BACKGROUND: Mutation of the mitochondrial DNA may occur during the aging process of organisms, which is especially likely in the central nervous system. Evidences have been obtained that mitochondrial dysfunction may ensue from genetic impairment involved in oxidative phosphorylation, which is accompanied by corresponding morphological changes.OBJECTIVE: To investigate the association between olfactory disturbance and ultrastructural mitochondrial changes in olfactory bulb neurons of aged rats in comparison with young rats.DESIGN: Randomized controlled experiment.SETTING: Department of Internal Medicine, Affiliated Hospital of Chende Medical College and Department of Electron Microscopy of Chende Medical College.MATERIALS: This experiment was conducted in the Department of Electron Microscopy of Chende Medical College between April and December 2002. Sixteen male Wistar rats were divided equally into aged group (＞ 24 months) with body mass of 300-350 g and young group (6 months) with body mass of 180-220 g.METHODS: The rats in the two groups were anaesthetized by intraperitoneal injection of 10 g/L urethane (1 g/kg) and the chest was opened to insert a tube into the ascending aorta for perfusion with 200 mL of the mixture containing glutaric dialdehyde and paraformaldehyde for fixation.The olfactory bulb was then obtained and sliced, fixed in perosmic acid and embedded. Each layer of the olfactory bulb was observed under optical microscope and ultra-thin sections were prepared for observation under transmission electron microscope.MAIN OUTCOME MEASURES: The stratification of rat olfactory bulb and ultrastructural changes of the mitochondria in the major neurons in the olfactory bulb.REULSTS: No obvious changes were found in the stratification of the olfactory bulb in the two groups. From the exterior to the interior of the olfactory bulb, the olfactory nerve fiber layer, glomerular layer, external plexiform layer, mitral cell lalyer, internal plexiform layer and olfactory bundle nerve fiber layer were observed. Ultrastructurally, the mitochondria were more numerous in the brush cells in aged rat olfactory bulb, appearing rodshaped or ovoid with irregular cristae which were arranged in local disorder and some fragmented into small granules to form small bodies of high electron density. A few mitochondria became myeliuoid body with irregular or concentric circular morphologies. In the younger rats, most of the mitochondria in the neurons were ovoid with distinct outer and inner membrane and regular arrangement of the mitochondrial cristae, and irregular arrangement of the cristae was seen only in rare cases.CONCLUSION: The stratification of the olfactory bulb is basically the same in aged and young rats, but the ultrastructural changes in the mitochondria in the major neurons in aged rat olfactory bulb can be obvious,which is consistent with the reduced mitochondrial oxidative phosphorylation function. This might be one of the major causes for olfactory disturbance related to aging.

[Objective]To investigate the clinical curative effect and superiority of subtotal corpectomy through the pedicle,titanium rete support and pedicle screws system fixation in the treatment of burst fracture of thoracic vertebrae with paralysis.[Method]Twenty-three patients who suffered from the burst fracture of thoracic vertebrae with paralysis were treated with subtotal corpectomy through pedicle,titanium rete supporting bone autograft and pedicle screws system fixation.[Result]The patients were followed up for 8 months to 2 years.All had their bone grafts fused,and no incision infection,pneumothorax,hemothorax,pulmonary infection,internal fixation loosening or breakage occurred.The mean loss of Cobb's angle was 3.5?.According to Frankel grading,6 of grade A had no obvious recovery.In 5 of grade B,3 improved to C,1 to D,and the last one to E.In 7 of grade C,3 improved to D,4 to E.Five cases of grade D improved to E.[Conclusion]There had relatively less operation wound and good clinical curative effect with subtotal corpectomy through pedicle,titanium rete supporting bone autograft and pedicle screws system fixation.

