Objective To observe morphological character of posterior arch of Atlas and lamina of axis,as well as provide anatomical basis to design special guiding device for the operation of upper cervical posterior fixation with Atlas titanium cable so as to make the operation safe and easy.Methods The posterior arch of Atlas and lami- na of axis were observed and measured in 100 adult dry Atlas and axis specimens,then special guiding devices were designed based on the anatomical data.Results (1)The posterior arch of Atlas was thin with a fan-shape section, whose inner plane descended from back to inside and the lamina of axis was stronger and thicker than posterior arch of Atlas,with a vertical inner plane and a ridge near the lower edge.(2)The special guiding device for posterior arch of Atlas should be designed with a bend head as well that for lamina of axis should be designed with a round head. They were used in 61 operations which became safer and easier.Conclusion The operation of upper cervical posteri- or fixation with Atlas titanium cable would be safer with the help of special guiding devices which were designed based on the anatomical character.

Purpose To assess left ventricular diastolic function in the patients with essentialhypertension. Methods 25 normotensives,93 hypertensiives without hypertrophy (NLVH) and 47 withhypertrophy (LVH)(LVMI, left ventricular mass index ＞ 124 g/m2 in males and 110 g/m2 in females)underwent 2DE and Doppler echocardiography. Results The ratio of early to late peak velocity (E/A)was 1.21 ± 0.24 in normotensives and 1.03 ± 0.23 in NLVH patients( P ＜ 0.01 ); reversed pulmonaryvenous flow at atrial systole PA wave was (32.7 ± 7.5 ) vs (38.9 ± 8.7) cm/s (P ＜ 0.01 ) in normotensivesand in NLVH patients respectively. The isovolumic relaxation time (IVRT) and left atrial dimension (LAD)have significant differences in three groups ( P ＜ 0. 05 - 0. 001 ). EF value was similar betweennormotensives and NLVH patients, but it was lower in LVH patients ( P ＜ 0.01 ). Conclusions E/Aratio, PA wawe, Pai, IVRT and LAD are sensitive parameters indicating mild diastolic left ventriculardysfunction. Systolic left ventricular function has no change in NLVH patients.

Epilepsy is a complications of brain injury or stroke,and is a common diseases in reha-bilitation or neurology department.Transcranial magnetic stimulation as a classical treatment means for stroke or brain injury,but also can promote the recovery of epilepsy.However,there is no clear clinical re-port for safety of epilepsy patients use both donepezil and transcranial magnetic stimulation .The article re-views the literature.Clinicians maybe provided some help.

Objective To assess the correlation between coronary heart disease and common carotid artery and femoral artery atherosclerosis with two-dimensional color Doppler ultrasound (2D-CDUS). Methods Ninety patients with coronary heart disease were divided into three subgroups according to the extent of coronary artery stenosis observed with coronary angiography, and 50 normal subjects were taken as normal group. Ultrasound examination with high-frequency linear array probe was performed to measure IMT of common carotid and femoral artery in order to observe the plaque and extent of stenosis, the formation of blood dynamics, physical characteristics and hemodynamic environmental parameters. Results Among the coronary disease groups, common carotid artery and the femoral artery IMT, atherosclerotic plaque in the number, rate and all points increased along with the degree of coronary artery stenosis increasing. Physical characteristics and its hemodynamic environmental parameters had some changes with the increase of atherosclerosis. Conclusion The atherosclerosis of common carotid artery and the femoral artery are closely related with coronary atherosclerosis.

ObjectiveTo investigate the long term effect of different antihypertensive agents on renal hemodynamics with ultrasound Doppler.Methods52 essential hypertensive patients were divided into three groups according to the antihypertensive agent they took: angiotensin-converting-enzyme inhibitor (ACEI), calcium channel blocker (CCB) and β-adrenoceptor blocker (βB). The blood pressures of right upper arms were measured with mercury column blood pressure gauge using Korotkoff method. Renal hemodynamics were examined with ultrasound Doppler before and after treatment with agents. ResultsSystolic blood pressure (SBP) and diastolic blood pressure (DBP) of all patients were decreased significantly. An significant correlation was found between the deceases of blood pressure and the betterment of renal homodynamic parameters in ACEI and CCB groups, but not in βB group. ConclusionTo a degree, the betterment of renal hemodynamics is correlation with the reduction of systemic blood pressure and mechanism of action of antihypertensive agents.

