Signal Transduction ; drug effects ; Thiadiazoles ; pharmacology ; Xenograft Model Antitumor Assays

Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake,and study the effects of rehabilitation treatment for stumps.Methods Fifty-two cases with stump limbs post-amputation were evaluated,including stump skin status,stump shape,stump length,stump swelling,range of motion (ROM)of joint and strength of stump,and were treated with physical therapy,stump moulding and kinesiotherapy.Results The incidences of stump ulcer,stump swelling,conical stump,short stump and limitation of ROM of joint in all 52 cases were 76%,73%,34%,40%and 42%respectively.After rehabilitation treatment stump ulcers healed,stump swelling eliminated;stump shape,ROM of joint and muscle strength improved obviously.All poor stumps could be fit with the prosthetic limb and get good function.Conclusion The incidences of poor stump limb post·amputation after earthquake were high.Rehabilitation treatment can improve the stump condition.Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb tO the stump.

Objective:To study the differences of ventilation function in patients between chronic right heart failure secondary to pulmonary arterial hypertension and chronic whole heart failure secondary to left heart diseases.
Methods:A total of 102 patients with clinical stable chronic heart failure (CHF) were studied. The patients were divided into 2 groups:Whole heart failure (WHF) group, n=41 and Right heart failure (RHF) group, n=61. The ventilation function test at rest and cardiopulmonary exercise test (CPX) were conducted and compared between 2 groups.
Results: The rest ventilation function was similar between 2 groups. For CPX examination, compared with WHF group, RHF group had the lower peak minute ventilation (VE), higher anaerobic threshold and peak minute ventilation/CO2 production (VE/VCO2), higher peak dead space volume/tidal volume (VD/VT), all P<0.05.
Conclusion:At exercise condition, RHF patients had decreased ventilation function and ventilation index due to severe abnormality of ventilation/perfusion (V/Q).