BACKGROUND: As indicated by clinical research, if cerebral infarction could be effectively treated at early stage, especially normal specific therapy provided within 6 hours or even earlier after attack, the prognosis would be significantly better than delayed therapy. However, it is still unclear that whether the changes of cellular apoptosis-inducing or -inhibiting indicators could be used as criteria in the judgment of prognosis.OBJECTIVE: To test the content of cell apoptotic factor and to investigate the prognosis in hospitalized patients with cerebral infarction who received treatment at different time for further verification of the therapeutic timing for the disease.DESIGN: A same term randomized controlled study based on patients.SETTING: Department of neurology of a general hospital of a military area command of Chinese PLA.PARTICIPANTS: Totally 144 male patients admitted in the Second Department of Neurology, General Hospital of Jinan Military Area Command of Chinese PLA between 2000 and 2002 were divided into four groups including 6 hours, 24 hours, 72 hours and 96 hours group according to different time of therapy provided.METHODS: Oral administration of 400 mg Lumbrokinase, 2 tablets of heparin sodium, 60 mg of nimodipine, and 100 mg of vitamin E, three times a day. 150 mL of normal saline(NS) containing 52.5 mg of Ginkgo biloba L extractive(Jin Na Duo) and 150 mL of NS containing 10 mL of Cerebroprotein Hydeolysate were used through intravenous drop once a day. Ten days were set as one therapeutic course and 2 courses were given. 200 g/L of mannite was given to dehydrate for patients with large area infarction(＞ 7 cm2) . Platelet membrane Fas, Apo2.7 and Bcl-2 percentage and prognostic assessment were tested in patients of four groups before and after therapy.MAIN OUTCOME MEASURES: Peripheral platelet membrane Fas,Apo2.7 and Bcl-2 percentage in patients of different group and prognosis evaluation.RESULTS: Percentage of platelet membrane Fas, Apo2.7 and Bcl-2 of 6 hours group was significantly higher or lower after therapy than before therapy ( P ＜ 0.05 ), and moreover, the difference with other groups was significant( P ＜ 0.05), As revealed in the analysis of prognosis, the effectiveness of patients who received therapy within 6 hours was significantly better than that of 96 hours group and the mortality reduced significantly.CONCLUSION: Normal hospitalizing therapy provided within 6 hours after attack could surely improve the prognosis and reduce the disability rate, and the abnormity and extent in Fas, Apo2.7 and Bcl-2 are closely correlated with prognosis.

Objective To investigate the effect of percutaneous eoronary intervention (PCI) on the prognosis of acute ST-segment elevation myocardial infarction (ASTEMI) in the elderly.Methods The 1318 ASTEMI patients in our hospital from June 1998 to June 2008 were retrospectively analyzed. Among them, 338 (25.6%) elderly patients were over 60 years old, and 316patients consistent with inclusion and exclusion criteria were consecutively enrolled in our research.Then they were divided into two groups: PCI group (136 cases, 43.0%) and conservative drug treatment group (180 cases, 57. 0%). The clinical data of study objects were collected. Then they were followed up regularly for two years. Results There were no statistically significant differences between the two groups in mean age, gender, hypertension, diabetes, dyslipidemia, excess smoking,wine and family history (all P＞ 0.05). And there were no statistically significant differences in anterior wall STEMI, Killip Ⅲ-Ⅳ class, thrombolysis therapy and malignant ventricular arrhythmia (all P＞0. 05). Most of the objects proceeded therapeutic lifestyle improvements, such as giving up smoking, restricting wine, regulating diet, losing weight and insisting on exercises, and so on.Secondary prevention drugs of acute myocardial infarction including angiotensin converting enzyme inhibitor, angiotensin receptors blockers, beta receptor, aspirin and statins were regularly administrated in the two follow-up years. In the retrospective research, incidence rates of reinfarction, NYHA (New York Heart Association) Ⅲ-Ⅳ class heart function and one-month mortality were much higher in conservative treatment group than in PCI group (17.2% vs. 2. 2%, OR=9. 224,95% CI: 2. 756-30. 857; 31.1% vs. 8.1%,OR=5.132, 95%CI: 2. 568-10. 257; 8. 3% vs. 1.5%,OR= 6. 091, 95% CI: 1. 369-27. 105, respectively; all P ＜ 0. 01). Above all, one and two-year mortalities were much higher in conservative treatment group than in PCI group (21.1% vs. 2. 2 %,OR=11.864, 95%CI: 3.577-39.349; 32.2% vs. 4.4%, OR=10.301, 95%CI: 4.289-24.736,respectively; all P＜0. 01). Conclusions PCI may reduce the re-infarction, NYHA Ⅲ-Ⅳ class heart function and one-month mortality, especially so in view of the one and two-year mortality. PCIcan significantly improve the prognosis of ASTEMI in the elderly.

