Objective To investigate the effect of integrative Chinese and western treatment in gouty nephropathy.Methods 200 cases of gouty nephropathy were divided into Integrative Medicine group( treatment group,n =100)and allopurinol treatment group( control group,n =100),The symptom scores,blood urea nitrogen(BUN),creatinine(CR),serum uric acid(UA),24h urinary protein excretion were observed.Results After treatment symptom scores were significantly lower than before treatment ( P ＜ 0.05 ～ 0.01 ) ; treatment group were lower than the control group( P ＜0.05 );Total effective rate of the treatment group( 86.0％ ) was significantly higher than that of the control group(75.0％ ) (P ＜ 0.05 ) ;After treatment,the renal function was significantly improved,but that of the treatment group was better than the control group( P ＜ 0.05 ).Conclusion Integrative Medicine in the treatment of gouty nephropathy had a good effect.

Twenty-five patients with traumatic carpitis treated by wrist fusion plate internal fixation in Department of Orthopedics, Commercial Staff Hospital of Wuhan from July 2000 to July 2007 were selected, of which 21 were followed up for more than 6 months. Twelve cases had slight dorsal extension dysfunction of thumb, forefinger and middle finger; 10 had slight initiative dorsal extension dysfunction of thumb interphalangeal articulation; 4 had forearm rotation dysfunction, such as distal radioulnar joint or ulnaris pain. Of 21 followed-up patients, 12 cases had no pain, 5 had bearable wrist pain after intensive physical labor, and 4 had pain in daily life of forearm rotation, which affected their working. Grip strength of 15 cases restored to 75% of the operate side, 5 cases to 50%-75%, and 1 case to 50%. The results suggest that plate implantation relieve joint pain, but partial wrist function is limited. The plate materials are biocompatible to human body with no specific adverse effects.

[Objective]To provide Chinese morphological data for anterior C1、2 transarticular screw fixation.[Method]With a digital vernier and a goniometer made in China,the anatomic parameters related to anterior C1、2 transarticular screw fixation were measured from 50 pairs of dried Chinese adult human C1 and C2 vertebrae.[Result]In the anterior transarticular screw fixation,the lateral angulation of the screw tract to the sagittal plane ranged from(10.8?2.10)? to(25.13?3.12)?,the posterior anguation to the coronal plane from(8.85?2.12)? to(26.96?3.09)?,the screw tract length was from(17.48?2.1) mm to(25.4?2.59)mm,the distance from medial part of C2 foramen to the middle of C2 body was(14.12?1.28)mm.[Conclusion]It is optimal for the anterior C1、2 transarticular screw fixation to place the anterior C1、2 transarticular screw with the length of 17 mm to 25 mm in lateral angulation ranged from 10? to 25? and the posterior angulation ranged from 9? to 27?.During the procedure,the dissecting distance from the middle of C2 to lateral should not exceed 14 mm.

Objective To explore the clinical characteristics of evolutionary type of traumatic subdural hydroma(ETTSH) and experiences of diagnosis and treatment of ETTSH. Methods The clinical data of 37 patients with ETTSH were analyzed retrospectively. Results The patients ages were from 3 months to 75 years old, most of primary craniocerebral injuries were mild, the main clinical manifestation was chronic increased intracranial pressure, and the final diagnosis time by CT scanning was 28 to 110 days after craniocerebral injury. All patients had a good prognosis by surgical drainage. Conclusion Polarized age, mild primary craniocerebral injury and chronic increased intracranial pressure are the main clinical characteristics of ETTSH. Dynamic CT scanning and surgical drainage were the first choice of diagnosis and treatment of ETTSH, respectively.

