Objective To observe dynamic changes of Nestin and Erythropoietin(EPO)expression after cerebral ischemia and investigate possible mechanism of intrinsic neurogenesis. Methods A total of 36 SpragueDawley rats were divided into a control group(n=4)and an experimental group(n=32)randomly.The experimental group were further divided into 8 subgroups corresponding to the observation time points of 3,6,12,24 hours and 3,7,14,and 21 days after reperfusion.The model of experimental ischemia was made by 4-VO.The specimens were made into paraffin section.The expression of Nestin and EPO were detected by immunohistochemistry method. Results (1)Nestin detection:No Nestin positive cells were observed in hippocampal zone,subventricular zone (SVZ)and contex in the control group.The expression of Nestin started at 3 h in SVZ but not in hippocampal zone and it started to increase at 6 h after cerebral ischemia and reach a peak at 14d after cerebral isehemia in the hippocampal zone,then decreased at 21 d.The difference of Nestin expression among different time points is statistically significant(P<0.05).(2)EPO detection:A few EPO positive cells were observed in hippocampal zone in the control group.The expression of EPO started to increase at 3 h after cerebral ischemia and reach a peak at 24 h after cerebral ischemia,then decreased with time.The difference of EPO expression among the different time points is statistically significant(P<0.05). Conclusion (1)The increased expression of EPO and Nestin after cerebral ischemia might be a beneficial protective response of cells to the ischemic injury.(2)The sequence of expression of EPO and Nestin after cerebral ischemia is relevant.EPO may promote proliferation of NSC.

Objective To investigate the effects of Bushen-Huoxue decoction on the plasma level of brain natriuretic peptide (BNP) and heart function in patients with chronic heart failure (CHF) due to kidney deficiency and blood stasis. Methods A total of 96 patients with CHF due to kidney deficiency and blood stasis were randomized into a treatment group (50 cases) and a control group (46 cases). In the control group, the normal treatment of western medicine was given. In the treatment group, on the basis of the control group, Bushen-Huoxue decoction was added. Both groups were treated for 4 weeks. The plasma BNP level was detected with enzyme-linked immunosorbent assay. The left ventricular ejecting function, New York Heart Association functional classes and score of traditional Chinese medicine syndromes were evaluated before and after the treatment. Results After the treatment, the plasma BNP level in the treatment group was significantly lower than that in the control group (897.3 ± 286.7 pg/ml vs. 1 423.5 ± 458.7 pg/ml;P<0.05);the left ventricular end systolic diameter (4.8 ± 0.8 cm vs. 5.4 ± 0.9 cm) and the left ventricular end systolic volume (57.23 ± 5.30 ml vs. 69.78 ± 5.86 ml) in the treatment group were significantly lower than those in the control group (all P<0.05);the stroke volume (72.56 ± 7.23 ml vs. 62.56 ± 5.86 ml) and the left ventricular ejection fraction (59.75%± 6.47%vs. 49.87%± 6.91%) in the treatment group were significantly higher than those in the control group (all P<0.05). The heart function (90.0%vs. 80.4%;χ2=4.369, P<0.05) and the traditional Chinese medicine syndromes (94.0%vs.82.6%;χ2=3.988, P<0.05) had shown significant improvement in the treatment than those in the control group. Conclusions Bushen-Huoxue decoction can reduced the plasma BNP level, improve the heart function in patients with CHF due to kidney deficiency and blood stasis.

BACKGROUND: Conservative treatment of osseous gonarthritis (OG) is mainly to reduce the loading of knee joint and maintain muscle exercise,and non-steroidal anti-inflammatory drugs serve as supplements in case of acute occurrence.OBJECTIVE: To investigate the effect of combination of intraarticular in jection of hyaluronate and pain-point injection of betamethasone in improving the pain symptom in patients with OG.DESIGN: Open experiment.SETTING: Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: We selected 45 OG patients, who were aged 40 to 85years and received treatment in the clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between January 2004 and October 2004.METHODS: OG parenteral solution was intraarticularly injected into the knee joint, 2.5 mL once a week, 5 weeks set as a disease course. Pain points around knee joint were searched for following thorough physical examination. Anti-inflammatory analgesic solution of 2.0-3.0 mL was injected at each pain point. Physical examination was repeated before treatment in each week. Injection at pain points was maintained if they were still present. Intraarticular injection of hyaluronate was performed only when the pain points disappeared after treatment.MAIN OUTCOME MEASURES: ① Pain score at rest and at exercise.② Time when pain disappeared and times of betamethasone administration.RESULTS: Totally 45 patients entered the result analysis. ① Pain at rest and at exercise 1 week after combination treatment of intraarticular injection of hyaluronate and pain-point injection of betamethasone was ignificantly lessened compared to that before treatment (P ＜ 0.01). Pain relief was more significant at rest than at exercise (P ＜ 0.01). ② Pain disappeared at (17.07±6.00)days after treatment on average. The average times of betamethasone administration was (2.42±0.78) times. ③ No local joint pain and other adverse reactions occurred after administration in any case.CONCLUSION: Combination of intraarticular injection of hyaluronate and pain-point injection of betamethasone can effectively relieve the pain symptom of osseous gonarthritis, with no obvious adverse reactions.