OBJECTIVE:To prepare Sanzi capsules and establish the Standard of its quality.METHODS:Water decocting method was applied to extract physic liquor,thin-layer chromatography(TLC)was used for qualitative identification,and high efficiency liquid chromatography(HPLC)was used to determine the content of Jasminoidin in the preparation.RESULTS:Feature spots of Fructus Gardeniae,Fructus Chebulae,Fructus Toosendan were identified by TLC,with no sensible interference seen in the negative control.The linear range for Jasminoidin was 3.0～ 30? g? mL-1(r=0.999 9)with average recovery rate at 100.06%(RSD=1.17%).CONCLUSION:The preparation method is well-grounded,highly-specific and reproducible in property identification,accurate and reliable in content determination,and can be used for the quality control of Sanzi capsules.

Objective To study whether serum matrix metalloproteinase 9, serum transforming growth factor ? 1, serum type C IV collagen concentrations are alternatoin in various stages of patients with T2DM. Methods 64 cases T2DM patients were divided into three groups according to urine albumin excretion rate (UAER):normoalbuminuria (NA)group and microalbuminuria (MA) group and overt diabetic nephropathy (ODN)group. Serum MMP 9,TGF ? 1 and C IV were detected in all cases. Results Serum MMP 9 in MA and ODN groups were higher than NA and normal control groups ( P

Objective To explore the clinical outcome of atlantoaxial pedicle screw instrument in treatment of extension-type odontoid fracture combined with aflantoaxial subluxation. Methods From December 2002 to December 2006, seven patients with extension-type odontoid fracture combined with at-lantoaxial subluxation were reduced and fixed with atlantoaxial pedicle screw instrument of Vertex system under general anesthesia. There were five males and two females, at mean age of 39.2 years (range 21-59 years). All odontoid fractures were fresh type Aderson Ⅱ. JOA scores of spinal core function was 8.6-14.9 (average 10.7) preoperatively. The X-ray examination, CT scanning and skull traction were performed in all patients preoperatively. Results There found no severe complications such as injuries of vertebral artery, nerve root and spinal cord postoperatively. All patients obtained complete reduction and healing of the fracture and dislocation. The mean off-bed time was four days (3-6 days) after opera-tion. A follow-up for 12-36 months (average 22 months) in all patients showed that the clinical symptom was improved significantly six months postoperatively and that all screws were in proper position verified by X-ray and CT scanning. All patients obtained solid bony union on radiographs, with no loosing or breakage of instrument. The postoperative JOA scores was 13.5-16.9 (average 15.8). Conclusions Allantoaxial pedicle screw fixation has advantages of intraoperative reduction, reliable fixation and high fusion rate and can be used as an effective method for extension-type odontoid fracture combined with at-lantoaxial subluxation.

Objective To evaluate the possibility and curative effect of total en bloc spondylectomy (TES) for the treatment of primary tumors of the lumbar spine. MethodsBetween June 2005 and July 2009,nine cases of primary tumor of the lumbar spine were treated with total en bloc spondylectomy through a single posterior approach performed in seven cases(L1 giant cell tumor, L1 osteosarcoma, L2 giant cell tumor,L2 solitary plasmacytoma, L2 chondrosarcoma, L2 chordoma, and L3 histiocytic sarcoma), and two cases through a single stage anterior and posterior combined approach (L4 giant cell tumor with paraspinal mass and L4 fibrosarcoma). They were performed a single stage reconstruction after removing tumors of vertebra. Neurofunction was evaluated perioperatively and recurrence of tumor was tracked for all cases.ResultsThe follow up was obtained for 3-49 months (averaging 19 months). All patients attained significant clinical improvement after surgery without any severe complications. There was no local recurrence and distal metastasis in shortterm follow-up. ConclusionThe treatment by TES to remove tumors and reconstruction of spine are reliable for primary tumors of the lumbar spine. The curative effect of short-term follow-up is satisfactory. However, the long-term curative effect remain to be further follow-up.