Objective To evaluate the characteristics of leptomeningeal metastasis of gliomas on magnetic resonance(MR) imaging and to provide evidence for clinical early diagnosis and treatment.Methods Twenty-one cases of intracranial gliomas with leptomeningeal metastases were scanned with conventional spin echo(SE) and fast spin echo(TSE),8 cases with fluid attenuated inversion recovery(FLAIR),and all of cases were operated with enhancement.Results ⑴ With MR plain scan,18 cases revealed vary range of distortion and illegibility structure of cerebral cistern and sulcus,and 6 cases revealed the asymmetrical enhancement of the wall of ventricle.Eleven meningeal neoplasms nodes were found in subarachnoid space in 7 cases,and some of the appearances could be seen in several cases.Eight cases of them were added with FLAIR,and the neoplasms nodes were showed more clearly and higher signal than TSE-T2W imaging.⑵ With MR enhancement,all cases with encephalic gliomas showed obvious enhancement with vary features of the enhancement of leptomeningeal metastasis,including tail sign(5/21),line sign(10/21),strip sign(3/21),node sign(7/21) and a few of cases included two signs.Conclusion It was very important for clinician to improve the cognition of MR imaging characteristics of leptomeningeal metastases of glioma,and to choose the proper MR imaging scan technique to increase the detection rate of early meningeal diseases.

Objective To investigate the curative effect of magnesium ion on patients with severe craniocerebral injury. Methods According to the standards,80 patients with severe craniocerebral injury were chosen and divided into control group and experimental group randomly. The control group received routine therapy and the experimental group received routine therapy plus magnesium sulfate. Serum endothelin(ET) and Glasgow coma score(GCS)of all the patients were measured at different time respectively,and Glasgow outcome scale(GOS)of all the patients were determined after 3 months,and then these data were analyzed statistically. Results Compared with the control group, Serum ET in the experimental group were lower,GCS were higher,and GOS were better. All these differences were significant(P

BACKGROUND: Cervical orthosis is one of the non-surgical therapeutic methods for the remedy of cervical deformities. The introduction of cervical orthosis into the clinical remedy of cervical deformities resulted by burn can maximally restore the cervical function of the patients.OBJECTIVE: To analyse the clinical applicative mode and the effects of moulded cervical orthosis (MCO) on cervical burn.DESIGN: A before-and-after verification study by employing pateitns as subjects.SETTING: Prosthetics and orthotic department in a provincial artificial limb center.PARTICIPANTS: Totally 19 cases including 13 males and 6 females after skin-transplantation due to serious burn in head, neck and chest admitted by the outpatient department of prosthetics center between January and September 2003.METHODS: Nineteen patients with cervical burn wore MCO. Return visits were made afterwards for the evaluation of the treatment effects of MCO.MAIN OUTCOME MEASURES: Resutls of therapeutic effectiveness evaluation.RESULTS: All nineteen patients with cervical deformities due to burn reached the effects of correcting cervical flexion and restoring cervical functions through wearing orthosis. The cervical functions restored entirely in seven cases, almost restored in eight cases and improved in four cases.CONCLUSION: MCO can be clinically used on cervical deformities resulted by burn and provide good effects on remedy and rehabilitation.

In order to solve the difficucties of renaturation and immunogenicity of new bifunctional fusion protein GAD,inclusion bodies of GAD were modified by PEG-maleimide.Conformational changes of the modified GAD were compared by circular dichroism and tryptophan fluorescence spectroscopy.The biological activity was verified by oral glucose tolerance test and lipid scavenging.The results showed that PEG-maleimide completed the specific-point modification of GAD,and improved its refolding efficiency.The secondary and tertiary structures of mPEGylated GAD were consistent with that of GAD.PEG-GAD has significant hypoglycemic and lipid-lowering effects (P ＜0.001) with longer half life in vivo and lower immunogenicity (P ＜0.01).This study provides effective strategies for the development of strongly hydrophobic peptide drugs.

