Objective To investigate the feasibility,safety and clinical efficacy of transvaginal myomectomy.Methods A total of 92 patients with uterine leiomyoma were given either vaginal myomectomy(Study Group,n=46) or abdominal myomectomy(Control Group,n=46).Clinical outcomes between the two groups were compared.Results Both vaginal and abdominal myomectomy were performed successfully.The operation time between the two groups was not statistically significant(t=-0.734,P=0.465).There were significant differences between the Study Group and the Control Group in the intraoperative blood loss(60.4(?5.6 ml) vs 82.5?50.2 ml;t=-2.210,P=0.000),the time to first passing flatus(15.3?3.2 h vs 27.5?4.8 h;(t=-14.343,)P=0.030),the incidence of postoperative pain (?~2=29.447,P=0.000),the rate of postoperative pyrexia(?~2=3.903,P=0.048),and the hospital stay(3.1?0.4 d vs 5.2?1.1 d;t=-12.169,P=0.000).Conclusions Transvaginal myomectomy has advantages of little invasion,quick recovery of bowel movement,slight postoperative pain,low rate of postoperative pyrexia,and short hospital stay,being a safe and feasible minimally invasive option for uterine leiomyoma.

0.05). The ROM of flexion-extension, lateral bending and axial rotation of these two groups was smaller than that of the other three fixators(P0.05). Conclusion Experimentally, the effect of TARP was equal to that of Magerl+Brooks, but it was proved to be more stable than the other three clinically widely used atlantoaxial fixators: Magerl, Brooks and anterior transarticular screw fixation through C 2 vertebral body. TARP's C 1 and C 2 screws were strong enough for atlanto-axial arthrodesis. TARP's biomechanical performance was excellent.

OBJECTIVEE23K polymorphism in KCNJ11 gene is associated with cardiovascular disease and diabetes. In order to explore the mechanism of E23K correlation to related diseases, the effect of E23K polymorphism in KCNJ11 gene on membrane current was investigated.

METHODSThe exon of KCNJ11 was obtained by PCR amplification and the G-->A mutation was completed by overlap extension PCR. The sequences of KCNJ11 exon contained 23E or 23K was inserted into pcDNA3.1/CT-GFP vector respectively. The recombinant plasmid, pcDNA3.1-KCNJ11(E) and pcDNA3.1-KCNJ11(K), were transfected into HEK293T cells by lipofectamine and the membrane current density was determined by whole-cell patch clamp technique.

RESULTS1,173 bp sequences of KCNJ11 gene's exon were amplified by PCR and the recombinant expression plasmid, pcDNA3.1-KCNJ11(E) and pcDNA3.1-KCNJ11(K), were constructed successful. Positive and negative currents were detected in HEK293T cells transfected with difference plasmid by whole-cell patch clamp technique. Results showed that the reversed voltage was 50mV. The current in HEK293T cells with pcDNA3.1-KCNJ11(E) was significantly greater than that with pcDNA3.1-KCNJ11(K) (P < 0.05, n = 10).

CONCLUSIONThe polymorphism of E23K in exon of KCNJ11 gene changed the membrane currents in HEK293T cells. It could be an experiment support for the possible mechanism between the locus and related diseases.

Objective To explore the diagnostic value of ultrasonic elastography and fine flow imaging in differential diagnosis of cervical lymph nodes.Methods Totally 87 lymph nodes were examined with ultrasonic elastography,fine flow and conventional ultrasonography.The results were confirmed with postoperative pathology or fine-needle biopsy as well as follow-up.Using consistency check of Kappa and ROC curve to analyse the accuracy of three types of ultrasonic examination.Results Taking the results of postoperative pathology or fine-needle biopsy as well as follow-up as golden standards,the Kappa value of conventional ultrasonography was poor (Kappa =0.153,P =0.078),fine flow was moderate (Kappa =0.526,P ＜0.01) and ultrasonic elastography was better (Kappa =0.741,P ＜0.01).The area under ROC of ultrasonic elastography,fine flow and conventional ultrasonography was 0.899 (P ＜0.01),0.787 (P ＜0.01) and 0.568 (P =0.241),respectively.Conclusions Ultrasonic elastography is more valuable to differentiate malignant from benign lymph nodes.

