Objective To explore the factors influencing the hyponatremia of hypertensive intracerebral hemorrhage.Methods One hundred and five patients with hypertensive intracere bral hemorrhage recorded 7 parameters in patients:age,gender,the use of furosemide,duration of using mannitol,the frequency of using mannitol every day,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.To get the obviously variability with the hyponatremia by single variable logistic regression analysis.To get the best equation by multivariable logistic regression analysis.Results The obviously variability with the hyponatremia is age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.Conclusion Hyponatremia has intimate relationship with age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.

Objective To investigate the surgical strategy of recurrent rectuvaginal fistula. Methods Retrospectivly analyzed the clinical data of 13 patients with recurrent rectovaginal fistula from December 2001 to December 2008. The etiopathogenisis and the ways of treatment were analyzed. Results All the 13 patients with a transverse colostomy surgical repaired with Mason operation in the secondary intention,and recepted closure of colostomy in the third intention for treatment, all patients were cured. No recurrent fistula was identified with postoperative follow-up 4 - 84 months. Conclusions After recurrent rectovaginal fistula with multiple surgical treatment,the blood supply of local tissue is poor,the scar is serious. Selecting the appropriate timing of operation, adequate preoperative preparation, the application of transverse colostomy and Mason operation in different period could significantly enhance the successful operation rate.

OBJECTIVE: To study the effect of MDR1 (P-gp) and ABCG2 on the drug resistance in Hep 2 cells. METHOD: Flow cytometry was used to detect the variations of the antitumor drugs accumulation and discharging, and activity variations when MDR1 and ABCG2 inhibitors were used in Hep-2. RESULT: The accumulation and discharging of mitoxantrone was significantly higher than the control group when ABCG2 inhibitor FTC was used in Hep-2 (P<0. 05). In contrast, P-gp did not appear similar case; To the mitoxantrone and cisplatin, there was no statistical correlation about activity of Hep-2 between P-gp or ABCG2 antagonist and the control; To the doxorubicin, combining FTC and P-gp, the activity of Hep-2 was higher than the control and difference was significant (P<. 05), In contrast, FTC and P-gp did not appear similar case when used alone; To the 5-FU, when PGP used, the activity of Hep-2 was higher than that in the control and difference was significant (P<0. 05), In con- trast, FTC and FTC+P-gp did not appear similar case; To the paclitaxel, when P-gp or FTC+P-gp used, the activity of Hep-2 was higher than that in the control and difference was significant(P<0. 05). CONCLUSION ABCG2 may lead to drug resistance mainly by changing the ability of cell in accumulating and discharging chemotherapy drugs. P-gp has other way. P-gp and ABCG2 play different roles in different drug resistance.
ATP Binding Cassette Transporter, Subfamily B ; metabolism ; ATP Binding Cassette Transporter, Subfamily G, Member 2 ; ATP-Binding Cassette Transporters ; metabolism ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Doxorubicin ; pharmacology ; Drug Resistance, Neoplasm ; Humans ; Mitoxantrone ; pharmacology ; Neoplasm Proteins ; metabolism ; Paclitaxel ; pharmacology

BACKGROUND:Because the geographical environment and diet cause obesity and osteoarthritis in Xinjiang Uygur local patients, the number of patients became more. At present, more and more patients received artificial knee replacement. How to master and further apply the technology of soft tissue balance during artificial knee replacement in patients of different physical fitness and nations becomes the focus of many scholars. OBJECTIVE:To analyze the clinical efficacy of soft tissue balance in Xinjiang Uygur patients with knee valgus in total knee replacement. METHODS:A total of 60 cases (72 knees) with severe knee osteoarthritis with a certain degree of knee valgus were subjected to total knee replacement through anterior lateral approach and individualized soft tissue balance from February 2009 to December 2010. Folow-up mode was the clinic visit. X-ray was used to measure tibiofemoral angle (i.e., the supplementary angle of the included angle between anatomic axis of femur and tibia). Clinical score and functional score of American knee society knee score were applied to assess knee joint function. RESULTS AND CONCLUSION:A total of 57 patients were folowed up for 6-35 months. The tibiofemoral angle decreased from 27.9° preoperatively to 5.6° postoperatively. Clinical score of American knee society knee score elevated from 16.7 points preoperatively to 87.5 postoperatively. Functional score of American knee society knee score elevated from 7.9 points preoperatively to 85.2 postoperatively. Significant differences in preoperative and final folow-up scores were detected (P < 0.01). Valgus deformity was corrected and joint stability was good in 57 patients after replacement. These findings indicate that in patients with severe knee osteoarthritis and valgus deformity, to select individualized treatment of soft tissue balance can effectively correct soft tissue imbalance and get more satisfactory clinical results.