OBJECTIVETo study the effect of Fuzheng Sanjie recipe in regulating tumor-associated macrophages (TAMs) in Lewis lung cancer mice.

METHODEfforts were made to establish the Lewis lung cancer mouse model, weigh tumors and calculate the anti-tumor rate. The immunohistochemical method was used to examine the infiltration degree of CD68 + in tumor tissues in each group. ELISA was used to examine the content of IFN-γ, TGF-β, IL-4, IL-13, IL-6, IL-10, IL-12, TNF-α in mice serum.

RESULTCompared with the tumor-bearing model group, all of the other groups showed higher tumor inhibition rates, i. e. 50.28% for the DDP group, 34.37% for the TCM-preventing group and 66.76% for the Chinese and western medicine group, with statistical difference (P < 0.05), but without statistical difference in the infiltration degree of CD68+. The expressions of the IFN-γ, IL-6, IL-12 in tumor-bearing groups were lower than that in the blank control group, but with higher contents of IL-4, IL-13, TGF-β. Intervened with different drugs, there were significant differences in content among some relevant cytokines (P < 0.05), as well as statistical differences among the TCM prevention group, the Chinese and western medicine group and the tumor-bearing control group (P <0. 05) , but without statistical difference in TNF-α and IL-10 content from the tumor-bearing control group (P < 0.05).

CONCLUSIONFuzheng Sanjie recipe could reverse the immune remodeling effect and control the tumor growth by down-regulating the expressions of IL-4, IL-13, TGF-α in lung cancer immune microenvironment and up-regulating the expression of IFN-γ.

Animals ; Cell Line, Tumor ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Interleukin-10 ; blood ; Interleukin-12 ; blood ; Interleukin-13 ; blood ; Lung Neoplasms ; blood ; drug therapy ; immunology ; Macrophages ; drug effects ; immunology ; Male ; Mice ; Mice, Inbred C57BL ; Transforming Growth Factor beta ; blood ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the safety of human purified Vero cell rabies vaccine(PVRV)after exposure in China by Meta-analysis.Methods With rabies,vaccine and safety as key words,a systematic search was performed in PubMed,EMBASE,Cochrane and China National Knowledge Infrastructure(CNKI),supplemented by manual retrieval.A Meta-analysis was performed to analyze the incidence of adverse events of two immunization regimens Zagreb and Essen using Review Manager 5.4 software after literature screening and data extraction according to the inclusion and exclusion criteria.Results A total of 12 studies were included,of which 7 were prospective studies and 5 were retrospective studies.Most included in the studies showed a low risk of bias.The incidence of adverse events in Zagreb regimen was significantly higher than that in Essen regimen[relative risk(RR)= 1.01,95% CI = 0.90 ～ 1.14;I2= 73.00%,P<0.05],but there was a high degree of heterogeneity.The incidence of fever,pain and induration in Zagreb regimen was significantly higher than that in Essen regimen(RR = 1.14,0.92 and 0.86,95% CI = 0.82 ～ 1.60,0.73 ～ 1.14 and 0.29 ～ 2.51;I2= 73.00%,P<0.05],but there was a high degree of heterogeneity.The incidence of fever,pain and induration in Zagreb regimen was significantly higher than that in Essen regimen(RR = 1.14,0.92 and 0.86,95% CI = 0.82 ～ 1.60,0.73 ～ 1.14 and 0.29 ～ 2.51;I2= 81%,65% and 92%,respectively,P<0.01).Conclusion Two regimens of PVRV vaccination after exposure showed good safety.However,when adopting Zagreb regimen,attention should be paid to the physical conditions of children and the elderly with relatively poor immunity to avoid adverse events.

