ObjectiveTo explore pathogenesis of headache after subarachnoid hemorrhage (SAH) whether related with immune inflammatory reaction in subarachnoid and observe the effect of immunosuppressive action of dexamethasone on headache.Methods80 patients who was consciousness and complained headache after SAH were randomly divided into four groups, treated only with mannitol, mannitol plus cerebrospinal fluid (CSF) replacement, intrathecal and vein injection with dexamethasone. Effects of four groups were observed.ResultsEfficiencies of four groups were respectively the mannitol group 27.27%, the permutation group 66.67%, the intrathecal group 92.36% and the vein group 30.00%. There was a significantly difference between the intrathecal group and other three groups, and the time of headache remission for intrathecal group was also longer than that of other three groups (P<0.01).ConclusionThe wide immune inflammatory responses in subarachnoid induced by degenerative and hemic CSF is likely main cause of headache after SAH and intrathecal injection with dexamethasone has an obviously effect.

Adolescent ; Humans ; Male ; Tooth Ankylosis ; etiology ; surgery ; Tooth Extraction ; methods ; Tooth Root ; Wounds and Injuries ; complications

A mutation is predominant in weak D individuals,and DⅥⅢ mutation in partial D individuals.

OBJECTIVE:To evaluate the association between UGT1A1 gene polymorphism and irinotecan-induced 3-4 degree neutropenia,and to provide evidenced-based reference for clinical treatment. METHODS:Retrieved from CJFD,Wanfang data-base,VIP,PubMed,EMBase,Science direct and Cochrane library,related studies about UGT1A1*28 and UGT1A1*6 gene polymorphism and irinotecan-induced 3-4 degree neutropenia were collected. After data extraction and quality evaluation of included studies,Meta-analysis was conducted by using Review Man 5.3 software. RESULTS:A total of 29 studies were included,involv-ing 2408 patients. UGT1A1*28 includ wild genotype TA 6/6(UGT1A1*1/*1)and mutations genotype TA 6/7(UGT1A1*1/*28)、TA 7/7(UGT1A1*28/*28),UGT1A1*6 includ wild genotype GG and mutations genotype GA、AA. Results of Meta-analysis showed:the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=1.92,95%CI(1.52,2.44),P<0.001;UGT1A1*6:OR=2.49, 95%CI(1.46,4.26),P<0.001]. Using medium-dose and high-dose of irinotecan,the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=2.06,95%CI(1.57,2.70),P<0.001);UGT1A1*6:OR=1.92,95%CI(1.35,2.74),P<0.001]. Using low-dose of irinotecan,there was no statistical significance in the incidence of 3-4 degree neutropenia between UGT1A1*28,UGT1A1*6 mutations genotype and wild genotype [UGT1A1*28:OR=1.20,95%CI(0.70,2.08),P=0.51;UGT1A1*6:OR=3.19,95%CI (0.85,11.89),P=0.08]. CONCLUSIONS:Using medium-dose and high-dose of irinotecan,UGT1A1*28 and UGT1A1*6 muta-tions will increase the risk of severe neutropenia in cancer patients. Using low-dose of irinotecan,there is no clear correlation be-tween gene polymorphism and the neutropenia.

Felty syndrome is a rare disorder that involves rheumatoid arthritis,a swollen spleen,de-creased white blood cell count,and repeated infections.This article analyze the clinical characters of this disease.

Objective: In order to study how to accelerate the reconstitution immunofunction in BMT mice, first of all, we established a immunodeficiency model of BMT in BALB/C mice. Then BMT mice were injected with PCD-hIL-2 directly into skeletal muscle, and treated with traditional Chinese medicine. Methods: The experiment groups are designed as（A）Chinese medicine + PCD-hIL-2;（B）PCD-hIL-2;（C）Chinese medicine +hIL-2;（D）Chinese medicine;（E）hIL-2;（F）BMT;（G）normal control;（H）radiation control. Results: We compared groups A B C D to E or F groups, found（1）The splenocytes/thymocytes count increase obviously.（2）Killing activity of NK cell rises obviously in vivo.（3）The response of splenocytes、thymocytes、BM cells to mitogen goes up.（4）The reactivity of splenocytes to foreign IL-2 goes up. （5）CFU-GM count is increased. Conclusion: The expression of hIL-2 is very low by nude DNA injection ,but it is enough to have biological function and therapeutic effect .If only Chinese medicine was applied, the immunological condition was obviously recovered.