Objective To observe the clinical effect of treating atlanto-axial subluxation by manipulative reduction therapy. Methods 128 patients with atlanto-axial subluxation confirmed by cervical plain X ray were randomized into two groups: 64 in the treatment group treated by manipulative reduction therapy, and 64 in the control group treated by the routine cervical traction. The clinical effect was evaluated by both clinical and X-ray confirmation. Results The X-ray study showed that after treatment the reconstruction of excursion in odontoid process in the treatment group was better than that in the control group significantly (P<0.01). The improvement of vertebra basal artery blood flow in the treatment group was also better than that in the control group significantly (P<0.05). The total effective rate of the treatment group was 95.3%, while the control group was 78.1%. Conclusion The technique of manipulative reduction on atlanto-axial subluxation acts more directly on the cause of the disease than the routine traction, and exerts better results in restoring proper atlanto-axiai joint position and mechanics stability of cervical vertebra.. Thus it is the effective shortcut way with high safety and low cost.

Bone and Bones ; pathology ; Humans ; Immunologic Deficiency Syndromes ; diagnosis ; Osteochondrodysplasias ; diagnosis

Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Jaw ; physiopathology ; Male ; Middle Aged ; Temporomandibular Joint Disorders ; physiopathology ; therapy ; Young Adult

Background and purpose:Obvious pulmonary dysfunction may exsist preoperatively in part of the patients undergoing pulmonary lobectomy. Volume-controlled ventilation (VC) during one-lung ventilation (OLV) may lead to lung injury in lung cancer patients with preoperative pulmonary dysfunction. However, pressure-regulated volume-controlled (PRVC) ventilation mode is a new type of ventilation mode, and can alleviate ventilation-induced lung injury. This study explored the effect of PRVC on respiratory mechanics, oxygenation index, pulmonary inlfam-matory response, and clinical outcomes in patients undergoing pulmonary lobectomy during OLV compared with VC mode.Methods:Forty ASAⅡ-Ⅲ patients with moderate to severe pulmonary dysfunction undergoing pulmonary lobectomy were randomly divided into group VC and group PRVC (n=20).PRVC ventilation mode was performed for patients in group VC during the ifrst 5 minutes after OLV, and then ventilation mode was switched to VC ventilation mode till the end of surgery. In the other group, ventilation modes were performed in reverse order. Ventilation settings remained unchanged when ventilation mode was switched. Respiratory mechanics, static lung compliance, hemody-namic parameters and arterial blood gas were obtained during the surgery. Blood samples and bronchoalveolar lavage (BALF) in ventilated lung were collected to determine the level of TNF-α, IL-1β, IL-6 and IL-8 at the end of surgery.Results:Both the peak expiratory pressure and static lung compliance in group PRVC were signiifcantly lower than those in group VC (P<0.01). However, there were no statistical difference in hemodynamic parameters (heart rate and blood pressure) and arterial blood gas analysis (pH,paO2andpaCO2) between the two groups during OLV, as well as postoperative pulmonary complications and length of hospital stay. The levels of TNF-α, IL-1β and IL-6 in BALF in group PRVC were signiifcantly lower than those in group VC (P<0.05), while there was no difference in blood sample. Conclusion:PRVC mode during OLV may relieve the extravagant airway pressure and then reduce the release of inlfammatory factors in ventilation lung, which might prevent acute lung injury induced by lung barotraumas, especially for those patients with pulmonary dysfunction preoperatively. Therefore, PRVC mode is a safe and effective ventilation mode for high-risk patients undergoing pulmonary lobectomy.

Objective To study the relationship between the activity of interleukin-4 and interferon-? with steroid effect in children with primary nephrotic syndrome before initiation of steroid therapy. Methods The activity of interleukin-4 and interferon-? in the supernatants of monocytes cell cultures activated with phytohemagglutinin was assessed with enzyme-linked immunosorbentassay in 31 children with primary nephrotic syndrome before iniatiation of steroid therapy. After steroid treatment for 8 weeks, data of steroid sensitivity and resistance were analyzed. Results Before initiation of steroid treament, in steroid sensitivity children with primary nephrotic syndrome an increased proliferative response of interleukin-4 was found (P0.05). Conclusion The activity of interleukin-4 is a useful tool for evaluating the likelihood of steroid sensitivity in children with primary nephrotic syndrome.

Objective To evaluate the features and visualization of venous arcades of the pancreatic head (VAPH) using 16-slice CT with different techniques.Methods Portal-phase CT scanning with 16-slice CT was performed in 40 cases.The visualized rate of VAPH with axial images,thin slice maximum intensity projection(TSMIP) and volume rendering(VR) was assessed.Results With axial images,TSMIP and VR,the visualized rate of right gastro-epiploic vein and gastro-colic vein were all 100% and 80% respectively;while for right colic superior vein was 100%,87.5% and 80%;pancreaticoduodenal posterior-superior vein was 92.5%,65% and 40%;pancreaticoduodenal anterior-superior vein was 92.5%,62.5% and 45% respectively.Conclusion VAPH can be showed definitely using 16-slice CT in combination of axial images,TSMIP and VR images.

To investigate the therapeutic effect of Lamivudine on reinfection of hepatitis B virus, seven patients with terminal HBV related hepatic diseases who had received orthotopic liver transplantation, were studied. Among them, 5 patients were treated with lamivudine bcfore and after liver transplantation, and 2 patients received common antiviral treatment. No hepatitis B virus reinfection and YMDD mutations occurred in the group of patients with Lamivudine therapy. However in the group of patients receiving common antiviral therapy, both patients suffered from hepatitis B virus reinfection. Lamivudine is potentially effective in the prophylaxis of hepatitis B virus reinfection after orthotopic liver transplantation.