OBJECTIVE: To evaluate the effectiveness of glucocorticoid in the management of olfaction in patients with chronic rhinosinusitis accompanied with nasal polyposis. METHOD: The published studies of the effectiveness of glucocorticoid in the management of chronic rhinosinusitis with nasal polyposis were searched in the Medline, Cochrane, EMBASE, Springer and CNKI databases(from the date of establishment of the databases to December 2014). The trails selection based on inclusion criteria and the quality of the included studies was assessed and meta-analysis was performed with RevMan 5. 3 software. RESULT: A total of 5 trials involving 325 patients were included. The Meta-analysis showed that oral glucocorticoid showed more significant improvement in subjective olfaction scores compared to placebo [SMD = -2.22, 95% CI (-3.94 - -0. 49), P < 0.05], oral glucocorticoid also showed significant improvement in objective olfaction scores compared to placebo [SMD = 0.65, 95% CI (0.28-1.01), P < 0.05]. But subsequent use of nasal glucocorticoid had no impact on subjective and objective olfaction scores [SMD = -2.15, 95% CI (-5.67-1.38), P > 0.05], [SMD = 0.28, 95% CI (-0.08-0.64) P > 0.05]. CONCLUSION According to current evidence, oral glucocorticoid can significantly improve subjective and objective olfaction among patients with CRSwNP, but nasal glucocorticoid cannot improve subjective or objective olfaction dysfunction.
Chronic Disease ; Clinical Trials as Topic ; Glucocorticoids ; therapeutic use ; Humans ; Nasal Polyps ; complications ; drug therapy ; Sinusitis ; complications ; drug therapy ; Smell ; drug effects

Objective: To create and validate a scoring system for predicting clinical prognosis in patients with cardiac resynchronization therapy (CRT). Methods: A cohort of 367 consecutive patients received CRT in our hospital from 2010-01 to 2015-12 were enrolled. The endpoint follow-up events were all-cause death including heart transplantation and heart failure re-admission. The patients were randomly categorized into 2 groups: Modeling group, to develop HEAL scoring system,n=300 and Veriifcation group, to validate HEAL model,n=67. HEAL system was established by Cox proportional hazards regression model, discrimination between HEAL and EARRN scoring systems was evaluated by AUC of ROC, HEAL calibration was assessed by Hosmer-Lemeshow test and clinical endpoint evaluation by 2 scoring systems were compared by Kaplan-Meier method. Results: Modeling group analysis indicated that hs-CRP (HR=1.137, 95% CI 1.072-1.205,P<0.001), big endothelin-1 (HR=1.934, 95% CI 1.066-3.507,P=0.03), left atrial diameter (HR=1.045, 95% CI 1.007-1.084,P=0.02) and NYHA IV (HR=2.583, 95% CI 1.331-5.013,P=0.005) were the independent risk factors of adverse prognosis in CRT patients. Based on β partial regression coefifcient, HEAL scoring system was established to classify the patient's risk levels: low risk<4, moderate risk 4-10 and high risk>10. AUC for risk classification in Modeling group and Verification group were 0.719(95% CI 0.629-0.809) and 0.708 (95% CI 0.539-0.878), HEAL can well distinguish clinical prognosis in patients at different risk levels (log-rank test showed in Modeling groupP<0.001 and in Veriifcation groupP=0.002); Hosmer-Lemeshow test presented good calibration,P=0.952. All 367 patients were respectively evaluated by HEAL and EARRN scoring systems, HEAL had the better discrimination than EARRN as AUC 0.763 (95% CI 0.692-0.833) vs AUC 0.602 (95% CI 0.517-0.687). Conclusion: HEAL scoring system can effectively predict adverse prognosis in CRT patients, it had the better discrimination than EARRN system and was valuable to distinguish high risk patients in clinical practice.