Antihypertensive Agents ; administration & dosage ; therapeutic use ; Humans ; Hypertension ; drug therapy ; genetics ; Molecular Biology

BACKGROUND: Nowadays, it is reported that vessel structural abnormity is the main morphological basis of vertigo due to vertebrobasilar arterial insufficiency abroad, but the report of vascular structural abnormality in vertebrobasilar arterial insufficiency is rare at home.OBJECTIVE: To observe the manifestation and clinical significance of vessel structural abnormity tested by digital substraction angiography (DSA)in patients with vertigo induced by vertebrobasilar arterial insufficiency.DESIGN: Case analysis.SETTING: Department of Neurology, Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University and Department of Neurology, Huaihua Hospital Affiliated to Nanhua University.PARTICIPANTS: A total of 57 patients, who were diagnosed as having episodic vertigo with or without nausea or vomiting, and hospitalized in the Department of Neurology, Huaihua Hospital Affiliated to Nanhua University from August 2003 to May 2004 and Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University between October 2004 and May 2005, were enrolled.METHODS: Fifty-seven patients with vertigo induced by vertebrobasilar arterial insufficiency hospitalized in the recent two years were treated with digital subtraction radiography in aortic arch and aortocranial angiography:Applying retrograde angiography of femoral artery puncture, Optiray nonionic contrast agent with syringe pattern to perform aortic arch angiography. Digital subtraction machine displayed bilateral carotid artery, vertebral artery, ranged from carotid artery to siphon of carotid artery from multiple angles. Measurement and evaluation were conducted by 2 doctors from department of neurology.MAIN OUTCOME MEASURES: Type, distribution and proportion of vesselstructural abnormity of aortic arch, carotid artery and vertebrobasilar system.RESULTS: Of the 57 patients, 1 patient was dropped out, because the left vertebral artery (LVA) could not be entered. A large area cerebral infarction was occurred in another patients during aortic arch angiography was performed, and the operation was stopped. Totally 55 patients were involved in the result analysis. It was found that 71%(39/55) of patients had vessel structural abnormity in cervical part and intracalvarium, 11%(6/55)of patients with simple anterior circulation lesion, 60% (33/55) of patients with posterior circulation lesion, of which 9 cases (16%) with compound lesion of anterior circulation abnormity. Two or above vessels in 24 cases (24/55,44%) were involved. Vertebral artery complicated with other angiostegnosis was the most common, and there was no vessel structural abnormity in other 16 cases (16/55,29%).CONCLUSION: Various types of vessel structural abnormity are the main etiological factors of vertigo induced by vertebrobasilar arterial insufficiency. Gold standard of diagnosing vertigo due to vertebrobasilar arterial insufficiency is DSA.

Geographic tongue, also called benign migratory glossitis, is a common and superficial benign inflammatory disorder that affects the tongue epithelium. The majority of geographic tongue lesions typically manifest as irregular central erythematous patches. These lesions, which are caused by the loss of filiform papillae, are defined by an elevated whitish band-like border that can change location, size, and pattern over a period of time. Histological observations of the oral mucosa affected by geographic tongue revealed nonspecific inflammation. Some reports described cases of migratory stomatitis, wherein lesions simultaneously manifested on the extra lingual oral mucosa. This condition is also called ectopic geographic tongue, which is clinically and histologically similar to the type normally confined to the tongue. In most cases, patients are asymptomatic and do not require treatment. The condition may spontaneously exhibit periods of remission and exacerbation with good prognosis. The specific etiology of geographic tongue remains unknown. Geographic tongue is age-related and is prevalent among young individuals. Various etiological factors that have been suggested in literature include immunological factors, genetic factors, atopic or allergic tendency, emotional stress, tobacco consumption, hormonal disturbances, and zinc deficiency. Geographic tongue may coexist with other disorders, such as fissured tongue, psoriasis, diabetes mellitus, gastroin- testinal diseases, burning mouth syndrome, and Down syndrome. Experts currently disagree on whether geographic tongue is an oral manifestation of psoriasis. Moreover, some scholars suggest that geographic tongue is a prestage of fissured tongue. The objective of this review is to summarize current research on risk factors of geographic tongue.
Epithelium ; Female ; Glossitis, Benign Migratory ; Humans ; Mouth Mucosa ; Risk Factors ; Tongue ; Tongue, Fissured

Objective To investigate the current status of medication compliance of patients with anky-losing spondylifis and analyze its related factors. Methods Seventy-four patients with ankylosing spondylitis were investigated about their general conditions,medication compliance and its related factors.The results were analyzed. Results Thirty-nine patients(52.7%) had good medication compliance while the rest 35 cases has poor medication compliance among which 24 patients with drug withdrawal exceeded 1 month.The medication compliance for patients with disease process of lower than 0.5 year,0.5 to 1.0 year,1 to 2 years and above 2 years was 82.0%,60.0%,25.0%and 31.0%.The logistic regression analysis showed that the disease process,dis-ease knowledge and media advertisement were the main influencing factor for medication compliance,while the age,sex,marital status,education background,adverse reaction,satisfaction degree with medication effect, economic conditions and depression were not major influencing factors. Conclusions About half of patients with anky-losing spondylitis had poor medication compliance,especialy with disease process of above 1 year.The main in-fluencing factors include disease process,disease knowledge and media advertisement.

