A case of traumatic delayed meningo-encephalocele suffered orbital fracture, but bony defects in frontal sinus had not been found on CT scanning. We treated the patient with surgery of intranasal endoscopy and repaired the skull base defect successfully during the first attempt. There was no recurrence in 10 months followed up. The leak site may not correlate with imaging in traumatic delayed meningo-encephalocele by comparing operative findings with the imaging estimate and endoscopy. Therefore, endoscopical approaching is effective in seeking and treatment.
Encephalocele ; complications ; Endoscopy ; Exophthalmos ; etiology ; Frontal Sinus ; pathology ; Humans ; Orbital Fractures ; pathology ; Recurrence ; Tomography, X-Ray Computed

Objective To study the effect of mecobalamine treatment on acute cerebral infarction combined with high homocysteine (Hcy) and post-stroke depression.Methods A total of 160 cerebral infarction patients with high Hcy were collected from January 2010 to December 2011 in our hospital.Patients were randomly divided into two groups:the control group (n=80,with routine therapy) and the treatment group (n=80,with routine therapy plus intramuscular injection with folic acid 500μg for 8 weeks).The plasma concentration of Hcy was determined by fluoresene polarization immunoassay.The improvement of depression,anxiety and life skills in patients were assessed by selfmade questionnaires and self-reporting inventory (SLC 90).Results There were no significant differences in plasma Hcy level in control group before versus after treatment [(21.86±4.76) μmol/L vs.(18.67±3.81) μmol/L,t=0.40,P＞0.05].Compared with before treatment,plasma Hcy level in treatment group was significantly reduced 4 weeks after treatment [(11.66 ± 3.28) μmol/L vs.(22.68±5.16) μmol/L,t=2.55,P＜0.01].There was a significant difference in plasma Hcy level between the treatment group and the control group after treatment [(11.66 ±3.28) μmol/L vs.(18.67±3.81) μmol/L,t=7.40,P＜0.01].TheSCL-90 total score,positive symptom items score,the total score and the average score of positive symptom items were significantly lower in treatment group after treatment than in treatment group before treatment (t=2.04,2.97,5.45,4.21,all P＜0.05) and in control group after treatment (t 7.40,7.58,12.78,4.15,all P＜0.05).The improvement on symptomatic patterns including somatization,obsessive-compulsive problems,interpersonal sensitivity,depression,anxiety and fear were better in treatment group after treatment than in treatment group before treatment (t 2.34,2.28,2.51,2.19,3.40,2.35,allP＜0.05) and in control group after treatment (t=4.10,5.04,5.12,4.18,5.48,5.20,all P＜0.05).There were no significant differences in the improvement in paranoid ideation between the treatment group before and after treatment (t=1.40,P＞0.05),between the treatment group and the control group after treatment (t=1.48,P＞0.05),and between the control group before and after treatment (P＞0.05).Conclusions Mecobalamine can effectively reduce plasma Hcy level in cerebral infarction patients with high plasma Hcy,and alleviate the symptoms of anxiety,depression,nervousness and other emotions.

Objective]To explore the clinical value of the theories in the seven papers of Yunqi.[Method] Analysing the usage of the correlation theories of Yunqi in Cases of Well-known Physicians and its sequel, consulting the commentaries and application of many well-known physicians, this paper summarizes some theories which are applicable to clinic.[Result]In the seven papers of Yunqi, the theory of avoidance of harm by restraining excess and the theory about the inconformity of pulse and disease can exclude false symptoms and infer real pathogenesis.19 questions about pathogenesis can be a reference of clinical diagnosis.The theory of South-North can be used to exclude the impact of climate on the pulse and assist diagnosis. Rationally using the theory of Suiyun contributes to infer etiology and establish therapy.[Conclusion]Cases of Well-known Physicians and its sequel reflect the application and exertion of the theories of Yunqi by ancient physicians. They help to understand the theoretical system and instruct clinical application. In addition to the theory of Suiyun, the seven papers of Yunqi also include a lot of theories which are applicable to clinic.

OBJECTIVETo explore an effective method for increasing therapeutic effect on chronic prostatitis.

METHODSEighty-two cases of chronic prostatitis were randomly divided into two groups. The western medicine group of 42 cases were treated with routine western medicine combined with retention enteroclysis of 30 g Danshen (Red Sage Root) decoction; the warming needle moxibustion plus western medicine group of 40 cases were treated with the western medicine of the western medicine group plus warming needle moxibustion at Guanyuan (CV 4), Qihai (CV 6) and Zhongji (CV 3), etc.