Objective To observe the effect of combined treatment with rhTRAIL(recombinant human TNF-related apoptosis inducing ligand) and selective Cox-2 inhibitor Celecoxib on gallbladder carcinoma in vitro and to explore the possible mechanism of the effect. Methods Western blot analysis was used to detect the expression of c-FLIP and death receptors after treatment by Celecoxib. Apoptosis of gallbladder cell line SGC-996 after the combined treatment with Celecoxib and rhTRAIL was detected in three ways: (1) phase microscopy of the cells, (2) detection of effector caspase-3 and caspase-7 activity, and (3) determination of the proportion of apoptotic cells labeled by Annexin V-PI flow cytometric analysis using CELLQUEST software. Results Celecoxib down-regulated the expression of c-FLIPs and up-regulated the expression of DR5 in a dose- and time-dependent mode on cell line SGC-996. Apoptotic levels in the combined treatment group in cell line SGC-996 were significantly higher than those in the single drug treatment group and control group. Conclusion Celecoxib markedly sensitized rhTRAIL-induced apoptosis through the down-regulation of c-FLIPs and up-regulation of DR5 in gallbladder carcinoma cell line SGC-996.

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Objective To investigate effect of arthroscopic ankle arthrodesis in the treatment of endstage post-traumatic ankle arthritis.Methods Between July 2007 and December 2010,21 patients with post-traumatic ankle arthritis underwent arthroscopic arthrodesis in our hospital.There were 14 males and 7 females,aged from 21 to 68 years (average,37 years).Before operation,conservative treatments were unsuccessful in all patients.During operation,the articular cartilage was removed completely,and then micro-fracture was made in bone near articular surface.Then,the operating ankle were reduced and fixed provisionally with Kirschner wires.A C-arm X-ray system was used to confirm the reduction of operating ankle,and the operating ankle was fixed with cannulate screws if the reduction was satisfactory.Two patients also underwent arthroscopic subtalar arthrodesis.After operation,the affected ankle was fixed with plaster for six weeks.Then partial weight-bearing were allowed and gradually increased until bone union.Results All patients were followed up for 1 to 4 years (average,1.8 years).All affected ankle achieved bone union after 10 to 16 weeks (average,12 weeks).No early complications occurred,such as poor wound healing and infection.Subtalar arthritis with pain occurred in 3 patients; the symptom relieved in 2 of them after conservative treatment and in 1 patient after subtalar arthrodesis.The VAS score improved from preoperative 8.1±1.5 to 2.7± 1.1 one year postoperatively,which showed statistical significance (t=3.153,P=0.005).Conclusion Arthroscopic ankle arthrodesis provides an alternative method for treating end-stage post-traumatic ankle arthritis,which has some advantages,such as less surgical trauma,more beautiful incision and higher fusion rate.However,it needs special equipments and a learning curve.

Objective To analyze the vascular architecture characteristics of the complex direct cavernous arteriovenous fistula (cd-CAVF) and to discuss its treatment and the curative effect of interventional embolization. Methods The hospitalization records, imaging features and operation records of 12 patients with cd-CAVF were retrospectively analyzed. Results In the 12 patients with cd-CAVF, the lesion’s blood supply arteries included internal carotid artery (ICA,n=8), primary trigeminal artery (PTA,n=1), middle cerebral artery (MMA,n=2) and basilar artery (BA,n=1). Different degrees of “arterial steal” phenomenon could be observed in all patients. The drainage routes included the superior ophthalmic vein and the inferior petrosal sinus (n=10), and cortical vein (n=2). Interventional embolization was carried out via ICA (n=4), through both ICA and BA (n=5), through MMA (n=2), or through BA (n=1). For the embolization of the lesion the balloons were used in 8 patients, steel coils were adopted in 2 patients, and balloons together with coils were employed in 2 patients. All the patients were followed up for 3-6 months. After the treatment the clinical symptoms and signs disappeared, and the lesions were completely cured in all patients with no complications. During the follow-up period of (60.2 ±26.8) months no recurrence of CAVF was observed. Conclusion The blood supply of cd-CAVF comes directly from the rupture of the blood vessels surrounding the cavernous sinus wall, the “arterial steal” phenomenon is prone to occur, and the drainage via the superior ophthalmic vein and the inferior petrosal sinus is more often seen. Transarterial balloon embolization is very effective for the treatment of cd-CAVF, and the use of coils together with multi-artery approaches is an effective supplementary method.