Objective To define the MRI features of biliary postoperative disoders,so as to find its exact causes.Methods MRI informations of 41 patients with biliary postoperative disoders were retrospectively evaluated to find whether there were such disorders as biliary dilatation,stricture,cholangeitis,remnant stones,remnant gallbladder,etc.Results The biliary abnormality was found in thirty-eight of the 41 patients,including ductal dilatation in 20,intraductal stones in 16,cholangietis in 13,ductal stricture in 7,tumors in hepatic hila in 3.The biliary dilatation commonly presented within 3 months after operation while the biliary stricture and cholangeitis presented commonly 6 months after operation.Conclusion The biliary postoperative disoders is mainly caused by biliary dilatation,stricture and remnant stone,MRI is the sensitive and effective method for diagnosis of biliary abnormalities.

Objective To detect the selective inhibitory effects of irradiation plus adenovirusmediated horseradish peroxidase ( HRP)/indole-3-acetic acid (IAA) suicide gene system using tumorspecific and radio-inducible chimeric promoter on human hepatocellular carcinoma subcutaneously xenografted in nude mouse.MethodsRecombinant replicated-deficient adenovirus vector containing HRP gene and chimeric human telomerase reverse transcriptase (hTERT) promoter carrying 6 radioinducible CArG elements was constructed.A human subcutaneous transplanting hepatocellular carcinoma (MHCC97 cell line) model was treated with -γ-ray irradiation plus intra-tumor injections of adenoviral vector and intra-peritoneal injections of prodrug IAA.The change of tumor volume and tumor growth inhibiting rate,the survival time of nude mice,as well as histopathology of xenograft tumor and normal tissues were evaluated.Results Thirty one days after the treatment,the relative tumor volumes in the negative,adenovirus therapy,irradiation,and combination groups were 49.23 ± 4.55,27.71 :± 7.74,28.53 + 10.48 and 11.58 ± 3.23,respectively.There was a significantly statistical difference among them (F = 16.288,P ＜0.01 ).The inhibition effect in the combination group was strongest as compared with that in other groups,and its inhibition ratio was 76.5%.The survival period extended to 43 d in the combination group,which showed a significantly difference with that in the control group(x2 = 18.307 ,P ＜0.01 ).The area of tumors necrosis in the combination group was larger than that in the other groups,and the normal tissues showed no treatment-related toxic effect in all groups.However,multiple hepatocellular carcinoma metastases were observed in the liver in the control group,there were a few metastases in the monotherapy groups and no metastasis in the combination group.Conclusions Adenovirus-mediated suicide gene therapy plus radiotherapy dramatically could inhibit tumor growth and prolong median survival time.It might provide a promising therapeutic modality for hepatocellular carcinoma therapy.

Objective To evaluate the value of transvaginal ultrasound in diagnosing intrauterine adhesions.Methods Transvaginal ultrasound was performed in 136 patients with suspicious intrauterine adhesions and compared with hysteroscopy correspondingly .The ultrasonographic features of intrauterine adhesions on transvaginal ultrasound were summarized .Results One hundred and twenty one cases (89.0%, 121/136 ) of intrauterine adhesions were verified by hysteroscopy .The hysteroscopic findings included:(1) Forty seven cases(38.9%,47/121) were minimal intrauterine adhesions , 46 cases(38.0%, 46/121) were moderate intrauterine adhesions , and 28 cases (23.1%,28/121) were severe intrauterine adhesions.(2) Sixty one cases(50.4%,61/121) were central intrauterine adhesions , 24 cases(19.8%, 24/121) were marginal intrauterine adhesions , and 36 cases (29.8%, 36/121) were mixed type of intrauterine adhesions.The transvaginal ultrasound findings included:(1)Nineteen cases(40.4%,19/47) were minimal intrauterine adhesions ,33 cases(71.7%,33/46)were moderate intrauterine adhesions ,and 23 cases(82.1%,23/28) were severe intrauterine adhesions .(2) Thirty nine cases (63.9%,39/61) were central intrauterine adhesions ,9 cases(37.5%,9/24) were marginal intrauterine adhesions ,and 27 cases (75.0%, 27/36 ) were mixed type of intrauterine adhesions .By transvaginal ultrasound, seventy-five (62.0%,75/121) cases of intrauterine adhesions were correctly diagnosed , whereas 46 cases (38.0%, 46/121) were missed.And 3 cases ( 3.8%, 3/78 ) were misdiagnosed as intrauterine adhesions on transvaginal ultrasound,including one endometrial polyp ,one thin endometrium and one septate uterus .The sensitivity, specificity and accuracy of transvaginal ultrasound in diagnosing intrauterine adhesions were 62.0%(75/121), 80.0%(12/15) and 64.0%(87/136) respectively.There were significant statistical differences in diagnosing different degrees of intrauterine adhesions ( χ2 =15.956,P=0.000) and different parts of intrauterine adhesions( χ2 =8.792,P=0.012) by transvaginal ultrasound.Conclusions Transvaginal ultrasound is an effective, easy to perform and noninvasive technique in screening and diagnosing intrauterine adhesions.Transvaginal ultrasound is an effective way in diagnosing intrauterine adhesions showing a noninvasive and simpler way than hysteroscopy .Transvaginal ultrasound is of great value in screening and diagnosing intrauterine adhesions .