RESULTSIn the warming needle moxibustion plus western medicine grbup, 20 cases were cured, 12 cases were markedly effective, 5 cases were effective and 3 cases were ineffective, the total effective rate being 92. 5%; and in the western medicine group, the corresponding figures were 13, 10, 7, 12 cases and 71.4%, with a significant difference between the two groups in the total effective rate (P < 0.05).

CONCLUSIONWarming needle moxibustion can increase the therapeutic effect on chronic prostatitis.

Adult ; Chronic Disease ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Prostatitis ; therapy ; Salvia miltiorrhiza

The purpose of this study is to explore depression metabolic markers in rat hippocampus and to investigate the anti-depressant effect of genipin and its mechanisms using nuclear magnetic resonance (NMR) metabonomics. Chronic unpredictable mild stress (CUMS) procedure was conducted to establish the depressive rat model. At the beginning of the third week, genipin low dose (25 mg x kg(-1)), middle dose (50 mg x kg(-1)), high dose (100 mg x kg(-1)), and venlafaxine (50 mg x kg(-1)) were given to the CUMS rats separately once daily for two weeks except control and model groups. Rat hippocampus was analyzed by 1H NMR based metabonomics after drug administration for 2 weeks. Significant differences in the metabolic profile of rat hippocampus of the CUMS treated group and the control group were observed with metabolic effects of CUMS including decreasing in glycine and N-acetylaspartate, increasing in inositol, glutamate, lactate, glutamine, taurine and alanine. Genipin showed ideal antidepressive effects at a dose of 50 mg x kg(-1) in rats, decrease of inositol, glutamate, lactate, alanine were observed, while glycine and N-acetylaspartate were increased. Important influence has been found on normal nervous system function of these significant changed metabolites, which suggests that the antidepressant effect of genipin may be played by enhancing the activity of neurons in hippocampus, repairing and improving the function of the neuron. The metabonomics approach is an effective tool for the investigation of the anti-depressant effect and pharmacologic mechanisms of genipin.
Alanine ; metabolism ; Animals ; Antidepressive Agents ; isolation & purification ; pharmacology ; Aspartic Acid ; analogs & derivatives ; metabolism ; Behavior, Animal ; drug effects ; Chronic Disease ; Depression ; drug therapy ; metabolism ; physiopathology ; Gardenia ; chemistry ; Glutamic Acid ; metabolism ; Glycine ; metabolism ; Hippocampus ; drug effects ; metabolism ; Inositol ; metabolism ; Iridoids ; isolation & purification ; pharmacology ; Lactic Acid ; metabolism ; Magnetic Resonance Spectroscopy ; Male ; Metabolomics ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley

Adult ; Embolism, Amniotic Fluid ; etiology ; therapy ; Female ; Humans ; Pregnancy

Objective To evaluate the radiobiological effect of different irradiation fractionated regimens in human glioma cells ( BT 325 cell line). Methods The xenografts in Balb/c-nude mice were irradiated with different single and fractionated regimens. The single fraction dose was 10, 20, 30, 40 and 60 Gy, respectively. The fractionated regimens were 2 Gy × 5 fractions ( irradiated every day), and 3 Gy ×3 fractions (irradiated every other day), 3 Gy × 5 fractions (irradiated every day) and 4 Gy × 3 fractions (irradiated every other day), with total doses of 125 Gy, 114 Gy, 126 Gy and 112 Gy, respectively. The growth curve was used to evaluate the tumor doubling time. clonogenic assays was performed to draw the cell survival curve and analyze the radiobiological parameters with doses of 1, 2, 4, 6, 8 and 10 Gy. T1/2 was measured by comet assay. Results Tumor regression were not observed by single fraction irradiation, 2 Gy × 5 fractons and 3 Gy × 3 fractions irradiation regimens. The tumor regress was more significant with the increas of fraction dose. The 4 Gy × 3 fractionrs inhibited tumor more though not curing tumor. The cell doubling time of the BT 325 cell was 30. 16 h and the tumor doubling time of the xenograft was 43 days.When fitted with L-Q model ,α was 0. 36 Gy -1 and β was 0. 057 Gy -2. When fitted with the single-hit multitarget model, D0 was 1. 394 Gy, Dq was 2. 127 Gy and SF2 was 0. 714, respectively. The T1/2 was 9. 999min. Conclusions Glioma is a radioresistant tumor. Increase of the fraction dose improves recent effect.Further study is needed to control the tumor stem cells.