Objective:To explore the clinical efficacy and surgical indications of Y type osteotomy in the treatment of post-tuberculous thoracolumbar severe angular kyphosis.Methods:From March 2012 to June 2018, 36 patients with post-tuberculous thoracolumbar severe angular kyphosis were treated with Y type osteotomy, including 22 males and 14 females, aged 23.6±5.7 years (range, 7-57 years). The parietal vertebrae of kyphosis were located in the upper thoracic vertebra in 3 cases, the thoracic vertebra in 11 cases, the thoracolumbar segment in 17 cases, and the lumbar vertebra in 5 cases. The Cobb angle of kyphosis before the operation was 92.8°±23.3° (range, 60°-147°). The visual analogue scale (VAS), American Spinal Injury Association (ASIA) neurological function grade, and Kirkaldy-Willis function score were used to evaluate the clinical effect. The imaging evaluation indexes were interbody kyphosis angle and spinal bone fusion.Results:The operation was successful in all the 36 patients. The operation time was 210 ±25.9 min (range, 180-270 min), the intraoperative blood loss was 520 ±110 ml (range, 400-800 ml), and the postoperative follow-up time was 26.38±1.75 months (range, 22-30 months). The postoperative kyphosis Cobb angle was corrected to 16.5°±7.7° (range, 5°-35°), which was significantly improved compared with that before operation( t=25.438, P<0.01), and the correction rate was 82.2%. At the last follow-up, the kyphosis angle was 16.5°±7.1° (range, 6°-32°), which was not significantly different from that after the operation. The preoperative VAS score was 7.3±1.8 (range, 3-9), and the postoperative VAS score was 2.4±0.8 (range, 1-3), while the improvement rate was 67.1%. At the last follow-up, it was 1.1±0.6 (range, 0-2), and the improvement rate was 85.0%. According to the Kirkaldy-Willis functional score, the results were excellent in 25 cases, good in 8 cases, and fair in 3 cases at the last follow-up, with an excellent and good rate of 91.7%. Before the operation, 9 cases were accompanied by neurological dysfunction (ASIA grade: grade C in 2 cases, grade D in 7 cases). At the last follow-up, all the 9 patients recovered to grade E. During the operation, the electrophysiological nerve monitoring was abnormal in 2 patients, and the awakening test was negative in 1 case. In another patient, neuroelectrophysiological monitoring after posterior column osteotomy showed a decrease in bilateral sensory and motor function. There was no compression around the spinal cord in the osteotomy area, so the operating bed was gradually folded and partially restored to kyphosis and temporarily fixed with double rods. Neuroelectrophysiological monitoring suggested the recovery of nerve function. The awakening test showed that the nerve function of both lower limbs recovered close to the preoperative state, and further osteotomy and internal fixation was performed 2 weeks later. The nerve function of both lower limbs returned to normal after 3 months. After the operation, one patient's muscle strength of the lower limbs decreased from grade 5 to grade 3, and the sensory function was normal. After symptomatic support treatment such as neurotrophic drugs, it returned to normal 2 weeks later. 1 case developed delayed neurological dysfunction 1 year after the operation. Neurotrophic drugs and rehabilitation treatment improved it. The sinus of the incision was formed in one case 3 months after the operation and healed after debridement and suture. Conclusion:Y typeosteotomyis a safe and effective method for patients with post-tuberculous thoracolumbar severe angular kyphosis. Compared with traditional osteotomy, anterior support bone grafting can be avoided, and spinal shortening can be reduced.

Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.

The aim of this study was to investigate the inhibition effect of arsenic sulfide (As2S2) on the growth of in vitro cultured BMMNC from MDS patients and to explore its possible cellular and molecular mechanisms. The apoptosis of MDS cells induced by As2S2 solution of different concentrations were studied with MTT, flow cytometry, and RT-PCR. The results showed that (1) low concentration of As2S2 (0-0.6 mg/L) had no marked inhibition effect on proliferation of MDS cells; (2) after treatment with 1.5-50 mg/L of As2S2, both low risk MDS cells and high risk MDS cells presented typical features of apoptosis with a dose-dependent manner, the expression of bcl-2 mRNA and the ratio of bcl-2/bax obviously decreased after As2S2 treatment (P < 0.05); (3) BMMNC from MDS patients had higher apoptosis ratio than that of BMMNC from control. It is concluded that BMMNC excessive apoptosis exists in MDS patients; low concentration of As2S2 (0-0.6 mg/L) shows no inhibition effect on proliferation of MDS cells; high concentration of As2S2 (1.5-50 mg/L) induces apoptosis of MDS cells.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; Bone Marrow Cells ; pathology ; Cyclin D1 ; biosynthesis ; genetics ; Female ; Humans ; Leukocytes, Mononuclear ; pathology ; Male ; Middle Aged ; Myelodysplastic Syndromes ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Sulfides ; pharmacology ; bcl-2-Associated X Protein ; biosynthesis ; genetics