Objective:To compare the accuracy and safety between percutaneous kyphoplasty (PKP) positioning device and traditional positioning device which posit entry point of pedicle of vertebral arch by using the C-arm X-ray.Methods: 117 patients with spinal centrum compression fractures were divided into positioning device group (57 cases) and Kirschner wire group (60 cases) depended on the entry point marked by the preoperative C arm X-ray irradiation. To compare the excellence rate, operation time and exposure times between PKP positioning device and traditional device.Results: The positioning times of the PKP positioning device group and Kirschner wire group were (2.3±0.9)min and (6.8±1.3)min, respectively. The exposure times of the two group were 1.6 times and 4.7 times, respectively. And both of the two differences were statistical significant (t=21.062,t=18.521;P<0.05). The puncture success rates of the two group were 100%. And the excellence rates of them were 93% and 87%, respectively, and the difference also was statistical significant (x2=2.761,P>0.05).Conclusion: There are series of advantages in developed PKP positioning device, such as portable, easy and simple control, higher accuracy and safety, less positioning time and exposure times of C arm X-ray.

Objective To study the effects of different doses of UVA1 on the development of hypertrophic scar in rabbit ears induced by excision of full-thickness skin. Methods A hypertrophic scar model was established by excision of full-thickness skin (2 cm×5 cm) on the ventral surface of rabbit ears. A total of 18 New Zealand rabbits were randomly divided into 3 equal groups to receive UVA1 radiation on the left ears immediately, 1 month, and 2 months after the excision, respectively, and every group were classified into two subgroups to be irradiated with 60 and 110 J/cm2 of UVA1, respectively, for 30 sessions. The right ears served as control without irradiation. HE staining and Masson staining were used to examine the dermal thickness and collagen content in scar, respectively. Results Compared with pre-irradiation, the dermal thickness (t = 5.85, 4.94, respectively, both P＜0.05) and collagen content (t = 6.50, 8.02, respectively,both P＜0.05) significantly decreased in scar irradiated with UVA1 of 110 J/cm2 one and two months after the excision. The difference value in dermal thickness and collagen content at the beginning and at the end of the study significantly differed between irradiated and non-irradiated ears in the rabbits treated with UVA1 of 110 J/cm2 (P＜0.05). The effects of UVA1 on dermal thickness and collagen content were dose-dependent (P＜0.05). On the contrary, the dermal thickness and collagen content markedly increased in scars of rabbits irradiated with UVA1 immediately after the excision (P＜0.05 ). Conclusions To begin UVA1 exposure of hypertropic scar in rabbits after epithelialization may lead to the softening of scar, thinning of skin, and decrease of collagen content. However, immediate irradiation with UVA1 after wound could not prevent the development of hypertrophic scar in rabbits, in contrast, it exacerbated the severity of scar.