Objective To study dose-response relationship and screen the optimized fractionated irradiation schedules in subclinical tumors of malignant glioma.Methods Balb/c-nude mice bearing human malignant glioma xenograft were assigned randomly into control group,fractionated irradiation schedules group and nimotuzumab-conventional fraction group.The fractionated schedules were 200 cGy x 5f/w,300 cGy ×5f/w,160 cGy ×2f/d x5 d and 400 cGy ×3f/w with total dose of 40 Gy and 60 Gy,respectively.Measurement indexes were tumor-forming rate,average recurrence time and maximum diameter of the tumor bottom.The observation lasted 24 weeks.Results With the total dose of 40 Gy,none of the significant long-term tumor regression were detected in any fractionated irradiation schedules; 400 cGy x 3f/w with complete tumor response at the end of treatment showed a better short-term curative effect.With the total dose of 60 Gy,long-term control rate of each fractionated irradiation schedule group was improved with prolonged average recurrence time of varable degrees,except 200 cGy x 5f/w fractionated schedule (tumor formation rate was 100％ at the end of treatment and average recurrence time was the poorest of 108 d).160 cGy × 2f/d × 5 d fractionated schedule showed the best curative effect with no tumor formation in 2 of 8 mice and longest recurrence time of 143 d.300 cGy x 5f/w fractionated schedule ranked second with no tumor formation in 1 of 8 mice and average recurrence time was 137 d.400 cGy x 3f/w fractionated schedule produced the poorest outcome with no case cured.There were no significant changes in the tumor-forming rate or average recurrence time when nimotuzumab was concurrently used for subclinical tumors of malignant glioma with total dose of 60 Gy.Conclusions Conventional fractionated irradiation is not the best option to control the sustained growth.160 cGy ×2f/d ×5 d and 300 cGy × 5f/w might be the optimized fractionated irradiation schedules for subclinical tumors of malignant glioma.

ObjectiveTo evaluate the efficacy and safety of domestic taerolimus in the manage-ment of acute rejection in renal transplantation reeipienta.MethodsA multieeneter, open and com-parative study for domestic Taerolimua and Prograf was performed. Eighty reeipienta of first allogenie renal transplantation were randomized into 2 groups: ①Experimental group (accepting Fumeixin ad-ministration, n=58) included 23 males and 35 females with the mean age of(39.1±9.6)years. ②Control group(accepting Prograf administration, n=22) included 12 males and 10 females with the mean age of(41.34±8.5)years. There was no significant difference in the volume, warm and cold is-chemia time of donor renal, age and sex of donor. All of the 80 cases accepted tacrolimus (domestic or foreign made, at the dose of 0. 10～0. 15 mg·kg-1·d-1 , q 12 h) treatment that combined with MMF and prednisone posttransplantation. Tacrolimus CO was aimed to 8-12 ng/ml in the first 60 days and 5-10 ng/ml later. The dose of MMF was according to the rule of each transplantation center based on the following recommendation: 1.5-2.0 g/d for the weight above 70 kg, 1.5 g/d for the weight 50-69 kg, and 1.0 g/d for the weight below 49 kg, in two divided doses. Prednisone was ad- ministrated as per ruler of each center. ResultsObservation termination was 3 months. Morbility of actue rejection was 3.40% (2/58)and 13.6% (3/22) in experimental and control group(P>0.05). Ad-verse events including hypertension, hyperlipemia, hyperglycemia and slight abnormality of liver func-tion occurred in 36. 2%(21/58) and 36. 4% (8/22) cases of experimental and control group(P> 0. 05). The survival rate in the 2 groups was 100%. The dose of tacrolimus in experimental group was significantly lower than that in the control group at 8 and 12 weeks posttransplant, while drug valley concentration in serum was proximal in 2 groups during the whole observation period.Conclusion Domestic tacrolimus capsules can be used effectively and safely in the management of acute rejection in renal transplantation.

Purpose To investigate the value of bedside ultrasonography for emergent patients in the diagnosis of vasa previa and umbilical cord prolapse. Materials and Methods The bedside ultrasonography data of 12 emergent cases of vasa previa and 18 emergent cases of umbilical cord prolapse were retrospectively analyzed for detection rate. Results Nine out of 12 emergent patients with vasa previa were detected by bedside ultrasonography;2 were misdiagnosed as umbilical cord prolapsed;and 1 patient who had missed diagnosis suffered fetal demise during vaginal labour. Fifteen out of 18 emergent patients with umbilical cord prolapse were detected by bedside ultrasonography;2 were misdiagnosed as vasa previa; and 1 missed diagnosis (no death case was reported). The detection rates for both groups of patients had no significant difference (P>0.05). Conclusion Bedside ultrasonography for emergent patients can visualize the traveling of vasa previa and umbilical cord prolapse so as to promptly provide evidence for clinical diagnosis and reduce perinatal mortality.