Adolescent ; Adult ; Asthenopia ; prevention & control ; Humans ; Male ; Military Personnel ; Radar ; Young Adult

Objective To study the long-term neurodevelopment in term neonates with hyperbilirubinemia and explore the predictive value of cerebrospinal fluid neuron specific enolase (CSF-NSE) on long-term neurodevelopment outcome.Methods A mental and psychomotor scale for 0-4 years old was performed to evaluate the intelligence development of 39 neonates with hyperbilirubinemia and 39 randomly selected healthy controls when they were at 3 to 24 months old. The former were tested for the level of CSF-NSE in jaundice climax.Results There was significant difference between 2 groups in total development quotient (DQ) tested at 3 month and 24 month old (P=0, 0.047). It was shown that the DQ scores for fine activity and social behavior were significantly lower in the study group than those in the control group (Pa=0). Furthermore, within the hyperbilirubinemia group, CSF-NSE was significantly associated with DQ of 3 month and 24 month old, while there was not association with TSB. The correlation coefficients were -0.46(P=0.04) and -0.32(P=0.047),respectively.Conclusions Hyperbilirubinemia may influence long-term neurodevelopment of term infants and CSF-NSE can predict this outcome.

ObjectiveTo explore the feasibility and efficacy of hyperbaric oxygen (HBO) therapy combined with mild hypothermi on severe craniocerebral injury (SCI).MethodsAll 80 SCI patients were randomly divided into therapeutic group (52 cases) and control group (28 cases). All patients received general synthesis treatment; while the hyperbaric oxygen combined with mild hypothermia treatment was added to the therapeutic group. Changes of Vm, Vs and PI of middle cerebral artery (MCA) in systolic stage were detected by transcranial-Doppler (TCD) before and after treatment. The plasma level of endothelin (ET) was also tested and prognosis of patients was analyzed.ResultsVm, Vs and PI of MCA in systolic stage improved obviously and ET reduced greatly in therapeutic group compared with those in the control group (P<0.01), and prognosis was also superior to control group.ConclusionHyperbaric oxygen combined with mild hypothermia can improve the consciousness state and prognosis of SCI patients as a result of the relaxation of the cerebral vascular spasm and the reduction of ET, which may contribute to the abatement of the cerebral ischemia and hypoxia.

BACKGROUND:C2 transpedicle screw fixation for Hangman fractures has been paid more attention due to reliability and no loss of physiological function.However,there are lacks of biomechanical evidences for indication treatment because the fixation is single segmental.OBJECTIVE:To investigate the biomechanical stability of C2 transpedicle screw fixation for Hangman fractures.DESIGN,TIME and SEITING:This was a contrast study which was performed at the General Key Laboratory of Biomechanics,First Military Medical University of Chinese PLA from May to August 2004.MATERIALS:AO-universal titanium alloy transpedicle screw of 18 25 mm in length and 3.5 mm in diameter was adopted in this study.Six fresh C1-C4 cervical vetebrae samples were ordiually made into type Ⅰ,ⅡA,and Ⅱ Hangman fracture models.METHODS:After transpedicle screw fixation.Hangman fracture models were measured by non-destroyed style with spinal anterior flexion/posterior extension,left/right lateral curvature,and left/right axial direction.Loading/unlonding circulation was performed three times during each testing.Kinematics indicators were measured on the 3rd circulation.MAIN OUTCOME MEASURES:Spinal motor images at zero load and maximal load were obtained with laser photoscanning(0.1% in precision),and the corresponding systematic software was adopted to calculate 3D range of movement.RESULTS:The relative stability of type Ⅰ Hangman fracture models after C2 transpedicle screw fixation was 100.62%(inflexion),96.91%(posterior extension),99.19%(lateral curvature),and 97.12%(rotation)as compared to control group (P＞0.05).The relative stability of type Ⅱ Hangman fracture models after C2 transpedicle screw fixation was 47.84%(inflexion),21.29%(posterior extension),65.98%(lateral curvature),and 41.69%(rotation)as compared to control group (P＜0.05).CONCLUSION:Biochemical evaluation suggests that type Ⅰ and Ⅱ A Hangman fractures do fit for C2 transpedicle screw fixation,and the fixation may generate well physiological fixation or stability.However,stability of type Ⅱ Hangman fracture is poor,so it is not suitably adopted single transpedicle screw fixation.