Objective To study the possible mechanisms of influence of different doses of UVA1 on the development of hypertrophic scar in rabbit ears induced by excision of full-thickness skin. Methods A hypertrophic scar model was established by excision of full-thickness skin on the ventral surface of rabbit ears.A total of 24 New Zealand white rabbits were randomly and equally divided into 4 groups to receive UVA1 radiation on the left ear immediately (U0 group), 1 month (U1 group), 2 months (U2 group) and 3 months (U3 group) after the excision, respectively, and each group were classified into two subgroups to be irradiated with UVA1 of 60 (middle) and 110 (high) J/cm2, respectively, for 30 sessions. The right ears served as the control without irradiation. Skin samples were obtained from the ears of rabbits before the first and after the last irradiation, transmission electron microscopy (TEM) was used to observe the ultra-structure and morphology of collagen fiber and fibroblasts, and immunohistochemical staining was performed to measure the expressions of matrix metalloproteinases (MMP)-1, tissue inhibitor of metalloproteinase (TIMP)-1, transforming growth factor (TGF)-β1, proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) in skin samples. Results Compared with the unirradiated skin, irradiated skin showed higher expression levels of MMP-1 (P ＜ 0.05), which were 10.43 ± 1.61 and 11.16 ± 1.57 in middle- and high-U1 group, 8.63 ± 2.61 and 7.33 ± 1.58 in middle- and high-U2 gorup, 5.74 ± 1.43 and 3.11 ± 0.27 in middle- and high-U3 group respectively. The expression level of TGF-β1 in irradiated skin was 12.51 ± 4.13 and 12.02 ± 5.02 in middle- and high-U1 group, respectively, 18.74 ± 6.42 and 19.69 ± 4.52 in middle- and high-U2 group, respectively, 20.51 ± 1.78 and 29.45 ± 6.55 in middle- and high-U3 group, respectively. A significant decrease was observed in the expression of PCNA in irradiated skin in middle- and high-U1 group (2.67 ± 0.44 and 2.04 ± 0.65), middle- and high-U2 group (4.50 ± 0.97 and 5.82 ± 0.68), middle- and high-U3 group (7.45 ± 1.47 and 8.16 ±1.07) in comparison with unirradiated skin (all P＜ 0.05). There was a lower expression of TIMP-1 in irradiated skin of high-U1, -U2, and -U3 group (12.74 ± 4.58, 15.17 ± 3.26, 20.72 ± 3.31, all P＜ 0.05) as well as α-SMA in that of high-U1, middle-U1 and high-U2 group (1.33 ± 0.34, 2.04 ± 0.20, 3.60 ± 1.75, all P＜ 0.05) compared with the unirradiated skin. Further more, a significant increment was observed in the expressions of TGF-β1 (23.90 ± 2.92, P ＜ 0.05) in irradiated skin of high-U0 group, PCNA(7.42 ± 0.65 and 7.59 ± 0.31 ),TIMP-1 (29.82 t 1.94 and 33.51 ± 1.19) and α-SMA (6.31 ± 0.61 and 2.97 ± 0.56) in irradiated skin of middle- and high-U0 group, but a decline in the expression of MMP-1 (.25 ± 0.38, P＜ 0.05) in irradiated skin of high-U0 group in comparison with the unirradiated skin. TEM showed that the collagen fiber diameter turned small, and fibroblasts, most of which were quiescent, showed a reduction in cytoplasm volume with the presence of immature organelles, after high-dose UVA1 irradiation. Conclusions The therapeutical effect of UVA1 on scar may be realized by accelerating the degradation of matrix proteins and decelerating the proliferation of fibroblasts and myofibroblasts via downregulating the expressions of TGF-β1, TIMP-1 and α-SMA and upregulating the expression of MMP-1. However, the results would be opposite if the interference with UVA1 irradiation is given at the early stage of wound healing.

Objective To summarize the nursing points for patients with mid-stage hepatocellular carcinoma who are receiving radiofrequency ablation (RFA) combined with 131I-chTNT treatment. Methods The clinical data of 12 patients with mid-stage hepatocellular carcinoma, who were encountered at authors’ hospital during the period from Aug. 2009 to Sep. 2011, were retrospectively analyzed. RFA combined with 131I-chTNT was carried out in all patients. Preoperative prophylactic anti-allergy medication and protection measure for the thyroid were employed. After the operation strengthened radiation protection and close observation for complications were conducted. The results were analyzed. Results After active treatment and proper nursing, the tumor shrank in all patients. All the patients were followed up for 5 - 48 months with a median follow- up time of 31 months. The median overall survival time was 43 months. No serious complications such as bone marrow suppression or thyroid dysfunction occurred. Conclusion For the treatment of mid-stage hepatocellular carcinoma, 131I-chTNT combined with RFA has satisfactory therapeutic effect. Close observation for the occurrence of complications and careful nursing can improve the quality of life and prolong the survival time.

Object The polysaccharide (CDPS) was isolated, purified and identified from Cistanche deserticola Y. C. Ma, a Chinese materia medica. Methods The polysaccharide was extracted with hot water and precipitated by alcohol. Protein in the precipitates was removed by Sevag method. The products were further purified with column chromatography on DEAE-Sephadex A-50 and Sephacryl S-200. The CDPS was idendified by IR spectrum and UV (200-400 nm) scanning spectrum. Results IR spectrum indicates that there are typical characteristic absorption peaks of polysaccharides. UV scanning spectrum shows that there are no absorption peaks of protein and nucleic acid at point 280 nm and 260 nm. Conclusion The CDPS was identified as homogeneous one.

ObjectiveTo explore the correlation between butylphthalide and plasma brain-type creatine kinase isoenzyme (CK-BB),endothelin (ET),calcitonin gene related peptide (CGRP) in patients with acute cerebral infarction (ACI).MethodsSixty patients with ACI were divided into treatment group and control group with 30 cases each by random digits table method.Both groups received normal treatment continuously for 7 days,and butylphthalide of 200 mg was added to treatment group for 3 times per day.The levels of plasma CK-BB,ET and CGRP of two groups before and after treatment were measured and compared.ResultsThe levels of plasma CK-BB,ET of two groups both decreased significantly after treatment,but CGRP rose obviously.It showed significant differences before and after treatment of both groups (P ＜0.01 or ＜ 0.05).The levels of plasma CK-BB,ET of treatment group after treatment were lower than those of control group in the same period [(216.48±36.95) U/L vs.(333.07±54.03) U/L,(83.33±26.48)ng/L vs.(98.46±31.46) ng/L,P ＜ 0.05 ].The level of plasma CGRP of treatment group after treatment was significantly higher than that of control group in the same period [ (44.16±13.28 ) ng/L vs.(36.42±12.31 )ng/L,P ＜ 0.05 ].ConclusionButylphthalide can reduce the plasma enzyme activity,balance ET and CGRP,extend the cerebral arteries to antagonize ET,improve cerebral ischemia and cerebral hypoxia,which can protect brain cells and endothelial cells.