The supercondensed DNA, a special kind of topological structure of plasmid DNA, was firstly found in E. coli SD108(topA+ gyrB225). Now, this structure is also found in E. coli DM800(topA- gyrB225). The result indicates that the formation of supercondensed DNA is related with decrease of the activity of gyrase in vivo. Topoisomerase Ⅳ was proved to relax the supercondensed DNA completely in vitro, which suggested that the supercondensed DNA and the supercoiled DNA could transform to each other in cells. The supercondensed DNA samples were analyzed by atomic force microscopy and compared to supercoiled DNA. The results showed that the length of supercondensed DNA decreased about 30% and the width and height of double-strand increased about 60%, which indicates that the structure of double-strand of supercondensed DNA is much more similar to A-DNA than B-DNA. The results also showed that chloroquine intercalation did not change the supercoiling level of supercondensed DNA, but made it knot and compact.

Objective:To study effects of large dose thymopeptides on T cell subpopulations of patients with malignant tumor under radiotherapy.Methods:Fifty one patients with malignant tumor under radiotherapy were divided into 2 groups with 100 mg and 200 mg thymopeptides respectively.The patients we re given thymopeptides,100 mg/d or 200 mg/d,iv, for 10 days.The positive percent ages of CD4,CD8,CD25 and CD56 in T cells of peripheral blood before and after thymopeptide treatment were determined by flow cytometry.Results:The positive percentages of CD4 and CD25 in T cells of peripheral bl ood after 100 mg/d thymopeptide treatment were significantly higher than those befor e thymopeptide treatment (P<0.05),while those of CD4，CD8，CD25 and CD56 in T cells of peripheral blood after 200 mg/d thymopeptide treatment all increased significantly (P<0.05 or P<0.01). Conclusion:These results suggest that large dose of thymopeptides can increase i mmune function of patients with malignant tumor under radiotherapy,and the curat ive effect of 200 mg/d thymopeptides is better.

Objective To investigate the correlation between serum bone metabolism biomarkers and bone mineral density (BMD) in chronic kidney disease (CKD) patients with different stages. Methods Seventy-eight CKD patients were enrolled in this study and were assigned to different groups according to their ereatinine clearance (Cer). Patients with Cer ≥ 15 ml/min were divided into 4 groups based on clinical CKD 1-4 stage standard, and those with Ccr<15 ml/min were divided into two groups of hemodialysis (HD) and non-HD. Their levels of serum calcium, phosphorus, alkalinity phosphatase (ALP), urea, Ser, osteocalein (gla-protein, OC), calcitonin (CT), intact parathyroid hormone (iPTH), osteoprotegerin (OPG) and BMD were detected respectively. Results (1) The serum levels of OPG, iPTH and phosphorus increased significantly in stage 3, 4, 5, respectively (P<0.01), and serum OPG level was elevated to (5.1±1.34) ng/L after HD, which was significantly higher than (3.35±0.76) ng/L before HD (P<0.05). The levels of serum OC, CT, calcium, ALP were not significantly different among patients with different CKD stages, while the level of OC was elevated in HD patients (P<0.05). The femoral WARDS triangle BMD of CKD stage 4 patients decreased to 0.77±0.09, which was less than the value of CKD stage 1 patients (P<0.01), with litde influence from hemodialysis treatment. (2) The level of serum OPG was positively correlated with the levels of serum phosphorus, iPTH, OC (r = 0.51, 0.39, 0.36,all P<0.01), and it was negatively correlated with the level of Ccr (r =-0.70, P<0.01). The femoral WARDS triangle BMD was negatively correlated with the levels of iPTH, OC, phosphorus and OPG (r =-0.59,-0.51,-0.45,-0.48, all P<0.05). Conclusions Most of serum bone metabolism biomarkers change according to the declined level of Cer. Compared with serum phosphorus, the levels of iPTH, BGP and femoral WARDS triangle BMD, serum OPG may be early diagnosticmarkers of renal osteodystrophy in CKD patients.