Objective To evaluate the effects of different doses of dexmedetomidine administered intranasally on the median effective concentration (EC50) of sevoflurane inhibiting responses to laryngeal mask airway (LMA) insertion in the pediatric patients.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes, aged 1-3 yr, with body mass index of 20-25 kg/m2, scheduled for elective surgery under general anesthesia, were randomly divided into 3 groups: control group (group C) , dexmedetomidine 1 μg/kg group (group D1) , and dexmedetomidine 2 μg/kg group (group D2).In D1 and D2 groups, dexmedetomidine 1 and 2 μg/kg (in 1 ml of normal saline) were administered intranasally at 1 h before induction of anesthesia, respectively.Group C received the equal volume of normal saline administered intranasally.The children were separated from their parents at 45-60 min after intranasal administration and admitted to the operating room.The children inhaled 8％ sevoflurane until they lost consciousness.After loss of consciousness, the end-tidal concentration of sevoflurane was determined using the modified Dixon's up-and-down method.The initial end-tidal concentration of sevoflurane was set at 2％.The concentration was increased/decreased by 0.2％ in the next patient according to the response to LMA insertion.The patient's sedation status and with LMA acceptance were evaluated, and the patient's satisfaction with sedation and with LMA acceptance was recorded.Probit analysis was used to calculate the EC50 and 95％ confidence interval of sevoflurane inhibiting responses to LMA insertion.Results The patient's satisfaction with sedation and with LMA acceptance was significantly higher in D1 and D2 groups than in group C, and in group D2 than in group D1 (P＜0.05).The EC50 (95％ confidence interval) of sevoflurane inhibiting responses to LMA insertion was 2.03％ (1.91％-2.15％), 1.76％ (1.65％-1.87％) and 1.63％ (1.53％-1.73％) in C, D1 and D2 groups, respectively.The EC50 was significantly lower in D1 and D2 groups than in group C, and in group D2 than in group D1 (P＜0.05).Conclusion Dexmedetomidine 1 and 2 μg/kg administered intranasally can decrease the EC50 of sevoflurane inhibiting responses to LMA insertion in the pediatric patients, and 2 μg/kg produces better efficacy.

Objective To investigate the correlation between the indicators of common carotid artery mechanical dynamics, a circumferential wal tension (CWT) and a shear stress (SS), and cerebral smal vessel disease (SVD). Methods The neurological outpatients without obvious cardiovascular disease were enrol ed consecutively. The inner diameters of carotid arteries and blood flow velocity of the patients w ere measured by ultrasound examination, and their CWT and SS w ere calculated. Lacunar infarction and/or leukoaraiosis w ere determined according to the findings of MRI. Results A total of 296 patients w ere enrol ed, 163 of them had lacunar infarction and 132 had leukoaraiosis. Univariate analysis show ed that there w ere significant differences in the distributions of age, hypertension, diabetes, systolic blood pressure, diastolic blood pressure, CWT, and SS betw een the lacunar infarction group and the non-lacunar infarction group, as wel as between the leukoaraiosis group and the non-leukoaraiosis group (al P<0.05). After adjusting for relevant risk factors, multivariate logistic regression analysis show ed that the peak systolic CWT (odds ratio [OR] 3.60, 95% confidence interval [CI] 1.48-8.30) and end diastolic CWT (OR 1.22, 95%CI 1.21-1.25) w ere the independent risk factors for lacunar infarction, w hile the peak systolic SS (OR 0.90, 95%CI 0.75-0.95 ) and end diastolic SS ( OR 0.87, 95%CI 0.84-0.98 ) w ere the independent protective factors for lacunar infarction; the peak systolic CWT (OR 4.67, 95%CI 2.05-10.52) and end diastolic CWT (OR 1.25, 95%CI 1.22-1.47) were the independent risk factors for leukoariosis, w hile the peak systolic SS (OR 0.93, 95%CI 0.75-0.94) and end diastolic SS (OR 0.91, 95%CI 0.85-0.98) w ere the independent protective factors for leukoaraiosis. Conclusions The common carotid artery mechanical stress w as associated w ith the occurrence of SVD.