OBJECTIVETo identify the correlation of the volume of residual urine (VRU) with the severity of bladder outlet obstruction (BOO) and detrusor contractility in patients with benign prostatic hyperplasia (BPH).

METHODSA total of 152 patients with clinically diagnosed BPH underwent ultrasonography for measurement of the prostate volume and RVU, free uroflowmetry, and urodynamic examination for the severity of BOO and detrusor contractility. Using the software SPSS20. 0, we analyzed the correlation between the ultrasonographic results and urodynamic parameters and compared the two sample means by the t-test.

RESULTSThe prostate volume was correlated positively with BOO severity (r = 0.432, P < 0.01) and detrusor contractility (r = 0.343 , P < 0.01) while Qmax negatively with BOO severity (r = 0.327, P < 0.01) but not significantly with detrusor contractility (r = 0.123, P > 0.05). VRU showed a significantly negative correlation with detrusor contractility when > 150 ml (r = -0.490, P < 0.01), even more significantly when > 300 ml (r = -0.717, P < 0.01), but exhibited no significant correlation with it when ≤ 150 ml (r = 0.041, P > 0.05).

CONCLUSIONVRU can somehow predict the detrusor function. For patients with VRU > 150 ml, especially for those with VRU > 300 ml, the detrusor function should be evaluated and urodynamic examination is recommended for exact assessment of BOO severity and detrusor contractility.

Aged ; Humans ; Male ; Muscle Contraction ; Muscle Hypertonia ; diagnostic imaging ; physiopathology ; Organ Size ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; physiopathology ; Severity of Illness Index ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; physiopathology ; Urine ; Urodynamics

Objective To investigate the surgical techniques and clinical efficacy of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery in the treatment of talus neck fractures.Methods From March 2008 to June 2011,12 cases with talus neck fractures were treated with cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery.External fixation in functional position for 12-14 weeks,and the load time was determined by X-ray fracture healing.Functional results were assessed according to AOFAS (American Orthopaedic Foot and Ankle Society) score at last follow-up.Results Twelve cases were followed up for an average of 24 months (12 to 48 months).One case of skin flap necrosis healed by dressing.All the fractures healed,and the mean healing time was 20 weeks (16 to 24 weeks).AOFAS ankle and hindfoot mean postoperative score was 82.5 (ranging from 55 to 96) points.Among them 4 cases were excellent,good in 5 cases,fair in 3 cases.Two cases presented with mild posttraumatic subtalar arthritis and pain relief after oral anti-inflammatory analgesic.One case with avascular necrosis of talus body,and X-ray displayed sclerosis of talus body,but no collapse,and the patient was told to reduce weight and regularly followed up.Conclusion The application of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery for the treatment of talus neck fractures is an effective treatment,which can improves the blood supply of the talus body and reduces the occurrence of avascular necrosis of the talus.

Objective To study the effect of ratanasampil (RNSP) which is Traditional Tibetan Medicine on the levels of serum β-amyloid protein, interleukin and tumor necrosis factor alpha (TNF-α) in patients with mild to moderate Alzheimer's disease (AD). Methods One hundred AD patients were divided into two groups in randomized controlled study, including treatment group (RNSP 1 g/d) and control group (piracetam 2.4 g/d). The treatment lasted 12 weeks. The Mini Mental State Examination (MMSE), Alzheimer' s disease Assessment Scale-cognitive subscale (ADAS-cog) and Activity of Daily Living Scale (ADLs) were taken to evaluate the efficacy. Serum levels of amyloid peptides (Aβ40 and Aβ42 ) were measured by ELISA assay. The radioimmunologic assay was used to determine the serum levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α. Results The scores of MMSE, ADAS-cog and ADL significantly improved at 12 weeks after RNSP treatment (P＜0.01, 0.01, 0.05, respectively), while had no significant changes in piracetam group (P＜0.05).The levels of TNF-α, IL-1β, IL-6 and Aβ42 were significantly lower in RNSP group than in Piracetam group (P＜0.01). There was a decrease trend of the Aβ42/Aβ40 ratio at 12 weeks after RNSP treatment (P＜0. 05, P＜0.01 ). The serum Aβ42 level had strong correlations with TNF-α, IL-1 β and IL-6. There were no significant differences in Aβ40 and IL-8 between RNSP group and piracetam group. No obvious drug side effect happened on the groups. Conclusions The reductions of serum TNF-α, IL-1β and IL-6 levels after RNSP treatment may lead to decrease of Aβ42 production in AD patients. RNSP may decrease the Aβ42/Aβ40 ratio and slow down the progress of AD. It may improve the learning and memory ability in treating patients with mild to moderate AD and is well tolerated and safe.