BACKGROUND: Decompression-internal fixation is needed in the treatment of atlantoaxial dislocation accompanying with spinal compression caused by cranium-neck junction area malformation and other diseases.Different internal fixation methods are chosen according to different conditions, including anterior atlantoaxial internal fixation, posterior atlantoaxial internal fixation or occipitocervical internal fixation. Transoralpharyngeal atlantoaxial plate internal fixation is a method for atlantoaxial anterior fixation. It is developed recently and used for difficult and complicated atlantoaxial dislocation induced by congenital disease, trauma or rheumatoid arthritis.OBJECTIVE: To probe into the clinical application of transoralpharyngeal atlantoaxial reduction plate system in the atlantoaxial dislocation caused by obsolete odontoid fracture.DESIGN: Single Sample observation SETTING: Department of Orthopaedics, Guangzhou General Hospital of Guangzhou Military Medical University of Chinese PLA PARTICIPANTS: Twelve patients with atlantoaxial dislocation caused by obsolete odontoid fracture were selected in the Department of Orthopaedics, General Hospital of Guangzhou Military Medical University of Chinese PLA from January 2003 to October 2005. Among them, 7 were male and 5 were female, they were aged 47 years on average ranging from 36 to 59 years. The mean injured time was 19 months ranging from 4.5 to 36 months; 6 patients were graded as C degree, 3 as D degree and 3 as E degree in Frank gradation.METHODS: Twelve obsolete odontoid fracture caused by atlantoaxial dislocation underwent transoralpharyngeal anterior decompression. Transoralpharyngeal atlantoaxial reduction plate system was used in reduction and fixation. Autogeneic ilium was implanted into bilateral articulatio atlantoepistrophica.MAIN OUTCOME MEASURES: ① Frank gradation of patients at the 4th week after operation. ② whether the internal fixation is loose or not after operationRESULTS: ①Frank gradation at the 4th week after operation: Among the 6 patients who were primarily graded as C degree, 4 patients improved to be E degree and 2 patients D degree; Three patients who were primarily graded as D degree all improved to be E degree; Patients who were primarily graded as E degree did not changed. ② Except for one patient who suffered dislocation again for loosening of screw caused by tumble, the other patients had firm fixation, ideal fusion and satisfying spinal decompression.CONCLUSION: Transoralpharyngeal atlantoaxial reduction plate system finishes atlantoaxial reduction and fixation once. It avoids conducting posterior fusion fixation operation after anterior decompression. It also avoids fetal injury for spinal cord caused by extreme atlantoaxial unsteadiness in the process of movement and turning over.

There have been very few studies on the effect of Gualou Xiebai Banxia decoction combined with Xuefu Zhuyu decoction in inhibiting apoptosis in myocardial ischemial injury caused by coronary heart disease. In this experiment, Gualou Xiebai Banxia decoction combined with-Xuefu Zhuyu decoction were used to intervene the miniature swine phlegm and blood stasis type coronary heart disease model, in order to observe the effect of the combined prescription on the myocardial apoptosis and the expressions of Bcl-2, Bax, Caspase-3, Caspase-9 in the model. Totally 15 Chinese experimental miniature swine were adopted and randomly divided into the control group, the model group and the phlegm and stasis-treating group. The model group and the stasis-treating group were fed with high fat diets for two weeks, intervened with the coronary artery injury and then given drugs and high fat diets for eight weeks. The control group was fed with ordinary diets for 10 weeks, without the coronary artery injury. After the experiment, myocardia at the juncture of infracted areas were collected and made into formalin-fixed paraffin sections. The TDT-mediate dUTP nick end labeling (TUNEL) assay was used to detect the myocardial apoptosis. The immunohistochemistry (IHC) technique was applied to detect Bcl-2, Bax, Caspase-3, Caspase-9 levels in myocardial tissues. According to the findings, the apoptosis indexes (AI) for the control group, the model group and the phlegm and stasis-treating group were 0.92%, 27.68%, 17.28%, respectively. The AI of the phlegm and stasis-treating group was significantly lower than that of the model group (P < 0.01). Compared with the model group, the phlegm and stasis-treating group showed significantly higher Bcl-2 protein expression (P < 0.01) and lower Bax, Caspase-3 and Caspase-9 protein expressions (P < 0.01). In conclusion, Gualou Xiebai Banxia decoction combined with Xuefu Zhuyu decoction have a significant protective effect against the myocardial apoptosis in miniature swine phlegm and blood stasis type coronary heart disease model.
Animals ; Apoptosis ; drug effects ; Caspases ; metabolism ; Coronary Disease ; drug therapy ; Disease Models, Animal ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Male ; Medicine, Chinese Traditional ; Myocardium ; pathology ; Phytotherapy ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Swine ; Swine, Miniature ; bcl-2-Associated X Protein ; analysis