Objective To investigate the association of radial arterial calcification damage with bone mineral density (BMD) and bone metabolism biomarkers in uremia patients.Methods Sixty-seven incident hemodialysis patients were recruited into uremic group.Serum creatinine,calcium,phosphorus,lumbar spine and femoral neck BMD were measured.Parathyroid hormone (iPTH),25OHD,1,25(OH)2D,fibroblast growth factor (FGF) 23,bone specific alkaline phosphates (BAP) and osteocalcin (BGP),type Ⅰ collagen pyridine crosslinked C-telopcptidc (ICTP) were detected.Radial artery calcification was analyzed by von Kossa staining and transmission electron microscopy.Arterial type Ⅰ collagen (Col Ⅰ) expression was examined.Twenty-three healthy cases received serum and BMD examination only as control.Results Uremic patients presented higher serum phosphate,iPTH,FGF23,lower serum calcium,25OHD,1,25 (OH)2D (all P ＜ 0.05),and lower lumbar spine and femoral neck BMD (all P ＜ 0.01) compared to controls.Significant calcium deposit was observed in radial arteries in 24 uremic cases (35.8％),including 10 cases of diabetes.Immunohistochemistric assay confirmed that Col Ⅰ expression increased around calcification site and electron microscope revealed that more calcium and phosphorus plaque attached among collagen fibers.No correlation was showed between iPTH and radial artery calcification (r =-0.08,P =0.306),but after stratified by iPTH levels,correlation of iPTH and calcification was found in low iPTH (＜ 150 ng/L) group and high iPTH group (＞ 300 ng/L) (r =-0.41,0.31,P=0.044,0.023).Diabetes,lumbar spine and femoral neck BMD,ICTP,FGF23 were correlated with arterial calcification (r =0.62,-0.25,-0.43,0.34,0.86,P =0.000,0.001,0.012,0.018,0.000).Multiple regression analysis showed femoral neck BMD,ICTP,FGF23 levels were independently associated with radial arterial calcification (β =-0.221,0.181,0.260,P =0.021,0.024,0.036).Conclusion In uremic patients,reduced BMD,abnormal bone turnover rate,especially accelerated bone reabsorption,and increased serum FGF23 level are independently associated with radial artery calcification.

Objective To study the value of ultrasound in operation for traumatic brain injury (TBI) in simulation field hospitals where computed tomography (CT) equipment is unavailable.Methods The wartime conditions were simulated, and the patients at age of 18-60 years were randomly selected.According to the principles of medical ethics, all patients received CT scanning.Two neurosur-geons from the field hospital who did not know the result of CT examination cooperated with another two neurosurgeons who got the results of the CT examination to determine whether operation should be ap-plied.Forty-five patients who needed emergency craniotomy were finally selected.The operations were performed by two neurosurgeons from the field hospital, with real-time ultrasound monitoring.The results of ultrasound were compared with that of CT scanning.Results A total of 64 lesions were found by ul-trasound , and 60 of which should be treated by operation.In the meantime, 82 lesions were found by CT scanning, 64 of which should be treated operatively.Epidural hematoma and subdural hematoma had high ultrasound detection rate, followed by intracerebral hematoma, subdural effusion and brain contusion.The overall detection rate of ultrasound was 87.1%.Conclusion Ultrasound plays an important role in correctly finding the focus so as to reduce blind operation and avoid omission of the focus in field hospi-tals, where CT equipment is usually unavailable.

Rituximab is currently used as a first-line therapy for phospholipase A 2 receptor-associated membranous nephropathy due to its good efficacy and safety. Although the remission rate after rituximab treatment is more than 60%, nearly 40% patients still do not respond to treatment. We used obinutuzumab to treat 3 cases of rituximab resistant PLA 2R-associated membranous nephropathy. After the first dose of 1 000 mg with or without additional dose, the amount of anti-PLA 2R antibody and urinary protein decreased significantly and the adverse reactions were mild. The results show that obinutuzumab has a certain therapeutic effect on rituximab resistant PLA 2R-associated membranous nephropathy, but the time of follow-up observation is short and can only be used as individual cases, which needs to be confirmed by a large sample and high-quality prospective cohort study.