Objective To study the efficacy of rituximab in the treatment of pemphigus vulgaris (PV) and its underlying mechanism. Methods A 38-year-old female with PV presented with refractory, painful oral ulcers and erosions. Since she was poorly responsive to prednisone 80 mg daily, intravenous ritu-ximab of 500 mg once a week was given for successive 3 weeks followed by 5 successive days of intra-venous gamma globulin at a dose of 400 mg/kg per day, and a total of two treatment sessions were conducted. ELISA was used to detect the serum titer of anti-Dsg3 antibodies and their IgG subtypes (IgG1 and IgG4) as well as serum level of interferon-gamma (IFN-gamma), interleukin-4 (IL-4), interleukin-10 (IL-10). Results Three months after the end of two treatment sessions, the symptom was obviously improved, and lesions subsided; alter another 1 month, clinical symptom fully disappeared. During the 1-year follow-up, no lesions recurred. The anti-Dsg3 antibody titer was 253.33 U/mL before treatment, plateaued at 250 U/mL within 4 weeks after the initial infusion, decreased till 3 months after the withdrawal, and reached 26.06 U/mL 7 months after the withdrawal, and remained within normal range till the time of this writing. The serum titer of IgGl subclass of anti-Dsg3 antibodies dropped dramatically fight after the first infusion, but that of IgG4 subclass remained at a high level at early stage of medication, began to decline until 3 months after the with-drawal, and finally reached the normal range following clinical remission. Also, serum level of IFN-garnma and IL-10 correlated with the severity of PV. Conclusions Combined rituximab is effective for the control of PV, likely by eliminating Dsg3-specific antibodies, especially IgG4 subclass of them.

Objective To study the association of biallelic polymorphism at position 196 in exon 6 of tumor necrosis factor receptor 2(TNFR2) gene and coronary artery disease(CAD).Methods A retrospective case control study was designed in this investigation.Patients with angiographically proven CAD (n=142)and coronary atherosclerosis(n=215)were compared to healthy volunteers(n=631). Genotyping was performed by ShineRoar probes analysis.Results People with GG genotype at position 196 in exon 6 of TNFR2 gene have more risks of development of CAD(OR=2.556,95% CI:1.051～6.218, χ2=4.57,P=0.033)and CA(OR=2.547,95% CI:1.162～5.579,χ2=5.81,P=0.016) than those with TT genotype.Further analysis after adjustment for sex and age demonstrated that GG genotype was not associated with CAD(OR=0.614,95% CI:0.166～2.279,χ2=0.53,P=0.466)and coronary atherosclerosis(OR=O.644,95%CI:0.200-2.069,χ2=0.55,P=0.459).Conclusion Tumor necrosis factor receptor 2 gene polymorphism at position 196 in exon 6 was not an independent risk factor of development of CAD and coronary atherosclerosis among Han Chinese.

Objective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.

OBJECTIVE:To observe therapeutic efficacy and safety of budesonide and formoterol in the treatment of acute exacerbation of mild to moderate asthma.METHODS:A total of 89 patients with acute exacerbation of mild to moderate asthma were randomized divded into study group (45 cases) and control group (44 cases).Study group was given Budesonide and formoterol dry powder inhalation,one inhalation,q6 h,gargling 5 times after inhalation,6 inhalation per day at most+Montelukast tablet 10 mg orally,once a day.Control group received Prednisone tablet 25 mg orally after breakfast,once a day,d1-5+Theophylline sustained-release capsule 0.2 g,twice a day+Montelukast tablet 10 mg,once a day in the evening.Both groups were treated for 5 d.Acute AQLQ score,FEV1,PEF％pred and SpO2 were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in acute AQLQ score,FEV1,PEF％pred or SpO2 between 2 groups(P＞0.05).After treatment,acute AQLQ score,FEV1,PEF％pred and SpO2 of 2 groups were significantly higher than before treatment,with statistical significance (P＜0.05),but there was no statistical significance between 2 groups (P＞ 0.05).There was statistical significance in the incidence of ADR between 2 group(P＜0.05).CONCLUSIONS:Budesonide and formoterol can improve pulmonary ventilation function and prognosis in patients with acute exacerbation of mild to moderate asthma with good safety.